Home Health & Hospice Week

Other states should follow suit, feds suggest.

If you had given up hope on the feds trying to enforce the U.S. Supreme Court’s Olmstead decision, a new Health and Human Services release may make you reconsider.

Recap: The 1999 Olmstead decision requires the government to serve beneficiaries in their least restrictive environment — often at home. The “Supreme Court held in Olmstead v. L.C. that unjustified segregation of persons with disabilities constitutes discrimination in violation of title II of the Americans with Disabilities Act,” the Department of Justice says on its ADA website. “The Court held that public entities must provide community-based services to persons with disabilities when (1) such services are appropriate; (2) the affected persons do not oppose community-based treatment; and (3) community-based services can be reasonably accommodated, taking into account the resources available to the public entity and the needs of others who are receiving disability services from the entity,” the DOJ explains.

Now, “as we approach the 25th anniversary of the Supreme Court’s Olmstead decision affirming the rights of people with disabilities to live at home and in their communities, [the HHS Office for Civil Rights] continues to vigorously enforce these federal rights,” OCR Director Melanie Fontes Rainer maintains in a release.

Case in point: OCR has reached “an agreement with the State of Iowa to enforce federal disability rights laws,” the agency says. “The investigation was based on a complaint filed by Garret Frey, who alleged that the State of Iowa violated his rights by failing to provide him with the 24-hour home-based support and services he needed so that he could continue to live at home.”

The ADA, the Rehabilitation Act of 1973 (Section 504), and the Affordable Care Act (Section 1557) each “requires that services are provided in the most integrated setting appropriate to the needs of a person with a disability — including within their own home and community,” OCR stresses.

“The steps that Iowa took can serve as a model for other states to meet their legal obligations and tailor services to meet an individual’s needs,” OCR suggests. The agreement includes these “specific corrective actions taken by the Iowa State Department of Health and Human Services”: raising the provider reimbursement rate; allowing for respite services (short-term coverage for primary caregivers); expanding the provider base to enable a sufficient array of providers; and securing necessary providers for overnight and nursing services.

The corrective action document including more case details is at www.hhs.gov/sites/default/files/mca-ecr-between-hhs-iowa-dhhs.pdf.