Judge slams D.C.’s disability integration services

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The U.S. District Court for the District of Columbia refused February 14 to dismiss a class action lawsuit brought by two major disability advocacy groups, suggesting that the nation’s capital may be skirting its obligations under the Americans with Disabilities by unnecessarily institutionalizing as many as 2,900 people with disabilities in its network of nursing facilities.

Following the Supreme Court’s 1999 decision Olmstead decision, upholding the ADA’s requirements barring state-sponsored segregation of people with disabilities, all states and territories were required to create an Olmstead plan.

Though it has not created a formal plan, the District, in a motion for summary judgement, argued that its disability and housing services satisfied the requirements of an Olmstead plan. In a 55 page opinion, the court disagreed, finding little evidence that the District is working to transition individuals from its nursing facilities to more integrated home and community based services.

From 1995 to 2009, the District’s nursing home population decreased by just 45 people, with most of the nursing facilities retaining a 90 percent occupancy rate during that time.

An estimated 526 to 580 of the nearly 2,900 residents have requested a Medicaid-funded Home and Community Based Services waiver so they can leave the nursing facilities and receive in-home services. The District has capped the number of people who can receive the waiver, effectively trapping these individuals in the nursing facilities.

The District receives significant funding through the federal Money Follows the Person program, which provides financial supplements to help people move from the nursing facilities to more integrated housing.

Five years ago, the District set out an initial goal to use the funding to support as many as 900 people. Three individuals have transitioned thus far.

“With respect to the District’s claim to have a plan that demonstrates a measurable commitment to deinstitutionalization, the undisputed numbers clearly undercut any such contention,” the court stated.

The District currently spends 55 percent of its budget for long-term care on institutional care, in the form of the nursing facilities, as opposed to home and community based services. Based on 2008 estimates cited in the opinion, it costs the District $58,000 per individual for institutionalized services, as opposed to $21,000 per individuals for home and community based services.

University Legal Services and the AARP Foundation Litigation filed the lawsuit in December 2010. The Department of Justice also filed amicus brief on behalf of the advocacy groups.

University Legal Services is part of the federally funded protection and advocacy system and a member of the National Disability Rights Network.