Below please find a fact sheet about a meeting between the President, Chief of Staff John Podesta, Mary Beth Cahill (Director of Public  Liaison), Chris Jennings (Deputy Director of the Domestic Policy Council), and representatives of the disability community, held this morning in  the Cabinet Room.  The meeting focused on home- and community-based services and supports.  The President opened the meeting with a  summary of priority disability issues he is now working to get passed before Congress adjourns, and announced a new regulation to disregard  income so more people with disabilities can qualify for Medicaid and receive services and supports in the community.

The disability community representatives in the meeting were: Mike Auberger, James Billy, Justin Dart, Andy Imparato, Debbie Kaplan, Paul Marchand, Mike Oxford, Bobby Silverstein, Barbara Toomer, and Nancy Weiss. Tim Westmoreland (of HCFA), Bob Williams (of HHS), and I  were also in attendance.  Many thanks to all the advocates, Members of Congress, and Administration officials who have worked hard on these  issues and, in particular, have developed a strong Administrative action that will move us further forward in providing home- and  community-based services and supports for people with disabilities.


     Invests Approximately $1 Billion To Provide a New Coverage Option Nationwide
                             October 27, 2000

Today, in a meeting with national disability groups, the President will announce a major new administrative action to expand Medicaid  eligibility for people with disabilities and promote the use of home and community-based services and supports.  He will also call on the  Congress to refocus their priorities from excessive and unaccountable HMO payment increases and towards investments in coverage  expansions for workers and children with disabilities, as well as new grants to help states expand access to home and community-based  services and supports.  The proposed regulation invests $960 million over five years in a new option for states to expand Medicaid coverage  for tens of thousands of people with disabilities, preventing them from having to become impoverished and allowing them to move from institutions into community based care settings.


+     State options for Medicaid coverage for people with disabilities are limited.  Thousands of people with disabilities and senior citizens only qualify for Medicaid if they have very high medical expenses that force their incomes below the poverty level.  Since Medicaid is the only available source of health care and essential personal assistance services for many people, they are forced to keep their incomes low in order  to qualify.  As a result, they must choose between paying for essentials such as food or shelter and critical health expenses in order to lower  their income to the "medically needy" income levels currently required.

+     Families of disabled children are forced into poverty in order to retain Medicaid eligibility for their children.   Current data indicates that  over 60 percent of the thousands of families with special needs children are turning down jobs, raises, and overtime in order to ensure that they  stay in the income bracket that qualifies their child for Medicaid.

+     There are insufficient home and community-based services and supports for people with disabilities.   For decades people with disabilities who need long-term care services, both old and young, have advocated for "real choice" about where to receive those services  and asked for alternatives to nursing homes and other institutions where they receive long-term care services.  Every state Medicaid program  must provide nursing home services, but community-based services are optional.  In part, this is because the institutional bias in Medicaid  precludes the development of community based services and supports.


Today, President Clinton  will announce new action to expand Medicaid eligibility for people with disabilities.  The proposed regulation, which  costs $960 million over 5 years, allows states to further "disregard" portions of an individual's income when determining their eligibility, such as  the amount spent on food or shelter.  States can use these broader rules to provide Medicaid coverage to people who would not otherwise be  eligible, and move people from institutions into the community by allowing them to retain additional income to pay for food, clothing, and  shelter.  In addition, the broader rules can be used to encourage people to return to work or continue to work by ensuring that they will not lose  their health insurance coverage if their income increases slightly.


Today, the President will call on the Congress to refocus their priorities from excessive and unaccountable HMO payment increases and  towards investments in coverage expansions for workers and children with disabilities, as well as new grants to help states expand home and  community-based services and supports.  As part of this effort, he will urge the Congress to act now to address critical health care priorities for the disability community, including:

+     Increasing access to Medicaid for working families with disabled children.  Today, the President will urge the Congress to pass the bipartisan Grassley-Kennedy-Sessions-Waxman Family Opportunity Act of 2000 (S. 2274 and HR 4825), which was sponsored by a  bipartisan majority in the Senate and a growing coalition in the House.  This bill, which is the next logical step beyond the Jeffords-Kennedy  Work Incentives Improvement Act, invests $2.1 billion over five years to establish a new Medicaid buy-in option for thousands of children with  disabilities who lose their Medicaid coverage because of increased family income due to employment and a time-limited demonstration that  extends Medicaid coverage to children who have a disabling condition that, without health care coverage, would cause them to become so severely disabled as to be eligible for SSI.

+     Enhancing state capacity to provide home and community-based services and supports.  The President will join Senator Harkin in urging  the Congress to fund $50 million in new grants to conduct intensive outreach efforts to educate people with disabilities about the home and  community based options currently available to them; create new one-stop-shopping centers that streamline application and eligibility  processes for home and community-based services and supports; and identify, develop, and implement strategies to modify state policy that  results in the unnecessary institutionalization of people with disabilities rather than the provision of home and community based services.  As a  condition of receiving funds, states would actively involve people with disabilities and their families in the development of programs enabling  people with disabilities to choose where they want to live and receive services.  Senator Harkin has been a tireless advocate for this critically  important initiative.

+     Finish the job on the Work Incentives Improvement Act.  The bipartisan Work Incentives Improvement Act, enacted by the Clinton-Gore Administration last year, extends Medicare coverage for eight and a half years for people with disabilities who return to work, ensuring that everyone with a disability returning to work have access to health care coverage, even if they live in a state that does not take the Medicaid option. The President will urge the Congress to finish the job on the Work Incentives Improvement Act by providing permanent Medicare  coverage to people with disabilities returning to work.

+     Additional health care priorities important to people with disabilities.  The President will reiterate the importance of a series of other high- priority health care initiatives, including: a voluntary Medicare prescription drug benefit; a strong and enforceable Patients' Bill of Rights; a  $3,000 long-term care tax credit for people of all ages; and a new $1,000 tax credit to offset the formal and informal employment related costs incurred by working people with disabilities.


Throughout this Administration, President Clinton and Vice President Gore have worked hard to achieve equality of opportunity, full  participation, independent living, and economic self-sufficiency for people with disabilities.  This Administration has vigorously defended the  ADA in court cases across the Nation; collaborated with State Medicaid directors to implement the Supreme Court's 1999 Olmstead decision,  which prohibits unjustified isolation of institutionalized persons with disabilities; helped ensure that 80 percent of America's public transit buses  are now accessible; worked to implement the Ticket to Work and Work Incentives Improvement Act, which the President signed into law last  December; and developed far-reaching policies for a comprehensive, coordinated employment agenda through the Task Force on Employment of Adults with Disabilities.