Push Towards Community Care Approaches a Crossroads

Ten years after a landmark Supreme Court ruling granted people with disabilities greater access to care outside of institutional settings, hundreds of thousands of people who could live happy, productive lives in their communities still find themselves trapped in nursing homes and state hospitals as funding for community care dries up.

According to a recent article in the St. Louis Post-Dispatch, more than 300,000 people living in institutional settings, the majority of whom have developmental disabilities, are currently waiting for community services. The number of people in line for services has remained high despite the Supreme Court's 1999 ruling in Olmstead v. L.C., an influential case in which the court ruled that the government could not merely provide Medicaid funding for institutional care in cases where community care provides a less restrictive alternative for a person with disabilities and is medically possible.

In the years since the Olmstead decision, 29 states have drafted plans designed to move institutionalized individuals into the community, but those programs have been significantly scaled back due to state and federal budget shortfalls. Federal legislation to fund community care has met with significant opposition from the nursing home industry, and Congress's most recent attempt to pass the Community Choice Act appears to have lost the backing of the White House, even though President Obama co-sponsored the Act when he was a senator.

Advocates for people with disabilities, who staged an angry rally outside the White House in April that resulted in at least 90 arrests, point out that increased funding for community care could actually save taxpayer dollars. One AARP study discussed in the Dispatch article shows a $50,000 yearly difference in the cost of community care versus care in a nursing home, and other studies point to similar evidence. However, given the current climate in Washington, activists worry that people with disabilities may end up at the short end of a compromise between the White House and Congress when it comes to health care reform.

To read the full article in the St. Louis Post-Dispatch, click here.