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AAPD, ADAPT, NCIL, SABE Questionnaire – Senator Biden Response

October 16, 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?
   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?

      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?
   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?
   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?

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

   I support universal health care to ensure that all Americans, including those with disabilities, have access to affordable, quality health care. I think we will get to universal health care by: (1) focusing on reducing the cost of health care; (2) covering all kids; (3) giving everyone access to, at a minimum, the same health care plans that members of Congress have; and (4) lowering the cost of providing health insurance for employers and providing catastrophic coverage.

   First, we must focus on prevention, treatment, simplification and modernization. If we do we can save $100 billion a year by eliminating waste, reducing errors, applying best practices to manage chronic conditions like diabetes and hypertension and lowering administrative costs. We spend $2 trillion a year on medical care – that is 16 percent of our gross domestic product – more than any other developed country including those that insure everyone. The cost of health care is simply growing out of control.

   Second, we are going to cover every child. 9 million children don’t have access to health care. That’s shameful.

   Third, we should allow the uninsured to purchase insurance through the Federal Employees Health Benefits Program – which will allow them to join a ready-made purchasing pool that already includes millions of Americans.

   Fourth, we will lower health care costs for employers and provide catastrophic coverage. Premiums have gone up 87 percent since 2000 – four times the rate of wages. Unless something changes dramatically, health insurance costs will overtake profits for many businesses by 2008. As a result, employers are cutting benefits. We can stop it. We should help employers – or any employee association -- that provide health care for all employees by covering catastrophic health costs for active and retired employees and their families. One employee with $100,000 in health care expenses can push premiums up for everyone – by stepping in and helping to cover costs over $50,000 we can keep premiums from going up. And we should allow small businesses to join health insurance purchasing pools so small business owners can afford to offer insurance.

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

      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?
      

      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?
      

      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?

      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)?

      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)?
      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)?
      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?
   2. Will you propose integrating acute and long-term services by using integrated managed care principles?
   3. How will you address the shortage of community direct care attendants?
   4. How will you address the lack of coordination between Medicare and Medicaid policies?

      I strongly believe that every individual living with a disability should have the opportunity to live independently as he or she chooses. I have consistently opposed the unjustified segregation of people into institutions. It is discrimination pure and simple. That’s why I am a cosponsor of the Community Choice Act of 2007 and have supported the precursor of this bill, the Medicaid Community Based Attendant Services and Supports Act (MiCASSA) since it was first introduced in the 107th Congress. The legislation would provide a variety of personal assistance services under the Medicaid program to enable disabled individuals to live at home rather than in institutions. Our long term care system has a heavy institutional bias and 65 percent of Medicaid long term care dollars pay for institutional services, while the remaining 25 percent must cover all the community based waivers, optional programs, etc. The Community Choices Act requires states to provide equal access to community attendant services and supports for eligible individuals in need of long term services and supports. To help states phase in the community attendant benefit, an enhanced match rate will be available for community attendant services and supports for the next five years. In addition, the legislation provides financial assistance to states as they develop and enhance comprehensive statewide systems of long term services and supports to provide access to consumer-directed community-based services and supports in the most integrated setting appropriate.

      While we must ensure that we do all we can to allow people to live as independently as possible, we also have to recognize the support people receive from their family members to enable them to live at home or in a community-based setting. Many family members devote a significant portion of their time to help their loved ones with many aspects of their daily living. We must do all we can to reduce the burden on family caregivers and that is one of the reasons why I cosponsored the Lifespan Respite Care Act in the last Congress. In order to realize the goals of this act, I would insist that it receive full funding during the budget process.

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?
   2. How will you assure the vigorous implementation of all Fair Housing Laws?
   3. How will you assure that HUD implements programs that will assist states in complying with the Olmstead decision?
      

      A 2005 Urban Institute study showed that people with disabilities face discrimination in up to half of rental inquiries. Not only do they face discrimination but people with disabilities, especially those who rely on Supplemental Security Income (SSI) benefits, face tremendous financial barriers in their efforts to find safe, affordable and accessible housing across this nation. Too often, they are priced out of the housing market. We must expand affordable housing in this nation to address this shortage. That’s why I’ve supported programs like the Housing Choice Voucher Program (Section 8) and tax credits for affordable housing development. We must fund Section 8 vouchers to encourage mobility and housing choice. We’ve never funded Section 8 to meet the needs of the people who are eligible, as only one in three eligible families gets assistance. We must also expand the Low Income Housing Tax Credit to lower the financing costs of housing developments so that the rental prices are more affordable. In addition, President Bush has continually attempted to cut funding from Section 811 housing programs. These programs provide capital grants and ongoing project rental assistance contracts (PRAC) to developers of new subsidized housing for persons with disabilities and provide vouchers for tenants with disabilities to use in the private housing market. As President, I would work to restore proper funding to these programs, expanding the affordable housing opportunities for people living with disabilities.

      We must not only expand affordable housing, we must also promote tougher enforcement of Fair Housing laws and the Olmstead decision. In 1988, I was an original cosponsor of the Fair Housing Amendments Act, which expanded the Fair Housing laws to prohibit discrimination in housing on the additional grounds of physical or mental disability. Unfortunately, President Bush has attempted to cut funding for Fair Housing programs. I would restore funding for these programs and work with federal and local groups to educate the public and housing providers about their obligations under the Fair Housing Act. In addition, I believe we should expand paired testing, along with more traditional reasonable accommodation testing, to promote stricter enforcement for Fair Housing laws.

      In addition, we must work to increase the amount of housing that is accessible by ensuring that HUD is overseen by people who understand the difficulties that people with disabilities face in finding affordable, accessible housing and support the enforcement of fair housing laws. As president, I would appoint people who understand these issues.

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

      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?
   2. Do you support full federal funding for the Individuals with Disabilities Education Act (IDEA)?
   3. What ideas do you have for strengthening federal enforcement of IDEA?
   4. What ideas do you have for increasing the high school graduation rate of students served by IDEA?
   5. How would you improve services for students transitioning from school to employment? From high school to higher education?

      I have supported legislation to promote and ensure the education of disabled children and adults. In my early years in the Senate, I cosponsored what was then called the Education for All Handicapped Children Act. The legislation was designed to ensure that all children with disabilities have access to special education and related services designed to meet their unique needs. Since then, the act has been amended several times to add provisions relating to the education of infants and toddlers and its name was changed to the Individuals with Disabilities Education Act (IDEA) in 1990. The original legislation included a provision to provide grants to states, with funding from the federal government reaching 40 percent of program costs by 1982. Unfortunately, the federal government has never reached this “full funding” level. I have repeatedly voted in favor of the federal government fulfilling its original commitment to pay 40 percent of the costs of the Individuals with Disabilities Education Act, and in recent years have cosponsored the Educational Excellence for All Learners Acts, which expressed the sense of the Senate that IDEA should be fully funded. While I believe we must substantially overhaul NCLB, it did shine a light on one important, and that is the idea that we need to provide every child with a high quality education. We need to ensure everyone, including students with disabilities, have access to a high quality education.

8. TECHNOLOGY AND TELECOMMUNICATIONS
   1. Do you support legislative measures to require that Internet technologies be made accessible to and usable by people with disabilities?
   2. What measures would you propose to ensure that consumer electronic and telecommunications devices are accessible to and usable by persons with disabilities?
   3. How would you ensure enforcement of Section 508 of the Rehabilitation Act and Section 255 of the Telecommunications Act?
   4. Would you support restoration of full funding for the Technology-related Assistance for Individuals with Disabilities Act programs?
      
      

      Section 255 of the Telecommunications Act and Section 508 of the Rehabilitation Act are important legislative steps to make sure that telecommunications products and services are accessible to people with disabilities. I support these measures, and believe that making telecommunications products more accessible is an important issue not just for Americans with disabilities but all Americans. I support full funding for assistive technology.

9. VOTING
   1. What steps would you take as President to ensure that voters with disabilities are able to vote privately and independently, consistent with the requirements of the Help America Vote Act (HAVA)?
   2. Would you require the Census Bureau, in its surveys of people with disabilities, to ask questions regarding whether the respondents are registered to vote and whether they voted in the last election?

      I supported the Help America Vote Act, and as President would work to ensure its enforcement, including the requirements that enabled people to cast their ballot privately and required that every polling location be accessible for people with disabilities. The Help America Vote Act was a step in the right direction – but we need to do more to ensure that states are getting the resources they need to update voting technology. In addition, I have opposed photo-identification requirements because it can provide logistical difficulties for those people with disabilities who do not have driver’s licenses. I support collecting data that would assist in developing programs to make voting easier and more accessible to people with disabilities.

10. CIVIL RIGHTS
    1. Of the existing members of the U.S. Supreme Court, which justices do you consider models for the kinds of federal judges you would appoint if elected president?
    2. Do you support an ADA Restoration Act, such as the bill introduced in the last Congress?
    3. What steps will you take to protect the diminishment of the civil rights protections under the ADA?
       

       The recent Supreme Court term proves that judges and justices can undo decades of progress on civil rights. That’s why I have been tough on judging judicial appointments. As chairman of the Senate Judiciary Committee, I worked to keep Robert Bork off the Supreme Court. More recently, I opposed putting Bush nominees John Roberts and Samuel Alito on the Supreme Court, fearing what unfortunately has proven true – they would erase decades of progress on civil rights – including disability rights. I oppose nominations of judges with a narrow view of the Constitution that denies minorities, women and people with disabilities equal protection.

       The greatest barrier to full integration of individuals with disabilities into mainstream society is not the limitation of their individual disability. Rather, it is the physical and attitudinal barriers imposed by society. I believe that without the removal of these barriers, the rest of our efforts to assist the disabled will be of only moderate consequence. To reduce these barriers, I support extending civil rights protections to individuals with disabilities. In the 101st Congress, I cosponsored the Americans with Disabilities Act of 1990, extending the civil rights protections to individuals with disabilities. I believe this 1990 law was the most important expansion of civil rights since the Civil Rights Act of 1964. To honor the anniversary of the legislation, I cosponsored a resolution in the 109th Congress commemorating the 15th anniversary of the legislation.

       My commitment to Civil Rights was one of the reasons I ran for the Senate in 1972 and I have been committed to the cause for over 30 years. Everyone in my Administration would share a similar commitment to protecting Civil Rights. As President, I would ensure that the Department of Justice Civil Rights division was empowered with strong lawyers and the full backing of the Administration. I would aggressively pursue legislation to expand civil rights protections for Americans with disabilities.

11. INTERNATIONAL HUMAN RIGHTS

    1. Do you support U.S. ratification of the United Nations Convention on the Rights of Persons with Disabilities and its Optional Protocal?

       I support the United States signing, and then ratifying, the UN Convention on the Rights of Persons with Disabilities. We know that approximately ten percent of the world's population lives with disabilities -- nearly 650 million people. People living with disabilities are more likely to face discrimination and encounter physical and social obstacles. The United States has been a leader in securing rights for the disabled through the Americans with Disabilities Act. The Convention is a means to promote these rights around the world, by setting universal standards, and by obligating countries that join the Convention to end discriminatory practices against the disable.