HAWAII

Like most states, Hawaii has been facing severe budget constraints, and policymakers have been forced to consider whether to cut programs and, if so, which programs. The Olmstead Plan: State of Hawaii, issued in September 2002, identifies goals in information, 'assessment'; financial resources; and housing, transportation and employment. A fifth goal identifies the need to evaluate progress in meeting the objectives of the plan. (The plan is not available on the Web.)

In December 2002, the Department of Health submitted a report to the 2003 Legislature on the implementation of its five-year strategic plan for services and supports for people with mental retardation or developmental disabilities (MR/DD). The report included an assessment of the current system and strategies to address the provision of long-term care services, the wait list for services, self-determination of individuals with MR/DD, and maximization of state and federal funds and other resources.

The report notes that it also was developed to satisfy Olmstead decision requirements and a lawsuit settled in April 2000 (Makin vs. State of Hawaii). The settlement included provisions for providing home and community-based services to at least 700 individuals from the wait list by June 30, 2003 (subject to legislative appropriations), and the development of a plan to move the wait list "at a reasonable pace" after June 30, 2003. Hawaii agreed to seek an estimated $8.75 million annually to clear the waiting list in three years. (In its 2000 session, the Hawaii Legislature approved an additional $4.3 million in state funds for the first stage of the expansion. The 2001 Legislature approved additional funding.)

The state began implementation of an amended Medicaid MR/DD home and community-based waiver in July. Self-direction was a key component of the waiver amendment.

A major component of the information and consumer education goal is Hawaii ACCESS (Accountability for Consumer Choice Entry Support System), which the state says will be the nation's first cross-agency, cross-disability, Web-based single entry point. Hawaii received a $1.3 million federal Systems Change grant in 2002 to develop this system. The system is expected to provide an interactive assessment process to help consumers identify services for which they are eligible and a unified database that will show all long-term care services offered by public and private agencies.