MiCASSA introduced in Congress again

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Jan. 29, 2002 — Last Wednesday, Jan. 23, 2002, The Medicaid Community Attendant Services and Supports Act, known as MiCASSA, was introduced into Congress as HR 3612 by Rep. Danny K. Davis (D. – IL) and co-sponsored by Rep. John Shimkus, a Republican, also of Illinois. The bill was first introduced five years ago by Speaker of the House Newt Gingrich. Last August, it was introduced in the Senate by Sens. Tom Harkin (D.-IA), Ted Kennedy (D.-MA), Hillary Rodham Clinton (D.-NY), Joseph Biden (D.-DE) and Arlen Specter (R.-PA) as S. 1298.

The bill would allow people eligible for Medicaid “to use their benefits to purchase community supports such as personal attendants,” writes Inclusion Daily’s Dave Reynolds. “Its passage would signal a radical move from the current system in which most Medicaid funds go to institutions and nursing homes.”

Groups are increasingly fighting the continuing trend to put people in institutions. Last Friday, residents of institutions in California filed a lawsuit against the state for not using its Medicaid dollars to allow them to live in the community. They say the state’s refusal is a violation of the 1999 Supreme Court Olmstead Decision.(Read coverage of the suit from the San Jose Mercury News athttp://www0.mercurycenter.com/premium/local/docs/disabled26a.htm — there’s also a news article athttp://www.raggededgemagazine.com/drn/01_02.shtml#355 )

The grassroots disability rights group American Disabled for Attendant Programs Today is one of the main groups behind MiCASSA. “For decades, people with disabilities, both old and young, have wanted alternatives to nursing homes and other institutions when they need long term services,” says ADAPT. “Our long-term care system has a heavy institutional bias. Every state that receives Medicaid MUST provide nursing home services, but community based services are optional. Seventy-five percent of Medicaid long-term-care dollars pay for institutional services.”

MiCASSA would change this, allowing “dollars to follow the person” who could “choose where they would receive services and supports,” says ADAPT. For a good overview of what the bill would do, visit their website athttp://www.adapt.org/casaintr.htm

To learn more about the Supreme Court Olmstead decision, go tohttp://www.accessiblesociety.org/topics/ada/olmsteadoverview.htm

To follow MiCASSA’s progress in Congress, go to http://thomas.loc.gov/ and search for HR 3612.

More E-Letters

Advocates on 144-mile ‘free our people’ march on Congress: Want to live ‘at home, not in nursing homes’

Sept. 9, 2003 — One hundred and sixty disability rights advocates from nearly 20 states are in the 6th day of their 14-day, 144-mile march from Philadelphia’s Liberty Bell to Washington, DC to press Congress to pass the Medicaid Community-Based Attendant Services and Supports Act. The website www.freeourpeople.org is chronicling the event, with photos available to reporters for downloading, press releases, background information and profiles of marchers.

This is the first time people in wheelchairs have staged such a grueling and difficult march — one reminiscent of the shorter marches undertaken by civil rights activists in the 1960s calling for passage of the Voting Rights Act. “We are marching for our lives, our freedom,” Delaware marcher Daniese McMullin-Powell told the crowd on Saturday as the group paused in its march through the state. “I lost my whole 30’s,” 40-year-old Marlene Turon of Philadelphia told fellow marchers. “I was 31 when I went in and I just got out.” Marcher Ursula Manley of Scranton, who turned 72 on Sunday, said, “”I have no respect for any nursing home.” She told fellow marchers she’d been in a nursing home for 7 years.

Over 15 wheelchairs broke down on Day 1 of the march, but vans were dispatched and wheelchair repair available at the church in Glenolden, PA, where marchers camped. A significant number of the marchers have lived in nursing homes. Some still do.

The Medicaid Community Attendant Services and Supports Act, known as MiCASSA (S971 and HR2032), would redirect the focus of the Medicaid long-term services program from institutions to “home- and community-based services and supports” — requiring Medicaid to pay for services in one’s own home — paying for assistance with bathing, dressing, meal preparation, money management and certain health-related tasks. The bill was first introduced in 1997 by then-Speaker of the House, Rep. Newt Gingrich (R-GA). A 1999 decision by the U.S. Supreme Court in Olmstead vs. L.C. and E.W ruled that keeping people in institutional settings when they could be served in the community constituted discrimination, and was therefore illegal.

Marcher Anita Cameron from Colorado told a reporter back home that she knew firsthand what it’s like to live in a nursing home. “Twenty years ago, the civil rights advocate was committed to a mental institution for a year because she was diagnosed with epilepsy and the courts felt she was a danger to herself,” wrote The Greeley, Co. Tribune’s Matt Schuman. “She wants to make sure no one has to live in one if they choose not to.”

Alice Bozeman told reporters of finding her husband, Ricky Bozeman, in his nursing home bed “lying in feces from his shoulders to knee.” Bozeman kept saying their were “lizards” all over him. Alice discovered that it was mice crawling on him. His wife also found mouse droppings in his dresser drawers” “When you saw what the nursing home was doing to other people and to him it just floored you. You can’t even imagine,” said Bozeman.

“Would you want to live in a nursing home?” ADAPT spokeswoman Judy Neal asks.

Cheryl Hampson of Delaware told reporters she worries “that if she becomes ill after her children move out, she may be forced into a nursing home because of her disability. ‘I’m very, very concerned.’ “

The marchers are part of ADAPT, American Disabled for Attendant Programs Today, the group considered the activist, “direct-action” arm of the U.S. disability rights movement.

Read more about MiCASSA

Follow the progress of MiCASSA athttp://thomas.loc.gov/

More about MiCassa from ADAPT, the group behind the legislation.

Read more about the nation’s institutional bias

What are “personal assistance services?”

OTHER ITEMS OF INTEREST:
The following sites contain information that may be of interest. Please bear in mind that the information at these sites is not controlled by the Center for An Accessible society. Links to these sites do not imply that the Center supports either the organizations or the views presented.

Consumer Choice and Control:
Personal Attendant Services and Supports in
America: Report of the National Blue Ribbon Panel on
Personal Assistance Services, August, 1999Directory of Publicly Funded Personal Assistance Programs from the World Institute on Disability

“Understanding Medicaid Home and Community-Based Services: A Primer” — from the U.S. Dept. of Health and Human Services, available athttp://www.aspe.hhs.gov/daltcp/reports/primer.htm

Information on Home & Community-Based, Consumer-Directed, and Personal Assistance Services from the Office of Disability, Aging and Long-Term Care Policy at the U.S. Dept of Health and Human Services

How States’ “Nurse Practice” Acts work against consumer direction — from the January, 1999 Ragged Edge magazine

MiCASSA

May, 2003 — The Medicaid Community-Based Attendant Services and Supports Act of 2003, or MiCASSA (S. 971 and H.R. 2032), was re-introduced in Congress for the third time. It is the result of efforts of many organizations in the disability community that are trying to get Medicaid to pay for services in one’s own home, not a nursing home. The bill calls for Medicaid funding to be used for personal assistance services and supports for people of all ages in their homes and communities, rather than only in an institution — paying for asssistance with bathing, dressing, meal preparation, money management and certain health-related tasks.

MiCASSA redirects the focus of the Medicaid long-term services program from institutions to home and community services and supports. It enables people to make real choices.

“Most Americans who need long term services and supports would prefer to receive them in home and community settings rather than in institutions,” said Sens. Harkin and Specter in a letter to Senate colleagues when an earlier version of this bill was in Congress. “And yet, too often, decisions relating to the provision of long term services and supports are dictated by what is reimbursable under Federal and state Medicaid policy rather than by what individuals need. Right now, the Medicaid program includes a significant bias toward reimbursing services provided in institutions over services provided in home and community settings (research reveals seventy-five percent of Medicaid funds pay for services provided in institutions).

“We believe that no individual should be forced into an institution to receive reimbursement for services that can be effectively and efficiently delivered in the home or community,” they said.

Read Sens. Harkin’s and Specter’s statement on MiCassa

More about MiCassa from ADAPT, the group behind the legislation.

Read more about the nation’s institutional bias

What are “personal assistance services?”

MiCassa was last introduced in 1999, Read about the 1999 MiCassa in Ragged Edge magazine

More on the 1999 bill from
Liberty Resources
TASH

Follow the progress of MiCASSA at http://thomas.loc.gov/

OTHER ITEMS OF INTEREST:
The following sites contain information that may be of interest. Please bear in mind that the information at these sites is not controlled by the Center for An Accessible society. Links to these sites do not imply that the Center supports either the organizations or the views presented.

Consumer Choice and Control:
Personal Attendant Services and Supports in
America: Report of the National Blue Ribbon Panel on
Personal Assistance Services, August, 1999Directory of Publicly Funded Personal Assistance Programs from the World Institute on Disability

“Understanding Medicaid Home and Community-Based Services: A Primer” — from the U.S. Dept. of Health and Human Services, available athttp://www.aspe.hhs.gov/daltcp/reports/primer.htm

Information on Home & Community-Based, Consumer-Directed, and Personal Assistance Services from the Office of Disability, Aging and Long-Term Care Policy at the U.S. Dept of Health and Human Services

How States’ “Nurse Practice” Acts work against consumer direction — from the January, 1999 Ragged Edge magazine