How States Can Take Advantage of New Opportunities in Home- and Community-based Services

by Rebecca Farley on August 13, 2010

The Centers for Medicare & Medicaid Services has issued a State Medicaid Director Letter outlining how states can take advantage of healthcare reform’s new provisions for Home- and Community-based Services. Effective Oct. 1, 2010:
  • Individuals no longer have to meet an institutional level of care requirement in order to qualify for HCBS.
  • States may provide a broadly defined range of community-based services to persons with chronic mental illnesses and/or substance use disorders.
  • States may provide these community-based services to persons whose incomes are 300% of the SSI income benefit.
  • Benefits can be targeted to specific population groups or specific functional needs groups without violating Medicaid’s comparability requirements – this means a state could target persons with chronic mental illnesses, for example.

For more details on the changes to home- and community-based services under healthcare reform, visit the Understand the New Law page.

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    { 1 comment… read it below or add one }

    E Wilson September 7, 2010 at 8:06 pm

    There are so many provisions with this Health Care Reform, but I have not read a description of the Enhance Act which was incorporated into the Patient Protection and Affordable Care Act. The provision calls for 30 Centers of Excellence for Bipolar and Depression. The original provision projected a 100 million dollars for the first 20 Centers and 150 million dollars for the other 10 Centers.

    On July 29, 2010 10 million dollars was appropriated for this provision.
    This is enough for 1 coordinating Center. This project can be funded over 5 years and it is imperative that people contact their Congress members to encourage them to support the funding of the rest of these Centers.

    When the cancer Centers of Excellence were funded in the 70′s their network brought phenomenal medical progress to Cancer. The US has seen a 30% decline in the death rate in cancer over 40 years. We need these Centers of Excellence for Depression and Bipolar to improve progress in these diseases.

    Mental health recieves 1/8 the funding that cancer does. So if a law is passed to form these Centers with Federal funds this is a golden opportunity for the mental health community that can not be passed up.
    It has been written by the National Network of Depression Centers that it will cost 1/10 of the cost of mental illness to the US if these Centers are funded. The cost of mental illness to the US can no longer be ignored. It is cheaper to treat people and research than do nothing.
    This chronic lack of funding for this community is beyond acceptable bordering on criminal with all the suicides that occur every year.


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