NEW: Administration for Community Living
HHS Announces a Reorganization
Tim Wheat and Henry Claypool
Today the US Department of Health and Human Services announced the reorganization of the Administration on Aging, Office on Disability and Administration on Developmental Disabilities into the Administration for Community Living.
Henry Claypool, a former staff member of the Center for People with Disabilities, gave a brief history of how HHS came to create the ACL. He said the US Supreme Court 1999 Olmstead ruling, the Real Choice Systems Grants, Money Follows the Person legislation in 2005 and the Obama Administration’s Year of Community Living were all forerunners of this consolidated federal agency.
Putting people in institutions is the way that federal programs served people with disabilities when Medicaid began. Today the remains of this institutional bias are still a significant part of our system and are the most costly part of Medicaid. Claypool tells a history of federal initiatives beginning with Olmstead that are working to reverse the institutional bias and provide Americans with choice in how we get Medicaid Long-Term Care Services.
Claypool said he will still advise on disability issues but he will focus on ACL and move the current policy office into the new agency. Kathy Greenlee, the Assistant Secretary for Aging will head the ACL while keeping some of her current duties with Claypool as chief deputy.
Following the announcement Claypool, Greenlee and Sharon Lewis of the Developmental Disabilities Administration took questions. Unfortunately, the first question was from an agent of the Voices of the Retarded who mischaracterized institutional incarceration as an Olmstead “choice.” The HHS staff did not cut the caller off, but all suggested they would continue to advocate for people who were institionalized.
Olmstead simply does not make the choice of an institution a Constitutional Right. The Supreme Court upheld the ADA concept that “inappropriate institutionalization is discrimination.” Although all states have Medicaid institutional programs that people may choose, it is our right as American citizens to live in our own homes and in our communities. We do not have a right to be institutionalized.
It was frustrating to hear the VOR misinformation on the national announcement call; but the creation of the ACL seems like a good move to end the segregation of people with disabilities and to end the institutional bias.
Tim Wheat
Community Organizer
CPWD
You are correct when stating that Olmstead provides Americans with choice in how we get Medicaid Long-Term Care Services. Olmstead definitely encourages community based services while preserving institutional services for those who choose or require the comprehensive and professional developmental services found in developmental centers. Olmstead clearly stated that institutional services could not be the only choice. Olmstead did NOT rule that institutional services should be dismantled.
The key word here is “choice” — something you appear not to support when the choice of the family is institutional services for their family member. One must walk in our family’s shoes before judging our decisions.
A distinction must be made between individuals with a disability associated with aging, a physical disability, or a developmental disability which may range from mild to profound. Each individual has specific needs. They should never be collectively referred to as “disabled” meaning all are equal. Let’s hope this new agency does not blur the lines either.
We are witnessing efforts to destroy choice through a misinterpretation of Olmstead which specifically supports choice. “Although all states have Medicaid institutional programs that people may choose” there is no “right to be institutionalized”. Your words Mr. Wheat. No right to choice?
Mark me CONFUSED!
Olmstead is not a choice in the sense of its being a legal ruling on a Civil Rights issue. Olmstead is designed to give the most integrated setting, that is the opportunity to live in the Community with proper supports for those who seek this. It renders illegal the forced imprisonment of people with disabilities who wish to live in the community. Also illegal under Olmstead are the discrimination which make imprisonment possible but not community living such as economic discrimination, inaction, or staked advantage.
Now, a person may choose a nursing, I don’t see that a lot in my work which is nursing home liberation–but this is not an Olmstead matter then–Olmstead doesn’t work against patient will–wish nursing “homes” could say the same.
The false information is that Olmstead works against choice, Olmstead is for the person whose nursing stay was not their choice, not their wish and not meeting their needs.
In the question and answer section of the ACL phone call the agents for the Voice of the Retarded also attempted to make the point that the choice is either the community or and an institution. I believe that I was clear that Olmstead protects Americans from “inappropriate institutionalization.” But the VOR misinformation simply attempts to make that term “choice” seemingly apply to a person choosing the community as one choice; therefore choosing an institution is the equally valid alternative choice.
The 1999 Supreme Court ruling upheld the Americans with Disabilities Act principle that inappropriate institutionalization is discrimination. There is no “right to be institutionalized” and Americans face discrimination when they are only provided with services in an institution. To be clear, someone is not discriminated against if they have community supports and live in the community but do not have the option of living in an institution.
As I pointed out, the new Association for Community Living did not endeavor to correct this misinformation. But they often use the term “choice” because of the past and current “institutional bias” that has kept Americans from having a choice to live in the community like everyone else. This is using the term choice to explain having an option other than an institution rather than a choice of either an institution or the community.
The Center for People with Disabilities supports the 1990 Americans with Disabilities Act, and more specifically all Americans right to live in the community. I hope this clears up your confusion.
Are you saying that “choice” does not mean that there is a choice between services in a Medicaid-certified congregate care setting, aka institution, or community (geographically defined obviously)? I did not know the Olmstead decision had been overturned. “We emphasize that nothing in the ADA or its implementing regulations condones termination of institutional settings for persons unable to handle or benefit from community settings…Nor is there any federal requirement that community-based treatment be imposed on patients who do not desire it.” “Each disabled person is entitled to treatment in the most integrated setting possible for that person - recognizing that, on a case-by-case basis, that setting may be an institution. Olmstead v. L.C.
@Tim Wheat