DELAWARE

Delaware is working with two recent reports that address Olmstead-related issues:

• The State of Delaware's Plan for Community-Based Alternatives and 'Olmstead' Compliance, developed by the Delaware Department of Health and Social Services, and published in October 2002, provides an overview of the state's progress in moving people with disabilities from institutional to community care and in expanding community-based alternatives to institutionalization. The plan can be found at http://www.state.de.us/dhss/admin/cbaolmstead.txt.
• Call to Action: Building a Community-Based Plan for Delaware, the work of the Commission on Community-Based Alternatives for Persons with Disabilities, was published in the spring of 2003. The commission was created by the Delaware House of Representatives in July 2002. Its members included a legislator and representatives of advocacy groups, providers and consumers.

Advocates for people with disabilities contend that the State of Delaware's Plan is neither broad-based nor comprehensive enough because it merely reports on existing programs and services for people with disabilities and addresses only a few system change issues. These include reducing the population at the Stockley Center for people with developmental disabilities and the Delaware Psychiatric Center for people with mental illness.

Commission members call their Call to Action report "a blueprint," to stimulate dialogue with state policymakers and the public. They said they have taken the report across the state to present it to the public, and they have discussed it with legislators and other state officials. They deliberately avoided setting timelines for the recommendations in the plan or including dollar amounts, they added, because of the realities of the state's budget problems.

State contacts said they were encouraged by the dialogue the commission has been having with the Minner administration since the development and publication of Call to Action. Having "all parties (state officials and stakeholders) come to the table," they say, is one of the priority recommendations listed in the report. Another key priority is implementation of a universal, cross-disability assessment process. A portion of the federal Systems Change grant that Delaware received to facilitate transitions of some nursing home residents to the community is going to the development of an assessment tool to determine individualized supports and service capacity for individuals with disabilities.

The State of Delaware's Plan notes that, although Delaware did not have a written Olmstead plan prior to the Olmstead decision, the state has been making "substantial efforts to expand placements in community settings." Officials point out that the number of residents at the Stockley Center has decreased steadily from 555 residents in 1975 to 423 in 1985, 308 in 1995, and 179 in 2002. The Division of Developmental Disabilities Services reports that it has in recent years placed 24 residents from Stockley annually into community residences, and will continue that process for an additional two to three years until all residents who can reasonably live outside the facility are accommodated. The division also says it plans to provide community services for another 35 to 40 people in the "urgent" category of its "registry" or waiting list.

The Delaware Psychiatric Center had a peak population of 1,530 residents in 1965; that total dropped to 248 in 2002. The Division of Substance Abuse and Mental Health (DSAMH) reported a 21 percent decline in the facility's average daily census between July 2001 and July 2002. DSAMH has opened several group homes and multiple supervised apartment programs.

However, the Medicaid home and community-based waiver program for people with developmental disabilities has been modified to reduce the cap on the number of slots. The federal government had approved 900 waiver slots for FY 2002-2003 and 1,000 slots for FY 2003-2004. Budgetary problems caused the Division of Developmental Disabilities Services to cap the slots at 564 and 574 for those years.