October Implementation Update: Home & Community Based Services

by Rebecca Farley on October 1, 2010

Close on the heels of new consumer protection requirements that went into effect Sept. 23, another new provision of healthcare reform becomes effective today, Oct. 1.

The Patient Protection and Affordable Care Act (ACA) enacted changes to Section 1915(i), the Medicaid home- and community-based services (HCBS) option, which are designed to expand beneficiaries’ access to these services. The ACA established a new state Medicaid option by which states can offer HCBS to individuals who otherwise would require the level of care provided in an institution and broadens the allowable range of HCBS that may be covered.

In August, the Centers for Medicare and Medicaid Services released a letter to state Medicaid directors providing details on how the new provisions will be implemented for states choosing to take advantage of the new option. Effective Oct. 1:
  • 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.

On Tues, Oct. 12 from 2:00-3:30 eastern time, the Bazelon Center for Mental Health Law will host a webinar to provide information on Section 1915(i), discuss its relevance to state mental health systems today, and explore its implications for the new group of eligible individuals who will come into the expanded program in 2014. The webinar will provide detailed information on issues relating to eligibility, services and plan requirements. Registration and additional details are available online.

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