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MiCASSA Once Again has Broad Support in Congress
by Gillian Maguire
June 20, 2002
MiCASSA is alive in Congress again. S 1298, and its companion bill, HR 3612 have been introduced, and co-sponsored by approximately 64 members of Congress. This is at least the third year that MiCASSA in its various forms has been successfully introduced in Congress, thanks to the organizing efforts of ADAPT and the support of hundreds of local, state and national disability rights advocates.
MiCASSA gives people real choice in long term care by reforming Title XIX of the Social Security Act (Medicaid) by ending the institutional bias. MiCASSA allows individuals eligible for Nursing Facility Services or Intermediate Care Facility Services for the Mentally Retarded (ICF-MR) the opportunity to choose instead a new alternative, "Community-based Attendant Services and Supports." The money follows the individual.
In addition, by providing an enhanced match and grants for the transition to Real Choice before October 2005 when the benefit becomes permanent, MiCASSA offers states financial assistance to reform their long term service and support system to provide services in the most integrated setting.
Over the years the bill has been re-written to address concerns of people with disabilities as well as the legislators. Read the full text of MiCASSA.
Read a general summary of MiCASSA, written by ADAPT,
SPECIFICALLY WHAT DOES THIS BILL DO?
1) Provides community-based attendant services and supports ranging from assistance with:
• activities of daily living (eating, toileting, grooming, dressing, bathing, transferring),
• instrumental activities of daily living (meal planning and preparation, managing finances, shopping, household chores, phoning, participating in the community),
• and health-related functions.
2) Includes hands-on assistance, supervision and/or cueing, as well as help to learn, keep and enhance skills to accomplish such activities.
3) Requires services be provided in THE MOST INTEGRATED SETTING appropriate to the needs of the individual.
4) Provides Community-based Attendant Services and Supports that are:
• based on functional need, rather than diagnosis or age;
• provided in home or community settings like -- school, work, recreation or religious facility;
• selected, managed and controlled by the consumer of the services;
• supplemented with backup and emergency attendant services;
• furnished according to a service plan agreed to by the consumer; and that include voluntary training on selecting, managing and dismissing attendants.
5) Allows consumers to choose among various service delivery models including vouchers, direct cash payments, fiscal agents and agency providers. All of these models are required to be consumer controlled.
6) For consumers who are not able to direct their own care independently, MiCASSA allows for "individual’s representative" to be authorized by the consumer to assist. A representative might be a friend, family member, guardian, or advocate.
7) Allows health-related functions or tasks to be assigned to, delegated to, or performed by unlicensed personal attendants, according to state laws.
8) Covers individuals’ transition costs from a nursing facility or ICF-MR to a home setting, for example: rent and utility deposits, bedding, basic kitchen supplies and other necessities required for the transition.
9) Serves individuals with incomes above the current institutional income limitation -- if a state chooses to waive this limitation to enhance the potential for employment.
10) Provides for quality assurance programs which promote consumer control and satisfaction.
11) Provides a maintenance of effort requirement so that states can not diminish more enriched programs already being provided.
12) Allows enhanced match (up to 90% Federal funding) for individuals whose costs exceed 150% of average nursing home costs.
13) Between 2001 and 2005, after which the services become permanent, provides enhanced matches (10% more federal funds each) for states which:
• begin planning activities for changing their long term care systems, and/or
• include Community-based Attendant Services and Supports in their Medicaid State Plan.
Systems Change
14) Provides grants for Systems Change Initiatives to help the states transition from current institutionally dominated service systems to ones more focused on community based services and supports, guided by a Consumer Task Force.
15) Calls for national 5 to 10 year demonstration project in 5 states to enhance coordination of services for non-elderly individuals dually eligible for Medicaid AND Medicare.
CALL TO ACTION
A. Write to Your Congressional Delegation
The more letters and e-mails members of Congress get from real people about the importance of real choice and community living in our lives, the greater the chance this bill will pass this year. Even if you have written in past years, it is very important to write again.
As of this writing, no Washington Senator or Representative has yet signed on as a co-sponsor of this important bill.
If you want your Congressman to sponsor the bill, write them a letter or e-mail. Letters to Congress can emphasize the following things:
1. Why MiCASSA is important to you personally.
2. Why you want your Congressional delegation to sign on as a Co-Sponsor of MiCASSA.
3. Why you want your Congressional delegation to support MiCASSA when it comes up for a vote.
For help in learning how to contact your Senators or Representative, visit this page.
B. Sign your Organization on as a Supporter of MiCASSA
ADAPT has drawn together a really impressive list of hundreds of local, state and national organizations who all believe the principles of MiCASSA. The groups supporting MiCASSA include Project PAS-Port for Change, WPAS, National Association of Protection & Advocacy Systems. Look at the list of supporting organizations throughout the nation. To sign up your organization as a supporter of MiCASSA, contact ADAPT, at www.adapt.org.
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