Olmstead Plans and Related State Activity

Terence Ng, Alice Wong & Charlene Harrington
UCSF National Center for Personal Assistance Services

Updated May 2013

Olmstead Plans and Related State Activity
Statea Olmstead Plan
Alternative Strategies
Date Title of plan
(or title of alternative strategies)
Further information
 AK No Yes 3/7/13 Moving Forward Comprehensive Integrated Mental Health Plan: 2006-2011, 2008 Update Report:


 AL Yes 1/12/13 Gateways to Community Living

State Olmstead website:


Report: Gateways to Community Living


 AR Yes No 2/1/13 The Olmstead Plan in Arkansas, March 2003



Olmstead website:


 AZ Yes No 8/1/13 Arizona's Olmstead Plan - Revised 2003



Olmstead website:


 CA Yes No 5/3/13 The California Olmstead Plan



Update: According to the Olmstead Advisory Committee, their 2010 accomplishments include:

Developing a conceptual framework to evaluate impacts on individuals depending on long-term care services that are reduced or eliminated in budget actions.

Advocating at State and Federal levels to improve rules governing the Medicaid Money Follows the Person demonstration (California Community Transitions). Changes made by the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services expanded eligibility criteria allowing facility residents to be eligible for demonstration services after 90 days of institutional care instead of 180 days.

Ex-Governor Schwarzenegger issued an Executive Order regarding California' s Olmstead state plan that replaces a previous Executive Order in 2004. The 2008 Executive Order states the Director of the California Health and Human Services Agency appoints members of the Olmstead Advisory Group and the members serve at the pleasure of the Director.

To view Executive Order S-10_08:


Olmstead Advisory Committee website:


State Olmstead website :


 CO No Yes 7/10/13 Colorado Olmstead Initiative

Colorado Olmstead Initiative website:


Olmstead: Recommendations and Policy Options for Colorado Report (this report can be found on the Olmstead Initative website if the following link does not work):


 CT Yes No 3/2/13 Choices Are for Everyone: Continuing the Movement toward Community-Based Supports in Connecticut Plan:


 DC No No X No

Progress: Focus on HCBS waiver program development.

Update: While the District does not have any Olmstead-related activities, University Legal Services, Inc., the mandated Protection and Advocacy program for D.C. residents with disabilities recently published a report regarding the status of people with disabilities and the need for HCBS.

The report, Home Sweet Home: Still an Elusive Right a Decade Later (June 22, 2009) can be downloaded at:


University Legal Services, Inc. website:


 DE Yes No 7/7/13 A Path Forward: Building a Community-Based Plan for Delaware



Governor's Commission on Community-Based Alternatives for Individuals with Disabilities website:


 FL No N/A X No

Progress: Focus on HCBS waiver program development.

 GA Yes No 3/3/13 State of Georgia Olmstead Strategic Plan - June 2009

Georgia Olmstead Plan website:


Strategic Plan:


Olmstead Successes Jan 2010:


 HI Yes No Oct 2002a Recommended Olmstead Implementation Plan (As of December 30, 2005)



Update: Hawaii Olmstead Implementation Plan (June 8, 2006):


 IA Yes 1/11/13 Olmstead Plan for Mental Health and Disability Services: Plan Framework 1-6-11

Update: As of January 10, 2010, the state announced the establishment of an Olmstead plan. To read the press release regarding the plan, go to:


For a brief history of Olmstead Activities in Iowa (Jan 2009), go to:


Olmstead Plan:


Targeted Capacity Expansion: Meeting the Mental Health Needs of Older Adults in Iowa report:


Iowa Olmstead Information:


Olmstead Consumer Taskforce website:


 ID No No X No

Progress: Community Integration committee developing a plan.

 IL No Yes 7/6/13 Illinois Disabilities Services Plan Update

Update: As a result of a class action lawsuit, Williams v. Quinn, the state was ordered to enter a consent decree on September 29, 2010. One element of the decree is for the state to draft an implementation plan regarding the options offered to persons with serious mental illness to live in community-based settings.

To read Williams Consent Decree: Draft Implementation Plan (February 10, 2011), go to:


Website regarding the Williams Consent Decree:


The Illinois Disabilities Services Advisory Committee assists in the development and implementation of a plan to help the state comply with the ADA and Olmstead decision. As of July 2006, the action plan for the Illinois Disability Services plan (that will address Olmstead issues) was approved. Full implementation is expected in FY 2007.


Home Services Annual Report 2008


Illinois Disabilities Services Advisory Committee meeting minutes:


Illinois Developmental Disabilities State Plan 2011-2017


Illinois Disabilities Services Plan Update (2001-2011):


Illinois Disabilities Services Plan Update (July 2006):


Blueprint for System Redesign in Illinois (Jan 2008) by Human Services Research Institute:


 IN Yes No 7/1/13 Comprehensive Plan for Community Integration & Support of Persons with Disabilities



State Olmstead Plan Elements website:


 KS No No X
 KY Yes No n/a Cabinet for Health Services: Olmstead Compliance Plan for FY 2004 through FY 2012 State Olmstead website:


 LA No Yes 5/6/13 Long-Term Care Reform in Louisiana

Systems Change in Long Term Supports and Services website:


Long-Term Care Reform in Louisiana (Powerpoint presentation):


Executive Order No. KBBB 2004-43: Louisiana's Plan for Choice in Long-Term Care:


 MA Yes No 6/30/05 The Community First Olmstead Plan

Community First Olmstead Plan website:


Community First Olmstead Plan:


 MD No Yes 6/29/05 2009 Maryland State Disabilities Plan

Progress: Olmstead plan is being developed. Workgroups are formed, composed of Maryland Commission on Disabilities. One accomplishment listed in the 2007 Maryland State Disabilities Plan was the establishment of baseline data to measure Maryland's Olmstead progress with regard to assessment, diversion and transition efforts to the least restrictive environment (p. 15).

Maryland Commission on Disabilities:


2009 Maryland State Disabilities Plan:


 ME No Yes 10/3/13 Homeward Bound program

Homeward Bound is a program that plans to transition 122 persons residing in either in-state or out-of-state nursing facilities or hospitals who fall into either of these three target populations


  • Older adults
  • Adults with physical disabilities
  • Persons with any complex combination of medical, behavioral and
  • cognitive impairment
 MI No Yes 6/27/05 Modernizing Michigan Medicaid Long-Term Care: Toward an Integrated System of Services and Supports

Progress: Michigan Long-Term Care Supports and Services Commission


Modernizing Michigan Medicaid Long-Term Care: Toward an Integrated System of Services and Supports:


Presentation to the Governor's Task Force on Medicaid Long Term Care, "Using Olmstead to Expand Home and Community Based Care in Michigan," (September 13, 2004):


Michigan Long-Term Care Supports and Services Advisory Commission website:


 MN No Yes 7/2/05 Minnesota Olmstead Planning Committee

Update: Minnesota Olmstead Planning Committee:


Minnesota Board on Aging 2011 Strategic Plan:


Aging 2030: Preparing Minnesota for the Age Wave


Annual Report On the Use and Availability of Home and Community-Based Services Waivers for Persons with Disabilities 2011 (July 2012)


Evaluation of Current and Potential Housing Options for Persons with Disabilities: Legislative Report (April 2011)


Status of Long-Term Care in Minnesota 2005: A Report to the Minnesota Legislature (2006):


 MO No Yes 12/1/00 Missouri's Money Follows the Person Demonstration; Missouri Governor's Council on Disability

Missouri Governor's Council on Disability Vision and Strategic and Operational Plan 2012-14:


Missouri Governor's Council on Disability


Missouri's Money Follows the Person Demonstration:


According to the state's Olmstead website, the Governor's Council is committed to Olmstead compliance but there is no mention of a formal plan. State Olmstead website:


 MS Yes No 5/3/13 Mississippi Access to Care Implementation Report #1



Update: Mississippi Access to Care Implementation Report #1, May 30, 2003


Mississippi Access to Care website:


 MT Yes No 7/6/13 Senior and Long Term Care Division, Dept. of Public Health & Human Services, Olmstead Plan Update, 2006



 NC No Yes 5/8/13 Olmstead Report to North Carolina State Legislature, 2008

Update: Money Follows the Person state demonstration project website:


Division of Aging and Adult Services website:


Olmstead report to North Carolina state legislature, 2008


 ND Yes 5/8/13 Comprehensive Working Plan to Enhance Community Services in Response to Olmstead

Progress: State has received systems change grant, amongst other activities.b

Comprehensive Working Plan to Enhance Community Services in Response to Olmstead (May 2008):


Completed Tasks from Olmstead Plan Goals (May 2008):


Olmstead Commission website:


 NE No Yes 6/7/13 Nebraska Health and Human Services, Developmental Disabilities System, Three-Year State Plan

Update: Nebraska's Money Follows the Person Project


Nebraska Health and Human Services, Developmental Disabilities System, Three-Year State Plan, 2007


 NH No Yes n/a Balancing Incentive Program

Update: While New Hampshire does not have an Olmstead plan in place, they responded via a press release regarding a recent investigation by the Department of Justice. The DOJ alleges that New Hampshire has violated the Americans with Disabilities Act by failing to provide services to people with mental illness in the most integrated setting appropriate to their needs. The state "believes that the most effective way to accomplish that goal is to stay focused on the implementation of the State's Plan."

To read the April 7, 2011 letter from the Department of Justice to the Attorney General of New Hampshire, go to:


To read the response to the letter from the DOJ from the Attorney General of New Hampshire disputing their review of the state's mental health system, go to:


Progress: The state has a grant to increase LTC in the community called the Balancing Incentive Program. For more information:


The state convened a taskforce that produced a 2008 report on community-based mental health services



Division of Community Based Care Services website:


 NJ Yes No 1/8/13 Home to Recovery - CEPP Plan. Plan to Facilitate the Timely Discharges of CEPP Patients in New Jersey's State Psychiatric Hospitals. The Path to Progress (May 2007)

Update: Due a lawsuit regarding the rights of people with mental illness to have the choice to live in the most integrated settings possible, the state created a plan as part of the settlement agreement.

To read the settlement agreement between the state and Disability Rights New Jersey, go to:


The Olmstead Initiative is Division of Developmental Disabilities's plan for moving 1,850 residents from its seven developmental centers into the community over eight years. This plan is outlined in a document called Path to Progress, which was released in May, 2007. To read a press release about the Olmstead plan, go to:


Path to Progress (May 2007):


Home to Recovery-CEPP Plan (January 2008):


Division of Mental Health Services Olmstead website:


Division of Developmental Disabilities Olmstead Initiative website:


 NM No n/a n/a N/A

Progress: The state now has a self-directed waiver for individuals with disabilities. As of April 2010, 1038 participants are in the Mi Via waiver program according to the 2010 Comprehensive Strategic Health Plan Update (p. 29).

Mi Via waiver website:


 NV Yes No 7/7/13 Nevada's Strategic Plan for People with Disabilities, 2009

Strategic Plan Accountability Committee, Agendas and Minutes


Nevada's Strategic Plan for People with Disabilities (Nevada's Olmstead plan), 2009


Nevada's Strategic Plan for People with Disabilities (Nevada's Olmstead plan), 2007


Nevada's Strategic Plan for People with Disabilities (Nevada's Olmstead plan), 2006


 NY Yes No 12/10/13 2010-12 Most Integrated Setting Coordinating Council Plan

Progress: Consumers sent the state of NY a set of recommendations in light of the shift of Medicaid to managed care in a document titled, "Incentives for Community-Based Services and Supports in Medicaid Managed Long Term Care: Consumer Recommendations for New York State" (March 2012):


Most Integrated Setting Coordinating Council:


2010-12 MISCC (Most Integrated Setting Coordinating Council) Plan


New York Office for People with Developmental Disabilities MISCC:


The Coalition to Implement Olmstead in New York prepared the report Developing a Comprehensive, Effectively Working Olmstead Plan in New York State (2003):


The Coalition to Implement Olmstead in New York, New York State Coalition for the Aging, Inc.


 OH Yes No 2/1/13 Ohio Access: Ohio's Strategic Plan to Improve Long-Term Services and Supports for People with Disabilities (2006)

Plan: Ohio Access: Ohio's Strategic Plan to Improve Long-Term Services and Supports for People with Disabilities 2006


Ohio Access website:


 OK Yes 8/6/13 Oklahoma Olmstead Strategic Plan: Making Choices a Reality in Oklahoma

Progress: Oklahoma Olmstead Strategic Plan: Making Choices a Reality in Oklahoma (August 2006):


Community Service Council of Greater Tulsa's Olmstead Committee website:

 OR No Yes 9/10/13 A Report on Long-Term Care in Oregon (2010)

Progress: Developmental disabilities 6-year plan to eliminate waiting lists.

Developmental Disability Services, Long Range Plan:



Report on Long-Term Care in Oregon, Department of Human Services (September 2010):


Future of Long-Term Care for Seniors and People with Disabilities website:


Riding the Wave: A Call to Action. A Report on the Future of Long-Term Care in Oregon and Long-Range Planning for Oregon's Communities (Nov 2006):


 PA No Yes 7/2/05 Supporting the Journey: Transforming Pennsylvania's Behavioral Health System

Progress: In 2004, the OMHSAS (Office of Mental Health and Substance Abuse Services) Statewide Planning Council was restructured and called for the redesign of the state hospital system to develop community resources to support the discharge of any individual who has been in the state hospital for over 2 years. Since then, three state hospitals consolidations/closures were completed (p. 75 of report).

To read the report, Supporting the Journey: Transforming Pennsylvania's Behavioral Health System, go to:


Home and Community Based Services Stakeholder Planning Team Website:


 RI No Yes n/a Olmstead Decision Task Force

Progress: Olmstead Decision Task Force website:


Community-Based Long-Term Care Services in Rhode Island: A Report Issued Pursuant to Joint Resolution 05-R 384 (2005)


 SC No Yes 8/1/13 South Carolina Home and Community-Based Services Task Force: Report

Report: South Carolina Home and Community-Based Services Task Force: Report:


 SD No No X No N/A
 TN No No X No

Update: Tennessee announced the launch of a new program that will allow more residents to receive long-term care services in the home in a press release on August 2, 2010. The program is called TennCare CHOICES and started on March 1, 2010. To read the press release, go to:


TennCare CHOICES website:


Tennessee Commission on Aging and Disability website:


Tennessee Commission on Aging and Disability Strategic Plan (2009):


 TX Yes No 12/2/13 2010 Revised Texas Promoting Independence Plan (February 2011)

2010 Revised Texas Promoting Independence Plan (February 2011):


 UT Yes No 3/2/13 Comprehensive Plan for Public Services in the Most Integrated Setting

Plan: Comprehensive Plan for Public Services in the Most Integrated Setting (March 2002):


Update: Comprehensive Plan for Public Services in the Most Integrated Setting Individual Department or Division Plan Progress Report (September 2003):


Utah Department of Human Services Olmstead website:


 VA Yes No 8/3/13 Virginia's Olmstead Strategic Plan 2012

State Olmstead website:


Virginia's Olmstead Strategic Plan 2012:


Community Integration Implementation Team:


Community Integration Advisory Commission


 VT Yes n/a Vermont Olmstead Plan, Prepared by the Vermont Olmstead Commission, February 6, 2006

Plan: Vermont Olmstead Commission-Comprehensive Plan 2006


State Olmstead website:


 WA Yes No 6/5/13 Washington's Olmstead Plan

Plan no longer available online.

Report: Expanding Community Services: Status of Efforts to Reduce the State Hospital Census by 178 Beds by April 2003 (November 2002):


 WI Yes Yes 12/10/13 Wisconsin's ADA Title II Plan.



Update: Through three programs, the Department provides elders and people with physical and developmental disabilities residing in nursing facilities and Intermediate Care Facilities for the Mentally Retarded (ICFs-MR) the opportunity to relocate to community-based settings. Under another program, the Department provides support to a limited number of individuals who are at imminent risk of entering a nursing home to be diverted from nursing home admission and remain in community settings.

As shown in the summary table, 572 or almost 64%, of all relocations and diversions were frail elders; 245 or 27%, were persons with physical disabilities. 81 or 9% were individuals with developmental disabilities.

To read the report, SFY 2010 Report on Relocations and Diversions from Institutions, go to:


Wisconsin's ICF/MR Restructuring Initiative website:


Principles to Guide Long-Term Care Reform in Wisconsin, WI Council on LTC Reform, 2005


 WV No Yes 9/3/13 Olmstead Position Paper

Progress: Olmstead Position Paper (Sept 2003):


State Olmstead website:


 WY Yes No 3/1/13 Wyoming Draft Olmstead Plan

Olmstead state plan not available online.

Project Out, Nursing Facility Transition Services program through the Division on Aging The program is especially important to individuals who are living in a nursing home temporarily due to an accident or stroke. Services offered include case management, help finding housing, help in finding in-home services, home modification (wheel chair access) and rent deposit payments. For information about Project Out, contact Vereen Bebo in the Aging Division at (800) 442-2766.


Four Year State Plan (2011-2015) Aging Division, Department of Health:


Notes on the table

Notes on the table
  1. Olmstead plans are those which have been included in the NCSL reporta as being Olmstead plans, and commonly specifically mention that (at least) part of their aim is to address the issues raised by the Supreme Court decision in Olmstead v. LC & EW
  2. In the 'Further information' column:
    • 'Plan' indicates the link is to the first edition of the plan (PDF version),
    • 'Update' indicates the link leads to a plan update or progress report on the plan or other Olmstead-related activities (PDF version),
    • 'Draft Plan' indicates that the link is to the draft state plan (PDF version),
    • 'State Olmstead website' indicates a state website describing Olmstead activities with a direct link to the plan and other resources (if available)
    • 'Progress' indicates any reported information about state activity in states where there is no plan or website.
  3. N/A indicates that the data is not available.
  4. X indicates that the column is not applicable.

aFox-Grage, W; Folkemer, D; Lewis; J (February 2003) The States' Response to the Olmstead Decision: how are states complying? Forum for state Health Policy Leadership, the National Conference of State Legislatures (NCSL), Washington DC.

bInformation obtained through direct contact with State officials in February and March 2011.