Many Americans living with disabilities do so independently. With the proper support, millions are able to live alongside their peers without disabilities. However, there is some concern now that the progress Americans with disabilities have made for decades could be in danger of being rolled back.
This year, as the White House has pushed to police homelessness, the Department of Justice released a memo lowering the bar for people with disabilities to be put into institutions. The memo stops the enforcement of an integration mandate for people with disabilities, put in place by the 1999 Supreme Court decision in Olmstead vs. L.C. The ruling says people with disabilities should not be forced into institutions if they can live in the community with proper support.
Jennifer Mathis, the deputy director for the Bazelon Center for Mental Health Law, believes this move by the DOJ will have repercussions.
“The message to states is feel free to cut community services, even if that leaves people with disabilities high and dry,” she said. “If you cut community services, the people don’t just go away. Those people are going to end up in so many cases in an institutional setting, which is going to cost three or five or more times as much as it costs to serve those people in the community.”
Kimberly Tissot is the president and CEO of Able South Carolina. She, along with her son, Carter, live with disabilities. Kimberly had a leg amputated due to childhood cancer. Her son has an intellectual disability. Despite their challenges, they are able to carry on healthy lives. However, following the release of the DOJ’s memo, she now worries about her son’s future.
“My son is definitely at risk of going into an institution because he is going to need lifelong support to be able to live and make decisions,” she said. “I’m going to do everything in my power to keep him from segregation.”
Mathis says it’s not just people with mental disabilities who are at risk. “I think all people with disabilities are vulnerable if the memo were to weaken the law,” she said. “Even if it is not the law, they are vulnerable if states change their behavior and stop investing as much in community services.”
Spectrum News reached out to the Department of Justice to respond to the pushback from advocacy groups over the memo.
“This opinion answered an ordinary-course request about updating guidance documents and the proper scope of Olmstead. It interprets statutes Congress enacted and a decision the Supreme Court issued. The effect is to return primary responsibility for regulating healthcare to the states, which already regulate most health care in this country. Concerns about how particular states will respond are best directed to those states,” the Department said in a statement.
Critics have pushed back. They say the memo pushes a “medical model,” where a disability is viewed as a defect to be cured. Advocates prefer a “social model,” where differences can be accommodated so people with disabilities can work alongside peers without disabilities.
In many states, the concern is amplified by proposed cuts to Medicaid and community services.
“Why would our government be forcing people into institutions when there’s years of research that show it does not work and years of examples of how people are abused and neglected. And also the return on investment in home and community based services. If we’re just looking at cost, home- and community-based services is what cuts the cost, not living in institutions,” Tissot said.
Mathis agrees.
“Community services are a win-win. They are what people want. They have better outcomes and they are cheaper,” she said.
“The disability community is resilient and will continue to fight,” she added. “We have had a long history of bipartisan support for the ADA [Americans with Disabilities Act] and for Olmstead.”
