The HCBS Settings Rule in a Shifting Olmstead Landscape: What Assisted Living & Adult Day Providers Need to Know

OVERVIEW

More than a decade after CMS finalized the Medicaid HCBS settings rule, its requirements continue to shape how assisted living and adult day providers design, deliver, and document services. At the same time, the federal legal framework behind community integration is changing quickly. In 2026 the Department of Justice reinterpreted the integration mandate under Section 504 of the Rehabilitation Act and title II of the Americans with Disabilities Act, as well as the holding of Olmstead v. L.C. and stepped back from its longstanding enforcement guidance, and in September a federal court in Texas v. Kennedy vacated the community integration provisions of the Department of Health and Human Services’ 2024 Section 504 rule.

This session gives providers a high-level walkthrough of the setting rule, including the qualities every HCBS setting must have, the added conditions for provider owned or controlled residential settings, person-centered care planning, and heightened scrutiny. We will look closely at the provisions that most often raise questions in assisted living and adult day. We will then explain what DOJ’s recent actions and the Texas v. Kennedy ruling do and don’t change, followed by commentary on what they may mean for state oversight, Medicaid HCBS policy, and provider operations.

Learning Objectives

• Summarize the core requirements of the Medicaid HCBS settings rule.
• Identify the provisions most relevant to aging services provider, such as residency agreements, privacy, control of schedule, visitors, access to food, and community access. Distinguish how modifications must be supported through the person-centered plan.
• Describe DOJ’s 2026 actions on the integration mandate, Olmstead, and the outcome of Texas v. Kennedy, distinguishing what has changed in federal regulation and enforcement from what remains in law.
• Assess the practical implications for compliance, state oversight, and advocacy in their own state.

WHO SHOULD ATTEND?

C-Suite, Leadership & Legal Professionals in CCRC, AL, IL, HCBS  and Adult Day communities

CE’s: Earn 1.0 CE

DATE

Thursday, February 11, 2027

TIME

10:30 am-11:30 am CST

LOCATION

Online.

Virtual Link: Class Material and Zoom link will be sent two days prior

FACULTY

Clarette Yen serves as the Vice President, Legal Affairs at LeadingAge. She previously spent 21 years as an attorney with the federal government. She started her federal career with the U.S. Department of Labor, where she drafted and reviewed regulations relating to foreign labor certifications and handled administrative litigation before the Board of Alien Labor Certification Appeals. She continued to develop her regulatory expertise at the U.S. Department of Justice, where she worked on regulation and guidance implementing the Controlled Substances Act, Americans with Disabilities Act, and Section 504 of the Rehabilitation Act. She helped lead Section 504 coordination efforts to ensure consistency in interpretation and enforcement across federal agencies. She concluded her federal career at the Government Accountability Office, where she provided legal support on performance audits in the areas of human capital, regulation, and tax policy. She is excited to continue her work in these areas (in addition to learning new ones) to support LeadingAge’s federal advocacy efforts.

FEES

Provider and Business Members: Free
Non-members: $99

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