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.
Minnesota Legal Services Coalition
Attorney Referral Services
The Minnesota State Bar Association statewide referral service
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