Alabama's long term care system is largely dependent on institutional services despite of the state's efforts towards increasing home and community-based services or HCBS. In fact, records prove that more than 10,000 people received Medicaid waiver services in 2001 compared to approximately 16 700 people in nursing homes. And, it still has waiting lists for waiver programs, but due to financial restrictions, it does not fill all the available slots.
To provide remedies to this arising concern, state legislators of Alabama passed various laws on extensive reforms specifically to the assisted living industry. As a result, a board of examiners for the administrators and a set of licensure standards for assisted living were established. The state's Department of Public Health's authority to inspect unlicensed assisted living facilities was strengthened and penalties for those unlicensed were instituted.
In return, the Public Health Department has created a structure of regulations with two levels of assisted living license, which was set separate standards for facilities that provide care to people particularly with dementia. An Olmstead Core workgroup was formed as well. This workgroup is a 40-member body which is comprised of representatives from state agencies, advocates, providers, consumers, and family members with the Alabama Medicaid Agency as the lead agency.
The Olmstead Core is divided into four subcommittees, namely, Needs Assessment, Best Practices, Consumer, and Resource Development. These subcommittees are required to submit recommendations with the goal of expanding home and community-based care for people with disabilities and thorough review of its entire Medicaid program.
Alabama, with the power of a settlement agreement in the Wyatt vs. Sawyer lawsuit of January, 2001, also plans to begin moving in institutionalized disabled people into the community. The agreement establishes the procedures for assessment and asked for a specific plan developed to identify people with mental illnesses and developmental disabilities. The plan addresses the reduction of institutional beds, discharge planning processes to develop investment and certification providers. Another objective is to create and expand options for consumer-directed care.
Moreover, the state plans to develop a community-based information and referral centre, developing outreach materials and information for consumers and family members, and establish a unity of awareness and education as well. Training objectives include the development and support for person-centred planning for consumers with developmental disabilities. Community transitional advocates will also assist nursing home residents to plan their move and obtain required supports.
Long term care in Alabama continues to stride and keep up with the fast evolving and growing demands of health care needs. These mentioned above are only a few of its little steps towards its long journey in acquiring a successful health care system.
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