Olmstead Act
SILC/VCIL Olmstead Report: 2nd Meeting Nov. 16th, 2011
The VT Statewide Independent Living Council (SILC), in joint sponsorship with the VT Center for Independent Living (VCIL), held its 2nd Olmstead Stakeholders meeting on November 16th, 2011. Disability and independent living advocates and others gathered to further refine the focus and emphasis of the current initiative to reinvigorate the VT State Olmstead Plan. This meeting follows up on preliminary insights garnered and strategic planning discussed at the 1st meeting on Sept. 1st, 2010.
The VT Olmstead Plan was released to the legislature in January, 2006 by the VT Olmstead Commission, created by Act 135 of 2002. The Commission’s inception and subsequent plan arose as the result of the 1999 U.S. Supreme Court ruling, in Olmstead vs. L.C., which, in turn, applied the principles entailed within the 1990 American with Disabilities Act (ADA) to a rather narrow decision involving the rights of those diagnosed with mental illness to achieve independent and community-based living.
At this 2nd meeting, advocates seem to have achieved the goals of narrowing focus and beginning to develop a realistic framework and set of tangible objectives which can be brought before legislators and Administration officials.
It was agreed that the current VT Olmstead Plan - as released, in both comprehensive and abridged form, to the legislature in January, 2006 – was much more a document that stressed the state of human service delivery at that point in time, as opposed to a strategic planning document meant to further long term independent, community-based living objectives. This meeting intended to begin to re-structure the Olmstead Plan into a set of policy objectives with concrete goals and realistic timelines for implementation.
It was also agreed to define a set of measurable outcomes such that stakeholders and others will be able to determine if action steps are indeed effective.
After general discussion, the meeting was divided into 3 specific areas of discussion:
1. Community integration 2. Transportation 3. Housing
Meeting Outcomes
It was decided that, strategically, the Olmstead stakeholders initially choose 1 or 2 specific issues which can be communicated effectively to the public and which can spur remedial action.
Throughout, stakeholders need to emphasize that as services are reduced, quality of delivery is jeopardized.
Suggestions:
1. Adult Protective Services (APS) – highlight shortcomings in the current State APS service system; provide recommendations to improve service delivery: eliminate backlog; improve response time
2. Developmental Disability (DD) Services – strengthen infrastructure for quality assurance; improve service provider training and team support
3. Mental Health (MH) Services – address issue of underfunding, particularly of outpatient, community-based services (Note: Governor’s current MH service delivery restructuring plan addresses this issue; indeed, an opportunity exists at present to create an efficient consumer-oriented and directed system with great potential moving forward; stakeholders/advocates must monitor implementation of this plan.)
Community Integration
Emphasis upon:
1. Personal Care Attendant (PCA) Services
2. MH service delivery restructuring (noting closure of State Hospital and community-based and participant-directed opportunities arising)
Recommendations: improve quality assurance (QA) standards for a. PCA’s and b. designated home care providers/agencies
All present noted the potential for increased funding for community-based services as the result of the State Hospital closure; potential for increased Federal matching funds (and decreased State general fund GF expenditures)
Additionally noted: heightened opportunity for employment (and thus self-sufficiency) secondary to community integration
All agreed upon the value of exploring the option of “intentional communities;” agreed to request info from DAIL and the DD system
Concerns expressed:
1. loss of “peer navigators” and resulting negative implications for family integrity and well-being; can the peer navigator system be restored? Note: several variations of “peer navigators” according to specific area of need addressed/specific program/.funding source
2. inadequate access to American Sign Language (ASL) services for deaf community with co-existing need for MH services (Ex.:
disallowance of use of videophone for MH/deaf community service delivery: payment system issue?)
As a transition into the next segment, it was pointed out that:
- transportation is the key to community integration for blind and visually impaired children and adults
- PCA’s are often needed to assist a person with a disability avail themselves of transportation
Transportation
Key points/concerns raised:
Inaccessible homes/houses pose a problem for emergency responders (e.g. EMT’s) and other transportation providers; paths to/from homes/houses must be accessible; resources must be found to make such paths/entranceways accessible and pay for such projects Note: occasionally, resistance of peer encountered
Flexible routes and hours offered by transportation providers are necessary to maximize community participation and socioeconomic potential for peers
Improve coordination among transportation service providers; for example, prevent inefficiency of unnecessary transfers and diversions
Ticket-to-Ride flexible transportation program: operating currently only in Washington and parts of two other counties; funds for expansion are not presently available; also, resistance from local transportation providers to expansion. Can/should the disability community assess prospects of program and mobilize to revive and expand?
Reassessment of cost structure for transportation might be necessary to eliminate disparities between Medicaid rates and “normal” (less costly) rates
Examine technological innovations as cost effective means of improving access to transportation
Clearly determine sources of funding and receipt of transportation services
Examine potential for private/public partnerships - for example, employment-based transportation models (as Jay Peak has developed)
Maximize potential for volunteering, donating and bartering in designing/executing accessible transportation programs Note: liability issues can pose an obstacle in this regard; disability community should familiarize itself with “good Samaritan” laws which can/may protect volunteers, etc
Can incentives be created – through legislation, etc. – to encourage volunteering?
Examine legality of taxi services charging a higher rate to transport persons with disabilities; is action on the part of the disability community needed?
Housing
Key points/concerns:
Reinforcement of importance of accessible homes/houses as safety issue (e.g. need to evacuate persons with disabilities; safety for EMT’s) and as socioeconomic/quality of life issue (accessibility for family/friends, etc.)
Accelerated effort needs to be made to advocate for tax incentives for builders to construct accessible and affordable housing units; decide upon strategy (e.g. regional vs. more general)
Importance of advocates to directly address builders (e.g. at forums) to educate regarding feasibility, economic opportunities and profitability of accessible housing units; emphasis upon universal design
Concurrently, advocates must educate peers/the general public of rights and responsibilities related to discrimination within public housing sector, incl. Federal “Section 8” issues; can be seen as an “anti-stigma” effort
Need to research VT transfer tax mechanism regarding VHCB (VT Housing and
Conservation Board) funding – make changes, if necessary; necessity of maintaining adequate funding stream(s) for affordable and accessible housing in VT!
Consider 5-year “Analysis of Impediments” re-write cycle [as a requirement of CDBG (Community Development Block Grant) funding], ; utilize periodic re-write as opportunity to stimulate construction of affordable/accessible housing units (e.g. by taking advantage of use of various incentives, such as “density bonuses”) – applies, in VT, to City of Burlington and to State (as “entitlement communities,” under HUD program)
Throughout, housing efforts must be directed toward ultimate consumer sensibility
Next Steps
- Emphasize and educate regarding enforcement of community integration mandates and mechanisms of complaint; Use Olmstead Plan as instrument of complaint, if necessary; recognize that VT, generally, relies on “complaint-driven system” to enforce de-segregation laws
- Post fact sheets on appropriate Websites and blogs
- Attempt to access radio/TV forums to discuss issue
- Suggestion of VCIL lead on this initiative
- Publicize the requirement of an ADA Coordinator for towns with 50+ employees
- Publicly post lists of towns which fail to meet requirement – SILC/VCIL Websites, e.g.
- Publicize via newspaper/magazine forums, blogs and various appropriate public forums (e.g. SILC Website)
- Utilize (nonpartisan) political opportunities (e.g. mayoral/local elections) to urge candidates/politicians to release statements on issue
- Initiate concerted effort to access data relating to quality assurance (QA) in DD servicesPotential for volunteer citizen monitoring (esp. considering budgetary shortfalls)
- Possible cooperation w/ Disability Rights VT (DRV); connection to APS corrective action initiatives Caution: must first thoroughly research relevant laws/rules
- Suggestion of consultation w/ Susan Yuan, Jeff Coy and Karen Schwartz (DD Council)
- Potential of grant from DD Council to fund effort
- Alternate suggestion of proactive effort by stakeholder coalition
- Possible use of Disability Awareness Day to publicize (prominent speaker, e.g.)
- Cooperate w/ VT Access Board; possibility of legislative remedies?
- Transportation Analyses IntiativeFeasibility of expanding Ticket-to-Ride Program
- Volunteer opportunities/incentives
- Costs, funding and payment system
- Possibility of formulating “white paper” on topic
- Confer w/ Peter Johnke of VCIL
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But the story of the Olmstead case begins with two women, Lois Curtis and Elaine Wilson, who had mental illness and developmental disabilities, and were voluntarily admitted to the psychiatric unit in the State-run Georgia Regional Hospital. Following the women's medical treatment there, mental health professionals stated that each was ready to move to a community-based program. However, the women remained confined in the institution, each for several years after the initial treatment was concluded. They filed suit under the Americans with Disabilities Act (ADA) for release from the hospital.
So, in 1999, the act is passed but hardly anybody gets out of institutions except for Elaine and Lois and a few others. We all agree that more needs to be done regarding enforcement of this most important legal decision.
The VT Statewide Independent Living Council (SILC), in conjunction with the VT Center for Independent Living (VCIL), convened an Olmstead Stakeholders’ meeting to discuss and gather information on the status of Vermont’s compliance with the integration mandate of the Americans with Disabilities Act (ADA) of 1990.
At this initial Olmstead Stakeholders’ meeting, a broad-based discussion was held. The discussion focused upon: 1. what has been accomplished to this point in relation to the Olmstead Plan and 2. what steps need to be undertaken going forward. A follow-up meeting(s) will be held with stakeholders to generate a timely assessment report which will be delivered to Gov. Shumlin and the VT legislature. The next scheduled public meeting is November 16th, in Randolph, VT. Please see the SILC calendar and the end of this article for meeting details.
In 1999, the U.S. Supreme Court ruled, in Olmstead vs. L.C. - based upon the ADA integration mandate - that persons with disabilities are entitled to live in the most integrated setting reasonably possible. As a direct result of this ruling, a majority of states created commissions to examine the feasibility of and set priorities for compliance.
The Vermont legislature, by Act 135 of 2002, created the VT Olmstead Commission, composed of a diverse group of stakeholders and government officials. Meeting 6-7 times per year, from October 2002 through 2005, the Commission deliberated and formulated the VT Olmstead Plan. The Plan was released to the legislature – both in comprehensive and abridged form – on Jan. 6, 2006.
The Vermont Olmstead Plan expands the relatively narrow mandates arising from the Olmstead Decision and lays out a set of priorities to encourage community inclusion for persons with disabilities. Above all, the Plan highlights the need for a life replete with self-determination and dignity among ALL of its citizens.
The Vermont Olmstead Plan was divided into several sections, each of them referencing a major aspect of human service needs. Taken together, a blueprint for fulfilling the ADA integration mandate was created:
1. Information, Referral and Assistance 2. Housing 3. Transportation 4. Health Care 5. Employment 6. Education 7. Family Supports 8. Assistive Technology 9. Trauma Services 10. Legal Systems/Protection 11.Voting/Citizenship 12. Mental Health (MH) Services 13. Developmental Disability (DD) Services 14. Supports/Services for Older Vermonters/Adults with Physical Disabilities
What Still Needs Improvement?
Stakeholders next discussed the many facets of disability and, specifically, independent living policies/programs/services which are lacking in scope and detail and which, in the collective opinion of those present, could be improved.
Generally speaking, participants felt that:
• Disability awareness could be increased among the public at large through enhanced use of media outreach and educational tools/facilities
• Awareness of the ADA – its many aspects and provisions – could be enhanced using approaches as above; in turn, resulting increasing awareness, it was expected, would lead to increased compliance
• The Olmstead Plan blueprint/provisions be smoothly integrated into the existing framework of State/organizational/societal policies/programs/services
• The Olmstead Plan be continually reassessed to assure relevance and compliance; the present might be an appropriate juncture for reassessment
• Reassessment across systems/programs/benefits be undertaken for better compliance with goals of the VT Olmstead Plan; programmatic restructuring, if necessary
• Stress needs to be place upon providing adequate services for those individuals with disabilities who currently “fall between the cracks” of State/organizational programs/services
• Emphasis be placed upon the integration provision of the ADA, rather than the narrower stipulations of the Olmstead Decision (realizing, however, that the VT Olmstead Plan does indeed broaden the focus of the Supreme Court Decision)
Get Involved!
Stay tuned for further updates and events!!