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Separate and Unequal: States Fail to Fulfill the Community Living Promise of the Americans with Disabilities Act

Authors: US Senate Committee on Health, Education, Labor, & Pensions


This United States Senate Health, Education, Labor, and Pensions (HELP) Committee report revealed that 14 years later, many states are failing to live up to the integration mandate of the Americans with Disabilities Act. The Supreme Court ruled in Olmstead v. L.C. in 1999 that the unnecessary segregation of individuals with disabilities in institutions is a violation of the Americans with Disabilities Act, thus directing states to enable community-based long-term care services for these Americans.

The report is the result of requests for information sent by HELP Committee Chairman Tom Harkin to all 50 states on the progress made to transition individuals out of institutions. Harkin, who is the Senate author of the landmark Americans with Disabilities Act, has long sought to ensure that all Americans have a real choice to receive Medicaid-funded care in the community. This report is a comprehensive review of the types of community-based services states provide to individuals with disabilities compared to the institution-based services they must provide.

The report reveals that almost a quarter of a million working-age Americans remain unfairly segregated in nursing homes, and the number of working-age Americans with disabilities confined to nursing homes is actually growing. While progress has been made nationally, by 2010 only 12 states spent more than 50 percent of Medicaid funds on community-based care instead of institutional care.

The full report can be viewed online by following the link under the "Web Links" tab above.

-Description taken from a press release of the report viewed on the U.S. Senate HELP Committee website on 7/24/13 (www.help.senate.gov/newsroom/press/release/?id=909ecec1-4c87-4891-8314-7b35e5316a35)

Contact Info:
Organization:Committee on Health, Education, Labor and Pensions
Address:428 Senate Dirksen Office Building
Washington, DC 20510

Web Links

Download the full report (PDF)

Read the press release

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