Beta Hospice Care is a Care Coordination Agency listed by the California Department of Health Care Services (DHCS).Beta is listed by DHCS. Here’s how to check
  1. Find Beta on the DHCS list. Beta is listed as a participating Care Coordination Agency under the name Beta Hospice Care. How to verify Beta
  2. No charge for care coordination. Medi-Cal pays Beta. Residents pay room and board. Costs and room and board
  3. Your choice. You may choose any Care Coordination Agency listed by DHCS and any participating home. Rights and complaints
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5 lessonsAbout 34 minutesNo CE or licensure credit

The HCBS Settings Rule in an ALW home: rights, choice and modifications

Five short lessons for facility leaders and CCA staff on the federal home and community-based settings rule in an ALW home: the qualities every setting must have, rights in daily life, the person's own unit and written agreement, how a right is modified through the person-centered plan, and how the state checks compliance.

Begin the courseSee the sourcesPrint the job aids

Written for

  • Facility leadership
  • CCA professionals
Course version
2026.10.3
Text checked against its sources

Before you begin

What you will be able to do

  • Check an ALW home against the five qualities of a home and community-based setting, and name the settings the rule presumes to be institutional.
  • Judge a house rule or routine against the rights to control one's schedule, food at any time, visitors at any time, privacy, and freedom from coercion and restraint.
  • Check a participant's unit and written agreement for a lockable door, roommate choice, freedom to decorate, and eviction protections comparable to tenant law.
  • Decide whether a limit on a right can be made, and document it in the person-centered plan with every required element and the person's informed consent.
  • Respond to a DHCS audit finding or a participant's concern by naming the next step, who acts, and where a grievance or complaint goes.

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In this course

  1. What the settings rule asks of every ALW homeAbout 7 minutes · Not yet
  2. Daily life: schedule, food, visitors and freedom from coercionAbout 7 minutes · Not yet
  3. The person's own unit and the written agreementAbout 7 minutes · Not yet
  4. Modifying a right through the person-centered planAbout 7 minutes · Not yet
  5. How the state checks settings, and where concerns goAbout 6 minutes · Not yet
  6. Course check · 10 questions0 of 5 lessons done

Sources

Sources behind this course

Each lesson lists the sources it uses. Open the original for the exact rule, form or instruction that applies to your work. The source library describes each one in more detail.

U.S. Centers for Medicare & Medicaid Services (eCFR)

42 CFR 441.301, contents of request for a waiver

The qualities every home and community-based setting must have, the added conditions in provider-owned or controlled residential settings, how those conditions may be modified, the settings that are not home and community-based, and the grievance system.

Where to look: Paragraphs (c)(4)(i) to (vi), (c)(5), (c)(2)(xiii) and (c)(7).

Open section 441.301 on eCFR
California DHCS

Application for a 1915(c) HCBS Waiver, CA.0431.R04.00 (the Assisted Living Waiver, from March 1, 2024)

The approved ALW waiver, including how ALW settings meet and keep meeting the federal settings requirements, and the safeguards on restraints, restrictive interventions and seclusion.

Where to look: Appendix C-5 (Home and Community-Based Settings) and Appendix G-2 (restraints, restrictive interventions and seclusion).

Open the ALW waiver application (PDF)
California DHCS

Assisted Living Waiver Individual Service Plan Desk Guide (August 2024)

How a care coordinator documents a rights modification in the ALW ISP, which rights can be modified, who implements and who monitors, and the Patient's Rights Form.

Where to look: Rights Modifications (pages 29 to 32) and the Patient's Rights Form (pages 33 to 35).

Open the DHCS ISP Desk Guide (PDF)
California DHCS

Statewide Transition Plan for Compliance with Home and Community-Based Settings Rules (June 2023)

California's plan for bringing HCBS settings into line with the federal rule: the ALW on-site assessments and remediation, relocation and notice, ongoing monitoring, complaints, and the review of RCFE rules against each settings requirement.

Where to look: ALW and HCBA Waiver sections (pages 29 to 32 and 39 to 40), Monitoring and Oversight (pages 45 to 48), and Appendix B, the RCFE table (pages 189 to 206).

Open the DHCS Statewide Transition Plan (PDF)
California Legislature (statute text on california.public.law)

Health and Safety Code section 1569.269

The personal rights of residents of residential care facilities for the elderly, including privacy, dignity, daily choices, freedom from coercion and retaliation, room and roommate choices, visitors, possessions and eviction protections.

Where to look: Subdivision (a), paragraphs (1) to (31), and subdivisions (c) and (e).

Open section 1569.269
Call the ALW teamFit check