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Alabama

Task Force

Officials from the Long-Term Care Division of Alabama Medicaid are spearheading the state's planning efforts. They are working with state officials from the Department of Mental Health, the Department of Human Resources, the Department of Public Health, the Governor's Office on Disabilities, representatives from providers groups, consumer advocates and people with disabilities.

Four subcommittees have been formed. These subcommittees are 1) Consumer Direction, 2) Needs Assessment, 3) Best Practices, and 4) Resource Development and Coordination. Each subcommittee is chaired or co-chaired by a stakeholder. The Resource Development and Coordination Subcommittee will compile the recommendations from the other three subcommittees to form the draft plan, which is scheduled to be revised in December 2002 and completed in January 2003 before the legislative session begins in February.

The Plan

To date, the final plan has not been completed. The finalized state plan will focus on expanding access to home and community-based services for all disability groups. The state intends to look at its entire Medicaid program in the next few years, rather than looking at home and community-based services in isolation. The state currently facilitates assessments of institutionalized disabled people for movement into less restrictive care settings, immediately acting on requests from people who want to move back to the community.

Implementation

There was no legislation in 2002 related to the Olmstead decision.

Wyatt vs. Sawyer, a lawsuit settled in 2001, established specific assessment procedures to identify people with mental illness and with developmental disabilities. The plan discusses reduction of institutional beds, discharge planning procedures, development of community placement and certification of providers. Similar procedures likely will be adopted for individuals in nursing homes and those in the Department of Rehabilitation Services' independent living units. For an update on lawsuits throughout the country, see Status Report: Litigation Concerning Medicaid Services for Persons with Developmental and Other Disabilities by Gary A. Smith at http://www.hsri.org/index.asp?id=news

Alabama received a $2 million Real Choice Systems Change Grant. The money is being used to identify successful strategies to recruit and retain in-home workers, including strategies that focus on wages, benefits, training and establishment of a career path. Funds also will support technical assistance regarding consumer self-determination practices to consumers and advocacy organizations and implementation of an assessment process based on consumer preferences.

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