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