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Wednesday, November 12, 2014

Home and Community-Based Services

At Autism Speaks, Angela Lello writes about Medicaid changes:
The changes call for “person-centered” planning that provides new rights for people with disabilities to determine their future. And they prohibit home- and community-based services (HCBS) in settings that would “isolate” individuals from the community at large. They were issued earlier this year by the federal Centers for Medicare & Medicaid Services (CMS) and now every state, including yours, is modifying its Medicaid waiver programs to comply.
Person-centered planning is a process that can help family caregivers and individuals identify the exact types of supports they need to achieve specific life goals.
Home and community-based services (HCBS) that are funded by Medicaid must now prioritize the needs of the individual, rather than public agencies or providers. The intent is to help people with disabilities assemble the exact services and types of supports they need to live a full and productive life. The person-centered requirements demand greater opportunities for self-determination by the individual with disabilities in planning their future. This means that the development of the plan must include:
  • People chosen by the individual
  • Good information for the individual to lead the process and make informed decisions
  • Choices for services and supports
  • Services based on the individual’s needs and preferences
  • The use of plain language and is accessible
  • A process to resolve any disputes
  • The debate over settings
Medicaid HCBS provides an alternative to living in an institution (like an intermediate care facility or nursing home). Before this rule, there was no clear definition of what types of settings could be funded with HCBS dollars. This rule clarifies the process by which states will determine whether a given setting can be funded with Medicaid HCBS.
How states implement this provision will affect the types of services individuals may ultimately receive. There are different opinions about whether or not Medicaid HCBS should be able to fund specific types of programs. Autism Speaks has long been involved in helping ensure that the needs of all members of the autism community were represented in the development of these new standards. Individuals with autism and their families know firsthand the barriers to true community integration and are the most appropriate individuals to help define isolating settings. View our position statement here.