Indiana 2003 | advancingstates.org

<H3>Indiana</H3>   <H4>Task Force</H4> Released on June 1, 2001, the First Edition of Indiana's Comprehensive Plan for Community Integration and Support of Person's with Disabilities is available at <A HREF=\"http://www.state.in.us/fssa/servicedisabl/olmstead/comprehensive.html\">www.state.in.us/fssa/servicedisabl/olmstead/comprehensive.html</A> The governor issued an executive order in September 2000 that identified the Family and Social Services Administration (FSSA) as the agency in charge of Olmstead planning and gave it until June 1, 2001, to submit its recommendations. Six policy directives guide the priorities of this plan. Comprehensive action steps include goals, timelines and the parties responsible for ensuring progress. The plan includes a \"Going Forward\" section that outlines further steps that need to be taken beyond the 2002-2003 biennial budget. It also proposes budgets for various areas, some of which have already been put into law and includes an inventory of available services. Details of the planning effort are available at <A HREF=\"http://www.in.gov/fssa/servicedisabl/olmstead/index.html\">www.in.gov/fssa/servicedisabl/olmstead/index.html</A> In July 2002, the governor appointed a 21-member Governor's Commission on Home and Community-Based Services, whose purpose is to develop short and long-term strategies to create or expand community for persons with disabilities. The Commission released an Interim Report on December 23, 2002 (final report due June 2003). The interim report contains 16 recommendations that can be \"implemented quickly and with little or no fiscal impact or regulatory requirements.\" This Commission was developed out of the recommendations in the First edition and based on Systems Change grants that the state received from the Centers for Medicare and Medicaid Services (CMS). It is meant to carry the plan to the next level by looking at immediate strategies and making a plan for the next 10 years to allow people more community-based options. The Commission's information and its interim report are located at <A HREF=\"http://www.in.gov/fssa/community/index.html\">http://www.in.gov/fssa/community/index.html</A>   <H4>The Plan</H4> The 1st Edition covers individuals with physical and developmental disabilities, those with mental illness and the elderly, with an emphasis on consumer choice. Further, it addresses current residents of institutions with regard to whether they can or cannot be served in a community-based setting and people living in the community who may be at risk of institutionalization due to a lack of adequate services. A standardized evaluation is being developed for people with mental illness. Although one currently exists, it often is not used to determine admission to long-term care facilities. The plan includes six policy directions: <OL> <LI>Emphasize consumer choice by enabling individuals to receive the types of services they desire in the location they prefer.</LI> <LI>Provide information, assistance and access to consumers to increase their opportunity for informed choice. </LI> <LI>Support the informal network of families, friends, neighbors and communities.</LI> <LI>Strengthen quality assurance, monitoring systems, complaint system, and advocacy efforts.</LI> <LI>Increase the system capacity for provision of high-quality Care.</LI> <LI>Create a coordinated workforce development system that recruits and supports a stable resource of direct support staff.</LI></OL> Highlights of the plan include a goal of reducing the state psychiatric hospitals' overall census by 100 (by January 2003), legislation enacted to allow consumers to self-direct attendant care, and the reconfiguration of several administrative aspects of disability-related services. The plan includes timelines (based on a two-year window) and funding provisions (where the legislation has appropriated funds). The plan called for the creation of a commission to provide ongoing oversight of the implementation, continuation of the public discussion, and a leadership resource. As noted above, this commission was created in July 2002.   <H4>Implementation</H4> Legislation A statute enacted in 2002 places restrictions on the state's ability to close a developmental center. Funding Indiana officials are working to maximize community-based care. The legislature approved several requests made in the governor's budget to deal with these issues. For example, additional slots were approved for the aged and disabled waiver for FY 2002 and FY 2003. Also, an additional $6 million was appropriated for in-home services programs for each year of the biennial budget, with money for raises for direct care staff. Other examples include additional developmental disabilities waiver slots for FY 2002 and FY 2003 and the passage of legislation creating a Medicaid buy-in program for disabled workers. Lawsuits Two lawsuits, filed on behalf of physically disabled individuals, are pending. One case, Flores vs. Hamilton (formerly Inch vs. Humphreys), specifically challenges a failure to provide services in the most integrated settings to individuals with disabilities living in nursing facilities. A second case, Kraus vs. Hamilton (formerly Bennett vs. Humphreys), has been filed and is still awaiting action. For an update on lawsuits across the country, see Status Report: Litigation Concerning Medicaid Services for Persons with Developmental and Other Disabilities by Gary A. Smith at <A HREF=\"http://www.hsri.org/index.asp?id=news\">http://www.hsri.org/index.asp?id=news</A> Next Steps The state of Indiana received a $770,000 Nursing Facility Transitions, State Program Grant. The money is being used to: <UL> <LI>Establish at least one local coalition. </LI> <LI>Make necessary changes to eligibility and pre-admission screening laws and regulations. </LI> <LI>Establish partnerships with hospital discharge planners. </LI> <LI>Make necessary amendments to Medicaid waivers.</LI></UL>