vermont’s developmental services system and what you really need to know about its system of care...
TRANSCRIPT
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Vermont’s Developmental Services System
And what you really need to know about its System of Care Plan.
Presented by Karen Schwartz, VT Developmental Disabilities Council
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About the Presenter
• Executive Director of the VT Developmental Disabilities Council since 2004.
• Parent of a 22 year old young man with a developmental disability.
• Involved with the developmental service system since son was about 8
• Worked for the Birth to 3 early intervention program for 11 years as family resource specialist and service coordinator.
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What is the Vermont Developmental Disabilities Council?
• There is a Council in every state, D.C, and U.S. territories.
• Funded for the last 40 years through a federal grant to do “systems advocacy”
• Key role is to – Monitor what is going on for people and families – Support people with developmental disabilities and their families
to have a voice about services and supports that affect them
• We hope you will learn more about how developmental services work, and get involved in making changes you want to see.
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What this Webinar will cover
• In a nutshell, how Vermont’s developmental system works, who it covers, and what services it can provide
• What the System of Care Plan is and how it affects who is served and what services can be provided.
• How you can get involved if you think it needs to change.
What this Webinar will cover
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That’s a lot to cover in an hour!
We’ll get started, and you will find out ways to follow up and learn more.
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Let’s make this interactive
Even if we can’t see each other you can use the type-in feature to let me know– what you are interested in
– what you need explained .– any questions.
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Vermont’s “System of Care” for people with intellectual disabilities
• Intent is to be a “System” that provides comprehensive services in the community instead of care in an institution.
• Set up by Vermont’s 1996 Developmental Disabilities Act (which needs a webinar of its own)
• Put in place after the closing of Vermont’s institution, the Brandon Training School, closed.
• Funded by Medicaid. Currently federal government pays 58% of the cost.
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What is the System of Care Plan?
In a nutshell:• Required by the VT Developmental
Disabilities Act
• Written by the State of Vermont’s Division of Disabilities every 3 years, and updated each year
• Framework for how services are funded and provided.
What is the System of Care Plan?
In a nutshell:• Required by the VT Developmental
Disabilities Act
• Written by the State of Vermont’s Division of Disabilities every 3 years, and updated each year
• Framework for how services are funded and provided.
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Currently it serves• 2,539 people with home & community based
funding packages –332 children under 21• 1,068 people with Flexible Family Funding
– 975 children under 21.• 422 people through limited services like
Targeted Case Management (adults); Bridge Program (children). [2% of total funding.]
Data is from the VT Developmental Services Annual Report 2012, just released.
Who does the System of Care serve?
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Who is eligible?
There are 2 gates to go through for home and community based services
1. You must be eligible ~ meet Vermont’s definition, which is limited to intellectual disabilities
• IQ of 70 or below or autism diagnosis, who have difficulties with skills of daily living
2. And you must also meet a funding priority. This is the
hard part!
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So, what is a funding priority?
• It is a way to decide who will be funded for a home and community based package, and who will not.
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What sets the funding priorities?
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The System of Care Plan!
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What are the current priorities?Key current priorities are:
• Age 18, with imminent risk to personal health and safety ~ danger, injury or harm
• Age 18 and pose risk of endangering others• Age 19, to maintain a job on high school
graduation• Any age, to prevent or end long term stays in
psychiatric hospital or institution or nursing home.
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Limited Priorities = Limited Services
Summary of Priorities:
• The only non-emergency priority is for students age 19 leaving school who already have a job lined up.
• Since 2001, the only priority for children under 18 is being on the brink or being admitted to a psychiatric facility.
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What do you get if you are eligible, but don’t meet a priority?
• Flexible Family Funding ~ capped at $1,000, which is less than 15 years ago
• For kids, Bridge program case management, which is capped at 393.
• For adults, Targeted Case Management, which provides check-ins. NOTE ~ TCM is not available in all regions of the state.
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What services can you get if you are eligible?
Based on individual budgets & can include
•Up to 25 hours combined–Community supports –Job supports, including job coach to help at work
•Home supports ~ typically pays for shared living provider, although it can cover group home & help to live independently
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Services, continued
•Respite ~ typically managed by family or home provider•Service Coordination•Clinical Interventions ~ could be therapy groups, behavioral consults, therapeutic riding, etc.
NOTE: Prior to 2010 people could have a Goods line of up to $1,000 to use flexibly including for purchases. Some regions cover some of the items formerly covered by goods. Others do not.
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What describes any limits to the services you can get?
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THE SYSTEM OF CARE PLAN!!
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Who decides who is eligible,and what services you get?
• You need to apply at the regional developmental service agency, which is a non-profit designated by the State.
• They decide eligibility and whether you meet a priority.
• If you are eligible and don’t meet a priority you are supposed to be sent a decision you can appeal. Often people get Flexible Family Funding instead.
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Here are the regional agencies
Their official name is Designated Agencies
Map is from the Annual Report.
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Who decides, continued
• If you are eligible a funding package of services is put together that needs to be approved by
– the regional agency’s Equity Committee
– the state-wide Equity Committee, and finally by the state Division for Disabilities & Aging Services ~ D-DAS
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What sets up and describes the Equity Committees?
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THE SYSTEM OF CARE PLAN!!
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Do priorities affect what services you get?
• Initial funding packages will be affected by the priority that gets you in the door.– Example. If you get into the system through the
funding priority of having a job when you leave school you will probably be limited to job supports and service coordination.
• However, once you are in the system you can add services by applying through the Equity Committee process.
Do priorities affect what services you get?
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Summing Up, the System of Care Plan [SOCP]
1. Sets the funding priorities
2. Sets limits on services & supports
3. Sets up the Equity Committees that allocate funding
Let’s find out more about the SOCP
And how you can help change it.
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How the SOCP works
Vermont’s Developmental Disabilities Act spells out what the System of Care Plan is and does:
• It needs to include√ Priorities for continuing programs &
developing new ones√ Criteria for receiving services√ Process for evaluating success
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AND needs to be based on
Information from people with developmental disabilities and their families and providers
A comprehensive needs assessment Demographic information AND information on
services being used underserved and unserved individuals and
populations reasons for gaps in services varying community needs and resources.
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Who decides the priorities?
• The Commissioner of the Dept. of Disabilities, Aging & Independent Living [DAIL]
• Based on funds available
• Any proposed changes need to be presented to the State Standing Committee on Developmental Services at least 60 days before they go into affect
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So, what can you do?
• Make sure you know about any changes that could affect you or your family member
• Let the State agency [D-DAS] and Committee members know what changes you think should be made.
• You can also insist that D-DAS consider all of the information it is supposed to when it writes the Plan.– For example, the last Plan mentioned aging parents
but the current Plan leaves them out.
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How can you do that?
• Attend and present at the Standing Committee meetings, held the 3rd Thursday of the month
• Submit written comments to D-DAS about your concerns
** Also remember ~ You can get to know the people you elect – senators, legislators and the Governor – and keep them informed.
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When is this happening?
Right now!
• Any changes this year will be effective September 30, 2012
• Next Standing Committee meetings are June 21, July 19 and Sept. 20.
• The agency D-DAS will present proposals for change by July 19
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How can you learn more?
• Ask to be on the Standing Committee list, and to get more info on SOCP changes, by e-mailing [email protected]
• Send an e-mail to me at [email protected]
• Contact Vermont Family Network’s developmental disability specialist at 1-800-800-4005.
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Links to Resources •VT’s Developmental Disabilities Act~ 18 V.S.A. 8721www.leg.state.vt.us/statutes/fullchapter.cfm?Title=18&Chapter=204A
•VT’s System of Care Plan for FY2012-14
www.ddas.vermont.gov/ddas-programs/programs-dds/programs-dds-default-page#policies
•VT Developmental Services 2012 Annual Report ~ www.ddas.vermont.gov/ddas-publications/publications-dds/publications-dds-documents/dds-publications-annual-report/dds-annual-report-2012
VT Developmental Services website ~ www.ddas.vermont.gov/ddas-programs/programs-dds/programs-dds-default-page
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We are here to help
• VTDDC website ~ www.ddc.vermont.gov
• VT Family Network Developmental Disability web pages ~ www.vermontfamilynetwork.org/i-need-help-with/developmental-disabilities/
Feedback always appreciated!
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