Federal Probe Finds Thousands Deprived of Home and Community Services

South Dakota has been found in violation of the community integration mandate of the Americans with Disabilities Act (ADA), after an investigation revealed the state unnecessarily relies on nursing homes to provide services to seniors and people with disabilities.

The Justice Department announced that South Dakotans don’t have a meaningful choice to receive services at home and in their communities, which violates the ADA and the Supreme Court’s decision in Olmstead v. L.C., a ruling that requires states to make these services available to people with disabilities. About 80% of the state’s long-term services budget was found to be spent on nursing facilities, but could be rebalanced to prioritize home care and community-based services.

“Regardless of their age, people with disabilities deserve privacy, autonomy and dignity in their everyday lies,” Principal Deputy Assistant Attorney General Vanita Gupta, head of the Justice Department’s Civil Rights Division, said in a statement. “Our findings reveal how South Dakota’s current system of long-term care violates federal law and fails to give people with disabilities the choice to live in their own homes and their own communities.”


The state was found to have one of the highest utilization rates of nursing facilities in the country, funding about 3,4000 [3,400?] people in nursing facilities at any given time, or approximately 5,500 people over the course of one year, the Justice Department reported. By comparison, other states are able to provide services in community and home settings to similar patient groups.

As a result of this high use, the state is not only violating the law, but missing out on cost savings by underutilizing home- and community-based services.

South Dakota also failed to provide help for home and community-based services even when beneficiaries actively sought out services at home.


“One 51-year-old man told the Justice Department that he had entered the nursing facility to recover after a leg amputation, but had been trying to leave the nursing facility for months, without help,” the analysis found.

Other residents simply did not know they were entitled to choose home-based services instead of a nursing facility because the state didn’t inform them or offer the services. Most of the residents living in South Dakota’s nursing facilities live with physical disabilities, chronic illnesses or cognitive disabilities and need day-to-day assistance, rehabilitative therapy or nursing services.

Since 2009, the Justice Department’s Civil Rights Division has been aggressively going after states that fail to comply with the Olmstead ruling after President Obama issued a proclamation launching the “Year of Community Living” and directed the administration to redouble enforcement efforts.

Written by Amy Baxter

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