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With An Eye to the Future

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Olmstead Plan Chronology

Department of Administration Governor's Council on Developmental Disabilities
July 1, 2019

2017

January 2017

The Person-Centered, Informed Choice and Transition Protocol was developed to ensure that people being served get to live the life they desire. This protocol communicated DHS' expectations regarding person-centered practices with its lead agency partners, which include counties, tribes, and health plans. Person-centered practices were the cornerstone of the Olmstead Plan. If adopted and practiced across systems, it would result in people being able to make informed choices for themselves and having a higher quality of life. It was the intent of the state that the entire system of long-term services and supports be person- centered. Thus, person-centered principles and practices were to be applied to all people who receive long-term services and supports and mental health services.

February 2017

The Quality of Life Survey was launched.

February 22, 2017

During an Olmstead Subcabinet meeting, the Subcabinet reviewed and approved a baseline and goal for transportation goal 4: By 2025, transit systems' on time performance will be 90 percent or greater statewide. The proposed baseline for this 10-year goal was 76 percent on time performance within a 45-minute timeframe. For additional details, see page 15 of the February 22, 2017 meeting materials.

The Olmstead Subcabinet also reviewed proposed revisions to the Plan, marking the Subcabinet's third review of the revised Plan. Changes to the Plan included (see page 4 of the February 22, 2017 meeting minutes for additional details):

  • A new introductory letter.
  • A summary of public comments received, particularly around direct service workforce issues, a topic that was to be discussed in further detail over the coming year.
  • Addition of language that created a strategy for expanding and improving Minnesota's direct service workforce.
  • Addition of language that created a cross-agency workgroup.
  • Addition of background language to support the assistive technology topic area.
  • Finally, two new baselines were reviewed and approved by the Olmstead Subcabinet:
  • Person-centered planning goal 1: Baseline for plans meeting protocols is 47.
  • Transition services goal 1c: Baseline number of people who have moved from segregated settings to more integrated settings is 1,121.

For additional details on these baselines, see page 23 of the February 22, 2017 meeting materials.

February 27, 2017

The quarterly report was approved by the Olmstead Subcabinet, including data acquired through January 31, 2017. This report included progress toward goals related to:

  • Movement of people with disabilities from segregated to integrated settings (n = 487).
  • Movement of individuals from waiting lists.
  • Quality of Life measurement results (not available at the time of the report).
  • Increasing system capacity and options for integration.

The majority of Olmstead Plan measurable goals (18 of 25) were met, on track to be met, or in process. Notable findings and planned responses included:

  • The June 30, 2017 goal to increase the percentage of people at AMRTC awaiting discharge to 33 percent or more was not on track to be met. To help address individuals under Rule 20 commitment, DHS increased capacity to provide additional community- based residential competency restoration services for individuals who no longer needed hospital level of care at AMRTC. The Community Competency Restoration Program (CCRP) was developed in late 2016 and began serving individuals in January 2017. An amendment to this goal was approved by the Olmstead Subcabinet on February 22, 2017. The amended goal focused on measurement of progress for individuals under mental health commitment.
  • The 2016 goal to increase the average monthly number of discharges of individuals leaving MSH to 11 or more was not met. DHS efforts continued to expand community capacity. In addition, MSH continued to work towards the mission of Olmstead by identifying individuals who could be served in more integrated settings. Noteworthy was that MSH served a large portion of people committed as Mentally Ill and Dangerous (MI&D). Effective January 1, 2016, the Minnesota statute governing MI&D processes was updated to require that each person under MI&D commitment be reviewed every three years to consider appropriateness for a reduction in custody. A reduction in custody could include a transfer from MSH to a non-secure treatment setting, provisional discharge, or dismissal from civil commitment. This new action was anticipated to help ensure that those under MI&D commitment were also considered within Olmstead's mission, and were being assessed for the most integrated setting. To support this initiative, MSH worked to establish an internal committee in June 2016, the Forensic Review Panel (FRP). The FRP was responsible for conducting a thorough and comprehensive review of individuals' clinical progress and risk management factors in order to make recommendations for changes in custody.
  • The June 30, 2017 goal to reduce mechanical restraints to no more than 277 reports was not on track to be met.
  • The June 30, 2016 goal to decrease the number of people who discontinue waiver services after a crisis (indicating a more segregated setting) to no more than 55 people was not met. Given the small number of people being identified in any given quarter as part of this measure, beginning in March 2017, DHS staff planned to conduct person- specific research to determine the circumstances and outcomes of each identified waiver exit. This research would enable DHS to better understand the reasons why people were exiting the waiver within 60 days of receiving a service related to a behavioral crisis and target efforts where needed most to achieve this goal.

Additionally, in December 2016, DHS awarded license capacity to serve 38 more people at any given time in out-of-home crisis respite services. This would increase the system's ability to provide crisis stabilization services for people on a waiver in a home- and community-based services environment, rather than in more segregated settings. This new capacity was scheduled to begin in March 2017.

  • The October 1, 2016 goal to increase the number of students who entered into an integrated postsecondary setting within one year of leaving secondary education by 50 over baseline to 275 was not met. MDE proposed to continue working with the colleges and universities in the Minnesota State system to provide technical assistance to local education agencies for the purpose of increasing the number of students with disabilities who were enrolled in an integrated (two- and four-year colleges and universities) postsecondary education setting by 2020.
  • The June 30, 2016 goal to reduce the number of students experiencing emergency use of restrictive procedures by 105 was not met, nor was the goal to reduce the number of incidents of emergency use of restrictive procedures by 750. In addition to prohibiting prone restraint, several other steps were taken to address this goal, including a request for funding during the legislative session by the Restrictive Procedures Stakeholder's Workgroup to provide capacity building to schools so that students could remain in more inclusive settings, PBIS training for schools, and provision of resources and other technical assistance for schools.

February 28, 2017

Annual amendment to the Olmstead Plan: Several rounds of public comment on the June 2016 Plan amendment were held. Many of the recommendations focused on direct service workforce issues either in general, or as they related to person-centered planning, transition services, housing, and employment. These comments raised concern that without improvements to these workforce issues, improvement in the topic areas was unlikely.

March 27, 2017

The Community Engagement Workgroup began. Changes to the workgroup's charter, including clarification on the roles and responsibilities of the workgroup and an adjustment of deadlines for completing assigned tasks, were approved by the Olmstead Subcabinet.

Additionally, the Person-Centered, Informed Choice and Transition Protocol, developed initially in January 2017, was approved by the Olmstead Subcabinet. This protocol communicated DHS' expectations regarding person-centered practices with its lead agency partners, which included counties, tribes, and health plans. DHS planned to work with lead agencies to implement this protocol across the home- and community-based long-term supports and services and mental health services systems. Person-centered practices ensure that the people served get to live the life they desire. Using person-centered practices also can improve job satisfaction for the professionals who use them. It is particularly important for a person who is transitioning from one living arrangement to another to have a person- centered process and transition plan. This protocol was fundamental to reforming systems to

be in compliance with the Olmstead Plan. If adopted and practiced across systems, it would result in people being able to make informed choices for themselves and having a higher quality of life. The protocol was a set of essential elements that support planners and assessors needed to use to drive Minnesota's long-term services and supports and mental health system, including but not limited to, services provided when a person moves from one setting to another. Both parts of the protocol illustrated how these person-centered practices apply through the entire service cycle of: discovery, learning and assessment; support and action planning; implementation; and quality review.

Finally, the Olmstead Subcabinet procedures were revised, including:

  • An update to the preamble to reflect the most recent updates to the Olmstead Plan.
  • An update to the membership list to better reflect the Olmstead Subcabinet membership of the Ombudsman for the State of Minnesota Office of the Ombudsman for Mental Health and Developmental Disabilities and the executive director of the Minnesota Governor's Council on Developmental Disabilities, who were granted ex officio voting status.
  • Clarifications on expectations regarding designees and designee alternates.
  • Clarification regarding the expectation that agencies will take appropriate steps to further progress on the Olmstead Plan goals and to comply with OIO compliance procedures.
  • Clarification regarding the distribution of meeting materials; regarding public comments at meetings; regarding the duties of the OIO related to compliance procedures; and regarding approval of workgroup membership by the Chair.
  • Inclusion of the dates of original approval and subsequent revisions at the top of Olmstead Subcabinet procedures for archival purposes.

For additional details, see page 5 of the March 27, 2017 meeting minutes.

April 5, 2017

A Court order was issued amending the deadline of the Plan amendment and submission of workplans. Also at the Status Conference, defendants' counsel raised an objection to the Court's continuing jurisdiction over this matter. Defendants' counsel argued that this Court lacked jurisdiction in light of the terms of the parties' settlement agreement. Plaintiffs' class counsel responded, arguing that the Court had jurisdiction, pointing to the procedural history of this case since the settlement agreement was approved. Based upon the presentations and submissions before the Court, and the Court being otherwise duly advised in the premises, IT IS HEREBY ORDERED that:

  1. At the March 24, 2017 biannual status conference, Commissioner Mary Tingerthal, the Chair of the Olmstead Subcabinet, presented two administrative proposals for the Court's approval. First, Commissioner Tingerthal proposed an adjustment to the current reporting schedule to move the deadline for reporting Olmstead Plan amendments, to March 31. Second, Commissioner Tingerthal proposed that Olmstead Plan Workplans no longer be submitted to the Court for review or approval. The Court appreciates Commissioner Tingerthal's attentiveness to ensuring the accuracy of Olmstead Plan reporting and the efficiency of the Olmstead Subcabinet's efforts. Consistent with these aims, the Court APPROVES Commissioner Tingerthal's proposals. To the extent prior orders of the Court are inconsistent with these proposals, they are hereby superseded.
  2. In light of defendants' objection to the Court's jurisdiction, the Court directs the parties to submit briefing on this issue, addressing whether the Court presently has jurisdiction over this case. The parties shall meet and confer to establish a briefing schedule and submit a proposal to the Court for approval no later than Friday, April 14, 2017. If the parties cannot agree on a briefing schedule, the Court will impose a schedule. The Court reserves the right to hold a hearing on defendants' jurisdictional objection or direct further briefing from the parties.

April 10-30, 2017

A public comment period was held on person-centered planning practices. Comments were obtained via email and survey, yielding 130 comments.

May 22, 2017

Two new baselines were reviewed and approved by the Olmstead Subcabinet:

  • Waiting list goal 2: From January to December 2016, of the 1,584 individuals assessed, 719 individuals or 45 percent moved off the DD waiver waiting list at a reasonable pace. This baseline was updated because the 2015 baseline for Waiting List Two in the Olmstead Plan was based on the previous reporting system and cannot be used for direct comparison with current waiting list data. After a full year of urgency data was collected, this new baseline was proposed.
  • Preventing abuse and neglect goal 2: Baseline number of hospital treatments that reflect abuse and/or neglect to a vulnerable individual is 50.

For additional details on these baselines, see page 17 of the May 22, 2017 meeting materials.

The quarterly report was approved by the Olmstead Subcabinet, including data acquired through April 30, 2017. This report included progress toward goals related to:

  • Movement of people with disabilities from segregated to integrated settings (n = 518).
  • Movement of individuals from waiting lists.
  • Quality of Life measurement results (not available at the time of the report).
  • Increasing system capacity and options for integration.

The majority of Olmstead Plan measurable goals (16 of 22) were met, on track to be met, or in process. Notable findings and planned responses included:

  • The June 30, 2017 goal to reduce the percentage of people at AMRTC awaiting discharge to 33 percent or less was not on track to be met. It was noted that in order to meet timely discharge, individual treatment planning was necessary for patients under mental health commitment who no longer need hospital level of care. This could involve the development of customized living situations to meet their individualized needs which was almost always a very lengthy process.
  • The 2017 goal to increase the average monthly number of MSH discharges to eight or more was not on track to be met. Ongoing efforts included collaboration with counties to identify individuals at MSH who had reached maximum benefit from treatment and to identify community providers and expand community capacity.
  • The June 30, 2017 goal to increase the percentage of plans for people using disability- and community-based waiver services that met the required person-centered and informed choice protocols to 50 percent was not on track. In January 2018, DHS planned to begin taking corrective action, requiring remediation when lead agencies did not comply with the person-centered review protocols. When findings from case file review indicated files did not contain all required documentation, the agency would be required to bring all cases into full compliance by obtaining or correcting the documentation. All corrections would need to be made within 60 days of the lead agency review site visits.
  • The June 30, 2017 goal to reduce mechanical restraints to no more than 277 reports was not on track to be met.
  • The 2016 goal to increase the percentage of people with disabilities other than intellectual and developmental disabilities (I/DD) who were always in charge of their services and supports to 75 percent or higher was not met.
  • The June 30, 2017 goal to increase the percentage of adults who received adult mental health crisis services and remained in their community (e.g., home or other setting) to 60 percent was not on track to be met. DHS planned to provide training to mobile crisis teams to increase their ability to work with more complex clients/situations effectively.

June 26, 2017

A new baseline was reviewed and approved by the Olmstead Subcabinet:

Preventing abuse and neglect goal 2: After the quarterly report was approved by the Olmstead Subcabinet, it was discovered that the baseline was improperly calculated using a span of four years rather than the actual five year span. This resulted in the Olmstead Subcabinet approving a baseline of 50. The corrected baseline of 40 was included in the quarterly report that was filed with the Court and the corrected baseline was brought back to the Olmstead Subcabinet for ratification. For additional details, see page 47 of the June 26, 2018 meeting materials.

August 28, 2017

A new baseline was reviewed and approved by the Olmstead Subcabinet:

Lifelong learning and education goal 3: Effective consideration of assistive technology in student IEPs baseline is 26 students with IEPs where there was active consideration of assistive technology in the IEP. For additional details, see page 11 of the August 28, 2017 meeting materials.

The quarterly report was approved by the Olmstead Subcabinet, including data acquired through July 31, 2017. This report included progress toward goals related to:

  • Movement of people with disabilities from segregated to integrated settings (n = 527).
  • Movement of individuals from waiting lists.
  • Quality of Life measurement results (not available at the time of the report).
  • Increasing system capacity and options for integration.

Just over half of Olmstead Plan measurable goals (12 of 20) were met, on track to be met, or in process. Notable findings and planned responses included:

  • The June 30, 2017 goal to reduce the percentage of people at AMRTC awaiting discharge to 33 percent or less was not met. Ongoing efforts to improve progress toward this goal included collaboration between AMRTC and counties to aid in identifying more applicable community placements and resources for patients awaiting discharge as well as improvements in AMRTC's notification process for patients who no longer met hospital criteria of care to county partners and other key stakeholders to ensure that all parties involved were informed of changes in the patient's status and resources were allocated towards discharge planning. As in the previous quarterly report, it was noted that in order to meet timely discharge, individual treatment planning was necessary for patients under mental health commitment who no longer need hospital level of care. AMRTC continued to collaborate with county partners to identify, expand, and develop integrated community settings. Additionally, new legislation required that $1 million in general fund revenues collected by the AMRTC and the community behavioral health hospitals (CBHHs) would be used to award grants to improve the access to and quality of community-based outpatient mental health services. Increased funding would help reduce the number of patients admitted to regional treatment centers and CBHHs and improve community resources for patients awaiting discharge.
  • The 2017 goal to increase the average monthly number of discharges of individuals leaving MSH to eight or more was not on track to be met. DHS efforts continued to expand community capacity. In addition, Forensic Services continued to work towards the mission of Olmstead by identifying individuals who could be served in more integrated settings. Legislation increased the base funding to improve clinical direction and support to direct care staff treating and managing clients with complex conditions, some of whom engage in aggressive behaviors. The funding enhanced the staffing model to achieve a safe, secure and therapeutic treatment environment. Ongoing efforts also included collaboration with counties to identify individuals at MSH that reached maximum benefit from treatment and to identify community providers and expand community capacity.
  • The June 30, 2017 goal to increase the percentage of individuals choosing to move to a more integrated setting who had a plan that adhered to transition protocols that met the principles of person-centered planning and informed choice to 30 percent was not on track to be met. In January 2018, DHS planned to begin taking corrective action, requiring remediation when lead agencies did not comply with the person-centered review protocols. When findings from case file review indicated files did not contain all required documentation, the agency would be required to bring all cases into full compliance by obtaining or correcting the documentation. All corrections needed to be made within 60 days of the lead agency review site visits. To address continuing compliance issues, DHS planned to conduct regional day-long training and technical assistance sessions with counties and tribes from May through September 2017. A supervisor tool kit was also being developed to support counties, tribes and contracted case management providers in the oversight of plan development according to the protocol. The expectation was that the number of plans that adhere to the protocols would increase over time and during 2018.
  • The March 1, 2017 goal to eliminate the DD waiver waiting list for persons leaving an institutional setting and for persons with immediate need as defined by Minn. Statutes, sections 256B.49, subdivision 11a(b) and 256B.092, subdivision 12(b) was not met. In addition to updating this goal to more accurately define success in the institutional exit and immediate need categories accessing waiver funding at a reasonable pace, DHS planned to work with lead agencies to continue to approve funding according to the reasonable pace goals.
  • National Core Indicator data from Minnesota from 2015 to 2016 suggested that the majority of people with intellectual and developmental disabilities would like a job in the community, were mobile, and that there was room for improvement in choice of living situation and community engagement.
  • The June 30, 2017 goal to increase the percentage of plans for people using disability home- and community-based waiver services that met required person-centered planning and informed choice protocols to 50 percent was not on track to be met. All counties had received recommendations relating to person-centered practices. Counties were in varying stages on their person-centered journey. The recommendations encouraged lead agencies to set expectations for the quality and content of support plans as well as to seek out and provide training for their staff on providing person-centered practices. This could involve changes in agency practices as well as changes to how agencies worked with their community partners.
  • The June 30, 2017 goal to reduce mechanical restraints to no more than 277 reports of mechanical restraint was not on track to be met.
  • Both June 30, 2017 goals to increase the number of self-advocates by 50 and to increase the number of people with disabilities involved in a publicly funded project by 75 were not met because there was no reliable and valid data to report.

October 23, 2017

Work plans for the 2017 Olmstead Plan were developed and approved by the Olmstead Subcabinet, subject to revisions discussed during the October 23, 2017 Subcabinet meeting.

Additionally, the Community Engagement Workgroup presented recommendations for the public input process to the Olmstead Subcabinet, which were approved with suggested edits. Major recommendations included the following—for additional details, see page 19 of the October 23, 2017 meeting materials:

  • Ensure that the public input process is as accessible and inclusive as possible.

  • Build culturally-competent relationships and two-way communication with diverse communities.

  • Develop strategies to incorporate transparency and accountability in every phase of the process.

An implementation plan for this work was to be developed by the OIO and presented to the Olmstead Subcabinet for review and approval at the November 27, 2017 Subcabinet meeting.

November 2017

The Quality of Life Survey closed. At completion, 2,005 people, selected by random sample, participated in the survey. This survey was designed specifically for people with disabilities of all ages who were authorized to receive state-paid services in potentially segregated settings. This survey sought to talk directly with individuals to get their own perceptions and opinions about what affects their quality of life.

November 27, 2017

Two new baselines were reviewed and approved by the Olmstead Subcabinet:

  • Employment goal 2: When the 2014 baseline was established, a data system was not yet developed to measure the number of people in competitive integrated employment. After data became available, a baseline was proposed: In 2014, of the 50,157 people age 18-64 receiving services from certain Medicaid funded programs, 6,137 were in competitive integrated employment.
  • Transportation goal 3: In December 2016, public transportation in Greater Minnesota was meeting minimum service guidelines for access 47 percent on weekdays, 12 percent on Saturdays and 3 percent on Sundays.

For additional details on these baselines, see page 15 of the November 27, 2017 meeting materials.

The quarterly report was approved by the Olmstead Subcabinet, including data acquired through October 31, 2017. This report included progress toward goals related to:

  • Movement of people with disabilities from segregated to integrated settings (n = 495).
  • Movement of individuals from waiting lists.
  • Quality of Life measurement results (not available at the time of the report).
  • Increasing system capacity and options for integration.

Just over half of Olmstead Plan measurable goals (17 of 26) were met, on track to be met, or in process. Notable findings and planned responses included:

  • The June 30, 2018 goal to reduce the percentage of people awaiting discharge at AMRTC to 32 percent or less was not on track to be met. Ongoing efforts to improve progress toward this goal included collaboration between AMRTC and counties to aid in identifying more applicable community placements and resources for patients awaiting discharge, as well as improvements in AMRTC's notification process for patients who no longer met hospital criteria of care to county partners and other key stakeholders to ensure that all parties involved were informed of changes in the patient's status and resources were allocated towards discharge planning.
  • The December 2017 goal to increase the average monthly number of individuals leaving MSH to a more integrated setting to eight or more was also not on track to be met. Ongoing efforts included collaboration with counties to identify individuals at MSH who reached maximum benefit from treatment and to identify community providers and expand community capacity.
  • The June 30, 2017 goal to increase the percentage of those choosing to move to a more integrated setting who had a plan that adhered to transition protocols that met the principles of person-centered planning and informed choice to 30 percent was not met. Since July 2016, the lead agency review team made recommendations to each county visited on how to improve their person-centered practices. Counties were in varying stages on their person-centered journey. The recommendations encouraged lead agencies to set expectations for the quality and content of support plans as well as to seek out and provide training for their staff on providing person-centered practices. This could involve changes in agency practices as well as changes to how agencies worked with their community partners. Beginning in January 2018, DHS planned to require individual remediation when lead agencies did not comply with the person- centered protocols. When findings from a case file review indicated that files did not contain all required documentation, the agency would be required to bring all cases into full compliance by obtaining or correcting the documentation. All corrections would need to be made within 60 days of the lead agency review site visits. Corrective action plans would be required when patterns of non-compliance were evident. DHS conducted regional day-long training and technical assistance sessions with counties and tribes during May through September 2017. Due to high demand, DHS scheduled an additional five training sessions through December 2017. A supervisor tool kit was being developed to support counties, tribes and contracted case management providers in the oversight of plan development according to the protocol. The expectation was that the number of plans that adhered to the protocols would increase over time and during 2018.
  • The March 1, 2017 goal to eliminate the DD waiver waiting list was not met. In addition to updating this goal to more accurately define success in the institutional exit and immediate need categories accessing waiver funding at a reasonable pace, DHS planned to work with lead agencies to continue to approve funding for persons according to the reasonable pace goals.
  • The June 30, 2017 goal to increase the percentage of plans for people using disability home- and community-based waiver services that met required protocols to 50 percent was not met. Since July 2016, the lead agency review team made recommendations to each county visited on how to improve their person-centered practices. Counties were in varying stages of their person-centered journey. The recommendations encouraged lead agencies to set expectations for the quality and content of support plans as well as to seek out and provide training for their staff on providing person-centered practices. This could involve changes in agency practices as well as changes to how agencies worked with their community partners. Beginning in January 2018, DHS planned to require individual remediation when lead agencies did not comply with the person- centered review protocols. DHS conducted regional day-long training and technical assistance sessions with counties and tribes from May through September 2017. Due to high demand, DHS scheduled an additional five training sessions through December 2017. A supervisor tool kit was being developed to support counties, tribes and contracted case management providers in the oversight of plan development according to the protocol. The expectation was that the number of plans that adhered to the protocols would increase over time and during 2018.
  • The June 30, 2017 goal to reduce mechanical restraints to no more than 277 reports of mechanical restrain was not met.
  • The June 30, 2017 goal to increase the number of people with disabilities who lived in the most integrated housing of their choice where they had a signed lease and received financial support to pay for the cost of their housing by 2,638 over baseline was not met.
  • The June 30, 2017 goal to increase the number of students who had enrolled in an integrated postsecondary education setting within one year of leaving high school by 100 was not met, though this may have been due to the limitation of not including data from the Office of Higher Education.
  • The June 30, 2017 goal to increase the percentage of people who were housed five months after discharge from the hospital to 83 percent was not met, though there was an overall increase in the number of individuals receiving services. DHS also expanded the number of grantees for the Housing with Supports for Adults with Serious Mental Illness grants. These grants would support people living with a serious mental illness that resided in a segregated setting, as well as those that were experiencing homelessness or were at-risk of homelessness, to find and maintain permanent supportive housing. The first round of grants began in June 2016, with additional rounds occurring every six months. DHS expected to see the impact of this work in later data.

Finally, an overview of the Olmstead Plan amendment public input plan was presented to the Olmstead Subcabinet and approved. The workplan included:

  • From December 20, 2017 to January 31, 2018 and February 27 to March 11, 2018:

    • Five listening sessions would be held throughout the state.

    • Host venues, collaborate with organizations, and utilize technology for listening sessions as needed.

    • Olmstead Subcabinet members would be informed of the dates of the listening sessions and may be asked to participate.

    • Three focus groups would be held with traditionally under-represented communities.

    • One video/phone conference call listening session would be held.

    • Two online input opportunities would be provided.

    • Ongoing public input through social media, email, phone, etc.

  • Communications plan toolkit developed for state agencies.
  • Process developed for closing the feedback loop.

For additional details, see page 79 of the November 27, 2017 meeting materials.

December 18, 2017

The Olmstead Subcabinet reviewed a preliminary Quality of Life Survey baseline report. Additionally, amendments to the Plan's measurable goals were approved by the Olmstead Subcabinet for posting for public comment and for inclusion in the addendum to the annual report. For additional details see page 133 of the December 18, 2018 meeting materials.

The 2017 annual report on Olmstead Plan implementation was also approved by the Subcabinet, including data acquired through October 31, 2017. This report included progress toward goals related to:

  • Movement of people with disabilities from segregated to integrated settings.
  • Movement of individuals from waiting lists.
  • Quality of Life measurement results.
  • Increasing system capacity and options for integration.

This annual report covered the 50 measurable goals in the Olmstead Plan. Twenty-three of the annual goals were either met or were on track to be met. Seventeen of the annual goals were not met or on track to be met. For those 17 goals, the report documented how the agencies planned to work to improve performance on each goal. Ten goals were in process. There were a number of major activities that were completed or were in process, designed to make improvements in Olmstead Plan implementation:

  • In October 2017, the Olmstead Subcabinet completed the second comprehensive review of the Olmstead Plan workplans. The annual results of the review of workplans can be found on page 70 of the annual report. Of the 294 workplan activities reviewed, only seven were reported as exceptions. The Olmstead Subcabinet initiated the second annual Olmstead Plan amendment process. This review was planned to include multiple opportunities for people with disabilities and the public to review and offer suggestions. The process was planned to be completed in March 2018.

  • During 2017, the Quality of Life Survey was initiated to establish a baseline. Subsequent surveys will use the baseline to measure progress on the Plan's impact on improving quality of life for people with disabilities. A preliminary report was due to be presented to the Olmstead Subcabinet in December 2017.

  • Additionally, movement was tracked in the following areas:

    • More individuals were leaving ICF/DD programs to more integrated settings;

    • More individuals were leaving nursing facilities for more integrated settings;

    • More individuals were leaving other segregated settings to more integrated settings;

    • There was an increase in the number of individuals exiting AMRTC in a timely fashion;

    • There was an increase in the number of individuals leaving MSH to a more integrated setting.

  • DHS adopted reasonable pace goals and began measuring performance in 2015. Since then, data showed fewer people were waiting to access waiver services.
  • Successful efforts to provide individuals access to the CADI waiver prevented the need for a waiting list since October 2016.
  • There were fewer individuals waiting for access to a DD waiver.
  • There continued to be increased capacity and options for integration in housing and employment. During this reporting period:
    • More people gained access to integrated housing;
    • There was an increase in the number of individuals obtaining competitive integrated employment.
  • The emergency use of manual restraint continued to decrease.

December 20, 2017–January 31, 2018

The first period for public comment was held to amend and extend the Olmstead Plan 2017– 2018. A report of public input themes and agency responses was presented to the Olmstead Subcabinet on February 26, 2018. Comments were obtained through public listening sessions, focus groups, and written input by email and the website, yielding over 102 comments.

2017