The Center for Medicare and Medicaid Services (CMS) has issued a new regulation establishing requirements for the qualities of settings that are eligible for reimbursement.  Medicaid is the primary source of funding for community living support services for adults with Down syndrome and other disabilities.

CMS states that 'In this final rule, CMS is moving away from defining home and community-based settings by "what they are not," and toward defining them by the nature and quality of individuals' experiences.' The home and community-based setting provisions in this final rule establish a more outcome-oriented definition of home and community-based settings, rather than one based solely on a setting's location, geography, or physical characteristics.  All decisions about services and settings must be made through a person-centered planning process.

Overview of the Settings Provision
The final rule requires that all home and community-based settings meet certain qualifications. These include:
* The setting is integrated in and supports full access to the greater community;
* Is selected by the individual from among setting options;
* Ensures individual rights of privacy, dignity and respect, and freedom from   coercion and restraint;
* Optimizes autonomy and independence in making life choices; and
* Facilitates choice regarding services and who provides them.

The states have a transition period in order to implement the changes to the current program.  These regulations represent a major step forward in recognizing the ability of people with disabilities to make decisions about their lives.

In President Obama's State of the Union address, he stated that he would raise the minimum wage of workers on federal contracts by Executive Order.   An Executive Order enables the President to take an action without involvement of the Senate and House of Representatives.  However, in a follow-up White House conference call for the disability community, when questioned, it was stated that the administration does not intend to apply the raised minimum wage to people with disabilities who are currently employed by federal contractors who pay them subminimum wages.

The National Council on Disability has written a letter to the White House stating "as affirmed in the State of the Union address, 'if you cook our troops' meals or wash their dishes, you should not have to live in poverty.'  We agree. Unequivocally, this must apply to all Americans, including people with disabilities. If executive action is appropriate to raise the wages of Americans without disabilities, it should be appropriate to raise the wages of those with disabilities."

Read the entire text of the letter here.