Source: HELP Committee
One year after releasing a report showing that many states have not made adequate progress in ensuring the availability of home- and community-based services as an alternative to nursing homes and other institutional settings for individuals with disabilities, Senator Tom Harkin (D-IA) introduced legislation to ensure that the choice and opportunity to live in home- and community-based settings are available to all Americans with disabilities. Harkin is the Senate author of the Americans with Disabilities Act (ADA) and is Chairman of the Senate Health, Education, Labor, and Pensions (HELP) Committee.
Fifteen years ago this week, the Supreme Court ruled in Olmstead v. L.C. that the unnecessary segregation of individuals with disabilities in institutions is a violation of the ADA. A July 2013 report released by Chairman Harkin’s HELP Committee staff found that more than 200,000 working-age Americans remain unfairly segregated in nursing homes. While progress has been made nationally, by 2010 only 12 states spent more than 50 percent of Medicaid funds on community-based care rather than institutional care.
“Fifteen years ago in Olmstead v. L.C., the Supreme Court held that under the ADA, individuals with disabilities have the right to choose to receive their services and support in home- and community-based settings, rather than only in a nursing home or other institutional setting. But we have yet to fully realize this promise, and many individuals with disabilities—our family members and our friends—continue to reside in institutional settings against their wishes.
“Studies clearly show that home and community-based care is not only what most people want, but it is also more cost-effective,” Harkin added. “The choice to live in the community is one of the most important civil rights issues we face today. The Community Integration Act honors the Olmstead decision and ensures that states take the steps needed to ensure that all individuals with disabilities are given the opportunity to receive their services and supports in a community based setting, where they can work, participate in community life, and be an integral part of their communities.”
Harkin also led a HELP Committee roundtable to hear from individuals who have successfully transitioned into the community, to consider further action that can be taken to increase opportunities for full integration, and to learn more about the important role that the federal government and Congress can play in protecting the rights of Americans with disabilities and making sure that community-integrated living options are available.
The Community Integration Act would:
- Eliminate the Nursing Home Bias in Medicaid by clearly allowing the provision of similar care or services in home and community based settings.
- Prohibit states from making anyone ineligible for home- and community-based services based on a particular disability.
- Require states that have found an individual to be eligible for nursing or institutional care to similarly find those same individuals to be eligible for care in home and community-based settings.
- Set clear requirements for states regarding the provision of services in home and community based settings.
- Require annual reporting by states about the number of individuals with disabilities in institutional settings and the number that have been transitioned to home and community based settings.
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