Governor's Council on Disability

Personal Independence Commission

Personal Care (Lead Agency: DESE)

Result Area: Common Application/Assessment Information & Common Release of Medical Information

Draft of a general information form to be used by all agencies is in progress. It will be designed for automation after pilot testing. The process begins when a consumer requests assistance and concludes with being connected with the appropriate (community or state) services. To minimize repetition of information, consumer information in the redesigned system will be collected as needed and utilized and shared by multiple agencies per consumer authorization:

General information necessary to understand the request for assistance and refer the consumer to the best provider;
Information needed to determine program eligibility: financial information, medical information, and functional/clinical/psychiatric assessment; and
Authorization for agencies and providers to share consumer/client information. Voc. Rehab, DHSS, DSS, and MH have agreed upon common general information data elements. All of these agencies will be using the same Authorization for Release of Medical Information.

Action (What needs to be done to accomplish the result - key actions)	Deliverables (How will we know if the action is complete)	Responsible Agency & Person (Only one name per action)	Due Date	Resources Existing and/or Needed	Measures or Indicators, if appropriate
Design a common general information form for all partner agencies to use and share (common application for services) - involve front-line staff in the development. Include consumer input	Common general information form piloted by multi-agencies	Jeanne Loyd, Voc. Rehab. DHSS, MRDD, and DSS	November 2003	Staff time to develop and implement	# of times a consumer is required to repeat the same information for multiple agencies
Consensus on a universal assessment tool and process	Universal assessment tool and process	Jeanne Loyd, Voc. Rehab. DHSS, MRDD, and DSS	2003-2004	Existing staff
Request rule change to allow DVR to accept DHSS and MRDD assessments	Rule Change for DHSS placed on State Board Meeting Agenda - July 2003	Jeanne Loyd, Voc. Rehab. DHSS & MRDD	2003-2004	Existing staff

Transition from Institutions (Lead Agency: MH)

Result: Process for Transitioning Individuals with disabilities who are institutionalized and who are eligible for community-based treatment.

Develop approaches to assist with funding the transition from institutions to community services and supports.

Action (What needs to be done to accomplish the result - key actions)	Deliverables (How will we know if the action is complete)	Responsible Agency & Person (Only one name per action)	Due Date	Resources Existing and/or Needed	Measures or Indicators, if appropriate
Submit an amendment to the CMS for MRDD Comprehensive waiver to add Transition Services	Amendment approved by CMS	DMH/DMRDD Kay Green	Submitted March 1, 2004	Existing funding
Further discussion with Voc. Rehab and DHSS to consider similar amendments	Amendments submitted to CMS	Kay Green will coordinate the discussion	Immediate Discussion	Additional funding may be required

Transition from Institutions (Lead Agency: MH)

Result Area: Recommend any potential means of expanding home and community-based services or community-directed programs.

Identify and alleviate barriers to community placement for "high risk" individuals.

Action (What needs to be done to accomplish the result - key actions)	Deliverables (How will we know if the action is complete)	Responsible Agency & Person (Only one name per action)	Due Date	Resources Existing and/or Needed	Measures or Indicators, if appropriate
Explore Housing Options US Housing and Urban Development (HUD) / Community Development MO Housing Development Commission (MHDC) US Department of Agriculture/Rural Development Karia Bastia, DMH Housing Coordinator	Invite contact person from each of the Housing Agencies to meet with subcommittee to provide information on options	Edwin Cooper DMH Housing Team Member	90 Days
Housing Conference in Iowa	Housing Professional Attends Conference	Karia Bastia, DMH Housing Coordinator	45 Days	DMS Real Choices Grant funding to defray any conference costs above $2500 allocated by Community Living Exchange and the Center for State Health policy at Rutgers University

Assuring Care Options Based on Needs, Choices, and Capacity (including diversion strategies as appropriate) (Lead Agency: DHSS)

Result Area: Amend DHSS Rule 19 CSR 30-88.010 (Nursing Home Resident's Rights)

DHSS is currently crafting a change to the above rule that would clarify that clients have the right to receive treatment in the least restrictive environment, as appropriate, and to be informed of their choices concerning community placement. Information regarding resident rights and facility rules are required to be posted in a conspicuous location in the facility and copies provided to anyone requesting them.

Action (What needs to be done to accomplish the result - key actions)	Deliverables (How will we know if the action is complete)>	Responsible Agency & Person (Only one name per action)	Due Date	Resources Existing and/or Needed	Measures or Indicators, if appropriate
Write the rule amendment and mail out the revision to Board of Health members	Amended rule with language concerning least restrictive environment	Nancie McAnaugh	11/6/03	Current Staff	NA

Consumer Options Based on Needs, Choices, and Capacity (including diversion strategies) (Lead Agency: DHSS)

Result Area: Work with MU-School of Nursing to Add Data Elements to the MDS Screening Form

Currently in Missouri the MDS only collects federal data elements. DHSS will work with MU to add state specific questions to the MDS screening form. For example, we do not know with any certainty why people choose to enter skilled nursing facilities. Is it because they could not find services in their local communities? Is it because they no longer had family members to help care for them? Were they informed of other options? Or, is it because it is the most appropriate placement for them at the time. By collecting data on why people enter nursing facilities it may be possible to identify gaps that may exist in our current service delivery system, and to develop programs to fill those gaps.

Action (What needs to be done to accomplish the result - key actions)	Deliverables (How will we know if the action is complete)	Responsible Agency & Person (Only one name per action)	Due Date	Resources Existing and/or Needed	Measures or Indicators, if appropriate
Meet with MU-School of Nursing concerning proposed changes to MDS	Modified MDS to include state-specific questions	Nancie McAnaugh	December 2003	Current Staff	NA

Consumer Options Based on Needs, Choices, and Capacity (including diversion strategies) (Lead Agency: DHSS)

Result Area: Transitional placement in habilitation centers

New admissions to state operated habilitation centers shall be considered time limited, unless the person is offered community services and chooses the habilitation center, the person has been admitted by the Court or has forensic status. Admission to the state operated habilitation center will be based on most critical need first. All new admissions to state operated habilitation centers shall be reviewed at thirty (30) days to determine if the person has a continued need for habilitation center services.

Action (What needs to be done to accomplish the result - key actions)	Deliverables (How will we know if the action is complete)	Responsible Agency & Person (Only one name per action)	Due Date	Resources Existing and/or Needed	Measures or Indicators, if appropriate
Implement policy that makes all placements in habilitation centers transitional placements.	Statewide Implementation of Policy	Anne Deaton, MRDD	2004	Existing Staff

Real Choices (Lead Agency: DSS)

Result Area: Streamline the system to assure easy and quick access to needed services and supports

Action (What needs to be done to accomplish the result - key actions)	Deliverables (How will we know if the action is complete)	Responsible Agency & Person (Only one name per action)	Due Date	Resources Existing and/or Needed	Measures or Indicators, if appropriate
Review the DHSS TBI project and Voc. Rehab Project Success collectively, agree on modifications and give final approval to the development of data standards for electronic data dictionary	Document identifying the data elements/standards for the electronic data dictionary	Sandra Levels, DMS DHSS MH DSS DOLIR DED OA-Office of Information Technology	October 1, 2003	To be discussed
Participate with partner agencies in initial planning of the development of Project Assessment Quotation for the development of data standards necessary for common electronic data dictionary	Project Assessment Quotation to secure development costs of developing a multi-agency data dictionary that links with national XML standards	Faye Zumwalt, DHSS and Jan Grecian, OA MH DSS DOLIR DED	October 31, 2003	MOU's for shared resources to fully develop the standards and a small pilot implementation project	Evaluation measures to be developed
Develop a plan to sustain ongoing training on Informed Choice	Plan for sustaining Informed Choice training	Sandra Levels, DMS Real Choices Grant	December 2003	Shared resources to be identified