ALABAMA

Alabama had not completed its Olmstead plan as of August 2003, but the 40-member work group that has been developing the plan continues to meet. State officials said that the "meat of the plan" was being pulled together at that time. Although the full committee does not meet regularly, one or more of the four subgroups has been meeting periodically (Needs Assessment, Best Practices, Consumer Task Force, and Resource Development and Coordination).

The Alabama Medicaid Agency is the lead agency for the Olmstead Planning Initiative, in collaboration with the Governor's Office on Disabilities. These agencies hope to complete the plan and incorporate public comments before the Legislature meets in February 2004. State funding problems are providing a context in which the plan is being developed; state officials and work group members are cognizant of state budget issues and looking at other alternatives if funding becomes more of a problem. Voters were asked in a September 9, 2003, statewide referendum to support a package of tax and revenue initiatives that would have netted an additional $1.2 billion in revenue. However, the referendum failed by a two-to-one margin, so state officials say they will have to "go back to the drawing board" in regard to Olmstead initiatives.

Meanwhile, state officials point to several projects that have moved forward since the Olmstead planning process began in August 2000. These include approval by the federal Centers for Medicare and Medicaid Services of three Medicaid home and community-based waiver programs: Technical Assistance for Adults, Specialty Care for Assisted Living, and AIDS. Also, a $2 million federal Systems Change Grant has provided funds for the creation of an Outreach and Education unit in the Medicaid agency. State officials credit this unit with helping develop public understanding of the process and policies of Medicaid community services.

Some obstacles faced early in the Olmstead planning process, say state officials, included "getting buy-in" from state agencies themselves. They had to sign on to "new terms and new concepts," officials say. Funding has always been a problem, they add, as has ensuring that the disability groups are put at the forefront of planning efforts. They credit the creation of the Outreach and Education unit with helping the public learn "who we are." The staff members of this unit and the director of the Medicaid Long-Term Care Division have made numerous presentations to groups around the state.

State officials also point out that the makeup of the 40-member work group that has been drafting the Olmstead plan is more than 50 percent consumers and advocates. "They feel like they're a part of the process now," said one state official. "They're kept involved and kept informed."