On March 24, 2009 Representative Danny Davis (D-IL) [H.R. 1670] and Senator Tom Harkin (D-IA) [S. 683] reintroduced the Community Choice Act (CCA) in Congress. This bill would provide people with disabilities and seniors with the option of receiving home support services rather than having to go into nursing homes and institutions.

Our long-term service system must change. Created over forty years ago, it is funded mainly by Medicare and Medicaid dollars; medical dollars not originally meant to meet people's long-term care needs. We must think out of the box to empower people and allow REAL choices.

Our country needs to give people with disabilities and seniors the real choice of living in their community, and the Community Choice Act would do that. Community choice would also create jobs for people who can work as personal care attendants.

People with disabilities - both old and young - even those with severe mental and/or physical disabilities want services in the most integrated setting possible. Overwhelmingly, people prefer community services so they can stay in their own home.

The Community Choice Act would guarantee individual choice as well as provide a real savings in economically troubled times. The CCA will protect the human right of people with disabilities to live in their own homes, instead of being forced into institutions or nursing homes. It will also save America money because community based supports cost far less than what it takes to live in a nursing home. We can no longer deny our citizens the right to live where they choose.

Let your federal representatives know that you support the Community Choice Act. If they've already sponsored the bill, thank them and ask them to make sure it included in health care reform. If they haven't sponsered it, let them know you would like them to sign on to the Community Choice Act and make it part of health care reform this year.

For more information visit Disability Options Network.

On March 24, 2009 Representative Danny Davis (D-IL) [H.R. 1670] and Senator Tom Harkin (D-IA) [S. 683] reintroduced the Community Choice Act (CCA) in Congress. This bill would provide people with disabilities and seniors with the option of receiving home support services rather than having to go into nursing homes and institutions.

In the United States, it's your entitlement to live in a nursing home and have the costs paid for by Medicaid. It's not your right to choose to live at home. Because of this disparity, the disabled are more or less being incarcerated without ever committing a crime.

People with disabilities - both old and young - even those with severe mental and/or physical disabilities want services in the most integrated setting possible. Overwhelmingly, people prefer community services so they can stay in their own home.

During his campaign last year, President Obama promised the disability community that if elected, he would work for prompt passage of the CCA. Instead of working to accomplish prompt passage of the CCA, however, the Obama administration has indicated that it wants to address health care reform first.

This is not just another political issue that can be pushed aside. It is a matter of basic human rights and needs to be treated as such. Health care reform cannot be complete without addressing the institutional bias that currently exists.

Contact the White House [link opens in new window] and tell the President to free our people.

The nation’s largest grassroots disability rights organization, ADAPT, expressed outrage today at the Obama administration’s selective endorsement of one piece of proposed long term care legislation while refusing to support a companion measure aimed at eliminating the institutional bias in Medicaid for aging or disabled lower income people that Obama, with strong support from over 80 national disability and aging organizations, co-sponsored as a Senator.

On July 6, Kathleen Sebelius, Secretary of Health and Human Services, sent a letter to Sen. Edward Kennedy, Chair of the Senate Health, Education, Labor and Pensions Committee, expressing President Obama’s support for Kennedy’s “CLASS Act,” which would allow middle class Americans to set aside money from their paychecks in anticipation of the expenses they will likely face for long-term services and supports as they age, or acquire a disability. After paying into the fund for at least 5 years, workers or their non-working spouses could draw on the fund for long-term services and assistance, either in a nursing home or in the community. Workers who wish could opt out of the program, an outcome more likely in tough economic times or in cases where low worker-wages barely cover individual or family survival expenses.

“Those of us with disabilities, who are aging, and who aren’t able to work are outraged that the President has issued public support for this primarily middle class legislation, and has completely ignored the companion legislation that would include lower income disabled and older people in reform of long term services and supports, and health care reform,” said Bob Kafka, Texas ADAPT Organizer. “It’s like we don’t exist!”

ADAPT and a multitude of other national disability and aging organizations in Washington have gone on record in support of Sen. Kennedy’s CLASS Act only if it is paired with a “fix” for Medicaid addressing lower income and non-working people, similar to provisions contained in the Community Choice Act (CCA). CCA inserts the concept of “personal choice” into the law, adding language that mandates states to pay for help in a person’s own home the same way the law mandates them to pay for nursing homes. Current law can force people with disabilities and who are aging into nursing homes in order to receive services that can just as easily be delivered in the community. Research has demonstrated that community-based assistance is almost always less expensive.

“When President Obama was a senator, he co-sponsored CCA,” said Dawn Russell, ADAPT Organizer from Denver Colorado, “and when he campaigned for the Presidency, he pledged to support CCA. But since he was elected, and we met with his people at the White House they told us that he will not include long term services and supports in health care reform. When we heard that, we expressed our disappointment and anger in a peaceful protest outside the White House. The President responded by having us arrested, and there were very heavy fines levied against us. It feels like the President is trying to intimidate and silence us so we won’t speak up for people with disabilities, people with low incomes, and those who are aging who are at risk of being forced into nursing homes under the current law.”

Because the CLASS Act does not address the Medicaid “institutional bias,” people who use up the benefits they save under the act will still face having to move to nursing homes to keep getting assistance, unless they can afford to stay in their own homes because of other resources they have.

“When I voted last November, I was sure I was voting for a great man who would bring freedom to people with disabilities,” said Bruce Darling, ADAPT Organizer from New York. “Just as President Lincoln freed the slaves, I felt that President Obama would free those of us with disabilities from the continued threat of incarceration in a nursing homes and institutions. Now, I feel like a fool, because this administration apparently cares nothing for us and has no respect for our freedom and our civil rights.”

President Obama says that rising health care costs are an imminent threat to our economy and that any reform must reduce these long-term costs. Rapidly escalating health care costs are crushing family, business, and government budgets.

Obama wants to "make health care more affordable by increasing competition, providing more choices and keeping insurance companies honest."

"Choice" is a big part of the proposed health care reform plan. It just so happens that an important bill that has been introduced in both Congress and Senate also includes that word. On March 24, 2009 Representative Danny Davis and Senator Tom Harkin introduced the Community Choice Act (CCA) in Congress. The Community Choice Act would allow Medicaid-eligible Americans with significant disabilities the choice of living in their community, rather than having to live in a nursing home or other institution.

Chances of the CCA bills successfully making their way through Congress on their own are slim. Chances of including CCA in health care reform are probably even slimmer. The Obama administration has refused to even consider including it in any health care reform plan.

According to Obama, health care reform is about improving choice and lowering costs. Why can't Obama and Congress see the trees through the forest?

About 1.7 million elderly and disabled people receive care in approximately 17,000 nursing homes across the United States. Anywhere from 10-40% of these people do not need to live there according to the 2006 book "Aging" by Harry R. Moody.

It costs approximately $67,000 per year to keep a person in a nursing home. On the other hand, home and community based services only costs about $21,000 per year. If 10% of 1.7 million nursing home residents could choose to live at home, it would save taxpayers approximately $8 billion a year. If 40% of these people could choose to live at home it would save about $31 billion a year.

You'd have to be foolish to not see that any health care reform package is incomplete if it does not include the Community Choice Act.

Lost until recently in the current debate about health care reform was the disabled community's movement to include the Community Choice Act (CCA) in health care reform.

The Community Choice Act would provide people with disabilities and seniors with the option of receiving home support services rather than having to go into nursing homes and institutions. On March 24, 2009 Representative Danny Davis and Senator Tom Harkin introduced the CCA bills in Congress.

President Obama wants to "make health care more affordable by increasing competition, providing more choices and keeping insurance companies honest." It is a fact that home and community-based services cost about 1/3 of what it costs to keep someone in a nursing home for a year and provides "choice" for our most vulnerable citizens.

Western PA ADAPT activists have been fighting for CCA in the last few months, undertaking numerous actions to let our legislatures know that any health care reform package is incomplete if it does not include elements of CCA.

On Friday, September 18, 2009, New York Senator Schumer introduced the Community First Choice amendment to the Senate Finance Committee's health care reform. If enacted, the Community First Choice Option would be an optional program that gives states an enhanced federal Medicaid match for providing attendant services and supports as an alternative to placement in a nursing facility or other institution.

On Tuesday, September 22, 2009, the Community First Choice Option was incorporated into the Senate Finance Committee bill. This is the closest we've ever been to getting the language of the Community Choice Act into federal law.

Please contact your Senators and let them know that you support the Community First Choice Option and that it is critical they keep it in the final version they approve. You can call using this toll-free number: 866-324-0787. A switchboard operator will connect you directly with the Senate office you request.