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From: Virtual Majordomo Account [mailto:[log in to unmask]]On
Behalf Of Justice For All Moderator
Sent: Tuesday, January 18, 2000 1:34 PM
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Subject: Teleconference on Letter to Medicaid Directors on Olmstead


                      Justice For All

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  Teleconference on Letter to Medicaid Directors on Olmstead

Bob Williams ([log in to unmask]) writes about call today:

What:  Teleconference about letter to Medicaid Directors on Olmstead

WHEN: Tuesday, January 18, 2000, 3:30 PM-4:30 PM, EST

CALL-IN #: 410-786-7374.


ú    The State develops a plan or plans to ensure that people with
disabilities
are served in the most integrated setting appropriate.  It considers the
extent
to which there are programs that can serve as a framework for the
development of
an effectively working plan.  It also considers the level of awareness
and
agreement among stakeholders and decision-makers regarding the elements
needed
to create an effective system, and how this foundation can be
strengthened.

ú    The plan ensures the transition of qualified individuals into
community-based settings at a reasonable pace.  The State identifies
improvements that could be made.

ú    The plan ensures that individuals with disabilities benefit from
assessments to determine how community living might be possible (without
limiting consideration to what is currently available in the community).
In
this process, individuals are provided the opportunity for informed
choice.

ú    The plan evaluates the adequacy with which the State is conducting
thorough, objective and periodic reviews of all individuals with
disabilities in
institutional settings (such as State institutions, ICFs/MR, nursing
facilities,
psychiatric hospitals, and residential service facilities for children)
to
determine the extent to which they can and should receive services in a
more
integrated setting.

ú    The plan establishes similar procedures to avoid unjustifiable
institutionalization in the first place.

Plan Development and Implementation Process

Principle:  Provide an opportunity for interested persons, including
individuals
with disabilities and their representatives, to be integral participants
in plan
development and follow-up.  When effectively carrying out this
principle:

ú    The State involves people with disabilities (and their
representatives,
where appropriate) in the plan development and implementation process.
It
considers what methods could be employed to ensure constructive,
on-going
involvement and dialogue.

ú    The State assesses what partnerships are needed to ensure that any
plan is
comprehensive and works effectively.

Assessments on Behalf of Potentially Eligible Populations

Principle:  Take steps to prevent or correct current and future
unjustified
institutionalization of individuals with disabilities.  When effectively
carrying out this principle:

ú    The State has a reliable sense of how many individuals with
disabilities
are currently institutionalized and are eligible for services in
community-based
settings.  The plan considers what information and data collection
systems exist
to enable the State to make this determination.  Where appropriate, the
State
considers improvements to data collection systems to enable it to plan
adequately to meet needs.

ú    The State evaluates whether existing assessment procedures are
adequate to
identify institutionalized individuals with disabilities who could
benefit from
services in a more integrated setting.

ú    The State also evaluates whether existing assessment procedures are
adequate to identify individuals in the community who are at risk of
placement
in an unnecessarily restrictive setting.

ú    The plan ensures that the State can act in a timely and effective
manner in
response to the findings of any assessment process.

Availability of Community-Integrated Services

Principle:  Ensure the Availability of Community-Integrated Services.
When
effectively carrying out this principle:

ú    The plan identifies what community-based services are available in
the
State.  It assesses the extent to which these programs are able to serve
people
in the most integrated setting appropriate (as described in the ADA).
The State
identifies what improvements could be accomplished, including in
information
systems, to make this an even better system, and how the system might be
made
comprehensive.

ú    The plan evaluates whether the identified supports and services
meet the
needs of persons who are likely to require assistance in order to live
in
community.  It identifies what changes could be made to improve the
availability, quality and adequacy of the supports.

ú    The State evaluates whether its system adequately plans for making
supports
and services available to assist individuals who reside in their own
homes with
the presence of other family members.  It also considers whether its
plan is
adequate to address the needs of those without family members or other
informal
caregivers.

ú    The State examines how the identified supports and services
integrate the
individual into the community.

ú    The State reviews what funding sources are available (both Medicaid
and
other funding sources) to increase the availability of community-based
services.
It also considers what efforts are under way to coordinate access to
these
services.  Planners assess the extent to which these funding sources can
be
organized into a coherent system of long term care which affords people
with
reasonable, timely access to community-based services.

ú    Planners also assess how well the current service system works for
different groups (e.g. elderly people with disabilities, people with
physical
disabilities, developmental disabilities, mental illness, HIV-AIDS,
etc.).  The
assessment includes a review of changes that might be desirable to make
services
a reality in the most integrated setting appropriate for all
populations.

ú    The plan examines the operation of waiting lists, if any.  It
examines what
might be done to ensure that people are able to come off waiting lists
and
receive needed community services at a reasonable pace.

Informed Choice

Principle:  Afford individuals with disabilities and their families the
opportunity to make informed choices regarding how their needs can best
be met
in community or institutional settings.  When effectively carrying out
this
principle:

ú    The plan ensures that individuals who may be eligible to receive
services
in more integrated community-based settings (and their representatives,
where
appropriate) are given the opportunity to make informed choices
regarding
whether -and how- their needs can best be met.

ú    Planners address what information, education, and referral systems
would be
useful to ensure that people with disabilities receive the information
necessary
to make informed choices.

Implications for State and Community Infrastructure

Principle: Take steps to ensure that quality assurance, quality
improvement and
sound management support implementation of the plan.  When effectively
carrying
out this principle:

ú    Planners evaluate how quality assurance and quality improvement can
be
conducted effectively as more people with disabilities live in community
settings.

ú    The State also examines how it can best manage the overall system
of health
and long term care so that placement in the most integrated setting
appropriate
becomes the norm.  It considers what planning, contracting and
management
infrastructure might be necessary to achieve this result at the State
and the
community level.

Bob Williams
[log in to unmask]

--
Fred Fay
Chair, Justice For All
[log in to unmask]
http://www.jfanow.org

Register to Vote Online at http://www.fec.gov/votregis/vr.htm

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