New guidance continues to flow from the federal government advising states on Medicaid and special education services in light of the pandemic.

The Centers for Medicare and Medicaid Services updated its 99-page frequently-asked-questions document for states detailing how COVID-19 may affect Medicaid services.

Significantly, advocates say CMS is emphasizing for the first time that despite the pandemic, states must continue to comply with the U.S. Supreme Court’s 1999 ruling in Olmstead v. L.C., which found that people with disabilities have a right to access services in the community.

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“Please note that states are reminded that they still are responsible for compliance with the integration mandate of Title II of the (Americans with Disabilities Act) and the Olmstead v. LC, 119 S. Ct. 2176 (1999) decision to avoid subjecting persons with disabilities to unjustified institutionalization or segregation,” the guidance states. “Therefore, states should strive to return individuals who were removed from their Medicaid-funded (home- and community-based) settings during the public health emergency to the community, and should consider what steps they can take to help individuals with disabilities who may require assistance in order to avoid unjustified institutionalization or segregation.”

Alison Barkoff, director of advocacy at the Center for Public Representation, said this mention of Olmstead is particularly important given how hard hit many institutional settings have been by COVID-19.

“We need to make sure people are getting supports in the community so they don’t get transferred to nursing homes and other institutions where they are most unsafe,” she said.

The Medicaid guidance also includes a number of questions related to Money Follows the Person — a program that helps people transition from institutions to community-based settings — signifying to states that this program should proceed during the pandemic, Barkoff said.

In addition, the document spells out that children receiving Medicaid must continue to access all of the benefits guaranteed as part of a menu of services known as Early and Periodic Screening, Diagnostic and Treatment — which includes everything from speech and occupational therapy to personal care services and medical equipment — even if schools are closed.

CMS indicated that it will provide more updates on a rolling basis as the agency reviews incoming inquiries.

Meanwhile, the U.S. Department of Education has rolled out three more sets of question-and-answer documents in recent weeks addressing a wide range of issues related to schools serving students with disabilities as a result of the coronavirus.

The latest guidance documents touch on how Individuals with Disabilities Education Act funding can be used, procedural requirements under special education law and the evaluation of young children with disabilities for services.

These materials follow a pair of documents issued in June that covered dispute resolution procedures as well as several directives released in the spring that sought to shape the direction of special education as school districts across the nation shuttered.

The Education Department said that the most recent guidance is in response to questions that have emerged. None of the materials are meant to establish new rules, but they simply represent the agency’s interpretation of existing law, officials said.

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