Checklist on State Actions
States need to act promptly to comply with the Supreme Court's decision
in L.C. At a minimum, a state should review its policies with respect
to the following programs and sources of funds in order to secure the resources
it will need to avoid unnecessary institutionalization:
- The state Medicaid plan covers targeted case management and psychiatric
rehabilitation services for adults, and these two services are well defined
for children entitled to them through the EPSDT mandate.
- The state Medicaid plan reimburses for intensive case management, including
assertive community treatment.
- The state has, or will develop, a request for a Medicaid home -and community-based
services waiver.
- Services furnished to residents of group homes are Medicaid-reimbursed.
- There are no restrictions on prescription of appropriate medications for
mental illnesses, including the newer "atypical" antipsychotics, and individuals
are not required first to fail on older, less effective drugs.
- The state routinely screens nursing home residents and individuals referred
for nursing home placement, and provides alternative community services for
those who do not need nursing home level of care.
- Medicaid-eligibility rules have been expanded so as to cover:
- individuals who are medically needy;
- children with serious emotional disturbance under the Katie Beckett
option;
- children ages 0-18 in families with incomes up to 100 percent of
poverty;
- children ages 0-6 in families with incomes up to 133 percent of poverty;
- CHIP-eligible children.
- The state will reduce spending on its state facilities as the census is
reduced and has a plan for resources to be transferred into community services
as the hospital census declines.
- The executive branch has requested appropriate increases from the legislature
for mental health spending in order to comply with L.C.
- The state uses federal block grant funds for individuals who might otherwise
require institutionalization.
- The state has sought resources under Section 811, Supportive Housing program,
to provide rental assistance for individuals who might otherwise be unnecessarily
institutionalized.
- The state has appropriate discharge planning to avoid homelessness for
individuals discharged from state psychiatric facilities and has sought resources
for housing individuals at risk of long-term institutionalization under the
McKinney Act.
- The state has policies and procedures that ensure that all eligible individuals
with serious mental illnesses have assistance in applying for Supplemental
Security Income or Social Security Disability Insurance benefits to which
they may be entitled, including procedures for collaboration between hospitals
and local Social Security offices.
- The state provides a supplement to the basic federal SSI benefit.
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