The Community Choice Act
Senate Bill 683 and House Bill 1670

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.

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;

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 a individual 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 individual 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 for maintenance of effort assurance 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 2005 and 2009, after which the services become permanent, provides enhanced matches (10% more federal funds each) for states which:

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

SYSTEM 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 non-elderly individuals dually eligible for Medicaid AND Medicare.

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