Wandering Poses Challenges for New Medicaid Waiver Rules
Federal officials are chiming in on how to balance independence and safety for people with disabilities who have a tendency to wander. In a recently-issued frequently asked questions document, the Centers for Medicare and Medicaid Services said that there have been concerns as states work to implement new regulations governing Medicaid home and community-based services waivers. The regulations, which are set to take full effect in March 2019, establish new standards for what settings are considered community-based. Services paid for through Medicaid home and community-based services funds cannot be provided at nursing homes, institutions or intermediate care facilities under the rule. Moreover, settings must be integrated in the community in places where individuals choose to live and those receiving services must be allowed to make independent choices about their activities, physical environment and interactions with others. Those requirements may pose special challenges when serving individuals with disabilities who elope, Medicaid officials acknowledged in issuing the guidance document. “As states, providers, beneficiaries and other stakeholders determine a strategy for complying with the setting requirements,” federal officials wrote, “questions have arisen on how to adhere to the individualized nature of service provision for individuals with dementia or other conditions in which unsafe wandering or exit-seeking behavior is exhibited.”
David Wingate is an elder law attorney at the Elder Law Office of David Wingate, LLC. The elder law office services clients with powers of attorneys, living wills, Wills, Trusts, Medicaid and asset protection. The Elder Law office has locations in Frederick and Montgomery Counties, Maryland.