[Hpn] MiCASSA Summary

Thomas Cagle nh-adapt@juno.com
Wed, 09 Apr 2003 05:13:14 -0400


--------- Forwarded message ----------
From: "Stephanie Thomas" <adapt@adapt.org>


If you want this is groovier format feel free to lay it out, or you can
look
on the website www.adapt.org in the MiCASSA section, just change the year
and take off the bill number till we have the new one (after 4/28)!

Medicaid Community-based Attendant Services And Supports Act
of 2003
MiCASSA - A Summary

MiCASSA gives people real choice in long term care options 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.

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.

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