Arizona Olmstead Plan

Supreme Court Decision

On June 22, 1999, the United States Supreme Court held in Olmstead v. L.C. that unjustified segregation of persons with disabilities constitutes discrimination in violation of title II of the Americans with Disabilities Act. This decision provided a legal framework for the efforts of the federal and state governments to integrate individuals with disabilities into the communities in which they live.

Under this decision, States are required to provide community-based services for persons with disabilities who would otherwise be entitled to institutional services when:

1. The State’s treatment professionals reasonably determine that such placement is appropriate,
2. The affected person is in agreement with the decision, and
3. The placement can be reasonably recommended, taking into account the resources available to the State and the needs of others who are receiving State-supported disability services

Although the Court did not require states to develop a plan, Arizona officials chose to do so by creating a plan as an opportunity for advocates, agencies, members, and community stakeholders to collaborate on a guide to further improve upon access to services for members with disabilities to ensure they live and receive services in the most appropriate integrated setting in the community.

Arizona considers the Olmstead Decision as an opportunity for self-examination and a continuous process of quality improvement when establishing priorities for the service delivery system in the context of other critical issues.

In 2001, AHCCCS, the Arizona Department of Health Services (ADHS) (who then and until 2016 was responsible under statute for implementing behavioral health services in Arizona), and the Arizona Department of Economic Security undertook the process to develop Arizona’s first Olmstead Plan. Updates were made in 2003. From 2014 to 2016, the above agencies initiated a planning process to update the Arizona Olmstead Plan. Then in July 2016, before the updated plan could be finalized, the ADHS’ Division of Behavioral Health Services statutorily integrated with AHCCCS to streamline the monitoring and oversight of the Regional Behavioral Health Authorities (RBHAs), who then became AHCCCS-contracted Managed Care Organizations (MCOs). While the system delivery change necessitated revisions to the drafted Olmsted Plan, the change also uniquely positioned Arizona to enhance the service delivery system through integrated care and further ensure members live and receive services in the most appropriate integrated setting in the community. For information on Arizona’s current Olmstead Planning efforts, please reference the section entitled “Current Olmstead Planning Efforts.”

This section outlines highlights of Olmstead activities that have been undertaken in recent years and future plans for activities furthering the Olmstead principles including system changes, contract and policy changes and program and project initiatives. A Recent History and Upcoming Olmstead Activities page or click on the buttons below to take you to these specific sections on that page.

AHCCCS has posted the proposed 2022 Arizona Olmstead Plan and is accepting public comment through Sept. 22, 2022.

The proposed plan includes:

• Element One: Assessment of current environment
  • Recent progress that Arizona has made that address Olmstead Principles.
  • Identify areas for improvement.
  • Identify specific member population groups that are unserved/underserved.
• Element Two: Measurable goals and desired outcomes
  • Development of an evaluation methodology for each goal
  • Plans to monitor and report the effectiveness and outcomes of each goal.

The timeline for the Olmstead Planning activities is outlined below.

The Olmstead Survey was designed to assist AHCCCS with updating the Olmstead Plan by seeking input from members, family members, provider staff, and representatives from health plans and state agencies. See the Olmstead survey summary.

AHCCCS held two community forum meetings at the end of August 2022 to educate members, families, and stakeholders about the Arizona Olmstead Plan’s contents and new format. Participants were able to ask questions and/or seek clarification about the plan in order to provide public comments during the Public Comment Period. View the Olmstead Forums presentation.