Community Integration Advisory Commission: ORIENTATION November 28, 2018 Virginia Department for Aging and Rehabilitative Services 8004 Franklin Farms Drive, Henrico, VA 23229

Discussion Items What is Olmstead? CIAC: Authority, Purpose, Powers and Duties CIIT: Directive, Purpose and Olmstead Plan FOIA, COIA and PRA Member Responsibilities Moving Forward Q & A

Americans with Disabilities Act (ADA) First enacted in 1990 “To provide a clear and comprehensive national mandate for the elimination of discrimination against individuals with disabilities.” In passing this groundbreaking law, Congress recognized that “historically, society has tended to isolate and segregate individuals with disabilities, and, despite some improvements, such forms of discrimination against individuals with disabilities continue to be a serious and pervasive social problem.” For those reasons, Congress prohibited discrimination against individuals with disabilities by public entities: [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.

What is Olmstead? Olmstead is not a law but a 1999 Supreme Court decision (Olmstead v. L.C.). The Supreme Court found that the segregation of persons with disabilities constitutes discrimination in violation of Title II of the Americans with Disabilities Act. Compliance requires that individuals with disabilities receive services in the most integrated setting appropriate to their needs. Applies to publicly funded services.

Olmstead Decision The Supreme Court held that public entities are required to provide community-based services to persons with disabilities when (a) such services are appropriate; (b) the affected persons do not oppose community-based treatment; and (c) community-based services can be reasonably accommodated, taking into account the resources available to the entity and the needs of others who are receiving disability services from the entity.

Olmstead Decision (cont.) The Supreme Court explained that this holding “reflects two evident judgments.” First, “institutional placement of persons who can handle and benefit from community settings perpetuates unwarranted assumptions that persons so isolated are incapable or unworthy of participating in community life.” Second, “confinement in an institution severely diminishes the everyday life activities of individuals, including family relations, social contacts, work options, economic independence, educational advancement, and cultural enrichment.”

Importance of Olmstead Virginians with disabilities have a right to enjoy the same benefits of society and freedoms of everyday life that Virginians without disabilities enjoy. The Commonwealth has an obligation under the U.S. Supreme Court’s Olmstead v. L.C. decision, the Americans with Disabilities Act, and the Virginians with Disabilities Act to provide appropriate opportunities for people with disabilities to become fully integrated into the community if they choose to do so. Executive Directive 6 (2007)

Virginia’s DOJ Settlement Agreement Filed in 2012 Pursuant to the Agreement, the Commonwealth will: Create a total of approximately 4,200 home and community-based waivers for people who are on waitlists for community services and individuals transitioning from institutional settings over a ten year period. Almost 3,000 of these waivers will be targeted to individuals with intellectual disabilities on the waitlist or youth with intellectual disabilities in private facilities; another 450 waivers will be targeted to individuals with non-intellectual developmental disabilities on the waitlist or youth in private facilities; and another 800 waivers will be targeted to individuals choosing to leave the training centers. An additional 1,000 individuals on waitlists for community services will receive family supports to help provide care in their family home or their own home.

DOJ Settlement Agreement (cont.) The Commonwealth will also: Create a comprehensive community crisis system with a full range of crisis services, including a hotline, mobile crisis teams, and crisis stabilization programs, to divert individuals from unnecessary institutionalization or other out-of-home placements. Develop and implement an "Employment First" policy to prioritize and expand meaningful work opportunities for individuals with developmental disabilities. Create an $800,000 fund for housing assistance to facilitate opportunities for independent living for people with developmental disabilities. Create a strong and comprehensive quality and risk management system to ensure that community-based services are safe and effective.

DOJ Settlement Agreement (cont.) The Agreement is court enforceable and is monitored by an independent reviewer with the capacity to hire staff to assist in the implementation and to conduct compliance and incident reviews.

CIAC and CIIT History 2002: Following the Supreme Court Decision, a Virginia Olmstead Task Force was convened by Governor Mark Warner. The Task Force was composed of many consumers, advocates, stakeholders and disability services providers. 2004: Executive Order 61 (Governor Warner) - Created a four cabinet-member, 18-state-agency Implementation Team, and a 19-member stakeholder Oversight Advisory Committee, following the completion of “One Community,” the final report of the Olmstead Task Force. 2005: Executive Order 84 (Governor Warner) - Continued implementation of the Olmstead initiative.

History (cont.) 2006: Executive Order 2 (Governor Kaine) - Continued the Olmstead initiative and directed the Implementation Team to seek advice and input from the Olmstead Community Integration Oversight Advisory Board. 2006: The General Assembly codified the stakeholder advisory group into the Community Integration Advisory Commission. (SB 182, Puller) The Implementation is now currently operating under the 2007 Executive Directive 6 (Governor Kaine). 2010: legislation relocated staffing for the CIAC to DARS.

CIAC Authority The Code of Virginia in §§ 2.2-2524 - 2.2-.2529 establishes the Community Integration Advisory Commission (CIAC) as an advisory commission in the executive branch. Sunset date of July 1, 2019. To meet four times a year. Members to serve four year terms. Limited to two consecutive four year terms.

CIAC Composition Membership consists of 21 citizen members: 4 appointed by the Senate Rules Committee 6 appointed by the Speaker of the House 11 appointed by the Governor (Code of Virginia §2.2-2525) Membership includes representation by: 8 persons with disabilities, 4 relatives of a person with a disability, 6 providers of services or advocates, 1 resident of a state mental health facility, 1 resident of a intellectual disability training facility, and 1 resident of a nursing facility.

CIAC Purpose The purpose of the Commission shall be to monitor the progress of all executive branch state agencies toward community integration of Virginians with disabilities in accordance with all applicable state and federal laws in order that persons with disabilities may enjoy the benefits of society and the freedoms of daily living. Code of Virginia §2.2-2524

CIAC Powers and Duties The CIAC was granted the following powers and duties (§2.2-2527): To monitor the implementation of state and federal laws pertaining to community integration; and To make appropriate recommendations to the Governor concerning community integration of Virginians with disabilities.

CIIT or Implementation Team Executive Directive 6 (2007, Governor Kaine) Directed various executive branch agencies and councils to continue their collaborative efforts to complete and annually update a comprehensive, cross-governmental strategic plan for community integration of Virginians with disabilities

Current CIIT Composition Secretary of Commerce and Trade Department of Housing and Community Development Department of Professional and Occupational Regulation Virginia Housing Development Authority Virginia Employment Commission Secretary of Education Department of Education State Council of Higher Education for Virginia Virginia Community College System Secretary of Public Safety Department of Veterans Services Secretary of Transportation Department of Rail and Public Transportation Virginia Department of Transportation Special Advisor to the Governor for Workforce Development Secretary of Health and Human Resources Department for the Blind and Vision Impaired Department of Health Professions Department of Medical Assistance Services Department of Behavioral Health and Developmental Services Department of Rehabilitative Services Department of Social Services Mental Health Planning Council Office of Comprehensive Services for At-Risk Youth and Families Statewide Independent Living Council Virginia Board for People with Disabilities Virginia Department for the Aging Virginia Department for the Deaf and Hard of Hearing Virginia Department of Health

Instructions for the Olmstead Plan Goals: Provide choice for individuals living in institutions wanting to live in more integrated and appropriate settings and Avoid unwanted institutionalization. To include strategies that comprehensively address: Community services and supports, Housing, Transportation, Employment, and Workforce issues. Plan to be updated and submitted annually by August 31.

CIIT Collaboration Cabinet Secretaries, executive branch agencies and councils directed to work closely with CIAC. Provide information requested by the Commission in monitoring community integration implementation. Collaborative efforts extended to local government and local government agencies as well.

Additional Team Partners Area Agencies on Aging Centers for Independent Living Community Services Boards Virginia Association of Counties Virginia First Cities Virginia Municipal League

Current Olmstead Strategic Plan Walk Through the Plan…

Current Olmstead Strategic Plan Recommendations for Community Living Supports to Target: Systemic Institutional Bias Access to Waiver Slots and Services Provider Choice, Capacity, and Training Lack of Services for Individuals Not Eligible for Medicaid Choice, Coordination, and Continuity of Care

Current Olmstead Strategic Plan Recommendations for Housing to Target: Need to Decouple Funding for Housing and Support Services to Support Choice and Options Lack of Coordinated Housing and Services Planning, Including Transportation Access Shortage of Housing Options Fed by a Growing Demand and a Lack of Affordability and Accessibility Inadequate Compliance with Fair Housing Practices Continued Local Community Resistance

Current Olmstead Strategic Plan Recommendations for Employment and Community Engagement to Target: Inadequate state agency coordination which creates a multitude of challenges ranging from the potential expansion of non-community integrated employment and non-employment waiver services, to inequitable and inaccessible services, as well as issues coordinating transition services Negative effect of waiting lists for vocational rehabilitation services Financial disincentives to employment Inadequate focus on career development in comparison with immediate job placement Social Isolation

Appendix E: Action Items Long-Term Action Items Short-Term Action Items Reporting Activities from Team Members and Agencies

Previous CIAC Recommendations 2016: Use of Supportive Housing in the Auxiliary Grant Program 2016/2017: Allow Exceptions to the Medicaid Consumer Directed Services Cap on Hours 2017: Medicaid Expansion 2017: Increase Funding for CILs 2017: Monitor WIOA Title III Funding Cuts 2017: Merge LTESS and ESS Funds

2018 CIAC Recommendations Extend the Sunset of the CIAC Relocate the CIAC to the Governor’s Office Fund a Five Percent Increase in Rental Assistance for Individuals with Disabilities Fund a $250,000 Increase for CILs Ensure State Agency Websites Are Accessible for All Virginians Pending: Draft Changes to CIIT

Freedom of Information Act (FOIA) Definition of Meeting Minutes Voting Electronic Communications & E-Mails Public Records

Conflict of Interests Act (COIA) Prohibited Conduct and Gifts Financial Disclosure Forms

CIAC By-Laws Guidance for Remote Participation Quorums and Voting Attendance Appointments and Terms Resignations Officers (Chair and Vice Chair) and Elections Committees By-Law Amendments

Other Housekeeping Items RSVP to Meetings Travel Reimbursements Contact Information – Keep Up to Date

Questions?