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Stuff to DO

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Stuff to DO . . .
Put your state on notice. Mike Oxford of TILRC with a microphone

1. Spread the word,
all the time, everywhere you go,
to everyone you know

Here are some suggestions.

2. Link up with other advocates in your state.
Together, you can get Freedom to happen.

3. Hold a meeting with the Director of your Medicaid Agency to talk about developing the Plan.

You should set up this meeting NOW!


Know what you're getting into. A funny-but-serious look at how to handle the meeting.


Be sure you know how to negotiate Use this "how to negotiate" primer.


4. Get your state to State set up a
"Most Integrated Setting" committee
to develop a "Community Integration Plan."


This is a state plan that will implement the Olmstead decision. This committee should have a majority of people with disabilities, family members and advocates. (The jargon-y term they use is "stakeholders.")

Advocates in some states have already held their first meeting to plan the Plan. Others haven't started. Read the report from a Missouri advocate.


Colorado advocates met with federal officials from OCR.
Find out what happened.

Your state must set timetables for

getting people out of institutions

setting up new programs or expanding current ones to serve people in the community.

Among their choices are:

Getting the Medicaid personal care option to be part of the state Medicaid plan;

Getting (or increasing) various Medicaid waivers;

Setting up state-funded programs to pay for in-home services.

More about the Plan.

5. To do 3 and 4, you have to write The Letter. Image of woman writing

First, go online to the HCFA website to get contact information for your state Medicaid director.

Be sure to call the number listed to make sure the information is up-to-date before you address your letter.


Download this sample letter and modify it for your state's Medicaid Director. Be sure to enclose the relevant enclosures. Take a look at our list of websites to visit for other information. One of the sites lets you download "Across the States 1998: Profiles of Long-Term Care Systems, Third Edition." Enclose information from this report in your letter.

6. Find out who wants to move out.

All individuals in the state who apply to get Medicaid (people often apply for Medicaid when they decide they have to move into a nursing home) should receive information on ALL home and community service options.

The individual should sign that they have received the information and it should be put in their case file.

Your state should contract with advocates (your group?) to actually go into the nursing homes and other institutions in your state and let people know they have a choice -- that they can move out and that the state will pay for the support they need to live in their own home.

Who's going to do this?

How's it going to be set up?

Does your group want to do this?

Do you want a role in doing this?

Here's what you'll need.

7. Help folks file complaints.

People in nursing homes and other institutions who've been identified as wanting to live in the community but who are not being moved into the community should be helped to file ADA Title II complaints. This is something you can organize, too.

These complaints, filed with the Department of Health and Human Services' Office of Civil Rights, will charge the state with violating the ADA's "most integrated setting" mandate.

Do we need a new federal law?

You don't have to wait for MiCassa to become law, though, to make these things a reality in your state. With the Olmstead decision and with directives from the Administration, we have what we need.




More about the Community Integration Plan:

Right now, states are supposed to be "implementing Olmstead" -- setting up a way to make sure people get a choice to live in the "most integrated setting". Behind the jargon of "implementing Olmstead" and "most integrated setting" is freedom.

Your state must develop a Community Integration Plan It must include:

1) assurances that anyone applying for Medicaid is told they have an option to live at home and use Medicaid money for services;

2) a plan to tell those currently in nursing homes and other institutions that they have a right to get services in the community and

3) a timetable for getting people out and expanding in-home services (through Medicaid Personal Care Options or Waivers.)

You, as part of the Freedom Clearinghouse network, are going to see that your state does that -- and does it in a timely manner".

See the January 14 letter federal officials sent state Medicaid Directors on implementing Olmstead.

Soon we'll have a sample Plan for you to look at and use to model your state plan on. Watch this spot for a link to it!
email us for more information about developing a plan.




Filing complaints

If your state balks at implementing Olmstead, or if it refuses to let people move out of institutions, you can file ADA complaints with the Office of Civil Rights in the Dept. of Health and Human Services. This website will give you the HHS Office of Civil Rights information for your region.


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