A U.S. Department of Justice report says Missouri’s use of nursing homes for people with mental illness violates the Americans with Disabilities Act. After an 18-month investigation, the federal agency says it has found that Missouri is failing to instead provide community-based services to these patients.

Jefferson City Attorney Harvey Tettlebaum represents the Missouri Healthcare Association, a group that serves hundreds of Missouri’s nursing homes. He said there’s a lot of accurate information in the report, but he said it does not mention two things.

“It doesn’t discuss the deficiencies of the federal agencies involved, like the Centers for Medicare and Medicaid Services, but have basically taken a hands-off position in terms of any responsibility that they have to be able to deal with the underlying problems the report describes,” he told Missourinet.

Tettlebaum also said the report does not make recommendations to Missouri to address the problem.

“The care that’s been provided to these individuals has actually been necessary, and it’s been necessary because the nursing home is the only place where the federal government does provide sufficient funding to be able to provide what should be transitional care, other than an institutional setting,” Tettlebaum said. “It’s not just a question of being better off not being in a nursing home. It’s a question of being better off than they currently are, because many of the individuals who are in the nursing home previously were on the street or in situations that were dangerous to them and to their and possibly to others.”

The U.S. Department of Justice says in some Missouri nursing homes, more than 80% of these residents have bipolar disorder or schizophrenia.

As for the path forward, Tettlebaum said that will depend on the federal government. He said the report criticizes and raises expectations which cannot be met because of the lack of state funding.

“Is your goal to improve the care for these individuals, many of whom have serious mental illness, to get them into a setting which is the least restrictive environment, which is the standard set by the Supreme Court in the Olmstead case? Or is your goal to be able to issue a press release criticizing the state in order to make it look like that you care when you’re not willing to put your money where your mouth is,” asked Tettlebaum.

To view the report, click here.

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