On January 10, 2014, the Centers for Medicare & Medicaid Services (CMS) released a long-waited final rule (regulation) about home and community-based services (HCBS) provided through Medicaid’s 1915(c) HCBS Waiver program, 1915(i) HCBS State Plan Option, and 1915(k) Community First Choice. The final rule is the result of multiple proposed rules and public comments over the past five years.
The rule and related CMS fact sheets are available at www.medicaid.gov/HCBS.
Medicaid Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID) are not directly affected by this rule; however, the rule continues to demonstrate an ideological bias against disabled people who find friendships and benefits from living together and accessing services and amenities "under one roof.”
Click here to read additional VOR Observations, Advocacy Opportunities, and an Overview of Key Provisions.
Reform and Reauthorization of the Developmental Disabilities Act Urgently Needed
It has been 13 years since Congress reauthorized the Developmental Disabilities Assistance Act (DD Act). Authorizations for DD Act appropriations expired in 2007, although Congress has continued to fund these programs. DD Act programs, including Protection & Advocacy (P&A), DD Councils, and University Programs, operate in every state. The DD Act programs’ administering agency is the Administration on Intellectual and Developmental Disabilities (AIDD).
Oversight of federal AIDD and DD Act programs is inadequate. Through lobbying, class action lawsuits and other tactics, some DD Act programs are using their public funds to achieve dangerous deinstitutionalization policies, evicting vulnerable people with intellectual disabilities from public and private Medicaid-certified homes, disregarding individual choice and the legal right to appropriate services, as required by the DD Act, the Americans with Disabilities Act (as interpreted by the Supreme Court’s Olmstead decision) and Medicaid law.
We urge Congress to reform the DD Act by taking the following actions:
Additional DD Act Reauthorization Resource
New! VOR Federal Comments Urging Independent Oversight and Unbiased Audit for P&As; More Inclusive Public Input Process Necessary to Ensure Deinstitutionalization Goal Supported by Individuals Directly Impacted by Goal (September 17, 2012)
VOR Federal Comments Urging Objective Performance Measures for State DD Councils (May 28, 2012)
VOR Federal Comments Urging Objective Performance Measures for State Protection & Advocacy Systems (June 28, 2012)
VOR Federal Comments Urging Objective Performance - Not More Self-Reporting - of DD Act Programs
VOR Comments and Objections to "Realizing the Intent of the DD Act: How the DD Network Advances The Independence, Productivity, and Integration of People with Intellectual and Developmental Disabilities" and VOR's Call for a Halt to DD Act Deinstitutionalization Activities Consistent with Clear Congressional Intent
VOR Responds to the National Council on Disability's "Rising Expectations: The Developmental Disabilities Act Revisted" report, released in February 2011.
Supporting Common Sense and the Law: Individuals and Families as 'Primary Decisionmakers'" (June 2011)
"Residential Choice: It's the Law" (June 2011)
The federal Medicaid program provides medical and other program benefits to eligible groups of low-income people who are also categorically eligible, such as people with intellectual disabilities (formerly, "mental retardation") and developmental disabilities. Although the Federal government establishes general guidelines for the program, the Medicaid program requirements are actually established by each State. Most Medicaid services for people with intellectual disabilities are considered optional, that is, provided at the option of a state.