September 5, 2002 

Help America's Seniors and People With Disabilities Get Real Choice for Long Term Support Services 

Dear Colleague: 

Please join us as a co-sponsor of H.R. 3612, the Medicaid Community-Based Attendant Services and Supports Act (MiCASSA) - long-awaited legislation that helps bring our Medicaid system into accord with the Supreme Court's 1999 Olmstead decision. The Olmstead ruling called upon States to end unnecessary institutionalization for people who can remain at home with community support services. 

At present, Medicaid funding is biased against the financing of individual care in community and home-based settings. As a result, our aging parents and hundreds of thousands of younger adults with disabilities who would prefer to receive care in more integrated settings are relegated to living in institutions. The only Medicaid long term care service currently guaranteed by Federal law in every State is nursing home care. Only 27 States have adopted the benefit option of providing personal care services under the Medicaid program. Although every State has chosen to provide certain services under home- and community-based waivers, they are unevenly distributed, have long waiting lists and reach just a small percentage of eligible individuals. 

John M. Shimkus Member of Congress

We can do better. The MiCASSA bill has been put together based on what we have learned from pilot programs and best practices throughout the States. Instead of creating a new entitlement, MiCASSA makes the existing Medicaid entitlement more flexible. It amends Title 19 of the Social Security Act and creates an alternative service called Community Attendant Services and Supports. This allows individuals eligible for Nursing Facility Services or Intermediate Care Facility Services for the Mentally Retarded, regardless of age or disability, the choice to use these dollars for "Community Attendant Services and Supports." 

These attendant services and supports range from assisting with activities of daily living, such as eating, toileting, grooming, dressing, bathing and transferring, as well as other related activities. Although such community-based services have been shown to be less costly than institutional services, the bill also allows states to limit the total amount spent on an individual's long-term care in a year to what the state would have spent on institutional services. 

Whether a child is born with a disability, an adult has a traumatic injury or a person becomes disabled through the aging process, we can and must do better. If you have any questions, please contact Robert Hartt in Congressman Davis' office (ext. 6-7817) or Kelly Childress in Congressman Shimkus' office (ext. 5-5271.) 

Sincerely, 
Danny K. Davis 
Member of Congress
John M. Shimkus 
Member of Congress