PENNSYLVANIA

The Olmstead task force, known as the Stakeholder Planning Team (SPT), is active. In 2003, the SPT developed a comprehensive document on issues in home and community-based services for the new governor. The SPT provides ongoing input to the Department of Public Welfare on issues related to operation and policy for community programs.

The SPT will complete its planning work in December 2003. State officials will review the plan and work with the SPT and other appropriate stakeholder groups toward implementation.

The Governor also created the Office of Health Care Reform, which will coordinate Pennsylvania's Health Care Reform Agenda. Members of the Governor's Health Care Reform Cabinet include seven state agency officials. In October 2003, the office implemented a three-county pilot project intended to streamline the Medicaid waiver eligibility process for diversion of people from nursing facility care through provision of home and community services.

Through Pennsylvania's Ticket to Work Medicaid Infrastructure Grant, two projects are under way aimed at addressing employment of people with disabilities. The projects will work directly with the state's one-stop career centers (CareerLinks) to improve linkage between the centers and other disability services. Lessons learned in pilot projects in two locations will be used to enhance statewide collaboration with CareerLinks centers, with the goal of increasing employment opportunities for people with disabilities.

In 2002, Pennsylvania received a Real Choice Systems Change grant to "address the barriers of the state's long-term home and community based system of care." One part of this grant's role is to support the Stakeholder Planning Team's efforts to develop Pennsylvania's Olmstead plan; another is to work with the state's Developmental Disabilities Council, stakeholders and state agencies to explore the feasibility of an Independence Plus waiver.

In light of state budget shortfalls, some implementation of the Olmstead decision may be delayed until the state fiscal picture improves, but "plans and programs designed to encourage living in the home and community will continue in Pennsylvania." The Governor's Office of Health Care Reform, for example, is implementing a second long-term care rebalancing pilot project in early 2004.

Pennsylvania received three Systems Change grants from the Centers for Medicare and Medicaid Services that will assist with itsOlmstead efforts. These grants are for Quality Assurance and Quality Improvement in Home and Community-Based Services; creation of an Aging and Disability Resource Center; and Money Follows the Person. The Office of Health Care Reform is coordinating grant efforts as part of a collaborative state government process that will include stakeholders.