Guest blog post: Olmstead, with Charts! By Andrew Pulrang
Andrew Pulrang is a friend of the project and a prolific blogger over at Disability Thinking. The following is an excerpt of a post he published on June 24, 2014.
Olmstead, with Charts!
Andrew Pulrang
This past Sunday was the 15th Anniversary of the U.S. Supreme Court decision in Olmstead vs. LC and EW … or just Olmstead for short. It is an imperfect analogy, but not too far off to say that Olmstead is to people with disabilities what Brown vs. Board of Education is to racial segregation.
In its Olmstead decision, the Supreme Court applied the Americans with Disabilities Ac, an act of Congress in 1990, in a novel way. It found that “long term care” is a service, like any other, and that state governments that fund long term care must be sure to offer the service in the “most integrated settings”, i.e., in peoples’ own homes, not just nursing homes and institutions. It also affirmed that a person’s choice of where and how to receive long term care services should play a role at least equal to the opinions of doctors and social workers. Finally, the decision … and the President’s Executive Order in 1999 which endorsed strengthened it … underscored that states and localities might have to change their long term care programs and practices, even to the point of complete overhaul, in order to comply. “The way it’s always been done” would no longer be an acceptable limitation, and “We don’t offer that kind of service here” could no longer be an excuse.
Let’s put it another way. If you, or your disabled child, or your aging parents, need help with everyday self-care every day, or several times a week, and your county or state says the only way they can get that help to leave their home and go into a nursing home, assisted living, group home, or other institutionalized facility … that is a violation of their civil right to choose getting care in the manner and place they choose. It doesn’t say they can’t go into the “old folks’ home” if they want to, but they can’t be forced to just because nobody can or wants to figure out another way for them.
Most people, given the choice, would rather live in their own homes than nursing homes. With this Olmstead concept asserted at the highest level of U.S. law, the expectation was that more people would get care in their own homes and fewer in institutions.
A good way to measure how Olmstead has changed long term care for disabled people is to look at how Medicaid spending on long term care overall is divided among institutional care and community care …
For the rest of the blog post: http://disabilitythinking.blogspot.com/2014/06/olmstead-with-charts.html
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For more about Andrew: http://disabilitythinking.blogspot.com/p/about-me.html
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