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Working with the Governors and with consumers and advocacy groups, we have made a number of key regulatory changes over the past two years that demonstrate our strong views about offering incentives for states to expand community based care. Despite grave threats of erosion of the fundamental structure of the Medicare and Medicaid programs, we continue to pursue ways to encourage this movement.

The Department of Health and Human Services is also pursuing an ambitious research and demonstration agenda to find imaginative, new ways to maximize consumer choice and self determination. Many of the elements of this research agenda will have the immediate result of helping many people receive the supports they need. We will, for example, look at new ways to help consumers hire, train and manage their attendants, at alternative providers, and experiment with offering consumers cash instead of services.

I take great pride in being part of an Administration that promotes these basic principles. am pleased that we have made so much headway in moving toward their realization, although I recognize that we still have much work to do. I continue to appreciate the opportunity to work with the disability community as WC work toward our common goals.

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