Generic Olmstead Demand Letter to a State

Olmstead is NOT really directed to every person with a disability --- it's directed to those people with disabilities who are:
  • ​INSTITUTIONALIZED or
  • At Risk of INSTITUTIONALIZATION

Because we're focused on people with disabilities with often the GREATEST NEEDS --- what is required in the way of SERVICES is generally going to be at the HIGH or HIGHER END of the CONTINUUM of CARE. 
​This likely will include:
  • National Statistics, Studies, Media Reports
  • State Specific Statistics, Studies & Media Reports
Studies
​
Study Finds Permanent Supportive Housing is Effective for Highest Risk Chronically Homeless People (2020)
​
​The vast majority of even the most impaired homeless people can be successfully housed if they are given access to permanent housing with voluntary supportive services, a rigorous new study from UC San Francisco has found.
Supportive housing helped people avoid police contacts, arrests, and jail days.

People experiencing homelessness, especially those forced to live outside, are more likely to interact with police and to face citations, arrests, and incarceration for low-level offenses like loitering or sleeping in parks.  Jul 15, 2021

Housing First Breaks the Homelessness-Jail Cycle - Urban ...
Prisoners with neurodevelopmental difficulties: Vulnerabilities for mental illness and self-harm (2020)


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We're specifically trying to get by without ANOTHER INVESTIGATION
  • ​Further, the first step to State Recovery is States being able to OPENLY ADMIT they've got a problem --- I think some states are ready to do that.
  • Requesting the State to  STIPULATE that Disability Housing and/or Services are not to SCALE and there is no Comprehensive or Effectively Working Plan to bring Disability Housing or Services to Scale for:
    • People with disabilities who are institutionalized or being released from Jails or Prisons;
    • People with disabilities who are at great risk of institutionalization such as is inherent in Homelessness.
 
  • A NOTE ABOUT THE 5th Amendment:  An action under Title II of the Americans with Disabilities Act:
    • ​Is NOT A CRIMINAL PROSECUTION --- there's no right against self-incrimination;
    • Most Government Officials have GOVERNMENTAL IMMUNITY
    • Further, there's no expectation there is going to be a criminal prosecution.
    • So we are really asking STATE OFFICIALS to work openly and honestly with us to bring States into compliance with Title II of the ADA and Olmstead.

Federal​ Funding & Resources​
MEDICAID Can Currently Pay for:
  • Olmstead Planning which includes Housing (see 2015 CMS Informational Bulletin)
    • "Collaborative Activities"
      • ​Statelevel Housing Related Collaborative Activities - services that support collaborative efforts across public agencies and the private sector that assist a state in identifying and securing housing options for individuals with disabilities, older adults needing LTSS, and those experiencing chronic homelessness. ​​
    • Bulletin also gently reminds states of their obligations under Olmstead.​
    • Further:  
      • "​State Medicaid agencies can play an important role in convening state program offices and other partners to identify other non-Medicaid funded sources to support these activities and to collaborate in HCBS systems transformation. "
      •  "States are increasingly using community-based housing-related services as part of a strategy when implementing Olmstead plans or settlement agreements to provide integrated community living opportunities for people exiting institutional or other segregated settings, as well as those at risk of unnecessary institutionalization due to being inappropriately housed." 
  • We "think" the Polis Administration "may" have IDENTIFIED this funding source for planning efforts and have some "ideas" in the works.
    • ​We don't really know what that is or to what extent it's providing MEASURABLE GOALS & REASONABLE TIME FRAMES.
    • I personally want and I think other Stakeholders want a lot more OPEN & TRANSPARENT COMMUNICATION around Olmstead than what we've received.
      • ​​That does involve OUTREACH.
      • It's also a FUNDAMENTAL CHANGE is how we include STAKEHOLDERS in DISABILITY POLICYMAKING.
        • ​"When we get this all figured out --- we'll let you know" --- IS NOT GIOOD ENIOUGH.
        • CCDC (the Colorado Cross Disability Coalition)  and other Organizations, Families & Individuals have greatly increased INCLUSION of people with Disabilities in Policy Making:  "NOTHING ABOUT US WITHOUT US."
        • BUT on something as IMPORTANT as OLMSTEAD & HOUSING --- we need more INCLUSION, OPENNESS & TRANSPARENCY than what we've gotten so far.



State Specific Funding & Resources 

County and / or Municipal Funding
(including Social Impact Bonds)
Corporation for Supportive Housing​


  • Federal Point in Time Homeless Count
  • Federal CMS Nursing Home Minimum Data Set​
    • ​Especially in Colorado --- lack of INTENSIVE SERVICES such as Assertive Community Treatment (ACT) may be more of an issue than lack of HOUSING VOUCHERS when it comes to transitioning people with cognitive disabilities from the NURSING HOME.
    • This goes to the ECONOMIC INCENTIVES of providing DISABILITY HOUSING ---- the FEDS and STATES have recognized that it is more EXPENSIVE to keep someone in a nursing home than provide HOUSING.
      • ​The importance of intensive treatment options / wrap around services and what that is accomplishing for people with EXECUTIVE FUNCTIONING DIFFERENCES & CHALLENGES has not always been well understood.
      • Further, it can be more the RULE than the EXCEPTION that people with EXECUTIVE FUNCTIONING DIFFERENCES & CHALLENGES have not only INVISIBLE DISABILITIES but also INVISIBLE ABILITIES --- it is the POWER of DIFFERENT and the POWER of NEURO-DIVERSITY.   ​