Dear list members,
This is my final report on the FamiliesUSA conference. As I wrote
before, although these are not strictly PD issues, I believe they are
important to all Americans living with chronic illness and disabilities,
and could affect any of us now or in the future.
Workshop : Olmstead update : How States are Expanding Home and
Community-Based Care. Speakers were:
Claudia Schlosberg: DHHS Office for Civil Rights.
Kirsten Dunham, Missoui OLmstead StakeHolders group
Background on Olmstead Supreme Court Decision 1999
Olmstead v. L.C. and E.W., 119 S.Ct. 2176 (1999) found the denial of
community placements to individuals with disabilities is segregation -
that Congress sought to eliminate in passing the Americans with
Disabilities Act (ADA).
The Supreme Court noted that unnecessary segregation and
institutionalization constitute discrimination and violate the ADA's
"integration mandate" unless certain defenses are established.
Additionally on November 26, 1999, the U.S. District Court for the
District of Hawaii issued a decision in Makin v. Hawaii, (a class action
brought on behalf of individuals with Mental Retardation living at home
without appropriate services,)that the integration mandate of Title II
applies to persons at risk of institutionalization and not only to those
already institutionalized.
Overview of workshop:
- Failure of states to provide community services to disabled is illegal
discrimination under ADA.
- Integration is mandated. Civil right to treatment in the community,
but it must be appropriate and require reasonable accommodations.
- Changes to Medicaid are needed -- currently promotes nursing homes
over community care. It is up to each state to comply with Olmstead
decision. So far:
--Only 12 governors have issued executive orders requiring their
Social services agencies to plan for compliance.
-- Only 17 states are currently developing plans.
- 225 Olmstead complaints were filed with the US Office of Civil Rights
so far.
- New federal grant money is available for states to bring their Medicaid
programs into compliance with Olmstead. Among them are :
Real Choice Systems Change Grants: to promote the design and delivery of
home and community-based services that support individuals with a
disability or chronic illness to live and participate in their
communities. $50 million available for this initiative.
Community-Based Attendant Services with Consumer Control: Grants totaling
$5-8 million will be available in 2001 to support State efforts to
improve community-based personal assistance services that are designed to
ensure that people who have a disability or chronic illness have maximum
control over their lives.
Kirsten Dunham from the Missoui OLmstead StakeHolders group reported on
the progress made in Missouri, which seems light-years ahead of other
states. (Jeanette, you should be proud! :) Among their accomplishments:
- formation of an advocacy group (Missoui OLmstead StakeHolders) which
worked with state agencies and legislators to gather info. on Medicaid
policies and devised an Olmstead implementation plan.
- Gov. Mel Carnahan issued an Executive Order establishing a HJOme and
Community-Based Services and Consumer-Directed Care Commission.
- Olmstead language was incorporated in Missouri's Social Services Budget
bill
-- A final report and recommendations for "Improving Missouri's Delivery
System for Persons with Disabilities" was issued in Dec. 2000. They are
working now on trying to implement the recommendations.
For more info:
For Complaints : There is a Olmstead contact person in each Regional
Office of Civil Rights, US Dept. of Justice.
web sites:
Olmstead advocacy -See http://www.protectionandadvocacy.com/lcolmste.html
Center for Health Care Strategies http://www.chcs.org/
ADA/Olmstead website at
http://www.hcfa.gov/medicaid/olmstead/olmshome.htm.
A Primer for Ways Medicaid may Assist with Home and Community Based
Services is available online at http://aspe.hhs.gov/daltcp/whatsnew.htm.
If anyone would like more detailed info -- let me know.
Linda
