The Community Choice Act is about individual CHOICE.  It allows an individual to choose to receive their care in the community, rather than in an institutional setting.  There is nothing in the Act, which takes away the right of an individual to receive their services in an institutional setting, if they so choose.

"We have all advocated for the Community Choice Act for many years and we all look forward to the day when no one remains in a nursing home or other institution who wishes to live in their own home.  I believe this important legislation has a real chance in passing through this Congress and will enable people with disabilities to have a choice to remain in their homes, in their communities with quality support services" says NCIL President Kelly Buckland.

You realize, of course, that many people in a nursing home require 24-hour care.  If they choose to remain in their home, they will still require 24-hour care only now taxpayers will pay for it.  That's 3 nurses a day (8 hour shifts) plus additional nurses on the weekend.  Essentially, taxpayers will be paying the salaries of 6 nurses PER PATIENT.  Instead of splitting the cost of 6 nurses working with multiple patients, you are now going to be paying for 6 nurses PER PATIENT.    

That's crazy!

I used to feel really sorry for families of handicapped kids until I stumbled across a Webring for a particular disease (can't remember which one) and I got to read a lot of family stories.  Most of these kids with this disease died young and quickly -- but one family, even after discovering this was a genetic thing with them, continued to have another kid -- and their kids lived a LONG time!  The oldest one was approximately 14 when I read the story.  You would think that they would be broke with two handicapped kids -- but no!  They had a new house, round the clock care for the kids, VACATIONS, new van, new everything.  The public school system was forced to teach these kids (who were basically hooked up to life support) on a daily basis with special teachers.  (I think the parents sued for this.)  Can you imagine how much public money is being spent on these two kids who probably won't live to be 21?  Why??!!  How will we ever have minimum healthcare for everyone when we are willing to waste millions of dollars on extraordinary care for a couple of kids who won't ever have productive lives?  And how do these people get FREE houses?  FREE vans?  FREE everything?  I know married couples with healthy kids who would KILL to get a vacation!

Anyway, I think Reagan made a huge mistake when he let the mentally ill loose in the communities.  They should have been kept in institutionalized care.  (That's why there were so many mentally ill homeless people back in the early '80s.)  

There isn't enough money to give everyone everything they would like to have!

There was a kid who died not long ago because he had an abcessed tooth and the infection spread to his brain.  Because there wasn't enough money (Medicaid) to pay for his dental work, he never got a filling he needed.  

In the meantime though, we waste millions keeping alive people who should have died long ago if it wasn't for extraordinary care.  

For decades, people with disabilities, both old and young, have wanted alternatives to nursing homes and other institutions when they need long term services. Our long term care system has a heavy institutional bias. Every state that receives Medicaid MUST provide nursing home services, but community based services are optional. Sixty five percent of Medicaid long term care dollars pay for institutional services, while the remaining 25% must cover all the community based waivers, optional programs, etc.

Families are in crisis. When support services are needed there are no real choices in the community. Whether a child is born with a disability, an adult has a traumatic injury or a person becomes disabled through the aging process, they overwhelmingly wan t their attendant services provided in their own homes, not nursing homes or other large institutions. People with disabilities and their families will no longer tolerate being forced into selecting institutions. It's time for Real Choice.

The Community Choice Act provides an alternative and will fundamentally change our long term care system and the institutional bias that now exists. Building on the Money Follows the Person concept, the two million Americans currently residing in nursing homes and other institutions would have a choice. In addition, people would not be forced into institutions in order to get out on community services; once they are deemed eligible for the institutional services, people with disabilities and their families will be able to choose where and how they receive services. Instead of making a new entitlement, the Community Choice Act, makes the existing entitlement more flexible.

The Community Choice Act establishes a national program of community-based attendant services and supports for people with disabilities, regardless of age or disability. This bill would allow the dollars to follow the person, and allow eligible individuals, or their representatives, to choose where they would receive services and supports. Any individual who is entitled to nursing home or other institutional services will now be able to choose where and how these services are provided.

Grace, I was more than a little disturbed at some of what you wrote in your comments.  I don't know if you have children, but I have two - thankfully, both normal and healthy and in their 20's - but the things you describe about the parents of the disabled children sound like nothing more than people who love their kids and want to give them as normal a life as possible - even if that doesn't make sense to you.  That means holidays and vacations and yes - even school.

I know a little bit about this stuff in 3 ways.

My ex-wife runs (manages) a series of group homes for a variety of disabled people who used to be in state institutions.  The gamut is from those with mental disorders to developmentally disabled to crippling diseases to accidentally crippled.  In general, the average financial impact is to reduce taxpayer costs from about $200,000 per year to about $55,000 per year for the 65 or 70 people in her caseload--do the arithmetic. And, yes, there are some disturbingly failed efforts at training & education of severely limited people that become newspaper articles or television stories. Such misguided attempts do not warrant trashing the programs.

A neighbor attended some "caregiver" course at a community college & has an associate degree in somesuch.  She scurries to 3 different homes 3 times per day to prepare meals, give baths, change colostomy bags, give injected meds, etc.  Her work keeps 3 disabled people out of the institutions, in their own homes, & financially independent.  According to her, the quality of life for those 3 is huge, orders of magnitude beyond "warehousing" in a charnel house.

In my area there is a Visiting Nurses Assoc.  As I understand it from a couple of them, they go into homes & provide medical care to such a large variety of different levels of disability that it's impossible to generalize.  Each & every one of these "patients" is effectively removed from expensive institutional care.  One of the nurses told me that her work with in-home post-operative care saves the state medicaid & the federal medicare programs millions of dollars per year.

Finally, a few of my neighbors have a simple program, Meals-on-Wheels, that keeps a couple of them in their homes instead of in a nursing facility.

It seems to me that focusing on a few hundred, or even a few thousand, "apparently" over-reaching attempts at independence from institutions is just churlish.

People with physical or mental problems who cannot function on their own without help are not animals to be kenneled; they are human beings who deserve respect and dignity and compassionate care.  Community-based care is a flexible and sensible and financially prudent approach that just reeks of common sense - which is maybe why there is opposition to it.

I have to tell you that I was listening to McCain's town hall on the radio yesterday, and I heard the question on this subject.  It was asked by a woman who had problems of her own - given that it was radio, I obviously could not see her, but she seemed to struggle to breathe.  I found myself holding my own breath waiting to see how McCain would respond, and was offended with his response when he did.  It was curt and cold and unfeeling.

Then I came to this thread today, and found comments that were equally offensive; I simply do not know what to make of Grace's comments - which just made me feel sick inside - but I hope she will return to read the comments of those who have lived these kinds of situations.  

The reference to Reagan above is right on. This is the sort of stuff Reagan would do. Except then all the press would swoon over him as he insulted or was cruel. McCain doesn't have that kind of skill despite the WSG comment.

I'm a bleeding heart when it comes to this stuff, I'd like to see all disabled persons be able to live on their own with whatever assistance they need from us, the community.  Institutionalized care in state-run hospitals is often heartless and crappy, imo, and no one should be forced to be institutionalized unless they are violent or a threat to others.  I don't believe in welfare for able-bodied adults, but I'm a firm believer for children, the disabled, the sick, and the old.

However, the money has got to come from somewhere.  If it were up to me I'd give up the DEA, NSA, ICE (pick your tyrannical acronym) to fund this program...but it's not up to me.

I have lived in seven countries, and the only one in which I have lived that approaches this country's dismal state of care for people who are less than rich is Indonesia.    Pre-natal care?  Infant mortality?  Quality of life?  Expectations of longevity?