White House Call re Georgia Olmstead Settlement, a Template to be used across the Nation

There was a White House Conference Call on Friday, October 22 regarding the Georgia Olmstead settlement signed last week.  It is being hailed as the most comprehensive Olmstead settlement to date.  Kareem Dale, Associate Director, White House Office of Public Engagement & Special Assistant to the President for Disability Policy, began the call with an overview of the administration's position on community living.  President Obama launched the Year of Community Living more than a year ago.  HHS, HUD and the DOJ have come together on improving Community Living, including the new housing vouchers and other initiatives.

Tom Perez and Sam Bagenstos from the DOJ then spoke about the case - The case has been going on for a long time so this was a landmark week for the department and people with disabilities.  This is a textbook example of partnership at its best - between government agencies, and between agencies and advocacy organizations.  He thanked all of the people involved, including HHS (funding) and HUD (housing).  Tom says to implement the Olmstead mandate, states must answer 2 questions: 1) who in institutions doesn't need to be there; and 2) for those remaining in institutions how can we ensure the conditions are safe and constitutional.  This is the framework for all of their Olmstead work.  In this case, they were able to reach this agreement.

For full details, please refer to the OCR site.  Some highlights: GA will stop admitting people with DD to state institutions by July 1, 2011.  They will transfer all people with DD out of state facilities by July 1, 2015.  They will provide support coordination services to ensure access to necessary community supports (medical, transportation, nutrition, etc.).  They will provide supports to 9,000 people with MI to be served in community. They will establish 24 hour crisis centers and crisis teams to respond to individuals anywhere in community.  They will create 1,150 waiver slots by July 2015.  750 of those are to help transition people from the hospital to the community, and 400 to prevent people returning to institutions.  The amount of supports in the mental health setting is noteworthy - ACT, CST, intensive case management, crisis centers, and community based crisis beds.  The DOJ has earned from movements of past decades - Need to give attention to wide ranging community supports that must be in place.  This can be a template for work they will do across the nation.

During the Q&A, they were asked, does it cost alot of money?  This agreement not only fulfills legal and moral obligations, but is also in economic self-interest.  In GA, estimate for state DD hospitals $147,000 compared to $47,000 in their home.

Where do we go from here?  Tom said this is a critical milestone because it is the most comprehensive settlement to date.  It will be their template.  They are involved across the country.  There are 2 sections involved - special litigation and disability rights sections.  They have been involved in the DAI case in NY, Haddad case in FL, in CA advocating that you can't use budget crisis as an excuse to shirk Olmstead responsibilities, statements of interest across the country, and just completed trial in Arkansas.  They are also establishing a body of case law to ensure P&A's, and others, have standing to file on behalf of people with disabilities.  They need both aggressive leadership and also private attorneys to ensure we have the capacity to assist people.  Want to share this settlement with other states.  They need continuing assistance to let them know about complaints. 

Sam Bagenstos, a DOJ attorney, wrote the book on disability rights.  Sam talked about what this is all about - the fundamental value that people with disabilities can live their life like everyone else does. They can choose where to live, when to eat, where to go for work, etc.  This is what they are trying to enforce across disabilities.  This also applies to people with physical disabilities in nursing homes - that's what they are working on with Alabama and Florida.  There is a new paradigm in enforcement - they made a commitment in the way they enforce Olmstead.  It was about institutions, very process-focused.  The new pieces added: focused intensively on services in community (!) including housing, employment, crisis, etc.; focusing on people at risk of institutionalization, not just those in institutions; close collaboration with people in disability rights community and people in local community.  They are looking for relief that looks like the Georgia. 

During the Q&A, they addressed the state perception that deinstitutionalization would be costly.  A NJ case claimed they didn't have the funding.  The record showed that they would save a substantial amount of money.  Litigation becomes necessary to get inertia.  They want to use this settlement with the assistance of HHS, etc. to show it is in the state's self-interest. In addition to DD stats, they want to give a reminder that states get the medicaid match for adults with MI served in the community (but not in institutions).  The need to draw down federal dollars is in the state's self-interest. 

It seems that a budget crisis may be an opportunity to seek more community living arrangements for people with disabilities.