National Organizations Release Toolkit to Help Stakeholders Advocate for Strong Implementation of HCBS Settings Rule

a toolkit graphicThe Bazelon Center for Mental Health Law in Washington, D.C., along with other disability and aging advocacy groups, has issued a Toolkit to help advocates push for strong implementation of the new Home and Community Based Services (HCBS) Settings Rules in their states.

The new HCBS Settings Rules require all settings funded by Medicaid HCBS programs to:

  • provide opportunities for participants to be integrated in and engage in community life,
  • have access to the community,
  • control their personal resources,
  • provide opportunities for people to seek employment and work in competitive integrated settings, and
  • ensure the person receives services in the community to the same degree of access as individuals not receiving Medicaid home and community-based services..

For these new rules to have “a real impact and move states towards more integrated and individualized services, advocates must get engaged now and push for a strong transition plan,” said Alison Barkoff, Bazelon’s Director of Advocacy. All states have already submitted to CMS their initial transition plans, and CMS has provided feedback to states about needed improvements and next steps for amending and implementing their plans. “The next several months are a critical time for advocacy because that is when states will be making important decisions about their transition plans,” she said.

a graphic of  the letter 'i' for informationThis new toolkit provides advocates with detailed information about the HCBS Settings Rule and provides action steps for advocates to impact implementation of the new rules in their states. The toolkit contains three documents:

  1. The Medicaid Home and Community-Based Services Settings Rules: What You Should Know;
  2. Home and Community-Based Services Regulations Q&A: Settings Presumed to be Institutional & the Heightened Scrutiny Process, and
  3. The Home and Community-Based Settings Rules: How to Advocate for Truly Integrated Community Settings (unabridged and abridged).

States have until March 2019 to transition their HCBS programs into full compliance with the new settings requirements. The Bazelon Center developed this toolkit with a coalition of other disability and aging advocates working together for strong implementation of the HCBS Settings Rule.

Which Types of Settings are Affected?

Type of Setting

Provider-Owned or Controlled

Residential Providers*
  • Group Homes
  • Family Centered Support Homes
  • Shared Living
  • Certain PNMIs
Non-Residential Providers
  • Adult day health centers
  • Center-based community support
  • Enclaves and sheltered work shops

*Rules apply to the setting in which a member receiving HCBS is living, whether or not the member receives HCBS in that setting.

The Bazelon Center’s advocacy around the HCBS Settings Rule is funded in part by the Ruderman Family Foundation.


Want more information?

To learn more, see and, a website with up-to-date information about the rules and states’ implementation maintained by several member organizations in the coalition.

To see a copy of the Statewide Transition Plan (STP) that was submitted by Rhode Island or any other State, click here.

National Advisory Committee on Increasing Competitive Employment for Individuals with Disabilities Issues Interim Report to US Secretary of Labor, Thomas Perez

WIOA Advisory CommitteeThe Advisory Committee on Increasing Competitive Integrated Employment for Individuals with Disabilities was established under Section 609 of the Rehabilitation Act of 1973 to advise the US Secretary of Labor in:

  1. Ways to increase competitive integrated employment (CIE) opportunities for individuals with intellectual or developmental disabilities (I/DD) or other individuals with significant disabilities;
  2. The use of certificate program carried out under Section 14(c) of the Fair Labor Standards Act (FLSA) for the employment of individuals with I/DD or other individuals with significant disabilities; and
  3. Ways to improve oversight of the use of such certificates.

The work of the Committee began with its first meeting in January 2015, followed by full committee meetings in March, May, and July 2015. The work of the Committee includes formation of five subcommittees.

These committees are:

  1. Transition to Careers;
  2. Complexity and Needs in Delivering Competitive Integrated Employment;
  3. Marketplace Dynamics;
  4. Building State and Local Capacity; Section 14(c) Subminimum WageCertificate Program; and
  5. AbilityOne® Program.

The Committee brought together leaders from numerous federal agencies with a diverse group of critical stakeholders including individuals with I/DD and other significant disabilities, providers of employment services, representatives of national disability advocacy organizations, academic experts with expertise on employment and wage policy issues for individuals with I/DD or other significant disabilities, representatives of the employer community and others with expertise on increasing CIE opportunities for individuals with I/DD or other significant disabilities.

Integrated Employment Blueprint

The primary focus of the Committee and preliminary recommendations is:

  1. to increase opportunities for CIE;
  2. to ensure CIE is the first option for people with significant disabilities in order to increase the employment participation rate; and
  3. to significantly reduce the use of FLSA Section 14(c) and the dependence on subminimum wages and segregated service placements.


Department of Justice US District Court Monitor Charles Moseley Issues Report on Progress of Consent Decree in RI

Charles Moseley - US District Court MonitorCourt Monitor Chas Moseley has issued his first report assessing RI’s progress on the Department of Justice Consent Decree filed on April 9, 2014. The terms of the Consent Order resulted in the State making a commitment to restructure the nature and operation of day and employment services to provide people with developmental disabilities the training/support they need to become employed in competitive, integrated jobs at or above minimum wage in the community.

This report documents the progress that has taken place during the first year of Consent Decree implementation with a particular focus on the provisions specifically related to two target populations, the RI Youth Exit Target population and the RI Youth Transition Target Population. The report also covers activities related to key infrastructure development including the establishment of the Sheltered Workshop Conversion Institute, the Conversion Trust Fund, Quality Improvement and other programs. Progress on several of the benchmarks related to activities of the RI Sheltered Workshop Target Population and the RI Day Target Population are deferred to subsequent reports.

adults with developmental disabilities attend a press release to announce the State's employment settlement with the Department of JusticeThe agreement requires the three State agencies responsible for providing the majority of services to children and adults with IDD, the department of Behavioral Health Developmental Disabilities and Hospitals (BHDDH), the Rhode Island Department of Education (RIDE) and the Office of Rehabilitative Services (ORS) to reach key performance milestones within the first year and on an ongoing basis thereafter.

This review reveals that the State has made significant progress in meeting the many performance benchmarks identified by the Consent Decree that were to be achieved during this period. Additional actions need to be taken by BHDDH, ORS and RIDE to fully operationalize the changes that have been made and to build the foundation for the next stages of system change and program development.

This report identifies key benchmarks for each operational provision of the Consent Decree and the status of the State’s efforts to address the various outcomes. Each section concludes with a statement of recommended actions the State should take to meet Consent Decree requirements.

infoFor more information:

To Review a Copy of the Full Report, click here.

Your Chance to Speak Up: 2015 Public Forums for People with Disabilities

State of Rhode Island and Providence Plantations
Public Forums to Identify the Concerns of People with Disabilities and their Families

During the week of the 25th anniversary of the Americans with Disabilities Act (signed on July 26th), the Governor’s Commission on Disabilities and many other state and non-profit agencies conduct a weeklong series of open forums to hear the concerns of people with disabilities and their families.

The forums are open for anyone to come in and speak; representatives of the sponsoring agencies will be there to listen. State policy makers and planners want to hear your concerns about current services, unmet needs, and suggestions for improving services and expanding opportunities.

Monday, July 27, 2015 | 3:45 – 5:45  PM

South Providence Library
441 Prairie Avenue

Hosted by Perspectives Corporation

Tuesday, July 28, 2015 | 2 – 4 PM

Warwick Public Library
600 Sandy Lane

Hosted by the Ocean State Center for Independent Living

Wednesday, July 29, 2015 | 4 – 6 PM

Peace Dale Library
1057 Kingstown Rd
Peace Dale

Hosted by National Multiple Sclerosis Society RI Chapter

Wednesday, July 29, 2015 | 4 – 6  PM

Middletown Public Library
700 West Main Rd

Hosted by Opportunities Unlimited For People With Differing Abilities

Thursday, July 30, 2015 | 1:30  – 3:30  PM

Zambarano Unit, Eleanor Slater Hospital
2090 Wallum Lake Rd

Hosted by Zambarano Unit, Eleanor Slater Hospital

Thursday, July 30, 2015 |  4 – 6  PM

Woonsocket Harris Public Library
303 Clinton St

Hosted by RI Department of Health

Friday, July 31, 2015 | 2:45 – 4:45  PM

East Providence Public Library
41 Grove Ave
East Providence

Hosted by RI Statewide Independent Living Council and National Federation of the Blind of RI

Additional information from the governor’s Commission on Disabilities about attending the Forum:

Remarks can be made in person during the forums, faxed to 401-462-0106, e-mailed to, or mailed by August 8th to:

Governor’s Commission on Disabilities
John O’ Pastore Center
41 Cherry Dale Court
Cranston, RI 02920

CART Recorders (real-time captioning) and assistive listening devices will be at all sites, courtesy of the Office of Rehabilitation Services/Assistive Technology Access Partnership. The RI Commission on the Deaf and Hard of Hearing will provide sign language interpreters for each forum.

To request information or accommodation, please call 401-462-0100 or 401-462-0101(tty) in advance; arrangements will be provided at no cost. Language interpreting is available with the Deptartment of Human Serivces and requests can be made to 401-462-2130 in advance.

When making the ADA reservation with RIde to get to and from the public forum, tell the RIde reservationist (1-800-479-6902) that this trip is for the Governor’s Commission’s Public Forums in order to guarantee your return trip, after normal RIde hours of operation. ADA fare is still applicable.

When attending the forum, please use unscented personal care products. Mild fragrances can constitute a toxic exposure for a person with an environmental illness.

Trauma Informed Care Conference Will Pave Way for RI System Transformation

On March 9, the DD Council partnered with the Sherlock Center, RIDE, DCYF and BHDDH to sponsor a one-day training on Trauma Informed Care.

We were fortunate enough to bring Joan Gillece, Ph.D., Director of SAMHSA National Center for Trauma Informed Care to RI to speak about trauma for people with developmental disabilities. In addition, Janice LeBel, Ph.D., ABPP, Director of Program Management, Child and Adolescent Services, Massachusetts Department of Mental Health spoke about the impact of trauma on the brain. Also featured was the Dan Habib film “Restraint and Seclusion: Hear Their Stories.”  Nearly 160 people attended, representing virtually every facet of care for adults and children with developmental disabilities.

The training emphasized the concept of “comfort instead of control” when treating people with a history of trauma. The day was focused on building “empathy with” rather than “sympathy for” traumatized individuals.

Feedback from the day was overwhelmingly positive, with many people expressing a desire to maintain the momentum and excitement of the day in their own practice. The DD Council supports further efforts to facilitate implementation of this crucial element of treatment for traumatized individuals. We will be exploring ways to make the Trauma Informed Care concepts available to all.

Wil Beaudoin, Chairperson
RI Developmental Disabilities Council (RIDDC)

The presenters have kindly provided the materials from their presentations:

SAMHSA’s Trauma-Informed Approach: Key Assumptions and Principles, Dr. Joan Gilles


The Neurobiological & Psychological Effects of Trauma, Dr. Janice Le Bel

PowerPoint | PDF

Moving Forward: Building Bridges Towards Systems Transformation and Making Trauma-Informed Care Real, Dr. Janice Le Bel

PowerPoint | PDF

Please note: files are large and may take some time to download