AAPD, ADAPT, NCIL, SABE Questionnaire

August 4, 2007

1. POLITICAL LEADERSHIP
   1. Do you support the creation and appointment of a permanent Assistant to the President for Disability Policy at the White House?
      

      Obama: Yes.

      Richardson: Yes. Since approximately 17-20% of Americans have a disability, I believe it is important to ensure that the rights of people with disabilities are protected. In addition, I will only hire a person with a disability to fill this position to ensure that disability issues from a disability perspective are maintained.

      Edwards: The federal government can and should do much more to help Americans with disabilities achieve independence, productivity, and inclusion. Too often, these issues are not even on the agenda in Washington. Policies affecting people with disabilities can only succeed if they are crafted with the help of people who understand firsthand the challenges Americans with disabilities and their families face. As president, I will ensure that a senior member of the White House staff is dedicated to ensuring that these issues are brought to my personal attention and given the top priority they deserve.

      Clinton: Ever since I walked door-to-door for a project for the Children’s Defense Fund where I sought to account for the number of disabled children not attending public school, I have recognized the need to expand opportunities for individuals with disabilities. From that experience in 1973 to now, I have been passionate about working on behalf of individuals with special needs. As President, I vow to remain committed to this issue, and I look forward to working with disability groups. Part of this outreach will include the appointment of liaisons and officials who are committed to enriching the lives of all Americans who live with disabilities. I have not made any commitments about how I would organize the White House at this level, but I can assure you that the needs and interests of persons with disabilities will be well represented in my Administration and, most importantly, integrated into every relevant domestic and international policy discussion.

      Dodd: Yes.

   2. How will you make sure qualified people with disabilities will be a part of your political team and, if elected, as part of your administration?

      Obama: Individuals with disabilities are an essential part of communities throughout this country, and I believe that receiving input from persons with disabilities is of utmost importance for government leaders. I am committed to ensuring that more job opportunities are provided to individuals with disabilities and that includes hiring people with disabilities on my campaign staff and, if elected, as part of my Administration.

      Richardson: In New Mexico I developed a strategy for hiring people with disabilities into state government. I believe the state should be the largest employer of people with disabilities. As President, I will work to make the federal government the largest employer of people with disabilities. This will be done through eliminating any disability bias in the application process, provide disability awareness training for all supervisors and managers and develop an outreach program targeted to the disability community encouraging them to apply for federal jobs. In addition, I would seek funding to make reasonable accommodations at the work place to assist a person with a disability perform their job.

      Edwards: To be effective, a presidential administration must include a diversity of perspectives. I am already working to ensure the perspectives of people with disabilities are included in my campaign by assembling a group of policy advisors, including people with disabilities, issue experts and advocates. If elected, I would appoint qualified people with disabilities to important jobs throughout my administration, not only jobs that are focused on disability policy. For me this is not just a matter of fairness: it is about having the best possible Administration, which means including a great diversity of perspectives and backgrounds.

      I would also make the federal government a model of diversity for the private workplace. Federal agencies should actively recruit qualified people with disabilities and remove the obstacles for working Americans with disabilities, such as supporting initiatives for telecommuting and flexible work schedules.

      The president must hear the needs and concerns of the 56 million people in America who have disabilities. The issues that people with disabilities are fighting for, like protecting civil rights, better education, good jobs and health care, will only make America stronger in the future. I am committed to maintaining open lines of communication with Americans with disabilities.

      Clinton: I was proud of the contributions of the numerous professionals with disabilities who made significant contributions to policy development and implementation during the Clinton Administration. I plan to repeat, if not enhance, that record. As President, I pledge that I will appoint the most qualified, dedicated, and public-minded people to serve in government, and I believe those people will be diverse in physical ability, race, ethnicity and other characteristics. I feel there is a compelling need to appoint people who understand the challenges facing Americans with disabilities, as well as appointing those qualified individuals that have a physical disability. Throughout my career I have hired a diverse staff because I believe that is how to obtain the best advice – through a range of perspectives. I am eagerly looking forward to working with a broad segment of the population, regardless of physical ability.

      Dodd: My Administration would represent all Americans. Just as individuals with disabilities play a significant role in contributing to their local communities, they would play a significant role in contributing to the Dodd Administration.

      Biden: Yes, I commit to appointing a director of disability policy who reports directly to the policy director and to the President. As President, I will work hard to ensure that my administration reflects the great diversity of the nation, including people with disabilities. I will make sure that people with disabilities and their priorities are shared by all in my administration.

2. EMPLOYMENT
   1. What steps would you take to reduce employment barriers and improve employment outcomes for Americans with disabilities?

      Obama: The barriers that workers with disabilities face in the labor market and workplace are complicated, interrelated, and stubborn. It will take strong leadership from a President dedicated to increasing the employment rate of workers with disabilities in order to define our goals, marshal the necessary resources, bridge bureaucratic and programmatic boundaries, and lead employers, service providers, and people with disabilities into the future.

      I recently met a 22 year-old woman with disabilities in New Hampshire. She spoke about her disabilities that have greatly affected her life, with symptoms similar to multiple sclerosis. Her requests were simple – she wanted to work and do those things that people with healthy bodies often take for granted. I am committed to making sure that those simple requests are honored. My goal is to increase the employment rate among workers with disabilities so that it is as close as possible to the employment rate for all American workers. Achieving this goal will require several steps.

      First, we must recognize that with proper support, people with disabilities are strong contributors to society. All Americans, regardless of disability, deserve a dignified life, and there are many government programs that are essential to this commitment. I am a strong supporter of the 1965 Javits-Wagner-O’Day Act, which facilitates government purchase of products made by blind and severely disabled Americans. I have worked closely with the Chicago Lighthouse (a nonprofit serving the blind that manufactures office products) to strengthen this legislation. And I have called on the Government Accountability Office to investigate the federal government’s compliance with the Act’s mandates.

      Second, we must increase educational opportunities for the disabled. What you learn plays an important role in what you earn and whether you are employed. Yet students with disabilities are more likely to drop out of high school and, even if they finish high school, are less likely to pursue four-year college degrees. We must fund IDEA and increase the emphasis in secondary schools on students’ transition planning for college. And we must provide the necessary funding for Vocational Rehabilitation and Pell Grants to support students with disabilities seeking college degrees.

      Third, we must solve our health care crisis. One of the most important barriers to workers with disabilities seeking and keeping jobs is the uncertainty associated with the employer-based health insurance system. For adults with disabilities, no health insurance can mean irrevocable physical and mental health deterioration because they need regular care and supervision of their conditions by doctors and specialists. Without health insurance, they must pay for these services out of pocket and, as a result, might forego or delay the medical care they need. Yet 45 million Americans currently have no health insurance. A smaller percentage of workers currently have employer-provided health insurance than had it in 1987. A smaller percentage of employers provide health insurance. And the costs of health insurance to workers have risen. Assuring that people with disabilities can have jobs with health insurance will be a critical step to increasing their opportunities to find employment. That is why I am committed to signing a universal health care plan into law by the end of my first term in office and having a plan that will lower premium costs for a typical family by $2,500.

      Fourth, we must strengthen our civil rights laws to protect disabled Americans from employment discrimination. I am committed to funding and better enforcing the Americans with Disabilities Act, as well as strengthening other legislation to ensure that individuals with disabilities have equal opportunity to participate in the workplace.

      Finally, I will direct my administration to increase the employment of workers with disabilities during my first term. I will also use the authority provided to the President, as well as my bully pulpit, to encourage private-sector employers to increase their hiring of workers with disabilities. Among other things, private-sector employers should be encouraged to increase their use of existing tax benefits like the Work Opportunity Tax Credit to hire more workers with disabilities.

      Richardson: In addition to the steps I have outlined above, I would continue to challenge federal and state government agencies as well as private employers to employ people with disabilities. It is difficult to track employees with disabilities because of the confidentiality clauses regarding employment, but I would establish a method of determining how many people with disabilities are employed and challenge business to increase that number every year. Tax incentives will also be established to encourage private businesses to hire more people with disabilities.

      Research shows that people with significant disabilities that hold college degrees are employed at about the same rate as their nondisabled peers. I would work on establishing student disability programs to encourage people with disabilities to further their education.

      Edwards: Work is central to our lives, not only for economic independence but also to give our lives dignity and meaning. However, two out of three working-age Americans with disabilities are out of work today. Excluding anyone from mainstream American life is morally unacceptable. It also needlessly wastes great potential. Reducing barriers can create tremendous economic opportunity for our country.

      One of the goals I have set for America is lifting 12 million Americans out of poverty in a decade and eliminating poverty in America over the next 30 years. It is something we must do to restore our moral authority in the world. Restoring our moral authority means leading by example and making clear that hard challenges don't frighten us, but call us to action.

      In America, every person should have the chance to live up to his or her potential at work and in our communities. We cannot achieve that goal without addressing the barriers that confront Americans with disabilities when they seek to work. Too often, people with disabilities are denied that opportunity because unfair obstacles get in their way. I believe we must break down these barriers, and I have a comprehensive agenda to give every American equal opportunity.

      First, we must concentrate on young people with disabilities who have higher dropout rates and lower college enrollment rates, making future employment more difficult. We must remove barriers to education. Those who do graduate have more difficulty finding a first job and getting their careers on track. Education must be accessible in elementary and secondary schools and in vocational schools, community colleges, universities, and graduate programs. I will ensure that the Department of Education strictly enforces the law and brings together experts to address means to eliminate these barriers.

      We lose far too many Americans with disabilities in the transition from school to either the workplace or higher education. My Breaking Down Barriers initiative will give young people meaningful job experiences and create a sense of the possibilities of their future. It will provide them valuable skills and contacts for finding a job after graduation, helping them on the path towards success and self-sufficiency. I support vocational rehabilitation programs and the expansion of employment-based settings for federally-funded job education.

      Second, we must extend the possibility of independent living. For people with disabilities, living within their own communities is essential to job opportunities. Work from home opportunities exist in greater quantity and quality when a person with a disability has family and home resources to utilize each day. Full oversight of state implementation of the Olmstead requirements will be a core objective in my administration. I will also create 1 million new Section 8 housing choice vouchers and support ongoing funding of existing vouchers, creating greater housing opportunities for people with disabilities. A portion of these vouchers will serve low-income people with disabilities. To ensure accessibility, I will instruct the Department of Housing and Urban Development to determine whether local housing authorities are complying with requirements to provide a list of accessible units; regular publication of these lists is the only meaningful way to demonstrate compliance.

      Third, the federal government has an important role in ensuring access to transportation. Accessible transportation is a critical component of increased work opportunities for people with disabilities. Funding and enforcement of transportation access requirements will be central to the mission of the Department of Transportation.

      Fourth, we owe a special debt to veterans with disabilities. I would restore vocational training programs for disabled and occupationally challenged veterans. The Bush administration terminated the well-regarded program at the Department of Labor that offered skill training and job placement for disabled veterans. I would renew the program to help meet the post-Iraq needs of large numbers of military personnel returning from active duty, as well as older generations of veterans.

      Fifth, to fight stereotypes and misconceptions, my Administration will work with national business leaders to create employment opportunities for people with disabilities. Employers who have a positive experience will be likely be more willing to hire someone with a disability in the future.

      Finally, we must vigorously enforce the law. I am committed to protecting the civil rights of people with disabilities. Full enforcement of the Americans with Disabilities Act and the Rehabilitation Act is critical to continued job opportunities for people with disabilities. We should be sure that federal agencies are ensuring compliance by federal contractors, going beyond the current minimalist approach described by a recent report of the National Council on Disabilities. The Civil Rights Division and Office for Civil Rights in the Department of Justice will become more involved in the enforcement of the ADA and especially the Olmstead decision. Open communication with the disabilities community will be essential to the mission of the Justice Department in enforcing these federal protections for the disabilities community in both the public and private workplaces. As president, I would nominate judges who are committed to protecting the rights of all Americans. While I served in the Senate, I was proud to vote against the judicial nomination of Jeffrey Sutton, who argued that federal protections of the ADA were not needed.

      Clinton: I strongly believe that we have an obligation to help those with disabilities achieve meaningful employment opportunities. As a testament to this commitment, I rigorously fought the Bush Administration’s "WIA-Plus" proposal, which would have undermined the Vocational Rehabilitation program by allowing states to spend the money on a wide range of activities, including those that would not help individuals with disabilities address barriers to employment. As President, I pledge to financially support the Vocational Rehabilitation Program, while also proposing additional legislation that would empower Americans with disabilities. In addition, my husband was proud to sign into law the Work Incentives Improvement Act, which created the Ticket to Work legislation. This bill made it possible for individuals with disabilities to maintain their Medicaid coverage while working full-time. I believe people shouldn’t lose their health insurance if they chose to go back to work, and that we should work aggressively to remove barriers to work for individuals with disabilities.

      Dodd: Despite progress made since passage of the Americans with Disabilities Act (ADA), people with disabilities experience unemployment at a rate far above the national average. Some estimates put the unemployment rate of people with severe disabilities at or near 70 percent. As President, I would encourage public/private partnerships as they relate to the recruitment, hiring and retention of people with disabilities, I would ensure that the tax code to encourages both private and nonprofit sectors to provide additional accommodations for applicants and employees with disabilities and I would support funding of "disability program navigators" at state One Stop Career Centers created under the Workforce Investment Act. My Administration would also strengthen the EEOC’s enforcement of the ADA as it relates to job protections for people with disabilities, support efforts to increase the development of and access to assistive and universally designed technologies, and significantly expand efforts to ensure that federal jobs are fully accessible to all.

   2. How would you reform the federal income support programs (Supplemental Security Income and Social Security Disability Insurance) so that beneficiaries enjoy a greater standard of living and participate more fully in the labor market?

      Obama: In addition to increasing the employment rate of workers with disabilities to match, as close as possible, the employment rate among all workers, I believe firmly that we must assure that people with disabilities who cannot support themselves through work have adequate income and health insurance to sustain dignified lives. Any reform of the SSDI and SSI programs must satisfy both of these goals.

      First, delays in benefit determinations must be drastically reduced. The Social Security Administration (SSA) has been consistently underfunded, resulting in unconscionable delays for individuals applying for the Social Security Supplement Security Income (SSI) program. I am committed to both increasing SSI administrative funding and streamlining the current application and appeals procedures to reduce the confusion that surrounds this important program.

      Second, we must assure that beneficiaries who are willing to seek employment and leave the SSDI or SSI rolls have access to affordable, reliable health insurance coverage. Again, lack of reliable and comprehensive health insurance is one of the reasons people with disabilities who might work seek benefits from SSDI and SSI and do not leave the rolls. My health care plan provides access to good quality health insurance for all.

      Third, by amending the ADA and otherwise pushing employers to provide accommodations to their employees with disabilities, we can decrease the number of workers who leave the labor market after experiencing an impairment. We can prevent workers seeking SSDI by endeavoring to find ways to keep them in their workplaces.

      Fourth, we must revisit the Ticket to Work Act to assess whether it has succeeded in providing SSDI beneficiaries with the supports they need to transition into work.

      Finally, I am eager to find strategies that will help young people transition from school to work rather than from school to SSI. Full funding of IDEA will help with this process, but there is more we can do.

      Richardson: SSI and SSDI needs to be changed to eliminate work disincentives. As it stands now, many people with disabilities who participate in either of these programs do not work even part-time. My policies would encourage people with disabilities to work rather than punish them for doing so. Less than 1% of people on SSI or SSDI return to the workforce. Some of these people will never be able to work, but many of them can with a little help.

      Edwards: Supplemental Security Income and Social Security Disability Income should not be an all-ornothing proposition for people with disabilities. SSDI asset requirements should permit beneficiaries to accumulate more assets without losing all benefits. I also believe we can provide incentives for SSDI recipients to earn reasonable income without losing Medicare and all supplemental income benefits. By doing so, we can promote economic opportunities for people with disabilities as well as strengthen the Social Security system.

      While we are eliminating disincentives for people with disabilities to accumulate assets, we also ought to help them actually build assets. For example, there is a lot we can do to expand home ownership within the disability community. People with disabilities should be able to buy a house and get loans to make universal design accommodations and other equity-building home improvements. I will also create a strong, national law banning predatory lending practices, which are targeted to vulnerable homeowners and result in equity-stripping and often foreclosure.

      Clinton: I firmly believe that programs like and Social Security Income and Social Security Disability Insurance provide an invaluable safety net for those individuals that might need governmental assistance. And I am committed to helping beneficiaries of SSI and SSDI not just make ends meet, but also improve their life and meaningfully participate in society. As President, I will examine these programs to see how they should be improved, including by increasing the benefit level, in order to ensure that Americans living with disabilities can enjoy a greater standard of living and participate in the labor market to the degree they are able. For example, I cosponsored the Ending the Medicare Disability Waiting Period Act of 2005, a bill that sought to phase out the waiting period for disabled individuals to become eligible for Medicare benefits.

      Dodd: As President, I would ensure that individuals who cannot support themselves due to a disability are provided with sufficient income through SSDI and SSI. In addition, I would work to revamp the current programs so that current recipients are not punished for what work they are capable of. Individuals that leave SSDI and SSI for full-time employment will have access to high-quality universal health care – universal in terms of affordability and access to the treatments, medications and medical devices that people need.

   3. According to the U.S. Equal Employment Opportunity Commission, between 1993 and 2004, federal workers with significant disabilities left the federal workforce at rate more than seven times the general reduction in the federal workforce during that period. What actions would you take to ensure that qualified workers with disabilities are given meaningful opportunities to participate in the federal workforce at all levels?

      Obama: I believe that qualified workers with disabilities should have the same opportunities as other workers. I am committed to funding and better enforcing the Americans with Disabilities Act, as well as strengthening other legislation to ensure that individuals with disabilities have equal opportunity to participate in the workplace.

      I also believe that the federal government should be a model employer of workers with disabilities. I will direct all of my department and agency heads to bring their agencies into full compliance with all aspects of the Rehabilitation Act. To assure that the federal government holds itself to high anti-discrimination standards, I will increase funding to the Equal Employment Opportunity Commission and assure that the person I appoint to Chair the Equal Employment Opportunity Commission is committed to enforcing anti-discrimination laws that protect federal employees through a strong Office of Federal Operations. Perhaps most important, I will provide leadership to my appointees throughout the executive branch so that they, employers in the private sector, and workers with disabilities across the country will understand the importance of this issue.

      Richardson: First, I would find out what caused the rate of people with disabilities leaving federal employment – attitudes, work environment, physical barriers, etc. Then I would put together a disability employment taskforce to correct the problems and keep close watch on all federal agencies. The taskforce would include people with disabilities to ensure the disability perspective is maintained.

      Edwards: The disappointing trend of people with disabilities leaving the federal workforce has not happened by accident. The percentage of federal employees with targeted disabilities – which are blindness, deafness, partial paralysis, complete paralysis, mental illness, mental retardation, convulsive disorders, and distortion of limbs or spine – did not increase at all from 1984 to 2005. I am committed to realizing the goal of Executive Order 13163: 100,000 qualified individuals with disabilities in the federal workforce.
      
      

      Americans with disabilities still face too many obstacles and discrimination in the workplace. I will make federal agencies a model for private workplaces by actively recruiting people with disabilities and removing obstacles, including creating initiatives for telecommuting and flexible work schedules.

      As president, I will fully enforce Section 504 of the Rehabilitation Act of 1973, the Architectural Barriers Act, and all other civil rights laws supporting access to employment for people with disabilities. The White House and the Department of Justice will work with the disabilities community to increase access to employment opportunities and identify and end workplace discrimination against people with disabilities in the federal government.

      I will reach out to appoint people with disabilities to high-ranking government positions. Visible integration of people with disabilities into the highest ranks of federal employees will send the right message of diversity and inclusiveness.

      I will also expand health care coverage for assistive technology and health care access for federal employees with disabilities.

      Gilmore: Disability policy will be carefully considered and the rights of disabled persons protected under my administration. This was my track record as governor. Administratively, I am more comfortable delegating policies such as these to the appropriate cabinet official. I would expect the Secretary of HHS to be accountable for and to coordinate disability in my Administration. My experience is this creates better results than a special assistant outside of the administrative structure.

      Clinton: I strongly feel that the federal government should spearhead the effort to provide meaningful employment opportunities to all individuals – especially individuals with disabilities. As President, I will encourage all executive agencies to aggressively recruit and retain qualified individuals with disabilities for federal service. Our country loses out when individuals with disabilities exit the federal workforce at higher rates than other workers. Individuals with disabilities bring a unique and important perspective to all aspects of governance. As President, I will ensure that the federal government carefully tracks data on the hiring and length of employment of individuals with disabilities and that we take corrective action if we continue to fall short of equity between disabled and abled workers. I will also ensure that we rely on best practices to increase the number of individuals with disabilities who are hired, increase their job satisfaction levels, and increase their duration of service so that it is at least on par with all workers.

      Dodd: I am extremely concerned with the rate at which employees with disabilities are leaving the federal workforce. Through the creation and appointment of a permanent Assistant to the President for Disability Policy at the White House, I would hope that we could gain an immediate understanding of why such large departures are taking place and find a way to address them. The federal government should be a model employer of all peoples, including those with disabilities. As stated earlier, my Administration would significantly expand efforts to ensure that federal jobs are fully accessible to all – whether by accommodations or more universal access to assistive technologies.

      Biden: Job training and employment are the pathways to greater independence for both people with disabilities and those without. I believe it is important to provide people with disabilities the necessary support to remain in the workforce. For these reasons, I cosponsored the Work Incentive Improvement Act which included a series of comprehensive programs to facilitate the ability of people with disabilities to return to work. It was signed into law by President Clinton in 1999. This act amended the Social Security Act to create the Ticket-to-Work program which expanded state options under Medicaid for workers with disabilities. By eliminating income, asset and resource limitations for workers with disabilities, the program allows them to buy into Medicaid and remain in the workforce, as well as providing an opportunity for employed individuals with a medically improved disability to buy into Medicaid. We must continue efforts in this vein to ensure that beneficiaries of federal income support programs can fully participate in the labor market and lead the full lives that they choose.
      
      While people with disabilities constitute 19 percent of the US population, they are severely underrepresented in the federal government. As President, I will work hard to ensure that my administration and the federal workforce reflect the great diversity of the nation, including people with disabilities.

3. HEALTH CARE FOR ALL
   1. What steps would you take to ensure that people with disabilities have access to affordable, quality health care that is responsive to their needs?

      Obama: As president, I will sign a universal health care plan into law by the end of my first term in office. I will modernize the U.S. health care system to improve quality and reduce costs by $2,500 for a typical family. And I will increase investment in public health to prepare and protect Americans against emerging health threats and to reduce rates of preventable diseases.

      My plan will cover the uninsured and lower costs to families and businesses. I will allow people who do not have access to group coverage through their employers or public programs (such as Medicaid, SCHIP, and Medicare) to buy into a national pool, which will offer a new public plan similar to the one I have as a member of Congress, and private plans that offer comprehensive benefits and meet quality standards. Federal subsidies will be made available to those who need it, to make coverage more affordable. And employers will have access to reinsurance to protect them from volatile and high increases in the cost of insurance. Finally, my plan will mandate health insurance coverage for every child in America.

      My health care reform plan recognizes that although all Americans are affected by problems with our health care delivery system, certain patient populations are significantly more likely to experience difficulties gaining access to health care and to receive lower quality health care. I will require that all health care providers collect, analyze and report data on the quality of health care given to vulnerable populations, including those with disabilities, to ensure appropriate care and good health outcomes. My plan also emphasizes care coordination and integration, which is particularly important for individuals with disabilities who often have multiple providers. Last but not least, I will support additional training of health care workers so that they are better able to address the needs of disabled populations.

      Richardson: My plan for universal coverage would ensure that Americans—with or without disabilities—would have access to affordable, guaranteed coverage.

      Edwards: I understand that health care is of special concern to people with disabilities. Not only do they have particularly important needs, but their independence often depends on good health care.

      We must act now to guarantee universal health care coverage for everyone in America. I am proud to be the first major presidential candidate to propose a specific plan to transform America's health care system and guarantee quality affordable health care for every man, woman and child in America. Under my plan, businesses will either cover their employees or help pay their premiums. The government will make insurance affordable through new tax credits and by leading the way toward more cost-effective care. New “Health Care Markets” will give families and businesses purchasing power and a choice of quality plans, including one public plan based on Medicare. Finally, once these steps have been taken, all American residents will be required to take responsibility and get insurance. Insurance companies will not be allowed to discriminate against people with preexisting conditions or disabilities.

      Under my plan, families without insurance will get coverage at an affordable price. Families that have insurance today will pay less and get more security and choices. Businesses and other employers will find it cheaper and easier to insure their workers.

      Beyond guaranteeing coverage, there is much that we can do to ensure that people with disabilities receive quality care. Medical training and education should help primary care physicians, dentists and allied health practitioners to work with adults with disabilities. Currently, federal funding for training physicians to treat patients with disabilities is focused on pediatric practitioners, but most people with disabilities are adults. Under my plan, we will establish a non-profit or public organization – possibly within the Institute of Medicine – to research the best methods of providing care, drawing upon data from Medicare and the new Health Care Markets and from medical experts from across the nation. Understanding and disseminating best practices for treating patients with disabilities will be an essential part of this initiative.

      Clinton: As President, I will enact legislation to provide high quality affordable health care coverage for all Americans, including those with disabilities. I will ensure that disability advocates are included in the process of developing the legislation to provide health care coverage for all Americans, and that the system that I ultimately sign into law addresses the particular needs of individuals with special needs. Today, even those individuals who have health insurance are often under-insured – that is, when they need treatment, their health insurer denies the claim. These practices can have a particularly damaging impact on individuals with disabilities who often need care urgently. I have been working to address the major problems in our health care system for fifteen years. I have taken on the health insurance companies and other special interests that too often work against the interests of those in need of care. In addition to addressing discriminatory insurance practices, we have to make sure that there’s affordable health coverage for all. To that end, we need to develop the best approaches to delivering quality cost effective care that meets the needs of individuals instead of continuing with the antiquated policy approach of today that applies a one size fits all model

      Beyond co-sponsoring the Medicare Disability Waiting Period Act of 2005, I’ve also supported the numerous and inadequate state-based medically needy programs that have a bias towards nursing home rather than home and community based coverage. I believe it’s time to focus on patients needs rather than on bureaucratic constraints imposed long ago. As President, I will continue to champion these policies.

      Dodd: I believe that the federal government has a responsibility to ensure that every American receives affordable, quality medical care that meets all of their needs. As President, I will call on the federal government to create a health insurance marketplace based on, and parallel to, the Federal Employees Health Benefit Plan (FEHB). Every employer and individual will be given the chance to go to the marketplace to purchase high-quality, affordable health care or, if they wish, keep their existing insurance arrangements. No one will be forced into the marketplace, and individuals, as well as businesses, will contribute based on their ability to pay. By focusing on prevention, and by investing in technology and data collection for better care and better efficiencies, we can better serve all populations of patients. Savings in better care and better efficiencies will finance new coverage. In a Dodd Administration, universal health coverage will be achieved through universal responsibility and universal access will mean access to the doctors, treatments and medical equipment that an individual needs.

   2. How or will you use managed care principles to deliver healthcare services?

      Obama: Important medical decisions should be made between patients and doctors, and my health care reform plan will ensure that insurers do not prevent disabled Americans from getting the care they need. My plan will constrain costs and adopt those managed care principles that work, such as the use of modern health information technology, disease management, care coordination and drug price negotiation, to achieve health care quality improvement and savings in the system that can directly benefit individuals and families through lower premiums. My plan will not contain costs at the expense of quality of care. To the contrary, my plan will both reduce health care costs and improve the quality of care.

      Richardson: Sometimes managed care is the best way and sometimes not. Managed care organizations have brought many successful applications to health care and when applied effectively provide patients with coordinated care, case management, preventive health care and ensures that providers are well qualified. People, however, like choices and sometimes managed care eliminates the choice of a desired hospital or specialist due to a restricted network. My model for universal coverage preserves choice.

      Edwards: Managed care has shown some success in managing the health needs to people with chronic health conditions and it should be a choice for people with disabilities. However, people with disabilities need access to specialists and care that is not artificially limited by narrow definitions of medical necessity.

      There are also other ways to integrate care across multiple settings. I have called for investments in information technology and other initiatives to ensure that individuals with disabilities do not fall victim to the fragmentation of care. Something is wrong, for example, when the quirks of disparate payment systems – Medicaid reimbursing for institutional care, while Medicare pays for doctors – prevent health care providers from sharing information that could help patients.

      Clinton: Poorly run fee for service as well as managed care is the wrong prescription for everyone, particularly people with disabilities. Rather than applying old line thinking of managed care or fee for service, I believe we should move towards patient-centered care. When my husband was President, I lead the fight for the Patient’s Bill of Rights in order to protect patients’ access to specialty care. I have also proposed establishing an independent public-private Best Practices Institute. This Institute would be a partnership among the public and the private sector that would let doctors, nurses and other health professionals know what drugs, devices, surgeries and treatments work best. These programs will be able to allow us to deliver the most affordable, and the highest quality, healthcare services to all Americans.

      Dodd: Modeled on the Federal Employees Health Benefit Plan (FEHB), the Dodd healthcare plan will provide individuals with a wide variety of choices in choosing the type of health care plan that best fits their needs.

      Biden: The form of Senator Biden's response deviates from the form provided (parts a, b, c). View his response to the above questions.

   3. How would you improve the quality of health and rehabilitation services provided to veterans with disabilities?
      

      Obama: I believe we need to care for our veterans with disabilities with the same commitment they demonstrated on the battle field. I am committed to creating a 21st Century Department of Veterans Affairs (VA) that will not be under-funded like the current VA. I will establish an independent team to accurately estimate the future needs and costs associated with our returning service members and their families – so we'll never have to stomach another budgeting process that cuts costs on the backs of veterans.

      This VA will be built around the principle that any service-connected injury – whether to the body, to the mind, to the service member or to the family member – represents a call to respond from our nation. It will not attempt to treat an eye injury, or Post-traumatic Stress Disorder (PTSD), or Traumatic Brain Injury (TBI), as a second-tier wound. Our review systems and dollar investments in this new VA would be geared in favor of the service member. I will ensure that any returning service member has the necessary job training and education opportunities when they get ready to begin the next chapter of their lives.

   In Illinois, I worked with Senator Dick Durbin (D-IL) to force the VA to notify veterans in Illinois and other states traditionally underserved about their right to seek a review of their past claims. The resulting outreach led to significant numbers of Illinois veterans getting the benefits they deserve.

   Richardson: We have a large number of young men and women who have returned home from Iraq and Afghanistan with traumatic brain injuries, lost limbs and behavioral health issues that need to be addressed. Our rehabilitation and health services will need to be increased to meet the demand. We need to add additional money into these services to ensure all our wounded veterans are well served in the communities in which they live and work. We need to enhance the current VA system to provide in home community services.

   Edwards: The VA has already seen over 200,000 veterans from Iraq and Afghanistan. We must do everything we can to properly care for these brave men and women and help them get timely access to care by fully funding veterans' health care. I am committed to providing the funding the VA needs to care for those who have sacrificed for the rest of us.

   Traumatic brain injuries have been described by the Veterans of Foreign Wars as the “signature wound of this war.” Rather than addressing these problems, the Bush Administration is pretending they don't exist. As president, I will increase the research and treatment of these injuries and the conditions that follow from them, including epilepsy, related seizures and other conditions that can cause disabilities. I will also increase funding for the VA's prosthetics programs and polytrauma centers.

   As a nation, America did not give enough to veterans returning from the Vietnam War, leaving thousands without the care they desperately needed. We need to admit our mistakes and learn from them. As president, I will require that all service members returning to the U.S. or leaving the military be provided with a new “Homefront Redeployment Plan," including post-traumatic stress disorder (PTSD) screenings, benefits information and seamless transfer of medical records.

   When the members of our armed services become veterans, we have to make sure the system doesn't fail them. As president, I will create a new national chain of care to ensure that no veteran again falls through the cracks. Because many veterans receive treatment outside the VA system, this chain will coordinate treatment and benefits in outreach centers and clinics in every county where a veteran resides, both within and outside the VA network. I will also improve training for health personnel to recognize and treat PTSD, establish uniform standards for mental health care to address the wide range of quality of care, increase counseling resources within TRICARE and VA networks and permit access outside of the networks when necessary, and ensure that outreach is extended to family members who can help recognize symptoms. Caring for the newest generation of veterans must be accomplished without neglecting the continuing needs of veterans from previous generations.

   Clinton: Our country owes a duty to our veterans for their service and as President, I will honor that duty. The current administration has done an inadequate job in providing quality healthcare and rehabilitation services to our veterans, especially those returning from recent combat missions in Iraq and Afghanistan. And I’ve been working to address these problems. I have previously proposed an independent review of denied claims to help veterans get the benefits they deserve. I have also passed legislation, called the Heroes at Home, to provide specialized treatment for veterans suffering from traumatic brain injuries and help them and their families reintegrate into society; and introduced the Restoring Disability Benefits for Injured and Wounded Warriors Act of 2007 and the Protecting Military Family Financial Benefits Act of 2007, which would ensure that wounded soldiers receive the disability benefits they need and deserve and to further protect military family financial benefits. As President, I would continue to fulfill our promise to those veterans that have so selflessly fought for our country.

   Dodd: My Administration would provide further investments in the VA system, particularly in the areas of post traumatic stress disorder (PSTD) and traumatic brain injury (TBI). Our commitment to our young men and women in the armed services must remain firm long after they have left the battlefield.

   Biden: We must reform the handling of disability claims for veterans. The backlog of pending claims and the delays in the appeals process is simply unacceptable: at the end of the 2006 fiscal year, rating-related compensation claims were pending an average of 127 days and appeals resolutions took an average of 657 days to resolve. In order to reduce these backlogs and the hardship they impose on veterans and their families I would:

   • Update and simplify the disability determination and claims processing system. Building on the recommendations of the President’s Commission on Care for America’s Returning Wounded Warriors, periodic reviews of veterans’ disability status should be undertaken to ensure proper compensation.
   • Establish a lawyer corps that represents veteran's free-of-charge during the adjudications process. Based on a JAG model, these lawyers would receive loan forgiveness and be paid a monthly stipend while agreeing to guide veterans and their families through the adjudication process.
   • Require the VA to review educational and training requirements for claims adjudicators. With an increasing number of veterans citing more disabilities in their claims, the claims are becoming more complex and the claims processors may need more training to complete the claims process in a timely fashion.
   • Require the VA to publish the number of claims that are rejected each year in each region. This could help bring transparency to the claims process and explain variations in disability ratings in different areas of the country.
   4. How would you improve the quality of health and rehabilitation services provided to Native Americans with disabilities? Do you support the reauthorization of the Indian Healthcare Act?
      

      Obama: Yes, I strongly support reauthorization of the Indian Health Care Improvement Act. I am an original cosponsor of the bill, which is expected to pass the Senate this year.

      As President, I would increase funding for a variety of tribal health care programs that have been cut under the Bush Administration. This includes fully funding clinical services, and restoring funds for programs such as the Urban Indian Healthcare Program. Second, Native Americans, including those with disabilities, will be able to participate in my universal health care plan which will provide high-quality health care services. I am aware, however, that universal health care for everyone does not mean equal access to healthcare for everyone. One of the major problems facing American Indians is a chronic lack of basic health care facilities. I am committed to investing the necessary resources into health care infrastructure. This includes providing funding for health care workers, and requiring compliance from plans that do not meet performance thresholds.

      Richardson: Coming from a state with a large Native American population (10%), issues that affect this community are of great interest to me. The lack of health care to Native Americans is a national disgrace. According to a recent Behavioral Risk Surveillance Survey, the disability rate of Native Americans on reservation land is 24%-26%. There is obviously a great need to address rehabilitation on Native lands and when Native Americans relocate. The Native Healthcare Act has not been reauthorized since it was passed in 1991. We need to adequately fund Indian Health Services. Again,universal coverage will guarantee access to affordable coverage regardless of where any American lives.

      Edwards: Native Americans face unique health challenges: less access to health care, high rates of certain chronic conditions, and an infant mortality rate that is nearly 50 percent higher than the rate for white Americans. The U.S. government has an obligation to address these inequities and live up to its historic commitments to Native Americans.

      The first step is to adequately fund the Indian Health Service. While in the Senate, I voted for increased IHS funding. I also support the badly needed improvements in the Indian Health Care Improvement Act. To ensure that Indian health gets the attention it deserves, I support elevating the position of the Director of Indian Health Services to the Assistant Secretary for Indian Health. I have proposed increasing research on medical disparities and creating a new health unit within the U.S. Department of Justice to address discrimination in health care.

      As I said above, training to educate health care practitioners on best practices for treating people with disabilities is essential, and it is part of my plan to improve the quality of care for every American.

      Clinton: I am a strong supporter of developing innovative ways to ensure that health and rehabilitation services are provided to minority groups, particularly Native Americans. In this regard, I am a cosponsor of current Senate Bill 1200, a bill that would expand and reauthorize the Indian Healthcare Act. As President, I will continue to outreach to those groups like Native Americans that have historically been denied high-quality healthcare.

      Dodd: In my administration, high quality, universal healthcare will be made available to all citizens regardless of their race, ethnicity, socioeconomic status or where they live. As President I would also incentivize healthcare professionals to serve in rural and underserved communities, including tribal lands, to ensure that patients not only have coverage, but access to the actual care those they need.

      Biden: I support the Indian Healthcare Act and believe that we must increase our efforts to provide quality health and rehabilitation services to Native Americans with disabilities.

   5. How will you assure people with disabilities have fair access to Medicare Part D prescriptions?
      

      Obama: I am committed to ensuring that Americans with disabilities receive Medicaid and Medicare benefits in a low-cost, effective and timely manner. I have worked with Senator Ken Salazar (D-CO) to urge the Department of Health and Human Services to provide clear and reliable information on the Medicare prescription drug benefit and to ensure that Medicare recipients are protected from fraudulent claims by marketers and drug plan agents. I also support efforts to improve coordination between Medicaid and Medicare so that individuals with disabilities who are enrolled in both programs do not face additional administrative barriers when seeking prescription drug benefits.

      We must also reduce inefficient federal spending on the Medicare Part D benefit to invest more money into improving our national health care system. Drug spending has quintupled over the last five years and now costs us almost $200 billion. We need to reduce drug spending by enabling the federal government to negotiate lower drug prices, clear barriers to generic competition, allowing the safe importation of drugs, and giving consumers the information to make smart purchasing decisions.

      Richardson: Programs will be established in each state to ensure that people with disabilities are made aware of all options available to them.

      Edwards: A recent report by the American Psychiatric Association (APA) documented that patients suffering from mental illnesses are unable to get the prescription drugs they need through Medicare Part D. That is unacceptable. The federal government should enforce rules preventing Medicare drug plans from switching patients to new drugs, which can upset months or years of work for patients and their health providers to find the right combination of specific medications.

      The federal government must ensure that Medicare Part D participants are able to access the prescriptions drug they need to maintain their health and independence.

      When I am president, I will rewrite the drug bill to put patients and people above drug companies and HMOs. I will clamp down on skyrocketing drug costs by empowering the government to negotiate better drug prices and allowing the safe reimportation of drugs from other countries. The Medicare prescription drug benefit is needlessly expensive due to giveaways to drug companies. Steps to reform the program should include addressing the “doughnut hole,” where many beneficiaries with high drugs costs find themselves without coverage.

      Clinton: As a Senator, I have been actively involved with ensuring fair and equal access to Medicare Part D prescription drugs. I previously introduced legislation in the Senate to help the most vulnerable seniors and disabled Americans transition to new Medicare plans. I have also urged the administration to aid local pharmacists and beneficiaries, helping these individuals better administer the new Medicare program. As President, I will continue to fight for fair access to Medicare Part D prescriptions and to ensure that policies do not undermine continuity of care for any population served. For example, patients who have been relying on particular pharmaceutical treatments that are most appropriate for their needs should not be suddenly forced to switch medications by indiscriminate cost cutting practices by pharmacy benefit managers. Having said this, we do need to have a better understanding of the best pharmaceutical treatment options for all patients, which is why I have proposedestablishing an independent public-private Best Practices Institute. This Institute would be a partnership among the public and the private sector that would let doctors, nurses and other health professionals know what drugs, devices, surgeries and treatments work best.

      Dodd: One of the best tools we have to lower the cost of prescription drugs is to allow Medicare to harness the enormous buying power of its membership to negotiate drug prices with the pharmaceutical companies. Currently, this option is not available and recipients are paying the price for a poorly crafted and executed drug plan. As President, I would require Medicare to negotiate drug prices. I would also immediately eliminate the so-called “doughnut hole” in Medicare Part D drug plans to ensure that every senior in America does not have to worry about being able to afford their medications at any point during the year.

      Biden: I am committed to restoring fairness in Medicare and protecting people with disabilities' access to it.

   6. How will you address the inequities caused by the Medicare "homebound" rule?

      Obama: I support amending the Medicare “homebound” rule so that those with severe disabilities have the freedom to leave their homes without fear of having their government benefits taken away. I believe that our Medicare policy must reflect the common sense notion that community engagement and support is a vital component of a meaningful life. I look forward to amending the law to remove arbitrary measures of “acceptable” time away from home and further ensure that individuals do not have benefits removed unfairly.

      Richardson: The "homebound rule" in Medicare is unfair to people with significant disabilities. The rule requires people to be homebound to receive certain services. This comes from the old medical model of disability. If a person is able, it is important for quality of life reasons for the individual to participate in society and not be penalized for stepping outside the home.

      Edwards: Medicare emphasis on institutional care, rather than home and community-based care, is out of date. Unreasonably narrow eligibility rules for in-home benefits fail to consider current medical technology, which have made it easier for people with disabilities or chronic health conditions to travel. Perverse Medicare rules may force people with serious disabilities to give up opportunities to leave home and have as normal a social experience as possible outside the house to maximize Medicare benefits.

      I will promote community-based care by fixing these unfair, outdated and bureaucratic rules that prevent Medicare beneficiaries from getting the things they need to live at home, such as wheelchairs. I support the Medicare Independent Living Act.

      Clinton: I believe that the Medicare “homebound” rule has been enforced in a far too restrictive manner. As President, I will embrace a fair modification of Medicare rules so that disabled Americans are able to live their lives fully, without fear of losing their Medicare benefits. I look forward to addressing this inequality when I am President.

      Dodd: No individual with a disability should be required to be stranded at home in order to receive the services necessary to support them. We should support efforts by individuals with disabilities to live full and complete lives in the setting that they choose.

      Biden: I would work to expand access to Medicare Part D by people with disabilities and to improve the program. Part D is complicated and has not done enough to keep costs down and provide quality service to all who qualify. I support allowing the Federal Government to directly negotiate for better drug prices with the pharmaceutical companies which would lower the cost to consumers. I would also close the 'doughnut hole' gap in overage that occurs once someone hits $2,250 in coverage. It is unfair and burdensome.

   7. Do you support ongoing Congressional efforts to ensure mental health parity in health insurance (S.558, H.R. 1367)?

      Obama: Yes. I championed similar legislation in the state of Illinois and I have cosponsored S. 558.

      Richardson: Absolutely. It's time for us to treat behavioral health issues the same as we treat other medical disorders. Mental health has been viewed as being less important than other medical conditions for far too long. I will push legislation to bring parity to health insurance for mental health.

      Edwards: Yes, I believe mental illness and physical illness must get the same insurance coverage. I have long supported mental health parity legislation. I co-sponsored the Wellstone Mental Health Parity Act when I served in the Senate. Mental health parity must be a national priority. Under my plan to guarantee quality, affordable health care for all Americans, every plan in the regional Health Markets includes comprehensive benefits -- including full mental health coverage.

      Clinton: I think that our government ought to ensure parity in health insurance coverage of mental health benefits. That is why I have cosponsored the Mental Health Parity Act of 2007. This bill would prohibit employers and health plans from imposing durational treatment limits and financial limitations on coverage for mental illness that do not apply to all other medical conditions. I believe this bill is one step in our effort to provide meaningful mental health care coverage.

      Dodd: I have long supported and will continue to support efforts to ensure mental health parity for all Americans. I believe that it is essential that we require employers and health plans to cover treatment for mental health conditions on the same basis as all other illnesses. A Dodd Administration would not only pass mental health parity legislation, it would strongly enforce it.

      Biden: I was a co-sponsor of the Paul Wellstone Mental Health Equitable Treatment Act and I remain committed to the goals of the Act as a cosponsor of the Mental Health Parity Act of 2007 in this Congress. In addition, I have fought to make sure that Medicare patients pay the same co-payments and deductibles for a mental health issue as they would for a physical injury.

4. LONG TERM SERVICES AND SUPPORTS
   1. How would you address America's increasing need for home and community-based long-term services and supports (such as personal assistance services, respite care, and other supports)?

      Obama: I believe the federal government must take a larger role in transitioning our long-term care system from institutions to home and community-based settings. I support efforts to improve federal funding and administrative support to states and the private sector to accomplish the goal of providing quality long-term care in home and community settings to all Americans who need such services.

      I have also worked to ensure that states and cities have adequate plans in place to care for special-needs populations. In the wake of Hurricane Katrina, my legislation to require that states properly plan to evacuate special needs individuals during times of crisis passed Congress. I believe that this is only the first step in ensuring that the most vulnerable individuals in local and national emergencies are adequately safeguarded.

      I have sponsored legislation to provide a traumatic injury protection rider to servicemembers insured under the Servicemembers’ Group Life Insurance (SGLI) program. I sponsored legislation in Illinois requiring an emergency evacuation plan for every high-rise structure for the safe and timely evacuation of people with disabilities.

      Richardson: I fully support the right of people to live in their community rather than institutions, if that is their choice. We need to work on building an infrastructure for community based living, but it can be done. New Mexico ranks in the top three states for having more people with long term needs live in community-based settings rather than in institutions.

      Edwards: Yes. I believe strongly in giving people with disabilities the choice of care in their communities. I cosponsored the predecessor to the Community Choice Act when I was in the Senate to offer personal attendant services though Medicaid. The Community Choice Act will help states comply with their Olmstead responsibilities.

      I have a longstanding commitment to the cause of supporting people with disabilities to live independently. I also supported the Long-Term Care Security Act of 2000 (HR 4040).

      Clinton: We need to have a new national long term care policy that recognizes a realistic division of responsibility between public and private payers. Today, all we have is an institutionally-based pseudo-long-term health care system called Medicaid, which is supplemented all too poorly by expensive, inadequate private long term care insurance. I believe all Americans should be able live in their homes and communities for as long as they are able, and that home and community-based long term services are essential to achieving that goal. I have been a strong champion for these services and support in the Senate. Recently, I joined with my colleagues to introduce the Home and Community-Based Services Copayment Equity Act, which would eliminate Medicare Part D co-payments for more than one million low-income Americans, including dual eligible residents of AL/RC facilities and other licensed facilities such as group homes for people with developmental disabilities, psychiatric health facilities, and mental health rehabilitation centers. I was also proud that my bill, the Lifespan Respite Care Act, which authorized almost $300 million over five years for grants to increase the availability of respite care services for family caregivers of individuals with special needs regardless of age, was enacted into law. As President, I will continue to champion access to long term home and community based services, and once again work to bring together all stakeholders to develop a far more rational American long term care policy.

      Dodd: I support the right of people with disabilities to live their lives to the fullest, in whatever setting they chose. To ensure that those who choose not to live in institutional settings have services and supports available to them, I would support creation of additional community based options for individuals with disabilities. At the same time, I will fight to ensure that people with disabilities that choose a community-based option have the same access to the Medicaid program as those who are living in institutions. In a Dodd Administration, Medicaid policy will not be stacked against community living.

      1. Do you support the Community Choice Act of 2007 (S.799, H.R. 1621) and/or the Community Living Assistance Services and Supports Act of 2007 (CLASS Act of 2007)?

         Obama: Yes.

         Richardson: I support providing choices for people with disabilities to live in the community and will support legislation that strengthens freedom of choice.

         Edwards: I support providing choices for people with disabilities to live in the community and will support legislation that strengthens freedom of choice.

         Clinton: I strongly support the Community Choice Act of 2007, a bill that would amend Title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports. In fact, I am one of the thirteen cosponsors of the bill. As President, I will continue to champion causes like the Community Choice Act.

         Dodd: I am an original cosponsor of the Community Choice Act and will support the CLASS Act when it is introduced. Taken together, these two important pieces of legislation will provide critical services to individuals with disabilities.

      2. What other steps would you take to help states implement the Olmstead v. L.C. Supreme Court decision and help address the institutional bias in the current Medicaid system?

         Obama: We still have considerable progress to make in ensuring that Americans with disabilities have the rights affirmed to them in the Olmstead v. L.C. decision. In addition to supporting the Community Choice Act of 2007 and the CLASS Act of 2007, I believe that we should further incentivize states to provide Americans with disabilities the ability to choose the most appropriate care for their individual needs. The federal government should help states increase the supply of high-quality community settings for individuals with disabilities by providing additional grants for new communities and community expansions. Second, we should help improve the quality of those settings by providing more transparency of the settings’ performance.

         We must use technology to make community-based living a reality for more people with disabilities. For this reason, I support elimination of the in-the-home Medicare exclusion which deprives people with disabilities of assistive technologies they need simply because those technologies might be used beyond the thresholds of their homes. I also support the Fostering Independence Through Technology Act for the same reason – it offers 21st century solutions to stubborn barriers for people with disabilities.

         Richardson: I support the integration of individuals with mental disabilities into the community, if that is their choice, and will work to ensure every state implement the Olmstead decision. I will also address the institutional bias of the Medicaid and Medicare system by supporting legislation to change this policy.

         Edwards: The Supreme Court’s Olmstead decision held that the ADA required states to offer services to individuals with disabilities in the most integrated, community-based setting possible. This was an important victory for disability rights. Unfortunately, states are still struggling to implement Olmstead. The federal government must help states by supporting the transition to communitybased services and offering technical assistance.

         I have proposed a “Living with Dignity” Initiative built on basic American principles: choice for families, the chance to get care in the home and community whenever possible, dignity and respect for both families and workers, and accountability for providers and the government.

         My Living with Dignity Initiative will fund state efforts to expand home care and reform the long-term care, including tax credits for long-term care, asset and income protection programs that prevent families from spending down their incomes, and experiments with long-term care insurance. I will also support the recruitment and retention of home care workers through better wages, training, and working conditions.

         In addition, my plan to guarantee quality, affordable health care for every American will also strengthen Medicaid’s support for long-term care and emphasize home- and community-based care to allow caregivers to keep their family members nearby.

         Clinton: I believe that the Olmstead opinion was a tremendously important moment in the disability movement. The Court affirmed that states have an obligation to move individuals with disabilities from institutional settings into more integrated settings in the community if moving them would not fundamentally alter the states’ service systems. As President, I would support efforts to help states comply with this and other Supreme Court decisions, and I would continue to abide by Executive Order 13217, which directed agencies to identify federal laws, regulations, policies and practices that impede community participation by people with disabilities, and I would also make certain that the office of Civil Rights is enforcing current law, for a law without enforcement is nothing more than an empty promise

         Dodd: The Olmstead decision makes clear that all individuals with disabilities should have the choice to live their lives as full and integrated members of their communities. I believe that the federal government should encourage states to provide Americans with disabilities the freedom to choose the kind of care that they believe will best enable them to live full, complete and manageable lives. As stated earlier, my Administration would support creation of additional community-based options for individuals with disabilities while at the same time working to ensure that individuals choosing to live in these settings have the same access to Medicaid as those living in institutions.

   2. Will you propose integrating acute and long-term services by using integrated managed care principles?

      Obama: Yes.

      Richardson: Integration is the key word. It is important that we promote and support full integration into society of all individuals who wish to live in the community.

      Edwards: I believe that people with disabilities should be able to fully enjoy the benefits of living in a home of their choosing and in a community of their choosing. They should be able to have their primary and specialty health care needs met by a system that recognizes their desire for independence, inclusion and productivity. Arbitrary quirks in health care payment systems should not limit the settings and varieties of delivery systems for primary and acute care.

      Integrated managed care holds the promise of focusing on patient needs rather than reimbursement rules. When implemented correctly, the integration of acute and long term care can make it easier for people with disabilities to live independently.

      However, the risks are high because managed care providers have incentives to deny care. It would be wrong to rush to implement integrated managed care without waiting for thoughtful program design, which stresses effective safeguards, coordination of care, and evaluation. I believe this process requires the full participation of the disabilities community. I would support demonstration projects that are thoroughly evaluated, and include people with disabilities in both the design and the evaluation. Without adequate oversight, patients will end up worse off, and that is unacceptable.

      Clinton: I have proposed to transform care of today’s chronically ill population to improve outcomes by using state-of-the-art chronic care coordination models within federally-funded programs, such as Medicare and the Federal Employees Health Benefits Program (FEHBP), to provide care for Americans afflicted with these costly, multi-faceted and difficult to manage illnesses. I have also proposed to allow multispecialty clinics, private plans and provider-sponsored organizations to bid on and provide coordinated care services. I also believe we need stronger incentives for participation in chronic care management programs, and have proposed establishing an independent public-private Best Practices Institute, which would be a partnership among the public and the private sector, to finance comparative effectiveness research.

      Dodd: Yes.

   3. How will you address the shortage of community direct care attendants?

      Obama: I support the Community Choice Act of 2007 and its provisions to both increase the number of community direct care attendants and ensure high-quality care for Americans with disabilities. The shortage of community direct care attendants is related to shortages in other sectors of the economy – low pay, limited or no benefits and inflexible working hours. I support increasing the minimum wage to provide a working wage to direct care attendants, as well as providing them in addition to all other Americans access to high-quality, affordable health insurance. I also support expanding the Family Medical Leave Act to include more workers and improve the support given to workers who have dependants at home. I believe that these measures will go a long way to improving the supply and job satisfaction of community direct care attendants. I also believe that we should strengthen ties between community direct care settings and federal, state and local job training programs to ensure that individuals receive information about job openings.

      Richardson: The quickest answer would be to increase the wages of care attendants. Right now attendants are not seen as professional workers. We need to work on training programs for attendants providing care and, thus, result in increased wages.

      Edwards: Millions of people with disabilities rely on attendants to help them live and work in their communities. These workers assist people with disabilities with activities of daily living, medication administration, preparing and eating meals, getting to work, gaining life skills and handling other daily affairs.

      Demand for these workers is growing. Hundreds of thousands of people with disabilities are on waiting lists for services and the demand will grow 62 percent by 2010 as these Americans get older. Unfortunately, these positions have a high turnover rate each year because of poor wages and job demands, putting the quality of life for people with disabilities at risk. My Living with Dignity Initiative includes specific steps to attract, support and retain home health aides and attendants. These workers ought to be treated with the same dignity and respect that we ask them to give to their patients. As president, I will provide resources to improve wages, training, and working conditions for aides. I will also establish strong workplace safety regulations such as the ergonomics regulations discarded by President Bush.

      Clinton: I think we ought to be particularly concerned about the dire shortage of community direct care attendants. I have tried to address this problem directly by proposing programs that would train family caregivers as direct care attendants so that these family caregivers can receive compensation for their payment. I would continue to champion this and other solutions to the shortage issue as well as providing added incentives, such as tax credits, to encourage more individuals to practice the selfless profession of caring for others. I also believe that we can and must work with labor representatives to serve as hubs for training and placement for all long term care settings, particularly those within the community.

      Dodd: Millions of people with disabilities rely on attendants to help them live and work in their communities. These workers assist people with disabilities with activities of daily living, medication administration, preparing and eating meals, getting to work, gaining life skills and handling other daily affairs.

      Demand for these workers is growing. Hundreds of thousands of people with disabilities are on waiting lists for services and the demand will grow 62 percent by 2010 as these Americans get older. Unfortunately, these positions have a high turnover rate each year because of poor wages and job demands, putting the quality of life for people with disabilities at risk. My Living with Dignity Initiative includes specific steps to attract, support and retain home health aides and attendants. These workers ought to be treated with the same dignity and respect that we ask them to give to their patients. As president, I will provide resources to improve wages, training, and working conditions for aides. I will also establish strong workplace safety regulations such as the ergonomics regulations discarded by President Bush.

   4. How will you address the lack of coordination between Medicare and Medicaid policies?

      Obama: Too many Medicare and Medicaid “dual eligibles” are subject to time-consuming and complicated administrative processes that delay access to care and can result in lower quality care. This administrative problem is compounded by the increased health needs of the dual eligibles population. Although CMS has taken steps to alleviate these problems, I believe more should be done. I support streamlining the benefits process for individuals with disabilities so that people receive the care they require in a timely manner. Both programs should give individuals with disabilities more information about the care they are entitled to receive under both programs, so decisions about care can be made in a unified manner. I also believe that the demonstration projects that the Community Choice Act of 2007 seeks to create to improve coordination between benefits received by dual Medicaid and Medicare recipients are an important step to undertake in addressing this problem.

      Richardson: "Dual eligibles" – those who are enrolled in both programs face more bureaucratic hassles than those on one program or the other. I believe that this population should be put into one program for all their needs. I believe Medicare would best serve this population and the system could be redesigned to provide the enhanced benefits that Medicaid provides.

      Edwards: Medicare and Medicaid were developed for different purposes, but neither focused on the needs of people with disabilities. Medicare offers the strength of allowing people the freedom to choose their providers. Medicaid offers an appealing list of benefits, although it is limited by inadequate reimbursement in some states. However, the interaction between the two programs creates inappropriate incentives.

      Medicaid provides long-term care but remains biased toward providing that care in institutional settings. Nursing home care remains a Medicaid entitlement, while people with disabilities who prefer home and community-based care are often put on a waiting list. As a result, low-income Americans with disabilities who are eligible for both Medicaid and Medicare tend to (1) have less choice in how they are treated and (2) receive their care in more restrictive – and more costly – settings than a more integrated system would permit. In addition, states don’t invest in treatment initiatives that would improve patient care for Medicare-eligible patients because the savings will disproportionately go to the federal Medicare program.

      Because Medicare and Medicaid operate on two different levels of government, it can be very difficult to synchronize reforms. But the task must start with strong federal leadership. As president, I will appoint an administrator of the Centers for Medicare and Medicaid Services who understands the needs of people with disabilities, and I will work to assure that both programs work to deliver the best possible care in the least restrictive setting.

      Clinton: To often Medicaid is the poor step child of Medicare and is treated as such within the federal government. But lack of coordination leads to wasteful, poorly coordinated care that produces little more than a cost shifting game between two programs. We need to make certain that federal and state administers of these programs work in close consultation with all stakeholders, including consumers and providers, to do a much better job in resolving enrollment, operations, benefits, payment, and appeals issues.

      Dodd: All too often the care of individuals with disabilities is imperiled by the lack of coordination between the Medicare and Medicaid programs. Believing that these two programs should be work together seamlessly, I will work to ensure greater transparency and coordination between these two critically important programs at the Centers for Medicare and Medicaid Services.

      Biden: The form of Senator Biden's response deviates from the form provided (parts a, b, c). View his response to the above questions.

5. HOUSING
   1. What would you do to increase the availability of affordable, accessible, integrated housing opportunities in the community for low and moderate income people with disabilities and their families?

      Obama: In too many communities, low-income families are priced out of the housing market. Between 1993 and 2003, the number of units affordable to low-income households fell by 1.2 million. As president, I will create an Affordable Housing Trust Fund to develop affordable housing in mixed-income neighborhoods. The Fund will use a small percentage of the profits of two government-sponsored housing agencies, Fannie Mae and Freddie Mac, to create up to 14,000 new units of affordable housing every year.

      A family’s most important investment is their home. However, there is a growing epidemic of mortgage fraud crimes in which sophisticated scam artists use elaborate scams to cheat homeowners out of their mortgages. I introduced legislation that would increase funding for federal law enforcement programs, create new criminal penalties for mortgage professionals found guilty of fraud, and require industry insiders to report suspicious activity. In the Illinois state legislature, I cosponsored a bill creating the High Risk Home Loan Act to protect borrowers who enter into high risk home loans. As president, I will fight to ensure more Americans can achieve and protect the dream of home ownership. I also support increasing federal support for affordable rental housing, and recently called for a new Affordable Housing Trust Fund to build up to 14,000 additional units each year for lower-income individuals in mixed-income neighborhoods.

      In the Illinois Senate, I was also the chief cosponsor of a bill including disabled persons within the provisions granting an assessment freeze homestead exception to senior citizens.
      

      Richardson: I will support increasing the funding to HUD Section 811 for housing for people with disabilities. Nationwide, there is a shortage of affordable, available and accessible housing for people with disabilities. Adequate housing is something most Americans take for granted – the disability community cannot, not yet.

      Edwards: Integrating people with disabilities into every part of society is the only way to guarantee equal access to all of the opportunities of society. It is also the morally right choice for society to make. Housing policy is central to this effort because integrating people with disabilities must start with where they live.

      As I said above, a portion of the one million new Section 8 housing vouchers will serve people with disabilities – increasing greater integrated housing opportunities for people with disabilities, particularly those leaving institutional care. At least 5,000 of these vouchers over five years should be dedicated to people with disabilities making the transition from institutional care to independent living. I will direct HUD to ensure compliance with accessibility requirements that local housing authorities publish a list of accessible units. I will also expand outreach and education efforts to ensure that eligible Americans with disabilities know how to apply for vouchers.

      We must also reform Section 811 housing – the segregated housing program for people with disabilities – to move toward more affordable, more accessible, integrated housing. In addition to ensuring affordable housing, the federal government has to do more to ensure that housing that receives federal funding – including tax credit financing – is accessible. We need to work to remove the obstacles that people with disabilities face when they go to visit their friends and family.

      Finally, as I said above, I want to expand home ownership and home rental opportunities within the disability community.

      Clinton: I think providing affordable, accessible housing opportunities is one of the most important keys to empowering citizens to be productive contributors to the broader community. While not unique to the disability community, it is even more important to people with disabilities. That is why I proposed the 21st Century Housing Act last year. The Act would reform and modernize the Federal Housing Administration (FHA), and allow for a long needed investment in personnel and technology infrastructure to remain competitive and useful to consumers. The 21st Century Housing Act provides the FHA with the flexibility to offer loan terms up to 50 years to decrease monthly mortgage payments and reduced or zero down payment plans to families that lack the upfront cash for a down payment. These types of program would extend housing opportunities to all individuals, especially those families that depend on governmental assistance.

      Dodd: I have been a leader in supporting affordable housing nationwide, for all families. In 1990, I was an original cosponsor of the National Affordable Housing Act, and I have long believed that access to a home that is comfortable, safe, and within close proximity to good schools, public services and parks, should be an attainable goal for every American, including people with disabilities and their families. I believe we can increase housing opportunities for people with disabilities by including requirements for a certain number of accessible housing options in all new affordable housing projects, and a requirement that we retrofit older buildings and developments.
      

   2. How will you assure the vigorous implementation of all Fair Housing Laws?

      Obama: As a former civil rights lawyer, I understand firsthand the importance of ensuring that all Americans have the same opportunities and rights. Unfortunately, as we know all too well, even with strong constitutional and federal mandates to provide equal opportunity, too many individuals have their civil rights infringed. I believe that we must ensure that the Office of Fair Housing and Equal Opportunity within the Department of Housing and Urban Development is adequately funded and staffed so that the Office is able to fully investigate all meaningful discrimination claims made by individuals with disabilities.

      Richardson: States will be held responsible for implementing all Fair Housing Laws. I will establish a workgroup to research what each state is doing about housing and if they are in compliance with Fair Housing Laws.

      Edwards: Vigorous implementation of Fair Housing laws starts with appointing officials committed to protecting the civil rights of every American. The next step is providing sufficient resources for effective enforcement. It continues by nominating judges who are committed to protecting the civil rights of regular Americans. Judge Alito’s Fair Housing decisions, for example, show the damage that the judiciary can do.

      The last and most important step is leadership. As president, I will direct the Secretary of Housing and Urban Development (HUD) to make the enforcement of Section 504 a priority alongside the Fair Housing Act.

      There is so much more HUD can do: ensure that housing built with federal low-income housing tax credits complies with accessibility requirements, actually follow up on the findings of the groundbreaking “Discrimination against Persons with Disabilities: Barriers at Every Step” HUD study; and study the effect of increased federal grants to faith-based organizations. As a very first step, I would ask my HUD Secretary to explain how HUD has implemented the 2001recommendations of the National Council on Disabilities and justify its reasoning for anyrecommendations it has ignored.

      Clinton: While I believe that we ought to ensure that all Fair Housing laws are enforced, I think we ought to have the government lead by example. To ensure that the government housing authorities act fairly, I have introduced the Federal Housing Fairness Act. This legislation would increase the FHA loan limits so that working families in high-cost areas can use the program. This Act would also ensure that working families in high cost of living states are not denied the benefit of this program. Likewise, I would champion rigorous enforcement of laws that govern fairness in private housing.

      Dodd: As President, I will make fair housing a priority. I believe that if we remain vigilant on all Fair Housing provisions using a thorough and complete review process, we can ensure that all Fair Housing laws are implemented and complied with. In order to accomplish this, we must fully fund all HUD programs and offices that are involved with Fair Housing implementation. We also must draw on community support and participation. The people who actually need access to fair housing opportunities are the best people to ask whether these opportunities are available and any problems they are encountering. We must educate the public about their rights and set up mechanisms such as hotlines so that any discrimination that occurs can be reported and eradicated immediately.

   3. How will you assure that HUD implements programs that will assist states in complying with the Olmstead decision?
      

      Obama: I support building on President Bush’s New Freedom Initiative to improve the supply of affordable housing opportunities for individuals with disabilities. First, I believe that housing assistance should ensure that individuals with disabilities have a greater choice as to where and how they can use their housing benefits. Second, I support efforts, such as the Community Choice Act of 2007, to improve the federal funding under the Medicaid program for individuals to live in home or community-based settings. I also support examining additional approaches to incentivize states to increase the supply of affordable, safe and quality housing for individuals with disabilities.

      Richardson: Stronger oversight of HUD is the only way to ensure that all states are being assisted with complying with the Olmstead decision.

      Edwards: Ensuring compliance with the Olmstead decision must be a central part of HUD’s ongoing civil rights work. Moving people with disabilities from institutional care to less restrictive settings is now the law of the land. Yet hundreds of thousands, if not millions, of Americans continue to live in congregate care settings because accessible and affordable home-based care and housing are not available. HUD needs to play a major role in ensuring that the legal standard is reflected in the real world.

      First, HUD’s civil rights and compliance staff should ensure that their state agency counterparts are communicating with health services agencies to make them aware of their Olmstead obligations.

      Second, as our country’s primary housing agency, HUD – working together with state and local agencies must ensure the availability of affordable and accessible so that the Olmstead holding is not an empty promise. Today, multi-year waiting lists are a barrier to achieving the vision of Olmstead.

      Third, to help ensure an adequate supply of appropriate housing, I will target a minimum of 5,000 housing vouchers over five years to help individuals move from institutional care to independent living and take the other steps described above to increase the supply of affordable and accessible housing.

      Fourth, I will help local housing authorities to work with disabilities groups, aging organizations and Medicaid programs to ensure that individuals in their communities have the opportunity to live in the most integrated setting possible.

      Clinton: I am committed to ensuring that HUD can implement its objectives and also assist states in complying with federal law and federal court precedent. Towards this end, I proposed the Suburban Core Opportunity, Restoration, and Enhancement (SCORE) Act in 2005, which established a $250 million Reinvestment Fund authorization within the Department of Housing and Urban Development. This fund was specifically designed to allow local community leaders and elected authorities to develop initiatives in cooperation with private-sector partners. As President, I will continue to fund HUD, and oversee the agency to ensure that HUD is fulfilling its objectives.

      Dodd: I will ensure that HUD implements such programs through adequate funding and vigilant oversight.

      Biden: The form of Senator Biden's response deviates from the form provided (parts a, b, c). View his response to the above questions.

6. TRANSPORTATION
   1. What would you do to expand access to affordable, accessible transportation for people with disabilities, especially in rural areas?

      Obama: Congress must enact pending transportation reauthorization legislation without further delay and make provisions for accessible options for individuals with disabilities. This includes highway, mass transit, commuter rail, and air transportation improvements.

      Richardson: In 2005 the National Council on Disability presented a report on transportation and disability to President Bush. I will work with the disability community and NCD to address the transportation shortages and problems throughout the U.S. using this document as a model.

      Edwards: Accessible transportation is a critical component of increased work opportunities for people with disabilities. For most jobs, you cannot work if you cannot get from your house to the job site. Only 69 percent of people with disabilities have a way to get to a job.

      Funding and enforcement of transportation access requirements will be central to the mission of the Department of Transportation. In addition, HUD funding for accessible local transportation and DOJ enforcement of the ADA are critical components to ensure local transportation that is fully accessible for people with disabilities. As a strong supporter of mass transit, I believe we must invest in providing more mass transit and ensuring that it is accessible to people with disabilities and meets their needs, such as “kneeling” buses that make it easier to board. I support increasing federal funding for nonprofit groups to meet the transportation needs of people with disabilities when public mass transit is not available.

      Things that sound little can be very important to ensuring accessibility. Clearing snow, removing standing water, providing shelter from wind and rain can make the difference between a bus or train stop that is accessible and one that is not. Train systems should have worker training to provide assistance across gaps between train cars and stations, with appropriate universal signage. The federal government has the power through Section 504 to ensure these efforts are made. It should use it.

      In addition to mass transit, the Justice Department can also enforce accessibility requirements for taxis and other common carriers. And common sense will ensure security needs are managed with dignity for people with disabilities -- the Transportation Safety Administration should use uniform, reasonable screening for people with disabilities that do not cause unnecessary pain, discomfort or delay in air travel.

      Beyond mass transit, which is often not a viable solution in rural America, we can do more to support mobility for drivers with disabilities. Electronic toll collection passes (e.g., EZ-PASS) make toll-paying much safer for individuals who rely on hand controls to operate their vehicles. They are more a necessity than a convenience. I would require states to waive fees for the passes for low-income people with disabilities.

      Hurricane Katrina highlighted that the need for reliable, affordable, accessible transportation is not limited to accomplishing everyday life and work functions. It can be – and – was the difference between life and death for hundreds of people in New Orleans and the Gulf Coat. People with disabilities were disproportionately affected – such as those who died in the hurricane and its aftermath or who were stranded in the Superdome because their needs were often overlooked or completely disregarded. Our emergency preparedness planning absolutely must do a better job of reflecting the needs of people with disabilities.

      Clinton: I am very aware that providing meaningful transportation opportunities to people with disabilities is an invaluable first step in empowering individuals to fulfill their potential and live self-sufficiently. Given the need for accessible and affordable transportation, I have consistently supported the Community Service Block Grant Program, a program that traditionally helps fund and support transportation projects (among other projects). Additionally, as a Senator, I have tried to secure funding for agencies that provide transportation services to those individuals with disabilities. As President, I will continue to proudly champion programs that ensure people with disabilities can have access to transportation resources.

      Dodd: Access to affordable, reliable public transportation is both an issue of fairness and environmental necessity. One of the key points of my energy plan is to increase access to affordable and convenient mass transit systems that are fully accessible to people with disabilities across all regions of the country. Such a system will be designed to enable people with disabilities to gain full access to jobs, schools, and healthcare facilities.

      I know that mass transit saves families money in fuel costs and lowers pollution by reducing the number of cars on the road during rush hours. I also know that affordable and convenient mass transit represents an essential component to ensuring that everyone can take advantage of services and opportunities. With the many resources and developments we have at our fingertips, in a Dodd Administration access will never be an impediment to people with disabilities, regardless of where you are from and where you need to go.

      Additionally, to fully serve people with disabilities who live in rural areas, we must offer them a wide array of personalized transportation support services, including van services and rideshare.

      Biden: I support expanding access to affordable transportation for people with disabilities. I understand the necessity of it in rural areas, where accessible public transport can be difficult to come by. That’s why I have consistently supported expansion of accessible public transportation options and of transportation services.

7. EDUCATION
   1. How would you ensure that students with disabilities are included within and accommodated as part of the accountability measures of No Child Left Behind?

      Obama: The goal of the No Child Left Behind Act is the right one – ensuring that all children can meet high standards – but the law has significant flaws that need to be addressed. Unfulfilled funding promises, inadequate implementation by the Department of Education, and shortcomings in the design of the law itself have limited its effectiveness and undercut its support among many people who care deeply about our schools and our students. I would reform and fund No Child Left Behind and add specific provisions for programs for students with disabilities. This includes early and targeted instruction and hiring highly qualified general and special education teachers. States, school districts and schools must continue to measure and report the academic performance of students with disabilities. This is why I fully support the IDEA Act.

      Richardson: No Child Left Behind has received a great deal of criticism from the disability community, particularly as it relates to children with cognitive disabilities. While most children with disabilities can take the standardized tests with accommodations, students with cognitive disabilities have often been left behind because they are required to take the same standardized tests as students without cognitive disabilities. I will establish a work group consisting of people with disabilities, parents and teachers to review No Child Left Behind to determine how we can best serve our children with disabilities.

      Edwards: One of the benefits of No Child Left Behind is that all students are included within a school’s accountability system. Special education is a part of general education. Holding schools accountable for their success at teaching children – including children with disabilities – will help us strengthen our schools. As president, I will make sure the Department of Education focuses on the need to treat children with disabilities inclusively within the No Child Left Behind accountability framework. However, much of the No Child Left Behind Act needs to be improved. The accountability provisions of No Child Left Behind need to be overhauled. They are often illogical and arbitrary, and they have damaging effects in the classroom. And we need higher quality assessments to more accurately measure all students’ learning.

      I support more research, technical assistance, and professional development about what constitutes valid and reliable assessments for the full range of students with disabilities.

      Clinton: While I have many concerns about the No Child Left Behind Act, one aspect of the law that I am pleased about is that it shines a spotlight on the education of students with special needs and ensures that schools focus greater attention and resources on getting all children achieving at a proficient level. At the same I think it is important that the assessment provisions allow children with special needs to receive the accommodations they need to demonstrate their true abilities on the assessments, and that we invest in programs to increase the number of qualified special education teachers. In addition, I have co-sponsored the Instructional Materials Accessibility Act, which would have significantly improved access to instructional materials for students who are blind or have other print disabilities by creating an efficient system for acquiring and distributing these materials in specialized formats, which include braille, synthesized speech, digital text, digital audio, and large print.

      Dodd: As President, I would vehemently oppose any efforts to remove students with disabilities from the NCLB accountability system or to weaken their participation in it. At the same time, I would heavily invest in efforts to ensure that appropriate supports, assessments and accommodations are available so that students with disabilities have full access to the regular curriculum. A Dodd Administration will also commit to, and invest in, a national effort to ensure that curriculum objectives, materials, teaching methods and classroom assessments are universally designed.

   2. Do you support full federal funding for the Individuals with Disabilities Education Act (IDEA)?

      Obama: This is one of my top educational priorities. I will fight to increase federal funding levels, and actively solicit the support of both Republicans and Democrats that are watching efforts at school improvement falter as school districts layoff teachers and much needed programs. The federal government is supposed to shoulder 40 percent of each state’s “excess cost” of educating children with disabilities, but currently we are less than halfway there (17 percent) because Congress has never lived up to this obligation. Children are the ones who are being shortchanged. Schools should not be forced to choose between salaries for effective teachers and special education for students who need that support. Fully funding IDEA will help to relieve that burden by supplying the necessary dollars to boost the quality and range of the services available.

      Richardson: Absolutely! The federal government has never fully funded IDEA and it's time we did. Under the 1975 IDEA, the federal government stated they would pay 40% of funding, it currently only pays about 20%. It's time we fulfill our promise.

      Edwards: For more than a quarter-century, the federal government has rightly insisted that every child with special needs receive a free and appropriate public education. However, it has failed to provide even half of its share of the cost, placing excessive burdens on local school budgets and undermining efforts to provide an excellent education to all children. I have repeatedly voted to fully fund special education and to make the funding mandatory. As president, I will continue to support full funding for the education of children with disabilities.

      Clinton: I am a strong proponent of full federal funding of the Individuals with Disabilities Education Act, and have consistently advocated for this policy throughout my tenure in the Senate. In 2005, I sponsored an amendment to the Labor, HHS, and Education appropriations bill to increase funding of IDEA by $4 billion. I think it is disgraceful that the federal government has promised to provide 40 percent of the cost of educating a student with special needs yet has never appropriated more than 20 percent. In addition, I have long embraced provisions that would increase the pool of qualified special education teachers, provide those teachers with additional professional development opportunities, and provide targeted support for the growing number of children with behavioral and emotional disorders.

      Dodd: Over thirty years ago, Congress passed IDEA to help states provide children with disabilities with a free, appropriate public education in the least restrictive environment possible. At that time, the federal government made a commitment to, over time, cover 40% of the state cost of servicing these students. Thirty years later, the federal level of funding hovers at less than 20%. I believe that the time has come to fully fund IDEA. I have been a leading voice on adequately funding this initiative throughout my Senate career and would reflect my commitment to do this in Presidential budgets.

   3. What ideas do you have for strengthening federal enforcement of IDEA?

      Obama: I have consistently supported legislation that would increase funding for the Individuals with Disabilities Education (IDEA) Act. In 2005, I supported legislation that would provide $4 billion in additional funding for IDEA. I also voted for waiving the Budget Act to consider the Byrd amendment, which would provide $5 billion for title I of the Elementary and Secondary Education Act of 1965. In 2005, I voted for creating a reserve fund that would provide $71.3 billion for special education programs under IDEA. I will work to increase that a meaningful portion of the funding increases for IDEA are targeted to enforcement of the Act’s mandates.

      Richardson: Withhold federal funding for school districts that are out of compliance with IDEA.

      Edwards: As president, I will strengthen enforcement by the Department of Education so children with disabilities receive the free, appropriate education they deserve and are legally entitled to. The first principles are the same as with Fair Housing – appointing strong enforcement officials, nominating fair judges, providing adequate resources and exercising leadership to make enforcement a priority.

      A strong partnership between the Departments of Education and Justice is key, and I will seek the most qualified people with disabilities to fill leadership positions at both agencies. Sharing data between the two departments will permit faster response to complaints and better evaluation of individual education plans. Full funding will assist IDEA enforcement in both the DOE and DOJ. My administration will draw upon the experience of educators, administrators and advocates who have successfully implemented IDEA programs as models for other states and communities to follow.

      At the same time, I oppose Republican efforts to roll back key provisions of the IDEA. Whether it is denying access to attorneys by putting artificial caps on fees or stripping children with disabilities of civil rights, we must stop rollbacks of IDEA.

      Clinton: While I am a very strong proponent of IDEA, I also believe that the federal government can do more to champion the values underlying the IDEA program through enforcement. I co-sponsored the Individuals with Disabilities in Education Improvement Act, which was signed into law on December 3, 2004. This bill strengthened IDEA by expanding monitoring and enforcement mechanisms and enabling parents and schools to resolve disputes equitably while also improving access to professional development for all teachers, improving students’ transitions from high school to adulthood, and involving parents more thoroughly in the education of their children. As President, I will continue to seek out ways to ensure that IDEA is enforced in order to ensure that it is truly effective in achieving the goal of having every child with special needs receive a free, appropriate public education.

      Dodd: Recently, the National Council on Disability (NCD) found that every State in America was out of compliance with IDEA requirements to some degree. They found that the Department of Education made limited use of its authority to impose available sanctions -- withholding of funds and making referrals to the Department of Justice --- and a system where parents with limited resources were unable to challenge violations of their children’s rights when they occured. As President, I would rectify this by first advancing a more aggressive approach to enforcement. I would do this by instructing the Department to establish clear, objective, and publicly available criteria for applying sanctions, funding and directing an immediate review of compliance across the states, and ensuring that sanctions are then fully applied.

      In regards to parents’ ability to challenge IDEA violations, I was a strong supporter of the Supreme Court’s decision in Winkelman v. Parma City School District and was among a handful of Senators to file an amicus brief with the court in favor of a parent’s authority to bring pro se claims under IDEA. The recent ruling in favor of parents will help to ensure that those of limited resources have a fighting chance in court. A Dodd Administration will work to ensure that children with disabilities are no longer denied their civil rights.

   4. What ideas do you have for increasing the high school graduation rate of students served by IDEA?

      Obama: Requirements determining graduation rates should include adequate yearly progress reports, but these must be enhanced in order to produce substantial and consistent improvement in graduation rates for students served by IDEA.

      Richardson: There needs to be a great deal of work on this issue. Currently almost 50% of children with IEPs do not graduate. I will put together a team of people consisting of people with disabilities, parents and educators to study this problem and come up with best practices.

      Edwards: We must address the higher dropout rates and lower college enrollment rates for students with disabilities. The starting place must be fully funding IDEA.

      Providing Individualized Education Program when requested, with meaningful complaint opportunities for parents who cannot obtain one, or negotiate a meaningful one, will help keep children with disabilities in school and help them graduate.

      For students with disabilities, planning for the transition from school to adult life must start early. I will make sure that the Department of Education works with states to put effective and accountable transition planning into place.

      Many dropouts realize dropping out was a mistake. America is about second chances, so I don't see why we shouldn't have “second-chance schools” to lift up former dropouts, offering them one-on-one attention and a chance to earn a diploma at night or at a local community college. In addition, my Breaking Down Barriers initiative will help high school and college students with disabilities find internships, so they can experience the working world and be encouraged to stay in school. This initiative will also provide them valuable skills and contacts for finding a job after graduation, helping them on the path towards success and self-sufficiency.

      Clinton: I believe that we ought to commit ourselves to improving high school graduation rates for all students, especially students with disabilities. Improving graduation rates often starts with improving the quality of all teachers and staff who are responsible for educating students. Towards this end, I was a proud co-sponsor of the Personnel Excellence for Children with Disabilities Act, which promised to help schools recruit and retain new special education teachers, and better prepare general education teachers and staff to work with children with special needs. This bill also pledged to make research-based, comprehensive professional development available to teachers. Much of the language in this bill was included in S. 1248, which was signed into law on December 3, 2004. I am also a strong supporter of the Vocational Rehabilitation Act, which helps students with disabilities make a smooth transition from high school to employment. I think we can do much more to help students with special needs envision an exciting future for themselves in which they live self sufficiently and fulfill their potential.

      Dodd: As President, I will require that every 9th grader in America, including students with disabilities, have a graduation plan to ensure that they are on-track for college and the workforce upon graduation. A graduation plan will allow students and parents to monitor progress and allow them to make adjustments as needed along the way. I would also work to ensure that all students successfully complete high school by supporting initiatives that provide targeted instruction and appropriate behavior supports to students that need them. The need for targeted instruction and interventions must not delay a student’s successful completion of high school.

   5. How would you improve services for students transitioning from school to employment? From high school to higher education?

      Obama: In order to make college more accessible and affordable for students, I will increase federal college loans and free up money for student aid. The first bill I introduced in the U.S. Senate would help make college more affordable for many Americans. The bill would increase the maximum Pell Grant from the current limit of $4,050 to a new maximum of $5,100. In February 2007, Congress passed and President Bush signed into law legislation to increase federal Pell grants to $4,310. I also want to reform college loans to make more money available for student aid. There are two federal college loan programs. The first allows students to borrow directly from the government, and the second gives private banks federal subsidies to make government-backed student loans. Privately funded loans are much more expensive to the federal government, which is why I support legislation to shift more loans to the Direct Loan program and use the savings to invest in grant aid to students.

      I support the creation of high-paying, secure jobs. I believe we need to increase federal funding for basic research, expand the deployment of broadband technology, and make the research and development tax credit permanent so that businesses can invest in innovation and create more and better jobs for students transitioning from school to employment.

      Richardson: I will support increasing transition services not only in high school, but begin working on transition of children with disabilities in junior high school. We have too many students graduating from high school who transition to SSI rather than a job or higher education.

      Edwards: The challenges of helping young people with disabilities matriculate to college and get their first job are equaled only by the reward for society of integrating them into the workplace. There is so much we can do – so much we must do – to help students make these transitions successfully.

      Too many students lack the encouragement and guidance they need to apply to college. The challenges are even greater for students with disabilities. In some large cities, a single counselor must serve more than 700 students. I will help every low-income high school eligible for Title I hire a new college counselor, helping students choose college-track courses and navigate the admissions and financial aid process.

      As president, I will support vocational rehabilitation programs and the expansion of employment-based settings for federally-funded job education.

      I also believe the work-study experience that my Breaking Down Barriers initiative will offer to young people with disabilities will help many make the transition from school to work.

      Clinton: I think we ought to focus our attention not only on providing educational opportunities, but also on ensuring students transition from primary school to other endeavors. That is why I support the Vocational Rehabilitation program, which helps ensure that every student with a disability has a plan for transitioning out of high school and into college or full time employment. I think this program needs additional funding so that it can reach more students. Too many states have been forced to enter an order of selection where they have to choose between students with varying levels of need. I believe this program should serve every young person with a disability and start reaching out to them when they are even younger. As President, I will increase funding for Vocational Rehabilitation and work with states to improve their programs so that they are sharing best practices and more effectively reaching all of the students who could benefit from these services.

      Dodd: Building on requirements within IDEA that every student have a transition plan in place by the age of 16, a Dodd Administration would work to provide additional funding to ensure that transition services take place wherever most appropriate for the individual student – on school grounds, at community or four-year colleges, or at works sites. As President, I would work hard to ensure that IDEA students stay on track not only to graduate, but to graduate college and/or workforce-ready.

      Biden: The form of Senator Biden's response deviates from the form provided (parts a, b, c). View his response to the above questions.

8. TECHNOLOGY AND TELECOMMUNICATIONS