Action Alert

October 11, 2005

NCIL INFORMATION ALERT: Recent Developments in Advocacy for Home And Community Based Services

This is the first in a series of three alerts on Medicaid and Home and Community Based Services and supports issues that NCIL will issue this week. We are currently in the midst of a very tough legislative environment in which there are very real concerns that policymakers may sacrifice the best interests of beneficiaries to meet arbitrary targets as a part of the approaching budget reconciliation process. Despite this challenging outlook, we have an opportunity to possibly achieve policy breakthroughs in expanding access to home and community-based Services for persons.

This first alert will advise you of the latest developments on legislation that NCIL currently supports involving home and community based services. Next, we will send you a call to action, asking you to take specific steps to send your Senators and Representative the message that Congress needs to ACT NOW to take concrete steps to expand the availability of Home and Community Based Services for persons with disabilities. Finally, we will ask you to contact your elected officials to urge them not to make changes to Medicaid that would go against the best interests of beneficiaries – such as increased cost-sharing or diminished protections of beneficiaries’ rights.

MiCASSA [H 910/ S 401] and Money Follows the Person
[H 3063/ S 528] Gain Momentum in Congress.

Though we are still well short of the 105 MiCASSA sponsors that we had in the House by the end of the 108th Congress, NCIL is pleased to report that H 910 has picked up 20 sponsors over the past month alone! This brings the total number of MiCASSA sponsors in the House to 48. New cosponsors include Republicans Sherwood Boehlert  [NY-24], James Walsh [NY-25] and Jerry Moran [KS-1], Independent Bernard Sanders [VT], and sixteen Democratic members. The sixteen new Democratic co-sponsors include Edolphus Towns [NY-10], Tom Lantos [CA-12], Lynn Woolsey [CA-6], Harold Ford Jr. [TN-9], Collin Peterson [MN-7], Louise Slaughter [NY-28], Luis Guttierez [IL-4], Rahm Emanuel [IL-5], Peter Visclosky [IN-1], Mark Udall [CO-2], Neil Abercrombie [HI-1], Brad Miller [NC-13] as well as Health Subcommittee members, Tammy Baldwin [WI-2], Gene Green [TX-29], Anna Eshoo [CA-14] and Diana DeGette [CO-1]. Since June, the total number of sponsors of S 401, the Senate version of MiCASSA, has remained unchanged at 15 – five less than MiCASSA had during the 108th Congress.

In the last month, H 3063, the House version of Money Follows the Person, has also gained momentum, picking up seven additional sponsors, including Thaddeus McCotter [R, MI-11], who became the first House Republican to officially endorse Money Follows the Person. The other six new sponsors are Independent Bernard Sanders [VT] and Democrats Anna Eshoo [CA-14], Tom Lantos [CA-12], Michael Capuano [MA-8], Silvestre Reyes [TX-16] and Peter Visclosky [IN-1]. This is the first Congress in which Money Follows the Person has been introduced in the House. The number of Senate sponsors for Money Follows the Person [S 528] has stayed unchanged at 7 since mid-July. During the 108th Congress, Money Follows the Person had 11 sponsors. See below and attached for the complete lists of sponsors for MiCASSA and Money Follows, as well as lists of who sponsored these bills during the 108th Congress.

NCIL endorses new proposal, Section 201 of S 1602, to make Home and Community Based Services available without waiver.

On July 29, 2005, just before Congress started August recess, Senators Charles Grassley (R-IA), Hillary Clinton (D-NY) and Evan Bayh (D-IN) introduced S 1602, the “Improving Long-Term Care Choices Act of 2005,” a bipartisan bill designed to promote home and community based services and make long-term care insurance more affordable. NCIL supports Section 201 of the bill, which would provide states with a new option to offer home and community based services to Medicaid-eligible individuals without having to get a federal waiver. States would also be able to permit people to choose to self-direct services. Under the self-direction model, states would be required to establish more rigorous eligibility standards for institutionalization than for placement in community settings. In his statement introducing the bill Senator Grassley explained,"…[T]he legislation I am introducing today compliments rather than supplants my efforts to enact Family Opportunity Act and Money Follows the Person. I believe we should provide a wide range of options to the states to encourage them to identify and eliminate barriers to community living including access to consumer direction and respite care."

After careful study, NCIL’s Health Care-Personal Assistance Services and Support Subcommittee submitted a letter in support of Section 201 of S 1602 late last month. Please find this letter below and attached. We welcome the provisions of Section 201 of the “Improving Long-Term Care Choices Act of 2005,” which are clearly consistent with NCIL’s legislative goals as well as the clear statement that Chairman Grassley is striving to enact Money Follows the Person.

FOR MORE INFORMATION: E-mail NCIL Acting Director of Advocacy and Public Policy Daniel Davis at daniel@ncil.org or Health Care- PASS Subcommittee Co-Chair Judy Roy at bhamilc@bellsouth.net

Letter to Senator Grassley re: Section 201 of S 1602

21 September 2005
The Honorable Charles E. Grassley
United States Senate
135 Hart Building
Washington, D.C.  20515
Re:  Support for Section 201 of S. 1602

Dear Senator Grassley:

On behalf of the Health Care/ Personal Assistance Services and Supports Subcommittee and the membership of the National Council on Independent Living, we are writing to express our support for Section 201 of S 1602, the “Improving Long Term Care Choices Act.”  We thank you for your leadership in introducing this provision, which represents a proactive bipartisan initiative to expand the range of options for the delivery of long-term care services.

We support Section 201 because it contains the following provisions:

NCIL commends you on your leadership and pledges our continued assistance to work with your office to expand the range of long term care options for people with disabilities and older Americans.

Respectfully,

John Lancaster, Executive Director
Kelly Buckland, President

H.R.910  MICASSA [HOUSE]

Title: To amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes.

Sponsor: Rep Davis, Danny K. [IL-7] (introduced 2/17/2005)    Cosponsors: (47)

Latest Major Action: 3/14/2005 Referred to House subcommittee. Status: Referred to the Subcommittee on Health. (Members of this subcommittee indicated with an “*”)

Rep Shimkus, John                              [R, IL-19]* - 2/17/2005

Rep Biggert, Judy                              [R, IL-13] - 4/5/2005

Rep Moore, Dennis                              [D, KS-3] - 4/5/2005

Rep Bonner, Jo                                 [R, AL-1] - 4/5/2005

Rep Kildee, Dale E.                            [D, MI-5] - 4/5/2005

Rep English, Phil                              [R, PA-3] - 4/5/2005

Rep Doggett, Lloyd                             [D, TX-25] - 4/5/2005

Rep Cummings, Elijah E.                        [D, MD-7] - 4/19/2005

Rep Kaptur, Marcy                              [D, OH-9] - 5/19/2005

Rep Waxman, Henry A.                         [D, CA-30]* - 5/19/2005

Rep Hinchey, Maurice D.                        [D, NY-22] - 5/19/2005

Rep Bishop, Sanford D., Jr.                    [D, GA-2] - 5/19/2005

Rep McHugh, John M.                            [R, NY-23] - 5/19/2005

Rep Larson, John B.                            [D, CT-1] - 5/19/2005

Rep Langevin, James R.                        [D, RI-2] - 5/19/2005

Rep Pascrell, Bill, Jr.                        [D, NJ-8] - 5/26/2005

Rep Payne, Donald M.                           [D, NJ-10] - 5/26/2005

Rep Kind, Ron                                  [D, WI-3] - 5/26/2005

Rep Christensen, Donna M.                      [D, VI] - 5/26/2005

Rep Holt, Rush D.                              [D, NJ-12] - 5/26/2005

Rep Schakowsky, Janice D.                      [D, IL-9] - 5/26/2005

Rep McNulty, Michael R.                        [D, NY-21] - 5/26/2005

Rep Weller, Jerry                              [R, IL-11] - 6/16/2005

Rep Ryun, Jim                                  [R, KS-2] - 6/16/2005

Rep Reyes, Silvestre                           [D, TX-16] - 6/16/2005

Rep Rahall, Nick J., II                        [D, WV-3] - 6/16/2005

Rep Grijalva, Raul M.                          [D, AZ-7] - 7/12/2005

Rep Towns, Edolphus                            [D, NY-10] - 9/8/2005

Rep Sanders, Bernard                           [I, VT] - 9/8/2005

Rep Green, Gene                                [D, TX-29] *- 9/8/2005

Rep Lantos, Tom                                [D, CA-12] - 9/8/2005

Rep Woolsey, Lynn C.                           [D, CA-6] - 9/8/2005

Rep Baldwin, Tammy                            [D, WI-2]* - 9/8/2005

Rep Eshoo, Anna G.                             [D, CA-14] *- 9/8/2005

Rep Ford, Harold E., Jr.                       [D, TN-9] - 9/20/2005

Rep Peterson, Collin C.                        [D, MN-7] - 9/20/2005

Rep Boehlert, Sherwood                         [R, NY-24] - 9/20/2005

Rep Slaughter, Louise McIntosh              [D, NY-28] - 9/20/2005

Rep Moran, Jerry                               [R,  KS-1] - 9/20/2005

Rep Gutierrez, Luis V.                         [D,  IL-4] - 9/20/2005

Rep Walsh, James T.                            [R,  NY-25] - 9/22/2005

Rep Visclosky, Peter J.                        [D, IN-1] - 9/22/2005

Rep Emanuel, Rahm                              [D, IL-5] - 9/29/2005

Rep Udall, Mark                                [D, CO-2] - 9/29/2005

Rep Abercrombie, Neil                          [D, HI-1] - 10/7/2005

Rep Miller, Brad                               [D, NC-13] - 10/7/2005

Rep DeGette, Diana                             [D, CO-1]* - 10/7/2005

[10 Republicans, 37 Democrats, 1 Independent]

Top States: 7 Illinois, 7 New York, 4 California, 3 Texas, 3 Kansas, 3 NJ

S. 401  MICASSA [SENATE]

Title: A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes.

Sponsor: Sen Harkin, Tom [IA] (introduced 2/16/2005)      Cosponsors (14)

Latest Major Action: 2/16/2005 Referred to Senate committee. Status: Read twice and referred to the Committee on Finance.

Sen Specter, Arlen [R- PA] - 2/16/2005

Sen Kerry, John F. [D- MA] - 2/16/2005

Sen Kennedy, Edward M. [D- MA] - 2/16/2005

Sen Biden, Joseph R., Jr. [D- DE] - 2/16/2005

Sen Dayton, Mark [D- MN] - 2/16/2005

Sen Landrieu, Mary L. [D- LA] - 2/16/2005

Sen Schumer, Charles E. [D- NY] - 2/16/2005

Sen Corzine, Jon S. [D- NJ] - 2/16/2005

Sen Lautenberg, Frank R. [D -NJ] - 2/16/2005

Sen Lieberman, Joseph I. [D- CT] - 2/16/2005

Sen Dodd, Christopher J. [D- CT] - 2/16/2005

Sen Sarbanes, Paul S. [D - MD] - 3/10/2005

Sen Clinton, Hillary Rodham [D- NY] - 5/23/2005

Sen Durbin, Richard [D-IL] - 6/21/2005

S. 528 Money Follows the Person [Senate]

Title: A bill to authorize the Secretary of Health and Human Services to provide grants to States to conduct demonstration projects that are designed to enable medicaid-eligible individuals to receive support for appropriate and necessary long-term services in the settings of their choice.

Sponsor: Sen Harkin, Tom [IA] (introduced 3/3/2005)      Cosponsors (6)

Latest Major Action: 3/3/2005 Referred to Senate committee. Status: Referred to the Committee on Finance.

Sen Smith, Gordon H. [R- OR] - 3/3/2005

Sen Kennedy, Edward M. [D- MA] - 3/10/2005

Sen DeWine, Mike [R- OH] - 3/10/2005

Sen Stabenow, Debbie [D- MI] - 5/23/2005

Sen Clinton, Hillary Rodham [D- NY] - 7/21/2005

Sen Schumer, Charles E. [NY] - 7/21/2005

HR 3063 Money Follows the Person [House]

Title: To authorize the Secretary of Health and Human Services to provide grants to States to conduct demonstration projects that are designed to enable Medicaid-eligible individuals to receive support for appropriate and necessary long-term services in the settings of their choice.

Sponsor: Rep Kildee, Dale E. [MI-5] (introduced 6/24/2005)  Cosponsors: (10) Latest Major Action: 6/24/2005 Referred to House committee. Status: Referred to the House Committee on Energy and Commerce.

COSPONSORS(10)

Rep Boucher, Rick [D, VA-9] - 7/28/2005

Rep Price, David E. [D, NC-4] - 7/28/2005

Rep Moore, Dennis [D, KS-3] - 7/28/2005

Rep Eshoo, Anna G. [D, CA-14] - 10/6/2005

Rep McCotter, Thaddeus G. [R, MI-11] - 10/6/2005

Rep Lantos, Tom [D, CA-12] - 10/6/2005

Rep Capuano, Michael E. [D, MA-8] - 10/6/2005

Rep Reyes, Silvestre [D, TX-16] - 10/6/2005

Rep Visclosky, Peter J. [D, IN-1] - 10/6/2005

Rep Sanders, Bernard [I, VT] - 10/6/2005

Section 201 of S 1602, “Improving Long-Term Care Choices Act”

Title: A bill to amend title XIX of the Social Security Act to require States to disregard benefits paid under long-term care insurance for purposes of determining medicaid eligibility, to expand long-term care insurance partnerships between States and insurers, to amend the Internal Revenue Code of 1986 to allow individuals a deduction for qualified long-term care insurance premiums, the use of such insurance under cafeteria plans and flexible spending arrangements, and a credit for individuals with long-term care needs, to establish home and community based services as an optional medicaid benefit, and for other purposes.

Sponsor: Sen Grassley, Chuck [IA] (introduced 7/29/2005)      Cosponsors (2)

Latest Major Action: 7/29/2005 Referred to Senate committee. Status: Read twice and referred to the Committee on Finance.

COSPONSORS(2),

Sen Bayh, Evan [IN] - 7/29/2005

Sen Clinton, Hillary Rodham [NY] - 7/29/2005

CoSponsors of Money Follows the Person and MiCASSA during the 108th Congress

MiCASSA (HOUSE OF REPRESENTATIVES)

HR 2032                                         108th Congress

In the 108th Congress MiCASSA had105 sponsors and co-sponsors in the House of Representatives, 85 Democrats, 19 Republicans and 1 Independent.  Those who have not returned to Congress are indicated with an asterisk (*) For the state of Texas, which was redistricted effective November, 2004, the districts listed reflect the boundaries in effect when the 108th Congress was elected.

LEAD SPONSORS

Danny Davis [D, IL-7]                           5/8/03

John Shimkus [R, IL-19]                         5/8/03

CO-SPONSORS

Lloyd Doggett [D, TX-10]                        5/8/03

Mark Udall [D, CO-2]                            5/8/03

Dennis Moore [D, KS-3]                          5/8/03

Michael McNulty [D, NY-21]                      5/8/03

Elliot Engel [D, NY-17]                         5/8/03

Jim Ryun [R, KS-2]                              5/8/03

Ruben Hinojosa [D,TX-15]                        5/8/03

John McHugh, [R, NY-23]                         5/8/03

Tim Holden, [D, PA-17]                          5/8/03

Barbara Lee, [D, CA-9]                          5/8/03

Michael Doyle, [D, PA-14]                       5/8/03

Steny Hoyer, [D, MD-5]                          5/8/03

Janice Schakowsky, [D, IL-9]                    5/8/03

Edolphus Towns,  [D, NY-10]                     5/8/03

Maurice Hinchey, [D, NY-22]                     5/8/03

Jose Serrano [D, NY-16]                         5/8/03

Donald Payne, [D, NJ-10]                        5/8/03

Raul Grijalva [D, AZ –7]                        5/8/03

Dale Kildee [D, MI-5]                           5/8/03

Robert Brady, [D, PA-1]                         5/8/03

Frank Pallone, [D, NJ-6]                        5/8/03

Donna Christensen [D-Virgin Islands]            5/8/03

Joseph Hoeffel [D, PA-13]*                      5/14/03

Eddie Bernice Johnson [D,TX-30]                 5/14/03

Silvestre Reyes [D, TX-16]                      5/14/03

Louise Slaughter [D, NY-28]                     5/14/03

Jim Cooper [D, TN-5]                            5/14/03

William Lacy Clay [D, MO-1]                     5/14/03

Jerry Moran [R, KS-1]                           5/14/03

Jerry Costello [D, IL-12]                       5/14/03

Sheila Jackson-Lee [D, TX-18]                   5/15/03

John Conyers Jr. [D, MI-14]                     5/15/03

George Miller  [D, CA-7]                        5/15/03

Tammy Baldwin [D, WI-2]                         5/15/03

John Murtha [D, PA-12]                          5/15/03

Gene Green [D, TX-29]                           5/15/03

Phil English [R, PA-3]                          5/15/03

Ed Pastor [D, AZ-4]                             5/15/03

Eleanor Holmes Norton, [D, DC]                  5/19/03

Rush Holt, [D, NJ-12]                           5/19/03

James Langevin, [D, RI-2]                       5/19/03

Harold Ford, Jr., [D, TN-9]                     5/19/03

Tom Lantos, [D, CA-12]                          5/19/03

Bernie Sanders [I, VT]                          6/02/03

Collin Peterson [D, MN-7]                       6/02/03

David Price [D, NC-4]                           6/02/03

Tom  Allen [D, ME-1]                            6/02/03

Betty McCollum [D, MN-4]                        6/02/03

John Larson [D, CT-1]                           6/02/03

Sherrod Brown [D, OH-13]                        6/04/03

Barney Frank [D, MA-04]                         6/04/03

Sherwood Boehlert [R, NY-24]                    6/04/03

Robert Andrews [D, NJ-1]                        6/10/03

Rosa DeLauro  [D, CT-3]                         6/10/03

Charles “Chip” Pickering [R, MS-3]              6/10/03

Mark Foley [R, FL-16]                           6/10/03

Jerrold Nadler [D, NY-8]                        6/10/03

Carolyn Maloney [D, NY-14]                      6/10/03

Todd Tiahrt, [R, KS-4]                          6/17/03

Diana DeGette, [D, CO-1                         6/17/03

Rahm Emanuel, [D, IL-5]                         6/17/03

Chris Van Hollen, [D, MD-8]                     6/17/03

Bart Stupak [D, MI-1]                           6/25/03

Marcy Kaptur, [D, OH-9]                         6/25/03

John Sullivan [R,  OK-1]                        6/25/03

Brad Carson [D, OK-2]*                          6/25/03

Ron Kind [D,  WI-3]                             7/09/03

Henry Waxman [D, CA-30]                         7/09/03

Denise Majette [D, GA-4]*                       7/09/03

Melissa Hart [R, PA-4]                          7/16/03

Elijah Cummings [D, MD-7]                       7/16/03

Tom Cole [R, OK-4]                              7/21/03

Chris Bell [D, TX-25]*                          9/03/03

James Walsh [R, NY-25]                          9/03/03

Jim Leach [R, IA-2]                             9/03/03

Dennis Kucinich [D, OH-10]                      9/16/03

Juanita Millender-McDonald [D, CA-37]           9/16/03

Richard Gephardt [D, MO-3]*                     9/16/03

Jim McDermott [D, WA-7]                         9/16/03

Rob Bishop [R, UT-1]                            9/16/03

Luis Guttierez [D, IL-4]                       10/08/03

Lane Evans [D, IL-17]                          10/08/03

Jim Matheson [D, UT-2]                         10/08/03

Tom Udall [D, NM-3]                            10/08/03

Lynn Woolsey [D, CA-6]                         10/29/03

Carolyn McCarthy [D, NY-4]                     10/29/03

Neil Abercromie [D, HI-1]                      10/29/03

Nick Rahall [D, WV-3]                          10/29/03

John Olver [D, MA-1]                           11/21/03

Robert Menendez [D, NJ-12]                     1/28/04

Jesse Jackson Jr [D, IL-2]                     1/28/04

Judy Biggert [R, IL-13]                        1/28/04

Henry Hyde [R, IL- 6]                          3/18/04

Jo Bonner [R, AL-1]                            4/01/04

Chaka Fattah [D,  PA-2]                        4/01/04

James Moran [D, VA-8]                          5/17/04

Bill Pascrell [D, NJ-8]                        5/17/04

Curt Weldon [R, PA-7]                          5/17/04

Paul Kanjorski [D, PA-11]                      6/17/04

C.A. “Dutch” Ruppersberger [D, MD-2]           7/15/04

Michael Michaud [D, ME-2]                     10/08/04

Martin Olav Sabo [D, MN-5]                    10/08/04

Hilda Solis [D, CA-32]                        10/08/04

MiCASSA (Senate)

S 971                                     108th Congress

19 sponsors and co-sponsors in the Senate. Senators no longer serving are marked with an asterisk (*)

Lead Sponsors

Sen. Tom Harkin (D-IA)

Sen. Arlen Specter (R-PA)

Co-Sponsors

Sen Joseph R Biden Jr., (D - DE)

Sen Hillary Rodham Clinton, (D - NY)

Sen. Charles Schumer (D-NY)

Sen Edward M. Kennedy, (D- MA)

Sen John Kerry (D-MA)

Sen Thad Cochran, (R- MS)

Sen Mary L Landrieu, (D-LA)

Sen Jon Corzine, (D - NJ)

Sen Frank Lautenberg (D- NJ)

Sen Mark Dayton (D-MN)

Sen Christopher Dodd (D-CT)

Sen John Edwards (D-NC)*

Sen Pat Roberts (R-KS)

Sen Barbara Mikulski (D-MD)

Sen Paul Sarbanes (D-MD)

Sen Richard Durbin (D-IL)

Sen Joseph Lieberman (D-CT)

Money Follows the Person (Senate)

S 1394                                          108th Congress

S 1394, Money Follows the Person had eleven sponsors during the 108th Congress. Senators no longer serving are marked with an asterisk (*)

Sponsor: Sen Tom Harkin [D-IA] (introduced 7/11/2003)

Co-sponsors

Senator Gordon Smith [R-OR]                7/11/2003

Senator Edward Kennedy [D-MA]              7/11/2003

Senator Frank Lautenberg [D-NJ]            7/11/2003

Senator John Kerry [D-MA]                  7/11/2003

Senator Mary Landrieu [D-LA]               7/14/2003

Senator Arlen Specter [R-PA]               9/03/2003

Senator John Breaux [D-LA]*               10/01/2003

Senator Hillary Clinton [D-NY]            11/12/2003

Senator Charles Schumer [D-NY]            1/23/2004

Senator Jon Corzine [D-NJ]                4/26/2004