If you're reading headlines indicating that residents of adult care homes are facing the risk of being evicted because the big, bad federal government is not going to provide Medicaid payments for personal services, read on before taking a stand.
The laws that are coming together to allow the cut off of such payments are the Americans with Disabilities Act and Medicaid rules.
This is because funding for basic personal services are at least partially funded with Medicaid dollars. However, the American with Disabilities Act is allowing actions that the slow-moving and inadequate enforcement of Medicaid rules has not corrected for decades.
The case to note is the 1999 Supreme Court case of Olmstead v. L.C. which is cited as 527 U.S. 581. That case held that states must provide community-based help for persons with disabilities where possible rather than institutionalizing such persons.
Unfortunately, it is often easier and more cost-effective for states simply to put persons in institutional settings rather than cultivate effective networks of community assistance to maintain individuals within a community rather than within an institution.
The issue of states housing categories of individuals in overly restrictive isolation within institutions ranges from troubled juveniles in more restrictive environments than they need to the current instance of those with mental disabilities being housed in institutions when they are able to live in less restrictive environments with some help.
It is a case of money and states will often flat out justify their inhumane treatment by complaining about the costs of complying with laws and policies that support humane treatment of others. For example, look up some of the headlines or read some of the objections made by states regarding their conduct in cases citing Olmstead v. L.C.
One state, North Carolina that is facing the loss of Medicaid dollars for its noncompliance was warned that its state rules encouraged unnecessary institutionalization of individuals rather than helping them in their homes or a less restrictive setting.
NC accomplished its goals of unnecessarily institutionalizing people by instituting a literal double standard.
In establishing the "need" for personal services by an individual, NC created two criteria that must be met to qualify for personal services in institutions while maintaining three criteria people must meet to receive personal services outside of an institution.
This double standard made it easier to get services for people by institutionalizing them.
If these adult centers close the blame lies with the states seeking to institutionalize people unnecessarily.
