Class action lawsuits have closed many ICFs/IID and reduced options for those who need fulltime care
Federally-funded attorney groups have pursued at least 30 class action lawsuits against ICFs/IID, driven primarily by a bias against ICF/IID care. In fact, since 1996, every federally-funded lawsuit against an ICF/IID has been for the primary purpose of removing residents from their ICF/IID home (“community integration”); the condition of care at the targeted ICFs/IID was not at issue in any of these cases.
Fifteen of these cases have led to the closure of ICFs/IID, affecting thousands of individuals with intellectual disabilities.
Despite the fact that ICFs/IID are a residential option created by federal law and funded and monitored by HHS, most of these lawsuits are filed under the Protection & Advocacy (P&A) program, whose lawyers are also funded by HHS. Because one program authorized by HHS is suing another program authorized by HHS, these suits could be labelled HHS v. HHS.
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VOR's Ongoing Document:
Updated April 14, 2018
This document provides a bibliography of investigative media series, state audits and peer-reviewed research in more than half the states that detail systemic concerns with regard to quality of care in community-based settings for persons with developmental disabilities. Tragedies range from physical, emotional, and financial abuse, neglect and even death. Many of these outcomes are associated with a zest to move to a "community for all" vision people with developmental disabilities without adequately considering the ramifications of separating vulnerable people from specialized care and then doing away with a critical safety net (a/k/a deinstitutionalization). The lessons learned from more than 25 states should cause policymakers and lawmakers to take pause and recognize that a range of needs requires a range of service options.
Right To Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID)
Individuals who qualify for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID)* under Medicaid have a legal right to such facilities for as long as they remain eligible and choose to do so. Despite a deinstitutionalization effort by those opposed to congregate care, the ICF/IID program remains a legally enforceable federal entitlement under Medicaid. States which have included ICF/IID in their Medicaid State Plans, but instead offer only Waiver services, are in violation of federal Medicaid law.
Policy favoring deinstitutionalization has had a major adverse effect on many individuals, with a shift in funding priorities from Medicaid Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID) and other specialized facilities, to smaller service options, such as Medicaid Home and Community-Based Services (HCBS) settings.