Olmstead act did it end segregation of people with disabilities

10 years after the creation of the Olmstead Act Alabama does not appear to be committed to ending the segregation of people with disabilities.

 

Late June marked the tenth anniversary of the Supreme Court decision in Olmstead vs. LC and EW. This decision held that the unnecessary segregation of individuals with disabilities in institutions may constitute discrimination based on disability. The Court said limiting services for Medicaid recipients to institutional settings was a violation of the Americans with Disabilities Act.

The LC was the initials of Lois Curtis and the EW was the initials of Elaine Wilson, two women who had spent most of their lives in state mental institutions. Their doctor said they did not need to be institutionalized. They did not want to live in institutions but Georgia provided no community options for them to live at home. In 1995, their lawyers filed a case against the state of Georgia asserting the state was in violation of the Americans with Disabilities Act. The ADA requires states to provide services for people with disabilities in the most integrated setting appropriate. The case made it all the way to the US Supreme court where Curtis and Wilson prevailed and were able move into smaller group homes.

 

Ten years later, what alternatives to nursing homes do Alabamians have? The Olmstead decision said that every state must make steady progress toward providing alternatives to institutions or they would be open to similar litigation. One way Alabama is responding is through the Cash and Counseling Demonstration Waiver.

 

Cash and Counseling Demonstration Waiver: “This program provides a cash allowance to recipients of Medicaid personal care services and other home and community-based services. Participants use this allowance to purchase their own care instead of receiving it from an agency. The allowance does more than help people with disabilities pay for needed services; it gives them some much-cherished freedom and independence”.

 

The counties currently served under this waiver are Bibb, Fayette, Greene, Hale, Lamar, Pickens, and Tuscaloosa.

Alabama Medicaid office describes this program:  “Alabama's Cash & Counseling program will provide consumers the option to control their own waiver services. Consumers will receive a monthly budget based on his/her needs, and will be able to use this money to hire personal assistant services, make home modifications, and more. Counselors will work with consumers to develop and revise individual budgets. Consumers will have the option of appointing a representative, and being part of a peer support group.”

Still in Alabama we find more elderly people who need assistance living in nursing homes than living in their own community. Alabama must recognize that all persons, regardless of their age, should be offered community-based services.

In 2006 Alabama INCREASED the percentage they spent on institutional nursing facilities from 1999, the year of the Olmstead decision, i.e., they spent a larger percent of Medicaid's long-term care expenditures on nursing homes in 2006 than they did in 1999.

10 years later Alabama has a long way to go……..