haps in services for a specific targeted purpose or a particular target group.

Mr. OWENS. Thank you very much.

Mr. Bartlett.

Mr. BARTLETT. Senator Brooks, my commendation on your attendant care legislation. The absence of attendant care is in fact one of the primary barriers to employment for persons with disabilities. Again, it is the Catch 22. You get attendant care if you are not employed and you do not if you are employed.

Is it too early to ask for results at this point? Do you have any compilation of changes in the behavior of employment as a result of this legislation?

Mr. BROOKS. It is probably a little premature for us to give you good hard statistical data. We are checking on that through our state agencies. We are working directly with the providers and, of course, the individuals receiving assistance.

I know personally from individuals with whom I am acquainted and work closely, that it has a very significant effect, positive effect on people's ability to get a job, hold a job, meet other kinds of commitments, and they are doing some technology training, updating of technology. If they are in a field where they need to do continuing education, all of those kinds of services are open and accessible to them.

Mr. BARTLETT. As you obtain data, it would be helpful if you could pass them on up to the congressional level for use in other programs.

I have two comments, both of them basically related, springing off the attendant care issue. In many cases we found at the Federal level, and I know it is true at the state level also that it is not so much-what is needed is not so much the creation of a new Federal program or a new state program. It is not new appropriations. But oftentimes what is needed is to identify the barrier, and in this case in Medicaid, and change the rules of the game so that someone who is employed has-someone who becomes employed has that ability to remove that barrier.

Oftentimes what I know is true at both the Federal and the state level, and is an indication in the attendant care, it is not so much a new program as it is to remove any existing barriers of the Medicaid program.

And with that, I would like to comment that I am not certain what the state is doing at this point. But I would suggest that at the Federal level we found some years ago the bible or the blueprint that we began to use when some years ago we authorized, not just authorized, we mandated the National Council on Handicapped to prepare a report that turned out to be one of the reason that we are here today. It is called "Towards Independence."

And we mandated that the council identify that whole spectrum of barriers to independent living that were currently in Federal law, and the mandate was very, very clear. We did not ask them to come forward with new programs or with new Federal ideas or with new benefits. We just simply asked for a compilation of all of the barriers that were in current Federal laws that restricted people from full independent living.

I am only too familiar with some, on an anecdotal basis, some of the barriers in state law. ICFMMRS, for example, require medical modeling for group homes when in fact a group home is not necessarily a medical model. Oftentimes it is just a chance for people to live, and there are a number of barriers in that. One of them is disabled people living in ICFMMR are not allowed to take a vacation such as you and I would take a vacation for no particular good reason. It is just simply that is the law.

So one of the things I would like to work with you that the state may consider would be to authorize someone to conduct that comprehensive review of all of the barriers so that then you can begin to dismantle those barriers one at a time. And I commend you for the work that you and Mr. Smith have already done on that, and we look forward to working with you in the future.

Mr. BROOKS. I agree with you 100 percent. It is the removal of disincentives. The recognition and removal of disincentives probably is more important than creating new services and new programs. We know what many of the things that will work. We know they will work. We have already demonstrated they will work. We do not have to go field test them anymore. We know they will work. It is just getting people the access to those kinds of services and link them up with the providers that can help them.

Mr. OWENS. Mr. Payne.

Mr. PAYNE. Senator, I have no questions, and your entrance into the thralls of the after 27 years in the state legislature certainly answers any questions I might have. You are on the right side, indeed. With what the state legislature is doing in spite of the problems that you have currently, I would hope that this would be a model for some of the other states that are lagging behind. So I would just like to commend you and the legislature on your excellent work. Thank you.

Mr. OWENS. I would like to thank both of you gentlemen as well as all of the witnesses who appeared today. We want to thank the audience, thank all the many volunteers who helped to make this hearing possible, and thank Houston generally for its great hospitality. The volunteers that helped out at this hearing were Warren Charles, Paul Chase, Susan De Vault, Joyce Frieden, Roxy Funchess, Laurie Gerken, David Kinneson, Linda Pickle, Sally Phillips, Tom Sellers, Vickie Harris Smith, and Ellen Woodall.

The hearing of the subcommittee is now adjourned.

[Whereupon, at 11:45 a.m., the subcommittee was adjourned subject to the call of the chair.]

[Additional material submitted for the record follows.]

the Education for all Handicapped Children act PL 94142, and various other components of entitlements for research, demonstrations, technology and services in legislation for the Veterans Department, the National Institutes of Health, National Science Foundation, the Vocational Rehabilitation Administration, the Social Security Administration, Department of Defense. Of course the levels of funding appropriated may be insufficient for the magnitude of disability, but the tools exist. HB2273 should provide more evidence of the cost effectiveness of these many entitlements needing to be funded and considered as part of a whole and integral effort of our nation.

(4) Opposition to this bill may be understandable, by those who have not faced disability personally or in their own family. They may not have had to experience the full consequences of disability. Perhaps they dont appreciate the benefits returned to our nation in realization of the productive potential of the disabled person. Yet they must perceive the value of eventually controlling huge economic outlays by the public sector, private insurers, and purchasers of health and disability insurance. This is clearly a consequence of the ever increasing costs of dependency and medical or custodial chronic care. How can one fail to appreciate the way in which increased availability of rehabilitation services, technology and assistance with home support for independent living provide a powerful way to stem the tide of inexorable financial payments for disability? How tragic that industrialized countries may expect 1.5 to 2.0 dependant young and elderly for every working person in the first half of the next century.6 How can one ignore the daily heroic efforts of even the most severely disabled persons wresting themselves from the abyss of dependency and contributing to the strength and productivity of our society? Recently, the dollar savings of eight to ten dollars realized for every dollar expended for rehabilitation services was reported by workman's compensation insurance and casualty insurance companies in actuarial experience. 7 What return on investment in our modest expenditures and entitlements for restorative medical and rehabilitative services! Studies and experiences of Independent living programs continually demonstrate the much lesser cost of personalized assistance and home support than long term care in nursing homes.

We therefore are so heartened that President Bush endorsed the passage of this bill and is willing to sign it as an investment in helping to stem these human and economic losses that are so much greater than the overblown cost estimates for removal of barriers to the independence of our nation's disabled persons.

the absence of

productivity and independence. Facts supporting this situation have recently been reported in the national and local press.2 For years this tragic progression has been experienced by hundreds of thousands of disabled persons, by professionals trying to assist them, by independent living center personnel and advocacy group members.

Those objecting to this bill are not comparing the inevitable needless public and private expenditures against the lesser costs for the removal of the physical and societal barriers as proposed in this bill. Nor is there any consideration of the great annual and aggregate lifetime economic as well as social losses to the family, the community the state and the nation!

(2) Our experience in Houston and elsewhere, has shown that access to community life is for less costly than has been projected in the estimates currently claimed by some spokesmen of business and industry.3 They should go back and read the experience of industrial giants like IBM, CDC, XEROX and Dupont whose management found the cost effectiveness of workplace modifications and access and greater productivity achieved by so called "disabled" workers. They even demonstrated less absentiism, illness and turnover than among their "able bodied" workers.

(3) Extensive and careful studies of the Presidentially appointed and Congressionally authorised National Council on the Disabled and the President's Committee on Employment of People with Disabilities has substantiated the magnitude of this need by means of independent national surveys, reports of the National Research Council on "Injury in America”, and testimony of public and private agencies and affected persons. 4 These sources also provide conclusive evidence of the beneficial consequences of a systematic approach to this great national problem 5 This proposed legislation is another great step in a path our nation has embarked upon to control disability, along with all other industrialized nations. If HB2273 is enabled as it is written it will become a true milestone in the long trail to independence for the disabled, which began after World War One. It will close the circle of cost effective Federal programs and entitlements including the Rehabilitation act of 1973 -PL9312, the Open Housing act for the disabled, the Technology Assistance act PL 100407,the Civil Rights Restoration act,

the Education for all Handicapped Children act PL 94142, and various other components of entitlements for research, demonstrations, technology and services in legislation for the Veterans Department, the National Institutes of Health, National Science Foundation, the Vocational Rehabilitation Administration, the Social Security Administration, Department of Defense. Of course the levels of funding appropriated may be insufficient for the magnitude of disability, but the tools exist. HB2273 should provide more evidence of the cost effectiveness of these many entitlements needing to be funded and considered as part of a whole and integral effort of our nation.

(4) Opposition to this bill may be understandable, by those who have not faced disability personally or in their own family. They may not have had to experience the full consequences of disability. Perhaps they dont appreciate the benefits returned to our nation in realization of the productive potential of the disabled person. Yet they must perceive the value of eventually controlling huge economic outlays by the public sector, private insurers, and purchasers of health and disability insurance. This is clearly a consequence of the ever increasing costs of dependency and medical or custodial chronic care. How can one fail to appreciate the way in which increased availability of rehabilitation services, technology and assistance with home support for independent living provide a powerful way to stem the tide of inexorable financial payments for disability? How tragic that industrialized countries may expect 1.5 to 2.0 dependant young and elderly for every working person in the first half of the next century. 6 How can one ignore the daily heroic efforts of even the most severely disabled persons wresting themselves from the abyss of dependency and contributing to the strength and productivity of our society? Recently, the dollar savings of eight to ten dollars realized for every dollar expended for rehabilitation services was reported by workman's compensation insurance and casualty insurance companies in actuarial experience. 7 What return on investment in our modest expenditures and entitlements for restorative medical and rehabilitative services! Studies and experiences of Independent living programs continually demonstrate the much lesser cost of personalized assistance and home support than long term care in nursing homes.

We therefore are so heartened that President Bush endorsed the passage of this bill and is willing to sign it as an investment in helping to stem these human and economic losses that are so much greater than the overblown cost estimates for removal of barriers to the independence of our nation's disabled persons.