This story was first published by Idaho Reports on Jan. 17, 2025.
(Boise, ID) The U.S. Department of Justice notified Idaho last week that it is in violation of the Americans with Disabilities Act because of how it administers its long-term care system for adults with physical disabilities.
In a letter sent to Gov. Brad Little on Thursday, the DOJ said it found that many residents who are relatively young or have low care needs could live in the community with appropriate supports, and cites the state’s limited community services and over-reliance on institutional settings. That has led to segregating adults with physical disabilities from their communities.
Federal law requires states to give services to people with disabilities in integrated settings, but a DOJ investigation found that Idaho puts too many people in nursing facilities unnecessarily, without any plan to reintegrate them into the community.
“Specifically, Idaho limits access to community-based services by limiting the capacity of community-based services and failing to authorize such services,” the report says. “Even though a report commissioned by Idaho’s Legislature acknowledged the insufficiency of its community-based services, the State has failed to remedy the problem.”
For years, disability advocates have cited Idaho’s low pay and Medicaid reimbursement rates for in-home caregivers, as well as a high caseload for staff at the Division of Medicaid, as causing problems for Idahoans with disabilities. Testifying in front of the Joint Legislative Oversight Committee in September 2023, State Independent Living Council Executive Director Mel Leviton shared stories of people with disabilities who were forced against their will to move into institutional settings after they couldn’t find direct care workers to help them stay in their homes.
According to the DOJ’s findings, 65% of Idahoans in nursing facilities have expressed a desire to live in the community, but 82% did not have an active discharge plan as of October 2024.
In Idaho, about 19% of nursing home residents are younger than 65, and about 14% have low care needs.
In-home nursing services can help people with disabilities with medication management, bathing, housekeeping, and more intensive care like managing medical devices. The DOJ letter says Idaho could remedy the ADA violations by expanding community-based services and allocating more resources to existing programs.
By doing so, the state could not only improve outcomes for individuals with disabilities, but also save money on Medicaid expenditures, the report says.
During a Friday SILC meeting, Leviton told council members that the Idaho Department of Health and Welfare was cooperative with DOJ investigators, and that state officials would meet soon to discuss the findings. It is unclear if that will be a public meeting.
Little’s office declined to comment, citing pending litigation. Idaho Reports also reached out to IDHW for comment and has not yet heard back.
Ruth Brown contributed to this report, which appeared on Idaho Capital Sun.
