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Pass the Community Choice Act of 2009 (H.R.1670/S.683)

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Permit persons with disabilities and the elderly to live in their own homes and independently in their community.

What is the Community Choice Act of 2009?

The Community Choice Act of 2009 - Amends title XIX (Medicaid) of the Social Security Act (SSA) to require state Medicaid plan coverage of community-based attendant services and supports for certain Medicaid-eligible individuals.

H.R.  1670  was introduced by Congressman Danny K. Davis on March 23, 2009 and has a companion bill in the U.S. Senate introduced by Senator Harkin S.683.

For more information on the Community Choice Act please click here

Why is this bill important?

Institutionalizing people is a violation of a person’s right to liberty and security of person. Whether it is 6 people or more, in intermediate care facilities or group homes, people are not in charge of their lives. They cannot leave. The 1999 U.S. Supreme Court decision of Olmstead holds, under the Title II of the ADA, that services must be provided in the most integrated setting appropriate to an individual’s needs. Although most states are moving people with developmental disabilities from large institutions to community living arrangements, institutionalization of people with disabilities remains a common practice. The system is still biased toward institutions and too often people with disabilities are neither afforded the choice of where to live, nor provided with adequate supports and services to maintain themselves in the community.

The reason people do not often have any real alternative to institutional placement is the institutional bias in Medicaid funding for long-term services.  Financial assistance for community-based services has been provided since the 1980s through the Home and Community Based Services Waiver (HCBS) program under Medicaid.  However, under Medicaid laws, states are required to provide institutional services (i.e. nursing facility care), while community-based services are optional.

There are currently 1.5 million Americans in nursing facilities and 129,000 in intermediate care facilities.  According to the Centers for Medicare and Medicaid Services, 20% of individuals in nursing homes have expressed an interest in living in the community.  Another study conducted by Access Living and the Center for Urban Research and Learning at Loyola University in Chicago found that 64.5% of nursing home residents surveyed expressed that they would prefer to live elsewhere given the opportunity.

The institutionalization of persons with disabilities in facilities that they are unable to leave, either because they are locked in or because the services they need are not provided in the community, violates the right to liberty and security of the person under UDHR Article 3 and ICCPR Article 9, as well as CRPD Articles 14 and 19, to which the U.S. is a signatory.

Why is there an urgent need to pass this legislation?

People continue to be abused and murdered when living in institutions.  In the past several years, many examples of abuses have been documented in Texas institutions for persons with disabilities.  In March 2009 it was discovered that employees of the Corpus Christi State School had been forcing mentally disabled residents to fight each other for the staff’s amusement.  In June 2009, 45-year old Michael Nicholson was suffocated to death by Lubbock State School worker, Donnell Smith. Smith was charged with manslaughter, but 5 other staff witnesses to the incident have not been charged.  These high profile events followed years of allegations that went mostly un-investigated and unprosecuted.  In fiscal year 2008, the Corpus Christi school had almost 1,000 allegations of abuse, neglect or mistreatment, of which 60 were confirmed.  On average, about 300 employees are fired or suspended every year for abusing or neglecting residents in Texas institutions alone. 

The abuse of persons with disabilities in institutions violates the right to security of the person and freedom from torture and ill-treatment, under UDHR Articles 3 and 5, and ICCPR Articles 7 and 9, as well as CRPD Articles 14, 15, 16 and 17, to which the U.S. is a signatory.

For more information on the Community Choice Act please click here

The Community Choice Act outlines requirements for: (1) an enhanced federal medical assistance percentage (FMAP) for ongoing activities of early coverage states that enhance and promote the use of community-based attendant services and supports; and (2) increased federal financial participation for certain expenditures incurred by the state for the provision of such services and supports.

It directs the Secretary of Health and Human Services to: (1) award grants to eligible states which have established a Consumer Task Force to assist the state in its development of real choice systems change initiatives; and (2) conduct a demonstration project for the purpose of evaluating service coordination and cost-sharing approaches with respect to the provision of community-based services and supports to dually eligible individuals.

H.R.1670 Title: Community Choice Act of 2009
Sponsor: Rep Davis, Danny K. [IL-7] (introduced 3/23/2009)      Cosponsors (126)
Related Bills: S.683
Latest Major Action: 3/23/2009 Referred to House committee. Status: Referred to the House Committee on Energy and Commerce.


S.683 Title: Community Choice Act of 2009
Sponsor: Sen Harkin, Tom [IA] (introduced 3/24/2009)      Cosponsors (26)
Related Bills: H.R.1670
Latest Major Action: 3/24/2009 Referred to Senate committee. Status: Read twice and referred to the Committee on Finance.

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