How the HCBS Settings Rule Protects Your Rights

As of March 17, 2023, Missouri providers must be compliant with the Home and Community-Based Services (HCBS) Rule.

HCBS is when people get long-term services and supports (LTSS) in their community. Examples of services include job coaching, transportation, or in-home support. Medicaid pays for LTSS.

The HCBS rule:

  • Gives people important rights.
  • Creates rules for providers to follow so they get HCBS money.
  • Requires providers to protect people’s rights.

You have the right to:

  • Live in the community with people without disabilities.
  • Choose where you live.
  • Have a person-centered plan.
  • Have freedom.
  • Have respect and privacy.
  • Not be restrained or secluded.
  • Decide how you spend your money.
  • Choose how you spend your free time.
  • Get health care in the community.
  • Choose where to get services.

A violation of this rule is when someone does not respect your rights or choices. Examples of violations of this rule can look like:

  • You want to stay up late, but staff says your bedtime is 9 p.m.
  • You want to have your friend over to hang out and staff says no.
  • You want to go somewhere but staff says no because they do not want to or they do not have enough staff to do it.
  • You want to have ice cream, but staff says that because you did not do your dishes, you cannot have ice cream.

You can report an HCBS Rights Violation.

Call Missouri Protection and Advocacy at 1-800-392-8667.

Call the Missouri Department of Mental Health Constituent Services at 1-800-364-9687.

Additional Resources

Autistic Self Advocacy Network HCBS Settings Rule Toolkit: Check out this toolkit for more information on the HCBS Settings Rule in plain language and easy-ready formats.

HCBS Advocacy Coalition Website: is your one-stop location for all things related to the HCBS Settings Rule.  

HCBS Access Act: The HCBS Access Act is designed to ensure eligible older adults and people with disabilities have a real choice of care and support options between home care and institutional care.