Summer 2000                                               OCR UPdate - 4

OCR Works to Implement Olmstead

In the year since the U.S. Supreme Court's landmark decision in Olmstead v. L.C., OCR has been immersed in Olmstead-related activities. Substantial progress is being made, although considerable work lies ahead. The decision itself held that unnecessary institutionalization of individuals with disabilities is discrimination under the Americans with Disabilities Act (ADA). The Court suggested that states can demonstrate compliance by showing that they have comprehensive and effectively working plans for providing services to qualified individuals with disabilities in the most integrated setting, along with waiting lists that move at a reasonable pace where such lists exist.

OCR has received more than 150 complaints alleging that states and other public entities have failed to provide services to people with disabilities in most integrated settings. OCR is attempting to resolve these complaints by following the Supreme Court's compliance roadmap: namely, working with all the parties to build comprehensive, effectively working plans for serving qualified persons with disabilities in the most integrated setting appropriate.

We recognize that there is no one-size-fits-all plan that will work for all states. As a result, the bulk of OCR's resources have been focused on working together on a state-by-state basis with state and county officials, individuals with disabilities, advocates, foundations and other stakeholders to increase opportunities for individuals with disabilities to live in their own communities. As a result of Secretary Shalala's leadership and commitment, OCR recently received additional fiscal year 2000 funding directed specifically at Olmstead- related activities.

In over 20 states, OCR is either working with existing coalitions, or has been instrumental in the development of Olmstead planning coalitions. Each of the 10 OCR regions has designated an individual to serve as "Olmstead Coordinator." In some states, special governor's commissions have been established to head Olmstead coalitions. In others, particular disability groups or specific state officials, such as a Medicaid Director, have taken up the challenge of coalition building. These 20 states are engaged in various stages of Olmstead planning. We are continuing to meet with other states to increase this number even further. Momentum is building, and coalition members across the country are "rolling up their sleeves" to get the job done.

OCR is by no means alone in the overall Department of Health and Human Services (DHHS) effort to expand community-based options for individuals with disabilities. Prior to the Olmstead decision, Secretary Shalala established a Department-wide Olmstead working group, co-chaired by OCR Director Tom Perez and Tim Westmoreland of the Health Care Financing Administration (HCFA). The working group has been involved in a number of important matters, such as:

• Earlier this year, a guidance letter was sent to State Medicaid Directors from OCR and HCFA which outlined the Department's view of the Olmstead decision, set forth "technical assistance recommendations" listing principles for Olmstead plan development, and expressed the Department's strong interest in working collaboratively with states;
• At the same time, Secretary Shalala sent a letter to the nation's governors, encouraging them to "place substantial emphasis on developing programs and services for individuals with disabilities that will
• further our shared goal of integrating individuals with disabilities into the social mainstream, promoting equality and maximizing individual choice;"
• The DHHS is examining its own policies, practices and procedures to aid states' compliance with Olmstead by ensuring maximum flexibility. For example, HCFA is developing policy clarifications to promote home and community based services (HCBS) for people with disabilities, and is reviewing possible regulatory changes to promote development of HCBS. Also, the working group continues to solicit feedback from states, advocates and other stakeholders on potential policy or regulatory changes that can be implemented to promote HCBS;
• The working group is collaborating with the Department of Housing and Urban Development to identify ways in which affordable, accessible housing can be made more readily available to individuals with disabilities; and
• The working group is developing additional guidance letters and other forms of technical assistance in response to feedback received from stakeholders, and has developed a website devoted exclusively to Olmstead issues (www.hcfa.gov/medicaid/olmstead/olmshome.htm).

For more information on the progress of Olmstead planning coalitions in your state, contact the OCR office in your region, or Sheila Foran at OCR headquarters at (202)619-0403.

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