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Harkin Disability Policy Update
July, 2005

Table of Contents for July 2005:

Update on Medicaid Community-Based Attendant Services and Support Act (MiCASSA)
Update on Money Follows Legislation
Press release on passage of the Training for Realtime Writers Act of 2005
Celebrating the 15th Anniversary of the American with Disabilities Act. A list of events in Iowa

1. Medicaid Community-Based Attendant Services and Support Act (MiCASSA) of 2005

On February 16th, Senator Harkin introduced S. 401, the Medicaid Community Based Services and Supports Act (MiCASSA) of 2005. This bill would increase access to community-based services and supports for individuals with disabilities, and would make home-based attendant care available to Medicaid recipients who are eligible for an institutional level of long-term care.

Under MiCASSA, states would receive increased funding for attendant services and administrative activities to enhance their long-term care infrastructure and improve their ability to provide home and community based services. The bill would also fund demonstration projects to evaluate service coordination and cost sharing approaches for persons who are eligible for both Medicaid and Medicare.

To be eligible for attendant care benefits under MiCASSA, individuals must be eligible for Medicaid and receive a determination that they require a level of care equal to that provided in a nursing facility or intermediate care facility. Services would include attendant care necessary to accomplish one or more activities of daily living or health-related functions. The bill would not cover such things as room and board, special education or vocational rehabilitation services, assistive technologies, durable medical equipment, or home modifications.

In a recent press release regarding MiCASSA, Senator Harkin said: "I strongly believe that it is important to level the playing field and give eligible individuals equal access to community-based services and supports. This vital legislation will open the door to full participation by people with disabilities in our neighborhoods, workplaces, our economy, and our American Dream."

Current co-sponsors of the bill include: Edward Kennedy (D-MA), John Kerry (D-MA), Joseph Biden (D-DE), Mark Dayton (D-MN), Mary Landrieu (D-LA), Jon Corzine (D-NJ), Charles Schumer (D-NY),Frank Lautenberg (D-NJ), Joseph Lieberman (D-CT), Hillary Clinton (D-NY), Paul Sarbanes (D-MD), and Christopher Dodd (D-CT).

2. Money Follows the Person Act of 2005

On March 7, 2005, Senator Harkin introduced S. 528, the Money Follows the Person Act of 2005. S. 528 would provide grants to states for demonstration projects to increase the use of home and community-based, rather than institutional, long-term care for persons with disabilities.

The Money Follows the Person Act would fully reimburse States for providing one year of Medicaid home and community–based services to individuals who move from institutions into their own homes and communities. After the initial year, States would be responsible for matching payments at their usual Medicaid matching rate.

Eligible individuals must have resided in an institution for a minimum period of time (at least six months to two years depending on the state) and have an on-going need for long-term care. They may be required to develop an approved Individualized Service Plan, including a budget for services. Home-based long-term care services could include home health and personal care services and may include one-time transitional expenses.

The bill authorizes $1.75 billion for five years, but could yield States substantial savings in Medicaid spending since home-based care is typically less expensive than institutional care. The bill also stipulates that States cannot reduce current spending for community-based care while receiving project funds and must continue to offer community-based services to individuals after completion of the project.

In a recent press release about the bill, Senator Harkin said: "This initiative would allow people with disabilities and older Americans to have choices we all take for granted… to live with family and friends, not with strangers; to live in a neighborhood, not a nursing home or institution; to eat what you want to eat; not just what is served to you; to go to a restaurant or for a walk anywhere you want to go, and not just on the grounds of a facility."

The bill is also co-sponsored by Senator Edward Kennedy (D-MA), Senator Debbie Stabenow (D-MI), Senator Mike DeWine (R-OH), and Senator Charles Schumer (D-NY).

3. Press Release on the passage of the Training for Realtime Writers Act of 2005

WASHINGTON, D.C. - Senator Tom Harkin (D-IA) today announced that his "Training for Realtime Writers Act of 2005" passed in the Senate last Friday. The 1996 Telecommunications Act mandates that all television programs are captioned by 2006. Harkin's legislation would establish competitive grants to educational institutions to train realtime writers in order to meet this goal.

"Although we have only a few years to go until the deadline set by the Telecom Act, our nation is facing a serious shortage of captioners," Harkin said. "This legislation is essential to ensure that we meet this important goal."

It is estimated that at least 3,000 captioners will be needed to fulfill the upcoming requirement. Unfortunately, today the United States only has 300 trained captioners, and student enrollment in programs that train realtime writers has decreased significantly.

"Realtime writers are needed in order to assist millions of deaf and hard-of-hearing Americans in taking full advantage of television programming," Harkin said.

Since 2002, Harkin has secured $2.17 million in funding for court reporting and captioning programs in Iowa. More than 28 million Americans, or eight percent of the population, are considered deaf or hard-of-hearing and require captioning services to participate in mainstream activities.

Harkin was the chief sponsor of the Americans with Disabilities Act (ADA), landmark legislation which seeks equality of opportunity, full participation, independent living, and economic self-sufficiency for millions of Americans with physical and mental disabilities. He also authored legislation creating the National Institute on Deafness and Communication Disorders.

4. Celebrating the 15th Anniversary of the American with Disabilities Act.

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