Memorandum from the President: Interagency Task Force to Examine the Role of Medicare and Medicaid Coverage of Assistive (9/21/00)
                              THE WHITE HOUSE

                       Office of the Press Secretary
                            (Detroit, Michigan)

For Immediate Release                          September 21, 2000

                                 September 21, 2000


SUBJECT:       Interagency Task Force to Examine the Role
               of Medicare and Medicaid Coverage of Assistive
               Technologies in Encouraging the Employment of
               Persons with Disabilities

The Ticket to Work and Work Incentives Improvement Act of 1999, the last
legislation that I signed during the 20th Century, was a breakthrough in
helping persons with disabilities enter the workforce.  Persons with
disabilities can now return to work and retain their Medicare and Medicaid
coverage.  No longer will they be forced to make an unfair choice between
work and essential health care coverage.  The Work Incentives law affirms
that persons with disabilities can and do make valuable contributions to
society through participation in the American workforce.

In ensuring that persons with disabilities have the same opportunities to
work as all Americans, our next step is to take advantage of the remarkable
advances in "assistive technologies" -- the innovative devices that
facilitate independent living and meaningful employment for persons with
disabilities.  This year I have included $100 million in my budget, an
increase of $14 million over FY 2000, for disability and technology
research, including assistive tech-nology research, at the National
Institute on Disability and Rehabilitation Research.  I have also included
in my budget this year $41 million for State-based assistive technology
programs through the Department of Education.  The National Center for
Medical Rehabilitation Research, which is overseen by the National
Institutes of Health, and the Department of Veterans Affairs, each provide
$30 million in grants for assis-tive technology research.  Together, these
funds will support comprehensive research and education on the use of
assistive technologies to further integrate persons with disabilities into
their community and the workforce.

While the Work Incentives law extended Medicare and Medicaid to workers
with disabilities, the Federal Government must make a comprehensive effort
to determine how best to make these programs more effective for persons
with disabilities, including improved coverage of assistive technologies.
It is especially important to examine how medically necessary assistive
technologies may facilitate independent living and also support employment
for persons with disabilities.

I hereby direct the Secretary of Health and Human Services to convene an
interagency Task Force on Health Care Coverage of Assistive Technologies
that includes the Departments of Health and Human Services, Justice,
Education, Labor, Veterans Affairs, and other agencies, as appropriate.
The Task Force shall study the role that Medicare and Medicaid does and
should play in the coverage of assistive technology devices.  The work of
the Task Force is intended to provide a framework for future Medicare and
Medicaid coverage decisions that complements my Administration?s overall
efforts to promote employment opportunities for persons with disabilities.

I direct the Task Force to conduct a study on the role of Medicare and
Medicaid in covering assistive technologies that encourage employment of
individuals with disabilities.  The study should:

(a)  examine current Medicare and Medicaid coverage of assistive technology
     devices and the cost of providing such coverage.  Assess the current
     coverage criteria under Medicare and Medicaid with comparisons to the
     private insurance market.  Review and evaluate other past and on-going
     research on Medicare and Medicaid coverage of assistive technologies;

(b)  seek input from the disability community to identify the types of
     medically necessary assistive technologies that facilitate independent
     living and employment.  Develop criteria for identifying such devices;

(c)  determine whether provision of assistive technologies may substitute
     for other Medicare and Medicaid health care services such as personal
     care services and, if so, provide an estimate of the potential

(d)  analyze Medicare and Medicaid medical necessity guidelines to
     determine whether they can support employment while continuing to meet
     the health care focus of the Medicare and Medicaid programs.  As we
     move toward an increased employment of persons with disabilities,
     there is a need to study the intersection of the concepts of
     disability, medical necessity, and employment;

(e)  determine an appropriate delineation of responsibility for coverage of
     assistive technologies between publicly financed health care and
     employers by evaluating employers? responsibilities under the
     Americans with Disabilities Act, section 504 of the Rehabilitation
     Act, and the Assistive Technology Act; and

(f)  make recommendations for administrative and legislative changes to the
     Medicare and Medicaid programs, including an estimate of costs, to
     encourage coverage of medically necessary assistive technologies that
     also support employment of persons with disabilities.

This memorandum does not create any right or benefit, substantive or
procedural, enforceable by a party at law against the United States, its
officers or employees, or any other persons.

                              WILLIAM J. CLINTON

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