Brent Kaderli has a wheelchair-accessible van waiting in the driveway, a hospital bed in a spare bedroom and an electric lift that’s left unused. If the 30-year-old quadriplegic had his way, he’d be living here, in his father’s house, with help from aides. Instead, he is in an institution, hoping each day for a place that feels more like a home.
Fifteen years after a landmark Supreme Court ruling that the disabled should be given the choice to live outside nursing homes, mental hospitals and other institutions, its legacies are dueling. Progress has been made in every state to keep more aged and disabled people in their homes and communities, but only half of Medicaid spending goes to such care, with the services routinely denied by a system that favors institutions even though they’re typically more expensive to taxpayers.
