Many Americans who could be living elsewhere are trapped in nursing homes against their will.
The Supreme Court ruled 20 years ago that disabled people needing public support are entitled to live in their communities rather than in institutions unless medically necessary.
But because of budget cuts, inflexible rules and too few alternatives, many people are stuck in homes they hate, says a story in the New York Times.
The story says not enough attention has been paid to the problem.
Some states have taken steps to shift Medicaid funds to home support programs, training caregivers to administer medications and paying family members who provide help. But in most places nursing homes are the only option.
Nationwide, 1.4 million people live in nursing homes. The story says it is hard to know how many are able to move back home if they had the choice. Maybe a few hundred thousand, it suggests.
In Washington state, they determined that the cost to put one person in a nursing home could pay for home care for seven people.
California is among several states that allow public funds to be used to pay family members for the care they provide. More states may follow that lead.
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