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MiCassa and the current Medicaid crisis
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April 22, 2003 -- It is only a matter of time before MiCassa, the Medicaid Community Attendant Services And Supports Act, is re-introduced in Congress (the bill will be introduced the week of April 28th, according to information from the Alabama Council for Developmental Disabilities).

The bill would change the nation's Medicaid program by allowing funding to "follow the person" -- individuals eligible for nursing facility services or intermediate care facility services would be able to choose instead "community-based services and supports." Read more about the concept behind the bill, and how it would work, at

A just-released evaluation of a pilot program called "Cash and Counseling," which incorporates the "consumer-direction" principles of MiCassa, has generated media attention; the study, not surprisingly, notes that consumers are happier when they hire their own personal assistance and stay in their own homes. The study also debunks the idea that such practices are less "safe" than institutional care (more on the study at

Advocates have long said that allowing people on Medicaid to receive personal assistance in their homes rather than institutions would save money for states as well.

Medicaid is in crisis, and the Administration's proposed relaxation of Medicaid rules does not address this issue. "The Administration's proposal would deconstruct and eviscerate a program that has been the lifeblood of millions of children and adults with disabilities and their families, says the Washington, DC-based Consortium for Citizens with Disabilities ( Advocates have been fighting state Medicaid budget cuts. ADAPT, the group chiefly responsible for MiCassa, has been staging protests against Medicaid cuts in Texas (see the Houston Chronicle story at ); advocates nationwide are holding similar protests.

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