ALABAMA
Alabama moved forward on a number of fronts in 2002 to improve and expand access to home and community-based services for people with disabilities, particularly for those with mental retardation or mental illness. With impetus from the state's Olmstead planning process, Alabama received funds from the federal Systems Change grant program and federal approval of new Medicaid home and community-based waiver programs.
Long-Term Care Planning
The Alabama Medicaid Department has been leading the state's Olmstead planning efforts to expand access to home and community-based services for all disability groups. Officials also are involved from the Governor's Office on Disabilities and the departments of Mental Health and Mental Retardation, Human Resources, Senior Services, and Public Health. Olmstead subcommittees, composed of consumers, advocates and agency officials, are expected to consolidate their reports into a draft plan by summer 2003. The four subcommittees are: Needs Assessment, Best Practices, Consumer Task Force, and Resource Development and Coordination.
Mental Health
The state continued to implement the provisions of a three-year plan (October 1, 2000 through September 30, 2003) to downsize state-operated psychiatric hospitals and developmental centers, while expanding community-based service options for people with mental retardation or mental illness. The plan emerged from the January 2001 settlement of a lawsuit, Wyatt vs. Stickney, which established specific assessment procedures to identify those with mental retardation or mental illness.
This activity was aided by federal approval of a new Medicaid Living-at-Home waiver approval, which became effective in October 2002. The program was expected to support up to 500 individuals with mental retardation during the next three years. The new services include personal care, respite care, in-home residential habilitation, day habilitation, pre-vocational services, supported employment, skilled nursing care, physical therapy, community specialist support, and crisis intervention services.
Assisted Living
The federal government also approved the state's use of Medicaid funds to help pay for people with dementia to stay in specialty care assisted living facilities in the state. The program is expected to pay $2,045 per month for each of 500 residents in the first year, for 650 residents the second year, and for 750 people the third year, with the Department of Senior Services providing $5 million to cover remaining costs. Individuals in the program will be expected to pay about $450 per month.
In another development, the Department of Mental Health and Mental Retardation in December 2002 announced the opening of a new Office of Consumer Empowerment to provide people with mental retardation and developmental disabilities (MR/DD) with additional resources for self-advocacy and self-determination. The goals for the office include greater participation for consumers with MR/DD in policymaking and the development of a consumer-driven support system for training, follow-up and mentoring.
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