For many Americans with the most severe disabilities turning 21 brings an end to critical in-home care, but some families are starting to fight back arguing that nursing homes just don’t measure up.

Under a Medicaid waiver program, many children with high medical needs receive extensive in-home nursing care. However, when those children become adults at age 21, that care is often drastically reduced. The reason: the alternative for children is expensive hospital care, but adults can be served in nursing homes, often at a lower cost than round-the-clock skilled care in the home.

As a result, many families end up taking on care responsibilities themselves at no cost to states out of fear that nursing home care will be subpar for individuals that previously qualified for one-on-one assistance.

Advertisement - Continue Reading Below

However, some families are going to court, arguing that their loved ones have the right to care in the community, citing the Supreme Court’s decision in Olmstead v. L.C. which found that individuals with disabilities should have the option to live in the community when possible. The Justice Department is supporting many of the lawsuits brought by families against states and in an increasing number of cases families are winning, reports NPR. To read more click here.