An item of Interest....

[Guest guest]

The coud eliminate functional communication training, skill acqusition programs,

social skills programs and even programs to build resilency....

Joe

Barbara Byers <babmay11@...> wrote:

-------- Original Message --------

This came from a list in PA but applies nationally.

The Centers for Medicare and Medicaid Services (CMS) published a " proposed

rulemaking " in the Federal Register on August 13th -- the content has been

floating around, in writing, since at least March 22nd. I haven't heard anybody

say anything about it yet and don't understand why. Check out www.cms.hhs.

gov/MedicaidGenI nfo/Downloads/ CMS2261P. pdf to see it for yourself.

It will stop funding of Behavioral Health Rehabilitation Services

( " wraparound " ) unless it's for REhabilitation services -- restoring a person to

a former level of functional capacity. OBRA '89 permitted funding for

" habilitation " services (teaching new skills to people who lack them), but these

new rules would " fix " that.

This is the most serious threat to the funding of effective treatment for

children with Autism and other developmental disabilities that I've ever seen.

Here are some quotes from the proposed rule-making text. They are admittedly

" out of context " but are perfectly clear in their intention nonetheless.

" Examples of services that are intrinsic elements of other programs and that

would not be paid under Medicaid include, but are not limited to, the

following: "

" (iv) Routine supervision and non-medical support services provided by

teacher aides in school settings (sometimes referred to as “classroom aides” and

“recess aides”). "

" (2) Habilitation services, including services for which [funding] was

formerly permitted under the Omnibus Budget Reconciliation Act of 1989.

Habilitation services include services provided to individuals with mental

retardation or related conditions. (Most physical impairments, and mental health

and/or substance related disorders, are not included in the scope of related

conditions, so rehabilitation services may be appropriately provided.) "

This proposed rule-making explicitly distinguishes between " rehabilitation "

and " habilitation " services. The former are funded, the latter are not. It

recognizes that a period of " transition " will be needed to transfer funding for

all of the " habilitation " treatment plans to the Medicaid Home and Community

Waiver program. It doesn't say anything about waiting lists. The period for

public comment ends in mid-October.

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