Georgia Olmstead Settlement Agreement - Summary

On July 1, 2008, HHS OCR entered into a statewide Olmstead settlement agreement with Georgia to expand community alternatives to institutionalization for individuals with disabilities. The comprehensive settlement agreement ensures that more than 2,500 persons in Georgia with intellectual and developmental disabilities (DD) and mental illness (MI) institutionalized in Georgia's seven public psychiatric hospitals and mental retardation facilities will have the opportunity to live in their communities with appropriate supports tailored to meet their individualized needs. This is the first statewide Olmstead settlement agreement covering all public psychiatric hospitals and mental retardation facilities in a state, and effectuates the U.S. Supreme Court decision in Olmstead v. L.C., 527 U.S. 597 (1999), which requires states to provide services in the most integrating setting, i.e. the setting that enables people with disabilities to interact with people without disabilities to the fullest extent possible.

The agreement resolves complaints filed by four State advocacy groups - Georgia Advocacy Office, Atlanta Legal Aid Society, Georgia Legal Services Program, and the Disability Law and Policy Center of Georgia. The complaints alleged that, in violation of the Americans with Disabilities Act, Georgia failed to treat qualified individuals with mental retardation/ developmental disabilities and mental health disabilities in the most integrated setting appropriate to their needs.

Under the agreement, Georgia recognizes that all persons with DD can be treated in the community with the appropriate supports and services, and commits to building an adequate community network of services and supports. Georgia also commits under the agreement within five years to move all qualified persons with DD into the community who do not oppose it, while simultaneously providing supports and services to persons with DD who are in the community but at risk of institutionalization. Similarly, Georgia agrees to develop adequate community mental health services and to place all persons with MI into the community when the State's treatment professionals determine that they are appropriate for community services. The State will reassess those deemed by treatment professionals as not appropriate for community services when there are clinically relevant changes in their condition or every 30 days, whichever comes first. Community services provided to persons with DD and MI will be based on a person-centered planning process to meet the individual's needs and preferences, and will include the full range of services and supports needed to live independently in the community.

Georgia also has agreed to: (1) appoint an Olmstead coordinator in the Governor's Office who will have primary responsibilities for assuring the State's compliance with the Agreement. State agencies with Olmstead responsibilities will report to the Olmstead Coordinator and must develop their budgets with the Olmstead Coordinator, who will ensure that the agencies' budgets adequately fund services and supports required by the Agreement; (2) establish an Olmstead Planning Committee composed of consumers, advocates, state officials, and treatment professionals; (3) develop a revised State Olmstead Plan, approved by the Olmstead Planning Committee within 7 months, that covers all institutionalized persons (in public or private facilities) and those at risk for institutionalization; (4) appoint two expert consultants who will review assessments and transition plans for individuals with DD and MI and provide corrective feedback and technical assistance to the state's professionals to help develop the supports and services needed for transition into the community; (5) provide quarterly reports over the five years of the agreement to OCR, the expert consultants, and the Olmstead Planning Committee, identifying all significant delays in transitioning people into the community and updating all corrective actions planned and completed; and (6) issue for public distribution an Annual Olmstead Report from the Olmstead Planning Committee detailing progress achieved, including the number of individuals leaving State-facilities, the number of individuals in the facilities, the number of persons waiting for community services, the policy changes made, and the actions planned in the year ahead.

Georgia's implementation of the agreement will rely, in part, on a $44 million dollar Money Follows the Person Rebalancing Demonstration Grant, which was awarded to the state by the HHS Centers for Medicare & Medicaid Services on June 30, 2008. This grant will allow Georgia more quickly to shift the emphasis of its Medicaid program away from long-term institutional care to a system that offers seniors and qualified individuals with disabilities consumer choice in the community. In addition, experts from HHS' Substance Abuse and Mental Health Services Administration will work with Georgia officials to develop the state's community mental health infrastructure to carry out the requirements of the agreement.