A new rule issued this year by the Centers for Medicare and Medicaid Services means housing for seniors and those with disabilities who live in assisted living and residential care centers is no longer in jeopardy around the nation.
“The original draft proposed rule by CMS was a real threat of possible dislocation to the seniors and individuals with disabilities our members serve every day,” said David Kyllo, Executive Director of the National Center for Assisted Living. “This is a major relief for thousands of seniors and individuals with disabilities residing in member centers across the country,” stated Mark Parkinson, President and CEO of AHCA/NCAL. “We saw the critical nature of this rule and worked with our members and other stakeholders to educate CMS about this potential crisis. Our goal was to ensure residents would be able to remain in place at the assisted living and residential care communities they and their families had initially chosen.”
The rule is all-inclusive and addresses sections of Medicaid law that allow states to use federal Medicaid funds to cover these types of services. It also protects those who receive housing and other services under various programs by providing full access to the many benefits of community living. This allows them to better integrate.
As many may know, there were concerns these rules could have had a negative impact on those with disabilities and seniors by displacing more than 130,000 people who rely on these services. In its own press release, CMS said the final rule is “moving away from defining home and community-based settings by ‘what they are not’ and toward defining them by the nature and quality of individuals’ experiences.”
Also, the new rules have provisions that better establish a more “outcome-oriented” definition of home and community based settings versus basing it solely on a setting’s location, geography or physical characteristics. Further, CMS also specifies that service planning for Medicaid HCBS participants must be developed through a person-centered planning process addressing health and long-term services and support needs. This could include representatives who have been freely chosen by the individual to contribute to that process.
There are several key points surrounding requirements that all home and community-based settings meet certain qualifications. This includes ensuring the settings are integrated and fully support access to the greater community.
It also empowers the individual to select his own setting options and puts into place the individual rights of privacy, dignity and respect as well as freedom from coercion and restraint. It facilitates the decision making process surrounding services and service providers and better clarifies autonomy and independence in everything from their living arrangements to making their own life choices.
It should be noted that implementation of these final rules do not begin until March 17. That said, there’s also an extended transition period of up to five years for states to fall into compliance.
It’s empowering and goes much further to address the needs of those residing in assisted living and their families as they go about the business of making the best choices for their loved ones.
If you’d like to learn more about this latest decision and how it affects seniors in New Hampshire, we invite you to contact our team of experienced estate planning and elder law attorneys. We stand ready to provide assistance for you and your family.