As a former high school teacher, the refrain of "I can't wait to move out on my own!" is a familiar one when students vent about their parents, who probably heard the same thing themselves after pronouncing a disciplinary measure or even a simple "no" to a request that seemed dire at the time. 

The desire to live in one's own space is a universal one.  Independent living means being able to choose where to live, deciding what and when to eat, and where you will go each day — work, school, shopping, religious services, seeing friends, etc.  For the average American, living independently is the natural progression into adulthood.  "Freedom of association" is even included in the Constitution as a basic right of all Americans, meaning that we have the right to be where and with whom we want at any given time.

If a person happens to have a disability the story is a bit different.  Our country has a troubling history when it comes to housing and caring for people with disabilities.  Their right of free association, to live independently in the least restrictive, most appropriate environment, has not always been a given as it has for their nondisabled counterparts.  In colonial times, caring for disabled individuals was the town's responsibility, especially if the family was unable to do so.  They were housed at places called "poor farms" and "almshouses" along with criminals and paupers.  The conditions were often horrific.

Thanks to the work of a woman named Dorothea Dix, and others like her, things began to take an upward turn in the mid-19th century.  Churches, synagogues, and other faith-based organizations began to assist communities in caring for their most vulnerable neighbors in slightly better settings, but they were still institutions.  They weren't even group homes.  Disabled people were often placed there against their will because of the lack of community support structures and other resources to care for them in an alternate setting.

My story is a bit unique among my age group of people with disabilities.  I have always lived in non-institutional settings, even if it seemed I had way too many roommates in some situations.  Several of my friends with similar disabilities, though, have lived in institutional-type settings, including nursing homes, until they were able to legally fight their way out to community-based settings.

Title II of the ADA, passed in 1990, prohibited the segregated or isolated placement of people with disabilities in any setting.  A brave woman, Lois Curtis of Georgia, led what became a class action suit against being placed in a mental institution, or asylum, simply because of being diagnosed with a disability of any kind.  On June 22, 1999, the Supreme Court of the United States (SCOTUS) said she and others with disabilities have the same right of free association and independent living in the least restrictive environment as deemed appropriate by their medical team. 

Almost a quarter of a century has passed since that SCOTUS ruling, known as the Olmstead decision, was made.  The story should be different now for more than three quarters of a million adults with disabilities, though it isn't.  They are still living in nursing homes and other institutional settings while on waiting lists for scarce community-based services that would help them live independently in the community of their choice. 

The reasons for this reality are myriad but could be addressed with some policy fixes and outside-the-box thinking.  Medicaid section 1915, which addresses these services, should be revamped to pay primarily for home and community-based services without a waiver — instead of nursing homes being the norm.  The money should follow the person based on where he can and wants to build a life — not where he is forced to live to satisfy arbitrary Medicaid rules.

Faith-based organizations should consider creating safe living environments for people who can, with a little support, live independent lives.  Helping them live their best lives as a part of existing community ministry and outreach is part of the Judeo-Christian ethic and something we as a moral society should strive for.

From a purely secular standpoint, tax credits could be offered to organizations who create these things in the same way that the Disabled Access Tax Credit is offered to businesses to offset the costs related to making their businesses accessible. 

The Small Business Administration could offer seed money loans to build needed housing and medical facilities for people with disabilities to people and organizations interested in caring for the most vulnerable among us.  The regulations need to be made clearer and less onerous.  The same tax incentives given to for-profit companies who set up non-profit arms of their organizations could be made available to individuals and faith-based organizations who set up home and community-based services (HCBS) for people with disabilities. 

It may seem like a "heavy lift" at first glance.  We are Americans, though, and part of our American values include caring for neighbors and including people in our community who might need a bit of assistance fitting in.  Nehemiah 3 says it best: "Many hands make light work."  It isn't a heavy lift after all if everyone helps. 

As we emerge from one of the worst periods of isolation in modern history, let's choose to use that experience as a springboard to make room at our American table for everyone, no matter his level of ability, and give everyone the avenues and resources to take his seat.

Melissa Ortiz
Senior Advisor, Able American's Project
National Center for Public Policy Research 

Photo credit: Joe Ravi, CC -BY-SA 3.0 license.