By Mr. HARKIN (for himself, Mr. Specter, Mr. Kennedy, Mr. Inouye, Mr. Salazar, Mr. Biden, Mr. Lieberman, Mrs. Clinton, Mr. Schumer, and Mr. Dodd):
S. 799. A bill to amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes, to the Committee on Finance.
Mr. HARKIN. Mr. President, today, Senator Specter and I, and others introduce the Community Choice Act. This legislation is needed to truly bring people with disabilities into the mainstream of society and provide equal opportunity for employment and community activities.
In order to work or live in their own homes, Americans with disabilities and older Americans need access to community-based services and supports. Unfortunately, under current Medicaid policy, the deck is stacked in favor of living in an institutional setting. Federal law requires that States cover nursing home care in their Medicaid programs, but there is no similar requirement for attendant services. The purpose of our bill is to level the playing field, and to give eligible individuals equal access to the community- based services and supports that they need.
Although some States have already recognized the benefits of home and community-based services, they are unevenly distributed and only reach a small percentage of eligible individuals. Some States are now providing the personal care optional benefit through their Medicaid program, but others do not.
Those left behind are often needlessly institutionalized because they cannot access community alternatives. The civil right of a person with a disability to be integrated into their own community should not depend on their address. In Olmstead v. L.C., the Supreme Court recognized that needless institutionalization is a form of discrimination under the Americans with Disabilities Act. We in Congress have a responsibility to help States meet their obligations under Olmstead.
The Community Choice Act is designed to do just that, and to make the promise of the ADA a reality. It will help rebalance the current Medicaid long term care system, which spends a disproportionate amount on institutional services. Today, almost two-thirds of Medicaid long term care dollars are spent on institutional services, with only one-third going to community-based care.
This current imbalance means that individuals do not have equal access to community-based care throughout this country. An individual should not have to move to another State in order to avoid needless segregation. Nor should they have to move away from family and friends because their own choice is an institution.
Federal Medicaid policy should reflect the goals of the ADA that Americans with disabilities should have equal opportunity, and the right to fully participate in their communities. No one should have to sacrifice their ability to participate because they need help getting out of the house in the morning or assistance with personal care or some other basic service.
We have made some progress to date, as CMS has started to award Money Follows the Person demonstration grants. But that is only a start. Together, that initiative and the Community Choice Act could substantially reform long term services in this country. With appropriate community-based services and supports, we can transform the lives of people with disabilities. They can live with family and friends, not strangers. They can be the neighbor down the street, not the person warehoused down the hall. This is not asking too much. This is the bare minimum that we should demand for every human being.
Community based services and supports allow people with disabilities to lead independent lives, have jobs, and participate in the community. Some will become taxpayers, some will get an education, and some will participate in recreational and civic activities. But all will experience a chance to make their own choices and to govern their own lives.
The Community Choice Act will open the door to full participation by people with disabilities in our workplaces, our economy, and our American Dream and I urge all my colleagues to support us on this issue. I want to thank Senator Specter for his leadership on this issue and his commitment to improving access to home and community-based services for people with disabilities. I would also like to thank Senators Kennedy, Inouye, Salazar, Biden, Lieberman, Clinton, Schumer, and Dodd for joining me in this important initiative.
I ask unanimous consent that the text of the bill be printed in the Record.
There being no objection, the text of the bill was ordered to be printed in the RECORD, as follows:
