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Volume 12 Number 104 News: Medicaid Alabama is the first state to receive federal approval to allow self-directed personal assistance services as a feature for its Medicaid plan, eliminating the need for repeated requests for Section 115 or Section 1915(c) waivers, Health and Human Services Secretary Mike Leavitt announced in a May 24 press release. Alabama's new benefit will permit participants to direct their own personal care, homemaker, unskilled respite, and companion services. Alabama will allow participants to hire legally liable relatives to provide care and to use their service budgets to pay for items that increase their independence or substitute for human assistance. The state also will permit participants to receive some "cash" so that goods and services can be purchased directly. Under Section 6087 of the Deficit Reduction Act of 2005 (DRA), states may offer Medicaid beneficiaries the opportunity to direct their own personal care services as a feature of their programs. Prior to Jan. 1, any state interested in introducing this option was required to obtain a Section 115 or 1915(c ) waiver from the Centers for Medicare & Medicaid Services. One-Time Federal Approval States still must seek federal approval to offer this state plan option, but once a state plan amendment has been approved by HHS, no further permission for the added benefit is required. States also must provide necessary safeguards to protect the health and welfare of participants who choose to direct their own care and must ensure that participants have the necessary information, counseling, training, and assistance to enable them to successfully manage their own care. "A number of states have already expressed interest in following Alabama's lead in taking advantage of this DRA provision permitting people to have more control over the services they receive," said acting CMS Administrator Leslie Norwalk. "I look forward to working with more states to provide the most up-to-date care possible for those on Medicaid," Norwalk said.
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