This report highlights federal inter-agency actions to implement Pres.
Bush's  NEW FREEDOM INITIATIVE , which "calls upon the federal government
to assist states and localities to swiftly implement the decision of the
United States Supreme Court in Olmstead v. L.C. In that case, the court
found that, under certain circumstances, the Americans with Disabilities
Act (ADA) requires states to provide community-based services for persons
with disabilities and holds that unjustified institutionalization of a
person with a disability is discrimination under the ADA. "

This initiative and the following report  look very promising --
hopefully it will be adequately funded and implemented. The report
identifies the supports needed by  disabled people to be able to live in
the community -- Housing, Personal Assistance, Direct Care Services and
Community Workers, Family Caregivers support, Employment, Transportation,
Access to Technology, Legal compliance with the Olmstead decision, Public
Awareness and income supports.
Linda

from: http://www.hhs.gov/news/press/2002pres/20020325.html

 March 25, 2002
HHS Factsheet:
DELIVERING ON THE PROMISE - REPORT OF FEDERAL AGENCIES' ACTIONS
TO ELIMINATE BARRIERS AND PROMOTE COMMUNITY INTEGRATION
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Overview: In February 2001, President Bush released the New Freedom
Initiative, a comprehensive plan to tear down the barriers facing people
with disabilities and preventing them from participating fully in
community life. As part of that initiative, the President issued
Executive Order 13217, "Community-Based Alternatives for Individuals with
Disabilities," June 18, 2001. The order calls upon the federal government
to assist states and localities to swiftly implement the decision of the
United States Supreme Court in Olmstead v. L.C. In that case, the court
found that, under certain circumstances, the Americans with Disabilities
Act (ADA) requires states to provide community-based services for persons
with disabilities and holds that unjustified institutionalization of a
person with a disability is discrimination under the ADA.
More information on the New Freedom Initiative and Executive Order 13217
is available at http://www.hhs.gov/newfreedom.

BACKGROUND

Executive Order 13217 directs six federal agencies, including the
departments of Justice (DOJ), Health and Human Services (HHS), Education
(ED), Labor (DOL) and Housing and Urban Development (HUD) and the Social
Security Administration (SSA) to evaluate their policies, programs,
statutes and regulations to determine whether any should be revised or
modified to improve the availability of community-based services for
qualified individuals with disabilities and to report back to the
President with their findings. The departments of Transportation (DOT)
and Veterans Affairs (VA) and the Office of Personnel Management (OPM),
though not named in the Executive Order, also joined in the
implementation effort.

Together, the participating agencies formed the Interagency Council on
Community Living (ICCL) under the leadership of HHS Secretary Tommy G.
Thompson. The self-evaluation process represented an unprecedented
government-wide effort to identify and find ways to remove barriers to
community integration. The interagency collaboration it generated will
serve as a model for future interagency efforts on disability and other
issues.

President Bush directed that public input would be a central component of
the federal review mandated by the order. To encourage the broad
participation of people with disabilities, family caregivers, providers
and advocates in the public input, the ICCL sponsored a national
listening session in Washington, D.C., a national teleconference, and a
Federal Register notice soliciting written public comments. More than 800
individuals and organizations provided comment.

On March 25, 2002, HHS presented President Bush with the reports of the
nine agencies participating in the self-evaluation. Prior to delivering
the full reports, Secretary Thompson presented the President with a
preliminary report on Dec. 21, 2001. The reports will be available soon
at http://www.hhs.gov/newfreedom.

FINDINGS OF THE 'DELIVERING ON THE PROMISE' REPORTS

In their reports to the President, the participating federal agencies
identified more than 400 steps to tear down barriers and improve
community integration in a number of key areas. Following are a few
highlighted recommendations in each of the barrier areas that were
identified:

Health Care Structure and Financing: When the Medicaid program was
created nearly 40 years ago, few community-based alternatives were
available for people with disabilities who required health care services.
Despite the expanded possibility of community alternatives available
today, approximately 73 percent of Medicaid long-term care funding pays
for institutional care while only 27 percent is directed toward home- and
community-based services.


HHS will establish a Medicaid Community Services Reform Task Force with
representatives from within the disability community and national, state
and local organizations to advise the department on actions within the
Medicaid program that may be advisable to remove barriers and promote
community living for people with disabilities.

HHS will develop a strategy to address quality of care issues in home-
and community-based settings, including: establishing defined
expectations for home- and community-based services; assisting states in
how to best use the results of HHS quality reviews of community
placements; providing technical assistance to states in effective systems
design or quality improvement strategies; and implementing new quality
assurance and improvement systems for services in the home.

HHS is providing states with substantial resources to improve
community-based services through Systems Change grants ($125 million in
fiscal years 2001 and 2002), Medicaid Infrastructure grants to promote
the employment of people with disabilities ($25 million in fiscal year
2002) and through the National Caregiver Support Program ($142 million in
fiscal year 2002).

Housing: The lack of accessible, affordable housing continues to present
a major barrier to the participation of people with disabilities in their
communities and in the economic life of the nation. As more people with
disabilities leave institutions for community life, this housing shortage
will become more acute unless actions are taken.

HUD will provide technical assistance to local public housing authorities
to improve information on the need and use of vouchers for people with
disabilities. HUD will strongly encourage local authorities to consult
with local disability organizations on how best to maximize the use of
vouchers in their areas.

HUD will coordinate efforts with DOJ to devote substantial resources
toward investigations and enforcement actions against developers,
architects and site engineers who design or build multi-family housing
that does not comply with the accessibility provisions of the Fair
Housing Act.

HHS will provide technical assistance and clarification as to methods
through which Medicaid is able to assist individuals in transitioning
from institutional to community residence.

Personal Assistance, Direct Care Services and Community Workers: There is
already a critical need for personal care assistants and other direct
care staff to provide services to people with disabilities living in the
community. The administration will work to increase the number of these
workers through recruitment, training, and work-related benefits.

DOL's Office of Disability Employment Policy will work with other federal
partners to identify and propose options for increasing the availability
of personal assistants for people with disabilities and providing paths
of career progression for personal assistants and other direct care
staff.

HHS will work with a limited number of volunteer states to initiate a
national demonstration to address workforce shortages of community
service and direct care workers. The demonstration will test the extent
to which workforce shortages might be addressed through better
coordination with the Temporary Assistance for Needy Families program and
the availability of vouchers to workers for health insurance or for
tuition or day care credits.

Caregiver and Family Support: The vast majority of direct care for people
with disabilities is provided by families, friends and neighbors.
However, despite the enormous contribution of family and informal
caregivers to the community integration of people with disabilities,
these caregivers receive little direct assistance and often face great
financial and emotional pressures.

HHS will seek authorization and funding from Congress for a demonstration
to allow states to include respite care for adults. Unrelieved caregiver
burden is a major contributing factor to institutionalization of
individuals with disabilities; respite care is the service most often
requested by families in order to keep a family member with a disability
at home.

HHS will also seek authorization and funding from Congress to implement a
10-year demonstration to provide respite services to caregivers of
children who have a substantial disability.

Transportation: Accessible transportation is necessary for people with
disabilities to go to work, get an education, receive medical care and to
have an active, inclusive role in society. Barriers to transportation
include a lack of available transportation options such as public
transportation and a lack of access to existing transportation services.

DOJ will look for opportunities to participate in private lawsuits as
amicus curiae on issues involving paratransit services and accessible
public transportation and will continue its efforts to expand the
available modes of accessible transportation nationwide.

Employment: The dignity, responsibility and economic independence
resulting from gainful employment is one of the most effective ways of
enhancing self-reliance, changing attitudes, reducing dependency on
public benefits and promoting community acceptance of people with
disabilities.

DOL will undertake an Olmstead Community Empowerment Initiative,
developing and implementing a coordinated strategy to ensure that all DOL
policies and activities fully address the employment and training needs
of people with disabilities who are at risk of institutionalization or
who are transitioning from an institution to the workplace and community
living.

DOL will award Olmstead Community Employment Planning and Implementation
Grants to states that develop an employment focus for persons with
disabilities in their Olmstead state implementation plans and incorporate
activities coordinating employment and related supports at the state and
local level.

ED will coordinate with state vocational rehabilitation agencies and
state education agencies to evaluate and improve transition services
provided to youth with disabilities who are making the transition from
school to work or to postsecondary education.

Education: Young people with disabilities face particular barriers to
succeeding in school and going to college. Low educational attainment and
confusing government programs and benefits have resulted in many young
people with disabilities not making successful transitions from school to
post-secondary education, employment and independent living.


ED's Office for Civil Rights will prepare a resource document for
nationwide distribution targeted to parents and students that clarifies
the rights of students and the obligations of schools as students with
disabilities transition from high school to postsecondary education and
will carry out training and technical assistance initiatives in this
area.

ED's Office of Special Education Programs will engage in activities to
ensure compliance with requirements of federal special education laws for
transition planning and transition services so that students and families
may be better prepared for the challenges and complexities of the adult
world.

Access to Technology: Assistive technological devices enable people with
disabilities to live independently or reduce their need for other
assistance services. Technology also provides a gateway to a wealth of
information about employment opportunities, community events and
educational forums and has fundamentally changed the skills and knowledge
needed to fully participate in the 21st century workplace.

DOL will work with ED, HHS, the Department of Agriculture and other
agencies to coordinate and implement a plan that improves the
availability, affordability and accessibility of technology in the
school, home and workplace for youth and adults with significant
disabilities.

Accountability and Legal Compliance: There is a need for an array of
activities to promote states' compliance with the Olmstead decision,
including: greater federal oversight of programs that serve people with
disabilities; stronger enforcement of laws that protect the rights of
people with disabilities; guidance to states on effective planning to
provide services in the most integrated setting; and greater and more
effective outreach to assist individuals with disabilities and their
family members in understanding the ADA and Olmstead's requirements.

DOJ will use its Fair Housing Testing program to identify patterns or
practices of discrimination against individuals with disabilities by
those who sell or rent housing.

DOJ will expand the use of its mediation program for Olmstead-related
claims, including: providing additional training to mediators regarding
the decision; investigating ways to train lay advocates; and working
toward implementing a formal arrangement under which HHS' Office for
Civil Rights would refer appropriate unresolved complaints to DOJ for
mediation.

Public Awareness, Outreach and Partnerships: Many people with
disabilities and their families are not aware of the full range of
community services that are available to them. Outreach to provide
information and incorporate the views of people with disabilities and
other stakeholders into federal policy will help fill this knowledge gap.


DOL will launch a comprehensive public awareness campaign to decrease
stigma, eliminate attitudinal barriers, and increase employment
opportunities for adults and youth with significant disabilities. The
campaign will target business and industry, lenders and families among
others.

DOJ will develop technical assistance documents to educate people with
disabilities living in institutions or at-risk of living in institutions
about their rights and to assist states in implementing their
community-integration responsibilities under the Olmstead decision.

Income Supports: Cash and medical benefits can be critical to an
individual's ability to live in the community. Cash benefits, often in
conjunction with food stamps and housing subsidies, can provide for basic
needs such as food, clothing and shelter. Medical benefits can enable
someone to obtain treatment that may be critical to his or her ability to
function in a community setting. Of course, work also contributes
significantly to an individual's ability to thrive in a community
setting.

SSA is providing special training to agency staff who serve the public
directly, emphasizing the importance of key policies and procedures to
assist people with disabilities and promote the community-integration
goals of the Olmstead decision.

Gathering, Assessment and Use of Data: The successful integration of
people with disabilities into community settings requires consistent data
collection to measure the progress of existing programs and initiatives
and to determine the specific needs of people with disabilities.

HHS' Centers for Medicare & Medicaid Services will work with states,
universities, foundations and others to ensure that there is an adequate
base of knowledge to inform public policy-making regarding: the impact of
the Medicaid and Medicare actions under the President's Executive Order;
state initiatives to improve community living services; methods for
designing long-term care systems so that they promote the ADA and can
address the population growth expected due to demographic changes; and
methods for designing quality assurance and improvement systems uniquely
suited for services in one's own home.

HUD will conduct a "Housing Choice Voucher Tenant Accessibility Study" to
assess the feasibility of conducting a nationwide mail survey of voucher
program enrollees who have disabilities regarding their experiences in
searching for accessible housing.

Cross-Agency Collaboration and Coordination: In order to effectively meet
the needs of individuals with disabilities and to efficiently utilize
federal resources, the various federal agencies that develop disability
policy and provide, fund and support community-based services will
communicate about and collaborate on their objectives.

HHS proposes that the President formalize and permanently establish the
ICCL, which Secretary Thompson convened to accomplish the tasks set out
in Executive Order 13217. The council would articulate a strategic
interagency plan to expand and promote home- and community-based services
as well as issues related to housing, employment, the long-term care
workforce, assistive technology and education.

DOL's Office of Disability Employment Policy will work to develop a
memorandum of understanding (MOU) with other federal agencies to work
together to improve resources and employment opportunities for people
with disabilities. The MOU will serve as a model for state-level
coordination to ensure that employment becomes part of the planning
process for people transitioning from institutional care into the
community.

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