MONTGOMERY, Ala. — The U.S. Department of Justice is investigating Alabama’s long-term care system for children with physical disabilities, questioning whether the state is violating federal law by institutionalizing children instead of providing care in their homes or communities.
The investigation, launched under Title II of the Americans with Disabilities Act (ADA), examines whether Alabama fails to provide adequate support for children with disabilities to remain in integrated settings. Title II mandates that public entities offer services in the most integrated environment appropriate to the needs of people with disabilities, a principle affirmed by the Supreme Court’s 1999 decision in Olmstead v. L.C.
Advocates say gaps in Alabama’s system often leave families with no choice but to place children in nursing facilities, separating them from their homes, schools, and communities.
“Children with disabilities deserve to grow up at home, where they can thrive with their families,” the DOJ said in a statement announcing the investigation.
Alabama families and disability advocates have long expressed concerns about limited access to in-home nursing care, medical equipment, and therapies. For many, these shortages have led to prolonged institutional stays, even when community-based care is a viable and less restrictive option.
The investigation comes amid growing scrutiny of Alabama’s long-term care policies, which have faced criticism in the past for prioritizing institutional care over home-based alternatives.
Nationally, the federal government has increased enforcement of the ADA’s integration mandate, which prohibits unnecessary segregation of people with disabilities. Similar investigations have spurred changes in other states, leading to expanded home and community-based services.
The outcome of this investigation could significantly impact families across Alabama, where access to community-based care varies widely, particularly in rural areas. Families often report that the lack of trained in-home caregivers and insufficient Medicaid funding forces difficult decisions.
The DOJ’s findings may also bring financial consequences for the state, as lawsuits stemming from ADA violations can result in costly settlements or mandates to overhaul care systems.
State officials have not commented on the investigation, which is ongoing. For Alabama families of children with disabilities, the outcome could determine whether they finally receive the support needed to keep their loved ones at home.
The Justice Department has not announced a timeline for the investigation’s conclusion.