US Department of Justice Report Says Iowa Violates ADAMonday, January 17, 2022
A United States Department of Justice (DOJ) report says Iowa is in violation of the Americans with Disabilities Act, which gives people with disabilities the right to be served in the most integrated setting possible. The most integrated setting is one that “enables individuals with disabilities to interact with nondisabled persons to the fullest extent possible.”
The report says Iowa violates the civil rights of Iowans with intellectual and developmental disabilities by placing them in public and private institutions at much higher rates than other states. The report found:
- Too many people with intellectual and developmental disabilities are served in State Resource Centers (Woodward, Glenwood), nursing homes and other large settings, what many call “institutions” – instead of in the community.
- The number of Iowans with disabilities who are living in an institution has stayed the same since 1982, even though the number nationally has been cut in half.
- Iowa is one of the top four states for placement of persons with intellectual and developmental disabilities in nursing homes and is in the top five states for placement in intermediate care facilities (ICFs).
- Many Iowans living in these institutions are not given the choice to live in the community.
- Iowa has failed to develop the home and community-based services and supports that are needed to give Iowans with disabilities that choice.
Remember the 1999 Olmstead Decision? In this decision, the US Supreme Court said that states were required to provide community-based services to people with disabilities when the services are appropriate, and the person wants to be served in the community. Despite the decades of hard work by Iowa’s Olmstead Task Force, the state has not spent the money needed to build a solid, statewide community-based system of supports for Iowans with intellectual and developmental disabilities. That is the work that is ahead for the state.
This report is a wakeup call for Iowa, the home state of the ADA’s lead sponsor Tom Harkin. Iowa must now start to develop community supports that equal the specialty services offered in institutions. This is not just a DHS issue – this report will require a major cultural shift in our state and local governments, and require a significant investment from the Legislature in order to make this happen.
Here are a few things the DOJ has told the state to do:
- Increase community capacity by expanding services and removing restrictions on community services for people living in or at serious risk of entering an institution.
- Remove barriers to accessing community services.
- Make sure people with disabilities and their guardians know their options.
- Help people successfully transition to community living.
- Build up the quality of care in institutions for those wishing to remain there.
- Give all institutional residents an individualized, person-centered service and transition plan that identifies the services and supports needed to be served in the community.
- Make sure Managed Care Organizations, Mental Health/Disability Services Regions, and community providers work together with other partners to avoid unnecessary institutionalization.
DHS expected all of this and has been working on a plan of action, but it success will only happen if everyone works toward a fix. One of the things DHS will be doing in the coming year is looking at Iowa's seven HCBS waivers and starting the process to streamline eligibility criteria and move toward a more need-based service array. We'll talk about this more in a future infoNET. For more information on the DOJ report:
This is about choice. You should have the choice of how you want to be supported.
Iowans with disabilities are not being given a choice to be served in their community, so now the Legislature must take action to make sure we build a system that supports these choices.
Some people do not even have the information to know there is a choice.
Iowa is serving too many people with disabilities in institutions because there are not enough options to live in the community.
When you are served in the community, you get to make your own choices. When you are served in an institution, other people make choices for you.
This is not just a DHS issue; all of Iowa needs to work to make our communities more accessible.
Change cannot happen without funding to build up the system – public transportation, community providers, and trained workers.
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