From Steve Gold, June 22, 2009
June 22, 2009, marks the 10th anniversary of the Supreme Court's Olmstead decision, holding unnecessary institutionalization violated the Americans with Disabilities Act. The decision requires states to move people, who want to live in the community, out of institutions.
I am sponsoring a national contest to determine which States have best implemented the 1999 Olmstead mandate. Points will be awarded for each of the following categories. A nationally reknown panel has been assembled to judge all entries. Here are the categories:
1. Ask your State Medicaid director for a year by year breakdown of the number of people whom the State has assisted to leave a nursing home. If data is not available for each of the past ten years, points will be prorated depending on the number of years for which you obtain the information. Additional points will be awarded if you learn where the people moved to, e.g., own home or apartment, a relative's home, assisted living, etc., after they left the nursing home.
2. Find out the amount of Medicaid savings on average for each person who moved from the nursing home institution to the community.
3. For each year since Olmstead, find out the Medicaid average per diem rates paid to nursing homes and the Medicaid average per diem rates paid to home and community-based services.
4. Ask for your State's written guidelines/criteria for assessing what services an institutionalized person may need in the community. Does your state have their own staff make the assessment or does it rely on the nursing home's staff?
5. Although not part of the contest, extra points will be awarded if you also obtain the written criteria your State uses to determine if and when a person in the community is at "imminent risk" of becoming be institutionalized and if based on the criteria, your State will provide services to avoid unnecessary institutionalization.
6. Find out if your State recognizes the right of persons with a disability in a nursing home, who have mental capacity, to decide they will take a "risk" in the community rather than continue to be institutionalized.B If your State does recognize this right, how does your State enforce it?
7. Has your State publicized its successes, and if it has, provide some of the success stories?
8. No entry emailed or posted later than August 1, 2009, will be accepted. Sorry. If it is necessary to file a "Records Request" or "Freedom of Information Request" to obtain this information,B we will permit an entry later than August 1, 2009, with appropriate substantiating documentation. Texas has filed an early (partial) entry to win!
The Texas applicant states that 18,000 Texans have been moved from nursing homes to the community. Texas does track where the people moved to. It is 20-30% cheaper to serve the people in the community. Yes, Texas has both an "imminent risk" form, as well as an individual responsibility agreement assuming risks. Last, the applicant's referred us to http://www.dads.state.tx.us/services/pi/olmstead where former residents tell their own stories.
Steve Gold, The Disability Odyssey continues
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To contact Steve Gold directly, write to stevegoldada@cs.com or call 215-627-7100.