I’ve lived in five different states – Michigan, California, Tennessee, Illinois and New York – and no two are alike when it comes to long term care services. If you have an injury, condition or illness that makes you unable to do everyday things like bathe or dress or do laundry by yourself, then you might be able to get help at home or you might wind up in a nursing home. It all depends on state regulations, insurance and what your health care provider says and does.

It all started in 1965, when Medicaid was created. The big mistake was that funding for nursing homes was mandated in all states under the then new Medicaid law, while home care services were optional. That funding grew a $60+ billion dollar industry and many stakeholders invested in the status quo. I remember at one point in Tennessee, the meat packers industry opposed home services reform because they had contracts with the nursing homes that they wanted to keep.

Since then, the law has changed in one very important respect. If you wind up in a nursing home against your will, and your stay is paid for by Medicaid (most nursing home residents are on Medicaid after a couple months), then that’s a violation of your civil rights. The U.S. Supreme Court said so on June 22, 1999 in the Olmstead decision.

Monday is the ten year anniversary of the Olmstead decision. It was a landmark decision, as significant to seniors and people with disabilities as Brown v. Board of Education to the Civil Rights Movement. It’s also been just as slow to be implemented. I still see and hear of older and disabled people unwillingly stuck in nursing homes and other institutions in every state. Federal regulators even report that over 300,000 nursing home residents have said that they want to move back to the community.

Congress and the White House could finally start the process of implementing the civil rights of seniors and people with disabilities by passing the Community Choice Act (HR 1670 / S 683) as part of health care reform. So far, the answer has been “No, you will have to wait.”

While people are waiting to regain their freedom from wrongful incarceration in nursing facilities, while their lives are being stolen from them day by day, it is up to us to honor the anniversary of Olmstead by pushing to make its promise a reality. The Community Choice Act is the “key” to freedom. Mail an unneeded key to the home office of Senator Max Baucus at Empire Block, 30 West 14th Street, Suite 206, Helena, MT 59601. Tell him to include the Community Choice Act in health care reform. That’s how to celebrate the tenth anniversary of Olmstead. Free our people! They should not have to wait any longer!
Diane Coleman, J.D.