CrossDisability Planning: Integrating Mental Health Issues Into Olmstead Implementation In Virginia

1
Cross-Disability Planning Integrating Mental
Health Issues Into Olmstead Implementation In
Virginia

• Prepared for the 4th Annual Training Institute
  for
• State Mental Health Olmstead Coordinators
• Georgetown University Conference Center
• September 13-15, 2004
• Julie A. Stanley, J.D.
• Director, Community Integration for
• People with Disabilities

2
Overview Implementation Efforts

• 2002 Olmstead Task Force (Item 329M)
• 2003 Olmstead Task Force Report
• Governors approved budget proposals
• 2004 Adopted 2005-2006 Budget
• Governors Executive Order 61
• Implementation Team and Report
• Oversight Advisory Committee and Report
• Proposed Legislation

3
Virginias Olmstead Task Force

• Item 329 M Virginia DMHMRSAS convened task force
  to develop recommendations
• All disability populations represented
• 70 members, over 50 additional participants,
  including
• Individuals with mental illness
• Family members
• Advocates, including NAMI-VA and MHAV
• Public and private providers of MH services
• DMHMRSAS
• MH Inspector General
• P A Agency (VOPA)

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Virginias Olmstead Task Force, contd

• Major activities
• Gathered population/service data on all
  disability populations, including MH
• Surveyed nursing facilities/ALFs/residential
  facilities
• Sought consumer/family feedback via survey forms
  and public comment
• 8 cross-disability teams
• Accountability Prevention and Transition
• Education Qualified Providers
• Employment Transportation
• Housing Waivers

5
Olmstead Task Force Report

• Final Report submitted 9/15/03 to Governor and
  Legislature
• Consensus vision
• Individual choice of/access to services and
  supports
• Accountability to all
• Sufficient numbers of qualified providers
• Safe, available, accessible, affordable housing
  and transportation
• Opportunity to work
• Full continuum of care

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Olmstead Task Force Report, contd

• Consensus Goals -- Create opportunities for
  people to
• Move to a more integrated setting
• Stay there once they move
• Live successfully there, receiving services to
  prevent unwanted institutionalization
• Work collaboratively with all public/private
  partners to ensure Olmstead implementation
• Report contains issues, 201 recommendations,
  specific objectives and action steps

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Olmstead Task Force Report, contd

• Examples of MH recommendations
• Eliminate state MH facility discharge wait
  lists/develop wait list for ALF discharges
• Support DMHMRSAS Regional Restructuring
  Partnerships
• Expand disability training of public
  safety/health personnel
• Increase advance directives education
• Implement transition planning for youth with SED
  who do not have IEPs
• Develop/promote recovery-oriented services,
  including effective consumer-operated and peer
  services
• Use public financing to support all
  evidence-based practices

8
Governors Approved Budget Proposals

• 77 individualized MH facility discharge
  assistance plans
• Community MH services for 500 children and
  adolescents
• 3 new PACT teams
• Inpatient Treatment in Community Hospitals for
  300
• Others
• Additional DD and MR waiver slots
• 5 new public guardian/conservator programs
• Alzheimers waiver
• Medicaid Buy-In
• Provider rate increases

9
Adopted 2005-2006 Budget

• 2004 Virginia General Assembly adopted all of
  Governor proposals
• AND. . . . .
• With the Governors support, added significantly
  to those proposals.

10
Executive Order 61 (2004)

• 1/6/04 Governors Executive Order 61, The
  Olmstead Initiative, established and specified
  responsibilities of
• Implementation Team 18 state agencies and 4
  Secretariats
• Oversight Advisory Committee 19 individuals with
  disabilities, family members, advocates, and
  providers
• Director of Community Integration for People With
  Disabilities, in Governors Office

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Implementation Team

• Four Secretaries are voting ex officio members
• Commerce and Trade
• Education
• Health and Human Resources
• Transportation
• State agency representatives include DMHMRSAS and
  DMAS
• Chaired by Director

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Implementation Team, contd

• Activities to date
• Categorized recommendations into action/s
  required administrative, regulatory,
  legislative, and/or budget
• Costed out 112 recommendations
• Sought Oversight Advisory Committees advice
• Submitted First Annual Report to Committee
  7/15/04
• Viewed Inside, Outside
• Studying interagency collaboration models
• Preparing for cost out of remaining
  recommendations
• Planning joint meeting with agency ADA
  coordinators

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Oversight Advisory Committee

• 19 members
• 7 individuals with disabilities (2 MH)
• 5 family members (1 MH)
• 4 advocates (1 MH)
• 3 providers (1 MH)
• One slot dedicated to current resident of state
  MH facility
• MH advocate serves as Vice-Chair

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Oversight Advisory Committee, contd

• Roles
• Oversee Olmstead implementation in Virginia
• Advise Implementation Team
• Receive annual reports from Implementation Team
• Report recommendations to Governor

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Oversight Advisory Committee, contd

• Activities to date
• Provided advice to Implementation Team
• Formed two subcommittees to address specific
  issues
• Reviewed/discussed the 112 cost outs with
  agencies
• Sought/considered public feedback on
  Implementation Team Report
• Currently drafting First Annual Report to
  Governor, due October 21

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Legislation Proposed for 2005 General Assembly
Session

• Would statutorily create Advisory Commission,
  Implementation Team and Director for 6-year
  period
• Roles/activities set forth in EO 61 would
  continue roles of Committee and Director would
  expand
• Membership of individuals with disabilities on
  Commission would increase state MH facility slot
  and nursing facility slot would be mandated
• 4 agencies would be added to Implementation Team
• Drafted and circulated for comment by Director
• Currently under consideration