Community Rule Grievance Process

How to file a grievance if you believe a setting doesn’t follow the Community Rule.

A federal rule–the Community Rule–requires home- and community-based services (HCBS) covered by Medicaid HCBS waivers to be provided in settings that meet certain criteria.  The Community Rule ensures that HCBS waiver participants have access to the benefits of community living, and that they live and receive services in integrated, non-institutional settings.

The Community Rule applies to

• The participant’s home—that is, where the waiver participant lives, and
• Other settings where participants receive services. This could include where a waiver participant works or goes to a day program.

The following lists describe some features of home or other settings that comply with the Community Rule.

Characteristics of the Home

Characteristics of Other Service Settings

It’s part of the community. You can be active in the community. You can go into the community when you want to. You can choose your roommates. You can decorate how you choose. You have legal protections relating to eviction. You can access all shared living space in the home. You have privacy and can lock your bedroom door. You can have visitors when you want. You decide your schedule. You can eat when you want. You can spend your money how you want. You can interact with people with and without disabilities. You can choose to volunteer. You can interact with people with and without disabilities.

It’s part of the community. You can be active in the community. You can go into the community when you want to. You choose whether you want to work and where. You have input on hours and schedules. You can choose to volunteer. You can interact with people with and without disabilities.

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An HCBS waiver participant may file a grievance with the state if they believe that one of their settings does not have these characteristics.

To report a setting that you believe is not compliant with the Community Rule, you may complete the Community Rule Grievance Form and email it to us at [e-mail]. See Additional Resources, below. You may also call us at [phone].

Additional Resources

Community Rule Grievance Form

Community Rule Grievance Form - Accessible Version

Community Rule Grievance Form (Spanish)

Community Rule Grievance Form - Spanish Accessible Version

Community Rule Grievance Process Fact Sheet

Community Rule Grievance Process Fact Sheet - Accessible Version

Community Rule Grievance Process Fact Sheet (Spanish)

Community Rule Grievance Process Fact Sheet -Spanish Accessible Version

Community Rule Grievance Process Fact Sheet (Haitian Creole)

Community Rule Grievance Process Fact Sheet - Haitian Creole Accessible Version

Community Rule Grievance Process Fact Sheet (Brazilian Portuguese)

Community Rule Grievance Process Fact Sheet - Brazilian Portuguese Accessible Version

Community Rule Grievance Process Fact Sheet (Vietnamese)

Community Rule Grievance Process Fact Sheet - Vietnamese Accessible Version

Community Rule Grievance Process Fact Sheet (Simplified Chinese)

Community Rule Grievance Process Fact Sheet (Simplified Chinese Accessible Version)

Date published:	June 27, 2023