All LTSS Provisions in the Health Care Reform Law

By section number in the Affordable Care Act (ACA)

2401 - Community First Choice (CFC) Option 

Allows state Medicaid plans to choose home and community-based services and supports as the rule, rather than the exception, for Medicaid-eligible individuals with disabilities with incomes up to 150% of the Federal Poverty Level, who would otherwise require institutional care. To encourage states to choose this option, states that opt in will receive an additional six percent to the federal government's share of Medicaid costs (referred to as the Federal Matching Assistance Percentage or FMAP) for five years. Effective October 1, 2011.  Learn more about the CFC option.

2402 - Removal of barriers to providing home and community based services (HCBS)

Removes barriers to providing HCBS by amending Section 1915i of the Social Security Act. This provision gives States the option to provide more types of HCBS through a State plan amendment rather than through a waiver.  It applies to individuals with incomes up to 300% of the maximum SSI payment and who have a higher level of need.  It  may extend full Medicaid benefits to individuals receiving HCBS under a State plan amendment.  Effective October 2010.

2403 - Money Follows the Person rebalancing demonstration

Extends the Medicaid MFP rebalancing demonstration through September 2016 and changes the eligibility rules for individuals to participate by requiring that individuals reside in an inpatient facility for not less than 90 consecutive days. Effective 30 days following enactment.   

2404 - Protection for recipients of HCBS against spousal impoverishment

Provides protection for recipients of home- and community-based services against spousal impoverishment. Effective for 5-year period starting January 2014.   

2405  - Funding to expand state aging and disability resource centers

Allocates $10 million per year for 5 years to continue the state Aging and Disability Resource Center (ADRC) initiatives. Funds appropriated for FY 2010-14.   

2406 - Sense of the Senate on long term care

States that Congress should address long-term care services and supports in a comprehensive way that guarantees elderly and disabled individuals the care they need, in the community as well as in institutions.   

8002  - Community Living Assistance Services and Supports (CLASS) Act

Establishes a new long term care (LTC) insurance program, the CLASS Independence Benefit Plan, for the purchase of community living assistance services and supports by individuals with functional limitations.  Automatic enrollment for actively employed adults age 18 and older, with option to opt out. Financed by voluntary payroll deductions or contributions for all eligible adults. No taxpayer funds will be used to pay benefits. Allows for 5-year vesting period for eligibility of benefits; creates benefit triggers that allow for the determination of functional and/or cognitive limitation; and provides cash benefit that is not less than an average of $50 per day with no lifetime or aggregate limit. Requires the Secretary to develop an actuarially sound benefit plan that ensures solvency for 75 years. Establishes a Personal Care Attendants Workforce Advisory Panel.  Effective January 2011.  For more information see: Advance Class.Org

10202 - Incentives for state to offer HCBS as an alternative to nursing homes

Creates a State Balancing Incentive Payments Program to increase the FMAP for states which offer home and community-based services as a long-term care alternative to nursing homes.

Subtitle H - Reporting crimes in LTC facilities

Requires reporting to the Secretary of HHS of  any reasonable suspicion of a crime (as defined by the law of the applicable political subdivision) against any individual who is a resident of, or is receiving care from, the long term care facility.