A 10-year-old Supreme Court ruling is being dusted off to make the case for taking the mentally ill out of nursing homes and supporting them in the community and at home.

In the 1999 case, Olmstead v. L.C., the Supreme Court ruled that isolating mentally ill patients in nursing homes constitutes discrimination based on disability. The Bazelon Center for Mental Health Law, a mental health law advocacy group, issued a report on June 24 in hopes of spurring the Centers for Medicare & Medicaid Services to act on the Olmstead ruling and revamp its HCBS system, according to the Bureau of National Affairs. That report argues that of the 500,000 mentally ill persons living in the nation’s nursing homes, nearly all could live independently with supportive care. That care would also cut costs for the state, the report says.
Among the Bazelon Center’s recommendations to CMS: streamline the HCBS Medicaid waiver process to increase the array of services covered by Medicaid; expand Medicaid eligibility for childless adults to 150% of the poverty level; and rework CMS’ rules governing rehabilitation to include supported employment and family psycho-education. The Bazelon Center also advocates aggressive pre-admission screening to prevent “dumping” of mentally ill patients into nursing homes. For more information, visit www.bazelon.org.