Centers for Medicaid & Medicare Services Regulation 76 Federal Register 21311 (April 15, 2011), REVI

I have considerable concerns with the recent proposed regulation regarding Medicaid Home and Community-Based Services (HCBS) waivers [76 Federal Register 21311 (April 15, 2011), REVISED 77 Federal Register 26362 (May 3, 2012)] and the adverse impact these proposals could have on people with the most significant disabilities served by disability service providers.
 
Congress authorized HCBS waivers for individuals with significant disabilities who would otherwise require a level of care provided in institutional settings.I am concerned that the language included in the proposed regulation will have the effect of thwarting informed choice by negating or severely restricting longstanding (and in some cases award winning) program options expressly authorized by the HCBS provisions of the Medicaid statute and regulations and significantly restricting state flexibility to respond to identified needs of Medicaid beneficiaries.More specifically, I am concerned that if the proposed language is adopted, the following program options could be eliminated or severely restricted:

The provision of home and community-based services explicitly authorized under Section 1915(c) of the Social Security Act (Medicaid), including center-based day habilitation programs providing critical prevocational services, day treatment programs, and psychosocial rehabilitation programs.

The provision of home and community-based services in group homes for people with disabilities in which community programs have adopted reasonable policies governing their operation designed to respect the individual’s rights and at the same time respect the rights of other residents.

The provision of home and community-based services to residents with disabilities in supported living arrangements authorized under and meeting the requirements of HUD Section 811 and Section 202 multi-family housing units.

The provision of home and community-based services in group homes set around a courtyard where individuals with disabilities have many needed services and supports built into their day-to-day living and have transportation and other assistance to access the general community.

The provision of home and community-based services in programs located adjacent to a public institution even though the program is also adjacent to other buildings such as local community colleges and universities, stores and businesses, and residential communities.

I truly believe that this is not the time to adopt federal “one-sizes fits all” absolute standards  that may have the effect of negating statutory options, restrict state flexibility, and severely limit informed choice in the most integrated setting appropriate, options, and opportunities for individuals with the most significant disabilities and their families and guardians. This is the time to reassure individuals with the most significant disabilities that they will continue to receive the Medicaid home and community-based services and supports they need and want and choose. Expanding and enhancing choice, options, opportunities, and access should be the guiding principles.

Sign Petition
Sign Petition
You have JavaScript disabled. Without it, our site might not function properly.

Privacy Policy

By signing, you accept Care2's Terms of Service.
You can unsub at any time here.

Having problems signing this? Let us know.