Vol. 9, No. 2 Spring 2001	Previous Issues Subscribe to AT Messenger Download PDF Viewer
	Large Print (pdf) Text Version

Consumers Rally Support for Attendant Services Bill

by Brian J. Hartman, Esq., Project Director
Disabilities Law Program

With the enthusiastic backing of consumer organizations, the "Community-based Attendant Services Act" is gaining lots of attention in Delaware's Legislature. Introduced on January 18, 2001 as House Bill No. 30, the bill enjoys broad bipartisan support. Apart from its prime sponsors, Rep. Pamela Maier (R­ Drummond Hill) and Sen. Patricia Blevins (D­Elsmere), it enjoys the sponsorship of 17 senators and representatives.1

By unanimous vote, the bill cleared the House Health & Human Development Committee on January 24. The Committee noted the written endorsements of several State councils and consumer organizations.2 Several advocates and consumers personally attended the Committee hearing to urge Committee approval.

Background

Federal Level

The introduction of H.B. No. 30 reflects a national trend to promote attendant services. Last year Federal legislation was pending in both the House and Senate to enhance consumer access to such supports. The Medicaid Community Attendant Services and Supports Act ("MiCASSA") received endorsements from more than 72 national organizations, including such diverse groups as the U.S. Conference of Mayors, Paralyzed Veterans of America, and National Council on the Aging.3 Although not enacted, reintroduction in the current Congress is expected in 2001.

Federal agencies are actively encouraging states to expand the availability of attendant services. In 1999, the U.S. Supreme Court issued a landmark decision characterizing unnecessary institutionalization as illegal under the Americans with Disabilities Act.4 Using Olmstead as a springboard, several Federal initiatives are being promoted to help states provide community-based services, including attendant care. On January 10, 2001, the Federal Government announced the availability of a promising grant program, "Community-Based Attendant Services with Individual Control."5 Grants between $150,000 and $1,000,000 will be available to states by September, 2001 for a host of activities to enhance the availability of attendant services.

State Level

Within Delaware, H.B. No. 30 is the product of years of research and collaboration. In 1998, the Disabilities Law Program (DLP) joined with three agencies to address the chronic lack of attendant services in the state.6 The University of Delaware obtained consumer input through forums and interviews. The DLP researched laws in all 50 states, issued a summary report, and drafted model legislation in 1999. After input from State government agencies, the bill was introduced in the Spring of 2000 as H.B. No. 485. Unfortunately, uncertainty over funding prevented action on the bill.

Features

If enacted, the current bill would establish a statewide attendant services program open to persons with severe, long-term disabilities. The program would be operated by the Department of Health & Social Services. Attendants could assist consumers in several contexts-eating, dressing, personal hygiene, shopping, and vocational activities. Recognizing the increasing role of technology, the bill explicitly authorizes assistance with medical equipment, devices and assistive technology. For example, transfers to and from wheelchairs and vehicles is covered.

The program stresses consumer choice and independence. Participants would enjoy the option of hiring and supervising their attendants. Individual service plans would tailor the services to meet the unique needs of participants. For safety, attendants would undergo a criminal background check.

Funding

Although broad in authorized scope, the new program would be implemented within the limits of actual funding. The sponsors hope that the Legislature will approve start-up funds to cover at least 50 individuals. To stretch dollars and promote equity, the Department would adopt an income-based sliding fee schedule. In the long-run, the program may eventually save money. The average cost of a nursing home stay is $55,845 per year.7 In contrast, the Department projects an annual per person cost of only $13,500-$15,000 per year for attendant services. Finally, the bill mandates the Department and its advisory council to seek other sources of funding. Given the prospect of multiple Federal funding initiatives, Delaware could better compete for grants by adopting model enabling legislation.

Conclusion

Enactment of H.B. No. 30 is a top priority among Delawareans with disabilities. The bill enjoys wide grassroots support, reduces unnecessary institutional placements, and is cost-effective. Consumers hope that legislative approval will let Delaware "hit the ground running" in competition for Federal grants.

Footnotes

1 Upon introduction, co-sponsors included Sens. Cloutier, Henry, and Winslow; and Reps. Boulden, Buckworth, Carey, Cathcart, DiPinto, Hudson, Keeley, Lofink, Smith, Spence, Stone, Ulbrich, Viola, and Wagner.
back to article

2 The Committee report reflects the endorsements of the following organizations: Easter Seals; the Developmental Disabilities Council; the Governor's Advisory Council for Aging & Adults with Physical Disabilities; the Governor's Advisory Council for Exceptional Citizens; Independent Resources, Inc.; the National MS Society/DE Chapter; and the State Council for Persons with Disabilities.
back to article

3 The list of endorsing agencies is compiled on the Web at www.adapt.org/casa/supporters.htm.
back to article

4 In Olmstead v. L.C., 119 S.Ct. 2176 (1999), the U.S. Supreme Court held that states must administer their services, programs, and activities "in the most integrated setting appropriate to the needs of qualified individuals with disabilities."
back to article

5 HCFA, Olmstead Update No. 5 (January 10, 2001), reprinted at www.protectionandadvocacy.com/HHSOlmsteadletter51.htm.
back to article

6 The Developmental Disabilities Council provided funding for a consumer needs assessment, research, and development of legislation. The State Council for Persons with Disabilities organized projects. The University of Delaware provided technical assistance and arranged consumer forums.
back to article

7 These figures are based on a national study conducted by MetLife Mature Market Institute, an arm of Metropolitan Life Insurance Company. The results were published in the August 21, 2000 Delaware News Journal, at D2.
back to article