Background Information for Spring Forums
This fact sheet briefly describes some of the efforts that led to the recommendations for policy change proposed by the Real Choice Advisory Committee to improve services for seniors and people with disabilities in South Carolina.
Olmstead vs. L.C.
The Olmstead decision gives seniors and people with disabilities the right to live in the community rather than in an institution, if that is what they choose. In 1999, the U.S. Supreme court ruled that states must provide services in the community for persons with disabilities when: (1) the state’s professionals determine the individual can live in the community; (2) the individual chooses to live in the community, and; (3) it does not negatively affect the overall services provided to others in the state. The Olmstead decision provided South Carolina and other states a unique opportunity to review their services and to plan for a better system that responds to the needs of its citizens with disabilities and long term care needs. In August 2001, after a year of study, the South Carolina Home and Community-Based Services Task Force submitted its plan to the Governor with a vision for a continuum of care that recognizes the importance of choice and the value of all parts of the continuum. The Real Choice Advisory Committee reviewed the 17 pages of recommendations of the Task Force to identify a few priority recommendations.
Real Choice Systems Change Grant
To help states respond to the Olmstead decision, the federal Centers for Medicare and Medicaid Services (CMS) made grant money available to them. South Carolina asked for funds for two new projects and, in October 2001, it received a $2.3 million grant. The SC Department of Health and Human Services, in partnership with the Department of Mental Health, other state agencies, advocacy groups, and consumers and families, has been working to develop “SC Access” and “SC Choice.”
For SC Access, SCDHHS and its partners are developing a database of information about services for people of any age with a disability or long term care need. SC Access will provide a tool for people to find services they need. The information will be available through the Internet and through a network of trained Information and Referral Specialists who will use the database to help people find the services they need.
For SC Choice, SCDHHS and its partners are developing the infrastructure to support greater consumer choice and control in Medicaid home and community based services. With help from a care advisor, consumers will be able to define their needs, develop a financial plan for purchasing goods and services to address those needs, and manage a budget to carry out that plan.
The Real Choice Advisory Committee has been guiding the development and implementation of SC Access and SC Choice.
New Freedom Initiative
The New Freedom Initiative, launched in February 2001, is President Bush’s comprehensive plan to reduce barriers to full community integration for seniors and people with disabilities. This initiative offers individuals who require long-term supports and services, and their families, greater opportunities to take charge of their own health and direct their own services. Families and individuals can exercise greater choice, control and responsibility for their care.
In May 2002, CMS gave states greater flexibility to design the program to their preferences. SC Choice was approved by CMS in March 2003, and implementation will begin initially in July 2003 in the Spartanburg CLTC area, which serves Spartanburg, Cherokee, and Union counties. By early next year a second CLTC site will begin, with statewide implementation following later.
National Association of State Units on Aging Consumer Direction Project
The Real Choice Advisory Committee, South Carolina’s Silver Haired Legislature, SC Department of Health and Human Services, and the University of South Carolina School of Public Health have been working with the National Council on Aging and the National Association on State Units on Aging Consumer Direction Project. This is a national project, funded through the Robert Wood Johnson Foundation and the Centers for Medicare and Medicaid Services, to identify issues related to consumer direction in the service delivery system for seniors and people with disabilities.
Last fall nearly 6,000 surveys were mailed to seniors and people with disabilities in South Carolina to receive their feedback regarding the current service delivery system. Over 500 surveys were returned and analyzed by the University of South Carolina School of Public Health. The results of the survey helped the Real Choice Advisory Committee to identify six key areas of concern. These key areas of concern were discussed more fully with six focus groups representing people with dementia, developmental disabilities, mental illness, spinal cord injuries, brain injuries, and seniors. The results of the survey and focus groups were used to identify the six priorities being presented at the public forums for discussion. The Real Choice Advisory Committee hopes consumers, their families and their advocates, and public and private providers, funders, and decision makers will support these areas with action as well as words.
