Medicaid Consumer-Directed Care Act

Medicaid Consumer-Directed Care Act

 Summary

The purpose of this Act is to allow consumers to be in charge of directing their own care.  In the existing system, disabled Medicaid beneficiaries have very little control over the long term care services they receive.  This legislation is designed to provide consumers more independence, flexibility, and choice in determining and arranging their care.  It challenges the notion that all Medicaid recipients are incapable of managing their own care effective and responsibly.  The Medicaid Consumer Directed Care Act is designed to provide control to eligible persons so that they might purchase the kind of services that are best for them.

Model Legislation

Section 1. Title. The Act may be cited as the “Medicaid Consumer Directed Care Act.”

Section 2. Definitions.

(A) “Eligible Medicaid beneficiaries” means the following:

(1) Frail elders (ages 60 +) who are receiving 1915(c) Medicaid waiver services;

(2) Adults with physical disabilities (ages 18-64) who are receiving Medicaid home and community based waiver services;

(3) Children (ages 3-17) with developmental disabilities who are receiving  Medicaid home and community based waiver services; and

(4) Adults (ages 18-64) with developmental disabilities who are receiving Medicaid home and community based waiver services.

(B) “Eligible services” means care received in the home or in the community by eligible Medicaid beneficiaries that meets the long-term care needs that would otherwise make them at risk for institutional placement.

Section 3.

The Department of Health and Human Services shall establish within Medicaid this program to allow eligible Medicaid beneficiaries, as defined above, to receive a cash allowance or control of a specific budget so that they might purchase the long term care services of their own choosing.
The Department of Health and Human Services will provide a case manager/consultant to assist the participant.  The Department of Health and Human Services will assess the participant’s needs and establish the budget.

Section 4. {Severability Clause.}

Section 5. {Repealer Clause.}

Section 6. {Effective Date.}

 

Reapproved by ALEC Board of Directors on January 28, 2013.

Keyword Tags: Public Health Insurance Reform