Candidate
Questions
& Responses
Teresa
Daly
DFL Candidate
for U.S. House of Representatives
2nd Congressional District
How
will the new federal prescription drug benefit being implemented
in 2006 help or hurt the 9 million non-elderly disabled Americans
receiving Medicare? Would you support (or author) a technical amendment
that would make prescription drug coverage more accessible for
persons with disabilities -- persons who have dual eligibility
under Medicare and Medicaid?
The
new Medicare law fails to adequately address the issue of affordable
prescription drugs. It creates a system of means-testing where
some seniors are ineligible for a prescription drug benefit because
of income and assets. The new law creates gaps in coverage where
millions of seniors will be forced to pay the costs of drugs because
their drug bills are not high enough to receive coverage.
The new Medicare law also fails to define the process for moving
the dual eligibles from drug coverage through Medicaid to Medicare.
It does not ensure simple and automatic enrollment for eligible individuals.
Success of this transition is critical since Medicaid drug coverage
ends for these individuals on January 1, 2006.
I will fight to rewrite the Medicare law to allow the government
to negotiate with the drug companies for lower drug prices, permit
individuals to import their FDA-approved drugs from the cheapest
pharmacy, and ensure that persons with disabilities receive the access
to the medications they need.
Currently
in 38 states people with physical, sensory and cognitive disabilities,
who seek assistance from vocational rehabilitation programs are
being placed on a waiting list because the programs do not have
the funds to serve them. In view fact that studies -- including
studies conducted by the Congressional Budget Office -- have shown
on the average for every dollar put into rehabilitation programs,
the federal government will receive 9 dollars in tax revenue over
the persons working life, would you support increased funding and
support for vocational rehabilitation programs so all applicants
can be served and begin returning needed tax revenue to the federal
government?
I will
support increased federal funding for vocational rehabilitation
programs. Many states have begun to scale back vocational rehabilitation
programs by reforming workers compensation and balancing state
budgets. Some states, including California, have completely abolished
vocational rehabilitation programs. I believe the federal government
should give workers the tools necessary to help them go back to
work after an injury.
The
Individuals with Disabilities Education Act (IDEA) is commonly
referred to as the civil rights act for children with disabilities
because it guarantees access to a free and appropriate public education.
The act is currently being considered for reauthorization and both
the House and Senate bills significantly weaken key components
of the current law that ensure accountability. These include such
things as opening the door to the development of three year individual
education plans (IEP's), rather than one year; eliminating the
requirement for short term objectives to be included in IEP's;
changing the way parents are notified of their rights; making it
easier for schools to suspend or expel students with disabilities
(even if the behavior is related to the student's disability);
and watering down due process protections. If this bill is not
reauthorized during the current session of Congress, will you support
reauthorizing an IDEA bill next session that will not strip current
rights from children with disabilities and their families?
It
is very likely that Congress will not reauthorize IDEA because
of partisan wrangling and their short legislative calendar. While
Congress made some progress on IDEA in this Congress, more is needed
to ensure that our children receive a quality education. Schools
should be required to consider the impact of a child's disability
when deciding to change his or her placement following a suspension
or expulsion violation. Congress should also increase funding for
schools to expand the use of behavioral support and school-wide behavioral
interventions in order to proactively address student behavior.
Schools should be required to conduct a behavioral assessment to
determine whether a child's violation of school conduct codes is
the result of a child's disability or of a school's failure to implement
the child's Individual Education Program (IEP).
If Congress is going to mandate all these new requirements on our
school districts, they must do something they have failed to do since
IDEA was first enacted 29 years ago, which is to fully fund the 40
percent requirement.
Please
outline your thoughts on the proposal to "block grant" Medicaid
funding to the states, instead of the currently used formula.
Congress
shouldn’t change Medicaid into a
block grant program. Block grants will force states to scale back
coverage over time. Because a block grant would limit the amount
of federal funds available for Medicaid based on expenditures today,
it would essentially freeze state programs at a time when states
have already reduced Medicaid coverage and services in order to
close budget gaps. As costs grow over time, a limit on federal
funds will force governors and state legislators to put the needs
of different populations against one another, leaving some unserved.
Block grants will hinder
states’ ability to respond to increasing
health care needs of their residents. While today’s system
guarantees a state additional federal funds if costs increase, under
a block grant states would have to negotiate with the Administration
or with Congress for additional federal funds when costs go up. A
downturn in the economy that causes more people to become uninsured,
public health threats or natural disasters, advances in costly medical
technology or new medicines, and the increasing costs of prescription
drugs or other medical treatments--all these could drive a state’s
costs higher than anticipated under the block grant.
Under a block grant, people who have Medicaid coverage would lose
valuable protections that are currently in Medicaid law. Such protections
include limits on the amount of out-of-pocket costs they have to
pay for health care, a standard benefit package, and the ability
to enroll in the program at any time if they qualify.
Block grants limit federal
funding and therefore put states at risk for paying for any health
care costs they incur above the fixed amount. The health care needs
of low income people remain regardless of the amount of federal
funding available. If the federal government caps its contribution
to the states for health care through Medicaid, states will be
left holding the bag when the federal government stops paying.
Do
you support the Paul Wellstone Mental Health Equitable Treatment
Act of 2003?
Yes,
I support the Paul Wellstone Mental Health Equitable Treatment
Act. This monumental legislation would prohibit group insurance
plans that cover mental illness from doing so under different terms
than general medical treatments. It would prohibit all types of
discrimination against those who seek mental health treatment,
including higher co-payments and deductibles and limits on the
numbers of treatment visits, by those health plans providing coverage
for mental health treatments.
This bipartisan legislation is being held up by reluctant House
Republican leadership and resistance of business and insurance groups
who fear for increased premium costs.
How
is Minnesota doing in response to the 1999 US Supreme Court Olmstead
decision?
The
Supreme Court ruled in landmark interpretation of the ADA that
the "integration mandate" of the Americans
with Disabilities Act requires public agencies to provide services "in
the most integrated setting appropriate to the needs of qualified
individuals with disabilities."
While Minnesota hasn’t developed an Olmstead plan, the state
has developed an alternative strategy to comply with the Court’s
decision. Much of the Olmstead-related activities are occurring through
Systems Change grants from the federal government. As a result of
one of its Systems Change grants, the Department of Human Services
(DHS) issued a request for proposals from organizations within the
state that seek to rebalance and integrate long-term care and promote
the independence of older adults.
As a member of Congress, I will fight for increased funding for
grants to help state governments develop comprehensive Olmstead plans.
How
can the Medicare system be altered to provide incentives for funding
community-based, versus institutional care or services to those
who are "home-bound"?
Improving
care for people with long-term illnesses is the next great challenge
in health care delivery. Billions in Medicare are spent treating preventable
maladies like sores, dehydration, and fractures, when it would
be much cheaper to hire more and better trained staff to prevent
such problems in the first place.
That is why Congress should fund the Nurse Education Act and the
Nurse Reinvestment Act to ensure sufficient numbers of qualified
nurses are available to provide a full range of nursing services
in all geographic areas.
Because health policy experts don't know precisely how to create
incentives for chronic care services in Medicare, Congress should
concentrate on creating processes that allow experimentation and
evaluation to find out what works. The result could be improved compliance
with drug regimens or in-home monitoring which can pay off in savings
from a reduced number of hospitalizations or other expensive health
services.
Given
that recent government surveys show some 6,690 or 18.7% of Minnesotans
living in nursing homes express a preference to live in the community.
What is your position on MiCASSA (S.971 and H.R.2032) and Money
Follows the Person Act (S.1394 and H.R.1811)? Please elaborate
on the pros and cons to the legislation and the rationale behind
your position.
Medicaid
Community-Based Attendant Services and Supports Act
The bill calls for Medicaid
funding to be used for personal assistance services and supports
for people of all ages in their homes and communities, rather
than only in an institution -- paying for assistance with bathing,
dressing, meal preparation, money management and certain health-related
tasks. I support MiCASSA because it helps people make real choices
about the type of care they need and deserve.
Money Follows the Person Act (S.1394)
In his budget for fiscal year 2004, President George Bush proposed
a `Money Follows the Person' rebalancing initiative under the Medicaid
program to help states rebalance their long-term services support
systems more evenly between institutional and community-based services.
While a few states have been successful at achieving this balance,
nationally, approximately 70 percent of the Medicaid funding spent
for long-term services is devoted to nursing facilities and intermediate
care facilities for the mentally retarded. Only 30 percent of such
funding is spent for community-based services.
Money Follows the Person reduces the costs since home and
community based services are far less expensive than institutional
care. It is also consistent with our values and that is why I support
Money Follows the Person.
