Skip to main content
  • This page, Community Rule Grievance Process, is   offered by
  • MassHealth

Community Rule Grievance Process

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

Table of Contents

You skipped the table of contents section.

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.

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 CommunityRuleGrievance@mass.gov. See Additional Resources, below. You may also call us at (617) 573-1751.

Additional Resources

Date published: June 27, 2023

Related

Help Us Improve Mass.gov  with your feedback

Please do not include personal or contact information.
Feedback