LTO Ventures re: proposed changes to HCBS waiver

LTO Ventures submitted comments today strongly opposing the proposed rule (CMS-2296-P) that would revise the regulations implementing Medicaid home and community-based services (HCBS) waivers under section 1915(c) of the Social Security Act.  Medicaid should be focused on increasing choice and removing barriers to innovation of and investment in residential solutions for adults with Autism Spectrum Disorder.

We strongly oppose the addition of paragraphs § 441.301(b)(1)(iv), (iv)(A), (iv)(B), and
§ 441.302(a)(5) as proposed because:

  • They will create a regulatory precedent that could be used by organizations or persons to oppose innovation of and investment in new residential settings and models
  • They will severely restrict choices of suitable residential settings, denying affected Americans the right to choose and exacerbating an already-critical housing shortage
  • CMS fails to provide a legal or defensible standard for “integration,” “segregation” or “meaningful access” at the same time it seeks to use these terms to determine eligibility
  • CMS fails to establish a defensible correlation between physical structure type, resident density, setting size or location AND suitability of certain residential settings to serve the needs of affected Americans
  • CMS exceeds and abuses its authority in seeking to regulate what settings do not qualify as home and community based settings
  • CMS is mis-using the rule-making process to broadly litigate what it describes as “…isolated situations that have emerged where States and other stakeholders are expressing interest in using HCBS waivers to serve individuals in segregated settings or settings with a strong institutional nature.”

Read our complete comment submission here.

About Mark L. Olson

Mark is father to a teenage daughter with autism. After a successful 25-year marketing and business development career in New York and Silicon Valley with F500 leaders and venture-funded startups, he founded LTO Ventures to serve adults with ASD. He chairs the Community Living Subcommittee for the Nevada Autism Commission, and is a graduate of the University of Kansas. For more information, visit:
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One Response to LTO Ventures re: proposed changes to HCBS waiver

  1. Desi says:

    I think that yes, it’s fair. As long as you have the support stysem (emotional, social, financial) in place so that you will be able to care for both children, and provide for both of their needs which may be very different. As long as one of the kids is not neglected due to the needs of the other child, I think it could be a pretty fantastic experience for everyone involved I am an autistic and adopted only child parenting an autistic only child and I think that the one thing missing from our family is another child. If I were to adopt, I’d lean toward adopting a child with autism, as I can’t imagine raising a non-autistic child or attempting to balance raising one of each (for lack of a better term). I wish we had the option to add another child to our family, but I feel like I’m strapped already (I have rheumatoid/autoimmune arthritis and spine damage). Hope this helps Let us know what you decide!

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