must not be permitted to bury invisible
land mines in legislation that later
explode to the devastation of a state's
amicus brief of eight State Attorneys
General in support of Olmstead in
Olmstead v. L.C. and
Olmstead petition argued that the
Americans with Disabilities Act cannot
require states to offer disability
services in the most integrated setting.
Olmstead lost that suit.
Winning it meant, for all
but a few of us, that we could be assured of living in freedom
with home- and community-based supports. Today 1.9 million
law-abiding Americans are imprisoned by states in long-term
"care" facilities for the crime of having a disability.
a land mine?
Woman protester with a sign that says
"There's a price on our heads."
information first appeared in Mouth
magazine #53, May 1999.
Photos are by Tom Olin.
Supreme Court declined to hear the issue
of cost in Olmstead v. L.C. and
E.W. Even so, Olmstead and his
amici continued to argue that home-
and community-based services are costlier
than services provided in nursing homes
and other institutions.
lost the case; advocates for home- and
community-based services won. Even so,
most states put up a mighty resistance to
change, offering this same old
taxpayers fund the majority of U.S.
long-term care, they have a right to know
which is cheaper. Here are the
American Health Care Association - A H C A - the nursing home
lobby group, claims on its website that nursing home beds
cost an average of "only $41,000 per year per resident."
84 percent of all nursing home
residents under Medicare, Medicaid, and
other state, federal, and local
National Conference of State
Legislatures, which curiously enough
filed an amicus in favor of Olmstead,
reported in its January, 1999, State
Legislative Report that "in 1996,
institutional care cost an average of
$94,348 per person, compared with
$14,902 per person for community-based
services.... States across the country
have realized significant savings by
offering services that allow people
with disabilities [of all ages]
to live in the community rather than in
nursing homes or other
University of Minnesota's Institute on
Community Living publishes State of the
States annually. That book compares
Medicaid expenditures for people with
disabilities who live in state
"schools" and state mental institutions
to Medicaid expenditures for community
figures for fiscal year 1998 show an
average of $98,550 per person per year
in institutions, $26,729 in the
community. The figures vary from one
study to the next because they measure
expenditures in different institutions
under varying accounting methods.
is the primary source of income for
nursing homes and for institutions
housing people with the label of
retardation. In the case of state
services to people with mental illness
labels, however, federal Medicaid
reimbursement is available only for
where Tommy Olmstead [was]
Commissioner of Human Resources, was
eligible to receive federal
reimbursement for nearly two-thirds of
the cost of treating people labeled as
retarded whether in institutions or
community-based settings. That state
was also eligible to receive nearly
two-thirds the cost of providing
services for people with psychiatric
labels -- but only if those services
were provided in community-based
settings. Olmstead, however, prefers to
continue his state's long tradition of
U.S. Department of
amicus in support of L.C. and E. W.
said this: "Virtually all of the
relevant literature documents that
segregating handicapped people in
large, impersonal institutions is the
most expensive means of care."
woman who had been forced to live in a
nursing home testified as follows at a
1995 Texas hearing on disability
pays for this cruelty. It's your
taxpayer dollar at work. America should
know what it's getting for that
That's what L.C.'s and E.W.'s attorneys
called Olmstead's contention that the
ADA imposes a massive fiscal and
administrative burden on states.
their brief for the Court, they said,
"... a handful of states, including
Georgia, have dragged their heels. The
reasons for that have nothing to do
with the quality of treatment and/or
the relative costs of providing it in
institutions or the community. Instead,
they have everything to do with
May 21, 1997, Mike (Mo) Oxford and Alene (A.J.) Jensen of
TILRC, the Topeka Independent Living Resource Center, received
The Health Care Financing Administration's (HCFA's) National
Award of Merit for their work to re-invent and expand home
health and personal assistance services for the people of
last time we'd seen the two of them near HCFA headquarters,
they were among the Adapt activists who surrounded it and
shut it down. To
read what Mike SAYS about your taxpayer
dollar at work, click here.
Photo of hundreds of disability rights protesters
One sign says, Home Health Care NOW.
isn't it safer to keep those
people in care facilities?
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Today, some genuine American patriots are at work, changing
the system. They call themselves Freedom Clearinghouse, and
you can learn
more about them right now.