News Release

NCD #03-430
August 5, 2003
Contact: Mark S. Quigley
202-272-2004
202-272-2074 TTY
mquigley@ncd.gov

National Council on Disability Applauds Administration's New Community-Based Services Proposal

WASHINGTON-The National Council on Disability (NCD) commends the Administration for its newly proposed "New Freedom Initiative Medicaid Demonstrations Act of 2003," which would help Americans with disabilities transition from nursing homes or other institutions into community-based living settings.

According to NCD chairperson Lex Frieden, "NCD applauds the President's new legislative proposal, which will help eliminate many barriers to full participation in community life for people with disabilities. NCD supports the President's commitment to changing policies that unnecessarily confine people with disabilities to living in institutions. Helping people with disabilities who want to live in their own homes by providing community-based programs that foster independence and community participation is good public policy. Congress should act quickly to enact this proposal."

"Thirteen years ago, Congress passed and President George H. W. Bush signed one of the most significant civil rights laws since the Civil Rights Act of 1964-the Americans with Disabilities Act (ADA). In so doing, the nation opened its doors to a new age for people with disabilities. The New Freedom initiative is consistent with ADA's promise of ensuring equality of opportunity, full participation, independent living, and economic self-sufficiency, especially for people living in institutions," Frieden added.

On June 22, 1999, the U.S. Supreme Court handed down a landmark decision in Olmstead v. L.C., 527 U.S. 581. The Court recognized that unjustified isolation and segregation of people with disabilities in institutional settings is a form of discrimination prohibited by the ADA. On June 18, 2001, President George W. Bush signed an executive order promoting community-based alternatives, rather than institutions, for people with disabilities.

NCD believes that implementation of the Olmstead decision is of paramount importance to the nation as demographics shift toward older Americans, and is one of the top priorities of the disability community.

In its January 2001 report, Investing in Independence: Transition Recommendations for President George W. Bush (http://www.ncd.gov/newsroom/publications/bush.html), NCD made several recommendations to the President. Among them were recommendations on how to achieve the most integrated community-based setting for people with disabilities, pursuant to the Supreme Court decision in Olmstead.

In its 2002 Congressionally mandated report, National Disability Policy: A Progress Report

(http://www.ncd.gov/newsroom/publications/progressreport_07-26-02.html), NCD recommended that people with disabilities have appropriate input into the allocation of funds in the Centers for Medicare and Medicaid's budget to assist with demonstration projects and a range of community-based activities throughout the life of the initiative.

In previous reports, such as Investing in Independence: Transition Recommendations for President George W. Bush

(http://www.ncd.gov/newsroom/publications/bush.html), NCD called on the administration and Congress to work together from the outset to pass the Medicaid Community Attendant Services and Supports Act (MiCASSA) to meet the needs and desires of older Americans and people with disabilities to live in their own homes to the fullest extent possible.

The Administration's 2003 proposals, which reflect NCD's recommendations, would address barriers to home and community-based care under Medicaid. The bill would address a number of important issues vital to a person's ability to live in the community, through the following demonstration projects:

Money Follows the Individual Rebalancing Demonstration: The legislation would provide for $1.75 billion over five years to assist states' efforts to provide people who reside in institutions more choices to live in their own communities.

Demonstration on Respite for Caregivers of Adults: The bill provides $449 million over 10 years to provide assistance to family caregivers of adults with disabilities or long term illnesses.

Demonstration of Respite for Caregivers of Children with Substantial Disabilities: The bill provides $118 million over 10 years to provide assistance to family caregivers of children with disabilities.

Demonstration to Address Shortages of Community Direct Care Workers: The bill provides $3 million in Fiscal Year 2004 to help address the national shortage of personal assistance and other direct service workers who assist people with disabilities and the elderly with their daily activities.

Demonstration of Home and Community-Based Alternatives to Psychiatric Residential Treatment Facilities for Children: The bill provides $504 million over 10 years to offer family and community-based alternatives for children with psychiatric disabilities.

In addition, this bill contains proposed changes that would permit states the option of providing Medicaid home and community-based services for up to 90 days during the time that final Medicaid eligibility is being determined. This provision would also facilitate meeting the needs and preferences of people who wish to return home to the community following a period of hospitalization or other acute care in an institutional setting.

Finally, the President's bill would remove disincentives for people with disabilities to return to work by protecting the Medicaid health insurance coverage of spouses, if those spouses also have a disability.

On August 14, as part of its work to provide the President and Congress with the most relevant information available, NCD will be releasing its report titled Olmstead: Reclaiming Institutionalized Lives. As exemplified by its prefatory quote ("Free our people! Free our people! Free our people!" - Supporters of MiCASSA), the report provides a comprehensive analysis of federal and state implementation of Olmstead.