The Community First Choice Option is among the lesser-known provisions of the Affordable Care Act. Formally known as Section 2401, this program offers states additional Medicaid funding to provide home- and community-based attendant services and other support to low-income disabled Americans, keeping them in the community and out of nursing homes.
Under the program, states can get a 6-percentage-point increase in federal Medicaid matching payments to cover costs associated with providing community-based services such as assistance with activities of daily living and instrumental activities of daily living, as well as health-related tasks. States also would have the option of paying for transitions costs, such as the first month's rent when a person moves from a nursing facility back to the community.
Eligibility and requirements associated with the program were outlined in a proposed rule in February; the program is scheduled to begin in October.
Kate Wilber, Ph.D., a gerontology expert at the University of Southern California, Los Angeles, explained how the program could help keep more disabled people in the community.
RN: About 35 states already provide some type of personal care services through Medicaid. Is the increased federal payment likely to expand this much?
RN: What impact will this have on nursing home care?
RN: How can primary care physicians direct their disabled patients toward these programs?
RN: The program requires a “person-centered planning process” and gives individuals the authority to hire, fire, and train their attendants. How does that improve the care provided?
DR. WILBER is the Mary Pickford Foundation Professor of Gerontology at the University of Southern California in Los Angeles.
States might take a 'wait and see' approach to offering a new entitlement in the current economic climate.
Source DR. WILBER