Olmstead Status: Massachusetts

Massachusetts

Task Force

The Executive Offices of Health and Human Services, Administration and Finance and Elder Affairs, in consultation with an Olmstead Advisory Group, issued "Enhancing Community Based Services: Phase One of Massachusetts' Plan" on July 31, 2002. It is located at http://mass.gov/resources/ecbs_plan.pdf

The governor directed members of her cabinet to develop this written plan and appointed an advisory group, known as the Olmstead Advisory Group, to provide insight and recommendations to the agencies involved with planning. The Olmstead Advisory Group held a series of listening sessions between November 2001 and January 2002 where nearly 1,000 people provided testimony.

In consultation with the Olmstead Advisory Group, the Interagency Leadership Team (consisting of the agencies listed above) is continuing to provide leadership and policy direction, will establish a Real Choice Consumer Task Force.

Disability advocates, in general, were unhappy with the state plan. As a result, the People's Olmstead Plan, spearheaded by the Massachusetts Statewide Independent Living Council and others, was published in January 2003 to be used as a tool and resource in the construction of a Massachusetts Olmstead plan. It is located at http://www.masilc.org/docs/peoples.html

The Plan

Phase One includes 62 activities to be implemented in FY 2003. Highlights of Phase One include:

Continuing to target for community placement individuals for whom community placement is desired and available;
Educating individuals residing in facilities, as well as their families and support systems, about the array of community-based services and residential options available, their eligibility, and then documenting their preferences;
Identifying information related to individuals with disabilities who reside in public facilities and could relocate safely to the community and either provide or document the absence of necessary services and supports;
Require that all state agencies offering long-term care pre-screen Medicaid eligible beneficiaries seeking facility-based services for the possibility of community-based care;
Designing and implementing pilot projects to evaluate different models of service coordination for community-based individuals and individuals wishing to leave a facility;
Completing the implementation of new income disregards in determining MassHealth eligibility for personal care attendant services to include people aged 65 or older;
Identifying improvements to expedite the approval of medical equipment, assistive technology and personal care attendant services prior approvals; and
Improving the availability of accessible and affordable housing.

Implementation of Phase One began in August 2002. The activities are being implemented using existing resources, including current appropriations and Real Choice Systems Change, Nursing Home Transition and Medicaid Infrastructure grants.

Implementation

Legislation

There was no 2002 legislation related to the Olmstead decision.

Successes

The advisory group met regularly and has issued Phase One of the plan.

Challenges

The lack of funding is the largest barrier for the state. There have been cuts in funding, and the state has a revenue shortfall for FY 2003.

Lawsuits

For an update on lawsuits in Massachusetts and other states, 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

Next Steps

Massachusetts applied for and received a $1.025 million Real Choice Systems Change Grant from CMS. This money is being used to enhance existing community-based services.

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