Individuals with disabilities supported in community living
Over the past several years during the month of March – National Intellectual and Developmental Disabilities Awareness Month – I have used this space to raise awareness and understanding of disabilities and the people in our communities who live with these conditions.
In past articles I’ve advocated for employment opportunities for individuals with intellectual and developmental disabilities, explained the importance of people with disabilities being able to live self-directed lives in their community (rather than in an institution), and provided an overview of Highland Rivers Health’s many IDD services.
This year I wanted to write about how funding for IDD services – specifically Medicaid waivers – can have a tremendous and positive impact on individuals with disabilities, and the strides the state of Georgia has made over the past decade to help transition individuals with IDDS from living in state hospitals to living in their community.
This topic can be somewhat complex. In Georgia, transitioning individuals with IDDS to community living accelerated significantly following a 2010 agreement between the state and the U.S. Department of Justice. And that followed a 2007 ruling by the U.S. Supreme Court which found that keeping individuals with disabilities in state hospitals violated the Americans with Disabilities Act.
Since 2010, the Georgia Department of Behavioral Health and Developmental Disabilities has transitioned hundreds of individuals out of state hospitals, investing nearly $300 million in the effort in the last decade. A good portion of that investment has gone into funding Medicaid waivers, which pay for services to support individuals with IDDS living in the community.
There are two primary types of waivers for individuals with IDDS in Georgia. The NOW Waiver (New Options Waiver) provides supports for people with disabilities who need less intensive services and supports and do not need 24-hour care. It was designed for people with disabilities who live with family members or in their own home.
The COMP Waiver (Comprehensive Supports Waiver) is for people who need a full range of out-of-home services or intensive in-home services. It’s also used for individuals who are transitioning out of institutions into community living. Both waivers also support a basic set of services including assistance with daily living activities, home health services and service coordination.
This is important because when individuals were housed in state hospitals, their care was included in the institution’s annual budget. But an individual living in the community may receive services from several providers – including personal care providers, healthcare providers, and educational, residential and community integration providers such as Highland Rivers. In fact, we currently serve approximately 145 individuals with either NOW or COMP waivers. Waiver funding, which follows the individual, not only supports the IDD services we provide but also those of other community providers who work with the individual.
What’s most important about the NOW and COMP waivers is that they allow individuals with disabilities – including individuals with substantial impairments or those who are medically fragile – to live in a non-institutional environment and be a member of the community. It gives them greater autonomy, something to which everyone is entitled to the extent possible.
Of course, with all the state has done, there is still more to do, and there are still individuals with IDDS living in state hospitals in Georgia. But Georgia has come a long way since 2010, and the ability to live in the community has made a tremendous difference in the confidence, self-esteem and quality of life for hundreds of individuals with disabilities. Highland Rivers is proud to serve these individuals in our community, in their community, and support those who, despite a disability, strive to live their best life and the life of their choosing.
Melanie Dallas is a licensed professional counselor and CEO of Highland Rivers Health, which provides treatment and recovery services for individuals with mental illness, substance use disorders, and intellectual and developmental disabilities in the 12-county region of Northwest Georgia.