The anniversary of the Olmstead decision reminds us of the importance of the work we do in ACL’s Office of Independent Living Programs, with centers for independent living (CILs) helping deliver on the promise of Olmstead. Designed and operated by people with disabilities, CILs across the nation provide independent living services for people with disabilities in their communities. By statute, every CIL is required to help people with disabilities move from institutions to homes in the community, and they also support individuals at risk for institutionalization.
Institutional transition work is time-intensive, and it can be difficult due to factors such as the shortages of affordable housing and direct care workers, administrative delays, inadequate funding, and a lack of coordination with state agencies, managed care organizations, and other partners. In addition, outdated attitudes persist in many places – biases about disability keep some people from ever being presented with the choice to move from an institution.
CIL staff are the boots on the ground, making difficult transitions from institutions possible. CILs work to ensure the individual’s voice is elevated, the person has informed choice, and that their choice is honored throughout the process. They meet with the person to determine their needs and budget, and then they assist with locating and applying for housing, personal care attendants, and other benefits. CIL staff help coordinate the actual move – providing furniture when needed and helping the person access home modifications, technology, equipment, and other necessary items. Staff also connect the person who has moved to the community to their peers at the CIL, and they teach independent living skills such as cooking, budgeting, and employment support. They continually follow up with the person to ensure their needs are met.
In the past three years alone, CILs have served 711,223 people and helped 11,564 people with disabilities move from institutions back into the community.
Partnerships and creativity are critical success factors. CILs work collaboratively with partners in the aging and disability networks, including area agencies on aging, state protection and advocacy programs, and aging and disability resource centers, and bring together funding from all sources to support people with disabilities in living where they want to live. For example:
- LIFE Inc. in Lubbock, Texas, partners with other CILs and managed care organizations to help move an average of 200 individuals from nursing homes each year, with very few returning. They credit their success to strong partnerships with community-based organizations and other CIL services. In 2017, LIFE, Inc. conducted a cost analysis, estimating a total return on investment to the state of $4,256,615 for the 193 consumers move that year.
- FREED in Grass Valley, California, braids multiple funding streams with state and local organizations to transition an estimated 160 people a year from hospitals and institutions. They use housing vouchers, the assistive technology re-use program for equipment, the services provided by their local area agency on aging and county funding for home modifications, a local donation store for furniture, state grants for household items, among other sources.
- Atlantis Community, Inc in Denver, Colorado, uses CARES Act dollars to innovate and pilot a program that helps homeless individuals with disabilities move from shelters and rehabilitation hospitals to homes in the community. They are also helping address the direct care worker shortage that keeps many people in institutions by training and funding other homeless individuals to be direct care workers.
As we celebrate the anniversary of the Olmstead decision, we are proud to acknowledge the important and hard work of our CILs. Through their advocacy, hours of individual assistance, resource coordination, problem solving, and strategic collaborations, they make Olmstead a reality for so many – advancing community living and informed choice to ensure everyone is extended the right to choose where they live.