WHAT THE NEW RULE FOR HOME AND COMMUNITY-BASED SETTINGS MEANS FOR YOU Medicaid has issued a new rule called the home and community-based settings rule that clarifies what it means to provide services to individuals with disabilities on Medicaid living in the community. Medicaid has given states five years to make sure that providers and homes that claim to be home and community-based can come into compliance with the new rule. Each state has to provide a step-by-step plan on how they are going to do this. Missouri’s transition plan is now available for public comment and it is important that they hear from families and self advocates who want to make sure that all Missourians who live in their community have as much freedom as possible, no matter if they need Medicaid supports are not. The address to send comments to is: MO HealthNet Division P.O. Box 6500 Jefferson City, MO 65102-6500 Attn: MO HealthNet Director The link for more information is here: dmh.mo.gov/dd/hcbs.htm. There will be a public hearing on the transition plan on January 12, 2015. This hearing will be in Jefferson City at 9:00 a.m. – 12:00 p.m. at the State Information Center – Interpretive Center, 600 West Main Street. If you would like to participate over the phone you may call 866-630-9350. The rest of this email/document attempts to describe the important provisions of the new home and community-based services rule in simple terms. Some legal language was left in, such as “landlord-tenant” because it is technical and very specific. In 1999, the Supreme Court said that Americans with disabilities have the right to live in the community, just like everyone else because segregating people with disabilities without their consent is discrimination. For a long time, the federal government has had programs that allow people with disabilities on Medicaid to live and be supported in their community, but they did not define what “community” meant. Recently, Medicaid issued new rules that define what a “home and community-based setting” is. This rule says that in order to be a “home or community-based setting“, the Medicaid provider has to provide you with certain specific rights that the rest of society takes for granted. Under the new rules a community-based setting must be: Integrated in and supports full access of individuals to the greater community, including opportunities to seek employment and work in competitive integrated settings, engage in community life, control personal resources, and receive services in the community, to the same degree of access as individuals not receiving services and supports because of a developmental disability. If you have a home that is a “home and community-based setting” it must: • Be selected by you from among different options, including non-disability specific settings and an option for a private apartment. The choices are written down in the person-centered plan and are based on the individuals needs, preferences, and how much money someone can spend for room and board. • Make sure that you have a right to privacy, dignity and respect, and freedom from coercion and restraint. • Optimize freedom, and independence in making life choices, including what you do during the day, where you go, and who you talk to. • Make sure that you have as much choice as possible regarding what help you need, and who helps you. • Be a specific physical place that can be owned, rented or occupied under a legally enforceable agreement. o You have, the same responsibilities and protections from eviction that tenants have under the landlord tenant law of the place where you live. If you live in a place where landlord tenant laws do not apply, there has to be a written agreement in place for each person, that provides protections that address eviction processes and appeals comparable to people without disabilities who live in the community. • Make sure you have privacy in your bedroom or living room: • Have doors to your home that could be locked by you, with only appropriate staff having keys to doors as needed. • Make sure people sharing a home have a choice of roommates. • Make sure you have the freedom to furnish and decorate your sleeping or living rooms within the lease or other agreement. • Make sure you have the freedom and support to control your own schedule and activities, and have access to food at any time. • Make sure you are able to have visitors you’re choosing at any time. • Make sure you can move around your home, including getting in the front door or any other living area that people without disabilities use. There are exceptions to these rules, but if the place where you live wants to make an exception, they have to do it on a case-by-case basis, it has to be documented, it has to be the least restrictive modification possible, and it has to be reviewed periodically, among other things. The rule also specifies places that are definitely not “home and community-based”: • A nursing facility • An institution for mental diseases • An intermediate care facility for individuals with intellectual disabilities • A hospital providing long-term care services or: • Any setting that is located in a building that also provides inpatient institutional treatment, or in a building on the grounds of, or immediately adjacent to, a public institution, or any other setting that has the effect of isolating individuals with disabilities from the broader community of individuals without disabilities will be presumed not to be a home and community-based setting. For more information on the HCBS Rule Transition Plan you can visit the following websites: Missouri Developmental Disabilities Council: moddcouncil.org Missouri Department of Mental Health: dmh.mo.gov/dd/hcbs.htm Mo HealthNet: dss.mo.gov/mhd
Posted on: Tue, 06 Jan 2015 20:15:24 +0000
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