Office of the Inspector General

Rebalancing and Money Follows the Person

West Virginia Transition Navigator Program

All Publications are available in alternative formats upon request.

What is the Olmstead Decision?

Olmstead v. L.C. (1999) is a landmark United States Supreme Court decision upholding the civil rights of people with disabilities to receive community-based services and supports. The case was filed on behalf of two women who had a developmental disability and co-occurring mental illness, and were residents of a Georgia state-operated psychiatric hospital. Both women wanted to leave the hospital to receive support in the community. The hospital’s treatment professionals agreed that the needs of both women could be met in community-based settings.

A lawsuit was filed on behalf of both women, and others similarly situated, against the state of Georgia. The lawsuit alleged that the state’s failure to provide community-based supports was a form of discrimination prohibited by the Americans with Disabilities Act (ADA).

On June 22, 1999, the U.S. Supreme Court agreed that unjustified isolation and institutionalization is a form of discrimination prohibited by the ADA and Title II of the ADA. The ADA is a civil rights law enacted to “provide a clear and comprehensive prohibition of discrimination on the basis of disability.” Title II of the ADA established the requirements for public entities, including state governments and health care services, which are funded and administered by state agencies.

Related Publications:

▪The U.S. Supreme Court Decision—Olmstead v. L.C.
▪Is Community Care a Civil Right? The Unfolding Saga of the Olmstead Decision
▪Olmstead v. L.C.: The Interaction of the Americans with Disabilities Act and Medicaid
▪Olmstead-Related Lawsuits and Plans
▪Still Waiting...The Unfulfilled Promise of Olmstead
▪Do Non-Institutional Long-Term Care Services Reduce Medicaid Spending?
▪Taking the Long View: Investing in Medicaid Home and Community-Based Services Is Cost-Effective

West Virginia Olmstead Office

The Olmstead Office was established on August 13, 2003, and has the following responsibilities: develop, implement and monitor West Virginia’s Olmstead activities in compliance with Title II of the ADA; provide support to the Olmstead Council in carrying out their duties; manage grant funding to carry out Olmstead-related projects; facilitate the implementation of the Transition Navigator Program; and provide information, referral and assistance to West Virginia citizens about Olmstead-related issues and needs.

The Olmstead Office provides West Virginia citizens with information, referral, and assistance services concerning Olmstead-related issues. For example: West Virginia activities, national initiatives, available community-based supports and providers, and available advocacy services. Anyone wishing to file an Olmstead-related complaint may contact the Olmstead Office.

The Office of Civil Rights (OCR) is the federal agency under the U.S. Department of Health and Human Services that is responsible for investigating discrimination complaints under the ADA. Any person who believes they have been subjected to discrimination on the basis of disability by a health or human services program may file a complaint with OCR. Contact the OCR Regional Office in Philadelphia at (800) 368-1019 or at www.hhs.gov/ocr

Related Publications:

▪Olmstead Brochure
▪Olmstead Handbook (Coming Soon!)
▪Frequently Asked Questions
▪Olmstead Annual Report—SFY 2008
▪Olmstead Annual Report—SFY 2009 (Coming Soon!)

West Virginia Olmstead Council

Mission
To assist all West Virginia citizens with disabilities to have the opportunity to receive
supports and assistance in the most integrated setting in the community.

The purpose of the Council shall be to carry out its responsibilities specified in the West Virginia Olmstead Plan: Building Inclusive Communities as approved by Governor Joe Manchin III on October 12, 2006 through Executive Order 11-06. The Olmstead Council was established in 2003, and has the following responsibilities: advise the Olmstead Coordinator in fulfilling the responsibilities of the Olmstead Plan and the duties of the Olmstead Office; review the activities of the Olmstead Coordinator; provide recommendations for the long term care institutional and community-based supports systems; issue position papers for the identification and resolution of systemic issues; and monitor, revise, and update the Olmstead Plan and any subsequent work plans.

The Council is a 29-member body comprised of eight (8) people with disabilities and immediate family members; eleven (11) advocacy and disability organizations; six (6) providers of institutional and community-based services; four (4) state agencies; and one (1) housing representative.

Related Publications:

▪Olmstead Council Membership Application
▪Olmstead Council By-Laws
▪Olmstead Council Priorities—2010 (Coming Soon!)

West Virginia Olmstead Plan

On October 12, 2005, Governor Joe Manchin III signed Executive Order 11-05 formally approving and directing the implementation of the Olmstead Plan. The Executive Order issued the following directives: the implementation of West Virginia’s Olmstead Plan within the budgetary constraints of the State; the cooperation and collaboration between all affected agencies and public entities with the Olmstead Office; and the submission of an annual report by the Olmstead Office to the Governor.

The Olmstead Plan has ten key components: informed choice; identification; transition; diversion; reasonable pace; eliminating institutional bias; self-direction; rights protection; quality; and community-based services.

Related Publications:

▪Olmstead Plan: Building Inclusive Communities (Full-Length Version)
▪Olmstead Plan: Building Inclusive Communities (Executive Summary)

Rebalancing and Money Follows the Person

The Olmstead Office and Council selected the Public Consulting Group (PCG) to: analyze the long term care system and provide recommendations for implementing specific “money follows the person” (MFP) and rebalancing initiatives; and provide fiscal projections for implementing MFP strategies.

According to the Centers for Medicare and Medicaid Services, rebalancing means adjusting the State’s publicly funded Long Term Care (LTC) supports to increase the availability of community options and reduce the reliance on institutions, so the supply of available services reflects the preferences of people with disabilities. MFP is a rebalancing method that refers to a system of flexible financing for long term care services that enable funds to move with the individual to the most appropriate and preferred setting.

There are two major components to MFP: a financial system that allows Medicaid funds to be spent on home and community-based services when individuals move from institutions to the community; and a nursing facility transition program that identifies individuals in institutions who wish to transition to the community and helps them do so.

States that have implemented MFP initiatives, the following common outcomes have occurred: provided individuals with choice and equal access to long term care supports; served more people; better managed the costs of long term supports; developed a more balanced long term support system; improved quality; and highlighted the value of preventive care.

Related Publications:

▪MFP and LTC System Rebalancing Study for WV (Full-Length Version)
▪MFP and LTC System Rebalancing Study for WV (Executive Summary)
▪MFP and LTC Rebalancing Study Summary Brochure

West Virginia Transition Navigator Program

The West Virginia Olmstead Office issues grant funding for the Transition Navigator Program. The Program currently assists West Virginia citizens with disabilities to transition from institutional facilities to live and be supported in their community.

The program assists people to cut through the “red tape” of the long term care system. Two regional pilot programs (Community Access and Northern WV Center for Independent Living) cover 22 counties and employ a full-time Transition Navigators. Transition Navigators provide direct transition support; outreach and education; information and referral; assessment and planning; and advocacy. The West Virginia Olmstead Office will provide some limited assistance to people residing in the 33 counties not covered by the pilot program.

Eligible participants may be eligible to receive up to $2,500.00 for reasonable and necessary transition start-up costs. Reasonable and necessary start-up funding includes: security deposits for housing; set-up fees or deposits for utilities; moving expenses; essential home furnishings; and/or home accessibility modifications.

The following eligibility criteria must be met to participate in this program: the individual must have a disability as defined by the Americans with Disabilities Act (ADA); the individual must require assistance to establish home and community-based services; and the individual must reside in an institutional facility (or at imminent risk of institutionalization).

Related Publications:

▪Transition Navigator Program Policy Statement
▪Transition Navigator Program Brochure