Understanding Medicaid Home and Community Services: A Primer, 2010 Edition. Publications


Crisp, S., Doty, P., Flanagan, S., Smith, G., O’Keeffe, J., et al. (2009).Developing and Implementing Self-Direction Programs and Policies: A Handbook. Chestnut Hill, MA: National Resource Center for Participant-Directed Services.

This publication was developed to provide state staff, policymakers, service providers, program participants, and other stakeholders with a single comprehensive source of information about participant direction programs and policies.

Available as the full handbook at http://www.cashandcounseling.org/resources/handbook

Available as individual chapters using the following links:

Chapter 1: Self-Direction http://www.cashandcounseling.org/resources/pdf/cc-01.pdf
Chapter 2: Legal Authority http://www.cashandcounseling.org/resources/pdf/cc-02.pdf
Chapter 3: Involving Participants http://www.cashandcounseling.org/resources/pdf/cc-03.pdf
Chapter 4: Enrollment http://www.cashandcounseling.org/resources/pdf/cc-04.pdf
Chapter 5: Individual Budgeting http://www.cashandcounseling.org/resources/pdf/cc-05.pdf
Chapter 6: Counseling http://www.cashandcounseling.org/resources/pdf/cc-06.pdf
Chapter 7: Fiscal/Employer Agent Services http://www.cashandcounseling.org/resources/pdf/cc-07.pdf
Chapter 8: Quality Management in Self-Direction Programs http://www.cashandcounseling.org/resources/pdf/cc-08.pdf
Chapter 9: Self-Direction and Health Care http://www.cashandcounseling.org/resources/pdf/cc-09.pdf
Chapter 10: Looking Ahead http://www.cashandcounseling.org/resources/pdf/cc-10.pdf
Appendix I: Using Strategic Communications http://www.cashandcounseling.org/resources/pdf/cc-app1.pdf
Appendix II: The Consumer Direction Module http://www.cashandcounseling.org/resources/pdf/cc-app2.pdf
Appendix III: History of Self-Direction http://www.cashandcounseling.org/resources/pdf/cc-app3.pdf

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CMS State Medicaid Director Letter (November 19, 2009). Implementation of §6087 of DRA §1915(j).

This letter provides guidance on the implementation of §6087 of the Deficit Reduction Act of 2005, Public Law Number 109-171. Section 6087, the “Optional Choice of Self-Directed Personal Assistance Services (PAS) (Cash and Counseling),” amended §1915 of the Social Security Act by adding a new subsection (j). The guidance also applies to §1915(c) HCBS waiver programs when states offer the self-direction opportunity and permit participants to purchase “Individual Directed Goods and Services.” The letter offers information on (1) Background, (2) Medicaid Authorities, (3) Criteria, (4) Support and Monitoring, and (5) Compliance with the Guidance.

Available at http://www.cms.hhs.gov/SMDL/SMD/ItemDetail.asp?ItemID=CMS1230894

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CMS. (2008). Application for a §1915(c) Home and Community-Based Waiver [Version 3.5]: Instructions, Technical Guide and Review Criteria.

The Application contains extensive information concerning Federal policies that apply to the operation of an HCBS waiver, in particular, Appendix E: Participant Direction of Services, which addresses how the waiver affords participants the opportunity to direct some or all of their waiver services. The addition of Appendix E to the waiver application recognizes that participant direction is an increasingly common feature of waivers.

Available at https://www.hcbswaivers.net/CMS/faces/portal.jspunder links and downloads, entitled §1915(c) Waiver Application and Accompanying Materials.

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Brown, R., Lepidus Carlson, B., Dale, S., Foster, L., Phillips, B., and Schore, J. (2007). Cash & Counseling: Improving the Lives of Medicaid Beneficiaries Who Need Personal Care or Home and Community-Based Services. Princeton, NJ: Mathematica Policy Research, Inc.

This report summarizes the findings from 5 years of research by Mathematica Policy Research, Inc. on how each of the three Cash and Counseling Demonstration states implemented its program, and on how the programs have affected participants, their paid and unpaid caregivers, and Medicaid costs.

Available at http://www.cashandcounseling.org/resources/20070910-145713/index_html

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