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Personal Independence Commission

June 16, 2003

Governor Office Building, Rom 450
MINUTES

Kirsten Dunham called the meeting to order. She welcomed Senator Bill Foster as the newest member of the Personal Independence Commission. Members present: Rick Horrell, Linda Allen, Sandra Levels (for Greg Vadner), Kirsten Dunham, Lt. Governor Joe Maxwell, Anna Jackson, Senator Bill Foster, Wendy Hayes, Mary O'Brien, Anne Deaton, Ron Vessell.

Status Report Discussion of PIC Accomplishments - Rob Honan, Governor's Council on Disability:

Of the eleven priorities 2, 4, 5, 6, 7, 8, 10 and 11 are pretty much completed by the four state agencies. 2, 4, 8 and 11 are complete by all of the agencies. 2,4.5.6.7, 8, and 11 have been completed to some extent. 

  • Training on Olmstead and Informed Choice - All of the agencies are doing this. We now need to get specific information on the numbers of people being trained and where they are being trained. Mr. Honan will try to get this information before the next PIC meeting.
  • Appeals procedure - All of the agencies do have an appeals procedure. The problem is the appeals procedures are not very consumer friendly.  Suggestions are to put it on the web and put it in a variety of languages besides English.
  • Waiting list information - This fluctuates monthly as people become aware of services. Need to come up with a more consistent waiting list figure and assign numbers to various programs that have waiting lists.
  • Lead agency issue - If a consumer receives services from more than one agency there needs to be a lead agency.
  • Universal application form - This is done in some respects. Both Division of Vocational Rehabilitation and Health and Senior Services use the 18-point assessment. MR/DD uses a slightly different form.

There needs to be more collaboration between the agencies.

Update on Real Choice Systems Change Grant - Sandra Levels, Division of Medical Services:

  • Resource Guide - Has been distributed according to the plan outlined at the May PIC meeting. The publication date was placed on the back of the brochure.  The disk with the Resource Guide was sent to the Governor's Council on Disability and has been added to the PIC web site. Division of Medical Services has been receiving requests for the brochure and is keeping a log of these requests. Would like a plan from the PIC before distributing any additional brochures.
  • Pilot programs - A survey has been developed by University of Missouri in Kansas City. The surveys are being printed and will be mailed out to consumers.

The Lt. Governor requested an updated financial report on the grant be sent to the co-chairs for distribution to the Commission. Also requested more detail on the demonstration projects.

Marketing Missouri's Guide to Home and Community Based Services Brochure:

There will be press releases to let people know that the brochure is available. The Commissioners will also be asked to help promote awareness of the brochure and the options available to people by speaking to various groups and organizations. The Lt. Governor's office will conduct a training for Commissioners relating to distribution of the brochures. Organizations will be encouraged to use the Internet to access the brochure. The training will follow the July 14th PIC meeting. Kyle Clower from the Lt. Governor's Office handed out a list of organizations with the dates for their upcoming meetings. Commission members were asked to select those they would like to present to.

It was suggested that the agencies and organizations that have received the brochure be surveyed to see if they have any suggested changes to the brochure before the next printing is done. The Lt. Governor requested the Governor's Council on Disability do this survey.  The request was also made to translate the brochure into Spanish. All departments will also have a link to the brochure off their web sites.

Suggestions were made for other groups to do the presentation about the brochure to.  These included; Missouri Hospital Association, Special Education Association, parents organizations, Parent Teachers Association, Statewide Council for Independent Living, MO Centers for Independent Living, various caucuses of the General Assembly, the Epilepsy Foundation, Head Injury Association, AARP.

Co-Chair Reports:

Ms. Dunham reported on the Medicaid Reform Proposals. The National Governor's Association Task Force has been working on a response to President Bush's proposal to do a Medicaid block grant. Governor Holden is serving on this Task Force and is in opposition to the caps on federal funding. Several of the other governor's serving on the Task Force were also in opposition to caped federal funding too. The Task Force issued a statement saying there was such concern and opposition to caps that they could not come to an agreement. These caps on federal funding would have hurt many Home and Community Based Services and optional Medicaid programs and would have endangered Missouri's efforts at Olmstead implementation.

Lt. Governor Maxwell recapped the Governor's request for a status report from the PIC, the meeting of the department leaders and the Governor, that the PIC is the forum before which all personal independence issues will be brought, the Governor trusts the process established by the PIC, that the PIC has brought together a plan focusing on eleven key issues, and that the PIC is charged with being the advisory commission for the Real Choice Systems Change Grant. In the report submitted to the Governor in April the Lt. Governor indicated that the Commission had done about as much as they could under the current model they were operating under. The eleven key issues had been chosen, the grant was on track and a budget had been set. More resources were needed and an action plan needed to be set and the departments needed to work together. There needs to be a lead agency to deliver the priorities established by the PIC and that are outlined as outcomes of the grant. The PIC would become the sponsor of the team of government leaders and employees and team members. The PIC would monitor their success in developing the plan and how they are going to accomplish the eleven tasks. It would be the job of the PIC to see that the agencies are fulfilling what they said they would do. The goal is to:

  1. Establish a lead agency to deliver an action plan. 
  2. Pick a couple of items to begin to move on.  One of these could be the universal application form.

PIC co-chairs, Lt. Governor Maxwell and Kirsten Dunham asked specific state agency representatives to develop recommendations and actions to address the two above goals. The team of people asked to work on this includes:

Steve Roling, Department of Social Services Director
Dick Dunn, Department of Health and Senior Services Director
Nancy McAbaugh, Department of Health and Senior Services
Ron Vessell, Department of Elementary and Secondary Education, Director Vocational Rehabilitation
Linda Roebuck, Department of Mental Health, Deputy Director

The co-chairs also outlined the scope of the work (charter) for the project along with specific timelines for reporting progress. These guidelines were presented to the entire PIC Commission for their comment and approval. Lois Heldenbrand facilitated the discussion. The scope of work is as follows:

Develop a plan of action that includes list of that can be phased in. Begin with developing a common application to accommodate various entry points and recommending a lead agency (including roles and responsibilities).  Lead agency will be responsible for pulling together the other agencies to accomplish the objectives of the Real Choice Grant and the eleven PIC objectives. Plan will include pilot sites and timelines for testing any proposed system improvements plus an action plan.

Timeline:

Team charter (scope of work) June 16th
Progress report presented to the PIC on July 14th
Report of the proposed actions and completed actions to the sponsors on August 1st
Proposed recommendations to the PIC on September 8th

Anne Jackson made a motion to adopt the charter. Wendy Hayes seconded the motion. Motion passed.

Ms. Dunham stated that the July 14th meeting would be a full commission meeting with the speaker's bureau training. Also will be looking at making the work groups work more effectively. Work group chairs have turned in a list of barriers and needed resources. Need to tie the work groups in with the action plan. Work group categories are too broad. Need to focus on specific goals.

Public Comment:

Wayne Lee - Told the group that transportation is a big issue for people with disabilities.

Allie Skanes, Independent Living Resource Center - Also said transportation is a major problem for the consumers she sees.

The meeting adjourned.