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Current Advocacy Agenda

Community Choice Act (formerly MiCASSA - Medicaid Community Attendant Services and Supports Act)


Why is living in the community so important? ADAPT explains it best.


“For decades, people with disabilities, both old and young, have wanted alternatives to nursing homes and other institutions when they need long term services. Our long term care system has a heavy institutional bias. Every state that receives Medicaid MUST provide nursing home services, but community based services are optional. Sixty five percent of Medicaid long term care dollars pay for institutional services, while the remaining 25% must cover all the community based waivers, optional programs, etc.


Families are in crisis. When support services are needed there are no real choices in the community. Whether a child is born with a disability, an adult has a traumatic injury or a person becomes disabled through the aging process, they overwhelmingly wan t their attendant services provided in their own homes, not nursing homes or other large institutions. People with disabilities and their families will no longer tolerate being forced into selecting institutions. It's time for Real Choice.


The Community Choice Act provides an alternative and will fundamentally change our long term care system and the institutional bias that now exists. Building on the Money Follows the Person concept, the two million Americans currently residing in nursing homes and other institutions would have a choice. In addition, people would not be forced into institutions in order to get out on community services; once they are deemed eligible for the institutional services, people with disabilities and their families will be able to choose where and how they receive services. Instead of making a new entitlement, the Community Choice Act, makes the existing entitlement more flexible.

The Community Choice Act establishes a national program of community-based attendant services and supports for people with disabilities, regardless of age or disability. This bill would allow the dollars to follow the person, and allow eligible individuals, or their representatives, to choose where they would receive services and supports. Any individual who is entitled to nursing home or other institutional services will now be able to choose where and how these services are provided.

Integration Not Segregation [Olmstead and Real Choice] :

In 1999, in the Olmstead v. L.C. case, the United States Supreme Court affirmed the right of individuals with disabilities to live in the community.

The case involved two Georgia women who were being housed in a state psychiatric hospital.

Based on the federal Americans with Disabilities Act, the court held that states are required to place persons with mental disabilities in community settings rather than in institutions “when the State’s treatment professionals have determined that community placement is appropriate, the transfer from institutional care to a less restrictive setting is not opposed by the affected individual, and the placement can be reasonably accommodated, taking into account the resources available to the State and the needs of others with mental disabilities.”

At the direction of Congress, the Attorney General issued regulations implementing the Americans with Disabilities Act. Under the regulations, states must undertake all reasonable steps necessary to allow people with developmental or mental disabilities to live in the community to the fullest extent possible.

Money Follows the Person – what is it?


Money Follows the Person allows states to take Medicaid dollars that would have supported the person in a nursing home bed and pay for community based services instead.

Read more about Pennsylvania’s plan for Money Follows the Person:


Housing [Fair Housing and Housing Help]
Inclusionary zoning


Inclusionary zoning (IZ) requires developers to make a percentage of housing units in new residential developments available to low- and moderate-income households. In return, developers receive non-monetary compensation-in the form of density bonuses, zoning variances, and/or expedited permits-that reduce construction costs. By linking the production of affordable housing to private market development, IZ expands the supply of affordable housing while dispersing affordable units throughout a city or county to broaden opportunity and foster mixed-income communities.


Read more
about Inclusionary Zoning



Housing vouchers


Housing vouchers can be used successfully to move people out of nursing homes. Read more.


Visitability – What is it?


Visitability is an initiative that makes public and private housing more accessible to people with disabilities. Visitability provides a minimal level of basic access, typically, zero-step entrance, sufficiently wide doorways and a usable bathroom on the first floor to permit friends and relatives with disabilities to easily visit your home.


The following links provide the best resources: