Personal Independence Commission |
July 26, 2004Hearing Room 3 Capitol
Building
Kirsten Dunham called the meeting to order. PIC members in attendance were: Kyle Clower (for Lt. Governor Joe Maxwell, Kirsten Dunham, Kelly Flaugher (for Jeanne Loyd), Diana Poole, Anne Deaton, Sandra Levels, Roya Hough (for Nancie McAnaugh), Anne Jackson, Neva Thurston, Martha Hicks. Approval of Minutes from the March 15th and May 10th Meetings: Anne Deaton made a motion to approve the minutes from both meetings. Sandra Levels seconded the motion. Motion passed. Co-Chair Reports: Kirsten Dunham – Recognized the date as the fourteenth anniversary of the signing of the American’s with Disabilities Act and provided information from a recent Harris Pole conducted by the National Organization on Disability. Only 35% of people with disabilities reported being employed full or part time. Three times as many people with disabilities live in poverty. They are twice as likely to drop out of high school, have inadequate transportation and go without needed health care. People with disabilities are less likely to socialize and are generally less satisfied with their lives than those without disabilities. She encouraged members of the PIC to work for needed supports in the community. She urged people to be sure and vote in the November 2nd election. Kyle Clower – Shared part of a press release from the Governor’s Office in which Governor Bob Holden announces the opening of the Office of Community Independence in the Department of Health and Senior Services. This office will serve as a clearinghouse to let people with disabilities and senior citizens know what options are available to them. The office will also conduct and coordinate trainings on informed choice to care facilities, groups and organizations. He also said that the Governor had ordered the increase of the Medicaid eligibility level from 95% to 100% of the Federal Poverty Level. This will help over 15,000 Missourian’s with their health care services. Special Projects Team Update: Kelly Flaugher, Vocational Rehabilitation – Reported they are continuing to work with Senior Services to develop a universal application form. Anne Deaton, Department of Mental Health – There has been a steady decline in the populations at Habilitation Centers since 1999. At the same time there is no lack of demand for services in a structured 24/7 setting. Adolescents with significant behavior problems and the lack of providers and funding to serve them in the community are an issue. Missouri’s Five Year Plan is very progressive because we are not doing it in response to a lawsuit. Ms. Deaton said she had worked with Nancie MacAnaugh on a grant proposal to look at aging persons with disabilities and aging caregivers. Missouri did not get the grant but there will be a focus group meeting about these issues and concerns. DMH is also working with the Hispanic population to help them identify other sources besides DMH to turn to for assistance. DMH also sought an amendment to the Medicaid Waiver to allow family members and parents to provide care to children over age 18. Kay Green then talked about the Independence Plus Grant. This is to help states work on their infrastructure so they can apply for an Independence Plus Waiver, which is a self-direction waiver. There are work groups looking at a change in how the fiscal intermediary process works. Once these are designed pilot projects will be implemented. Real Choice Systems Change Grant Update: Cash and Counseling Update - Roya Hough, Division of Senior Services. Department of Health and Senior Services had applied for the Cash and Counseling Grant but did not receive it. Will look at other possible opportunities. Real Choice Grant Update – Sherl Taylor, Division of Medical Services. Objective 1 – Assure that the infrastructure and process reflects consumer choice and input. Real Choice Forums were held around the state. Transportation issues seem to be the leading area of concern. Other areas of concern were: challenges with benefits; personal care assistance; flexibility of the system and medical care. UMKC will do a presentation about the results at the next PIC meeting. Informed Choice Train the Trainer Trainings – A report on Informed Choice trainings throughout the state has been written. Follow up surveys show that few of those trained in Informed Choice have actually gone into nursing homes to provide this training. This report will be forwarded to the Office of Community Independence in the Department of Health and Senior Services. Research on Best Practices – A team of researchers has been working to identify service delivery models developed and managed by local communities, such as Meals on Wheels. These models are supported with resources other than those supported or funded by the state. These models will be made available to enable other communities around the state to review and/or duplicate where they deem appropriate. Objective 2 – Streamline the system to assure easy and quick access to needed services and supports. The Missouri Guide to Home and Community-Based Services has been transferred to the Office for Community Independence. Objective 3 – Conduct interagency coordination and collaboration to address Olmstead Stakeholders and Commission recommendations, Cash and Counseling. A focus group of consumers, advocates, providers and state staff has been meeting. They have had three meetings with the final meeting scheduled in August. They will present a full report of their findings to the PIC at the September meeting. Objective 4 – Assure Informed Choice at all stages of care so consumers can make good decisions. The Office of Community Independence will address this objective. Objective 5 – Enhance linkages at critical points to assure successful community transition to community living. Waiting list activities will begin again after the Cash and Counseling activities end. Objective 6 – To conduct research on small demonstration projects, to identify best practices and projects that should be replicated. Four out of the six community-based organizations and providers selected by the PIC for this project, (Paraquad, Willow Way, Crider and People First), are working to wrap up their projects and gather their final evaluation data. Again, there will be a report from UMKC at the September PIC meeting. Presentation on the Office of Community Independence: Andy Petty – The Office of Community Independence is housed within the Department of Health and Senior Services. Are in the process of establishing the office, establishing polities and procedures, filling positions. They are filling positions for Community Health Nurse V, two Health Program Representatives, a Social Service Worker and an Office Support position. There is a whole range of concerns, issues, information and services that need to be accessible for someone to move back into the community. The staff will deal with these. They hope to provide Informed Choice Training to individuals in nursing homes, to those just entering a nursing home or long term care facility and to hospital discharge planners to prevent people from being sent to a nursing home or long term care facility. They also plan to work with individuals in the community at risk of going into a nursing home or long term care facility to inform them of their options. The Office on Community Independence can be reached at 573-526-7869. Housing Presentation: Karia Basta, Department of Mental Health – The Housing Work Group is working on a companion guide for the Home and Community Based Services Guide. The booklet will list the different housing programs, eligibility criteria and contact information for the various agencies providing housing information. Also he Department of Mental and the Department of Health and Senior Services have submitted a grant proposal to CMS to provide long-term supports in affordable housing. The grant is for $750,000 and would last three years. It would include a database similar to socialserve.com that is now available in Kansas City, St. Louis, St. Charles and Springfield. This database helps people find the type of housing they are looking for. The grant would expand this database to be statewide. They will find out by early September is they got the grant or not. Also the Balance Estate Continuum of Care was submitted. This includes proposals for housing for those who are homeless and those who are disabled. Discussion followed concerning the different state agencies that receive housing funds and the possibility of these agencies working together. Public Comment: Tish Thomaas, Adult Day Care Provider – There needs to be an increase in Medicaid finds for Adult Day Health Care. There also needs to be an increase in funding for respite care. More Adult Day Care Centers are needed. There will be a Caregiver Recognition Day September 22nd with a reception in the Lt. Governor’s Office. This is part of Adult Day Services Week. Another concern is that the beds at Bellefontaine are being filled as soon as they are emptied. People are being moved out to the community but others are taking their place in the hab centers. This is because direct support workers need better pay. There need to be day programs geared toward young people rather than mixing them in with elderly adults in Adult Day Care Programs. Wayne Lee, advocate – Has learned three things from the PIC since attending these meetings. These are: coordinated cooperation, individualization and education. Dolores Hampton, Missouri Planning Council for DD – Missouri Planning Council supports Anne Deaton and the Five Year Plan for the Habilitation Centers. She also expressed concerns about Informed Choice Training not happening in the nursing homes and encouraged the PIC to ask for reports on the trainings at each PIC meeting. She also complemented the Cash and Counseling group and the work they are doing. The next PIC meeting is September 13th. The meeting adjourned. |
