Creating The Plan

A state is not required to have a single plan covering the needs of all people with disabilities. A state may have different plans to address different populations, as long as the needs of all individuals who are unnecessarily institutionalized are addressed. National advocacy groups for people with disabilities have prepared a proposed Template of Key Elements to be considered when developing a comprehensive state plan. The template can be obtained from the National Association of State Protection and Advocacy Systems.⁽³⁾

As the state moves to meet its new obligations under L.C.:

• the planning process should move expeditiously, and should involve consumers, families and other advocates;
• the planning process should be accompanied by some immediate effort to expand the state's capacity for serving people in the community;
• the plan, to be comprehensive, must address the placement needs of all individuals in the "program" at issue (such as the program for serving individuals with mental illnesses);
• the plan must be funded, or it will not be "effective" (a plan that cannot be implemented because of insufficient resources is no plan at all);
• the plan must ensure the identification of individuals who are needlessly confined and identify both the services they require and the cost of those services. Without such information, the state has no means even to evaluate, let alone assure the reasonableness of the pace by which people are moved from the institution to the community;
• the effectiveness of the plan must be evaluated in order to monitor its impact; and
• the plan must ensure quality care in the community to prevent individuals' unnecessary return to institutions and promote the community integration mandated by the ADA

The state must also ensure that placements occur at a "reasonable pace." This may vary from state to state, but in the end it will depend on how swiftly the state is capable of moving people to the community. For this reason, the plan must include time frames for achieving its intended outcomes. One important aspect might be the development of standards for "reasonable pace" that vary by specific populations, such as children, adults with long-term care needs or adults with acute episodes.

Given that the ADA is a civil rights mandate, states must move individuals at the fastest pace that is feasible and that would not require a fundamental alteration.

Next: Paying for Community Treatment