Senator Tom Harkin:
Setting Our People Free
Dear ABILITY Readers,
This year celebrates the 15th anniversary of the Americans with Disabilities
Act (ADA). Authoring the ADA and shepherding its passage was one of the
proudest achievements of my career in Congress. When we passed the ADA,
we set four great national goals for individuals with disabilities: equal
opportunity, independent living, full participation and economic self-sufficiency.
With this landmark legislation, America committed itself to the principle
that disability does not limit a person’s right to participate in
the cultural, economic, educational, political and social mainstream.
Today, the positive impacts of the ADA are all around us. Many restaurants
have visual displays allowing people who are deaf to place their orders
independently. Many banks have talking ATMs to assist individuals who
are blind. Service animals are welcome in restaurants and shops. Many
more streets and buildings are accessible. And just as important, people’s
attitudes are changing in positive ways.
During the past 15 years, America has made enormous strides in breaking
down barriers for people with disabilities. But we still have a long way
to go before we have truly opened the doors of opportunity to everyone.
The current Medicaid system is unacceptably biased in favor of institutional
care. Two-thirds of Medicaid long-term care dollars are spent on institutional
services, with only one-third going to community-based care. It’s
time to rebalance the system.
To that end, I have re-introduced two bills in the new Congress that I
believe will make a tremendous difference. The first bill is called the
Medicaid Community-Based Attendant Services and Supports Act (MiCASSA).
MiCASSA would give people who are currently eligible for nursing home
or institutional services equal access to the services and supports they
would need to live instead in the community. The legislation would also
provide funding to states to help them reform their long-term care systems
and increase the provision of home-and community-based services.
The second bill is the Money Follows the Person Act.
This legislation would create a pilot program in which the Medicaid money
paid by states and the federal government would follow the person with
a disability from an institution into the community. The Act would provide
100 percent reimbursement for the community services that an individual
needs during the first year after he or she moves out of a nursing home
or similar facility. After the first year, the individual would remain
in the community, and states would receive their regular Medicaid match
for their services.
These bills would allow people with disabilities to have choices that
many take for granted: to live with family and friends, not with strangers,
and to live in a neighborhood, not a nursing home or institution. Federal
Medicaid policy should facilitate, not frustrate, our belief that Americans
with disabilities should have an equal opportunity to contribute to our
communities and participate in our society as full citizens.
We all know it takes money to pay for community services. But I think
of my nephew Kelly, who acquired paraplegia while serving in the military.
The Veterans Administration pays for his attendant services so he is able
to get up in the morning, go to work, operate his small business, pay
his taxes and be a fully contributing member of our society.
That’s what every person with a disability wants. And the costs
would be largely offset by the benefit of having people with disabilities
who are employed, paying taxes and contributing to the economy.
We are building support for these two bills from members on both sides
of the aisle. But let’s not kid ourselves. This is by no means a
done deal. We’re going to have to fight for these new laws. But
with appropriate community-based services and supports, we can continue
to transform the lives of people with disabilities.
by Senator Tom Harkin
continued in ABILITY Magazine subscribe
Other articles in the Jane Pauley issue include Letter From The
Editor, Gillian Friedman, MD; Humor: Whats up Doc?; Headlines: MS Cruise,
Breast Cancer & Court Ruling; Michael Rogers-A Journey of Self-Discovery;
Butterfly Power: Native American Healing; Bipolar Disorder: Standup Comed
Showcase: Sixth Annual Event; World Ability Federation; Events and Conferences...