Council Members
The Most integrated Setting Coordinating Council is created within the Executive Department, and is to be comprised of :
The Commissioner of the Department of Health
The Commissioner of the Office of Mental Retardation and Developmental Disabilities
The Commissioner of the Office of Mental Health
The Commissioner of the Department of Transportation
The Commissioner of the Office of Children and Family Services
The Commissioner of the Office of Alcohol and Substance Abuse Services
The Commissioner of the Department of Education
The Commissioner of the Division of Housing and Community Renewal
The Director of the Office for the Aging
A representative from the Office of the Advocate for Persons with Disabilities
A representative from the Commission on Quality Care for the Mentally Disabled
3 Consumers of services for individuals with disabilities- one to be appointed by the Governor, one to be appointed by the Temporary President of the Senate, and one to be appointed by the Speaker of the Assembly
3 individuals with expertise in or recipients of services available to senior citizens with disabilities- one to be appointed by the Governor, one to be appointed by the Temporary President of the Senate and one to be appointed by the Speaker of the Assembly.
Responsibilities of the Council
The Council will meet at lease once per quarter, and the chair will rotate among the Commissioners of the Department of Health, Office of Mental Health, OMRDD, and the Director of the Office for Aging.
The Council is charged with the following tasks:
1) To determine the number of individuals with disabilities who are
a. Currently institutionalized and are eligible for community-based services;
b. Residing in the community and dependent on the assistance of community based services to avoid institutionalization;
2) Develop a single assessment process, implemented by one community-based agency, through the use of a uniform assessment tool
3) Identify what community-based services are available in the State of Geneva;
4) Assess what improvements need to be made to the system of community-based services to ensure that it meets the needs of and provides adequate supports for individuals with disabilities living in the community;
5) Examine how the identified community-based services integrate individuals with disabilities into the community;
6) Review existing funding sources in an effort to increase the availability of community-based services, and conduct an analysis of how these varied funding streams can be organized into a coherent system of long-term care;
7) Assess how well the current system works for different populations
8) Conduct an examination of waiting lists;
9) Examine current information, education, outreach and referral systems and evaluate the feasibility of creating a toll-free information hotline;
10) Examine how quality assurance and quality improvement can be conducted effectively;
11) Conduct an examination of how the overall system of health and long term care can best be managed so that placement in the most integrated setting becomes the norm.
The Council shall provide a report to the Governor, the Temporary President of the Senate and the Speaker of the Assembly in one year, and annually thereafter.
For the full text of the bill, click here.
Geneva State Is Awarded Systems Change Grant
The Geneva State Department of Health was awarded a 2002 Real Choice Systems Change Grant by the Centers for Medicare and Medicaid Services (CMS). The award totals $1.385 million and will run for three years, from September 30, 2002 through September 30, 2005. CMS staff have confirmed that no additional awards are anticipated at this time.
The purpose of the Real Choice Systems Change Grant is to allow States and others, in partnership with their disability and aging communities, to design and implement effective and enduring improvements in community long term care support systems. Contingent upon federal approval of the revised grant narrative, the Department anticipates issuance of a Fall 2002 Request for Applications (RFA) for entities wishing to apply for demonstration funding.
The Department of Health has been holding collaborative meetings in an effort to achieve true community input in drafting the grant narrative. The final grant application must be to CMS by July 10, 2002, so we will post the full text of the application as soon as it is available.
Summary of the Olmstead Decision and State Plans for Compliance
In Olmstead v. L.C. and E.W., 119 S.Ct. 2176 (1999), the Supreme Court stated loud and clear that the denial of community placements to individuals with disabilities is precisely the kind of segregation that Congress sought to eliminate in passing the Americans with Disabilities Act (ADA). The Supreme Court correctly noted that unnecessary segregation and institutionalization constitute discrimination and violate the ADA's "integration mandate" unless certain defenses are established. The decision presents new opportunities for advocating for community-based services and supports for people with disabilities.
The decision says a state may have a defense to lawsuits challenging the state's failure to serve individuals in the most integrated setting appropriate if it has a "comprehensive, effectively working plan for placing qualified persons with mental disabilities in less restrictive settings."
The Court did not define a "comprehensive" plan. It seems appropriate that a "comprehensive" plan is one that addresses the placement needs of all individuals who are unnecessarily institutionalized or at risk of institutionalization. A state may have different plans to address different populations, as long as the needs of all individuals unnecessarily institutionalized are addressed. Neither does the Court define "effective." It seems logical however that an "effective" plan must have certain important elements.
The guiding principle reflected in this template is that the state must develop and enhance community programs and services so that each individual resident can move to the most integrated setting appropriate to meet his or her needs. The community program and service shall promote choice, independence and dignity.
State plans must include the following elements:
Element 1: Participation of key stakeholders in the development of the plan.
Element 2: Needs Assessment Process
Element 3: Development of new community services and supportive infrastructure.
Element 4: Transition services to prepare individuals for a change in placement.
Element 5: Data collection which is individualized and tied to individual program plan.
Element 6: Outcomes measurement and target dates.
Element 7: Monitoring/Quality assurance.
Element 8: Resource Development.
Element 9: The state plan shall be reviewed, revised and updated every two years or sooner if appropriate.
(Source: National Association of Protection and Advocacy Systems)
To find out more about the key elements which must be included in State Plans, visit the web site of the National Association of Protection and Advocacy Systems:
http://www.protectionandadvocacy.com/temploct12.htm
Web Site Links on Olmstead
The following web site links provide extensive information on the Olmstead Decision.
The Olmstead Decision
Link to the Supreme Court decision.
http://supct.law.cornell.edu/supct/html/98-536.ZS.html
Olmstead Issues Page
(The Disability Policy Consortium)
http://www.dpctexas.org/dpctx2002/olmsteadissues/olmstead.html
Missouri's Olmstead Implementation
http://www.dolir.state.mo.us/gcd/Olmstead/OlmsteadWebpage121401.htm
Steve Gold, Esq views on Olmstead
http://www.freedomclearinghouse.org/mouth/sgolmstead.htm
Steve Gold, Esq views on ADA
http://www.mouthmag.com/says/stevesays.htm
Olmstead, the Supreme Court & You (Steve Gold, Esq.)
http://www.dpctexas.org/dpctx2002/olmsteadissues/steve_gold_notes.htm
Olmstead Riders to the Texas Dept of Human Relations budget
http://www.stevegoldada.com/stevegoldada/cgi/getlink.cgi?4
HCFA Links
Provides a huge list of links to government agencies,
government-based research, parent assistance,
self-determination, and university-based research.
http://www.cms.hhs.gov/olmstead/olmslink.asp
Community Integration/Olmstead Compliance
Information and Resources
Web site prepared by "Protection & Advocacy Systems. The
Nation's Disability Rights Network"
a) List of proposed State Olmstead Compliance Plans.
http://www.protectionandadvocacy.com/olmsteadcomplianceplans.htm
b) Letters from federal HHS to State Medicaid Directors providing guidance to states in their efforts to comply with the Olmstead decision.
http://www.protectionandadvocacy.com/olmsteadstateplandev.htm
Olmstead Progress Report
Disability Advocates Assess State Implementation after One
Year. Prepared by The National Association of Protection and
Advocacy Systems July 25, 2000
http://www.protectionandadvocacy.com/progressreportfinal.htm
Status Report on States' Development and
Implementation of Olmstead Plans
The Arc of the United States. July 26, 2000
http://www.thearc.org/olmstead_report.htm
Systems Change Grants for Community Living
For complete information, visit:
http://www.cms.hhs.gov/systemschange/
Summary: Describes the 4 proposals offered by HCFS to
design and implement effective and enduring improvements in
community long term support systems. These systemic
changes will be designed to enable children and adults of any
age who have a disability or long term illness to:
(a) Live in the most integrated community setting appropriate to their individual support requirements and their preferences;
(b) Exercise meaningful choices about their living environment, the providers of services they receive, the types of supports they use and the manner by which services are provided; and
(c) Obtain quality services in a manner as consistent as possible with their community living preferences and priorities.
Four distinct grant solicitations comprise the "Systems Change for Community Living" grants that are the subject of this coordinated invitation. They are:
(1) "Nursing Facility Transitions" grants: HCFA is making available between $10-$14 million to help States transition eligible individuals from nursing facilities to the community. Two types of grants are offered:
(a) State Program grants will be made to support State program initiatives;
(b) "Independent Living Partnership" grants will be made to selected Independent Living Centers (ILCs) to promote partnerships between ILCs and States to support nursing facility transitions.
(2) "Community-integrated Personal Assistance Services and Supports" grants: Personal assistance is the most frequently used service that enables people with a disability or long term illness to live in the community. Grants totaling $5-$8 million are available to support States' efforts to improve personal assistance services that are consumer-directed or offer maximum individual control.
(3) "Real Choice Systems Change" grants: The goal is to help design and implement effective and enduring improvements in community long term support systems to enable children and adults of any age who have a disability or long term illness to live and participate in their communities. Approximately $41-$43 million is available in direct grants to States. For more info on "Real Choice" grants, visit
http://www.cms.hhs.gov/systemschange/
(4) "National Technical Assistance Exchange for Community Living" grant: This national technical assistance initiative will provide technical assistance, training, and information to States, consumers, families, and other agencies and organizations. Funding for the technical assistance will range from $4-$5 million.
Grant applications will be due in July 2001. All grant awards are expected to be made prior to October 1, 2001. States will have up to 36 months to expend these funds. Grantees are not required to provide a financial match, but a small non-financial recipient contribution from Grantees and/or a third-party "in-kind" contribution is required.
Geneva State Association of Area Agencies on Aging
272 Broadway
Albany, NY 12204-2717
Phone 518-449-7080
Fax 518-449-7055
e-mail:
