Checkered progress on disabled care despite ruling

Checkered progress on disabled care despite ruling
Betty Grady administers care to 80-year-old Ola Bluitt.
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Fifteen years after a landmark Supreme Court ruling on giving the disabled a choice to live outside institutions, states report checkered progress.

The 1999 Olmstead v. L.C. decision says unnecessarily segregating people in mental hospitals, nursing homes and other institutions amounts to discrimination. Advocates for the mentally ill, older people and the disabled cite the ruling in arguing for home- or community-based care.

Since 1999, the percentage of Medicaid funds going to services outside those institutions has nearly doubled.

But progress varies widely nationwide. States devote anywhere from 27 percent to nearly 80 percent of Medicaid long-term care money to home and community services. Some states have lengthy waitlists for alternative care.

The ruling has limitations. It says individuals should be "reasonably accommodated" and offers no guidance on allotting funds.

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