This morning, while for information on independent living centers, I came
across the following bill that I think we should be aware of and help
support - it is called MiCASSA, ( S.1935) introduced by Senator Tom
Harkins, and cosponsored by Sen. Arlen Specter. It would redirect
Medicaid funding policy from emphasizing nursing home care to more
funding for community support services that would allow more disabled and
elderly people to remain in their homes. It would also encourage states
to develop better home care programs. Below is an announcement of the
bill's kick-off campaign on May 3, a summary of the bill and some web
sites that have more information.

FROM: Independent living USA
http://www.ilusa.com

MiCASSA 2000 KICK OFF EVENT - Washington D.C. and around the country!
Dear MiCASSA Supporter:

On Wednesday, May 3rd at noon Eastern time in Washington, D.C., Senator
Tom
Harkin (D - Iowa) and Senator Arlen Specter (R - Pennsylvania) will hold
a
press event to kick off the introduction of MiCASSA, S.1935, the Medicaid
Community Attendant Services and Supports Act.

The Senators, along with organizational and individual MiCASSA
supporters,
will call for bi-partisan Medicaid reform to end the institutionally
biased
long term service system and to give people with disabilities and older
Americans a REAL Choice to live and receive services and supports in
their communities.

In order that MiCASSA Supporters from throughout the country can
participate in this national event, arrangements are being made for a
national telephone conference-call hook up to hear the Senators' remarks
as
well as other kick-off proceedings.

Due to limitations on the phone lines we are asking that groups of 20 or
more people come together on Wednesday May 3rd at an accessible site that
has speaker phone capability to join the national event. Work with other
MiCASSA supporters to select a site agreeable to your community. You will
need to call an 800 number by 11:45 am eastern, 10:45 am central, 9:45 am
mountain and 8:45 am pacific time. (NOTE: THE DEADLINE FOR SETTING UP NEW
SITES is PAST) We encourage outreach to all organizations currently
supporting MiCASSA as well as those who are interested in becoming
MiCASSA Supporters. If you need a list of current Supporters from your
state contact Stephanie at 512/442-0252 or
[log in to unmask]

FROM: MiCASSA FAQ
                         Frequently Asked Questions

     1. How are community attendant services and supports defined in
     MiCASSA?

     In MiCASSA, the term community attendant services and supports
     means help with accomplishing activities of daily living (eating,
     toileting, grooming, dressing, bathing, and transferring)
     instrumental activities of daily living (meal preparation,
     managing finances, shopping, household chores, phoning, and
     participating in the community), and health-related functions
     (which can be delegated or assigned as allowed by state law).
     These can be done through hands-on assistance, supervision and/or
     cueing. They also include help with learning, keeping and
     enhancing skills to accomplish such activities.

     These services and supports, which include back-up, are designed
     and delivered under a plan that is based on a functional needs
     assessment and agreed to by the individual. In addition they are
     furnished by attendants who are selected, managed, and dismissed
     by the individual, and include voluntary training for the
     individual on supervising attendants.

     MiCASSA specifically states that services should be delivered,
     "in the most integrated setting appropriate to the needs of the
     individual" in a home or community setting, which may include a
     school, workplace, or recreation or religious facility.

    Do you have to be impoverished to be eligible for MiCASSA?

     No. If you are eligible to go into a nursing home or an ICF-MR
     facility you would be eligible for MiCASSA. Financial eligibility
     for nursing homes is up to 300% of the SSI level (roughly $1,500
     for a single person). In addition, states can choose to have a
     sliding fee scale for people of higher incomes; MiCASSA
     specifically references this as an incentive for employment. This
     sliding fee scale can go beyond the current Medicaid eligibility
     guidelines.

   Options include vouchers, direct cash payments or a
     fiscal agent, in addition to agency delivered services. In all
     these delivery models the individual has the ability to select,
     manage and control his/her attendant services and supports, as
     well as help develop his/her service plan. Choice and control are
     key concepts, regardless of who serves as the employer of record.

       Why is MiCASSA needed?

     Our current long-term services system has a strong institutional
     bias.  *** Seventy five percent of Medicaid long term care dollars
go
     to institutional services, leaving 25% to cover all the
     community-based services. Every state that takes Medicaid funds
     must provide nursing home services while community based services
     are completely optional for the states. MiCASSA says, let's level
     the playing field, give the person, instead of government or
     industry, the real choice.

  What is the purpose of the Real Choice Systems Change
     Initiatives section of the bill?

     MiCASSA brings together on a consumer task force, the major
     stakeholders in the fight for community-based attendant services
     and supports. Representatives from DD Councils, IL Councils and
     Councils on Aging along with consumers and service providers
     would develop a plan to transition the current institutionally
     biased system into one that focuses on community-based attendant
     services. Closing institutions, or at least closing bed spaces
     must be thought through by the people that have an investment in
     the final outcome, the consumers. The plan envisions ending the
     fragmentation that currently exists in our long-term service
     system.

     In addition, the bill sets up a framework and funding to help the
     states transition from their current institutionally dominated
     service model to more community-based services and supports.
     States will be able to apply for systems change grants for things
     like: assessing needs and gathering data, identifying ways to
     modify the institutional bias and over medicalization of services
     and supports, coordinating between agencies, training and
     technical assistance, increasing public awareness of options,
     downsizing of large institutions, paying for transitional costs,
     covering consumer task force costs, demonstrating new approaches,
     and other activities which address related long term care issues.

 FROM: THOMAS
Bill Summary & Status for the 106th Congress
S.1935
Sponsor: Sen Harkin, Tom (introduced 11/16/1999)
Latest Major Action: 11/16/1999 Referred to Senate committee
Title: A bill to amend title XIX of the Social Security Act to provide
for
coverage of community attendant services and supports under the medicaid
program.

TITLE(S):  (italics indicate a title for a portion of a bill)
   * SHORT TITLE(S) AS INTRODUCED:
     Medicaid Community Attendant Services and Supports Act of 1999

   * OFFICIAL TITLE AS INTRODUCED:
     A bill to amend title XIX of the Social Security Act to provide for
     coverage of community attendant services and supports under the
     medicaid program.
STATUS: (color indicates Senate actions) (Floor Actions/Congressional
Record Page References)

11/16/1999:
     Read twice and referred to the Committee on Finance.

COMMITTEE(S):
     Committee/Subcommittee:    Activity:
     Senate Finance             Referral
COSPONSORS(1),
 Sen Specter, Arlen - 11/16/1999

MOST RECENT SUMMARY:
11/16/1999--Introduced.
Medicaid Community Attendant Services and Supports Act of 1999 - Amends
title XIX (Medicaid) of the Social Security Act to: (1) provide for
Medicaid coverage of community attendant services and supports for
eligible
individuals with disabilities; (2) direct the Secretary of Health and
Human
Services to award grants to eligible States which have established a
Consumer Task Force to assist the State in its development of real choice
systems change initiatives with regard to consumer-responsive long-term
services to eligible individuals; (3) direct the National Council on
Disability to review and report to Congress on certain Medicaid
regulations
on home health and personal care services; and (4) direct the Secretary
to
establish a task force to examine appropriate methods for financing
long-term services and supports. Directs the Secretary to report to
Congress on how expenditures under the Medicaid program can be reduced by
the furnishing of community attendant services and supports under this
Act.
Authorizes appropriations.

SEE ALSO:

MiCASSA
http://www.npnd.org/MiCASAHOME.htm

Disability Advocacy World Wide
http://www.tash.org/govaffairs/support_micassa_now.htm

Adapt
http://www.adapt.org/casaintr.htm