The California Disability Alliance (CDA) has officially endorsed S. 1935 (Harkin, Specter), the "Medicaid Community Attendant Services and Supports Act of 1999," popularly known among disability rights advocates as MiCASSA.
Sponsored by ADAPT, this bill would require all states to give Medicaid beneficiaries who qualify for nursing home services or for services in an intermediate care facility for the mentally retarded the option of receiving the services for which they qualify in their homes or in small community facilities instead of being institutionalized. Unlike the previous version of this bill (which was carried by Newt Gingrich), this version specifically includes "maintenance of effort" language that will penalize states financially if they try to reduce the state's own spending on home/community-based services. This provides some assurance that MiCASSA would, as intended, supplement current spending on services to keep people with disabilities out of nursing homes instead of just replacing current state dollars.
We are continuing to study S. 1935 and to explore certain aspects of the bill further to determine whether amendments might be necessary or appropriate to strengthen it. But we believe that this bill is a critically important policy advance for people with disabilities throughout the country--one that represents a major shift in official thinking about long-term services.
--Jean Nandi, Marilyn Golden and Laura Remson Mitchell
CDA Executive Committee