Feds Propose Greater Flexibility For Community-Based Services
A new federal proposal could make it easier for people with disabilities to get the community-based services they need through Medicaid.
The proposed rules published Friday in the Federal Register are designed to allow states more flexibility when providing home and community-based services for people with disabilities, according to Mary Kahn, a spokeswoman for the Centers for Medicare and Medicaid Services.
Currently, states offer services to individuals based on the person’s diagnosis. But if the new rules go into effect as proposed, states could instead offer a menu of services from which a person could select the most appropriate ones based on individual need, Kahn said.
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The recommendations require that any person receiving services have significant say in decisions about where they live and what type of supports they need through a process known as person-centered planning.
Additionally, the rules would place clear limits on what qualifies as a home and community-based setting. Such residences must be in the community and must not “include regimented meal and sleep times, limitations on visitors, lack of privacy and other attributes that limit individual’s ability to engage freely in the community,” according to the proposal.
The effort to clarify what “community-based” means came in response to reports from across the country suggesting that new homes being passed off as community-based were being built on the sites of existing institutions.
“These long awaited rules will help people living with disabilities realize the promise of the ADA to live in the least restrictive environments possible for them,” said Henry Claypool, director of the Office on Disability at the U.S. Department of Health and Human Services. “We hope states will take advantage of this new flexibility.”
The proposed rules are up for public comment for the next 60 days.
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