Judge sets steps for more NC disabled people to live at home

RALEIGH, N.C. — North Carolina’s health agency is weighing whether to challenge a judge’s order demanding that the state ramp up services for people with intellectual and development disabilities to allow more of them to live at home or in their communities.

In 2020, Superior Court Judge Allen Baddour ruled that too many such people were forced to live in institutions in violation of state law.

Baddour allowed the Department of Health and Human Services to develop a plan to address the violation, but recommendations made by a consulting firm haven’t been carried out, the judge wrote in an order filed Wednesday that directs his own remedies.

Baddour ordered that at least 3,000 people must be diverted or shifted to community-based programs by early 2031.

Separately, he told DHHS to eliminate by mid-2032 a waiting list of roughly 16,000 people who are qualified to participate in a Medicaid-funded program that helps them live at home or outside of an institution.

A shortage of well-paid direct-care workers also must be addressed by the state Department of Health and Human Services, the judge ruled.

North Carolina residents with intellectual and development disabilities and their families “have waited far too long for this,” said Virginia Knowlton Marcus, CEO of Disability Rights North Carolina. The nonprofit is a plaintiff in a 2017 lawsuit along with several people with disabilities and their guardians that led to Baddour’s rulings.

“It is long past time for the state to enable people with (these disabilities) to have independent lives in the communities of their choice. This is no different than what people without disabilities expect and demand every day,” Knowlton Marcus said.

Dave Richard, the DHHS deputy secretary for Medicaid, said Thursday that the department has several concerns about Baddour’s order but hasn’t yet decided whether to appeal it.

“We are all for enhancing community-based services, giving people the choices that they need,” Richard said in a brief interview, but Baddour’s roadmap in the order “has the possibility to actually create some unintended consequences.”

Baddour didn’t describe how much state or federal money would be required to reach compliance. Disability Rights NC suggested that it could cost hundreds of millions of dollars annually. Medicaid would fund many of these services — at least two-thirds of the funding would originate from the federal government — helping generate demand for new…