Olmstead Status: Tennessee

Tennessee

Task Force

Tennessee does not have an Olmstead task force. In 1998, prior to the Olmstead ruling, the Long-Term Care Planning Council was created by statute. It was charged with developing a comprehensive, long-term care plan for the state to guide funding, coordination and delivery of long-term care services for Tennesseans, regardless of age, disability or economic status. The Planning Council included the commissioners of Health, Finance and Administration, and Human Services and the executive director of the Commission on Aging. A 16-member Long-Term Care Advisory Council worked with the planning council. In March 1999, the planning council released the Tennessee Comprehensive Plan for the Delivery of Long-Term Care Services to the Elderly and Disabled Persons. The plan focused on extending and expanding home and community-based services, especially through Medicaid waivers, to people with disabilities and the frail elderly.

Due to the concerns about a fragmented delivery system, the Department of Finance and Administration (the agency that houses Medicaid) is seeking to hire a disability coordinator in the near future to coordinate activities across departments and funding sources.

Pre-Olmstead Plan

The planning council identified several principles in the long-term care services plan, including: 1) broad-based education and dissemination of information; 2) services in home and community-based settings to those most financially and medically needy; 3) well-coordinated programs; 4) simplified access to services; and 5) ways of encouraging individuals to take responsibility for themselves and their future. Specific components included:

Developing and implementing a statewide home and community-based waiver;
Developing strategies for extending home and community services to people who do not meet Medicaid eligibility criteria;
Exploring other service options for individuals who need long-term care services;
Enhancing and simplifying consumer and caregiver access to long-term care services for the elderly and physically disabled;
Developing additional information and education initiatives to promote and explain long-term care and additional health-related services;
Pursuing a long-term care insurance partnership program; and
Exploring ways to promote long-term care insurance programs with public and private employers.
The council was expected to continue to meet to monitor the implementation of the programs recommended by the governor and the legislature.

Implementation

Legislation

There was no 2002 legislation related to the Olmstead decision.

Funding

Since the release of the 1999 plan, most state discussions have focused on funding levels for community-based care.

Lawsuits

A lawsuit, Brown vs. Tennessee Department of Mental Health and Developmental Disabilities, is pending in federal court on behalf of individuals with developmental disabilities who are not receiving services. For detailed information on this litigation, see Status Report: Litigation Concerning Medicaid Services for Persons with Developmental and Other Disabilities by Gary M. Smith at http://www.hsri.org/index.asp?id=news

Next Steps

The state of Tennessee received a Real Choice Systems Change Grant of more than $1.768 million in 2002. The money is being used to design and implement a more effective, consumer-directed and accessible housing resource system for people with mental illness. The money also will be used to increase the number of people in quality, affordable housing and to reduce the stigma of mental illness statewide.

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