Senate Finance Committee Holds Hearing On Community-Based
By Dave Reynolds, Inclusion Daily Express
April 7, 2004
WASHINGTON, DC--An overflow crowd of advocates gathered Wednesday at the Dirksen Senate Office Building for hearings on legislation that would change the current bias in long-term care funding that forces people into nursing homes and other institutions.
"This is an issue of the highest importance for people with disabilities in our country," Senator Tom Harkin of Iowa explained to the Senate Finance Committee which hosted the hearing on long-term care and the president's New Freedom Initiative.
Harkin explained the need for S. 971, otherwise known as MiCASSA, the Medicaid Community-Based Attendant Services and Supports Act, along with S. 1394, the Money Follows the Person.
MiCASSA, which was first introduced to Congress in 1997, would give Medicaid recipients the choice of in-home supports over institutions. The Money Follows the Person demonstration, which was introduced last summer, would provide money to states to help transition people from institutions to community-based services.
Harkin has been a long-time supporter of disability rights, and championed the 1990 Americans with Disabilities Act. He said the current Medicaid law is "from the Dark Ages", decades after the passage of the Rehabilitation Act of 1973 and the Individuals with Disabilities Education Act of 1975.
Nearly 70 percent of all Medicaid long-term care dollars currently go to nursing homes and institutions. Funding for such programs is mandated in some states, while in-home supports are not.
"We've got two sets of laws," Harkin told the panel. "We've got one set of laws telling people with disabilities 'We want you to be self-sufficient, we want you to live independently, we want you to be full participants, we want to give you equal opportunity.'"
"We have another set of laws where we're saying, 'Wait a minute, you have to live in an institution, you have to live in a nursing home. You cannot be a full participant, you cannot have equal opportunity, you cannot have your own choices.'"
"This situation calls for quick remediation," Harkin concluded.
Bruce Darling, Executive Director of the Center for Disability Rights, submitted a 100-page statement representing testimony from dozens of people who had lived in nursing homes and other institutions.
"The biggest difference between living in a nursing home and living in the community, is freedom," wrote Carol Young, who had lived in a New York nursing home. "Freedom is being able to go where you want, when you want, and the ability to make your own choices."
"Strategies to Improve Access to Medicaid Home and Community Based Services" (U.S. Senate Committee on Finance)
(Includes RealPlayer video clip of hearing)