Section E: Housing Protection and Due Process
Section F: Living Arrangements

Policy & Evidence Expectation: Preferred evidence would be a policy(s)/procedure(s) or a blank lease agreement indicating persons-served are afforded protections against eviction, the same as persons not receiving HCBS services.

NOTE: CMS has indicated to KDADS that it is the provider’s responsibility to ensure those protections are in place. E1 is a trigger question for whether the Landlord-Tenant Law applies in the area of the residence.

NOTE: Please ensure that any evidence has been de-identified and does not include PHI.

CMS/Final Rule Guidance: The unit or dwelling is a specific physical place that can be owned, rented, or occupied under a legally enforceable agreement by the individual receiving services, and the individual has, at a minimum, the same responsibilities and protections from eviction that tenants have under the landlord/tenant law of the State, county, city, or other designated entity. For settings in which landlord tenant laws do not apply, the State must ensure that a lease, residency agreement or other form of written agreement will be in place for each HCBS participant, and that the document provides protections that address eviction processes and appeals comparable to those provided under the jurisdiction’s landlord tenant law.

Policy & Evidence Expectation: Preferred evidence would be policy(s)/procedure(s) indicating that all tenants regardless of whether they have a disability or not have the same rights to protections from eviction as outlined in the Landlord-Tenant law.

NOTE: Please ensure that any all evidence has been de-identified and does not include PHI.

NOTE: If question E1 is valid then question E1.1 is valid

CMS/Final Rule Guidance: The unit or dwelling is a specific physical place that can be owned, rented, or occupied under a legally enforceable agreement by the individual receiving services, and the individual has, at a minimum, the same responsibilities and protections from eviction that tenants have under the landlord/tenant law of the State, county, city, or other designated entity. For settings in which landlord tenant laws do not apply, the State must ensure that a lease, residency agreement or other form of written agreement will be in place for each HCBS participant, and that the document provides protections that address eviction processes and appeals comparable to those provided under the jurisdiction’s landlord tenant law.

Policy & Evidence Expectation: Preferred evidence would be policy(s)/procedure(s) indicating entrance doors can be locked by persons-served and only appropriate staff have keys to the doors. Entrance doors may indicate the doors to the individuals personal living space.

CMS/Final Rule Guidance: Each individual has privacy in their sleeping or living unit: Units have entrance doors lockable by the individual, with only appropriate staff having keys to doors.

Policy & Evidence Expectation: Preferred evidence would be policy indicating that setting has an alternative method for allowing entry.  This can be achieved through knocking, a doorbell or other methods.  It should also extend to the person-served having some amount of control over allowing their own visitors to come and go.  

CMS/Final Rule Guidance: Individuals are able to have visitors of their choosing at any time. Each individual has privacy in their sleeping or living unit: Units have entrance doors lockable by the individual, with only appropriate staff having keys to doors.

Policy & Evidence Expectation: Preferred evidence would be a policy(s)/procedure(s) indicating persons-served are assured privacy in their personal living space with only appropriate staff having access to their personal living space.

CMS/Final Rule Guidance: The setting ensures an individual’s rights of privacy, dignity and respect, and freedom from coercion and restraint. Each individual has privacy in their sleeping or living unit.

Policy & Evidence Expectation: Preferred evidence would be a policy(s)/procedure(s) indicating persons-served are assured privacy in their personal living space with only appropriate staff having access to their personal living space.

CMS/Final Rule Guidance: Each individual has privacy in their sleeping or living unit: Units have entrance doors lockable by the individual, with only appropriate staff having keys to doors.

Policy & Evidence Expectation: Preferred evidence would be a policy(s)/procedure(s) indicating persons-served are assured privacy in their personal living space with only appropriate staff having access to their personal living space. This policy(s)/procedure(s) should indicate that staff are required to announce themselves (knock, ring entry bell, or other method) and request permission to access the persons-served personal living space.

CMS/Final Rule Guidance: Each individual has privacy in their sleeping or living unit: Units have entrance doors lockable by the individual, with only appropriate staff having keys to doors.

Policy & Evidence Expectation: Preferred evidence would be a policy(s)/procedure(s) indicating persons-served are assured privacy in their personal living space with only appropriate staff having access to their personal living space. This can be achieved through having locks, doors or other methods for obtaining privacy.  Most importantly, evidence should reflect in policy that persons-served are assured privacy while addressing their own personal needs and care.

CMS/Final Rule Guidance: Ensures an individual’s rights of privacy, dignity and respect, and freedom from coercion and restraint. Each individual has privacy in their sleeping or living unit.

Policy & Evidence Expectation: Preferred evidence would be a policy(s)/procedure(s) indicating persons-served are assured privacy in their personal living space. This should include privacy while using the telephone, internet, or any other personal communication devices. Persons-served should at the very least have the same assurance of privacy as someone not receiving HCBS services in their own home.

CMS/Final Rule Guidance: Ensures an individual’s rights of privacy, dignity and respect, and freedom from coercion and restraint. The setting is integrated in and supports full access of individuals receiving Medicaid HCBS to the greater community, including opportunities to seek employment and work in competitive integrated settings, engage in community life, control personal resources, and receive services in the community, to the same degree of access as individuals not receiving Medicaid HCBS.

Policy & Evidence Expectation: Preferred evidence would be a policy(s)/procedure(s) indicating persons-served are assured privacy in their personal living space with only appropriate staff having access to their personal living space. This policy(s)/procedure(s) would include the ability to choose their roommate if a double occupancy or larger living space.

CMS/Final Rule Guidance: Each individual has privacy in their sleeping or living unit. Ensures an individual’s rights of privacy, dignity and respect, and freedom from coercion and restraint. Individuals sharing units have a choice of roommates in that setting.

Policy & Evidence Expectation: Preferred evidence would be a policy(s)/procedure(s) indicating persons-served are assured privacy in their personal living space with only appropriate staff having access to their personal living space. This policy(s)/procedure(s) would include the ability to choose their roommate if a double occupancy or larger living space.

CMS/Final Rule Guidance: Individuals sharing units have a choice of roommates in that setting.

Policy & Evidence Expectation: Preferred evidence would be a policy(s)/procedure(s) indicating persons-served have the right to and can decorate and furnish their personal living space as they choose.

CMS/Final Rule Guidance: Individuals have the freedom to furnish and decorate their sleeping or living units within the lease or other agreement.

Policy & Evidence Expectation: Preferred evidence would be a policy(s)/procedure(s) indicating persons-served have the right to and can decorate and furnish their personal living space as they choose.

CMS/Final Rule Guidance: Individuals have the freedom to furnish and decorate their sleeping or living units within the lease or other agreement.

Policy & Evidence Expectation: Preferred evidence would be a policy(s)/procedure(s) indicating persons-served have the right to set their own daily routines for such things as hygiene, care delivery, recreation and meals.

CMS/Final Rule Guidance: Individuals have the freedom and support to control their own schedules and activities and have access to food at any time.

Policy & Evidence Expectation: Preferred evidence would be a policy(s)/procedure(s) indicating persons-served have full access to the laundry facilities.

CMS/Final Rule Guidance: Individuals have the freedom and support to control their own schedules and activities and have access to laundry facilities at any time.

Policy & Evidence Expectation: Preferred evidence would be a policy(s)/procedure(s) indicating persons-served have the right to choose to do their own laundry.

CMS/Final Rule Guidance: Individuals have the freedom and support to control their own schedules and activities and have access to laundry facilities at any time.

Policy & Evidence Expectation: Preferred evidence would be a policy(s)/procedure(s) indicating persons-served have full access to the common areas.

CMS/Final Rule Guidance: Individuals have the freedom and support to control their own schedules and activities and have access to common areas at any time.

Policy & Evidence Expectation: Preferred evidence would be a policy(s)/procedure(s) indicating persons-served have full access to the dining area.

CMS/Final Rule Guidance: Individuals have the freedom and support to control their own schedules and activities, and have access to food at any time.

Policy & Evidence Expectation: Preferred evidence would be a policy(s)/procedure(s) indicating persons-served have full access to the microwave and refrigerator.

CMS/Final Rule Guidance: Individuals have the freedom and support to control their own schedules and activities and have access to food at any time.

Policy & Evidence Expectation: Preferred evidence would be a policy(s)/procedure(s) indicating persons-served have full access to the kitchen.

CMS/Final Rule Guidance: Individuals have the freedom and support to control their own schedules and activities and have access to food at any time.

Policy & Evidence Expectation: Preferred evidence would be a policy(s)/procedure(s) indicating persons-served have access to a separate meal prep area or options to cook if they desire. Modifications/limitations to this would be indicated in the persons-served personal care plan.

CMS/Final Rule Guidance: Individuals have the freedom and support to control their own schedules and activities and have access to food at any time. Optimizes, but does not regiment, individual initiative, autonomy, and independence in making life choices, including but not limited to, daily activities, physical environment, and with whom to interact.

Policy & Evidence Expectation: Preferred evidence would be a policy(s)/procedure(s) indicating persons-served have a choice of when and what to eat.

CMS/Final Rule Guidance: Individuals have the freedom and support to control their own schedules and activities and have access to food at any time. Optimizes, but does not regiment, individual initiative, autonomy, and independence in making life choices, including but not limited to, daily activities, physical environment, and with whom to interact. The setting is integrated in and supports full access of individuals receiving Medicaid HCBS to the greater community, including opportunities to seek employment and work in competitive integrated settings, engage in community life, control personal resources, and receive services in the community, to the same degree of access as individuals not receiving Medicaid HCBS.

Policy & Evidence Expectation: Preferred evidence would be a policy(s)/procedure(s) indicating persons-served have a choice to eat alone or with others, including with whom they would like to eat with.

CMS/Final Rule Guidance: Optimizes, but does not regiment, individual initiative, autonomy, and independence in making life choices, including but not limited to, daily activities, physical environment and with whom to interact.