S.C. Ranks Near Bottom in Home Care of Disabled

Fifteen years after a landmark Supreme Court ruling on giving people with disabilities a choice to live outside institutions, South Carolina has shown little progress.

But state officials say they're working to change that.

The 1999 Olmstead v. L.C. decision says unnecessarily segregating people in mental hospitals, nursing homes and other institutions amounts to discrimination. Advocates for the mentally ill, elderly and disabled cite the ruling in arguing for home- or community-based care.

Since 1999, the percentage of Medicaid funds spent to help people live independently has nearly doubled. But progress varies widely, with states devoting anywhere from 27 percent to 78 percent on non-institutional spending.

South Carolina ranks behind 40 other states and the District of Columbia by spending 41 percent of Medicaid long-term care funding on home and community services in 2012. That's up from 35 percent a decade earlier, when the state ranked 22nd, according to the Centers for Medicare and Medicaid Services.

"We do have a long way to go" in funding more cost-effective, humane care, said Sue Berkowitz of the Appleseed Legal Justice Center.

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