MISSISSIPPI

The Medicaid Division issued its first progress report on its Olmstead plan, Mississippi Access to Care (MAC), on May 30, 2003. The progress report entitled Implementation Report #, identifies those recommendations in the MAC plan that have been implemented and those that have not. Both the original MAC plan and the new implementation report can be accessed at http://www.mac.state.ms.us.

Because of the state's fiscal crisis, several of the system change recommendations regarding housing, transportation, assessment, training and consumer education were not implemented. In addition, the MAC plan called for the designation of a MAC Oversight Committee to monitor the MAC plan and to create one-stop centers for caregivers and people with disabilities to more readily access important long-term care information and resources. Neither goal was realized. In addition, home and community-based waiver waiting lists continue to grow, even though the state is now serving more people under its waivers. During the past five years, the state experienced greater than 200 percent growth in its waiver programs, but the current state budget has made it impossible to sustain that growth.

Despite that fact that the Legislature did not appropriate any new, significant funds for implementation activities, state agencies continue to implement many recommendations within their existing agency budgets and to apply for several federal grants. In fact, the MAC is being implemented not by any type of stated priority but through new federal grant fund awards. The state received a $1.385 million Real Choice Systems Change Grant for person-centered discharge planning for people with mental illness between the ages of 17 and 25. Under the grant, a team of professionals assists adults diagnosed with mental illnesses make the transition from state mental health hospitals to community settings. The state also was awarded a new Ticket to Work grant in April 2003 to assist in reaching out to workers with disabilities to let them know about their options for buying into the Medicaid program. In addition, the state has applied for new federal grants to create the resource centers and to better serve children with mental illness.

The 2003 Legislature removed certain restrictions on the home and community-based services waiver program. Specifically, House Bill 897 removes a 5 percent reimbursement reduction for case management services under the home and community-based program for the elderly and disabled provided by a planning and development district and prescribes a rate of reimbursement for such services and a funds transfer requirement.

The MAC network that issued the 2001 plan no longer is active. However, the Governor's Commission for People with Disabilities is meeting quarterly and is working on a report of recommendations to the governor. Using the MAC plan and the implementation report. In addition, state agency officials are committed to implementing the plan despite a lack of funds. Officials plan to issue a second implementation report in the future, although no specific release date has been set. As one state official said, "The commitment is there, but the fiscal situation is so dire."