The Interface between PASRR and the Home and Community Based Services Final Rule

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Olmstead ruling, states have made considerable progress in creating opportunities for individuals with disabilities to live in the community, outside of Institutional settings. Yet there is still work to be done. The Home and Community Based Services Final Rule, issued recently by the Center for Medicare and Medicaid Services, stipulates that Medicaid reimbursement for Home and Community Based Services is allowable if individuals are living in settings fully integrated into their communities that afford full access to the benefits of community living. States have until April 2019 to come into compliance with the Final Rule or risk financial penalties. While well intended, the Final Rule may be perceived by some states as a reason to revert back to the use of institutional settings, including nursing facilities, for individuals with disabilities. Agencies and Individuals involved with the PASRR process need to be prepared for a potential increase in demand for PASRR screening and assessments, and to be vigilant in assuring that individuals receive the services, and in the settings, most appropriate to meet their needs and wishes.

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