Stop the Home and Community-Based MA Reductions.
The Wall Street Journal on 5/20/10 wrote an article "Disabled Face Hard Choices as States Slash Medicaid." To read the entire article, go to:http://online.wsj.com/article/SB10001424052748704292004575230673483973904.html?mod=WSJ_ hps_MIDDLETopStories
This article points out a number of important issues that disability advocates might consider.
First, even though South Carolina (and other States) may be having budget problems, they cannot violate either the ADA or the Olmstead decision, even if they are reducing budget due to income shortfalls. In the next year, we will see a number of States trying to reduce home and community-based services in violation of the ADA.
What states should be doing, and the Wall Street Journal article alluded to it, is to use any budgetary reductions as an opportunity to affirmatively confront, deal with, and if necessary reduce their institutional expenditures. The WSJ article assumed that institutional expenditures could not be touched. That is not true.
In the 10th Circuit decision, which does not include S.C., in Fisher v Okl Health Care, the Court noted that the there would be sufficient funds saved by reducing nursing home reimbursements to pay for the community-based services.
From the WSJ article, it does not sound like S.C. has tried this. Rather, S.C. sounds like it took the path of least political resistence.
Sure, owners of institutions receive big bucks and they play in the political arena. That does not mean that either S.C. or your state can buckle into the money interests, discriminate against and segregate people with disabilities, and violate the rights under the ADA.
In the Fisher decision, the Circuit also held it was a violation of the ADA "when a State wanted to, or even had to, save funds" to require persons with disabilities to go into institutions to receive the same services they could receive in the community - if the state would fund them in the community.
Second, the individual stories in the article are extremely compelling. Local advocates should be introducing individuals who are at risk of being institutionalized because of a reduction of MA's home and community-based services to local newspapers. Columnists will respond to individual stories. Our job is to find those individuals and introduce the press to them.
Similarly, advocates should be filing ADA and Olmstead complaints with the U.S. Department of Justice and with the CMS/OCR. Remember, in the last Information Bulletin, we quoted extensively from the recently filed DOJ lawsuit in Arkansas. DOJ in that lawsuit stated, as one basis for an ADA/Olmstead violation, that "the State fails to provide services in the community in sufficient quality, quantity and geographic diversity to enable individuals with... disabilities to be served in the most integrated setting appropriate to their needs." Hmmm. Reduction of S.C.'s MA community-based services sure will impact on whether there are "sufficient" services.
Third, thanks to the South Carolina Legal Services for representing people at due process hearings when the reduction of services will violate the ADA if the MA reductions are fully implemented. We need more lawyers and more lawsuits. Now is not the time to sit on our hands.
ACTION WE CAN TAKE:
1. Identify people who services are being reduced and may be in jeopardy
of going into institutions.
2. File complaints both with Regional HHS/OCR and Federal DOJ offices.
3. Contact your Protection and Advocacy, Legal Services or other civil
rights attorneys who might help with Olmstead litigation.
4. Contact state and local media to give them personal stories as well as
the system and legal actions you are pursuing.
5. Work with other advocates to build political pressure against cuts
DON'T MOURN... ORGANIZE!
—Steve Gold, The Disability Odyssey continues
Back issues of other Information Bulletins are available online at http://www.stevegoldada.com with a searchable Archive at this site divided into different subjects.
To contact Steve Gold directly, write to stevegoldada@cs.com or call 215-627-7100.