1. The demographics of our country are changing. More and more people with disabilities are living, and could be thriving! Reasons for these changes include:

   a) the aging process, the graying of America, b) children born with disabilities are living, c) young adults, who previously would have died from accidents or illnesses, are living -- thanks to medical technology and other advances.

2. Our long-term service system must change. Created over forty years ago, it is funded mainly by Medicare and Medicaid dollars; medical dollars not originally meant to meet people's long-term care needs. We must think out of the box to empower people and allow REAL choices.

3. The money should follow the individual, not the facility or provider. A national long-term service policy should not favor any one setting over the other. It should let the users choose where services should be delivered. Our current system is not neutral, and it doesn't reflect people's choices.

4. The current system is needlessly expensive. We must explore cost-effective ways to meet people's needs.

   Community services have been shown to be less expensive on average than institutional services, and better liked by individuals.

   In FY 2005, 63% of our total $94.5 billion long term care Medicaid dollars ($59.34 billion) are spent on nursing homes and other institutional services, leaving only 37% ($35.16 billion) for all community services (waivers, personal care, home health, etc.)

5. People with disabilities -- both old and young -- even those with severe mental and/or physical disabilities want services in the most integrated setting possible. Overwhelmingly, people prefer community services so they can stay in their own home.

6. People with disabilities and their families want REAL choice, which means:

   a) equitable funding opportunities, b) no programmatic or rule disincentives to community services, and c) options for services delivery which include agency based services, vouchers, and fiscal intermediaries. Empower people with disabilities and families.

7. Family values keep families together

   a) children belong in families b) grandparents at home! c) Mom and dad together with the kids d) communities take care of their own.

8. Money following the individual can eliminate overburdening government rules and regulations.

9. A functional system based on need instead of medical diagnosis could end FRAGMENTATION of the service delivery system.

10. Keeping people in the community allows the possibility for individuals with disabilities to train for work so they can become TAXPAYERS instead of TAX USERS.

11. The federal government needs to work in partnership with the states to create flexible delivery systems that give people REAL choice.

12. Change can cause fear of the unknown. Some long time providers of services and families believe REAL choice would threaten what they have. We cannot continue the system as it is today; it is expensive, fragmented, overly-medical and disliked by almost everyone.

There's No Place Like Home!