Service Capacity and Continuum Workgroup
May 9, 2003
PAS Training Manual Model
Personal Attendant Manual "Enhancing Independence;" a personal attendant training manual was reviewed by our workgroup. (SIL Productions, Columbia, MO) It was a comprehensive and practical manual that we would like to endorse statewide for use at each of the 21 Independent Living Centers in Missouri. This was discussed briefly with Ron Vessel, and he expressed he thought it was a good idea to implement manual statewide.
Action: It was sent to State Independent Living Council as well for their endorsement. If they endorse it we will send it to each Independent Living Center.
Transportation
Identify successful models
Easter Seals did a Community Inclusion Drivers Project at minimal to no cost.
Action: Governor's Council on Disability is researching this project
Housing
Personal Independence Commission to adopt these principals for housing. Lifetime homes (Senator Wheeler SB580) Housing Trust Fund Missouri (Senator Good)
Action: Legislation is introduced. Jim Tuscher update
American Dream Project
This is a housing construction grant which Terry Sanders, Ozark Action has been working with for some time. Designed for lower income populations. Includes home ownership counseling training as part of the requirement. Two houses have been completed and there are plans for several more/Ozark Independent Living Center is meeting with his office to assist them with some of the accessibility issues, to implement universal design to include the disabled in there grant.
Action: Meeting scheduled May 14, 2003 10:00 a.m.
Results: Research shows accessible housing and transportation virtually nonexistent in rural Missouri. Rural Independent Living Center revealed seven county service area is the largest area square miles with lowest population and does not have enough tax base to support these services. Fifteen percent of population is disabled.
Results: Personal Assistant Services budget with positive economic impact $3.68/$8.50 - administrative fees/attendant wage. Roughly 70% of Medicaid and General Revenue funding statewide paid to attendant employee, resulting in positive economic impact to each county (ie. taxes and long-term stimulus for local busiensses.)
January 13, 2003
Background: At the November PIC meeting, the " Service Capacity and Continuum" workgroup was looking for a way to assess the level of services to persons with disabilities in Missouri. To this end, this workgroup wanted view current service provision as measured by the number of persons served. The following groups/ entities were targeted for information: MOCIL, County SB 40 boards, and various state agencies (DVR, Health and Senior Services, DMH, DFS and DMS). Since the Governor's Council on Disability has access to the aforementioned service providers, it was suggested they take on this task.
The primary areas of services examined are:
- Housing
- Transportation
- Attendant Services
- Miscellaneous/Other
Method: The request for information was sent out to the aforementioned groups in early December 2002 with the request that it be sent back by December 20, 2002. We used existing state resources to get this information.
Retrieving information for the SB 40 board organizations was done a little bit differently. GCD went with a secondary source, MACDDS (Missouri Association of County Developmental Disabilities Services) to get contact information. Of the 115 counties in Missouri, 31 counties do not have an SB 40 running services for persons with developmental disabilities. Of the remaining 84 counties, 39 are members of MACDDS. We emailed (three did not have email) all 39 MACDDS members to ask for data. Of the ones we emailed, about five were returned as "undeliverable." We have received six adequate responses from SB 40 groups.
MOCIL. The GCD wrote the request for information to the MOCIL president, Nancy Murphy. She then forwarded the letter to the 19 MOCIL members as well as the two non-member CILs. To date, we have received responses from seven centers for independent living.
Results of Survey
DMH/CPS will not have information available until January 31, 2003.
Division of Vocational Rehabilitation submitted their data in December 2002
- Transportation: For shopping and Medical trips: 3,271 users
- Housing: Not Available (do not provide this service)
- PAS: All 21 CILS have 8,380 part-time attendants whose hourly wage range from $7.50-$8.25 an hour
- Miscellaneous: Not Available
Division of Family Services sent a response on December 12, 2002. They indicated that they do not provide direct services, and referred me to DMS.
Division of Medical Services, the state Medicaid administrator, provided us with a lengthy report. This report focuses on services provided with Medicaid dollars.
MOCIL/ Centers for Independent Living (CILs)s:
| CIL |
Transportation |
Housing |
PAS information |
Miscellaneous Supports |
Access II - Gallatin MO. Covers eight counties in NW Missouri. Rural |
- Has two lift-equipped vans
- 199 riders used van (704 report)
|
|
77 Attendants. Pay range is $7.50 to $7.75 and hour |
- Transition Program
- Consumer Assistance fund
- Home Modification Program
- TAP/TAP-I
- Low Vision Loan Program
- Benefits Planning
|
Bootheel Area Independent Living Services - BIALS. Covers four counties in SE Missouri. Rural |
- Dunklin County Transit
- SMTS
- Stoddard County Transit
- BAILS van: 46 rides
|
Very Limited private housing:
Long List of Nursing Homes, Residential Care Facilities, Group Homes, assisted living, Housing Authority Apartments, and HUD funded Accessible apartments
|
Privately owned home health agencies, Health and Senior Services' providers, DMH. Total number of consumers in
|
Limited assistance with utility and rent.
|
Delta Center for Independent Living - Three Counties in Eastern Missouri. Suburban and Rural |
To date limited transportation provided. For period of July 1-Nov. 30, 2002 $1,592 expended for transportation. OATS provides services in Lincoln and Warren Counties, and Delta Center contracts with OATS to provide services. |
Housing requests are filled primarily by referral:
- Persons with MR/DD referred to Regional Center
- Some referrals to DMH
- Persons seeking low cost housing are referred to NECAC
|
Currently (as of Dec. 20, 2002) there are 158 attendants for 94 Delta Center PAS consumers Wages for Delta PAS attendants: $8-$8.25/hour Division of Health and Senior Services also contracts with home health care agencies to provide services to "shared consumers." |
Delta center assists program participants in purchasing adaptive devices, such as bath chairs and grab bars. $2,500 was expended for such purposes between July 1- Nov. 30, 2002 |
Ozark Independent Living (OIL) Seven Counties in Southern Missouri. Rural |
Options include: taxi, Medicaid Transportation, SMTS, and OATS.
OIL has two vans. They provide 30 to 50 rides each quarter, and this number is rising |
Not very many housing alternatives. Referred to as "non-existent."
Older homes turned into rental
Many residential care facilities
Few public housing complexes exist, and none are accessible (per OIL)
OIL is considering building an accessible home to sell
|
No number given on number of attendants or consumers.
Wage is $7.50/hour
|
Other services include:
- ASL classes
- Therapeutic horseback riding
- Assistive technology
|
Paraquad. St. Louis. 4 counties in St. Louis area. Urban and Suburban (some rural) |
PQ Van: 247 People. Care Cab: 252 users from PQ Call A Ride: # is not available |
All types of housing available, from community options to institutional: Independently, with family, supported living, group homes, assisted living, nursing homes, habilitation centers, shelters |
973 attendants for PQ PAS consumers. Wage is $8.25 Types of Providers: PAS, Home Health Care Providers, Nursing Homes, CNAs |
Many other additional supports: Partial list: transition services, employment, home modification funds, rental/ mortgage assistance, universal design summit. |
Southwest Center for Independent Living (SCIL). Springfield. Eight Counties in Southwest Missouri. Urban and rural |
Available services include: Fixed Route bus service in Spgfld, paratransit, OATS vans, Intrados (non-profit agency), SCIL van |
Numerous subsidized housing services, rental services, supported living, group homes, residential care, skilled nursing facilities, some accessible, but segregated apartment complexes |
164 attendants in SCIL program. Salary range: 7.50- 7.65/hour |
Many other services, among them: Start up expenses for transition Four Core Services
Assistive Technology loan program
Access surveys |
Warrensburg Independent Living Services. Six counties in West Central Missouri. Rural |
Fixed Route System in Warrensburg and Sedalia, Paratransit in both of these cities as well. Greyhound and AMTRAK Taxi in most of the larger towns in service area WILS now has two vans. Provides 46 users per month. Transportation program operates on $30,000 yearly budget and growing. |
Provided list of over 50 housing complexes for six-county service area. There is a range of housing from institutional to truly independent community options. |
Approximately 350 attendants are used by 114 consumers. Wage range: $7.50 to $8.25/hour |
Four Core Services (IL Skills training, advocacy, peer support, Information and referral) Other services: Access surveys, assitive tech. Loan closet, support groups, circuit breaker tax refund assistance, and others |
SB 40 Boards. We received 5 responses, but anticipate more
arriving in the near future. Again, this is a very small sampling of the
actual county-wide services provided, but does give an idea of the numbers of
persons served in transportation, housing and attendant services.
Agency/Group Name |
Transportation |
Housing |
Personal Attendant Services |
Miscellaneous services provided |
Developmental Services of Franklin County |
For the year, 64,897 trips. 120 riders |
- One Group Home (6 individuals live here
- 1 HUD apartment (16 live here)
- Several ISLs - (21 reside)
|
About 66 attendants serve Franklin County SB40 participants. Wage range is $7.50 - $9.50 |
- Support
- Early Intervention and First Steps
- Fund two sheltered workshops
- Supported employment
- Therapeutic horseback riding
|
Gasconade County Special Services |
Agency reimburses sheltered workshop for employees (24 employees 2x per day at 5 days/week) OATS is also available. |
- ISL - Agency provides funding for one person
|
Agency provides match money for one person to receive PA services. Agency has no PA staff, but contracts with local agency (name of local agency not provided) |
Supported employment program supports an average of 8 persons/year. |
Developmental Disabilities Assistance Board of Montgomery County |
Agency provided 30,000 trips to participants Provide transportation services to those in Callaway and Warren Counties OATS is also available |
Operate two group homes in Montgomery City. Total of nine reside in the two. |
Staff (not necessarily PA attendants): - Two drivers
- 10 direct care staff
Wage range: 6.50 to 11.38/hour |
Respite Funding for medical and Personal needs |
Ray County Board of Services for Developmentally Disabled |
36,400 trips provided by SB 40 transportation, mainly to employment |
Operate Seven ISLs (serves 14) Operates HUD 811 project (serves 12) 68 live independently or with family |
26 attendants are employed and wages: $15,600/year for weekend employees and $17,680 for non-weekend employees |
Sheltered workshop employs 90 individuals Supported employment program has three individuals employed in community Day program serving seven individuals |
St. Louis City |
|
|
|
"Only provide case management and voucher program" |
Taney County |
ISL, day program providers, sheltered workshops and SB 40 Board provides services to some degree. SB 40 contracts with local provider to provide daily fixed-route transportation for 35 persons (about 19,000 trips). Transportation is not wheelchair accessible. No charge for trips. Two local taxi providers. Neither is wheelchair accessible |
Taney County SB 40 will open residential services for up to six individuals before end of fiscal year (6/30/ 03) RCF (in Forsyth) 40 persons with mental illness ISL- 8 reside Independent/Reside with Families: 20 Waiting List: 14 |
N/A. Does not provide |
In-home residential support and other family supports on a limited basis. Autism technician through Judevine Center Community integrated training and Supported Employment follow along services through intergovernmental agreement w/ Regional Center Socialization Activities |
Rick Horrel of The Bureau of Special Health Care Needs (Department of Health and Senior Services) did not actually provide us information, but informed us that the original Home and Community-Based commission has a slew of data in its final report. This information is available for public consumption and can be found on the Governor's Council on Disability's website: http://www.dolir.mo.gov/gcd/Olmstead/OlmReport/Cover_Page.htm. The information is in the Final Olmstead Report published in December 2000.
Conclusion: Despite the paucity of information gathered by disability service providers, there is an overwhelming evidence that the supports for true integration are not there. The workgroup is continuing to receive responses and it is hoped that additional information will be useful to policy makers to make policy decisions to make Missouri a genuinely integrated state.
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