Host Annette Hines and her guest, David Goldfarb who is the Director of Policy at the Arc of the United States discuss policy and advocacy issues related to housing and institutional bias in the disability community.  Despite the landmark Olmstead decision of the U.S. Supreme Court in 1999 that found that people with disabilities were being segregated into institutional facilities and should be supported in community living situations, these services are not mandatory under Medicaid. So even though we as a nation have agreed that people with disabilities should leave institutions, we haven’t funded the ability for people to live in a healthy and safe way in the community.  Therefore, most people with disabilities are only able to secure funding for housing in institutions. Hines shares startling statistics from a report released by the National Council on Disability that 14 million Americans need community-based services, and nearly 40% of those people are under age 65.  As a result of this, people under the age of 30 account for the fastest growing group of nursing home residents. She refers to lack of financial investment for home and community-based services “institutional bias,” which prevents people from living their best lives and neglects their choices and freedoms in their home life.

This episode addressed the necessary activism we need from all citizens to insist that Medicaid mandate home and community-based services (HCBS) as an option for those with disabilities and that additional federal funding sources be identified to support integrated living situations. The Covid pandemic shined a spotlight on the weaknesses in (HCBS) and Long Term Services and Supports delivery systems through congregate and institutional facilities that saw a disproportionate amount of deaths due to insufficient and unsafe living conditions.

Without the financial support that enables access to affordable housing, quality direct support workers, and community support programs, people with disabilities are forced to choose between living at home or living in an institutional setting. Let your representatives know that community-based services should be mandatory under Medicaid.  Learn more on The Arc of the U.S.’s website:

What policy issues would you like to hear about in our podcast? What are your thoughts about affordable, safe, and supportive housing for people with disabilities? Leave us a comment on our website: