Medicaid Patients Get More Authority to Direct
Personal Care in Some States
Medicaid rule will even allow hiring family members
for personal assistance in states with self-direct option
Sept.
29, 2008 A final rule was posted today that allows some Medicaid
beneficiaries to take charge of their own personal assistance services
including hiring family members for personal assistance. The guidelines
apply to states that adopt the self-directed personal assistance
services option for their programs.
The
rule, which becomes effective on November 3, allows those on Medicaid in
state programs allowing the self-directed option to make key decisions
on their own personal care, rather than have such services directed by
an agency, according to the Centers for Medicare & Medicaid Services
(CMS).
The rule, on display today at the Federal Register,
guides states who wish to allow Medicaid beneficiaries who need help
with the activities of daily living to hire, direct, train or fire their
own personal care workers. Beneficiaries could even hire qualified
family members who may already be familiar with the individuals needs
to perform personal assistance (not medical) services.
This new plan would give Medicaid beneficiaries
significant freedom to determine how their personal assistance services
are delivered and by whom, said Kerry Weems , CMS acting
administrator.
As health care is not simply an economic
transaction, this plan represents a fundamental shift that restores a
persons ability to improve their overall health by taking greater
control of his or her own decisions, Weems said.
If a state adopts a self-directed personal
assistance services state plan option, beneficiaries could receive a
cash allowance to hire their own workers to help with such activities as
bathing, preparing meals, household chores and other related services
that help a person to live independently.
Allotments could also be used to purchase items
that help foster independence such as a wheelchair ramp or microwave
oven.
The beneficiaries also have the option to have
their cash benefit allotment managed for them.
The rule would put into place a provision of the
Deficit Reduction Act of 2005 that allows states to elect a state plan
option to provide care in ways that previously required waivers of
existing Medicaid laws. Such waivers are subject to certain budgetary
requirements and are temporary in nature.
Before a state could request this change to its
state plan, it must have an existing personal care services benefit, or
be operating a home or community-based services waiver program.
Enrollment in this new state plan option is
voluntary and the state must also provide traditional agency-delivered
services if the beneficiary wishes to discontinue self-directed care.
States choosing this option must have necessary
quality assurances and other safeguards in place to assure the health
and welfare of participants. States must also furnish sufficient
information, training, counseling and assistance to participants in
order to help them effectively manage their budgets and their personal
assistance services.
Keep up with the latest news for senior citizens, baby
boomers
Sept.
29, 2008 A final rule was posted today that allows some Medicaid
beneficiaries to take charge of their own personal assistance services
including hiring family members for personal assistance. The guidelines
apply to states that adopt the self-directed personal assistance
services option for their programs.