Howard Dean

1. Do you support the passage and full implementation of the Medicaid Community Attendant Services and Supports Act, MiCASSA?

Yes. 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.

2. Do you support the passage of legislation that will implement the concept of Money Follows the Person that is included in S.1394?

YES

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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? 

YES. 3a. What specific actions would you take?

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.

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?

YES. 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.

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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?

YES. 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.

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?

YES.

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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?

YES. 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.

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.

YES. 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 for 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.

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9. Do you support the integration mandate in the Americans with Disabilities Act, ADA and believe this mandate is a federal civil right?

YES 9a. If elected what actions will you take to protect this right?

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.

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?

YES. I look forward to appointing a Special Assistant to the President for Disability Policy.

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