Olmstead: Thirteen Years Later, New Opportunities
Posted on June 22, 2012 by Kimberly Lackey
It has been thirteen years since the Supreme Court announced the groundbreaking Olmstead decision. On June 22, 1999, the Court issued a decision ruling in favor of plaintiffs stating that unjustified institutional isolation of individuals with disabilities is discrimination and is a violation of Title II of the ADA. Because of this case, many individuals with disabilities have been able to avoid unnecessary institutionalization and live in their communities with proper supports and services.
People have faced many obstacles along the way and some individuals still remain in institutions. Advocates must continue to work hard to ensure that more resources are allocated to home and community based services and that individuals are presented with all possible living options. A lot of people get caught up in the debate over what it costs to transition someone to the community, even though in many cases it costs significantly less to provide supports and services to someone in the community. In 2010 it cost $132.69 per day for someone to remain in a nursing home. The State does spend a lot of money on long term supports and services, but the more important question is where is the State spending this money? The more money the State spends on home and community based services, the closer we get to eliminating discrimination and unnecessary institutionalization.
Efforts have been made in recent years to increase enforcement of the Olmstead ruling. In 2009, the Civil Rights Division launched the "Year of Community Living," and the Administration for Community Living has recently been created. Given the new focus on community living, it is more important than ever to make sure that everything is done to increase home and community based services.
Missouri has recently taken advantage of the opportunity to utilize benefits of the Balancing Incentive Payments Program (BIPP) by submitting an application to the Center for Medicare and Medicaid Services (CMS) to implement this program in Missouri. BiPP will provide Missouri with a 2% increase in federal Medicaid matching funds to provide more home and community based services with the goal of increasing the long term supports and services expenditures in the community to at least 50%. This is a great opportunity for Missouri.
In addition, CMS has issued its proposed rules which define what it means to live in "a home and community-based setting." Disability rights advocate, Steve Gold, is urging advocates to submit comments on these proposed rules. It is important to keep in mind that this not only about having appropriate supports and services in the community, but also about having control over your own home. Here are several talking points for what home and community based settings should look like:
- A lease under the State's landlord tenant law protecting against illegal evictions.
- Privacy in sleeping and living units. This means a lockable entrance.
- Sharing units ONLY if person with disability freely and knowingly wants to share and with person of one's choice.
- Right to decorate sleeping and living units.
- Control own schedules and access to food at any time.
- Visitors of their choosing at any time.
- Physically accessible.
You can read Paraquad's comments here.
You can submit your comments online or by mail:
Centers for Medicare & Medicaid Services
Dept. of Health and Human Services
Baltimore, MD 21244-8016
These must be received before July 2, 2012