Arizona’s proposed Olmstead Plan open for public comment, includes strategies to integrate individuals with disabilities into community living


Soraya Marashi


Arizona’s Olmstead Plan has been updated for the first time since 2003, representing an additional effort of the state to comply with the 1999 US Supreme Court decision requiring states to sufficiently integrate individuals with disabilities into their communities.


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While the Court decision does not require state Medicaid programs to develop a strategic plan, the plan states that “Arizona officials chose to create a plan as an opportunity for advocates, agencies, members, and community stakeholders to work together on a guide to further improve access to services for individuals with disabilities and ensure they live and receive services in the most appropriate integrated setting in their community.”

The plan includes strategies to support an individual’s successful transition from an institutional setting into community-based living, and it is limited to initiatives upon which the Arizona Health Care Cost Containment System (AHCCCS) has direct impact on systemic change. 

The strategies outlined in the plan include: 

  • “Effective Permanent Supportive Housing (PSH) for members to successfully reside in the community.”
    • According to the plan, this will involve addressing financial and delivery barriers to supportive housing and wrap-around services, expanding the range of housing settings for all eligible populations, and identifying appropriate housing options for an individual in a more timely manner. This PSH should promote the least restrictive and most integrated community setting as possible. 
  • “Reach-in discharge planning for hospital settings.”
    • The plan states that this will involve developing policy changes for Managed Care Organizations (MCOs) to strengthen provider oversight and ensure compliance with care coordination, and use the statewide Closed-Loop Referral System (CLRS) for individuals exiting hospital settings to increase access to community resources that address the social determinants of health.
  • “Reach-in discharge planning for correctional settings.”
    • According to the plan, this strategy will involve forming relationships with correctional settings that are not current participants in AHCCCS data sharing, developing a discharge process that ensures inmates acquire medically-necessary medical equipment immediately upon release, and analyzing data for justice-involved individuals with chronic and/or complex physical and/or behavioral health needs.
  • “Expansion of Home and Community-Based Services (HCBS) for aging individuals with Serious Mental Illness (SMI) determinations.”
    • The plan states that this will involve providing HCBS to the aging SMI population who do not meet the criteria to become eligible for the Arizona Long Term Care System (ALTCS).
  • “Workforce Development initiatives.”
    • According to the plan, this will involve improving the hiring and retention of behavioral and direct health care workers.
  • “High quality network to ensure members are served in the most effective and least restrictive manner.”
    • The plan states that this will involve using Electronic Visit Verification to monitor the level of access to care in HCBS, and monitoring the timeliness of appointments available for behavioral health providers, children in legal custody of the Arizona Department of Child Safety (DCS), and adopted children. The plan also states that this will involve increasing network adequacy for behavioral health services. 
  • “Person-centered planning enhancements.”
    • According to the plan, this strategy will involve implementing performance measurements and targets for ALTCS MCOs and case management chart audits for more frequent performance monitoring, as well as increasing the utilization of Supplemental Security Income/Social Security Disability Insurance Outreach, Access, and Recovery (SOAR) services provided to eligible individuals. 

AHCCCS is accepting public comments for the proposed Olmstead Plan through Sept. 22nd, which will help inform the final draft.