The Centers for Medicare & Medicaid Services hasproposed a rule that would allow more Medicaid beneficiaries to choose theirpersonal care workers instead of relying on the agency to coordinate theservices.

Under the rule, which was on display Monday in theFederal Register, beneficiaries who need assistance with activities of dailyliving could hire, direct, train or fire their own personal care workers. Thoseworkers could include qualified family members who may already be familiar withthe individual’s needs, according to CMS in a statement.

If a state adopts this state plan option, beneficiariescould receive a cash allowance to hire their own workers. Before implementingthis option, the state must have an existing personal care services benefit, orbe operating a home or community-based services waiver program.

Comments are due on the rule by February 19, 2008. Toview the proposed rule visit: http://www.cms.hhs.gov/MedicaidGenInfo/Downloads/CMS2229P.PDF.