Colorado isn’t doing enough to allow people with physical disabilities to live in the general community, effectively segregating them in nursing homes in violation of the Americans with Disabilities Act, according to the US Department of Justice.
The department laid out the allegations in a 15-page letter sent to Gov. Jared Polis on Thursday.
The law requires states to offer services that allow people with disabilities to live in the least restrictive environment that can meet their needs. While some people do require the level of care found in nursing homes, others could live in the community, provided they have enough support.
Colorado had more people living in nursing homes who had “low-care needs” than all but nine states, according to the Justice Department, and is near the bottom when it comes to transitioning people out of nursing homes.
“Unnecessary institutionalization is common in Colorado despite several programs to help adults with physical disabilities remain in, or transition back to, their own homes and communities,” the letter said.
Conor Cahill, a spokesman for the Polis, said the governor “welcomes all help” in transitioning older Coloradans to home-based care.
“Gov. Polis is hopeful that this development will accelerate his efforts to make Colorado the best state for seniors and people with disabilities,” Cahill said in a statement.
The Colorado Department of Health Care Policy and Finance, which pays for nursing home and community-based services through Medicaid, said in a statement that it would compare the findings with its own data and look for ways to improve services.
Department spokesman Marc Williams said about 81% of eligible people receive services in their homes, which is an improvement from about 76% six years ago. The state has a program to help people transition out of institutions, and is using about $530 million in COVID-19 response funding to improve home- and community-based services, he said.
“Colorado has a deep commitment to creating a system that ensures people with disabilities always have the option to receive their care in the community,” he said.
The Justice Department said Colorado could address the problems it found by making sure people with physical disabilities have more information about home- and community-based services; expanding those services so more people can use them; helping those who are in nursing homes to transition out; and building on its program to modify homes so that people with new disabilities can stay in place.
Colorado’s process for transitioning people out of nursing homes relies on the facilities to identify residents who might be interested in moving into community settings. Residents who express interest then have to talk to an “options counselor” and “transition coordinator” to determine if they can live in the community before getting a case manager to help them find services.
The process can break down at multiple points, because people who don’t know community services are available may say they aren’t interested, and less than 7% of those who said they were interested between January 2020 and October 2021 were referred to options counselor.
Those who complained to the Justice Department said they waited an average of seven months to meet with a transition coordinator, and some waited more than a year after that to get the services they needed to move out of a nursing home.
The investigation started in November 2018, after “several” complaints the state’s system was effectively segregating people with disabilities. The next step would be for the state and the Justice Department to negotiate a plan to address its findings, though the state could face a lawsuit if they could not come to an agreement.