The class action lawsuit that the DLC settled with the State of Utah is reaching the end of its term. The Settlement Agreement required the parties to create a committee that would release a report that “shall include recommendations for policies and practices that the State may choose to implement to further reduce the institutionalized population of individuals with intellectual and developmental disabilities in ICFs over the subsequent ten years.”
The Committee included a representative of the defendants (DHHS), plaintiffs (DLC), individuals living in the community and ICFs, family members, a large and medium sized ICF provider, providers of HCBS residential services, providers of HCBS supported living services, and HCBS support coordinators. The Committee also includes representatives of the Utah Parent Center (UPC), and the Institute for Disability Research, Policy, & Practice (IDRPP) at Utah State University. The Committee met regularly over the past several years, and they looked at strategies from other states, data and trends in Utah during the term of the Settlement Agreement, and gathered input from the members of the Committee. They developed numerous recommendations that are detailed in the full report.
The report looks at five specific topics to address this, which are the following: strategies for (1) further reducing the number of ICFs and licensed ICF beds in Utah; (2) further reducing the number of large ICFs in Utah and shifting to greater reliance on small ICFs (6 beds or fewer); (3) increasing funding and resources for community-based services; (4) ensuring competency of staff and appropriate staffing levels in ICFs; and (5) identifying barriers to community-based services for individuals residing in, or at risk of residing in, ICFs and strategies for removing those barriers. The report also includes, in Attachment 1, the efforts the State has made to this point in addressing those concerns.
The overall recommendation from the Committee is that DHHS continues to work toward serving more individuals in the community. Also, the most common response from committee members about ways to reduce ICF beds and transition to smaller ICFs was to increase access to HCBS in a variety of ways, e.g., increasing HCBS funding, getting more people off the waiting list, and expanding waiver programs. The Committee also recommends that the State increases its funding for HCBS, including looking for a dedicated funding source for the waiting list, and noted that developing a statewide plan to ensure compliance with integration mandate of the ADA is one way we might accomplish this.
With respect to barriers to transitioning from an ICF to HCBS, the Committee recommendations focused heavily on the efforts the State has already made, including ensuring dedicated funding to transition, continuing with the in-reach and education about HCBS for ICF residents, and addressing discouragement by ICF staff. In addition, once again, the Committee suggests addressing gaps in the HCBS system. Similarly, the Committee recommends looking at wages and other incentives to ensure staffing levels are appropriate in ICFs.