Personal Independence Commission

October 17, 2005

Hearing Room 3, State Capitol Building
MINUTES

Kirsten Dunham called the meeting to order.  PIC members present were; Kirsten Dunham, Eric Feltner (for Lt. Governor Kinder), Kelly Flaugher (for Jeanne Loyd), Robyn Rust (for Brenda Campbell), Kay Green (for Kent Stadler), Sandra Levels, Anne Jackson and Martha Hicks.  A quorum was not established so the PIC began meeting as a sub-committee.

Co-Chair Reports:

Ms. Dunham - Will be contacting PIC members who have not responded as to if they would like to be re-appointed or no longer wish to serve on the PIC. 

Also, October 17th and 18th are national call-in days to Congress to urge them to pass a budget bill that does not cut Medicaid or other services and programs that help people with disabilities.  There is also hope that the money follows the person language may be included in the budget language of the Budget Reconciliation Bill.  Senator Grassley is working on this as well as allowing states with families of children with disabilities the opportunity to buy into the Medicaid system. 

The Real Choice Systems Change Grant has ended so there is no longer funding for the PIC meetings.  The Executive Order says that PIC members will be reimbursed for travel expenses for attending the meetings.  The Executive Order also states that the cost of the PIC meetings will be split between the four departments.  After some discussion the decision was made that the PIC will go to quarterly meetings.  This way each of the four departments will only have to cover the cost on one meeting per year.  Other funding sources will also be sought.

Mr. Feltner – The Medicaid Reform Commission has ended their public hearings and is working on their proposal to be submitted to the Legislature and the Governor in January. 

Outcomes of Real Choice Systems Change Grant:

Sherl Taylor – Reported on several projects:

• DMS has reprinted 40,000 copies of the Missouri Guide to Home and Community-Based Services.  This includes alternative format i.e.: large print, Braille, Spanish, audio and CD’s.  Bundles of these will be distributed to libraries throughout the state. 
• 25,000 copies of the Missouri’s Guide to Housing Assistance Programs were also printed, with the same alternative formats available.  These also will be sent to libraries. 
• Sixteen staff and consumers attended a Home and Community-Based Waiver Training in Kansas City to help them understand the quality activities that will be needed for each state under the 1915 C Waiver. 
• DMH, Division of MR/DD has a three-year contract to present a training package called College of Direct Support.  This will help expand the number of direct support professionals in Missouri and also make training more available to those already in that field. 
• Sponsored delegates from People First to attend the Alliance for Full Participation National Summit. 
• People First also hosted a statewide training for adults with developmental disabilities to build capacity for members to participate in local and state government systems change. 
• DMH, Division of Alcohol and Drug Abuse worked on first phase of a data warehouse that is meant to ensure quality care and provide clinically meaningful information. 
• DMH, ADA also worked on conducting a financial analysis to examine multiple funding streams for child-serving agencies.  This is to create a comprehensive child mental health system, and to track the flow of dollars to ensure an effective, efficient and comprehensive seamless system. 
• DMH, ADA also expanded their school based drug program in three schools to prevent alcohol and drug use and early intervention to identify problem behaviors in students in grades eight through twelve.

Informed Choice:

Two Informed Choice training were held, one on September 21st in Hannibal and one on September 23rd in Springfield.  Seventeen people attended the training in Hannibal and nine attended the Springfield training.  These were train-the-trainer type trainings so hopefully those attending will be able to provide Informed Choice to individuals in nursing homes and also train others in providing Informed Choice.  Would like to schedule training in the West Plains area at some point in the future.  There was discussion about contacting those who have been trained to see if they could hold additional trainings in their area. 

There was discussion concerning what department will continue the work of the Office of Community Independence.  The Division of Senior and Disability Services in the Department of Health and Senior Services has taken on that responsibility.

Could also offer Informed Choice Training sessions at conferences for social workers, medical professionals, etc.

Proposals from Missouri State Government Review Commission:

The Government Review Commission has finished their work.  Their proposals will go to the Governor for his review.  There were several proposals effecting people with disabilities and the elderly.

• One proposal was to essentially eliminate funding for Centers for Independent Living and transfer their services to in-home providers.  Lt. Governor Kinder offered an amendment to that proposal.  The amendment would not eliminate funding for the CIL’s, but would direct DHSS to examine CIL’s, their funding and the programs they offer. 
• Direct the Executive Branch through DHSS to implement a single point of entry process for senior services and pre-admission determination screenings with emphasis on serving the individual in the least restrictive environment.
• Outsource or privatize case management services with approval from CMS with the idea that case management should be at the local rather than the state level. 
• Transfer the First Steps Program from DESE to DHSS
• There was some talk about moving Vocational Rehabilitation to DHSS but decided to leave it in DESE.

Report to the Governor:

Ms. Dunham reminded the PIC that the Annual Report is due the end of October.  She said the report would include information about the background of the PIC and what the mission of the PIC is.  It will also highlight some of the challenges faced this year with the closing of the Office of Community Independence and the effort to keep the Informed Choice Training going and to continue transition planning.  The report will also include some of the challenges that lie ahead.  Ms. Dunham asked for any other suggestions from the other PIC members.  Suggestions included adding information about the Missouri Guide to Home and Community Based Services, the Guide to Housing Assistance Programs, Cash and Counseling and Bellefontaine.

Public Comment:

Eydie Young, ILC of Poplar Bluff – Was concerned because the Medicaid Reform Commission hearings scheduled in Southeast Missouri were canceled, so many advocates and people with disabilities did not get to voice their opinion on what is going on.  Ms. Young had concerns about the Medicaid Reform Commission hearings and the way some people with disabilities were treated.  She feels the Commission listened.  She also expressed concerns about rules and regulations being handed down to the state departments without the personnel or money to do the job.  She also had concerns about the Government Review Commission and the time limits that were given to individuals to testify.

Wayne Lee – Had comments concerning the Medicaid Reform Commission hearings.  Said “expert witnesses” were given fifteen minutes or more to testify but people with disabilities were limited to only five minutes testimony.  Also had concerns because people with disabilities were not involved in the process.

Brenda Mitchell, West Plains – One of the highest costs for people who have lost their Medicaid coverage is medicine.  Pharmaceutical companies have programs to provide prescription drugs free of charge to those who need them but the application process is lengthy.  She has software that would eliminate this whole process and she is contracting with doctors in her area to provide this service to their patients.  The doctors pay $100 a month for this and it costs the patient nothing.  This could be available statewide.

Other Business:

Need to find out which PIC members want to continue to serve on the Commission before January.

Next PIC meeting will be January 9, 2006.  The meetings will be held quarterly beginning in January.

The meeting adjourned