Thursday, February 7, 2008

Opportunity for public comment:Medicaid changes

A proposed rule that would allow more Medicaid beneficiaries to be in charge of their own personal assistance services, including personal care services, instead of having those services delivered by an agency.

Through the rule, found at the Federal Register, CMS requests public comment on how states could allow Medicaid beneficiaries who need help with the activities of daily living to hire, direct, train or fire their own personal care workers rather than working with personnel employed by an agency. Beneficiaries could even hire qualified family members who may already be familiar with the individual's needs to perform personal assistance (not medical) services.

If a state adopts a self-directed personal assistance services state plan option, beneficiaries could receive a cash allowance to hire their own workers to help with such activities as bathing, preparing meals, household chores and other related services that help a person to live independently. Allotments could also be used to purchase items that help foster independence such as a wheelchair ramp or microwave oven. The beneficiaries also have the option to have their cash benefit allotment managed for them.

The proposal would put into place a provision of the Deficit Reduction Act of 2005 that allows states to elect a state plan option to provide care in ways that previously required "waivers" of previous Medicaid laws. Such waivers are subject to certain budgetary requirements and are temporary in nature.

Family Voices encourages its membership to submit comments on this proposal.

Instructions for submitting comments on proposal, CMS-2229-P:

1. Read the proposal by clicking on the following link:

2. To submit comments:

a. Electronically. You may submit electronic comments on specific issues in this regulation (Attachments should be in Microsoft Word, WordPerfect, or Excel; however, we prefer Microsoft Word.)

i. By going to the following website: .

ii. Then click on the link "Submit CMS-2229-P 2 electronic comments on CMS regulations with an open comment period"

iii. Write out your comments

iv. Include your name and address

v. Include the reference number of CMS-2229-P to clarify what you are commenting on

b. By regular mail. You may mail written comments, however you MUST include one original and two copies, to the following address ONLY:

Centers for Medicare & Medicaid Services,

Department of Health and Human Services,

Attention: CMS-2229-P

P.O. Box 8016,

Baltimore, MD 21244-8016.

The deadline for submitting your comments is February 19, 2008. Remember to include "CMS-2229-P" in your comments.

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