On January 10, 2014 the Centers for Medicare and Medicaid Services (CMS) issued the Medicaid Home and Community-Based Services (HCBS) settings final rule (CMS-2249-P2). The final regulation addresses several sections of Medicaid law under which states may use federal Medicaid funds to pay for HCBS. The rule establishes requirements for the qualities of settings that are eligible for reimbursement for Medicaid HCBS provided under sections 1915(c), 1915(i), and 1915(k).
CMS has released several fact sheets on the final rule, which can be viewed here:
Consumer Voice and Justice in Aging created two guides on how the Medicaid Home and Community-Based Services (HCBS) rules can be used to improve services for older persons. These guides are meant to assist state advocates as they develop "transition plans" to implement new federal rules and set policy in that state for 2019 and into the future. "Medicaid’s New Rule to Promote Independence and Choice for Persons Receiving HCBS" provides an overview of the rule, with a focus on HCBS for older persons. "Applying the New Federal HCBS Rules to Adult Day Centers" examines how the HCBS rules can improve services provided in those settings.
A session entitled "New Standards for Caring for Individuals with Dementia at Home and in Assisted Living" was held during the 2016 Consumer Voice Annual Conference. New standards of care established by the HCBS settings rule are intended to significantly improve how individuals live and receive Medicaid funded services at home and in assisted living. The presentations provide the federal perspective on the expectations regarding rule implementation, particularly for people with dementia, and the importance of the person-centered/community integration philosophy behind the rule. They include information about promising practices related to individuals with dementia, particularly practices related to community access, choice, and wandering/exit-seeking behaviors.
Presentation (PDF version) by Ralph Lollar, Director, Division of Long-Term Services and Supports, Disabled and Elderly Health Programs Group, Centers for Medicare & Medicaid Services and Serena Lowe, Senior Policy Adviser, Office of Policy Analysis & Development, Center for Policy & Evaluation, Administration on Community Living
Presentation by Jennifer Goldberg, Directing Attorney, Justice in Aging
HCBSadvocacy.org - Information for advocates about the new home- and community-based services rule
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