Obama Administration announces new deinstitutionalization services

A full view of the White House with cherry blossoms in bloom and the American protruding from the roof
The White House in Washington D.C.

The Department of Health and Human Services announced new rules April 14 allowing states more flexibility when providing services for people with disabilities capable of living in their homes and communities, as opposed to institutions.

“These long awaited rules will help people living with disabilities realize the promise of the (Americans with Disabilities Act) to live in the least restrictive environments possible for them—like their own homes,” said Henry Claypool, director of the Office on Disability at the Department of Health and Human Services, in a news release. “With these new tools as well as incentives included in the Affordable Care Act, states, working closely with advocacy groups, beneficiaries, and other stakeholders, can more easily develop effective plans to improve options for people with disabilities.”

When states currently design their Home and Community Based Services Waivers, they are required to target three groups: those who are aged with a disability, those with developmental disabilities and those with mental illnesses. Under the new regulations, states would be allowed to consolidate these categories into one group, providing them the ability to better target their in-state needs. It would also reduce redundancies, such as families with needs in more than one category and, as a result, fill more than one waiver slot and do not receive services efficiently.

Another rule seeks to clarify the definitions of home and community based services, in response to attempts by states to unconstitutionally place individuals in new institution-type settings that remain segregated, in violation of the ADA’s intent.

The new rules also detail the importance of person-centered planning when states design services for individuals with disabilities, change some amendment and public input requirements, and provide recommendations to the Centers for Medicare and Medicaid Services to ensure state compliance.

The announcement came in conjunction with the release of other Obama Administration initiatives to improve coordinated care for people on both Medicare and Medicare, upgrade Medicaid IT enrollment system and expand Medicaid coverage in New Jersey.