New Legislation Would Give People with Special Needs an Alternative to Institutionalization

Sen. Tom Harkin (D-IA) and Rep. Danny Davis (D-IL) recently introduced the Community Choice Act in both houses of Congress. If passed, the bill would greatly expand community services and in-home care for people with special needs who qualify for institutional level care.

Currently, all states have some form of in-home care available through what are known as "Medicaid Waiver" programs, but the programs offer different levels of services and are typically underfunded and under-utilized. According to a press release from Sen. Harkin's office, the new legislation allows all Medicaid recipients with special needs who currently qualify for institutional-level care to receive that care at home if they choose to do so, regardless of their state's current waiver program.

The bill addresses key concerns raised by the United States Supreme Court in its 1999 decision, Olmstead v. L.C. In that decision, the court ruled that people with disabilities are entitled to care in the least restrictive setting available. Under the Community Choice Act, states have until 2014 to implement services that provide an institutional level of care in a less restrictive community setting. Once the plan is up and running, Medicaid beneficiaries with special needs could choose in-home care or opt to remain in a more restrictive institutional setting.

Rep. Davis highlighted the reduced cost of most community based services when compared with institutional care, saying "[t]his legislation allows States and consumers to obtain more cost effective long-term services in the most appropriate setting for the individual. Individuals with disabilities will be able to choose between services in an institution or services at home permitting more independence, more dignity and reduced cost."

To read the full text of the Community Choice Act, click here for the Senate version or here for the House version.

The sponsors of the Community Choice Act are looking for stories from families who have benefited from receiving care in the community rather than in an institution. Click here for more information.

Article Last Modified: 04/06/2009