No state adequately fulfills its obligation under the Supreme Court’s Olmstead decision to provide community-based living for people with disabilities, according to a report released Wednesday by the Bazelon Center for Mental Health Law.

The report, “Still Waiting… The Unfulfilled Promise of Olmstead,” details the current situation ten years after the court’s decision in Olmstead v. LC and EW. Under that decision, the court said that states have an obligation to provide care for people with disabilities in a community setting, where medically possible.

Currently, it’s unclear how many Americans are unnecessarily living in hospitals, nursing homes and other institutional environments because each state reports information differently. And that’s one of the biggest problems, the report indicates. Many, if not most, of the individuals in these situations could live in the community with supports at a lower cost.

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The report recommends that states assess the number of people in their care who could be better served in community settings and shift funding from institutions to community-based supports. Further, on the federal level the report encourages an expansion of the Medicaid Home and Community Based Services Waiver, passage of the Community Choice Act and making mental health insurance coverage accessible to all Americans.

To view the full report click here.