I have to say that I don't agree that the therapies Jenny wrote about
are in any way "proven." I do not discount in any way the success
you may have had with your child, Jenny. But it is a well-known fact
that desperate parents are often willing to jump in to any program or treatment
or nutritional therapy which cites anecdotal evidence--and miraculous results--as
"proof."
So I--and many legislators, I'm sure--would have great difficulty with
tax-payer funding for these approaches (which unfortunately, often turn
out to be The Answer for one or a few kids...and a complete waste of precious
time and money for all the rest. Remember Lorenzo's Oil? Remember
Patterning? I do)
I suppose that making funds available to parents for the purpose of
investigating alternative therapies is an option...but it would be an option
fraught with obvious difficulties.
Again, I'm sorry to be a voice of dissent, but I'm concerned that pursuing
something so controversial--before we've established a solid foundation/reputation/track
record--would be harmful to our efforts as a whole.
In my opinion, funding like what's being discussed should not be part
of an initial proposal.
Kelly Trout
Valdosta
Hello everyone,
Family Support should be individualized. Services that I may need for my
child may not be the services that another family needs and that is ok.
Families should have control of the funds but still be held accountable.
Family Support should cover services that insurance companies and Medicaid do
not cover or deny.
Thanks,
Heidi Fernandez
From Beth Tumlin, Chair Extraordinaire, a quick save (I hope!):
Beth T. wrote: Cindy, CORRECTION NEEDED. In your incredible minutes/recap of
last
week's meeting, I noticed an "Oooops!" which we may want to
clarify....the meeting at the Loudermilk Center is Tuesday, not Monday.
4) The Revenue Maximization/Governor's Budget Request has much to do
with the aforementioned efforts. If you can not participate in
TUESDAY'S 9:30 meeting in Atlanta at the Loudermilk Center be assured
that Unlock & the Family Support Talk Ga Lists will keep you informed
of whatever is pertinent.
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
Whew! Thanks, Beth. I hope everyone gets this in time and is not put to the
trouble of going to the Loudermilk Center on the wrong day.
Hope to see you all at the Rev Max meeting on TUESDAY, February 6-(where I'll
apologize in person to anyone who may have been inconvenienced!)
Thanks for all you do!
Cindy
I THINK MAKING THE MONIES AS FLEXIBLE AS POSSIBLE SO EACH FAMILY
CAN USE THE MONIES IN THE WAYS IT WILL BEST HELP THEIR FAMILIES
IS IMPORTANT AND HOPE THIS IS PART OF THE PLAN. I HEAR IT IS SUCCESSFUL
IN OTHER STATES WHEN THE FAMILIES DIRECT THE MONIES THEMSELVES.
CD
I had a dicussion with a parent who attapparent parent to parent support group
meeting where a representative from Unlock the Waiting List, as well as someone
from the local Mental Health board spoke at their meeting. They spoke about the
different waiver programs in relations to family support. It was mentioned that
families could not have the Deeming Waiver and another waiver. So, the question
is will Deeming Waiver families qualify for family support? Will families have
to change waivers?
Jenny, if we can get family support to be flexible enough you could get the
money you need and spend it however you think if right for your child and you
won't have to convience anyone that it is right for your child. That is where
the cash subsidy is really family friendly. I think that most families will
do the right thing with money intended for helping their child's disability.
Many states have been doing it for a while.
Nina
I just wanted to second all Jenny Kelly wrote about covering ABA therapy,
special diets, and vision therapies, things not covered by Medicaid.
I would like to see Medicaid cover these things , but if not, it would
be appropriate for the Family support funds to fill in these sorts of gaps.
We've seen some families using the therapies and diets see amazing results
with their autistic children - some to the degree where they are mainstreamed
and behaviors are almost eliminated so the cost effectiveness is incredible!
One other thing I wanted to add was adaptive clothing or equipment,
like Rifton toilet chairs, of specialized clothing. I have to even have some
clothes custom made for my child due to his size. Claire Dees
SPECTRUM co-president
and Parent of autistic child
Ideas from families around the state:
Community-based recreation programs. These would be therapeutic recreation
services, that are provided by Recreation therapists that would provide a
"purposive intervention" which would enable the children/adults to utilize all
the skills they are learning on the job or in therapy. These therapists modify
and customize each activity so that EVERYONE is successful in whatever
recreational pursuits that they are engaged in. Right now, there is nothing
available to any population like that in the community, some have them in the
institutions or large nursing homes. These services can make a big difference
in a persons quality of life as well as improving their functional ability.
They also help to decrease aggressive behaviors and prevent crisis situations.
I noticed the fact sheet included "Behavioral
intervention and consultation to help families manage
challenging behaviors." I hope that this can include
Applied Behavior Analysis (ABA) therapy which is
typically a home-based behavior modification program
that has been very effective for many kids with
autism, but unfortunately it is not covered by typical
insurance or Medicaid so many families are not able to
get this service for their child. Since almost all of
the ABA therapists are not certified this could be an
issue?
Also listed was "Cash subsidies to help with the
expense of .....nutritional formula for G- Tube
feeding..." What about nutritional supplements and
specialized foods needed because of disability related
immune system issues (including food allergies)? Case
in point -- my daughter's weakened immune system and
food allergies/intolerances are directly related to
her diagnosis of autism. I could put my daughter on a
drug and it would be covered by my insurance or
Medicaid, but since I choose to help her behaviors by
giving her vitamins/minerals and putting her on a
special diet nothing is covered. Many families do not
choose the dietary intervention option because it is a
lot more expensive than the drug option (we spend
about $500/ month on special supplements and
foods...this doesn't include any "regular" groceries).
Just one more thing...vision therapy has been proven
to be very beneficial to many kids with ADD, ADHD,
autism, etc but is rarely covered by insurance or
Medicaid.
I know these are kind of off-the-beaten-path ideas but
I know many families who are in need of support in
these areas.
Thanks for allowing me to participate!
Jenny
=====
Jenny Kelly
Jackson, GA
__________________________________________________
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We would like to remind you of this upcoming event.
Steering Committee Meeting/Family Support Policy Council
Date: Tuesday, February 6, 2001
Time: 12:00PM - 5:00PM EST (GMT-05:00)
Steering Committee to Family Support Policy Council will meet at
Two Peachtree Street, Atlanta, Ga. on the 41st floor, room 41F,
from Noon-5PM Steering committee members: the Family Support
Project would like to provide your lunch at no cost to you. So
please notify Cindy of your intent to participate in the
steering committee so that we can get an accurate head count.
Information about allergies & food needs (vegetarian,etc.) would
also be helpful. If we don't know you're coming don't count on
their being a lunch for you! Please confirm your participation
in advance by contacting Cindy Arceneaux
(uwlfamsuppolicycouncil@...)404 657 2129, toll free 1 888
275 4233, TDD 404 657 2133, Fax 404 657 2132
Not sure if you are a steering committee member? Don't be shy!
Ask!
Your use of Yahoo! Groups is subject to http://docs.yahoo.com/info/terms
I'm looking at Family Support from two views. My own family concerns,
socialization is a big concern since Dustin is 16 and this is important
to him and opportunities are limited. If they exist there always so far
away, since we live in a small, rural community. As I work with the
adults in our area, their top request is also" something fun to do" it
usually doesn't matter what, they just want to be a part of something.
Some type of Buddy System keeps coming to mind for me. I am also
finding that we have a number of families where the parent has the
disability, most common is mental retardation/developmental disability.
It is usually a single parent, most often the mother, and her children
have no delays. Presently we can access limited support for the person
with disabilities. There is a desperate need for intervention/support
for the children, especially when they reach adolescent years and they
become higher functioning than the parents. Of course transportation is
an issue. To add to the list : After school care, behavior specialist to
work with family, dental, dentures and eye glasses a must. My list could
go on and on as
I'm sure each of us could go on. I look forward to meeting again. I'm
excited about this opportunity to give input on a subject that has such
great impact on my own family and the families I'm am fortunate to work
with.
I've been reading all of this and taking it all in and I must admit if I
had more family support I would have more time and energy to respond.
Even though they are 2 separate issues, I would like to address both the
merging of the waivers and Pat's comments and Family support. This is
for 2 reasons, one for the sake of brevity but the other is that I
believe they are inevitibly linked. It's very nice to talk about having
our family member's at home with us and receiving the support to help us
to do this, the other part is that there is a time to help them go on to
live without us. Most of our children will live beyond us and the
Medicaid waiver is the most practical way for our children to get the
support they require (unless we are independently wealthy). One of the
most tragic situations that we run into in respite is a family that has
not prepared their adult child for their own death. Often the person has
never been with other people and ends up not only losing their parent but
going to a new home or facility where they don't know anyone.
*On the merging of the waiver, I wanted to add that Service Coordination
in GA currently pays $141. and change per case per month. That works out
to approx. $1695. x 20 which is the maximum MRWP caseload and that comes
to about $34,000. by the time an agency takes a percentage for benefits
and operation costs etc., service coordinators get paid between $20,000
and $23,000. per annum- this is why we have the constant turnover that we
currently have. Service coordinators need to have experience and a 4 year
degree, drive hours every week in traffic, for a very low rateof pay. If
we improve their pay, I suspect we might improve their quality. Ditto
with personal support staff.
* On the waiver, I would like to see more services added. We currently
have personal support, service coordination, day habilitation, supported
employment and respite types of services. I think behavioral supports
and perhaps diapers would be helpful. Our agency has been trying to
figure out how to bill Medicaid for diapers for months and they make it
so difficult. If it was written into the DMA80, like personal support,
maybe it would just happen. Same with behavioral supports. Some people
just need them, and will every year. If we had adequate crisis
interventiion and prevention expertise readily available in the
community, we might not need to guarantee it in this way. But if it is
written into the DMA80 then the funding is at least there. Currently it
is very difficult to figure how to pay a psychologist for behavioral
services, thus we seem to have few of them around. Hopefully, this would
change if there were means to support their services.
*Family Supports . I have just analysed a survey that I have been
conducting in Region 7 (Gwinnett/Rockdale/Newton counties) on community
needs. The results of the 34 families that have returned their forms are
that most like the Individualized Family support, that is family directed
as we currently are administering them to families with autism. That was
the number one, out of 11 choices. 2. Summer Camps; 3. In home Behavioral
Supports; 4. After school care; 5. In home personal support/ companion;
6. A respite facility in GRN region. So the good news is that families
are really appreciative of what we are doing with the funding we have
gotten so far. The bad news is that because there are so few community
resources, i.e. summer camps, afterschool programs, respite
opportunities, many families find their lives are extremely limited by
caring for their loved one with a disability. This will vary alot from
Region to Region, and is why it is so important to have funding
administered by region. For instance, I hear that in Cobb Co. DOE
provides summer camps and afterschool care for children. If GRN did the
same, it would remove the 2nd and 4th greatest need - and demand on
family support (in fact like respite, family support IS NOT supposed to
pay for afterschool care). I think we need to either force DOE to
provide afterschool care or pay it from family support. (As a working
parent, that is certainly my #1 struggle, virually every day. In the
past year, I have gone through over 12 people looking after my son in the
afternoon so I can work. I am running an ad now as I have no one and the
agency can't find anyone either! I have funding through the waiver, just
no reliable consistent help!) There seems to be an illusion that there is
pleanty of afterschool care, as there are centers all over and after all,
we do have the ADA. The truth is that , either they don't take our kids
as they truthfully can't support them or they do such a bad job we take
them out. They just won't take mine, and after 12 then they are too old
anyway. Sorry to ramble, this is a sore point for me! Having read the
information in the family support handout, I do also like the idea of
developing some system of funding diapers in our region. This has been a
frequent request, especially for people with older children, as they get
so expensive in the big sizes.
Susan Ariel Creek
s.ariel.c@...
Family Support Coordinator
Parent Advocate
Susan
Thanks for joining and welcome aboard! We appreciate your input in
defining what Family Support should look like in Georgia, and how the
waiver should be written!
Beth
Also, need to have Sel Determination, natrual suppports, cris intrvition for when there are crises for behavior and medical isses, & coninuity of services so that their are chioces and there is win win situation for the individual in the community so that hospital isn't the first stop nor a respite for the providor staff and aslo dupping ground
Tim
----- Original Message -----
From: Pat Puckett
Sent: Friday, February 02, 2001 11:29 AM
To: familysupporttalkGa@yahoogroups.com; familysupporttalkGa@yahoogroups.com
Subject: Re: [familysupporttalkGa] It is a discussion list-let's discuss!
I really think that we need to reduce the number of discreet services rather than add to them. As I mentionned in the meeting, we have an example of an approved waiver which contains two services: (1) Planning and (2) everthing else. Here are the definitions from the Kansas waiver: (1) Independent Living Counseling (this is what we would call service coordination): "This service is required for all HCBS consumers and is provided by qualified providers as defined later in the document." It includes: "Serving as the point of access for Medicaid Services, assessing consumers' services needs; developing the annual plan of care, ensuring that the consumers' plans of care are cost-effective and meet basic health & safety needs, ensuring that consumers have full and unbiased access to a variety of services and service providers to meet their specific needs including a list of all available agencies which provide that service and advocating for consumers by brokering and negotiating with individuals, businesses and agencies for the best available services within limited resources. This service is limited to 120 units per calendar year. (A unit is $27.13 on average for this waiver which translates to a maximum of $3,240 per person per year. Don't know how this cost is in comparison to our service coordination costs but I do know that KS doesn' have the extra layer of a service monitor.)
"Personal and Assistive Services means one or more persons assisting another person with a disability with tasks which the disabled individual would typically do for themselves in the absence of a disability. Tangible equipment or hardware, such as but not limited to, technology assistance devices, adaptive equipment or environmental modifications, may be substituted for a caregiver when it is dentified as a cost-effective alternative on the individual's plan of care. Purchase or rent of tangible equipment or hardware undeer the definition of this service is limited to those items not covered through regular state p[lan services and which cannot be procured from other formal or informal resources (such as VR or Education). This service will be used only as the funding source of last resort. Tangible equipment or hardware requires prior authorization from Medicaid. All Personal and Assistive services will be brokered by the Service Coordinator with written authorization from the consumer. Reimbursement for this service is limited to the individual's assessed level of services need. (KS has a standardized assessment instrument which assigns levels of care.) Personal Care Attendant Service provided within the scope of this service must be reimbursed within the approved reimbursement range established by the state.
At 08:08 PM 2/1/01 -0000, uwlfamsuppolicycouncil@... wrote: >Dear Family Support Policy Council Members, > >Please know that is an opportunity to provide guidance and >recommendations based on our life and experiences and expertise. But >we must provide input quickly. Keep in mind that this is not a support >group but is an opportunity to suggest how services should be >delivered, who is eligible, etc. > >Let us start by reviewing the e-mail on the MRWP and provide feedback >to the rest of the group with suggestions for expanding the menu. > >Please take time to make your thoughts, concerns, questions, >suggestions known about who will be eligible, who will be a >provider, where and how will families and adults with >disabilities access services, will there /should there be a >complint procedure, how will services be evaluated. The clock >is ticking and your input is need. Hope to hear from you soon. And >please suggest others who you think mat be interested in being added >to the online group discussion. Thanks for all you do! Cindy > > > > >To unsubscribe from this group, send an email to: >familysupporttalkGa-unsubscribe@yahoogroups.com > > > >
To unsubscribe from this group, send an email to: familysupporttalkGa-unsubscribe@yahoogroups.com
While I'm sure you've discussed many of these issues, (I was not at the last meeting), here are some things to think about that I've heard from parents around the state:
-Crisis management behavioral intervention team that could be accessed on an emergency basis 24/7.
-Full day, summer programs/child care for the entire summer
-Older children need peer "companions" for friendship as well as to assist with ADLs -Sick child respite-- where a child can be cared for during a lenghthy illness like flu, OHI's, etc during parent's working hours
-Definitely after school care in home to assist with homework, meals, bathing dressing, trained in use of assistive/ augmentative communication devices or alternative communication modalities.
-Intervenors/interpreters -Free/sliding scale/tax credit for families taking alternative communication training. ie:, sign language, tactile communication systems, etc.
Deborah A. Fields-Harris
Family Coordinator
GaDeafblind Project
Note: forwarded message attached. (Pasred below for
those who have trouble opening attachments. Message
from Beth Tumlin, Unlock's Chair with useful
information for our discussion.:
I thought it might be helpful to kick off our
discussions with the
Recommendation for Family Support that went to the
Blue Ribbon Task
Force
to stimulate some thinking from our group regarding
"what else" is seen
-
or has been experienced - as a need. Expand on these
categories:
- what kind of behavioral intervention in the
community would help
you....a mobile crisis unit?.....a behavior specialist
to work with the
family on a "behavior management plan"?
- What other kinds of equipment needs have you had -
or do you
anticipate - that is not covered through
insurance/Medicaid. A
wheelchair lift, for sure. A lift system in the
home....?
- Do you need respite, and how/when would you
need/use it most?
- As your child gets bigger, do you see a need for
help with
bathing/dressing?
- If you work, do you need someone who is trained to
be at home after
school/after work to help your child with physical
needs or skills
training or oversight?
Try to think "out of the box" of what is, and try to
envision "what
could
be"! We, as parents and family members, have an
opportunity to CREATE
a
different way of doing business. Let us seize the
moment and create
something that will help families for years to come!
Please let us know what would really help YOU in the
day to day of
caring
for your child, and as your child gets older.
Beth Tumlin
Blue Ribbon Task Force
June 15, 2000
RECOMMENDATION #3 - Crisis Prevention Through Family
Support,
Supported Employment/Day Services,
Assistive Technology
Georgia must move from a system of service delivery
that responds
primarily to crisis and emergency, to one that
emphasizes delaying or
preventing the need for residential supports. In
order to do this,
Georgia must enhance its commitment to family
preservation and do
"whatever it takes" to support people who want to live
in their own
homes
or with their families. Families and individuals with
developmental
disabilities need more information, education and
support in order to
reduce their reliance on the formal service system
Family Support
Family support services are the foundation for keeping
families
together
while providing care to their family member(s) with
mental
retardation/developmental disabilities. Family
support services will
reduce the incidence of family crisis when the family
reaches a
breaking
point in care giving, causing them to request 24-hour
residential
services. Examples of family support are:
¨ in-home assistance with personal care and hygiene,
help getting in
and
out of bed / wheelchair, and dressed each day
¨ respite care (relief and time away for the
caregiver)
¨ home modifications such as adding a wheelchair ramp,
widening doors
¨ behavioral intervention and consultation to help
families manage
aggressive behaviors,
¨ assistive technology like communication devices,
environmental
controls, or personal alert systems
¨ cash subsidies to the family to help with the
expense of adult
diapers,
therapies, nutritional formula for G-Tube feeding,
prescriptions,
dentist
bills, and/or eye glasses that are no longer covered
by Medicaid after
age 21
Recommendations:
1. The national average cost for family support per
family is $13,000
per
year. Currently Georgia's average cost is $1,500.
(National
statistics
indicate that for every two people provided the
in-home support to
remain
in their own home through Medicaid Waiver-funded
Family Support, one
less
person will seek 24- hour residential services.) To
support families,
and
to reduce the residential services waiting list,
Georgia should provide
the amount of service equal to the national average.
2. Every family of an eligible applicant who is on the
current waiting
list should be offered family support services if the
applicant lives
with the family.
3. Every family of an eligible applicant should be
offered family
support
services if the applicant lives with the family.
4. The division should ensure flexibility in the use
of family support
funds so that families get the help they need.
Transition Planning and Adult Intake
When students with disabilities graduate from high
school and leave the
structured school setting, they often find themselves
sitting at home,
waiting on waiting lists, instead of utilizing the
skills they learned.
Valuable skills and confidence are lost, often
replaced with boredom,
regression, and behaviors. Frequently a family member
must leave much
needed employment in order to supervise and provide
care to the person
with a disability. This can be even more devastating
to a single parent
family. These situations lay the groundwork for the
family's future
inability to care for a person with a disability.
1. The Department of Education and local school
districts must
collaborate with the Division of MHMRSA and the
Division of
Rehabilitation Services to provide data and early
identification for
planning purposes.
2. Consideration should be given to developing intake
for adult
services
at the first transition meeting (age 14-16). With
adequate time to
plan,
service needs documented, and goals for the future
developed, more
realistic planning for supports and services can be
calculated and
resources allocated.
Supported Employment and Day Services
3. A comprehensive plan for employment for people with
disabilities
should be developed and implemented which creates
incentives for
providers and businesses to use best practices for
people with
disabilities and partnering agencies such as Dept. of
Labor.
4. No person requesting supported employment or day
services should be
put on a waiting list. Supported employment or other
appropriate day
services should be offered to each eligible applicant.
Assistive Technology
1. Each person on the waiting list should be assessed
to determine
his/her need for assistive technology. Technologies,
such as a
wheelchair lift, augmentative communication device, or
home
modifications, such as a ramp or widening doorways,
can alter the need
for residential services as the child grows into
adulthood.
Additionally, AT helps develop independence, a sense
of dignity and
increased self-esteem, which comes with having control
over one's
environment and circumstances.
__________________________________________________
Get personalized email addresses from Yahoo! Mail - only $35
a year! http://personal.mail.yahoo.com/
I thought it might be helpful to kick off our discussions with the
Recommendation for Family Support that went to the Blue Ribbon Task Force
to stimulate some thinking from our group regarding "what else" is seen -
or has been experienced - as a need. Expand on these categories:
- what kind of behavioral intervention in the community would help
you....a mobile crisis unit?.....a behavior specialist to work with the
family on a "behavior management plan"?
- What other kinds of equipment needs have you had - or do you
anticipate - that is not covered through insurance/Medicaid. A
wheelchair lift, for sure. A lift system in the home....?
- Do you need respite, and how/when would you need/use it most?
- As your child gets bigger, do you see a need for help with
bathing/dressing?
- If you work, do you need someone who is trained to be at home after
school/after work to help your child with physical needs or skills
training or oversight?
Try to think "out of the box" of what is, and try to envision "what could
be"! We, as parents and family members, have an opportunity to CREATE a
different way of doing business. Let us seize the moment and create
something that will help families for years to come!
Please let us know what would really help YOU in the day to day of caring
for your child, and as your child gets older.
Beth Tumlin
Blue Ribbon Task Force
June 15, 2000
RECOMMENDATION #3 - Crisis Prevention Through Family Support,
Supported Employment/Day Services,
Assistive Technology
Georgia must move from a system of service delivery that responds
primarily to crisis and emergency, to one that emphasizes delaying or
preventing the need for residential supports. In order to do this,
Georgia must enhance its commitment to family preservation and do
"whatever it takes" to support people who want to live in their own homes
or with their families. Families and individuals with developmental
disabilities need more information, education and support in order to
reduce their reliance on the formal service system
Family Support
Family support services are the foundation for keeping families together
while providing care to their family member(s) with mental
retardation/developmental disabilities. Family support services will
reduce the incidence of family crisis when the family reaches a breaking
point in care giving, causing them to request 24-hour residential
services. Examples of family support are:
¨ in-home assistance with personal care and hygiene, help getting in and
out of bed / wheelchair, and dressed each day
¨ respite care (relief and time away for the caregiver)
¨ home modifications such as adding a wheelchair ramp, widening doors
¨ behavioral intervention and consultation to help families manage
aggressive behaviors,
¨ assistive technology like communication devices, environmental
controls, or personal alert systems
¨ cash subsidies to the family to help with the expense of adult diapers,
therapies, nutritional formula for G-Tube feeding, prescriptions, dentist
bills, and/or eye glasses that are no longer covered by Medicaid after
age 21
Recommendations:
1. The national average cost for family support per family is $13,000 per
year. Currently Georgia's average cost is $1,500. (National statistics
indicate that for every two people provided the in-home support to remain
in their own home through Medicaid Waiver-funded Family Support, one less
person will seek 24- hour residential services.) To support families, and
to reduce the residential services waiting list, Georgia should provide
the amount of service equal to the national average.
2. Every family of an eligible applicant who is on the current waiting
list should be offered family support services if the applicant lives
with the family.
3. Every family of an eligible applicant should be offered family support
services if the applicant lives with the family.
4. The division should ensure flexibility in the use of family support
funds so that families get the help they need.
Transition Planning and Adult Intake
When students with disabilities graduate from high school and leave the
structured school setting, they often find themselves sitting at home,
waiting on waiting lists, instead of utilizing the skills they learned.
Valuable skills and confidence are lost, often replaced with boredom,
regression, and behaviors. Frequently a family member must leave much
needed employment in order to supervise and provide care to the person
with a disability. This can be even more devastating to a single parent
family. These situations lay the groundwork for the family's future
inability to care for a person with a disability.
1. The Department of Education and local school districts must
collaborate with the Division of MHMRSA and the Division of
Rehabilitation Services to provide data and early identification for
planning purposes.
2. Consideration should be given to developing intake for adult services
at the first transition meeting (age 14-16). With adequate time to plan,
service needs documented, and goals for the future developed, more
realistic planning for supports and services can be calculated and
resources allocated.
Supported Employment and Day Services
3. A comprehensive plan for employment for people with disabilities
should be developed and implemented which creates incentives for
providers and businesses to use best practices for people with
disabilities and partnering agencies such as Dept. of Labor.
4. No person requesting supported employment or day services should be
put on a waiting list. Supported employment or other appropriate day
services should be offered to each eligible applicant.
Assistive Technology
1. Each person on the waiting list should be assessed to determine
his/her need for assistive technology. Technologies, such as a
wheelchair lift, augmentative communication device, or home
modifications, such as a ramp or widening doorways, can alter the need
for residential services as the child grows into adulthood.
Additionally, AT helps develop independence, a sense of dignity and
increased self-esteem, which comes with having control over one's
environment and circumstances.
The last Family Support Policy Council meeting was held Tuesday,
January 30, 2001 @ Two Peachtree Street.
Family Support Policy Council members in attendance:
1)Dottie Adams, provider, Athens
2)Karen Davis, parent & FOCUS Liaison, Atlanta
3)Sheila Landry, Parent, Augusta
4)Claire Dees, Parent & SPECTRUM Autism support group rep, Gwinnett
5)Susan A. Creek, provider & parent, Gwinnett
6)Ethel Curtis, parent and Children with Special Needs/ Babies Ban't
Wait staffer from Family Health Branch/Division of Public Health,
8)Joanne Alford Robinette, Parent and Community's In Schools
Coordinator, Houston County
9)Dee Gillespie, state Family Connection Family Support Coordinator &
resident of Athens
10)Margie Dassau, Parent, Gwinnett
11)Renn Doyle, Parent & AADD Staffer coordinating Partners In
Policymaking,
12)Jenny Kelly, Parent, GCARE Representative
13)Allen Goldman,DHR Division of Aging
14)Andrew Hales, Georgia Council on Aging
15)Dustin Chamlee, self advocate in training, Butts County (teen)
16) Azalene James, AADD
17)Cary Grubbs, Griffin Area Resource Center
18)Renee Peek, self advocate, Osteogenesis Imperfecta Council of Ga
19)Leonard Roscoe, self advocate, OI Council of Ga.
20)Pat Puckett, SILC (Statewide Independent Living Council) of Georgia
21) Kim Gillespie, Parent To Parent of Georgia
22) Lana Hardy, AADD
23)Gloria Chamlee, parent and provider of Family Support through Butts
County Family Connection collaborative
24)Beth Tumlin, parent & Unlock the Waiting Lists! Campaign Chair
25)Eric Jacobson, Director, Governor's Council on Developmental
Disabilities
26)Charles Hopkins, DHR,Division of MH/MR/SA
27)Judy Feimster, DHR,Division of MH/MR/SA
29)Marcey Dolgoff,Governor's Council on Developmental Disabilities
30)Pat Nobbie, Policy Coordinator, Governor's Council on Developmental
Disabilities
31) Cindy Arceneaux, Unlock the Waiting Lists! Campaign/Family Support
Project Coordinator
The group met in the chilly open space area of the 2nd Floor
Conference area at Two Peachtree. Despite best efforts, the meeting
began a little after the 1:00 PM start time. Beth Tumlin, Unlock Chair
and parent extraordinaire was kind enough to provide a brief welcome.
Charles Hopkins then provided an overview of Family Support, with some
history in Georgia and nationally. Pat Nobbie reported on her
research of Family Support in Georgia and nationally. (A copy of
this report is available to you as a Family Support Policy Council
member) Pat's report was distributed to those in attendance. Eric
Jacobson reviewed the Blue Ribbon Task Force Report and the Governor's
Budget Request. (You can find the Blue Ribbon Report on the DD Council
website: www.ga-ddcouncil.org) This report was provided to those in
attendance. Marcey Dolgoff then gave a brief update on the Family
Support Project grant. (The Family Support Project will now focus on
the training aspects of Family Support as the Governor has requested
funding for Family Support to be available statewide, so demonstration
projects are no longer necessary.)Cindy Arceneaux and Marcey Dolgoff
the asked the Family Support Policy Council to begin to do the work of
the council- defining: elgibilty,family, provider,
individual/family-centered. The meeting was scheduled to end at 2:30.
As the group began to brainstorm eligibilty and defining family it was
apparent that we would not finish in time. Cindy Arceneaux asked the
group if they could see how much work was to be done just by the
excercise we had gone through. It was agreed that there was a lot. We
discussed the fact that the FS Policy Council comments / suggetions
had two maybe more deadlines & tracks: (4 points follow)
1) The Division of MH/MR/SA must amend the Mental Retardation Waiver
Program (MRWP)by February 30, 2001. Any changes the FS Policy Council
would like to make or suggestions for amending the MRWP, including
increasing the menu or list of options must ne provided before then,
if our recommendations are to be considered for inclusion in the
amended application to HCFA by the Division. This gives us 2-3 weeks
at most for that piece. (Judy Feimster of MH/MR/SA is responsible for
writing the waiver and requested that we give her advice on enlarging
the menu. She is concerned that if we do much more it may take HCFA
longer to approve it. This amended MRWP waiver will only be in effect,
once HCFA approves it, untill it is superceded by the Merged Waiver.
Which brings us to
2) The Division must have an application in to HCFA by the end of
March which will merge existing waiver options into 1 waiver. The MRWP
& other waivers will cease to exist and be replaced by this one
"Merged Waiver" This is where we also need to develop input. We have
3-4 weeks to develop our Individual/Family Support Policy Council
recommendations for the Division's consideration. Once the application
is in to HCFA (federal Health Care Financing Administration which
oversees every state's Medicaid agency)we must then give guidance
during the 90 days waiting period for HCFA approval to the Division
about implementation and training.
3)The Governor has also recommended in his budget state money for
Family Support that is not attached to any waiver. Therefore families
who are not Medicaid eligible can access Family Support without the
waiver.
4)And there is Family Support Autism money and Family Support programs
still in existence from the past.
What advice/guidance can the Family Support Policy Council provide
regarding family access and reducing the confusion about which family
support funds are being requested ? How can the Family Support Policy
Council help ensure a consistency to where & how families access
support, how they are treated and how we can ensure individual
directed or family directed planning that will help adults with
disabilities and /or families know what services they are already
eligible for from every govcernment agency, non profits, private
providers, etc. and then help in planning for how to access the
supports that they need.
After reviewing the above and with Judy Feimster making requests of
the FS Policy Council to quickly give suggestions on the MRWP, Cindy
Arceneaux asked those FSPC members in attendance if they were
committed to providing the advice even with this quick turn around
times. There was an enthusiastically positive response. The Family
Support Policy Council agreed that a group discussion list needed to
be started immediately. The FSPC agreed to meet again on February 15
to review Steering Committe to the FSPC suggestions and continue to
work on the MRWP recommendations and begin to define eligibility for
Family Support services for the merged Waiver and the state Family
Support (waiver free) funds. Look for a reminder notice coming from
this group discussion list about the next meeting Thursday 2/15/01
Noon - 4PM, Brown Bag Lunch w/ Drinks/Snacks provided by Unlock's
Family Support Project.
FYI:
1)The Family Support Talk Georgia Internet Discussion Group was
founded immediately after the meeting, as a direct result of the
meeting to get input and recommendations.
2)The Division of MH/MR/SA has graciously included the Unlock the
Waiting Lists! Campaign Family Support Project to participate in
meetings regarding the Merged Waiver.
3)The Division of MH/MR/SA is sharing with UWL!C Family Support
Project the reports and recommendations that they are getting from
consultants assisting them with both the amended MRWP and the Mergeed
Waiver. Judy Feimster has requested our input to those
recommendations.
4) The Revenue Maximization/Governor's Budget Request has much to do
with the aforementioned efforts. If you can not participate in
Monday's 9:30 meeting in Atlanta at the Loudermilk Center be assured
that Unlock & the Family Support Talk Ga Lists will keep you informed
of whatever is pertinent.
5)Collaboration is in the air! A lot is coming our way, with short
timelines. But this is a chance for customers, providers and agencies
to come together and develop not only Family Support services but seed
a Family Support systems change that will impact the way all customers
of services are treated! I know that we can rise to the challenge.
Remember Martin Luther King's words "The measure of a man is not
where he stands in moments of comfort and convenience, but where he
stands in times of challenge and controversy."
Thanks for all you do.
Cindy L. Arceneaux, Family Support Coordinator
I really think that we need to reduce the number of discreet services
rather than add to them. As I mentionned in the meeting, we have an
example of an approved waiver which contains two services: (1) Planning
and (2) everthing else. Here are the definitions from the Kansas waiver:
(1) Independent Living Counseling (this is what we would call service
coordination): "This service is required for all HCBS consumers and is
provided by qualified providers as defined later in the document." It
includes: "Serving as the point of access for Medicaid Services, assessing
consumers' services needs; developing the annual plan of care, ensuring
that the consumers' plans of care are cost-effective and meet basic health
& safety needs, ensuring that consumers have full and unbiased access to a
variety of services and service providers to meet their specific needs
including a list of all available agencies which provide that service and
advocating for consumers by brokering and negotiating with individuals,
businesses and agencies for the best available services within limited
resources. This service is limited to 120 units per calendar year. (A
unit is $27.13 on average for this waiver which translates to a maximum of
$3,240 per person per year. Don't know how this cost is in comparison to
our service coordination costs but I do know that KS doesn' have the extra
layer of a service monitor.)
"Personal and Assistive Services means one or more persons assisting
another person with a disability with tasks which the disabled individual
would typically do for themselves in the absence of a disability. Tangible
equipment or hardware, such as but not limited to, technology assistance
devices, adaptive equipment or environmental modifications, may be
substituted for a caregiver when it is dentified as a cost-effective
alternative on the individual's plan of care. Purchase or rent of tangible
equipment or hardware undeer the definition of this service is limited to
those items not covered through regular state p[lan services and which
cannot be procured from other formal or informal resources (such as VR or
Education). This service will be used only as the funding source of last
resort. Tangible equipment or hardware requires prior authorization from
Medicaid. All Personal and Assistive services will be brokered by the
Service Coordinator with written authorization from the consumer.
Reimbursement for this service is limited to the individual's assessed
level of services need. (KS has a standardized assessment instrument which
assigns levels of care.) Personal Care Attendant Service provided within
the scope of this service must be reimbursed within the approved
reimbursement range established by the state.
At 08:08 PM 2/1/01 -0000, uwlfamsuppolicycouncil@... wrote:
>Dear Family Support Policy Council Members,
>
>Please know that is an opportunity to provide guidance and
>recommendations based on our life and experiences and expertise. But
>we must provide input quickly. Keep in mind that this is not a support
>group but is an opportunity to suggest how services should be
>delivered, who is eligible, etc.
>
>Let us start by reviewing the e-mail on the MRWP and provide feedback
>to the rest of the group with suggestions for expanding the menu.
>
>Please take time to make your thoughts, concerns, questions,
>suggestions known about who will be eligible, who will be a
>provider, where and how will families and adults with
>disabilities access services, will there /should there be a
>complint procedure, how will services be evaluated. The clock
>is ticking and your input is need. Hope to hear from you soon. And
>please suggest others who you think mat be interested in being added
>to the online group discussion. Thanks for all you do! Cindy
>
>
>
>
>To unsubscribe from this group, send an email to:
>familysupporttalkGa-unsubscribe@yahoogroups.com
>
>
>
>
For those Family Support Policy Council members who did not see the
following post on the MRWP I am resending it. Please review the list
of services under the MRWP (pasted below from the Medicaid web page)
and consider what else might be added. Susan Creek suggested that
under Home Modifications fencing could be helpful. Thanks to those of
you sharing info on others who might be helpful to these discussions.
Cindy
--- In familysupporttalkGa@y..., uwlfamsuppolicycouncil@y... wrote:
1.Request for suggestion on changes to MRWP
2.MRWP list of services from DCH website
Those who attended the Family Support Policy Council meeting Tuesday,
January 30, 2001 heard Judy Feimster of the DHR Division of MH/MR/SA
request the Family Support Policy Council's help as she must make an
application to HCFA (Health Care Financing Administration-federal
agency that oversees every states Medicaid agency) to amend the
current MRWP (Mental Retardation Waiver Program) to include Family
Support. This is being done in anticipation that the Merged Waiver
Application to HCFA will not be approved in time to begin serving
families by July 1. (HCFA can take a long time to respond to
application requests.) Judy felt that, while waiting for a response
to
that application which she hopes to have ready by April 30, amending
the already approved MRWP may take less time.
The challenge to the Family Support Policy Council is to review the
MRWP and suggest changes. Additions to the list of services provided
was a specific request from Judy Feimster. However some Policy
Council
members felt that any needed changes should be suggested, not just
adding to the menu of options. Please review the list of services of
the MRWP that I have pasted below froom the Department of Community
Health website. Then share with the rest of the list your suggestions
for expanding the options- What else would you like to be available?
Please post these suggestions with the subject title MRWP Amendment
Suggestions since we'll have other discussions going on at the same
time. The MRWP information from the Department of Community Health
website is pasted below:
Home and Community Based Services
Mental Retardation Waiver Program
Mental Retardation Waiver Program (MRWP)
The Mental Retardation Waiver Program (MRWP) is a home and
community-based waiver for persons who have been diagnosed with a
developmental disability. Services for the Mental Retardation Waiver
Program (MRWP) began April 1, 1989. The cost of providing MRWP
services for FY99, to 2,370 people was $67,723,620 or $28,575 per
recipient. Approximately 38 enrolled providers furnished:
home-based (home health) services,
day habilitation and supported employment,
respite care,
residential training and supervision,
service coordination,
personal support services,
personal emergency response system services,
specialized services.
vehicle adaptations
home modifications
supported employment
For future reference The Division of Community Health website is
http:www.communityhealth.state.ga.us, once on the site go to Medicaid
or Division of Medical Assistance and then select Home and Community
Based Services OR please know that the site is bookmarked on our
Family Support Policy Council Group Discussion page. Go to
http:groups.yahoo.com/groups/familysupporttalkGa/ On the left hand
side of the screen in yellow is a row of options to click on
beginning
with the word home. Double click on "bookmarks" and Community Health
will be there with others. (Consider checking out the calendar option
or files from time to time too!)
Thanks, Cindy/Unlock's Family Support Project Coordinator at the
Governor's Council on Developmental Disabilities
404 657 2129 toll free: 1 888 ASK GCDD (1 888 275 4233)
TDD:404 657 2133, Fax: 404 657 2132, uwlfamsuppolicycouncil@y...
or CArceneaux@a...
--- End forwarded message ---
Thanks for keeping me posted. I've been having some trouble getting
through egroups. This looks really good. On home modifications you might
want to add fencing to keep kids safe. You might want to think about it
as it is restrictive but this has been one of the major requests that I
have had. It is definitely family support if the child can get outside
and play without the family having to be concerned with wandering and
other safety issues.
Susan Ariel Creek
s.ariel.c@...
Family Support Coordinator
Parent Advocate
Dear Family Support Policy Council Members,
Please know that is an opportunity to provide guidance and
recommendations based on our life and experiences and expertise. But
we must provide input quickly. Keep in mind that this is not a support
group but is an opportunity to suggest how services should be
delivered, who is eligible, etc.
Let us start by reviewing the e-mail on the MRWP and provide feedback
to the rest of the group with suggestions for expanding the menu.
Please take time to make your thoughts, concerns, questions,
suggestions known about who will be eligible, who will be a
provider, where and how will families and adults with
disabilities access services, will there /should there be a
complint procedure, how will services be evaluated. The clock
is ticking and your input is need. Hope to hear from you soon. And
please suggest others who you think mat be interested in being added
to the online group discussion. Thanks for all you do! Cindy
Info in body of message for those who have difficulty
w/ attachments but is also an attachment where it
should appear as it does in hard copy. Cindy
Family Support = Crisis Prevention For Georgians with
Disabilities and Their Families
"…The research found that, on average,
for every two families served in Medicaid Waiver
funded Family Support,
states had one less person on their waiting lists for
residential services."
G. Smith, "Closing the Gap," NASDDDS*
Family Support means resources, services, and other
assistance provided to people with disabilities and
their families. Family Support prevents crises by
providing supports and services before an emergency
happens.
v Family Support may include assistance to the person
with the disabilities and to family members, not
just the person with a disability in isolation.*
v Family Support services are as different as each
person and family. If the services provided are
"Family Supportive" they will meet the unique needs of
the individual person with the disability and their
family.*
v Family Support recognizes the adult person with a
disability or the family of a child under 21 as the
decision makers about the supports and services they
need.*
*Examples of some Family Support services that may be
provided to people with disabilities and their
families includes, but is not limited to:
ü In home assistance with personal care, hygiene,
and/or help getting a person with a disability in
and out of bed and dressed each day.
ü Home modifications like adding wheelchair ramps,
widening doors.
ü Behavioral intervention and consultation to help
families manage challenging behaviors.
ü Assistive Technology like communication devices,
environmental controls or personal alert systems
ü Cash subsidies to help with the expense of adult
diapers, therapies, nutritional formula for G- Tube
feeding, prescriptions, dentist bills, and eye glasses
when not covered by Medicaid.
ü Respite Care
For more information on Family Support please
continue reading Þ
Georgia will demonstrate that people with disabilities
are valued citizens who are a priority when state
goals:
v Support families who have children with disabilities
to raise their children with disabilities at home;
v Prevent involuntary out of home placement for adults
and children with disabilities;
v Maintain family unity;
v Reunite families with children who have disabilities
who have been placed out of the home, whenever
possible;
v Welcome into the community adults with disabilities
and supports their ability to live as independently
as possible.
Effective Family Support services in Georgia should:
ü Reduce the number of people with disabilities on
waiting lists for residential services.
ü Increase the availability of funding and access to
Family Support.
ü Recognize the need to further develop, strengthen,
and implement a coordinated, comprehensive system of
Family Support services.
ü Promote leadership by people with disabilities and
their families in the planning, policy development,
implementation and evaluation of Family Support
services.
ü Promote and develop interagency coordination and
collaboration between agencies responsible for
providing services.
ü Base eligibility on Developmental Disability, as
well as Mental Retardation.
ü Define who is a family member and who is eligible to
provide Family Support.
Investing in Family Support is an investment in
Georgia's families.
Need more information? Contact the Unlock the Waiting
Lists! Campaign 1 877 924 8547
Cindy Arceneaux, Family Support Coordinator, 404 657
2129, familyrep@...
Unlock's toll free number is 1 877 924 8547 or 1
877-WAITLIST
*NASDDDS is the National Association of State
Directors of Developmental Disabilities Services
__________________________________________________
Get personalized email addresses from Yahoo! Mail - only $35
a year! http://personal.mail.yahoo.com/
We would like to remind you of this upcoming event.
Family Support Policy Council Meeting
Date: Thursday, February 15, 2001
Time: 12:00PM - 4:00PM EST (GMT-05:00)
Full Family Support Policy Council meeting at #2 Peachtree
Street, Atlanta, Georgia. Please bring a Brown Bag Lunch. The
Unlock Family Support Project would like to provide snacks and
drinks. Please do your best to notify us in advance of your
intent to attend so that we can get an accurate head count and
be sure that we have enough for all. Please advise in advance of
any assistance, materials in alternate formats, interpreter
services. Consumer representatives, including adults with
disabilities and parents and other family members of children
and adults who are disabled are encouraged to notify the *Family
Support Project of how we can assist them to participate. (For
instance- travel, mileage ,meals, other out of pocket expenses
may all be considered for reimbursement or provided at the
meeting.*BUT in order to assist we must receive the request and
respond to it in advance of the meeting. If we have not
discussed it with you and told you that we can cover the
requested cost don't count on being reimbursed!! Please ask for
the support you need. If you can not be physically present for a
meeting, do inquire about participating by conference call.
(Though 4 0r 5 hours is a long time to be on a call!) Contact:
Cindy Arceneaux, Family Support Project Coordinator, Unlock the
Waiting Lists! Campaign 404 657 2129,Toll free: 1888 275 4233,
TDD:404 657 2133, Fax:404 657 2132,
uwlfamsuppolicycouncil@...
Your use of Yahoo! Groups is subject to http://docs.yahoo.com/info/terms
The Division of MHMRSA has scheduled a meeting to discuss the
Governor's budget recommendations, specifically the revenue
maximization and rehabilitation option. This meeting is open to anyone
interested. The Division will be looking for feedback on how to
implement these recommendations. Consumers and advocates' involvement
is crucial.
Consumer and Advocates Meeting
Tuesday, February 6th at 9:30 AM to 11:30 AM
Loudermilk Center for the Regional Community
40 Courtland St., Atlanta
The Loudermilk Center is located next to the United Way parking
garage,across from the Woodruff Volunteer (United Way) Building. The
Loudermilk entrance is on Lynches Alley, the cobblestone alley
between the parking garage and the Woodruff building (between Auburn
Avenue and Edgewood Avenue).
For more specific directions, call the Loudermilk Center at
404-507-1690
1.Request for suggestion on changes to MRWP
2.MRWP list of services from DCH website
Those who attended the Family Support Policy Council meeting Tuesday,
January 30, 2001 heard Judy Feimster of the DHR Division of MH/MR/SA
request the Family Support Policy Council's help as she must make an
application to HCFA (Health Care Financing Administration-federal
agency that oversees every states Medicaid agency) to amend the
current MRWP (Mental Retardation Waiver Program) to include Family
Support. This is being done in anticipation that the Merged Waiver
Application to HCFA will not be approved in time to begin serving
families by July 1. (HCFA can take a long time to respond to
application requests.) Judy felt that, while waiting for a response
to
that application which she hopes to have ready by April 30, amending
the already approved MRWP may take less time.
The challenge to the Family Support Policy Council is to review the
MRWP and suggest changes. Additions to the list of services provided
was a specific request from Judy Feimster. However some Policy
Council
members felt that any needed changes should be suggested, not just
adding to the menu of options. Please review the list of services of
the MRWP that I have pasted below froom the Department of Community
Health website. Then share with the rest of the list your suggestions
for expanding the options- What else would you like to be available?
Please post these suggestions with the subject title MRWP Amendment
Suggestions since we'll have other discussions going on at the same
time. The MRWP information from the Department of Community Health
website is pasted below:
Home and Community Based Services
Mental Retardation Waiver Program
Mental Retardation Waiver Program (MRWP)
The Mental Retardation Waiver Program (MRWP) is a home and
community-based waiver for persons who have been diagnosed with a
developmental disability. Services for the Mental Retardation Waiver
Program (MRWP) began April 1, 1989. The cost of providing MRWP
services for FY99, to 2,370 people was $67,723,620 or $28,575 per
recipient. Approximately 38 enrolled providers furnished:
home-based (home health) services,
day habilitation and supported employment,
respite care,
residential training and supervision,
service coordination,
personal support services,
personal emergency response system services,
specialized services.
vehicle adaptations
home modifications
supported employment
For future reference The Division of Community Health website is
http:www.communityhealth.state.ga.us, once on the site go to Medicaid
or Division of Medical Assistance and then select Home and Community
Based Services OR please know that the site is bookmarked on our
Family Support Policy Council Group Discussion page. Go to
http:groups.yahoo.com/groups/familysupporttalkGa/ On the left hand
side of the screen in yellow is a row of options to click on
beginning
with the word home. Double click on "bookmarks" and Community Health
will be there with others. (Consider checking out the calendar option
or files from time to time too!)
Thanks, Cindy/Unlock's Family Support Project Coordinator at the
Governor's Council on Developmental Disabilities
404 657 2129 toll free: 1 888 ASK GCDD (1 888 275 4233)
TDD:404 657 2133, Fax: 404 657 2132, uwlfamsuppolicycouncil@...
or CArceneaux@...