Home Health & Hospice Week

Despite the U.S. Supreme Court's landmark Olmstead decision 10 years ago, wait lists for state-funded home care programs remain long in many places. Now the Obama administration is trying to address that problem.

The Olmstead decision requires the government to serve beneficiaries in their least restrictive environment -- at home. But many states have not followed through by offering home care as an equal alternative for institutional care, particularly for the disabled. President Obama has designated 2009 as "The Year of Community Living" and instructed the Department of Health and Human Services and other government agencies to collaborate on making community-based care for the disabled and elderly a priority, HHS Secretary Kathleen Sebelius notes in a release.For example: In the June 22 Federal Register, the Centers for Medicare & Medicaid Services gives advance notice that it will publish a proposed rule focusing on how state waiver programs can be based on need rather than condition or diagnosis.

"Unnecessary institutionalization may constitute discrimination under the [Americans with Disabilities Act]," CMS points out in the notice.

HHS and its partners will also offer more housing vouchers for beneficiaries transitioning to the home, make grant funds available to states to strengthen and expand HHS's Aging and Disability Resource Center Programs, and will hold listening sessions on "overcoming barriers to communitybased living for people with disabilities and the elderly,"

the release notes. "ADRCs provide 'one-stop shop' sources of information, one-on-one counseling, and streamlined access to programs and services that can enable people to remain in their own homes and communities," CMS explains in a separate release.

HHS also will step up enforcement of Olmstead and ADA requirements, it says. "Since Olmstead, progress has been made," the National Association for Home Care & Hospice says. "But waiting lists for community services have grown considerably and many individuals who would like to receive community services are not able to obtain them."