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Final Regulations Issued for Community First Choice Option

May 2, 2012

The Centers for Medicare & Medicaid Services (CMS) released final regulations (pdf) for the Community First Choice (CFC) Option after incorporating input from stakeholders, including PHI (pdf).

The CFC Option is a new state plan option in the Medicaid program created by the Affordable Care Act.

States that participate in the CFC Option will receive a six percentage point increase in federal Medicaid matching funds (FMAP) to provide home and community-based services (HCBS) to beneficiaries who would otherwise receive services in an institution.

As noted in a recent Kaiser Family Foundation report, many states continue to face high demand for Medicaid services while state resources are limited.

Some states have implemented — or are considering — a wide range of Medicaid cost-containment measures, including significant cuts in eligibility and benefits for some groups.

Opportunity to Improve Direct-Care Jobs

Not only does the CFC Option offer states additional funding for expanding Medicaid HCBS, it is also an opportunity to improve direct-care jobs, explains a PHI health reform fact sheet (pdf).

“This is an important opportunity for states to achieve their rebalancing goals and invest in a strong personal care attendant (PCA) workforce,” said Carol Regan, PHI government affairs director.

“We urge advocates to promote participation in the CFC Option in their states and to encourage state policymakers to use of some of the new federal funds to improve compensation for PCAs, while expanding services,” Regan said.

Although the CFC Option regulations are final, CMS is seeking additional public comments on how “home and community-based settings” should be defined. That definition will apply to the CFC Option as well as to other Medicaid programs that deliver HCBS.

On an April 27 call with stakeholders, CMS representatives encouraged interested states to proceed with the CFC Option implementation while the definition of “home and community-based settings” is being finalized.

For states deciding to begin implementing the CFC Option, CMS will provide “at least one year” of transition time to allow them to adjust once the final rule defining HCBS settings is published.

– by Gail MacInnes, PHI National Policy Analyst

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