Mass. Promises $1B to Community Integration for Disabled

Special Needs Answers legal update.In Olmstead v. L.C., which will mark its 25th anniversary this June, the Supreme Court held that Title II of the Americans with Disabilities Act (ADA) protects individuals with disabilities from unnecessary institutionalization. A lawsuit initiated in 2022 challenged Massachusetts’ accordance with Olmstead, leading to a recent landmark settlement.

In the settlement, the state promised to provide increased services and support fostering community integration for people with disabilities transitioning out of nursing homes. Massachusetts committed $1 billion toward these efforts.

Case History

In Marsters v. Healey, the Massachusetts Senior Action Center and several adults with disabilities who live in nursing facilities alleged that Massachusetts officials unjustifiably institutionalized the class of people with disabilities. The Center for Public Representation served as counsel for the plaintiffs.

According to the plaintiffs in this class action, the failure to provide services violated Title II of the ADA and Olmstead. They argued that the officials failed to supply needed community residential services and support, which would allow integrated community living. Furthermore, they stressed that this deficit in services disproportionately affected people of color.

Steven Schwartz, a lawyer for the plaintiffs interviewed by the Boston Globe, estimated that most of Massachusetts’ 21,000 long-term care residents receiving Medicaid could live in the community. Medicaid recipients comprise the majority of people with disabilities in long-term care.

The complaint demanded that Massachusetts offer more residential programs. These programs would give people with disabilities in nursing facilities the opportunity to make informed choices about where they live and create valid options for successful community living. In light of the disparate impact on people of color, the complaint also sought culturally competent services for these communities.

Preliminary Settlement Agreement Approved

On April 23, 2024, a federal judge preliminarily approved a settlement agreement in the case. The settlement would apply to all nursing home residents who receive Medicaid. After certifying the class, the judge approved a notice to all nursing home residents in Massachusetts. The notice gives residents until the end of May to file any objections to the settlement agreement with the federal court. The judge will decide whether to give final approval to the settlement on June 17, 2024.

Settlement Requirements

The settlement requires the state of Massachusetts to take steps to help nursing home residents with disabilities return to the community. This includes the following measures:

  • Expanding funding for housing programs for residents to return to the community

  • Establishing rental vouchers for people with disabilities seeking to transition to the community
  • Creating new residential options
  • Expanding access to round-the-clock residential care
  • Providing educational programming to help nursing home residents transition out of long-term care

In addition to informing residents of their housing options, the program would provide transition liaisons. With weekly visits, these liaisons would give information about community housing options. In order to address disparities, liaisons would offer culturally sensitive consultations in residents’ native languages.

The state Executive Office of Health and Human Services said that the reforms should permit at least 2,400 Medicaid recipients to transition to different residences over eight years.

Funding

In the settlement, Massachusetts promised to invest $1 billion in community-integration measures over the next eight years and pay $1.8 million in plaintiffs’ attorney fees. The money originates from federal and legislature-appropriated funds. The state also committed $100,000 to accessibility modifications for residences, allowing 120 people with disabilities to return home.

State’s Support

The settlement evinces the state’s heightened commitment to complying with Title II of the ADA under Olmstead.

In a statement, Massachusetts Secretary of Health and Human Services Kate Walsh said: “Whether that means helping people find and access appropriate community-based care or housing opportunities, we want everyone to feel empowered in making their own most informed decision.”