IMPORTANT: Medicaid Community First Choice Regulations Published

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Community First Choice Regulations Published. Information Bulletin # 357(5/2012)Let's hear the trumpets and the Halleluiahs chorus.Finally, the Department of Health and Human Services/Centers for Medicare & Medicaid Services issued the final regulations for the Community FirstChoice option. The regulations state that CFC's scope is designed to makeavailable home and community-based attendant services and supports toeligible individuals, as needed, to assist in accomplishing activities ofdaily living, instrumental activities of daily living, and health-relatedtasks through hands-on assistance, supervision, or cueing.CMS listed CFC's Total Benefits as providing States with additionalflexibility to finance home and community-based services and attendantservices and supports. The regulations state that CFC will increaseState and local accessibility to services that augment the quality of lifefor individuals through a person-centered plan of services and variousquality assurances. CMS further noted that CFC reduces the financialstrain on States and Medicaid participants.CFC is a win-win for States to save money and for people who needcommunity-based and attendant services to stay in their homes andapartments.For many years, the Community First Choice was strongly supported andinitiated by ADAPT, a national grass roots organization of people withdisabilities of all ages and all disabilities. ADAPT organized largenumbers of supporters, testified before Congressional committees, and lastweek demonstrated in front of HHS's Washington offices demanding CMS releaseCFC's regulations.Now that the federal regulations have been released, the struggle shifts toyou disability and aging advocates in each State - to make sure thisprogram is implemented in your State. Nothing happens automatically. Unlessadvocates demand CFC state-by-state, it will not happen. Yes, anotherlocal effort but quire worth the effort.Here's why your State should amend its Medicaid Plan to include the CFCthe federal government will pay an additional 6 percentages to your State'sFederal Medical Assistance percentages. (Go tohttp://aspe.hhs.gov/health/fmap.htm to see what the FMAP is now WITHOUT theadditional six points.) That translates into a LOT of federal money!Another reason: yes, your State can save a lot of State funds while at thesame time complying with the ADA/Olmstead requirements to preventunnecessary isolation and institutionalization of people with disabilities.Here's a brief summary of the final regulations:1. CFC provides home and community-based attendant care services andsupports to persons with disabilities.2. Such services must assist the individual with activities of dailyliving, instrumental activities of daily living (e.g., shopping cleaning)and health-related tasks.3. States can provide, at the State's option, transition costs (rentand utility deposits, first months rent/utilities, basic kitchen/beddingneeds).4. Individual eligibility requires that the person with a disabilitymeets your State's institutional level of care criteria. The person neednot be in the institution nor packing their bags or at risk of beingimminently institutionalized. If the person meets the level of care forthe institution, the CFC services can be provided.5. Individual financial eligibility is the same as what your State hasestablished for the institution.6. Under the CFC, States must use a person-centered service plan andthe services must be self-directed, either with a self-directed servicebudget or an agency-provider model.7. This plan must be in writing and agreed to by the individual andmust be based on a functional needs assessment. The regulations state thatthe person-centered service plan must reflect the services and supportsthat are important for the individual to meet the needs identified throughan assessment of functional need.8. These plans must be reviewed, and revised upon reassessment offunctional needs, at least every 12 months, when the individual'scircumstances or needs change significantly, and at the request of theindividual.What advocates must do:1. Your State Medicaid Plan must be amended to include the CFC.Advocates should be at the table to ensure the services meet your needs.2. You need a statewide, multi-disability coalition and strategy toensure your State amends its Medicaid plan to include the CFC. If yourState does not already have such a coalition, the CFC presents anopportunity to develop one. If your State has such a coalition, conveneit!3. You need to show your Governor why s/he should amend your State'sMedicaid plan to provide CFC services. This will require real live peoplewho want and need CFC services. They must be ready to speak out. CFC is acritical opportunity to end waiting lists.4. You should get to your media and explain how this program will saveyour State money, while bringing into your State additional Federal funds.Steve Gold, The Disability Odyssey continuesBack issues of other Information Bulletins are available online athttp://www.stevegoldada.comwith a searchable Archive at this site divided into different subjects.As of August, 2010, Information Bulletins will also be posted on my bloglocated athttp://stevegoldada.blogspot.com/To contact Steve Gold directly, write tostevegoldada1@...or call . Ext227.