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A D A P T |

A D A P T  Action Report |



Medicaid Community-Based Attendant Services and Supports Act of 2003

S. 971 and HR 2032: MiCASSA

Adobe Acrobat screen version of the MiCASSA SummaryAdobe Acrobat "PDF" version (Tabloid Print) of the MiCASSA SummaryMiCASSA Summary - text version.

A brief Summary of the

What does MiCASSA do? It gives people real choice in long term care.

MiCASSA: A Summary

MiCASSA gives people real choice in long term services. Amending Title XIX of the Social Security Act (Medicaid), it creates an alternative service called Community Attendant Services and Supports. MiCASSA allows individuals eligible for Nursing Facility Services or Intermediate Care Facility Services for the Mentally Retarded (ICF-MR) the choice to use these dollars for "Community Attendant Services and Supports." THE MONEY FOLLOWS THE INDIVIDUAL!

Specifically what does this bill do?PHOTO: Alfredo Jurez of A D A P T

Provides community attendant services and supports which range from assisting 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.

Includes hands-on assistance, supervision and/or cueing, as well as help to learn, keep and enhance skills to accomplish such activities.

Requires services be provided in THE MOST INTEGRATED SETTING appropriate to the needs of the individual.

Provides Community Attendant Services and Supports that are:

  • based on an assessment of functional need;

  • 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;

  • include voluntary training on selecting, managing and dismissing attendants.

MiCASSA Allows consumers to choose among various service delivery models including vouchers, direct cash payments, fiscal agents and agency providers, all of which are required to be consumer controlled.

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.PHOTO: Chris Colsey of ADAPT surrounded by state police

MiCASSA Allows health-related functions or tasks to be assigned to, delegated to, or performed by unlicensed personal attendants, according to state laws.

MiCASSA 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.

MiCASSA Serves individuals with incomes above the current institutional income limitation -- if a state chooses to waive this limitation to enhance the potential for employment.

MiCASSA Provides for quality assurance programs which promote consumer control and satisfaction.

MiCASSA Allows states to limit the aggregate amount spent on long term care in a year to that amount the state would have spent on institutional services for such eligible individuals in the year.

MiCASSA Provides a maintenance of effort requirement so that states can not diminish more enriched programs already being provided.


MiCASSA also provides grants for Real Choice Systems Change Initiatives to help the states transition from current institutionally dominated service systems to ones more focused on community services and supports.

Each state will create a Consumer Task Force to develop a plan for transitioning services into a more community oriented system. A majority of the members must be people with disabilities or their representatives.

The Secretary of Health and Human Services, along with the National Council on Disabilities, will review regulations and report to Congress on how to reduce excessive use of medical services. The Secretary will also establish a task force to examine financing of long term care services.




The National ADAPT website | The ADAPT Action Report | MiCASSA Information
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