CDCAN REPORT #095-2011: CA Health & Human Services Agency Secretary Diana Dooley will convene toll-free Olmstead Advisory Committee meeting Thursday April 28

• California Health & Human Services Secretary Diana Dooley Will Hold Brown Administration’s First Meeting of Olmstead Advisory Committee Thursday 10 AM
• Advisory Committee Established Under Governor Schwarzenegger in 2004 To Advise On State’s Compliance of Landmark 1999 US Supreme Court Decision That Requires States To Take Steps To Avoid Unnecessary or Unjustified Institutionalization of People With Disabilities, Mental Health Needs and Seniors – Original 1995 Lawsuit Filed By Two Women (Lois Curtis and Elaine Wilson)With Developmental and Other Disabilities From State of Georgia

SACRAMENTO, CALIF  (CDCAN)  [Last Updated 04/27/2011  11:55 PM] -  California Health and Human Services Agency Secretary Diana Dooley convenes the Brown Administration’s first meeting of the Olmstead Advisory Committee Thursday morning (April 28th), from 10:00 AM to 4:00 PM, at the Department of Rehabilitation office building, Room 242, 721 Capitol Mall (corner of 8th Street), Sacramento, just two blocks from the State Capitol.  A toll free line is available for persons who cannot physically attend the meeting: Toll-Free Call-In Number: 1-888-232-0362    Passcode:785453    There will be time for public comment for those attending in person and for those participating by phone [see below for meeting agenda.

Secretary Dooley, whose agency oversees the Departments of Health Care Services (Medi-Cal, long term care), Social Services (IHSS, SSI/SSP, CalWORKS, Community Care Licensing, foster and adoption assistance programs), Developmental Services (regional centers and developmental centers), Mental Health (community based  services and state hospitals), Rehabilitation (Independent Living Centers), and Aging (Multipurpose Senior Services Program, Area Agencies on Aging and other senior programs), Public Health and several other departments and boards, is scheduled to provide opening remarks and an update – presumably  on the still unresolved State budget crisis as it impacts health and human services that serves infants, children and adults with disabilities, mental health needs, and seniors.

Health & Human Services Hard Hit By Budget Reductions

• The health and human services budget was hard hit by over $6 billion in reductions in State general fund spending proposed by Governor Brown in January – most of which were approved by the Legislature in March and signed into law by the Governor [some of the cuts – such as the reduction to the Multipurpose Senior Services Program - are in the main budget bill which was passed by the Legislature but has never been sent (“presented”) to the Governor due to the issue of extending for five years the 2009 temporary tax increases and other related issues. 
• That main budget bill will likely be brought back and revised after the Governor releases his budget revisions on May 16th – and then put up for another vote on or just before June 15th – the State Constitutional deadline to pass a State Budget before the Proposition 25 penalties go into effect.
• Those penalties include permanently not paying (forfeiting) the pay, travel and living expenses and reimbursements of each legislator for each day after June 15th that a State budget is not passed and presented to the Governor.(budget doesn’t have to be signed into law – just presented or sent to the Governor).

Committee Named After Landmark 1999 US Supreme Court Decision

• The committee name and purpose is from the landmark 1999 US Supreme Court decision known as the “Olmstead Decision” from a lawsuit that was filed in 1995 in a federal district court in Georgia by two women with developmental and other disabilities, Lois Curtis and Elaine Wilson [Photo of above left of Elaine Wilson, wearing white, and Lois Curtis, wearing purple] who resided at the time in a state facility. CDCAN Note: Wilson passed away December 5, 2004 at age 53]
• The US Supreme Court ruled in June of 1999 that states were required to take steps to avoid the unnecessary or unjustified institutionalization of persons with disabilities, mental health needs and seniors. 
• Some of those steps were linked directly to availability of funding but the decision clearly underscored, according to advocates, the basic rights of people with disabilities, mental health needs and seniors.
• Ironically, the decision is widely known not for the names of the two women who filed the lawsuit but after the defendant – the then head of the Georgia State agency dealing with health and human services in 1995 – Commissioner Tommy Olmstead.

Committee Established by Schwarzenegger Continues Under Brown

• California Health and Human Services Secretary Diana Dooley, who succeeded Kim Belshe in January, indicated in early February that she intended to continue the disability, mental health, senior rights advisory committee that was established by executive order under Governor Arnold Schwarzenegger in September 2004 immediately after he vetoed legislation authored by then Sen. Wes Chesbro in 2004, which would have required, in State law, the creation and continued establishment of such an advisory committee.
• Governor Schwarzenegger later issued an executive order in 2008 that replaced his previous order.  The advisory committee continues under Governor  Jerry Brown unless he rescinds the executive order by Schwarzenegger.  
• That executive order by Schwarzenegger continues unless rescinded by Governor Brown. Secretary Dooley in early February said that she wanted the committee – and the members – to continue. 
• The Olmstead Advisory Committee advises the Secretary of the California Health and Human Services Agency,  – the state agency that oversees several departments that administer statewide a wide range of services and supports for children and adults with disabilities (including developmental), mental health needs, the blind, people with MS, Alzheimer’s disorders and diseases, people with traumatic brain and other injuries, and seniors. However like other government related advisory committees, the Olmstead Advisory Committee has no actual decision making authority. 
• Since its first meeting in March 2005, the committee received important updates from the Secretary of the Health and Human Service Agency and the heads of the major departments and Belshe has stated several times over the years that the committee members input and concerns are taken into consideration during internal policy discussions – including those on the state budget – by the Schwarzenegger Administration.
• The committee has its supporters and critics – some who say the committee has been a good vehicle to get information and updates, and to help shape some major important policy initiatives dealing with long term care, community-based services and other issues, including various major proposals, including new federal waivers (or demonstration projects) that have drawn down more federal matching dollars in support of those programs.
• Supporters of the committee say the near constant presence and participation at virtually every committee meeting since it was established by Secretary Belshe, and also the various department heads has been important in understanding or influencing State policies regarding implementation of the Olmstead Decision. 
• Critics however contend the committee has not been effective in changing the Schwarzenegger Administration’s or Legislature’s approach in solving the enormous budget shortfalls over the past several years that they argue have undermined or even reversed previous progress in the State’s implementation of the Olmstead Decision.  They point to sweeping cuts and even outright program eliminations that were proposed and deep cuts that were actually enacted since 2002 under Gray Davis and Arnold Schwarzenegger, impacting thousands of people with disabilities, mental health needs, the blind and seniors – and now massive reductions and cuts proposed by Governor Brown and passed by the Legislature. 
• Similar concerns have been raised in other states that have a similar advisory committee – and nearly all of the other  states have made major reductions and changes in eligibility – many permanent that impact people with disabilities, mental health needs, the blind and seniors

Compliance of US Supreme Court Decision Has Impact On State Budget Decisions and Policy

• The issue of California’s compliance with the Olmstead Decision – and the provisions of the federal law that the decision was made under – the Americans with Disabilities Act, along with federal Medicaid and Social Security laws and regulations, are critical in terms of implementing (or not implementing) State budget reductions and elimination of several services and benefits. 
• Since that decision, advocates across the nation and in California have criticized the slow pace of implementation and compliance by the federal government and in various states.
• Compliance and implementation was made more difficult due to on-going budget deficits in nearly all the states that resulted in major budget reductions to health and human services.
• California state officials during the Davis and Schwarzenegger Administrations have said that the state, given the fiscal and other budget problems since 2002, is moving as fast as it can toward compliance.

AGENDA FOR APRIL 28th MEETING

Olmstead Advisory Committee Meeting
Meeting Notice and Agenda
Aril 28, 2011:  10 am – 4 pm
Department of Rehabilitation, Room 242
721 Capitol Mall, Sacramento, California
Toll-Free Call-In Number: 1-888-232-0362    Passcode: 785453

AGENDA (public comment time between each item)

1.  Introductions:  Brenda Premo, Chair, members and department representatives          

2.  Welcoming Remarks: Secretary Diana Dooley                

Secretary Dooley will share her background and perspective as part of the Brown Administration, and will discuss goals for the Olmstead Advisory Committee and objectives for the day’s meeting.

3.         Working Lunch

Update on activities of California Community Choices and the California Community Transitions demonstration. Both projects received funding in the fall of 2010 to assist Californians in navigating their health and long term care options.  The CHHS received a grant to develop standards for and to strengthen long term care options counseling, and another to increase participation in existing evidence-based care transition projects. Department of Health Care Services received funding to assist community-based organizations in responding to requests for options counseling by nursing facility residents.                                                                               

4.  California Olmstead Plan Update Overview: Secretary Dooley

Committee members have identified a need to update the California Olmstead Plan of 2003. A subcommittee will be needed to develop a workplan and to recommend a structure to deliver a strong product. Members will break into two groups to brainstorm and prioritize the “who, what, how and when” relating to updating the plan.

5.  Breakout Group Discussions

Small group discussions will focus on strategies for updating the 2003 Olmstead Plan. Groups will discuss priorities for a subcommittee that will identify work necessary to update the plan, including: membership/participation, scope of work, content structure, timeframes and strategies for funding the effort.

6.  Reports from the Breakout Groups: Members

Each group will share the most important elements for a newly charged subcommittee relating to:

• [Olmstead committee] membership/participation
• scope of work
• content structure
• timeframes, and
• strategiesfor funding the effort.
   

7.  Discussion of care coordination initiatives

Members will discuss California’s [Section] 1115 [Medicaid] Waiver implementation and the recently announced federal award to integrate care for people eligible for both Medicare and Medicaid. California is among 15 states that the Centers for Medicare & Medicaid Services, Federal Coordinated Health Care Office funded to implement strategies to coordinate primary, acute, behavioral and long-term supports and services for people dually-eligible for these healthcare benefits.

8.  Olmstead-related Legislation: Members

An open discussion of legislation relating to members’ Olmstead priorities.

9.  Closing Remarks: Diana Dooley

In consideration of attendees who are sensitive to environmental odors created by chemicals and perfumes, please restrict the use of fragrances at this meeting.  If disability-related accommodations are required for your attendance or you need materials in alternate formats, please contact Megan Juring at               (916) 654-0662, TTY (916) 558-5807, or at mjuring@chhs.ca.gov at least five days prior to the meeting date. American Sign Language interpreters will be available at the meeting.

Please note:  The order in which the agenda items are considered may be subject to change. Opportunities for public comment will be provided throughout the agenda.              

Meeting Dates and Locations For 2011

• April 28, 2011 – Thursday
• August 18, 2011 – Thursday
• November 9, 2011 - Wednesday

All meetings will be held at:

Department of Rehabilitation office building - Room 242
721 Capitol Mall (corner of 8th Street)
Sacramento, CA  95814(just two blocks from the State Capitol)

For more information contact:

Megan Juring, Deputy Director - Independent Living and External Affairs
Department of Rehabilitation
Phone: (916) 558-5820
Email: mjuring@dor.ca.gov

GOVERNOR’S 2008 ORDER REGARDING OLMSTEAD ADVISORY COMMITTEE (REPLACED 2004 ORDER)

• CDCAN Note: Governor Schwarzenegger issued two executive orders regarding the establishment of an Olmstead Advisory Committee – the first in September 2004 and the second (which replaces that original order) issued in September 2008. 
• The only major difference between the two orders is that the establishment of the advisory committee is now at the discretion of the Secretary of the California Health and Human Services Agency rather than by order of the Governor.
• Unless rescinded by Governor Brown (Secretary Diana Dooley indicated in early February that the advisory committee – and the executive order – would continue), Schwarzenegger’s 2008 executive order remains in force.

EXECUTIVE ORDER S-10-08

09/24/2008

WHEREAS unnecessary institutional placement of individuals with disabilities adversely affects the everyday life activities, family relations, social contacts, work options, economic independence, and cultural enrichment of those institutionalized persons; and

WHEREAS the state has a responsibility to protect against the unnecessary institutionalization of individuals with disabilities; and

WHEREAS the opportunity to direct one's own affairs, live independently, and attain economic self-sufficiency is an essential component of developing self-worth and personal responsibility; and

WHEREAS direction has been provided to states under the Americans with Disabilities Act and the United States Supreme Court's decision in Olmstead v. L.C.; and

WHEREAS community-based care and services can be more cost effective than institutional care, and result in a higher quality of life that promotes the values of community participation, inclusiveness, and respect for diversity; and

WHEREAS the active involvement of people with disabilities and their representatives in the development and implementation of activities designed to move people into, or allow them to remain in, community-based settings is critical to insuring effective strategies; and

WHEREAS California has a demonstrated record of success in providing services that support the full integration of persons with disabilities in community life through such programs as In-Home Supportive Services, Medi-Cal, community mental health, and the comprehensive array of services defined under the Lanterman Act; and

WHEREAS it is possible to build upon California's previous success to improve procedures and implement new tools that will enable more people to fully access their communities.

NOW, THEREFORE, I, ARNOLD SCHWARZENEGGER, Governor of the State of California, by virtue of the power vested in me by the Constitution and Statutes of the State of California, do hereby issue this order effective immediately:

1.  The state affirms its commitment to provide services to people with disabilities in the most integrated setting, and to adopt and adhere to policies and practices that make it possible for persons with disabilities to remain in their communities and avoid unnecessary institutionalization.

2.  The California Health and Human Services Agency (HHSA) shall do all of the following:

A.  Assess the state's ability to reasonably accommodate new and improved efforts to prevent unnecessary institutionalization of individuals with disabilities and to facilitate or expand community-based services and supports.

B.  Continue to evaluate the May 2003, California Olmstead Plan and make revisions as necessary to insure that it will result in positive action toward the objectives of providing services to people with disabilities in the most integrated setting possible, and enabling persons with disabilities to remain in their communities and avoid unnecessary institutionalization.

C.  Identify additional strategies to identify Californians who could be served successfully in non-institutional settings and the barriers to these individuals moving at a reasonable pace from, or avoiding admittance to, institutional long-term care facilities.

D.  Research funding opportunities to support expanded or new activities to support individuals with disabilities in their communities.

E.  Develop recommendations for changes in state policies that will remove programmatic and fiscal incentives for institutional placement and increase opportunities to utilize community-based services.

F.  Develop recommendations for changes in federal policies that will remove programmatic and fiscal incentives for institutional placement and explore options for expanding or modifying the state Medicaid plan or Medicaid waivers.

3.  In order to inform the Administration's understanding of the current system and future opportunities and insure the involvement of persons with disabilities and other system stakeholders, the Secretary of HHSA [California Health and Human Services Agency], at his or her discretion, is authorized to form an advisory group to provide input to the HHSA on its efforts to evaluate, revise, implement, and monitor the Olmstead Plan, on recommended actions to improve California's long-term care system, and on opportunities to fund expanded or new activities to support individuals with disabilities in their community.  The Secretary should take into account the diversity of California's citizenry with respect to culture, language, geography, and disability in formulating the membership of his or her advisory group.

4.  All state agencies and departments are hereby directed to cooperate with and assist the HHSA in carrying out its duties under this Executive Order.

5.  This Executive Order supersedes Executive Order S-18-04, dated September 27, 2004.

I FURTHER DIRECT that as soon as hereafter possible, this order be filed in the Office of the Secretary of State and that widespread publicity and notice be given to this order.

This order is not intended to, and does not create any right or benefits, substantive or procedural, enforceable at law or in equity, against the State of California, its departments, agencies, or other entities, its officers or employees, or any other person.

IN WITNESS WHEREOF I have hereunto set my hand and caused the Great Seal of the State of California to be affixed this 22nd day of September 2008.

ARNOLDSCHWARZENEGGER
Governor of California

ATTEST:

DEBRA BOWEN
Secretary of State