Last week, guidance was released for home- and community-based settings that serve persons at risk for wandering, including those with dementia. In the guidance, the Centers for Medicare & Medicaid Services (CMS) clarified that settings (primarily residential and adult day settings) serving Medicaid beneficiaries at risk for unsafe wandering may employ various kinds of secured egress for the safety of those beneficiaries, as long as a person-centered approach is used for every individual, and safety restrictions are documented in the person-centered service plan.
The guidance also offers best practices and examples of how to ensure individuals' integration in their internal and broader communities. The Association has been working closely with CMS on this important issue since the Home and Community Based Services (HCBS) Final Rule was released in 2014, conducting a series of meetings to ensure that CMS understands the nature of dementia, wandering, and the need to balance safety and autonomy in HCBS settings. These conversations culminated in formal comments and reports by the Alzheimer's Association and the Center for Excellence in Assisted Living (CEAL). We are pleased to see that recommendations from all of these documents are reflected in the new CMS guidance. The Association's comments can be found here;", the CEAL reports here, and CMS' guidance here.
Posted on behalf of Donna K Beal, MPH, MCHES, Vice President of Program Services and Advocacy, Alzheimer's Association California Central Chapter
