HCBS Final Rule: What It Means in Kansas

What the Final Rule says, in plain language

The HCBS Final Rule was finalized by the Centers for Medicare & Medicaid Services in 2014 and updated in 2023. It establishes that home and community-based services must be delivered in settings that are truly integrated into the broader community, not settings that replicate institutional characteristics regardless of what they call themselves.

For individuals receiving residential supports, the rule is specific. Every person receiving HCBS-funded residential services has, as a matter of federal law, five enforceable entitlements:

Privacy in your own room

Your bedroom is your space. You have the right to privacy in it: to close your door, to have personal belongings treated as yours, and to not have staff entering without your permission except in genuine emergencies or with explicit advance agreement. A support arrangement that routinely enters rooms without knocking or consent is not operating within the rule.

Choice of roommate

If you share a living space, you have the right to choose who you share it with, or to have meaningful input into that decision. The rule does not guarantee a specific roommate, but it prohibits assignments made solely for provider convenience without any regard for your preferences. When Servants Mission places staff in shared-support arrangements, your stated preferences govern the match.

Lockable door

You have the right to a lockable door on your unit, and you control the key. This is not a suggestion. Settings that do not provide lockable doors, or that hold master keys without a documented and individual-specific reason, are operating outside the rule. If your current arrangement does not include this, it is appropriate to raise it with your provider, your CDDO, or your MCO.

Full access to food

You have the right to access food at any time: to have food in your space, to prepare your own food when you choose, and to not be restricted to scheduled meal windows without individualized clinical justification. “House rules” that restrict food access for operational convenience do not override this right.

Visitors any time

You have the right to have visitors at any time, including overnight guests, and to privacy during those visits. Reasonable safety policies (e.g., signing in for security in a shared-living building) are permissible; blanket restrictions on visiting hours or overnight guests are not. This right includes the right to communicate privately with whoever you choose by phone, internet, or in person.

What that looks like at Servants Mission

Servants Mission operates under all five entitlements above. Here is how we implement each one, plus the areas where we are still maturing:

• Room privacy: Staff are trained on knock-and-wait procedure as a non-negotiable. Entry without permission is a reportable conduct issue.
• Roommate choice: We gather stated preferences before any shared placement and document them in the support plan. We do not override preferences without a documented reason and individual agreement.
• Lockable doors: Every client-occupied unit in our residential arrangements includes a lockable door with the individual holding the key.
• Food access: Clients have unrestricted food access in their living spaces. Dietary planning (for health reasons) is documented in the ISP with individual consent, not imposed operationally.
• Visitors: Visitors are welcome at any time. We are still developing formal overnight-guest documentation procedures. This is an area we are improving and we are transparent about that. See our Transparency page for current operational self-disclosures.

If you see something that doesn't match

If you are a Servants Mission client, family member, guardian, or support coordinator, and something you observe does not match what is described above, we want to know. You can raise it directly with us, or through any of the escalation paths below.

• Report to Servants Mission directly: Use our contact form or speak with your support coordinator. We treat every concern as an operational signal worth investigating.
• Review your rights: Our Rights guide explains the full set of HCBS rights you hold and how to exercise them when they are not being honored.
• Access advocacy resources: Our Advocacy guide covers escalation paths: CDDO, MCO, KDADS, and independent legal advocacy through the Disability Rights Center of Kansas.
• ANE reporting: If you believe abuse, neglect, or exploitation is occurring, Kansas Adult Protective Services operates a 24-hour hotline. Contact information is in our Rights guide.

Who to ask for more information

The following organizations can answer questions about HCBS Final Rule compliance, your rights, or how to address a violation:

• KDADS HCBS Program: Kansas Department for Aging and Disability Services (opens in new tab): the state agency that oversees HCBS waivers and provider certification in Kansas.
• CMS Regional Office: CMS Region VII (Kansas City): the federal oversight office for Medicaid-funded HCBS in Kansas.
• Disability Rights Center of Kansas: DRC-Kansas (opens in new tab): the federally-designated protection and advocacy organization for Kansas. Free legal advocacy for people with disabilities, independent of providers, MCOs, and KDADS.