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DOJ: People with serious mental illness unnecessarily segregated in assisted living communities

Medical worker with hand on sad woman’s shoulder

Nebraska is “unnecessarily” segregating people who have serious mental illness in assisted living communities and day programs, violating federal disability laws, according to the Justice Department.

The federal government found that Nebraska restricts access to community-based services needed by people with serious mental illness to live and work in the community, in violation of the Americans with Disabilities Act and the Olmstead vs. L.C. US Supreme Court decision, which requires states to make services available in the most integrated setting. 

“Far too often, people with mental health disabilities are institutionalized when they could succeed and thrive in the community,” Assistant Attorney General Kristen Clarke said in a release. “It’s time to bring an end to the days of funneling people with disabilities down a dead-end road toward institutionalization and unemployment when they could succeed if provided pathways toward independence and dignity.”

The DOJ said that rather than helping Nebraskans with serious mental illness find jobs, the state relies heavily on segregated day programs that group individuals together in facilities. With no path to employment, those individuals are forced to enter assisted living communities, the department said.

“Once people enter assisted living facilities and day programs, Nebraska offers them little help to get out,” Clarke wrote in a letter to Gov. Jim Pillen (R) detailing the government’s findings.

LeadingAge Nebraska recently provided comments to the DOJ in a listening session regarding the need to reform the state’s behavioral health services. CEO Kiersten Reed told McKnight’s Senior Living that the state uses a very broad definition of assisted living services, and those services provided to individuals with serious mental illness often are distinct and separate from assisted living and day services used by older adults in the Cornhusker State.

LeadingAge Nebraska members providing assisted living services — and even skilled nursing services — in the state expressed concern regarding the increase in the number of people experiencing serious mental illness, along with other physical health needs, Reed said. Families may find those settings to be a safer alternative when loved ones require care due to the supervision and support, which may not be available in community-based settings.

“We hope that the negotiations with DOJ can include community-based alternatives that will provide services at an intensity that will meet the needs of Nebraskans experiencing a serious mental illness and allow them to have services in integrated settings,” Reed said. “We also hope that the state of Nebraska will continue to make improvements to the behavioral health system that include services for older adults who may experience a serious mental illness as they age so that we can have safe settings for those who may need a nursing home level of care.”

The Justice Department opened an investigation into Nebraska’s overreliance on segregated service settings for people with serious mental illness in 2021 in response to complaints. Although the state offers supported employment services, the DOJ found that Nebraska limits access to community-based services and said that the state has not developed sufficient service capacity to enable people with serious mental illness to avoid unnecessary placement. 

“By increasing its investment in community-based services for Nebraskans with serious mental illness, the state can help these individuals become engaged and vibrant members of their communities,” US Attorney Susan Lehr said in a statement. 

Source: McKnights Seniorliving

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