SIOUX FALLS, S.D. (AP) — South Dakota's unnecessary reliance on nursing facilities to serve people with disabilities isolates those residents from their communities and violates federal law, according to the findings of a U.S. Department of Justice investigation released Monday.
The investigation discovered that thousands of people who depend on the state for services have to live in nursing facilities to receive them. But the Americans with Disabilities Act and a U.S. Supreme Court decision require states to provide services to people with disabilities in the most integrated setting that is appropriate for their needs, the Justice Department said.
Gov. Dennis Daugaard's administration is reviewing the results of the investigation.
The head of the Justice Department's Civil Rights Division said people with disabilities deserve privacy, autonomy and dignity. South Dakota's long-term care system fails to give those individuals the choice to live in their own homes or communities, Principal Deputy Assistant Attorney General Vanita Gupta said in a statement.
The Justice Department notified the state in August 2014 that it was starting the investigation, which included obtaining documents, touring facilities, meeting with state officials and interviewing nursing facility residents, staff and administrators.
The probe found that many who rely on state services don't know they could opt for community-based services since South Dakota hasn't made them aware of those services. The investigation also discovered that people with disabilities who live in rural areas and on reservations have particular trouble getting home- and community-based services.
At a given time, about 6,340 people live in the state's nursing facilities, including more than 3,400 whose placements are financed by the state through Medicaid, the Justice Department said.
Some nursing home residents told the Justice Department they feel trapped in the facilities or imprisoned. The agency found that a significant number of residents want to live at home or are open to moving out of a nursing facility if their concerns about getting adequate services are addressed.
The state's failure to prioritize home-based services over institutional care "has confined thousands of people with disabilities unnecessarily and indefinitely in nursing facilities and puts many others at serious risk of unnecessary institutionalization," according to a letter the Justice Department sent to Daugaard about the investigation.
The inquiry said the state's community-based services haven't been developed sufficiently to meet the needs of people who are institutionalized unnecessarily.
The department wants to work with South Dakota to create a "more effective, more efficient and more just service system for all," Gupta said. But in the letter, the agency said in the "unexpected event" that a resolution can't be reached, the attorney general could initiate a lawsuit to correct the problems.
The governor said in a statement that he recognizes the state needs to improve in some areas, but that it's making headway.
"Ideally, we want elderly residents and people with disabilities to be able to stay in their communities and receive the services they need without going to a nursing home," Daugaard said. "That can be a challenge for a state like ours which is made up of rural communities."
A spokeswoman for the governor said the administration will not comment beyond the statement because of the ongoing analysis.