The Honorable Barack Obama
President of the United States
The White House
1600 Pennsylvania Avenue, NW
Washington, DC 20500
Dear Mr. President:
June 22, 2009 is the 10th anniversary of the U.S. Supreme Court’s landmark Olmstead decision. Disability and aging organizations all over the country will be recognizing this civil rights decision.
The Olmstead decision, based on the integration mandate in the Americans with Disabilities Act (ADA) declared, “unnecessary institutionalization amounts to segregation and is a violation of individual civil rights under the ADA.” This case promised to be the national mandate not only to free tens of thousands of people with disabilities and older Americans from unnecessary and unjust institutionalization but also to avoid this type of institutionalization in the future.
The ADAPT Community has heard little from your Administration on how it will implement and enforce the Olmstead decision. Under the previous Administration the implementation and oversight by the federal government had been sporadic and generally ineffective.
The ADAPT Community believes that only with aggressive oversight and the development of accountability measures on how states are to implement the Olmstead decision, will people with disabilities and older Americans be able to stay or transition out of nursing homes and other institutions.
Below are recommendations The ADAPT Community’s are making to your Administration for stronger Olmstead implementation and enforcement. We would appreciate a response to these recommendations by June 15, 2009:
President Obama should issue an Executive Order for an Intraagency review as well as Inter-agency cooperation on policy changes that will implement and enforce the Olmstead decision
with benchmarks and timetables for Accountability.
HHS should be the lead agency. President Bush issued an Executive Order soon after taking office to coordinate the federal governments
response to the Olmstead decision. Though initially producing
some policy modifications, the overall results have been
disappointing. President Obama should use the current Executive
Order as a model but give it more authority for real changes. http://www.whitehouse.gov/news/releases/2001/06/20010619.html
President Obama should direct the Secretary of Health and Human Services (HHS) to develop policies and accountability measures for how states must implement the Olmstead decision.
President Obama should direct the HHS/Office of Civil Rights (OCR) to be given more authority to make states more
accountable for implementing the Olmstead
decision with referrals to the Department of Justice for legal
action when necessary. HHS/OCR should accept and review
individual as well as systemic complaints against a state. Possible withholding of Medicaid payments to states for non-compliance should be made clear to all Governors and Medicaid
Directors. Results of all state reviews should be made public on
the HHS website.
President Obama should direct the Secretary of Housing and Urban Development (HUD) to develop policies and programs that will facilitate the transition of people from nursing homes and other institutions to integrated community living.
ADAPT’s “Access Across America” should be looked at as one program to implement.
President Obama should direct HHS to work with the National
Governors Association, National Conference of State Legislators
(NCSL) and advocacy stakeholders on Olmstead implementation
best practices as well as the expectations of the his
Administration for reforming the current institutionally
biased long term care system.
The Domestic Policy Council in coordination with the Secretary of HHS should convene quarterly meetings of The ADAPT Community and other aging and disability advocate organizations to: 1) get recommendations on policy changes that would get and keep people out of nursing homes and other institutions; 2) report on Administration’s progress in implementing the Olmstead decision.
Reform of the institutionally biased long term care system ultimately will require addressing the Medicaid entitlement that is currently only to nursing homes services. That is why the Community Choice Act (CCA) should be included in your comprehensive reform of the health care system. The anniversary of the Olmstead decision provides a timely opportunity for you to express your support for this legislation and the principle that people with disabilities and older Americans have a civil right to live in the most integrated setting.
Including CCA in health care reform and aggressive Olmstead implementation and enforcement will assure that the growing number of people with disabilities and older Americans will have a real choice to live and receive services and supports in the community. We hope to work with you to this end.
Looking forward to your positive response by June 15, 2009.
For an Institution Free America,
The ADAPT Community
1640A East 2nd Street
Austin, Texas 78702
adapt@adapt.org
www.adapt.org
512/442-0252