ADAPT Candidate Questionnaire
Date Mailed: Monday, January 26th 2004 06:34 AM
"ADAPT Candidate Questionnaire"
>From ADAPT <adapt@adapt.org>:
For Immediate Release
January 26, 2004
WHERE DO PRESIDENTIAL CANDIDATES STAND ON COMMUNITY-BASED
LONG TERM CARE?
ADAPT RELEASES RESULTS OF NATIONAL SURVEY
The Democratic front-runners in the campaign for the
Presidency responded to a national survey on their position
on community based long term care. ADAPT, the largest
national grassroots, disability activist group, which did
the survey, released the results today.
The goal is to inform voters - before New Hampshire and the
other primaries -- where the candidates stand on issues
related to long term care. Too often these issues are not
addressed in general campaign information and debates.
"Long term care and the bias toward nursing home and other
institutional programs is the elephant in the room," said
national ADAPT organizer Bob Kafka. "We spend 85 billion
dollars a year on long term care services and Medicaid is
the fastest growing part of every state's budget."
ADAPT hopes this survey and the responses and non-responses
given, will spark debate on this critical issue.
All the candidates were surveyed but President Bush,
Senator Lieberman, General Clark and Al Sharpton did not
respond.
========================
Here are the combined responses to the ADAPT Survey sent to
all the Presidential Candidates. We received no response
from President Bush, Senator Lieberman, General Clark or Al
Sharpton. Clark has stated he is a MiCASSA supporter but
Bush, Lieberman and Sharpton have not come out in support
of MiCASSA. Carol Mosley Brown 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 Governor Dean, Senator Edwards, Senator
Kerry and Congress person Kucinich. Their responses are
listed in alphabetical order after each question.
Most, if not all, of the Candidates have disability
platforms which can be found on their websites.
1. Do you support the passage and full implementation of
the Medicaid Community Attendant Services and Supports Act,
MiCASSA?
>> Dean
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.
>> Edwards
___X______YES ___________NO __________NO OPINION
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.
>> Kerry
____X______YES ___________NO __________NO OPINION
Comments
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.
>> Kucinich
Yes: Dennis Kucinich co-sponsored the bill.
2. Do you support the passage of legislation that will
implement the concept of Money Follows the Person that is
included in S.1394?
>> Dean
____x________YES ___________NO ___________NO OPINION
>> Edwards
_____X______YES ___________NO ___________NO OPINION
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.
>> Kerry
_____X_______YES ___________NO ___________NO OPINION
Comments
See #1.
>> Kucinich
__X__________YES ___________NO ___________NO OPINION
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?
>> Dean
______X______YES ___________NO ___________NO OPINION
3a. What specific actions would you take?
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.
>> Edwards
______X_____YES ___________NO ___________NO OPINION
3a. What specific actions would you take?
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.
>> Kerry
______X______YES ___________NO ___________NO OPINION
3a. What specific actions would you take?
Comments
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.
>> Kucinich
___X_________YES ___________NO
___________NO OPINION
3a. What specific actions would you take?
Comments: As President, Dennis Kucinich will provide
technical support to the states implementing the Olmstead
decision, ensuring that people with disabilities receive
the best community integration possible.
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?
>> Dean
_____x_______YES ___________NO ___________NO OPINION
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.
>> Edwards
_______X____YES ___________NO ___________NO OPINION
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.
>> Kerry
_____X_______YES ___________NO ___________NO OPINION
Comments
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.
* 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.
>> Kucinich
_____X_______YES ___________NO ___________NO OPINION
Comments: Under a Kucinich Administration, everyone in
America will be provided with comprehensive enhanced
Medicare through a universal single payer health care
system. This includes prescription drugs and mental
health costs.
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?
>> Dean
______x______YES __________NO ____________NO OPINION
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.
>> Edwards
____X_______YES __________NO ____________NO OPINION
>> Kerry
_____X_______YES __________NO ____________NO OPINION
Comments
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
>> Kucinich
____X________YES __________NO ____________NO
OPINION
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?
>> Dean
______X______YES __________NO __________NO OPINION
>> Edwards
____X_______YES __________NO __________NO OPINION
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.
>> Kerry
_____X_______YES __________NO __________NO
OPINION
Comments
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.
>> Kucinich
_____X_______YES __________NO __________NO
OPINION
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?
>> Dean
_____X________YES ________NO __________NO OPINION
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.
>> Edwards
_______X______YES ________NO __________NO OPINION
>> Kerry
______X_______YES ________NO __________NO OPINION
Comments
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.
>> Kucinich
______X_______YES ________NO __________NO OPINION
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.
>> Dean
_____X_______YES _________NO ___________NO OPINION
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
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.
>> Edwards
____X_______YES _________NO ___________NO OPINION
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.
>> Kerry
_______X_____YES _________NO ___________NO OPINION
Comments
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.
>> Kucinich
_______X_____YES _________NO ___________NO OPINION
Comments: Incentives must be offered to ensure a sufficient
long term care service that will meet the needs of our
rapidly expanding senior population.
9. Do you support the integration mandate in the Americans
with Disabilities Act, ADA and believe this mandate is a
federal civil right?
>> Dean
_____X______YES _________NO _____________NO OPINION
9a. If elected what actions will you take to
protect this right?
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.
>> Edwards
______X____YES _________NO _____________NO OPINION
9a. If elected what actions will you take to
protect this right?
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 supportmeasures to achieve this goal, to help people
with disabilities achieve full
integration in society.
>> Kerry
______X_____YES _________NO _____________NO
OPINION
9a. If elected what actions will you take to
protect this right?
Comments
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.
>> Kucinich
____X_______YES _________NO _____________NO OPINION
9a. If elected what actions will you take to
protect this right?
Comments: As President, Kucinich will nominate equal
rights-oriented judges who interpret the Americans with
Disabilities Act (ADA) broadly, and he'll propose an
amendment to the ADA to ensure the coverage that was
intended prior to restrictive rulings by Republican-
appointed judges. Kucinich will also increase resources to
the Equal Employment Opportunity Commission and the
Departments of Justice, Education and Health and Human
Services civil rights divisions to enforce the right of
people 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?
>> Dean
______X_____YES _________NO ___________ NO
OPINION
Comments: I look forward to appointing a Special Assistant
to the President for Disability Policy.
>> Edwards
______X____YES _________NO ___________ NO OPINION
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.
>> Kerry
_____X______YES _________NO ___________ NO OPINION
Comments
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.
>> Kucinich
_____X______YES _________NO ___________ NO OPINION
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