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UPDATE on the US v. Virginia Settlement Agreement and National Enforcement Efforts

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UPDATE on the US v. Virginia Settlement Agreement and National Enforcement Efforts. U.S. Department of Justice Civil Rights Division Special Litigation Section. Background. CRIPA investigation Expanded investigation – Apr. 2010 Findings – Feb. 2011 Negotiations – 2011-2012 - PowerPoint PPT Presentation

Text of UPDATE on the US v. Virginia Settlement Agreement and National Enforcement Efforts

  • UPDATE on the US v. Virginia Settlement Agreement and National Enforcement Efforts

    U.S. Department of Justice

    Civil Rights Division

    Special Litigation Section

  • Background CRIPA investigation Expanded investigation Apr. 2010 Findings Feb. 2011 Negotiations 2011-2012 Agreement Jan. 2012 Approval by court Mar. & Aug. 2012 Implementation / Enforcement Now

  • Activities of the DOJFY 2013 Meetings w/ Stakeholders (500+) Families (waitlist, TC, waiver recipients) Providers Organizations CSBs Case managers Employment coordinators Crisis services

  • Activities of the DOJFY 2013 Reviewing Data

    Meetings with Independent Reviewer

    Meetings with State of Virginia including drill downs on specific topics

  • Topics well discuss todayWaivers Transition PlanningIndv. & Family Supports Crisis System Integrated HousingIntegrated Employment and Day ActivitiesFamily-to-family and peer-to-peer programs

    8. Case ManagementAccess and AvailabilityQuality Assurance

  • WaiversFY 2014225 ID Waivers25 DD Waivers 160 TC Waivers40 prioritized for Youth in Nursing Homes/large ICFs

    Independent Reviewer reported Virginia has allocated many more waivers than required in FY 2014

  • National Perspective: Youth with ID/DD in Nursing HomesFlorida2012 Findings LetterFound hundreds of children with significant medical needs resided unnecessarily in nursing homes & many more at-risk of entering nursing homes because lack of community alternatives and cuts to in-home supports (esp. in-home nursing) After six months of negotiations United States filed suit in July 2013.Lawsuit seeks a comprehensive remedy, including offering community alternative s to all children in nursing homes, effective transition planning, expansion of community-based and in-home services as alternatives to nursing home care, and changes to policies/practices re in-home supports. It also seeks damages for affected children.

  • National Perspective: Adults with ID/DD in Nursing Homes

    TexasIntervened in Steward v. Perry, a class-action regarding the unnecessary institutionalization of thousands of people with ID/DD in and at-risk of entering private nursing homesLitigation implicates intersection of ADA and PASRR Reached Interim Agreement (to be filed for Court approval in Aug 2013) that requires Texas to:identify people with ID/DD in NHs, inform them about community alternatives, and establish necessary services and transition those who want to move to the communitycreate hundreds of new Medicaid waivers to transition people from, and divert people from entering, NHsexpand community-based medical servicesestablish a system to divert people from unnecessary NH admissions (including regional diversion coordinators)Continuing to finalize a final comprehensive agreement

  • Transition PlanningFY 2014Individualized, person-centered plansEssential supports and Barrier-busting Both the DOJ and the Independent Reviewer will continue to focus on: Adequate Community Options for those receiving waivers from the ID/DD waitlists and from Training Centers

  • Indv. & Family SupportsFY 2014In FY 2013 established the program and met targets of 700 individuals Commonwealth reports that typical requests in FY 2013 were for respite, summer camps, or transportation

    In FY 2014 required to support 1000 individualsCommonwealth reports there will be an online application in addition to the paper application

  • Crisis SystemFY 2014Mobile crisis response timesCrisis plansRegion 4 & 5 stabilization unitsTransportation to the stabilization unitsNumber of regional stabilization unitsServing children with ID/DDStaffingCoordination with CSB Emergency Services

  • Integrated HousingFY 2014Increased specificity of March 6, 2013 Housing PlanSection 811 application$800,000 Rental Assistance Pilot ProgramCoordination with local housing entitiesIncreased development of living options

  • National Perspective: Housing for People with DisabilitiesJune 2013 HUD GuidanceHUD-funded affordable housing programs are a critical resource for Olmstead implementationHUD is committed to ensuring that HUD-funded housing gives choice, self-determination, and opportunities for people with disabilities to live and interact with people without disabilities Provides guidance on how to structure preferences that relate to state Olmstead implementation (VA has a HUD-approved preference for US v. VA implementation)

  • National Perspective: Housing for People with DisabilitiesCMS Regulations re HCBS SettingsCMS finalizing regulations defining characteristics of community-based settings for HCBS authorities (1915c, 1915i, Community First Choice (1915k))NPRM has list of required positive characteristics for all HCBS settings, additional requirements for provider-owned settings, list of non-HCBS settings (eg, ICFs, NHs), and presumptively non-HCBS settings (eg, on grounds of or adjacent to public institution)

  • Integrated EmploymentFY 2014December 2012 Employment First Policy

    Increased specificity of November 7, 2012 Employment Implementation Plan

    Sufficiency of March 29, 2013 supported employment targets

    Implementation of training initiatives

  • National Perspective: Integrated DaysRhode Island-- Investigation regarding adults with ID/DD in states largest sheltered workshop and pipeline of students from school-based SW to this adult SW-- Interim Settlement Agreement June 2013Integrated supported employment (individual placements, at least min. wage) and integrated day services for more than 200 people currently in SWs

    40-20 Integration StandardRequirement of average of at least 20 hours a week across the groupRequirement of integrated day activities when not working, for a total of 40 hours of integrated work and non-work activities per week.

  • National Perspective: Integrated DaysOregonFindings Letter June 2012Found segregation in sheltered workshops of people who could and want to work in integrated settingsFocus on people unnecessarily in sheltered workshops and people at risk (esp. transition age students)Seeks expansion of integrated supported employment (individual, at least min. wage) Complaint and Motion to Intervene March 2013Over-reliance on segregated employment settings -- 61% of people receiving e-ment svs are in SWs; only 16% are in indiv. supp. employment No real opportunity to leave segregated e-ment -- People remain in SWs an average of 11-12 years, up to 30 years. Pipeline from school to segregated e-ment

  • Family-to-family/Peer-to-peerFY 2014Activities of Family Recourse Consultant

    Meeting with Family and Peer Mentors

    Waitlist mentoring, as well as training center mentoring

  • Case ManagementFY 2014Regular face-to-face meetingsIndividual Support PlansEnhanced case management SafetyIncreased integrationRole of case manager

  • Access & AvailabilityFY 2014Guidelines for families seeking services

    Easy Access website

    Transportation oversight

    Access to Adaptive Equipment/ Environmental Modifications

  • Quality Assurance & Risk ManagementFY 2014Expanded reporting: Computerized Human Rights Information SystemQuality Improvement CommitteeRegional Quality Council developmentQuality Service Reviews developmentLicensureProcess for Corrective Action Plans

  • Independent ReviewerNext Report- Dec 2013 Crisis Services

    Case Management

    Quality and Risk Management

    Transition & Discharge Planning from Southside & Northern Virginia Training Center

  • of DOJs Olmstead enforcement efforts nationally (findings letters, settlements, briefs, etc.) [includes US v. Virginia]Guidance documentsSpeechesFaces of v. Virginia specific websiteIndependent reviewers reportsSettlement agreement and summaryFindings letter

  • Contact InformationKyle [email protected] [email protected] [email protected] [email protected] [email protected]