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Legislative Background

The Disability Integration Act builds on the 25 year campaign that ADAPT has done to end the institutional bias and provide seniors and people with disabilities an alternative to unwanted institutionalization. There have been a number of different incarnations of legislation intended to address Medicaid’s institutional bias, starting with the Medicaid Community Attendant Services Act.

Previous versions of legislation were required to do two things: create a Medicaid infrastructure that would meet the assistance needs of all individuals at the institutional level of care and mandate that states implement such a program. Consequently, previous versions of legislation were focused on Medicaid.

However, the Affordable Care Act included language that created the Community First Choice (CFC) Option. This language established a simple Medicaid State Plan option that pre-invests the savings associated with transition to home and community-based services into an incentive of an enhanced FMAP.