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Implementing Olmstead in Iowa
Accomplishments 1999-2006
Since the Supreme Court handed down the Olmstead Decision
(see "Understanding Olmstead")
in 1999, progress has been steady in addressing the
priorities
of the Olmstead Real Choices for Iowa Consumer
Task Force. Below is a summary of
Iowa's accomplishments, beginning with the most recent. Other
Iowa resources also provide detailed
information about Olmstead implementation in Iowa.
|
Year |
Action |
|
2006 |
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|
2005 |
Iowa is awarded a
new Real Choices Systems Change Grant,
Iowa Care: Rebalancing for Increased Community Capacity, Access, and
Choice. The Iowa Medicaid Enterprise will oversee grant
activities, which will focus on implementing
Iowa Care Act (House File 841). This legislation sets the
direction for the redesign of our long-term care system for Iowans with
disabilities and older Iowans.
State agencies present their Olmstead implementation
strategic plans, updates,
or both to the Office of the Lieutenant Governor.
DHS creates the
Iowa Medicaid Enterprise
to bring together DHS staff and service contractors within a "performance based
model for the administration of the Medicaid Program." Much of their work
centers on
Iowa's six Medicaid Waiver programs.
Housing for Persons with Disabilities State Action Plan, developed through the 2003 and 2004 Summits on
Housing for Persons with Disabilities, set the ambitious goal of developing 1000
new housing opportunities for Iowans with disabilities in three years. Taking
the lead, the Iowa Finance Authority reports that at the 2½ year mark, 753 new
affordable, accessible housing opportunities have been made available, and the
effort to meet the goal continues.
The Iowa General Assembly passes,
and the governor signs into law:
- Comprehensive Medicaid reform,
the
Iowa Care Act (House File 841), which
begins the rebalancing of our
long-term care system by making it more difficult to place someone in a nursing
home, and easier to get home and community-based services. Reimbursement for
community service providers will be based on level of services a person
requires.
It requires the development of a case-mix
adjusted reimbursement system for both institutional and community-based
providers, which would pay providers more to support people with higher levels
of need, and less to serve people with fewer needs, regardless of where services
are delivered.
-
House File 825 provides funding to eliminate the current waiting lists (of about 2500
people) for Medicaid Home and Community Based Services (HCBS) Waivers increases Medicaid provider rates by
three percent, and provides $2.7 million additional funding for Medicare Part D
outreach and education.
-
House File 816 raises state funding
for vocational rehabilitation by about $236,000, allowing the state to receive
nearly $1 million in federal funding.
-
House File 538 gives parents to
access to mental health services for their children through a new mental health
waiver that does not require them to give up custody of their children in order
to get help. The waiver provides the an additional 300 children with severe
emotional disturbances to get the services and supports they require in their
communities.
-
House File 617 calls
upon the DHS to work with providers to add assisted living to the Medicaid HCBS
Elderly Waiver, so that it can also be used to fund assisted living as an
alternative to nursing home care.
-
House File 420, the
Mental Health Parity Bill, requires health
insurance companies to cover seven
biologically-based mental illnesses in the same way they cover other
biologically-based illnesses.
The US Department
of Justice reaches a legal settlement with the State
of Iowa regarding the complaints
filed against Glenwood and Woodward State Resource Centers.
The US Health and Human
Services Administration on Developmental Disabilities funds a Youth
Information, Training, and Resource Center grant,
Self-Advocacy and Leadership for Youth with Disabilities, to develop the
advocacy skills in young people with disabilities.
The CMS Medicaid Infrastructure
Grant supports improving
Iowa’s Medicaid buy-in program for employed people with disabilities; enhances
Medicaid-funded supports and education activities that promote employment.
|
|
2004 |
Most state agencies complete self-assessment and begin to
develop
plans for implementing Olmstead.
The Mental Health, Mental Retardation Commission takes a new
name:
Mental Health, Mental Retardation, Developmental Disabilities, and Brain Injury
(MH/MR/DD/BI) Commission. The Iowa General Assembly calls for a redesign of
the Iowa systems that serve people with disabilities. Real Choices staff and the
Olmstead Real Choices Consumer Task force provide input and technical assistance
to the commission as they develop redesign recommendations.
The Real Choices grant work plan (html,
text) is revised
and updated.
Executive Order Number 37
convenes the Aging Services Cabinet to address issues confronting older Iowans,
such as expanded case management, long-term care access, counseling, use of
technology, behavioral health, and the direct care workforce.
Strategies begin to be developed by DHS to redesign
Iowa Medicaid Waivers, used by Iowans with disabilities and by Iowans who
are elderly, to better implement Olmstead and the ADA.
A Robert Wood Johnson Foundation grant funds the development
of a "cash and counseling"
option for Iowa's six Home and Community Based Waivers, to help create a service
system that supports self-determination.
An Administration on Developmental Disabilities
Family Support 360 Grant supports the planning and implementation of
one-stop information and referral centers to assist individuals with
developmental disabilities and their families.
A CMHS/SAMHSA State Mental Health Data Infrastructure Grant
funds improvements in data management and sharing among state and local mental
health care providers, as part of a plan to increase state flexibility and
improve accountability for the use of CMHS Block Grant funds. |
| 2003 |
Governor Vilsack issues
Iowa Executive Order 27, calling on state
agencies to "…move purposefully to swiftly implement the Olmstead
decision”; and designating key state agencies to coordinate a comprehensive
effort to "reshape the structure and nature of community-based services."
The
Olmstead Real Choices Consumer
Task Force provides technical assistance to state agencies as they:
The U.S. Administration on Aging and the Centers for Medicare
and Medicaid fund an Iowa
Aging and
Disability Resource Center to integrate the internet-based aging resources
management information system with Iowa COMPASS, our developmental disabilities
information system. This center will also develop a consumer-oriented website
to serve as a one-stop gateway to link people with long-term care services.
A Supplemental Security Income Youth Transition
Process Demonstration Grant, the Smart Start Transition Project,
implements a cash and counseling model that is used by young people moving from
high school to adult living as they attain the skills they need to direct their
own services.
The Improving Transition Outcomes for Youth with Disabilities Grant works
to create a community-wide system of inclusion, support, and engagement for
young people with disabilities as they move into adult roles in their
communities.
Executive Order Number 28 gives
seven state agencies, including the DHS and the
Iowa Veteran’s Home, administrative flexibility to pursue innovative,
outcome-oriented services.
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2002 |
The task force expands to include representatives of state
agencies, service providers, and other stakeholders. Task force members identify
priorities and begin working to address them. An Administration
on Aging Project Seamless Grant supports the development a framework for
sharing data between state and local agencies to streamline the process of
assessment and eligibility determination for frail older Iowans. |
|
2001 |
Iowa's "effectively working plan, the
Iowa Plan for Community Development, required by the federal Centers for
Medicare and Medicaid, is finalized in July.
DHS is awarded a federal Real Choices Systems Change
grant; the steering committee becomes Iowa Olmstead Real Choices Consumer Task Force. |
|
2000
|
The federal
Centers for Medicare and Medicaid
Services (CMS) call on the states to develop "effectively working plans"
to
implement Olmstead, and move people from institutions to community-based
services whenever appropriate.
President Bush issues
Executive Order 1327, part of the New Freedom Initiative, directing key
federal agencies to ensure full compliance with the Olmstead Decision
Iowa Governor Tom Vilsack calls on the Iowa DHS to develop
the "effectively working plan" by convening a statewide steering committee of
people with disabilities, family members, and advocates to draft the plan
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1999 |
US Supreme Court hands down the
Olmstead Decision. |
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