THE INTEGRATION MANDATE. Roberta Opheim Ombudsman Minnesota Office of the Ombudsman for Mental Health and Developmental Disabilities. Minnesota Office of Ombudsman for Mental Health and Developmental Disabilities. Disclaimers. I am not an attorney.
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Minnesota Office of the Ombudsman for Mental Health and Developmental Disabilities
The Ombudsman is an independent governmental official, who receives complaints against government (and government regulated) agencies and/or its officials from aggrieved citizens, who investigates, and who, if the complaints are justified, makes recommendations to remedy the complaints.
The right to look into…
…acts of government even though they may have been done in accordance with the law or rule.
“The ombudsman for persons receiving services for treatment for mental illness, developmental disabilities, chemical dependency, or emotional disturbance shall promote the highest attainable standards of treatment, competence, efficiency, and justice.”
Any person receiving services or treatment from
an agency, facility or program for:
You may have
Looking back at the Supreme Court’s Olmsteaddecision--and forward
“. . . [N]o qualified individual with a disability shall, by reason of such disability, be excluded from participation in or be denied the benefits of the services, programs, or activities of a public entity, or be subjected to discrimination by any such entity.”
42 U.S.C. §12132
“A public entity shall administer services, programs, and activities in the most integrated setting appropriate to the needs of qualified individuals with disabilities.”
Title 28 of the Code of Federal Regulations, section 35.130(d).
Olmstead vs. L.C. and EW:
June 1999 decision by the United States Supreme Court holding that the unnecessary segregation of individuals with disabilities in institutions may constitute discrimination based on disability.
Case citation: Olmstead v. L.C., 527 U.S. 581 (1999).
They sued: LC and EW claimed that Georgia violated the ADA integration mandate by failing to provide services in the most integrated setting appropriate to meet their needs--in the community, not an institution.
It first focused on key congressional findings contained in the ADA’s preamble:
“Discrimination against individuals with disabilities persists in such critical areas as institutionalization.”
To live in my own home, well I feel very grateful to all the people who helped me to get my own home and I feel very good about my home. I have a great life and I can make my own decisions. And I can handle my own business, and I feel good about myself.-- Elaine Wilson, from an interview published by ILRU
The Court’s decision left room for individuals to show:
The ADA can require a state to make reasonable modifications to its programs and services to provide integrated community-based services, rather than relying on institutional placements, including segregated placements in the community.
I thought Minnesota did not need an Olmstead Plan because we already have a waiver system providing Home and Community Based Services!
In response to both the Supreme Court’s suggestion that an effective community integration plan that moved at a reasonable pace would go a long way toward satisfying Olmstead’s mandate, and the Administrations’ letters and other guidance, 29 states have issued Olmstead-related plans or reports.
Under pressure from the federal court, legislative auditor and from the community, Minnesota has taken first steps toward an Olmstead state plan.
The Jensen lawsuit was based in part on a report by OMHDD; lawsuit alleged that METO residents were unlawfully and unconstitutionally secluded and restrained.
The State of Minnesota agreed to make, as a top concern, the safety and quality of life of the Residents of METO; states that its goal is to provide these residents with a safe and humane living environment free from abuse and neglect.
The State also agrees to extend this policy to all people with developmental disabilities, and to those receiving waivered services.
Within sixty (60) days upon Court approval of this Agreement, no later than July 1, 2011, there shall be no transfers or placements of persons committed solely as a person with a developmental disability to the Minnesota Security Hospital.
No later than December 1, 2011, persons presently confined at Minnesota Security Hospital who were committed solely as a person with a developmental disability and who were not admitted with other forms of commitment or predatory offender status set forth in paragraph 1, above, shall be transferred by the Department to the most integrated setting consistent with Olmstead v. L.C.
Persons committed solely as a person with a developmental disability may be transferred to AMRTC only if they have an acute psychiatric condition.
Within thirty (30) days of the Court’s approval of this Agreement, any AMRTC resident committed solely as a person with a developmental disability who does not have an acute psychiatric condition will be transferred from AMRTC. The transfer shall be to the most integrated setting consistent with Olmstead v. L.C.
The Olmstead Principles go beyond individuals receiving services in institutional settings. It is Support Services and opportunity for persons with disabilities to engage in all aspects of life in the most integrated settings. That includes a broad array of community life such as:
After the plan is completed and approved by the Olmstead Sub Cabinet, it must be submitted to
To determine if the State of Minnesota is in substantial compliance with the Jensen Settlement Agreement
Once the plan is complete the state must implement the plan and measure outcomes achieved related to plan goals. This plan is a living plan intended to be modified as data and feed back emerge along with new research on best practices. This responsibility is ongoing and is a civil right so we have to permanently integrate this into the fabric of services.
Kaiser Commission -http://www.kff.org/medicaid/upload/olmstead-at-five-assessing-the-impact.pdf
Minnesota’s Olmstead Planning Committee -http://www.dhs.state.mn.us/main/idcplg?
Department of Justice Olmstead Site -http://www.ada.gov/olmstead/http://www.ada.gov/olmstead/q&a_olmstead.pdf