Lincoln Journal Star. May 23, 2024.
Editorial: DOJ findings are a people issue, not a political one
Nebraska is violating the Americans with Disabilities Act by unnecessarily segregating people with serious mental illnesses in assisted living facilities and day programs.
That is the finding of a three-year probe of the state’s mental health system by the U.S. Department of Justice.
That investigation found that Nebraska’s system relies too much on “mini-institutions,” particularly assisted living facilities, where people with serious mental illnesses are grouped together, supervised by paid staff and have little contact with people without disabilities.
Residents often leave the homes only for medical appointments, group visits to grocery and convenience stores or to participate in day programs, that, the investigation found, provide no path to employment and offer little beyond supervision and crafts.
About 5,000 Nebraskans with serious mental illnesses live in facilities, according the letter sent by Kristen Clarke, assistant attorney general for the DOJ’s civil rights division to Gov. Jim Pillen.
At least 19 assisted living facilities primarily house people with serious mental illnesses with capacity ranging from 10 residents to nearly 250, and there are 22 Medicaid- and state-funded day programs for those people.
Nebraska, Clarke wrote, needs to make changes in programming.
“Far too often, people with mental health disabilities are institutionalized when they could succeed and thrive in the community,” Clarke wrote. “It’s time to bring an end to the days of funneling people with disabilities down a dead-end road towards institutionalization and unemployment when they could succeed if provided pathways toward independence and dignity.”
The Pillen administration responded to Clarke’s letter expressing “disappointment with allegations issued by the Biden administration,” seemingly trying to turn the investigation and recommendations for change into a partisan issue, which it is not, rather than responding to the findings and recommendations for change.
Rather, it is a societal issue that affects a wide cross-section of Nebraskans, friends and family members, taxpayers, businesses who could become employers and, especially, the seriously mentally ill who are not being provided services “in the most integrated setting” as required under the ADA.
Nebraska has a few programs that provide the required supportive services. But they are limited in number and location. And the state again fails the mentally ill by using restrictive criteria for the programs, lacking the staff for programs and utilizing a payment structure that favors assisted living rather than independent living.
All those issues must be addressed by the Department of Health and Human Services and should be done voluntarily in cooperation with the DOJ, which is threatening a lawsuit if the state does not move to bring its programs into ADA compliance.
Battling with the DOJ in court, in a case that the state is almost certain to lose, would solve nothing and only delay the program changes that should help, rather than warehouse, Nebraska’s severely mentally ill.
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