| Here are the UPDATED combined responses to the ADAPT Survey sent to all the Presidential Candidates. We received no response from President Bush, Senator Lieberman, or Al Sharpton, neither has Bush, Lieberman or Sharpton come out in support of MiCASSA. Carol Mosley Braun also responded to the survey, but since she has dropped out of the race we did not include her responses, though we would like to acknowledge and thank her for responding. Below are the responses of General Wesley Clark, Governor Howard Dean, Senator John Edwards, Senator John Kerry and Congressperson Dennis Kucinich. |
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Jump Right To: General Wesley Clark Governor Howard Dean Senator John Edwards Senator John Kerry Congressperson Dennis Kucinich |
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General Wesley Clark Question 1: Do you support the passage and full implementation of the Medicaid Community Attendant Services and Supports Act, MiCASSA? Answer: Yes Comments: While the United States has become a world leader in promoting the civil rights of persons with disabilities, our nation has a long way to go to reform our benefits programs so they help achieve goals of civil rights laws like the ADA rather than undermine the ADA's purposes. Many people with disabilities need long-term assistance with their daily activities. But the Medicaid system that serves them was conceived more than thirty years ago, and it's showing its age. In contrast to the ADA with its goal of independent living, Medicaid is a system that devalues choice and says that government knows what is best for people with disabilities. Under this system, about 75% of funding goes toward institutional care - and only 25% for community-based services. I believe we've got the balance all wrong. I think that people who need long-term services and supports should be able to choose when and where they get them, and who provides them. Because unnecessary institutionalization is discrimination, plain and simple. Tearing families apart is just plain wrong. And taking people out of their communities is un-American, because inclusion is our greatest strength, and when we undermine that, we undermine America. That's why I'm going to stand up for MiCASSA - because I think it's time we empowered individuals, not institutions. I also believe that effective implementation of MiCASSA depends on enhancing the capacity of community-based organizations such as independent living centers to aid in the transition from institutional to community-based living. While we work for passage of MiCASSA I will therefore work with Congress to provide community-based organizations with the tools they need to make community-based living a reality, not just a policy. Answers By: Dean Edwards Kerry Kucinich Question 2: Do you support the passage of legislation that will implement the concept of Money Follows the Person that is included in S.1394? Answer: Yes Comments: We need to take advantage of the ability of individual states to serve as laboratories for refining effective reforms for our benefits programs. I support the concept of individuals rather than institutions determining how our long-term care dollars are spent. By authorizing a demonstration project to explore the most effective approaches to implementing this concept, S.1394 will help us determine the policies we should be implementing on a national scale. Answers By: Dean Edwards Kerry Kucinich Question 3: Will you work with the states to assure they implement the Supreme Court's Olmstead decision so all people with disabilities, old and young, have the right to support services in the most integrated setting? What specific actions would you take? Answer: Yes Comments: The Olmstead decision framed the issue of long-term services and supports in civil rights terms. When a person with a significant disability is forced to live in a segregated, institutional setting because no alternative has been created by the State, that person is being relegated to a second-class life - frequently with little freedom, dignity or autonomy. That is wrong. As President, I will work with bipartisan leadership in the Congress and with governors to create stronger Federal incentives for States to provide meaningful choices in the community for all their citizens with disabilities of all ages. I believe that this policy will result in a higher quality of life for children, adults and seniors with disabilities and their families. It will also result in more cost-effective service delivery, more accountability from caregivers, and new workers for the labor market. However, unless we make it a top priority to help alleviate the financial burdens that the states presently face, which are restricting their abilities to implement the Olmstead decision, we won't be giving the states and Congress all the tools they need to end the institutional bias. That's why I have proposed a $40 billion dollar state and local tax refund. By helping states' financial outlook we can more effectively empower them to collaborate in partnership with the federal government in implementing the Olmstead decision. Moreover, we cannot implement the Olmstead decision and increase home and community-based services unless there is an adequate supply of housing. Presently, there is a severe shortage of housing that is safe, accessible, and affordable for people with disabilities. Improving our housing infrastructure includes increasing support for the Section 8 voucher program to broaden access for non- elderly persons with disabilities, as well as Section 811 for people with severe disabilities; increasing production of affordable housing; and providing incentives for the builders to adopt visitability in their design and construction. Answers By: Dean Edwards Kerry Kucinich Question 4: Will you appoint a Secretary of Health and Human Services that will have a Community First philosophy and will review all Medicare and Medicaid policies with the intention of removing all policies that contribute to the institutional bias that exists in the current long term care system? Answer: Yes Comments: I will appoint cabinet officials and sub-cabinet officials who will effectively implement my policy priorities, including a thorough review of Medicare and Medicaid policies that contribute to the institutional bias in our nation's long-term care system. Answers By: Dean Edwards Kerry Kucinich Question 5: Will you appoint a high level task force to review the funding of long term services and supports and make recommendations on concrete ways to reverse the institutional funding bias? Answer: Yes Comments: Our nation will only make progress in ending the Medicaid institutional bias if we make it a real priority. This means bringing together representatives of all affected constituencies to identify solutions that maximize benefits for all concerned. That's why I will appoint a high-level task force to systematically review options and recommend specific steps, and then I'll work aggressively to implement the task force's proposals. Answers By: Dean Edwards Kerry Kucinich Question 6: Will you support/develop long term service and support policies that enhance the consumer direction/self determination of personal attendant services by allowing persons to select, manage and dismiss attendants? Answer: Yes Comments: Choice in our long-term care system will only be meaningful if it is implemented at the individual level where people with disabilities select, manage and dismiss their own attendants. I will charge my long-term care task force to include selection and management of attendants as one of the areas that needs to be examined and implement their recommendations. Answers By: Dean Edwards Kerry Kucinich Question 7: Will you support/develop long term service and support policies that will demedicalize personal attendant services by allowing physician/nurse assignment/delegation as well as tasks being defined as non medical? Answer: Yes Comments: Given the escalating health care costs our nation faces, we need to be creative in identifying ways that we can reduce costs by utilizing non-medical personnel where medical training is not required. I believe personal attendant services is an area where we can give people with disabilities greater freedom in selecting the services they need while at the same time helping to minimize the costs of such services. Answers By: Dean Edwards Kerry Kucinich Question 8: Will you support/develop long term service and support policies that will develop wage and benefit incentives so that there is a large pool of attendants available to meet the growing personal attendant service needs in this country? Currently you can make more money working in a fast food restaurant than as an attendant. Answer: Yes Comments: We can't meet the goals of the ADA and implement the Olmstead decision if we don't focus on capacity-building so that there is a sufficient pool of attendants available to meet the demand for personal assistant services. I support identifying ways to increase wages and enhance benefits for attendants so that working as an attendant is more attractive. Personal attendants make it possible for many people with disabilities to live more independently. We must therefore attend to the well-being of these critical service providers if we expect to improve the lives of people with disabilities. Answers By: Dean Edwards Kerry Kucinich Question 9: Do you support the integration mandate in the Americans with Disabilities Act, ADA and believe this mandate is a federal civil right? If elected what actions will you take to protect this right? Answer: Yes Comments: The Supreme Court upheld the ADA's integration mandate in its Olmstead decision. I support this mandate and I will work to sustain it by appointing federal judges who will respect and uphold the law as understood in Olmstead. I will also work to implement policies, including support for passage of MiCASSA, that will make this federal civil right a reality in the lives of individual Americans with disabilities. Answers By: Dean Edwards Kerry Kucinich Question 10: Will you include people with disabilities, including ADAPT members, in the development of all policies that effect the community long term service and support system? Answer: Yes Comments: My administration will reflect the diversity of America. This means ensuring that the people who experience the impact of various programs and policies most directly are full participants in the development and implementation of those programs and policies. I welcome the involvement of the disability community, including ADAPT members, in ensuring that my administration moves forward in ending the Medicaid institutional bias once and for all. Answers By: Dean Edwards Kerry Kucinich Governor Howard Dean Question 1: Do you support the passage and full implementation of the Medicaid Community Attendant Services and Supports Act, MiCASSA? Answer: Yes Comments: One of the most important pledges in my Disability Rights Platform, which I released last July 26 on the 13th Anniversary of the ADA's enactment, was that I will work hard to enact MiCASSA. As I testified before the Senate Special Committee on Aging in July, 2001, "If a long-term care system were being designed from scratch today, I do no think we would conceive of building a system in which a bias is shown for institutional care, rather than for services designed to keep people independent in their homes or the community." MiCASSA is an important bill whose time has come. Answers By: Clark Edwards Kerry Kucinich Question 2: Do you support the passage of legislation that will implement the concept of Money Follows the Person that is included in S.1394? Answer: Yes Comments: (No Comment Provided) Answers By: Clark Edwards Kerry Kucinich Question 3: Will you work with the states to assure they implement the Supreme Court's Olmstead decision so all people with disabilities, old and young, have the right to support services in the most integrated setting? What specific actions would you take? Answer: Yes Comments: I look forward to providing technical support as states implement Olmstead plans to provide viable, sustainable options for community-based living. In the 1999 case LC v. Olmstead, the Supreme Court interpreted the ADA to require that individual with disabilities be offered state services in the most integrated community- based setting appropriate to their needs. States are now modifying programs and activities to comply with Olmstead. The federal government must assist states making this transition by providing technical assistance and funding innovative model for full integration. Answers By: Clark Edwards Kerry Kucinich Question 4: Will you appoint a Secretary of Health and Human Services that will have a Community First philosophy and will review all Medicare and Medicaid policies with the intention of removing all policies that contribute to the institutional bias that exists in the current long term care system? Answer: Yes Comments: I will appoint a Secretary of Health and Human Services who will understand the rights of individual with disabilities. As reflected by my support for MiCASSA, my administration will work to end the institutional bias in long-term health care. Answers By: Clark Edwards Kerry Kucinich Question 5: Will you appoint a high level task force to review the funding of long term services and supports and make recommendations on concrete ways to reverse the institutional funding bias? Answer: Yes Comments: I look forward to working with members of the disability community in many capacities to reverse the institutional funding bias and to ensure that my disability agenda is a national priority. Because individuals with disabilities provide a valuable perspective on federal policy and contribute immeasurably to the fabric of our nation, I will include people with disabilities in a wide spectrum of executive appointments. Answers By: Clark Edwards Kerry Kucinich Question 6: Will you support/develop long term service and support policies that enhance the consumer direction/self determination of personal attendant services by allowing persons to select, manage and dismiss attendants? Answer: Yes Comments: (No Comment Provided) Answers By: Clark Edwards Kerry Kucinich Question 7: Will you support/develop long term service and support policies that will demedicalize personal attendant services by allowing physician/nurse assignment/delegation as well as tasks being defined as non medical? Answer: Yes Comments: I will work with medical professionals, patients and patient advocates to ensure an appropriate division of responsibility in the area of personal attendant services. It makes sense to assign non-medical tasks to non-medical personnel. Answers By: Clark Edwards Kerry Kucinich Question 8: Will you support/develop long term service and support policies that will develop wage and benefit incentives so that there is a large pool of attendants available to meet the growing personal attendant service needs in this country? Currently you can make more money working in a fast food restaurant than as an attendant. Answer: Yes Comments: In the past three years, the wages of personal attendants have fallen as the cost of living has risen. The big tax cuts that helped the multi-millionaires did not trickle down to these people. I agree that wages or personal attendants and others who provide human services are pitiably low and that this country must refocus its priorities so this is not the case. Answers By: Clark Edwards Kerry Kucinich Question 9: Do you support the integration mandate in the Americans with Disabilities Act, ADA and believe this mandate is a federal civil right? If elected what actions will you take to protect this right? Answer: Yes Comments: The ADA is one of the most important civil rights laws in history. I support its goals and the legal rights that it provides. We need to restore the full promise of the ADA, by legislation if necessary. Answers By: Clark Edwards Kerry Kucinich Question 10: Will you include people with disabilities, including ADAPT members, in the development of all policies that effect the community long term service and support system? Answer: Yes Comments: I look forward to appointing a Special Assistant to the President for Disability Policy. Answers By: Clark Edwards Kerry Kucinich Senator John Edwards Question 1: Do you support the passage and full implementation of the Medicaid Community Attendant Services and Supports Act, MiCASSA? Answer: Yes Comments: I am a cosponsor of the Medicaid Community-Based Attendant Services and Supports Act (MiCASSA) that allows individuals to choose community-based care with Medicare coverage. In addition to supporting MiCASSA and other bills to help people with disabilities, I have proposed a $3.5 billion "Living with Dignity" Initiative. My plan is built on basic American principles: choice for families, the chance to get care in the home and community whenever possible, dignity and respect for both families and workers, and accountability for providers and the government. The Living with Dignity Initiative will: Fund State Efforts to Expand Home Care and Reform the Long-Term Care System, including tax credits for long- term care; asset and income protection programs that prevent families from spending down their incomes, and experiments with long-term care insurance. Double Resources for Respite Care and other Support to Families Who Care for Loved Ones, including an Internet clearinghouse to give families more information about available services. Recruit and Retain Nursing Home and Home Care Workers by providing resources to improve wages, training, and working conditions for aides and establishing strong workplace safety regulations. Improve the Quality of Home and Community Based Care and Nursing Homes and Crack Down on Patient Abuse through national nursing care standards; increased national-level enforcement against abusive facilities; expanding inspections; and increasing penalties for facilities that don't provide decent care. I will also offer awards for excellence and grants so facilities can improve quality with measures like reducing patient-staff ratios and expanding recreational opportunities for residents. Answers By: Clark Dean Kerry Kucinich Question 2: Do you support the passage of legislation that will implement the concept of Money Follows the Person that is included in S.1394? Answer: Yes Comments: I support the Money Follows the Person Act of 2003. As part of my Living with Dignity Initiative, I also support initiatives that enable people with disabilities to choose how they receive their care and live their lives. Answers By: Clark Dean Kerry Kucinich Question 3: Will you work with the states to assure they implement the Supreme Court's Olmstead decision so all people with disabilities, old and young, have the right to support services in the most integrated setting? What specific actions would you take? Answer: Yes Comments: The Supreme Court's Olmstead decision held that the ADA requires states to offer services in the most integrated, community-based setting possible for individuals with disabilities. The ruling said that a disabled individual who is able to live in the community must be given the choice whether to do so. This was an important victory for disability rights. Unfortunately, states are still struggling to implement Olmstead. I believe that the federal government must help states by supporting the transition to community- based services, and increasing enforcement to ensure compliance with the law. States need resources to do this, at a time when they are already cash-strapped. I have proposed to offer fiscal relief to states in these difficult times. These dollars will help states expand Medicaid coverage, including prescription drugs and personal assistance, to those with disabilities. It will also help states meet their obligation to give people with disabilities the choice of care in their communities and homes as well as in institutions. I will also give states the resources they need to reform their long-term care systems by providing benefits such as tax credits for long-term care, asset and income protection programs that prevent families from spending down their incomes, and experiments with long-term care insurance. Answers By: Clark Dean Kerry Kucinich Question 4: Will you appoint a Secretary of Health and Human Services that will have a Community First philosophy and will review all Medicare and Medicaid policies with the intention of removing all policies that contribute to the institutional bias that exists in the current long term care system? Answer: Yes Comments: The Edwards Administration will be committed to ending the era of forced institutionalization. The Department of Health and Human Services under President Edwards will ensure the dignity of all Americans with disabilities by enabling them to live and work in the community if they so choose and are able. Answers By: Clark Dean Kerry Kucinich Question 5: Will you appoint a high level task force to review the funding of long term services and supports and make recommendations on concrete ways to reverse the institutional funding bias? Answer: Yes Comments: (No Comment Provided) Answers By: Clark Dean Kerry Kucinich Question 6: Will you support/develop long term service and support policies that enhance the consumer direction/self determination of personal attendant services by allowing persons to select, manage and dismiss attendants? Answer: Yes Comments: I believe that adults with disabilities should have the widest possible choice available for their services, including the ability to choose and manage their personal aides. Answers By: Clark Dean Kerry Kucinich Question 7: Will you support/develop long term service and support policies that will demedicalize personal attendant services by allowing physician/nurse assignment/delegation as well as tasks being defined as non medical? Answer: Yes Comments: (No Comment Provided) Answers By: Clark Dean Kerry Kucinich Question 8: Will you support/develop long term service and support policies that will develop wage and benefit incentives so that there is a large pool of attendants available to meet the growing personal attendant service needs in this country? Currently you can make more money working in a fast food restaurant than as an attendant. Answer: Yes Comments: We have a critical shortage of health care attendants and nurses in this country. That's why, under my Living with Dignity Initiative, I lay out specific steps to attract home health aides and attendants to the industry, by treating them with the same dignity and respect that we ask them to give to their patients. As President, I will provide resources to improve wages, training, and working conditions for aides. I will also establish strong workplace safety regulations such as the ergonomics regulations discarded by President Bush. Answers By: Clark Dean Kerry Kucinich Question 9: Do you support the integration mandate in the Americans with Disabilities Act, ADA and believe this mandate is a federal civil right? If elected what actions will you take to protect this right? Answer: Yes Comments: I believe strongly that we must ensure that the ADA remains consistent with the broad goal of achieving equal opportunities and breaking down barriers for people with disabilities. Fair treatment of people with disabilities is civil rights issue, and it must be a priority. As President I will support measures to achieve this goal, to help people with disabilities achieve full integration in society. Answers By: Clark Dean Kerry Kucinich Question 10: Will you include people with disabilities, including ADAPT members, in the development of all policies that effect the community long term service and support system? Answer: Yes Comments: Policies affecting people with disabilities can only be meaningful - and successful - if they are crafted with the help of people who understand first-hand the frustrations of disabled Americans. I welcome the inclusion and participation of people with disabilities in reforming our community long term service and support system so that it is more responsive to their needs and concerns. Answers By: Clark Dean Kerry Kucinich Senator John Kerry Question 1: Do you support the passage and full implementation of the Medicaid Community Attendant Services and Supports Act, MiCASSA? |