Missouri adopts Olmstead
Missouri's legislature has passed the nation's first bill to reverse the institutional bias of Medicaid-funded health and personal assistance services. Every dollar of Medicaid long-term care funding in the state will now "follow the person" to the place where he or she wishes to live.
coalition of advocates, including Candace Hawkins of
Freedom Clearinghouse, held a press conference April 27 to
announce that Missouri is the first state to adopt
legislation which follows the U.S. Supreme Court's historic
Olmstead ruling. As of July 1, 2000, every Medicaid
long-term care dollar will be free to follow the person into
the setting where they prefer to receive services.
state has no rocks left to hide behind," Hawkins said. She is the
Freedom Clearinghouse national organizer and has been active in the passage
of this legislation since early January. "I've been living at the Capitol,"
she laughed. "Some of the representatives asked me, 'Are you sleeping
here too?' It was a lot of work, but 78,500 nursing home beds in our state
could be empty beds -- once people know they have the right to live where
they choose. And think of all the state institutions, ICFMRs and other
'slots' that will go empty now. We won!" For more of what Candace
read that whole interview by Josie Byzek in the July 2000 MOUTH.
April 18, 2000, Governor Mel Carnahan issued an
executive order establishing an Olmstead Commission that
will develop the state's comprehensive plan to integrate
people with disabilities. Until now, 73 percent of
Missouri's Medicaid long-term care expenditures have been
paying for institutional care.
Shown here, Candace Hawkins and Max Starkloff, two of the heroes of the Battle of Missouri. (Both are wheelchair users. But Max, being a much larger person, uses a much larger wheelchair.) Starkloff spent twelve years in a nursing home.
Missouri's advocates geared up for the job of liberating all people with disabilities from the state's institutional bias in late December, 1999. They called on the U.S. Health & Human Services regional Office for Civil Rights to assist them in bringing their state into compliance with the Olmstead ruling. "OCR has been with us every step of the way," Hawkins said. Attorneys from that office, as well as representatives of the Health Care Financing Administration, accompanied Clearinghouse advocates to crucial meetings with state department heads and with the governor's legal representatives.
March, Hawkins used the Freedom
Clearinghouse state plan blueprint
to draw up a state plan for Olmstead compliance. The
Regional Manager for OCR, John Halverson, was on hand with
litigators from his office when advocates presented it to
the state. Read
the Missouri Plan.
pattern to follow
those thirty Option states (read
all advocates must do is get money-follows-the-person
language written into an appropriations bill. In other
states, we must push for states to adopt the Personal Care
Option. Failing that, we must press each state department to
write a number of waivers, and press state legislatures to
That $645 million for freedom goes into circulation on July 1 this year. Realistically? The state has not yet put the necessary freedom mechanisms in place. We expect Missouri will dish out some put-it-offs, but freedom will come -- and soon.
Together, we can open the gates of freedom. Believe it.