DELAWARE
Long-term care activity in Delaware centered around planning efforts to assess the status of the state's home and community-based services and to develop further plans for expanded community alternatives to nursing homes. A federal grant allowed the state to plan to move some people from nursing homes into the community.
Planning and Reports
On the last meeting of the session of the Delaware General Assembly on June 30, 2002, the House of Representatives passed House Resolution 90, which created a Commission on Community-Based Alternatives for Persons with Disabilities. Commission members include representatives of advocacy groups, consumers, and service providers. A report, A Call to Action: Building a Community-Based Plan for Delaware, was released in March 2003, listing the following goals to be provided to people with disabilities.
- Establish a systematic, simplified and fair process for assessing individual needs. Create a comprehensive database of the number of people who currently have access to or are waiting for services, and the methods to facilitate this move for individuals who move from one setting to another.
- Provide safe, affordable and appropriate housing and transportation options.
- Create a coordinated, comprehensive and affordable health care system.
- Center quality vocational services and supports around an individual's strengths, preferences and capabilities.
In October 2002, four divisions of the Delaware Department of Health and Social Services released a "Plan for Community-Based Alternatives and 'Olmstead' Compliance." The four agencies are the Division of Social Services, the Division of Developmental Disabilities Services, the Division of Substance Abuse and Mental Health, and the Division of Service for Aging & Adults with Physical Disabilities.
The report does not include any recommendations, nor does it provide an action plan. Rather, the report provides an overview of the state's progress in providing community-based alternatives and in moving people with disabilities from institutional to community care. For example, the report describes the state's efforts over the years to relocate people with mental retardation/developmental disabilities from the Stockley Center and people with mental illness from the Delaware Psychiatric Center. The population at the Stockley Center has decreased from 555 residents in 1975 to 179 in 2002. From a peak population of 1,530 residents in 1965, the Psychiatric Center population dropped to 248 residents in 2002.
In spring 2002, The Arc of Delaware sued the state, claiming that Delaware had not moved quickly enough to provide group homes and other services for those with disabilities. The organization contended that the state had limited its efforts largely to moving people out of institutions, instead of developing services that would help people remain in their homes. State officials said that about 300 people were on a state registry for residential placements, such as group homes, foster homes or supervised apartments.
Grant Initiatives
The Delaware Department of Health and Social Services received a $566,772 grant from the Centers for Medicare and Medicaid Services to develop a program to move 15 people from nursing homes to community settings. The state also planned to use the grant funds to educate the provider and housing communities about the program.
Home Health
The legislature enacted new standards in 2002 for public health quality assurance in home health agency programs. The law defines a home health agency under Delaware law and spells out staffing standards, permissible services and prohibited practices for these agencies.
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