Explainer: 1999 Ruling Still Shapes NJ Policies for People with Disabilities

Andrew Kitchenman | June 30, 2015 | Explainer
In Olmstead case, U.S. Supreme Court required that patients live in the least restrictive and most appropriate setting

What it is: Olmstead v. L.C. was a case heard by the U.S. Supreme Court in its 1999 term, based on a lawsuit filed in 1995 on behalf of two women with intellectual disabilities who lived in institutional settings.

Justice Ruth Bader Ginsburg’s majority opinion held that: “States are required to place persons with mental disabilities in community settings rather than in institutions when the State’s treatment professionals have determined that community placement is appropriate, the transfer from institutional care to a less restrictive setting is not opposed by the affected individual, and the placement can be reasonably accommodated.”

What it means: It has led the state government to emphasize placing all residents in either their family homes or in group homes that are near their communities. This has put the state in conflict with specific groups of family members, including those of residents who have lived in two developmental centers that were closed by the state, as well as those who live in out-of-state residences.

Why it’s still in the news: State officials are still adjusting policies – and their implementation – to conform with their interpretation of the 1999 decision.

Disability Rights New Jersey filed a lawsuit in 2005 arguing that the state wasn’t complying with the decision. Under a settlement announced by Gov. Chris Christie in 2013, his administration increased funding for community placements.

Another major landmark in the shift toward community placement was a report released in 2007, “The Path to Progress,” released by the state Department of Human Services in 2007, which called for an eight-year transition of moving residents into community placements.

Where did people with intellectual disabilities previously reside? Many lived in large developmental centers,institutions, in which a comprehensive set of services, ranging from medical services to physical activities, were provided. Others lived in out-of-state facilities if no appropriate in-state services were available.

Organizations that advocate for intellectually disabled people to live in their own homes, as well as organizations that provide community housing and services, have long argued that state and federal Medicaid funding should shift from these large institutions toward group homes.

But many families of people living in the larger centers contend services have improved over time and that their family members should stay in the institutions they believe are more appropriate for their family members than group homes.

Developmental center controversy: A state commission ruled that the Woodbridge Developmental Center and the North Jersey Developmental Center in Totowa should close as part of the ongoing state response to Olmstead.

This prompted an outcry from family members of residents, who said that the state was putting the interests of organizations that primarily serve people with mild and moderate disabilities ahead of those who lived at the centers, many of whom had severe disabilities.

The families of center residents sued to prevent the closures, but the lawsuit failed.

Return Home New Jersey: The focus of legislative battles has shifted from the developmental centers — whose closing was supported by Democratic legislative leaders, as well as Christie – toward a state program known as Return Home New Jersey. This program aims to transfer those who had been placed outside the state back to group homes in New Jersey.

[related]Senate President Stephen M. Sweeney (D-Cumberland, Gloucester, and Salem) and other Democrats have supported bills to put a moratorium on the transfers, citing the pleas of family members who say their loved ones with disabilities have lived in their homes for most of their lives.

Administration officials are working with local group home providers to find locations for individual residents that will meet their needs – family members have described the repeated meetings that they’re required to attend with potential care providers as wasteful.

Arguments in favor of community placement: Supporters of the state’s efforts argue that all people with disabilities are better served by living in settings that more closely resemble single-family homes, and spending time in activities in their communities.

Opponents say that the lower wages of group-home workers and greater distance from medical professionals has resulted in worse experiences and more dangerous conditions.

What happens next: It’s been several years since the state has placed any new residents in developmental centers. As for Return Home New Jersey, the state plans to continue to try to bring more residents back into the state.

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