[Public Papers of the Presidents of the United States: WILLIAM J. CLINTON (2000, Book II)]
[September 21, 2000]
[Pages 1893-1894]
[From the U.S. Government Publishing Office www.gpo.gov]



Memorandum on the Interagency Task Force To Examine the Role of Medicare 
and Medicaid Coverage of Assistive Technologies in Encouraging the 
Employment of Persons with Disabilities
September 21, 2000

Memorandum for the Attorney General, the Secretary of Health and Human 
Services, the Secretary of Education, the Secretary of Labor, the 
Secretary of Veterans Affairs

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 technology 
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 
assistive 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

[[Page 1894]]

            Medicare and Medicaid health care services such as personal 
            care services and, if so, provide an estimate of the 
            potential savings;
       (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