Home and Community-Based Services waivers (HCBS waivers) or Section 1915(c) waivers, 42 U.S.C. Ch. 7, § 1396n §§ 1915(c), are a type of

Medicaid waiver Medicaid Waiver programs help provide services to people who would otherwise be in an institution, nursing home, or hospital to receive long-term care Long-term care (LTC) is a variety of services which help meet both the medical and non-medic ...

. HCBS waivers expand the types of settings in which people can receive comprehensive long-term care under Medicaid. Prior to the creation of HCBS waivers, comprehensive long-term care was available through Medicaid only in institutional settings. Under an HCBS waiver, states can use Medicaid funds to provide a broad array of non-medical services (excluding room and board) not otherwise covered by Medicaid, if those services allow recipients to receive care in community and residential settings as an alternative to institutionalization.

History

Section 1915(c) was an amendment to the Social Security Act created as a part of the

Omnibus Budget Reconciliation Act of 1981 The Omnibus Budget Reconciliation Act of 1981 is the federal budget enacted by the 97th United States Congress and signed into law by U.S. President Ronald Reagan. The bill established federal expenditures for fiscal year 1982, which ran from 1 O ...

. Adoption of HCBS waivers by states was initially slow, but Congress has enacted a series of reforms since 1981 to make the use of HCBS waivers less prohibitive. The Supreme Court case, '' Olmstead v. L.C.'' (1999), found unnecessary institutionalization to be a violation of the civil right established by the

Americans with Disabilities Act of 1990 The Americans with Disabilities Act of 1990 or ADA () is a civil rights law that prohibits discrimination based on disability. It affords similar protections against discrimination to Americans with disabilities as the Civil Rights Act of 1964, ...

that service be provided in the

least restrictive environment In the U.S. the Individuals with Disabilities Education Act (IDEA) is a special education law that mandates regulation for students with disabilities to protect their rights as students and the rights of their parents. The IDEA requires that all s ...

. ''Olmstead'' allowed that states could be in compliance with the Americans with Disabilities Act if they could demonstrate that they had a comprehensive, working plan to move people with disabilities into less restrictive settings. This provision along with Centers for Medicare and Medicaid Services guidance on ''Olmstead'' compliance led to rapid adoption by the states of the HCBS waiver.

References

Bibliography

* * * {{cite book , last1=Smith , first1=David G. , last2=Moore , first2=Judith D. , date=2015 , edition=Second , title=Medicaid Politics and Policy , location=New Brunswick, N.J. , publisher=Transaction Publishers , isbn=978-1-4128-5674-4

External links

HCBS Advocacy
– Information for advocates about the new home and community-based services rules Disability law in the United States Mental health law in the United States Federal assistance in the United States Medicare and Medicaid (United States) 1981 in law

History

See also

References

Bibliography

External links