Community First Choice Option Included in Senate Finance Committee Legislation

The Community First Choice Option was proposed by Senator Harkin (D-IA) as a way to include the Community Choice Act (CCA) in health care reform. The option would encourage states to provide Medicaid home and community based attendant services (rather than require them as the original CCA would do).

Senator Charles Schumer (D-NY) introduced the language of the CFC Option as an amendment, but Chairman Baucus (D-MT) included it in modifications to his original mark.

Language on the Community First Choice Option from the Chairman’s Mark:

Insert ―The Chairman’s Mark would establish the Community First Choice Option, which would create a state plan option under section 1915 of the Social Security Act to provide community based attendant supports and services to individuals with disabilities who are Medicaid eligible and who require an institutional level of care. These services and supports include assistance toindividuals with disabilities in accomplishing activities of daily living and health related tasks. States who choose the Community First Choice Option would be eligible for enhanced federal match rate of an additional six percentage points for reimbursable expenses in the program. The option would sunset after five years.

―The Community First Choice Option also would require data collection to help determine how states are currently providing home and community based services, the cost of those services, and whether states are currently offering individuals with disabilities who otherwise qualify for institutional care under Medicaid the choice to instead receive home and community based services, as required by the U.S. Supreme Court in Olmstead v. L.C. (1999).

―The Community First Choice Option would also modify the Money Follows the Person Rebalancing Demonstration to reduce the amount of time required for individuals to qualify for that program to 90 days.