Arizona’s proposed Olmstead Plan, which is open to public comment, includes strategies for integrating people with disabilities into community life – State of Reform

Arizona’s Olmstead Plan updated for the first time since 2003, it represents an additional effort by states to comply with the 1999 US Supreme Court decision requiring states to adequately integrate people with disabilities into their communities.

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While the court decision does not require state Medicaid programs to develop a strategic plan, the plan states that “Arizona officials have decided to develop a plan to enable attorneys, agencies, members and community stakeholders to To work together on guidance to further improve access to services for people with disabilities and ensure they live and receive services in the most appropriate integrated environment in their community.”

The plan includes strategies to support an individual’s successful transition from an institutional setting to a community-based life and is limited to initiatives directly impacted by the Arizona Health Care Cost Containment System (AHCCCS) for systemic change.

Strategies outlined in the plan include:

  • “Effective Persistent Supportive Housing (PSH) for members to thrive in the community.”
    • According to the plan, this will include removing financial and delivery barriers to assisted living and all-round services, expanding the range of housing environments available to all eligible populations, and identifying suitable housing options for an individual in a timely manner. This PSH should promote the most restrictive and inclusive community environment possible.
  • “Reach-in Discharge Planning for Hospital Environments.”
    • The plan says this will include developing policy changes for managed care organizations (MCOs) to strengthen provider oversight and ensure compliance with care coordination, and to leverage the statewide closed-loop referral system (CLRS) for individuals Leaving Hospital Environments to Expand Access to Community Resources addressing the social determinants of health.
  • “Reach-in Discharge Planning for Correctional Facilities.”
    • According to the plan, this strategy will include building relationships with correctional facilities that are not currently participants in the AHCCCS data exchange, developing a release process that ensures inmates are provided with medically necessary medical equipment immediately upon release, and analyzing data for Persons involved in the justice system have chronic and/or complex physical and/or behavioral health needs.
  • “Expansion of Home and Community-Based Services (HCBS) for Older Persons Diagnosed with Serious Mental Illness (SMI).”
    • The plan states that this will include providing HCBS to the aging SMI population who do not meet criteria to be eligible for the Arizona Long Term Care System (ALTCS).
  • “Personnel development initiatives.”
    • According to the plan, this will include improving the recruitment and retention of behavioral and direct healthcare workers.
  • “High quality network to ensure members are served in the most effective and least restrictive manner.”
    • The plan states that this will enable the use of electronic visit verification to monitor access to care in HCBS and monitor the timeliness of appointments for behavioral health professionals, children in the legal care of the Arizona Department of Child Safety (DCS), and adopted children. The plan also states that this will include increasing network appropriateness for behavioral health services.
  • “People-centric scheduling improvements.”
    • According to the plan, this strategy includes implementing performance measurements and targets for ALTCS MCOs and case management chart audits for more frequent performance monitoring, and increasing the use of Outreach, Access, and Recovery (Supplemental Security Income/Social Security Disability Insurance) (SOAR ) Services for Eligible Persons.

AHCCCS is accept public comments for the proposed Olmstead plan by September 22, which will help inform the final draft.

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