The Community Choice Act gives people real choice in long term care options by reforming Title XIX of the Social Security Act (Medicaid) by ending the institutional bias. The Community Choice Act allows individuals eligible for Nursing Facility Services or Intermediate Care Facility Services for the Mentally Retarded (ICF-MR) the opportunity to choose instead a new alternative, "Community-based Attendant Services and Supports." The money follows the individual!

In addition, by providing an enhanced match and grants for the transition to Real Choice before October 2011 when the benefit becomes permanent, the Community Choice Act offers states financial assistance to reform their long term service and support system to provide services in the most integrated setting.

Specifically what does this bill do?

1) Provides community-based attendant services and supports ranging from assistance with:

• activities of daily living (eating, toileting, grooming, dressing, bathing, transferring),
• instrumental activities of daily living (meal planning and preparation, managing finances, shopping, household chores, phoning, participating in the community),
• and health-related functions.

2) Includes hands-on assistance, supervision and/or cueing, as well as help to learn, keep and enhance skills to accomplish such activities.

3) Requires services be provided in THE MOST INTEGRATED SETTING appropriate to the needs of the individual.

4) Provides Community-based Attendant Services and Supports that are:

• based on functional need, rather than diagnosis or age;
• provided in home or community settings like -- school, work, recreation or religious facility;
• selected, managed and controlled by the consumer of the services;
• supplemented with backup and emergency attendant services;
• furnished according to a service plan agreed to by the consumer;

and that include voluntary training on selecting, managing and dismissing attendants.

5) Allows consumers to choose among various service delivery models including vouchers, direct cash payments, fiscal agents and agency providers. All models are required to be consumer controlled.

6) For consumers who are not able to direct their own care independently, the Community Choice Act allows for "individual's representative" to be authorized by the consumer to assist. A representative might be a friend, family member, guardian, or advocate.

7) Allows health-related functions or tasks to be assigned to, delegated to, or performed by unlicensed personal attendants, according to state laws.

8) Covers individuals' transition costs from a nursing facility or ICF-MR to a home setting, for example: rent and utility deposits, bedding, basic kitchen supplies and other necessities required for the transition.

9) Serves individuals with incomes above the current institutional income limitation -- if a state chooses to waive this limitation to enhance employment potential.

10) Provides for quality assurance programs which promote consumer control and satisfaction.

11) Provides maintenance of effort requirement so that states can not diminish more enriched programs already being provided.

12) Allows enhanced match (up to 90% Federal funding) for individuals whose costs exceed 150% of average nursing home costs.

13) Between 2007 and 2011, after which the services become permanent, provides enhanced matches (10% more federal funds each) for states which:

• begin planning activities for changing their long term care systems, and/or
• include Community-based Attendant Services and Supports in their Medicaid State Plan.

SYSTEMS CHANGE

14) Provides grants for Systems Change Initiatives to help the states transition from current institutionally dominated service systems to ones more focused on community based services and supports, guided by a Consumer Task Force.

15) Calls for national 5 -10 year demonstration project, in 5 states, to enhance coordination of services for individuals dually eligible for Medicaid AND Medicare.

Thanks:
NATIONAL ADAPT MAILING LIST - Adapt MiCASA List http://www.adapt.org