John Kerry.

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

YES. Americans with Disabilities must be assured equal access to quality home and community living services. I am an original cosponsor of MiCASSA and the Money Follows the Person Act. Passage of both of these bills is vital to ending the institutional bias that makes it impossible for millions of Americans to exercise the most basic of human liberties: freedom, choice, and independence. 

I support increasing funding for independent living centers, areas agencies on aging and similar local organizations to build capacity and support people with disabilities in moving out of or keeping from needlessly going into a nursing home or another institution. I will work to provide decent wages and benefits to the community based services workers who help make independence possible.

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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 see #1

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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?

We must fully implement the Olmstead decision. I believe that states must be given increased resources and tools to carry out the Olmstead decision and must be held accountable for doing so. As with racial segregation, we must put an end to the institutional bias that prevents millions of Americans of all ages from living fuller lives in their own homes and communities. States are experiencing tough fiscal times and many are slashing Medicaid funding for home and community based services. The Bush Administration has done nothing to stop this from happening. I am committed to finding ways to relieve these pressures on states and make certain that people with disabilities and older Americans receive the support they need to live in their own homes and communities.

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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, my Secretary of Health and Human Services will have a Community First philosophy. There is an institutional bias that must be reversed to ensure that Americans with disabilities of every age have the services and supports to live in the community of their choice. To do this, I will appoint a national bipartisan Community First Commission made up of Members of Congress, Governors, distinguished older Americans, veterans, Americans with disabilities and other experts. The commission will identify short and long term policy reforms that could and should be pursued to:

* Guarantee that all Americans with disabilities who can live in their community with affordable supports have equal opportunity to do so regardless of age, disability, State of residence, employment status or form of assistance required. 

* Create a greater federal role in equitably financing and enhancing the quality and appropriateness of all long-term services. 7 Eliminate the institutional bias in Medicaid and Medicare that robs millions of Americans of their most basic freedoms, dignity and daily independence.

The commission will submit findings and recommendations to the Kerry Administration and the leadership in both houses of Congress by July 26, 2005 - the 15th anniversary of the ADA.

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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 am the only candidate for President in either party to propose creating such a commission and I will do this in my first 100 days in office. Many say reversing the institutional bias that pervades so much of our health financing systems and robs so many Americans of the opportunity to live full lives is impossible. I believe it is not only possible but imperative to the future of our Nation. See #4

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, I believe we should work to enhance consumer directed care. People with disabilities deserve the right to make decisions that directly impact their own lives and the services and supports they need. That includes selecting, managing and dismissing attendants.

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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 develop policies that enable people with disabilities to access non-medical services which improve their quality of life. To make Medicare and Medicaid more responsive to the needs of people with disabilities of all ages, I will direct HHS to identify cost effective ways that best promote the health, independence and productivity of people with disabilities and improve upon the permanent risk adjustment payment system to promote better health care.

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. We need to recruit and train more highly motivated Americans to become attendants, home health aides, nurses and paraprofessionals. These individuals work around the clock to it possible for millions of children, adults and older Americans with disabilities to live in their own homes and communities. We need to make sure these indispensable workers are well compensated, receive appropriate health coverage and other opportunities to advance in their life and career.

Margaret Mead said that every society must be ultimately judged by how much it values and supports its very young, its very old and those with disabilities. Today, we also must judge ourselves by a fourth critical criterion: how well we value, compensate and support those whose job it is to assist Americans with significant disabilities of every age with such essential tasks as eating, bathing, dressing, using the bathroom, and going to school or work. Sadly, we are failing badly at this throughout the nation. Together, we can and must change this.

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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 integration mandate is a federal civil right. The letter and intent of the ADA is to put an end to the segregation that persons with disabilities historically have suffered, and June 22, 1999, marked a pivotal moment in that effort. On that date, the United States Supreme Court held in Olmstead v. L.C. that under some circumstances, the ADA requires states to provide community-based services rather than institutional placements for individuals with disabilities.

I believe that the de-institutionalization and integration of persons with disabilities into the community is of fundamental importance. By providing persons with disabilities the opportunity to work, participate in civic life, and become community leaders, we strengthen our entire community. As President, I would support programs such as MiCASSA that promote integration of persons with disabilities.

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. Absolutely. People with disabilities will always have a seat front and center in the Kerry Administration. I have released a comprehensive platform on disability issues which was developed in collaboration with leaders of the disability community from across the country. When I am President, Americans with Disabilities will play active roles not only in policy-making which effects the community long term service and support system but in every single area of public policy.

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