In January of this year, the Centers for Medicare and Medicaid Services (CMS) released new rules regarding home and community-based services (HCBS). The new rules and new definition of community living represent a historic change in the Medicaid program and opportunity to improve the system of community supports in every state. Home and community-based services include non-residential services like supported employment. David Mank, Director of the Indiana Institute on Disability and Community, wrote this guest post about the intersection of community living and employment.
CMS recently issued new rules defining home and community based services. The language in these regulations emphasize person centered planning and “creates a more outcome-oriented definition of home and community based settings, rather than one solely on, geography or physical characteristics”. CMS indicates its intent is to ensure that people have access to the benefits of community living and full opportunity to be integrated in their communities. CMS has also indicated this applies to all settings, including day program settings and will issue further guidance in the future.
The clear possibility is that this change will result in continued movement toward individualized jobs for people with intellectual and developmental disabilities. And, is entirely aligned with the “Six by 15 Campaign”. Increasingly, integration is being defined in terms of how people spend their time and what choices people are free to make rather than the location of a building, or the number of people that live there. Community living is about choices and freedom of movement in the typical spaces of community. Translating this to how people spend their day time, can only result in increased opportunities for community jobs for everyone that might want one.
Learn more at HCBSadvocacy.org.
This summer, the US Department of Health and Human Services and Department of Justice celebrated 15 years of the US Supreme Court Olmstead decision with an event in the Humphrey building and screening of new videos. The Promise of Olmstead: 15 Years Later and Voices from the Olmstead Decision are now available on ADA.gov. For more from the anniversary, don’t miss this White House blog post about Olmstead or our list of anniversary events.
According to the Kaiser Family Foundation, Maryland is now the third state to implement the Community First Choice Option! The Centers for Medicare and Medicaid Services (CMS) have approved Maryland’s Medicaid State Plan Amendment and the Maryland Department of Health and Mental Hygiene has begun to offer person assistant services, self-direction, and other home and community-based services under the Community First Choice Program. Combined with Maryland’s expansion of Medicaid, CFC will extend needed community-based supports without a waiting list to many more Maryland residents who need them.
Where do Other States Stand?
Montana has submitted a state plan amendment (SPA), Colorado has convened a council and feasibility study, and Arkansas, Minnesota, Montana, Texas, and Wisconsin have all indicated that they plan to participate in CFCO in 2014. Stay tuned for more news!
Senator Tom Harkin (D-IA), chairman of the Health, Education, Labor, and Pensions (HELP) committee introduced the Community Integration Act (S. 2515) on the same day the committee held a roundtable hearing on “Moving Toward Greater Inclusion” as part of the activities commemorating the 15th anniversary of the Supreme Court Olmstead decision (watch a video of the hearing on the committee website). The bill would eliminate the institutional bias in Medicaid by requiring the option of home or community-based services (HCBS) for anyone who requires an “institutional level of care”. The bill is based on the findings of the HELP Committee’s July 2013 report: Separate and Unequal: States Fail to Fulfill the Community Living Promise of the Americans with Disabilities Act. The bill not only ends the institutional bias in Medicaid, but addresses other barriers to community living like support for a high-quality direct support workforce and the lack of accessible, affordable housing.
Fifteen years ago, the Supreme Court ruled that under the Americans with Disabilities Act, people with disabilities cannot be unnecessarily segregated and must receive services in the most integrated setting possible. That ruling, known as the Olmstead decision, sparked significant changes in how federal, state, and local agencies support people with disabilities and their families. Read more…
Across the country, advocates are celebrating the 15th anniversary of the Supreme Court’s Olmstead decision on June 22, 1999. Here are just a few highlights:
June 23, Atlanta, GA: Celebrating the Long Road Home: 15 Years of Olmstead, following the opening of the Civil and Human Rights Center
June 23, Austin, TX: ADAPT of Texas press conference and celebration
June 25, Washington, DC: The US Senate Health, Education, Labor and Pensions Committee will hear from people with disabilities, advocates, and supporters in a roundtable meeting called “Moving Toward Greater Inclusion – Olmstead at 15″
July 16: LEAD Center and US Department of Labor Office of Disability Employment Policy webinar
Follow these events (and share your own!) using #Olmstead15 on Twitter
As the 15th anniversary of the Supreme Court’s Olmstead decision approaches this month, a new brief from the Kaiser Family Foundation examines the legacy of the landmark civil rights ruling that the institutionalization of people with disabilities is illegal discrimination under the Americans with Disabilities Act. The brief, Olmstead’s Role In Community Integration for People with Disabilities Under Medicaid: 15 Years After the Supreme Court’s Olmstead Decision, revisits the historic case and examines legal developments and policy trends that have emerged in recent years. The paper focuses on the role of the Court and the legal system in ensuring community integration of long-term care services through the Olmstead decision. The brief highlights Medicaid’s role as a vehicle in financing long-term care and furthering the delivery of such services in community settings. It includes brief profiles of people who have benefited from long-term care services under Medicaid and identifies ongoing challenges to achieving full community integration for people with disabilities.
Celebrating a Landmark Civil Rights Anniversary: 15th Anniversary of the Olmstead Decision
Friday, June 20, 2014
Hubert H. Humphrey Building
200 Independence Avenue SW
Washington, DC 20201
1:00 p.m. – 2:30 p.m.
On June 22, 1999, the United States Supreme Court held in Olmstead v. L.C. that unjustified segregation of persons with disabilities constitutes discrimination in violation of title II of the Americans with Disabilities Act. This landmark Supreme Court decision requires states to eliminate unnecessary segregation of persons with disabilities and to ensure that persons with disabilities receive services in the most integrated setting appropriate to their needs.
In observance of this important milestone, please join senior officials from the U.S. Department of Health and Human Services (HHS), the U.S. Department of Justice (DOJ), and the U.S. Department of Housing and Urban Development for a celebration of the Olmstead decision. The event will also feature three panels of speakers on the past, present, and future of Olmstead as well as a screening of a DOJ-HHS video entitled “The Promise of Olmstead: 15 Years Later” that includes testimonials from people whose lives were changed by the Olmstead decision.
Registration is required and space is very limited. Space will be held on a first come first served basis. Please accept this invitation by contacting Evelyn Hernandez by email at Evelyn Hernandez as soon as possible but not later than June 13th.
If you have questions please call Evelyn at 202-357-3518. Please call if you require special accommodations. For those not able to attend the event in person, HHS Live will carry the event live at http://www.hhs.gov/live/
HCBSadvocacy.org is a platform for the aging and disability communities to post information and resources regarding the new HCBS settings rule and steps each state is making to comply with the new rule.
In January, 2014 the Centers for Medicare and Medicaid Services (CMS) finalized a new regulation regarding the settings of home and community-based services funded through Medicaid 1915(c) waiver, 1915(i) state plan, and 1915(k) Community First Choice Option. It seeks to improve the community living and integration of people with disabilities and older people, focusing on the experience of individuals receiving HCBS.
States are beginning to assess their current HCBS settings and write plans to come into compliance with the rule. To help advocates learn about the rule and get involved, the DD Network partners – AUCD, NDRN, and NACDD – created HCBSadvocacy.org, a hub of information and resources for state advocates to share, learn, and post. The site includes new tips and ideas about how to get involved and help your state implement the rule and improve community living for people with disabilities and older people across the nation.
In July of 2013, Senator Tom Harkin as Chair of the Senate Committee on Health, Education, Labor and Pensions released a report showing that, 14 years after the enactment of the Americans with Disabilities Act (ADA), many states were still failing to live up to the community integration mandate included in that law. The report, titled “Separate and Unequal: States Fail to Fulfill the Community Living Promise of the Americans with Disabilities Act,” was the result of requests for information sent by Chairman Harkin to all 50 states on the progress made to transition individuals out of institutions.
The 6 by 15 campaign seeks to improve the community integration of people with disabilities by encouraging states to implement the Community First Choice Option. Read more about our goal…