The U.S. Supreme Court ruled more than a decade ago in a case known as Olmstead v. L.C. that unnecessarily segregating individuals with disabilities in institutions is a violation of the Americans with Disabilities Act. Nonetheless, a report released last year by the U.S. Senate Health, Education, Labor and Pensions Committee found that the number of people with disabilities in nursing homes is on the rise and, as of 2010, just a dozen states devoted the majority of their Medicaid dollars to community-based care.

Because so many states are failing to meet their obligations to transition individuals with disabilities out of institutions and into community settings, a key U.S. senator is looking to introduce legislation to dramatically expand access to community-based services for people with disabilities nationwide.

Sen. Tom Harkin, D-Iowa, who chaired the U.S. Senate Health, Education, Labor and Pensions Committee, is currently looking at developing legislation that would enhance community access, inclusion and support in order to ensure that all individuals with disabilities can receive home and community-based services and supports in their own towns, cities and neighborhoods throughout America.

Across the country, hundreds of thousands of people with disabilities remain in nursing homes or they are on waiting lists for Medicaid home and community-based services. Meanwhile, the percentage of Medicaid funding spent on these integrated offerings varied widely from more than 80 percent to less than 20 percent in some states in 2009, the report indicates.