SUPPORT H.R. 3612, THE MEDICAID COMMUNITY-BASED ATTENDANT SERVICES AND SUPPORTS ACT
The Americans With Disabilities Act, signed into law by President Bush in 1990, ushered in a new era of promise for a segment of our long ignored. It promised a new social compact to end the paternalistic patterns of the past that took away our rights if we become disabled. It says that people with disabilities have the right to be active participants integrated into the everyday life of society. This promise, however, cannot become a reality until we roll up our sleeves and do the work necessary to eliminate the barriers that still hinder its full implementation.
In its 1999 Olmstead ruling, the Supreme Court said that States violate the Americans With Disabilities Act when they unnecessarily put people with disabilities in institutions. The problem is that our Federal-State Medicaid program has not been updated and has a built-in bias that results in the unnecessary isolation and segregation of many of our senior citizens and younger adults in institutions.
Too often, decisions relating to the provision of long-term services and supports are influenced by what is reimbursable under Federal and State Medicaid policy rather than by what individuals need and deserve. Research has revealed a significant bias in the Medicaid program towards reimbursing services provided in institutions over services provided in home and community settings. The only option currently guaranteed by Federal law in every State is nursing home care. Other options have existed for decades, but their spread has been fiscally
MiCASSA, the Medicaid Community Attendant Services and Supports Act, is that alternative! Instead of making a new entitlement, MiCASSA makes the existing entitlement more flexible.
MiCASSA 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 have the choice where and how these services are provided. The two million Americans currently guaranteed by Federal law in every State is nursing home care. Other options have existed for decades, but their spread has been fiscally choked off by the fact that 75 percent of our long-term care dollars go into institutional settings, in spite of the fact that studies show that many people do better in home and community settings.
Only 27 States have adopted the benefit option of providing personal care services under the Medicaid program. Although every State has chosen to provide certain services under home and community-based waivers, these services are unevenly distributed, have long waiting lists, and reach just a small percentage of eligible individuals.
Governor Howard Dean is a physician and Vermont's Chief Executive. He recently testified on Capitol Hill on behalf of the National Governors Association and asked Congress to give the States the tools they need to grow home and community-based service.
In his testimony he said,
``We can provide a higher quality of life by avoiding institutional services whenever possible. Some people insist we will need more nursing homes. They are wrong. Baby boomers today are looking for alternatives for their parents. We can't afford to protect the status quo. We need to listen to people and act boldly to develop those services they want and are, in fact, affordable.''
So I ask, Mr. Speaker, all Members of this honorable body to be in support of services for individuals in home-based settings so that they too can realize the assurance of living as they choose and as they see fit. Support MiCASSA.