Redefining Inclusion: The Final Settings Rule & Its Impact on IDD Services

So far, you have explored the history of IDD services, from the early days of institutionalization to today’s community-based care model. You have also learned about Home and Community-Based Services (HCBS) in Colorado and the roles of Service Agencies and Case Management Agencies. Now, it’s time to take a deeper dive into an essential piece of modern disability rights: the Final Settings Rule and what it means for the people we serve.

When HCBS programs were introduced, they were meant to be an alternative to institutions. However, over time, it became clear that some community-based settings were operating with institutional characteristics, restricting individual rights, limiting choices, and failing to provide true community integration. In response, the Centers for Medicare & Medicaid Services (CMS) issued the Final Settings Rule, which sets new standards to ensure HCBS services provide full access to the rights and freedoms that people without disabilities take for granted.

Learning Objectives: By the end of this training, you will understand:

• What the Final Settings Rule is and why it was created.
• How the rule affects IDD services in Colorado.
• What compliance looks like for service providers.

The ongoing impact of this rule on the future of disability services.