The 10th anniversary of the Olmstead decision was on June 22, and the White House celebrated with a press release announcing “The Year of Community Living.” Too, the press release refers to our right to live at home as a “critical civil rights” issue. So that’s nice. But what’s it actually mean?

Obama has instructed HHS Secretary Sebelius to work with HUD Secretary Donovan to ensure that people get home-based services and, uh … a home. This is incredibly important. Housing has long been overlooked as a disability issue, but it’s at least as crucial as services.

Let’s say a woman named Laurie has a stroke. Or breaks her neck at a high level. Or has a long-lasting MS exacerbation and can no longer walk. She’ll go to a hospital, and the social worker won’t release her unless her home’s accessible, or until she has services. Given how hard it is to piece together a crazy quilt of available programs, most social workers will place Laurie in a rehab/nursing home. This might be a good thing at first, as Laurie will probably need PT, OT, and all kinds of other “T”s to learn how to live as a woman with a disability.

But while all this “T”ing takes place, Laurie loses her job. Then her apartment. Friends and family pack her stuff, putting as much as possible into storage. But she loses most of her big items.

Right now, unless Laurie’s lucky enough to live somewhere with a functional Independent Living Center, Laurie’s probably going to be stuck in that facility for a very long time. If she does live somewhere close to a decent ILC, they’ll find her housing, get her services and even buy her replacement items. This at least gets Laurie back in the game, maybe even her job back (could happen).

This is the type of coordination Obama’s pushing, only on a national policy level. He wants the services and housing pieces to mesh better, be more seamless. To get this done, the president acknowledges, Independent Living services are going to have to be beefed up. Frankly, ILCs are often the only agencies on the ground that could implement whatever policies come out of this new coordinated effort. As the press release says, Obama already put $140 million for ILCs in the stim package a few months ago. This new coordinated effort is a logical next step.

It’s so nice to finally see logic in the president’s disability policy. Is this new effort a hint about what to expect from the Obama administration? It seems, based on this press release and a similar one put out from HHS, that Obama may be more about coordinating and bolstering existing services than creating brand-new programs. The Blue Dog in me likes this a whole lot. Now if he directs CMS to continue its good work of consolidating existing waiver programs, we’ll be in good shape.

Of course, activists correctly note that nothing in the press release states Obama will make good on his promise to support the Community Choice Act. Also, it’s looking less and less likely that any kind of meaningful long term care reform will make it into a viable health care bill.

Let me be the heretic and suggest this isn’t such a bad thing. Let health care reform of some sort clear Congress so Obama can have his big victory (it’s not like we have the power to influence this).

The way I see it, although his popularity remains high, Obama has to deliver on something huge fast in order to retain his edge. He can’t fix a two-year-old recession in six months, he can’t snap his fingers and bring peace in the Middle East … so he needs a big win that the general public will applaud him for. Health care’s his only chance in sight.

Health care reform without consideration of long-term services and supports is not health care reform. In addition, unless the institutional bias is removed from the nation's Medicaid program, the federal government is in daily violation of both the ADA and the 6/22/99 U.S. Supreme Court decision in Olmstead v. LC and EW. Our President can not purport to uphold civil rights (aka the law) and still refuse to change a system that continues to, by default, incarcerate people who are aging and who have disabilities simply for the crime of their age and/or disability. The institutional bias must go!

just wait until the baby-boomers start retiring en masse. no way are they going to allow their asses to get institutionalized.