The Senate Special Committee on Aging and the Senate HELP Committee hosted a June 20 panel discussion in honor of the anniversary of the landmark 1999 Supreme Court Decision in Olmstead v. L.C. The decision found that individuals with disabilities could not be offered only institutional settings in which to receive services.

From this decision, states worked to deinstitutionalize and rebalance long-term services and supports offered through Medicaid programs. These efforts were proposed in Centers for Medicare & Medicaid Services (CMS) rule making initially released in 2008, and later codified in final rule making in 2014 as the Home and Community Based Settings Final Rule. The rule was heavily influenced by the younger disability advocates and better reflects person-centered planning and goal development for this population.

The rule is not a good fit for aging services providers.

LeadingAge president and CEO Katie Smith Sloan briefly outlined our position and concerns with the settings rule in a letter to the joint panel. We note that broadly applying the settings rule to providers of aging services and their participants doesn’t advance person-centeredness and further dilutes the laudable goals of rule.

LeadingAge is finalizing an issue brief outlining various concerns and pain points for aging services providers with the settings rule. For example, adult day and assisted living providers in some states are being advised they must help participants (many with dementia) find employment or volunteer positions.