• From Policy to Practice: Socio...

*Result*: From Policy to Practice: Socio-Ecological Challenges in Implementing the Home and Community Based Settings Rule

Title:
From Policy to Practice: Socio-Ecological Challenges in Implementing the Home and Community Based Settings Rule
Language:
English
Authors:
James B. Gould (ORCID 0000-0002-7614-3169)
Source:
Journal of Disability Policy Studies. 2025 36(1):29-39.
Availability:
SAGE Publications and Hammill Institute on Disabilities. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
Peer Reviewed:
Y
Page Count:
11
Publication Date:
2025
Document Type:
*Academic Journal* Journal Articles<br />Reports - Evaluative
Descriptors:
Adults, Intellectual Disability, Home Programs, Community Services, Inclusion, Federal Regulation, Normalization (Disabilities), Individualized Programs, Barriers
DOI:
10.1177/10442073241289081
ISSN:
1044-2073
1538-4802
Entry Date:
2025
Accession Number:
EJ1471790
Database:
ERIC

*Further Information*

*The 2014 U.S. Centers for Medicare and Medicaid Services "Settings Rule," which took effect in 2023, restricts Home and Community Based Services funding for adults with intellectual disabilities to small integrated settings and person-centered supports. The Settings Rule responds to the fact that community services, mandated by the Americans with Disabilities Act (ADA) and the Supreme Court Olmstead ruling, while integrated physically, often operate as institutions. The Settings Rule is meant to create integration and individualization. I argue that the regulation cannot, on its own, accomplish these goals. The deinstitutionalization movement has had mixed outcomes--and without change across multiple socio-ecological systems, the Settings Rule will also deliver mixed results.*

*As Provided*