They said they had received 43 complaints from people in 20 states. But the number of people eventually affected by the policy would be much greater. Federal officials contend that the ruling applies to people of all ages with all types of disabilities in all institutions and all state programs. William Waldman, who represents state officials as executive director of the American Public Human Services Association, agreed. It affects not only people in state psychiatric hospitals and centers for the mentally retarded, but also people in nursing homes and children in institutions who want to live somewhere else.
States can redirect spending from institutions to community services.
But very likely there will also be new expenses for states. The Clinton administration policy, combined with the Supreme Court decision, is likely to lead to tangible changes in the lives of people with disabilities. Even before the court decision, state officials had been moving fitfully to increase community-based care, but the wait for such services exceeds eight years in some states. The ruling applies not just to people in state institutions, but also to Medicaid recipients in private nursing homes. The ruling applies not only to people in institutions, but also to people who are living at home and might have to enter an institution if they do not receive proper services.