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The Disability Integration Act Would End Discrimination Against People Who Need Long-term Supports: It is Stalled in Committee
by Karin Falcone Krieger
Thirty years ago, on July 26, 1990, President George Bush Sr. signed the Americans with Disabilities Act. It establishes “a clear and comprehensive prohibition of discrimination on the basis of disability,” (1) yet 30 years later both disabled and elderly Americans are regularly segregated into institutional settings.
In its 1999 Olmstead v. LC ruling, the Supreme Court found that disabled people have a right to live in the “most integrated setting appropriate” under the ADA. In the years since, rather than implementing systemic change to recognize that the “most integrated setting appropriate” is always in the community, disabled individuals must fight for community living on a case by case basis. (2)
Advocates agree legislation is needed that secures the right to live in the community as a civil right. When public and private insurers offer long term services and supports, they must offer them in the community, not just long-term care facilities, the current default. Congress would need to pass this legislation to ensure the full potential of the ADA.
The Disability Integration Act (H.R.555, S.117) remedies many of the problems that disabled people face in getting paid help with the day to day tasks that allow them to live in the community. As it stands, the pipeline to congregate settings and nursing facilities is much stronger than each individual’s case for getting community-based services.
The Disability Integration Act of 2015 died in Congress. The bill was reintroduced in 2019 by Charles Schumer (D NY) in the Senate (S117) where it has 36 sponsors, and Congressman James Sensenbrenner Jr. (R WI) in the House of Representatives (H.R.555), where it has 237 co-sponsors. The Disability Integration Act of 2019 has now been stalled in the Senate Committee on Health, Education, Labor, and Pensions, and the House Subcommittee on the Constitution, Civil Rights, and Civil Liberties for well over a year. It is unknown when or if it will be introduced to the Congress.
Its mandate is “to prohibit discrimination against individuals with disabilities who need long-term services and supports” and it is supported by over 600 groups nationwide.
The Affordable Care Act of 2010 established the “Community First Choice Option” which allows states to provide home and community-based attendant services and supports to eligible Medicaid enrollees under their state plan.
According to the Center for Disability Rights, “Community First Choice Option sets the framework for a fully integrated, non-diagnosis-specific, community-based service system that provides individuals the civil right to live independently in the community and out of an institution.”
However, the recently passed budget in New York State included Medicaid cuts which seriously jeopardize Community First Choice Option implementation.
Bryan O’Malley, the executive director of the Consumer Directed Personal Assistance Association of New York, called the cuts “incomprehensible.” (NY Daily News)
Richard Gottfried, chair of the Assembly Committee on Health, expressed outrage at new restrictions on finances and changes in qualifications, which will go into effect on October 1, 2020. “This is based on a cruel notion that people are getting home care when they don’t really need it,” Gottfried said. (“Cuts Affect Medicaid Funded Programs,” June, 2020 Able News)
This illustrates why a national civil rights law must be passed. As long as we approach disability as a medical problem, there will be ongoing excuses for mass segregation and institutionalization.
Portions of this piece appear in the July, 2020 issue of Able News.
Karin Falcone Krieger is a staff writer at Able News. Her recent history of Dover Publications appears in Contingent Magazine.