[Congressional Record Volume 148, Number 117 (Tuesday, September 17, 2002)]
[House]
[Page H6289]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




SUPPORT H.R. 3612, THE MEDICAID COMMUNITY-BASED ATTENDANT SERVICES AND 
                              SUPPORTS ACT

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Illinois (Mr. Davis) is recognized for 5 minutes.
  Mr. DAVIS of Illinois. Mr. Speaker, I rise to request support for 
H.R. 3612, the Medicaid Community-based Attendant Services and Supports 
Act, also known as MiCASSA. This bill will enable our older Americans 
and citizens with disabilities who qualify for long-term care services 
under the Medicaid program to receive the noninstitutional community 
support service options they are entitled to under the Americans With 
Disabilities Act.
  The Americans With Disabilities Act, signed into law by President 
Bush in 1990, ushered in a new era of promise for a segment of our 
population whose talents and rights as American citizens have been too 
long ignored. It promised a new social compact to end the paternalistic 
patterns of the past that took away our rights if we become disabled. 
It says that people with disabilities have the right to be active 
participants integrated into the everyday life of society. This 
premise, however, cannot become a reality until we roll up our sleeves 
and do the work necessary to eliminate the barriers that still hinder 
its full implementation.
  In its 1999 Olmstead ruling, the Supreme Court said that States 
violate the Americans With Disabilities Act when they unnecessarily put 
people with disabilities in institutions. The problem is that our 
Federal-State Medicaid program has not been updated and has a built-in 
bias that results in the unnecessary isolation and segregation of many 
of our senior citizens and younger adults in institutions.
  Too often, decisions relating to the provision of long-term services 
and supports are influenced by what is reimbursable under Federal and 
State Medicaid policy rather than by what individuals need and deserve. 
Research has revealed a significant bias in the Medicaid program 
towards reimbursing services provided in institutions over services 
provided in home and community settings. The only option currently 
guaranteed by Federal law in every State is nursing home care. Other 
options have existed for decades, but their spread has been fiscally 
choked off by the fact that 75 percent of our long-term care dollars go 
into institutional settings, in spite of the fact that studies show 
that many people do better in home and community settings.
  Only 27 States have adopted the benefit option of providing personal 
care services under the Medicaid program. Although every State has 
chosen to provide certain services under home and community-based 
waivers, these services are unevenly distributed, have long waiting 
lists, and reach just a small percentage of eligible individuals.
  Governor Howard Dean is a physician and Vermont's Chief Executive. He 
recently testified on Capitol Hill on behalf of the National Governors 
Association and asked Congress to give the States the tools they need 
to grow home and community-based service. In his testimony he said, 
``We can provide a higher quality of life by avoiding institutional 
services whenever possible. Some people insist we will need more 
nursing homes. They are wrong. Baby boomers today are looking for 
alternatives for their parents. We can't afford to protect the status 
quo. We need to listen to people and act boldly to develop those 
services they want and are, in fact, affordable.''
  So I ask, Mr. Speaker, all Members of this honorable body to be in 
support of services for individuals in home-based settings so that they 
too can realize the assurance of living as they choose and as they see 
fit. Support MiCASSA.

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