STATEMENT OF RANKING MEMBER MICHAEL B. ENZI at HELP Committee Hearing - “The ADA and Olmstead Enforcement: Ensuring Community Opportunities for Individuals with Disabilities”

Good afternoon and thank you Chairman Harkin, for your leadership on this important issue and for holding this hearing.   I would also like to thank our witnesses for taking time out of your schedules to be with us.   It’s a pleasure to welcome all of you to our hearing.

Today’s hearing is quite important as it recognizes an important event that took place eleven years ago today.  On June 22, 1999 the Supreme Court ruled in the Olmstead decision which requires that states must provide individuals with disabilities with community-based long term-care services and transfer people into such settings when a state treatment professional has determined such an environment is appropriate; the community placement is not opposed by the individual; and, the placement can be reasonably accommodated.  The Olmstead decision, as it is known, was a landmark that has helped to reshape years of policy in which more costly institutional care was the norm.

Today we will be discussing this important decision and also where we are today in our efforts to implement it.  Shortly after the court issued its ruling, President Bush announced the New Freedom Initiative as part of a nationwide effort to remove barriers to community living for people with disabilities.  On June 18, 2001 President Bush also issued Executive Order 13217, "Community-Based Alternatives for Individuals with Disabilities."  The Order called upon the federal government to assist states and localities so the Supreme Court’s decision would be implemented swiftly and without delay.  Several agencies, including the Department of Justice and the Department of Health and Human Services were required to work with the states to help them determine how well they were complying with the Olmstead decision and develop work plans to provide services to qualified individuals with disabilities in the most integrated settings.  The Departments of Justice and Health and Human Services were also charged with enforcing Title II of the Americans with Disabilities Act, and investigating and resolving complaints filed on behalf of individuals who had alleged that they had been the victims of unjustified institutionalization.   

In June 2009, President Obama announced the “Year of Community Living” to mark the 10th anniversary of the Olmstead decision.  Shortly thereafter, the Department of Health and Human Services announced the Community Living Initiative which includes implementing solutions that address barriers to community living for individuals with disabilities and older Americans.  I look forward to hearing from the witnesses from the Department of Justice and the Department of Health and Human Services (specifically the Centers for Medicare and Medicaid Services) and learning more about what is working and what needs to be improved as states across the nation work to ensure that the requirements of the Olmstead decision are met.

More important than any bureaucracy, the decision is about helping people so they can live where they want to live.  As previous HELP hearings have highlighted, many Americans do not have the resources necessary to pay out of pocket for long-term care in an institution.   According to the Congressional Budget Office fewer than 7 percent of seniors have annual incomes equal to or greater than the annual cost of a nursing home stay.

Even more importantly, most Americans do not want to live in nursing homes and other institutions.   When speaking with seniors and those with long term care needs in my home State of Wyoming, one thing I often hear is that they would rather stay in the community than live in a nursing home or other institution. 

Not only is the community the preferred living option among Americans it is also less costly.  The Amerigroup Corporation reports being able to provide services for three people living in the community for the cost of one person living in a nursing home.  They also report that the Texas Health and Human Services Commission has concluded that community based services cut health and long term care costs by 6.5 percent.

Less costly, community based services and supports are being actively pursued and funded through Aging and Disability Resource Center programs which were authorized by the Older Americans Act and the Centers for Medicare and Medicaid Services Money Follows the Person (MFP) demonstration program, as well as by Medicaid Infrastructure Grants.  Additionally, Wyoming is using the Green House project as a model for community based service delivery.  The Green House Project has taken the next step to deinstitutionalizing skilled nursing care by moving care into real neighborhoods and small towns across rural America.  This model reduces the reliance on costly institutional care and provides community-based options and services in the neighborhoods where beneficiaries and their families live.

I hope this hearing will make it clear that we need to think more creatively and figure out ways in which all Americans can access community services and receive the support they need to lead more rewarding and fulfilling lives in the community. 

Again, I want to thank the witnesses for their participation in today’s hearing.  I look forward to their testimony.