Proposal strictly defines home and community-based care.
Under current regulations, states must administer funds for home and community-based services (HCBS) separately to three target populations: aged or disabled individuals; mentally retarded or developmentally disabled individuals; and the mentally ill. The Centers for Medicare & Medicaid Services (CMS) have proposed a new rule that seeks to combine the three populations into one.
Additionally, CMS’s proposed rule would set strict guidelines for what constitutes a home or community-based setting, and only permit HCBS funding for non-institutional care that allows patients to “engage freely in the community.” The rule would also encourage personalized, patient-directed treatment plans.
The proposal follows a 2009 Advance Notice of Proposed Rulemaking
that received hundreds of public comments
, many of which CMS reports helped to shape its proposed rule. For example, concerns over the definition of “institution” apparently led CMS to include language specifically permitting HCBS funds to be used for non-restrictive retirement communities.
CMS is accepting comments
on the proposed rule until June 14, 2011.