DE

Comments below and also attached. February 11, 2008 Centers for Medicare & Medicaid Services Department of Health & Human Services Attn: CMS-2237-IFC P.O. Box 8016 Baltimore, MD 21244-8016 Re: Comments on CMS2229P (Personal Care Services) Dear Sirs/Madams: I write on behalf of the State Council for Persons with Disabilities (SCPD) to endorse the concept of the CMS proposed rule that would allow individuals with disabilities who receive Medicaid to be in charge of their own personal assistance services, including personal care services. As background, SCPD is charged in 29 Del.C. Section 8734 with the responsibility of proposing and promoting laws, regulations, programs and policies to improve the well-being of persons with disabilities. Consistent with its stated mandate, Council has the following observations. At present, the Delaware Division of Services for Aging and Adults with Physical Disabilities operates a personal attendant services program consistent with the proposed rule. The program is for individuals with disabilities who need help with the activities of daily living and allows them to hire, direct, train and fire their own personal attendants rather than working with personnel employed by an agency. Individuals can even hire qualified family members who may already be familiar with the individual?s needs to perform personal assistance services. This program enjoys a terrific ?track record? and the latest consumer satisfaction surveys were overwhelmingly positive. SCPD agrees with Kerry Weems, CMS Acting Administrator who reported that: ?This proposal would give Medicaid beneficiaries significant new freedom to determine how their personal assistance services are delivered and by whom. As health care is not simply an economic transaction, this proposal represents a fundamental shift that restores a person?s ability to improve their overall health by taking greater control of his or her own decisions.? It is SCPD understanding that if a state adopts a self-directed personal assistance services state plan option, beneficiaries could receive a cash allowance to hire their own workers to help with such activities as bathing, preparing meals, household chores and other related services that help a person to live independently. Allotments could also be used to purchase items that help foster independence such as a wheelchair ramp or microwave oven. The beneficiaries also have the option to have their cash benefit allotment managed for them. Enactment of such an option appears logical given Delaware?s award of a MFP Demonstration Grant by CMS Thank you for your consideration and please contact SCPD if you have any questions or comments regarding our observations on the proposed regulation. Sincerely, Daniese McMullin-Powell, Chairperson State Council for Persons with Disabilities cc: Mr. Harry Hill, DMMA Ms. Zel Cannon Developmental Disabilities Council Governor?s Advisory Council for Exceptional Citizens P&l/cms reg 2229p 2-08