Institutional bias definition
Institutional bias means that historically, individuals could receive support services while institutionalized, but if they wanted to return to the community they could not receive similar services.
Institutional bias means that federal Medicaid law requires state Medic- aid programs to pay for nursing facility placement, but does not require states to provide an adequate level of integrated services and supports to ensure that all people with disabilities can reliably and safely remain in their own homes and par- ticipate fully in community life. Medicaid does require states to offer “home health services,” but this service is similar to Medicare Home Health Services, in that it cannot be provided 24/7 and is not avail- able to people who regularly leave their homes to work or participate in integrated community activities. More integrated and flexible categories of homecare, such as Personal Care (which includes CDPA), are optional for states; they can choose to provide it in limited amounts, or not at all. Therefore state Medicaid plans have often given short shrift to truly integrated long- term services and supports, sometimes claiming the need to save money, and state planners regard the guaranteed avail- ability of nursing facilities as a “back up plan” that justifies their failure to do more.