Personal Independence Commission |
March 15, 2004Hearing Room 3, State Capitol Building Kirsten Dunham called the meeting to order. Roll call was taken. PIC members present were: Lt. Governor Joe Maxwell, Kirsten Dunham, Jeannie Loyd, Richard Horrell, Anne Deaton, Sandra Levels, Nancie McAnaugh, Senator Bill Foster, Senator Patrick Dougherty, Anne Jackson, Robin Reed, Roger Garlich, John Solomon, Martha Hicks and Bobette Figler. Approval of Minutes: The meeting minutes from the January 12, 2004 Personal Independence Commission meeting were approved. Co-Chair Reports: Lt. Governor Maxwell – October is the end of the grant. Feels things are on track but need to keep then on track. The departments need to think about asking for some waivers. Ms. Dunham – The four people who represented the PIC at the CMS Conference in Baltimore will submit a written report before the next PIC meeting in May. The conference was a positive experience. Also said there are several pieces of legislation that could affect the work we are doing. Need to keep an eye on the budget as it goes through. There are proposed changes to Medicaid that could cause some people to loose their Medicaid coverage. Also need to watch HJR 49 that would put a limit in future years on the amount the State Legislature could appropriate. Also need to watch HB 1566 which would affect services provided under Medicaid. Special Projects Team Update: Dr. Jeanne Loyd, DESE – Are looking at a universal application form so consumers only need to fill out one application form. One problem is that the various state agencies use different computer systems to store data and it is hard to get the different systems to communicate with each other. Jerry Wethington presented a report on the Data Dictionary Project. The State of Missouri is working on a Data Dictionary Project. This program would standardize data collection between different state agencies and possible between the different levels of government. Are using a Process Assessment Quotation (PAQ) to look at how this could be done and the cost. Are hoping to have the Data Dictionary designed and defined by the end of this fiscal year. There are seven state departments/agencies currently participating in this effort: the Departments of Social Services, Mental Health, Health and Senior Services, Elementary and Secondary Education, Vocational Rehabilitation, Labor and Industrial Relations and Employment Security. Hopefully these departments/agencies will be willing to share the cost of implementing this project. The Lt. Governor requested his office be informed of the cost and which agencies are participating. Anne Deaton, Department of Mental Health – Transition from Institutions lead agency. Are treating all admissions to hab centers as temporary admissions. Are involving the parents and family members from the beginning. Are forming partnerships between the hab centers, the regional centers and the providers in the community to aid in successful transitions to the community. Are having provider fairs and Informed Choice Trainings are continuing. This is all part of the Five Year Plan for the Habilitation Centers. More Informed Choice trainings are planned for the Habilitation Centers, including Nevada, Bellefontaine, St. Louis DD Treatment Center, Higginsville and Southeast MO Habilitation Center. They plan to conduct Informed Choice trainings each year. Some case managers from the Regional Centers are also doing transitional case management at the Hab centers one or two days a week. Kay Green talked about the Comprehensive MR/DD Waiver. They are adding a transition service to one of their waivers. This service would pay for start up costs for persons who are moving from an institution (ICF/MRS) into the community. They are waiting for this to be approved by DMH. The Lt. Governor requested to be notified when this was or was not approved. He also requested a detailed explanation of the funding limitations. Nancie McAnaugh, Department of Health and Senior Services – DHSS has sent a Letter of Intent to the Robert Wood Johnson Foundation to apply for a Cash and Counseling Grant. The Cash and Counseling Group will target four populations:
Would like to have demonstration projects in the Joplin area, Central Missouri area and the St. Louis area. The expectation from RWJ and CMS is that over a five-year period we would expect to achieve enrollment of 10 to 15% of the targeted population. Will not know until September of this year if the grant will be awarded to Missouri. Will email a copy of the grant application out to the PIC members. Also, DHSS is going to create an Office of Community Placement within the Division of Senior Services. This office will work on transitioning persons out of nursing homes, diverting people from nursing home placement and developing resources for persons to remain in the community. This will be a high profile office and will eventually be responsible for continuing the Informed Choice Trainings. DHSS has filed a rule to amend the Nursing Home Rights, Resident Rights part of their rules to add language about least restrictive environment. Are also looking at modifying the MDS to include state specific questions. Sandra Levels, Department of Social Services – Cash and Counseling is also a part of the Real Choice Grant so DSS Medical Services is planning to conduct focus groups around the state to get an idea of people’s perceptions of how Cash and Counseling would look like in Missouri.
Real Choice System Change Grant Up Date: Sherl Taylor, DSS, Division of Medical Services – Demonstrations to Main Independence Pilots. Comtrea has submitted letter saying they will not participate. Re-evaluation process has begun for other demonstration projects. Should have a report at the next PIC meeting. A second Training for Choices training will be held in St. Joseph in April. These trainings are geared toward the judicial system. Alternative format copies of the Missouri Guide to Home and Community Based Services are being distributed to various libraries across the state. Informed Choice trainings to train the trainers are being held around the state. Community based organizations are being targeted for these trainings. DMS would like to publish the list of those agencies/organizations invited to participate on the Governor’s Council on Disability web site. Best Practices projects. There is a team traveling around the state looking at programs to determine which ones meet best practices standards. The state has been divided into seven regions and each region will have a booklet of programs from their area. Community forums. As part of the grant they are required to get input from individuals with disabilities and individuals with long term care needs. Community forums will be held around the state and will focus on issues such as; self-determination and choice, relationships, use of community, employment, housing and health care. Will also be surveying providers to determine their perceptions of services delivered in the community. Cash and Counseling; Invited people to sign up to participate in focus group. Expect 25 to 50 people to participate. Cash and Counseling provides a cash allowance to a recipient of Medicaid Personal Care Services or Home and Community Based Services. The individual uses this money to become more independent in the community. Update on Habilitation Center PlanAnne Deaton, Division of MR/DD – Plan is a living plan and is open to change. Looks at each individual’s needs. The plan tries to meet the intent of Olmstead while also considering the needs of the states most vulnerable citizens. The plan is a two-part plan. The first part covers the first two and a half years and short-term objectives while the second part covers long-term objectives. The short-term plan looks at community placement options, looks at the buildings on the four hab center campuses and the feasibility of ,maintaining these buildings. The short-term plan also looks at monitoring of those individuals moved from the hab centers into the community. Parents and guardians are involved in the transition process. The long-range plan is looking at making sure there are adequate hab center facilities available to serve those who need them. Also looking at the needs of adult children of aging parents who have not presented themselves at the Regional Centers or hab centers in the past. Also concerns about workers who will loose their jobs if hab centers close units and concerns about clients receiving adequate medical and dentil care in the community. Work Group Updates: The Community Education/Outreach Work Group and the Housing Work Group will meet April 12th. The Informed Choice Work Group will not need to meet. Public Comment: There was no public comment. The next meeting of the Personal Independence Commission is May 10th at the Governor Office Building. Meeting adjourned. |
