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Medicaid News
Medicaid Patients to Gain More Control of Personal
Care with New CMS Rule
Could even hire qualified family
members, other non-agency workers
 Jan. 16, 2008 - A proposed rule that would allow
more Medicaid beneficiaries to be in charge of their own personal
assistance services, including personal care services, instead of having
those services delivered by an agency, was announced this week by the
Centers for Medicare & Medicaid Services (CMS).
Through the rule on display at the Federal
Register, CMS requests public comment on how states could allow Medicaid
beneficiaries who need help with the activities of daily living to hire,
direct, train or fire their own personal care workers rather than
working with personnel employed by an agency.
Beneficiaries could even hire qualified family
members who may already be familiar with the individuals needs to
perform personal assistance (not medical) services.
This proposal would give Medicaid beneficiaries
significant new 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 proposal 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 proposal 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 previous 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, the state must have an existing personal care services
benefit, or be operating a home or community-based services waiver
program.
Furthermore, 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 train potential
participants in ways to manage their budgets and assess their personal
care needs.
The notice of proposed rulemaking will be published
in the January 18, 2008 issue of the Federal Register. There is a
30-day comment period. Comments are due February 19, 2008.
To view the proposed rule visit:
http://www.cms.hhs.gov/MedicaidGenInfo/Downloads/CMS2229P.PDF.
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