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State Legislatures and the Olmstead Decision : What’s the Latest? Independent Living Research Utilization Webcast July 17, 2002 Jo Donlin Senior Policy Specialist National Conference of State Legislatures. Goals of this Presentation.

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Goals of this Presentation

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  1. State Legislatures and the Olmstead Decision :What’s the Latest?Independent Living Research Utilization WebcastJuly 17, 2002Jo DonlinSenior Policy SpecialistNational Conference of State Legislatures

  2. Goals of this Presentation • Summarize survey results from The States’ Response to the Olmstead Decision • Highlight opportunities and challenges • Review the role of state legislatures in implementing the Olmstead decision • Summarize current NCSL Olmstead activities

  3. The States’ Response to the Olmstead Decision • NCSL Survey - An Ongoing Project • 1st Report Released March 2001 • 2nd Report Released December 2001 • New Update in Progress - More to Come

  4. The States’ Response to the Olmstead Decision • Bulk of activity has been in the Executive Branch • 40 states plus D.C have established task forces, commissions or state agency work groups (as of December 2001) • appointed by governors, legislators and health commissioners • few involved legislators • broad scope

  5. The States’ Response to the Olmstead Decision • States are focusing efforts on developing state plans • 18 states have some type of written report or plan: AZ, CT, DE, GA, IL, IN, IA, KY MD, MO, MT, NC, OH, OK, SC, TX,WI, WY • 4 stand out as “comprehensive and effectively working”: MS, MO, OH, TX • 8 other states have plans in the works • States are not required to do a state plan

  6. Jan. 14, 2000 Guidance letter from HCFA & OCR Develop & implement a … plan for … services … in more integrated, community-based settings Involve consumers in plan development and follow-up Prevent or correct unjustified institutionalization Ensure availability of community-integrated services Provide opportunity for consumer informed choices Address quality assurance & sound management State Plan Guiding Principles

  7. Housing Transportation Waiver program expansion Transitioning individuals Data collection Staffing Assessment Consumer/provider/ agency education & outreach The States’ Response to the Olmstead Decision Commissions have made recommendations that address 8 major issues:

  8. The States’ Response to The Olmstead Decision • In 2001, little legislative activity directly related to Olmstead but… • MO enacted a wage pass through for MR/DD caregivers; funds for training staff and individuals; $$ for transition costs and added a personal care benefit to the Medicaid plan • MD expanded its waiver to 300% of the supplemental security income eligibility level • TX expanded all six waiver programs

  9. Challenges and Opportunities • Challenges • Budget Shortfalls • Housing • Workforce Shortage • Transportation • Data Collection

  10. Challenges and Opportunities • Opportunities  Everyone’s Involved - Working Together  Federal Government is Helping • CMS Guidance Letters • “Real Choice Grants” • New Freedom Initiative • Administration’s policy on removing barriers to equality for 54 million Americans living with a disability • Latest development, new independence template waivers

  11. Legislature’s Roles in Implementation • If you haven’t involved your legislature, now is the time! • Why Should you Care? • Control the purse strings • Establish programs • Enact requirements • Provide oversight

  12. Legislature’s Role in Implementation • Medicaid • long-term care accounts for 35% of all state and federal Medicaid funds. • Olmstead will affect Medicaid budgets • Other State Programs are Involved • Housing, Transportation, Vocational Rehabilitation

  13. Term Limits, Elections & Redistricting - Oh My! • Combination could cause 25% turnover • AZ, AR,CA, CO, FL, ID, LA, ME, MI, MO, MT, NE, NV, OH, OK, OR, SD, UT, WY • Opposition and supporters leave • Continuing education process • Severe transitions in some states • Michigan Senate: 71% new • Missouri House: 45% new

  14. Don’t: Assume you don’t count Wait Until Session Mislead or give false information Make enemies Be too narrowly focused Refuse to compromise Go on and on . . . Give up Dos and Don’ts DO: • Get involved (year round) • Be accurate, reliable, honest, concise, and vigilant • Build relationships early • Offer to be a resource • Be inclusive of others • Have written materials • Personalize the issue/take a field trip • Thank your audience

  15. NCSL Olmstead Activities • The jury is still out. Early stages of implementation. • Continue to Educate Legislatures about Olmstead vs. L.C.- publications, meeting, website • Tracking State Activities • state plans • legislative activity • Providing technical assistance

  16. Resources • NCSL Olmstead website • http://www.ncsl.org/programs/health/disabil2.htm • Centers for Medicare and Medicaid Services • http://www.hcfa.gov • National Technical Assistance Exchange • Susan Reinhard, Rutgers University, Center for State Health Policy, 732-932-3105, x230 • Richard Petty, Independent Living Research Utilization, 713-520-0232

  17. Contact Information Jo Donlin National Conference of State Legislatures jo.donlin@ncsl.org 303-830-2200, x130 Wendy Fox-Grage National Conference of State Legislatures wendy.fox-grage@ncsl.org 202-624-3572

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