Association of University Centers on Disabilities Applauds Bush Administration for Commitment to Reform Institutional Bias in Medicaid

January 23, 2003

George S. Jesien, PhD
Former Executive Director

SILVER SPRING, MD (January 23, 2003) - The Association of University Centers on Disabilities (AUCD, formerly the American Association of University Affiliated Programs) is pleased by the recent announcement that the Bush Administration will propose a new $1.75 billion, five-year program to demonstrate the effectiveness of using the Medicaid waiver program to provide community-based rather than institutional services for people with disabilities. AUCD applauds the Administration's stated commitment to "changing policies that unnecessarily confine people with disabilities in institutional settings" and the commitment to "work with the states and the disability community to change old programs and develop new ones that will serve people with disabilities in the settings that work best for them."

AUCD has long advocated for reforming the institutional bias in the Medicaid program. Currently, over 75 percent of Medicaid long-term care dollars are spent on institutional services, leaving few dollars for community-based services. "A national long-term service policy should not favor institutions over home and community-based services. It should allow families and individuals real choice regarding where and how services should be delivered," said association President Bob Bacon. "AUCD looks forward to learning more details about this new demonstration program. This new program has real potential to fulfill President Bush's promise to assist states to meet their obligations under the Supreme Court 1999 Olmstead decision. However, the Administration must follow through on the promise by making this and other New Freedom Initiative goals a legislative and budget reality. AUCD has been disappointed that many of the President's New Freedom Initiatives, although already two years old, have not yet been implemented."

AUCD is also very pleased that the President's Budget will also include $40 million to continue funding the Systems Change Grants for Community Living in FY 2004. "These systems change grants, part of the Administration's NFI, have had the greatest impact, so far, in supporting states to create innovative and concrete ways to support people with disabilities in the community," said Bacon.

AUCD also hopes that the Administration continues to seek ways to address other significant barriers to community living for people with disabilities. These barriers include a lack of comprehensive, quality, affordable health care; the need to support family caregivers; the shortage in affordable, accessible housing; a lack of accessible public transportation; a shortage of qualified direct care and job training professionals; and the need for technology and other supports to achieve employment. AUCD hopes that all federal departmental agencies will work cooperatively toward removing all these barriers to full inclusion.
Authorized under the Developmental Disabilities Assistance and Bill of Rights Act, AUCD's University Centers for Excellence in Developmental Disabilities, have been instrumental in providing systems change through research, education and training, advocacy, and the provision of quality services to and supports for people with disabilities in the community. AUCD stands ready to assist the Administration and Congress to implement the President's new demonstration proposals.