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Community Choice Act (CCA)

The Community Choice Act
Senate Bill 683 and House Bill 1670

 Image: Random Faces of ADAPTImage: Random Faces of ADAPT

The Community Choice Act has been introduced by
 Senator Tom Harkin of Iowa and Congressman Danny K. Davis
on March 24, 2009!

Folks from all across the country will be calling in. We'll have speakers and can listen to the introduction of the CCA on Capitol Hill. Write, call and fax your members of Congress to make sure they support the CCA!

The Community Choice Act gives people real choice in long term care options by reforming Title XIX of the Social Security Act (Medicaid) by ending the institutional bias.

The Community Choice Act allows individuals eligible for Nursing Facility Services or Intermediate Care Facility Services for the Mentally Retarded (ICF-MR) the opportunity to choose instead a new alternative, "Community-based Attendant Services and Supports". The money follows the individual!

In addition, by providing an enhanced match and grants for the transition to Real Choice before October 2011 when the benefit becomes permanent, the Community Choice Act offers states financial assistance to reform their long term service and support system to provide services in the most integrated setting.

Specifically, what does this bill do?

1) Provides community-based attendant services and supports ranging from assistance with:

2) Includes hands-on assistance, supervision and/or cueing, as well as help to learn, keep and enhance skills to accomplish such activities.

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:

that include voluntary training on selecting, managing and dismissing attendants.

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:


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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