Sign Nebraska Electrical Services Contract Myself

Document type sign electrical services contract nebraska myself

see you seen it but you don't really see me welcome so the fourth workshop in a full life ahead series this is being presented by West families organizing for change in partnership with the building futures project and the family connection center of the Nebraska group so I'm glad you are able to join us today this actually is an unusual circumstance today is actually nicer 14th and we've had some Facebook issues so this is being recorded if you do have questions so throughout the presentation don't hesitate to type them in and we'll be able to respond to those questions after after the fact today's topic is the score system what's next and I should say before I go there that the full life ahead series is a series for parents guidance and support professionals of individuals with disabilities the series has focused on providing information that we made to each the parent who lives in the community for global disabilities and I've had through workshops prior to today and that's where the floral workshop in the in the in the series so today's topic is leaving the school system what's next and I think it's such an important issue that needs to be talked about the transition from being in the school system to graduating whether it has a high school diploma or certificate of attendance is extremely overall the strands and your families and particularly I think the families who have children with disabilities one of the things we like to talk about here at Nebraska is the good things in life and how all people with disabilities should be braved social roles the things that we aspire to to work and have friends to opportunities for continued learning and being in places where people can see the talents and gifts their loved ones have the challenges of course to make sure that people have the supports they need to make these things happen and to have access to good things in life and the transition from the school system they're not service system where deserves a lot of attention I often feel it's something that we don't like to talk about because it's really such a big overwhelming topic but I think it's important families have information as to what's out there today we're very fortunate to have two people who will try and demystify this transition process and explain what services are available and I'd like to work local Tracy Daly Museum taken eligible at equator for the southeast department major Department of Developmental Services and you later will behavior in Wilson house the self-directed services regional major the southeast office of DDS so where will other information presented but hopefully after this she'll leave with a clear idea of makes tips but at least the a name that you could speak to if you have additional questions and concerns so with that introduction I'd like to know welcome Tracy Thank You Russ so as was mentioned my name's Tracey dag new I am the regional eligibility coordinator for the Department of Developmental Services the Southeast Regional Office and I'm going to talk about an overview of the eligibility criteria for DDS as well as the process to apply and hopefully be found eligible I'd like to start by just briefly talking about the sort of organizational structure of the Department of Developmental Services DDS is central office is located in Boston but the state itself is broken up into four different regions so I represent the Southeast region of DDS which is essentially down through cape and the islands and then into every town in between for the most part my office the regional office is located in little belly and then taken eligibility is so any application that we do receive goes to the middle bar or office and that is where we process it just so folks know there are seven local area DDS offices within the Southeast region these are located in Brockton there's one in Hyannis that covers cape and the islands Fall River new bedford flemeth tony Attleboro which is in turn south coast oil area office is the seventh and final local DDS office which is located in Braintree so what is DDS support and serve we support folks that of all ages birth through end of life so truly anyone at any age may apply to DDS for eligibility and potentially for service delivery we support children and adults so therefore our folks can apply under either child eligibility or adult eligibility the southeastern region receives approximately eight to nine hundred applications each year and this has increased substantially since 2014 when we began supporting individuals with autism spectrum disorder which I'll talk about a little bit later and the last bullet on this slide refers to about the majority of applications that we do receive for folks that are intellectually disabled or I have a diagnosed developmental disability so again we'll talk about what that means and what our specific criteria is so intellectual disability is a term I'll use throughout my portion of the presentation it's the acronym if you will is ID for intellectual disabilities so I may also refer to it as ID but this is actually just the definition of what what we classify as intellectual disability it's a disability that's characterized by significant limitations in both intellectual functioning and adaptive behavior which originates before the age of 18 the important piece of best weather is actually two the first is that that key word both it needs to be for somebody to be considered intellectually disabled being to need a specific criteria both with their their intellectual functioning and also an adaptive behavior piece again this is something I'll get into a little bit more but it's worth mentioning at the start the other piece is intellectual disability DDS does require documentation that this disability originated prior to the age of 18 the next slide talks about developmental disability so the Department defines developmental disability as persons 5 years of age or older who have a severe chronic disability that is attribute attributable to a mental physical impairment that could result from intellectual disability autism spectrum disorder sniffing again esand in the prader-willi syndrome but last - there are some up there genetic disorders developmental disability is manifested before the individual attains 22 years stage it's likely to continue indefinitely into visits and substantial functional limitations which is another term we use often throughout the sad presentation and I'll talk about in a minute ago to detail so for this side I think the important piece and folks have probably already noticed that for somebody applying under developmental disability we are seeking to see that that developmental disability manifested prior to the age of 22 so for folks applying under intellectual disability as in the previous slide the age is 18 and for folks applying under developmental disability would like to see some documentation of that prior to the age of 22 so I mentioned substantial functional limitations in the previous slide that is really it's really a way of saying somebody's adaptive functioning so there's a definition on this side that and then I'll talk a little bit more about it but in order for someone to be found eligible applicants that are 5 years of age or older need to dunk demonstrate substantial functional limitations in three or more of the following areas of major life activity so those seven areas are listed on this slide they are self-care receptive and expressive language learning mobility self collection capacity for independent living and economic self-sufficiency substantial functional limitations and adaptive functioning overall are things that we will assess during the other two we process at the time of intake essentially we have an adaptive assessment tool that we use during an intake meeting that will give us a good feel for how somebody is at a function what their limitations may be so now I'll talk about eligibility criteria and I will talk for children what the criteria is for adults and then I'll talk specifically about intellectual disability and autism but to discuss child eligibility children are considered birth all the way through 22 in reality it's through 21 because adult services begins at age 22 for DDS so anybody may apply under child eligibility from birth really through age 21 any applicant to DDS regardless of child or adult must submit along with the application some proof that they are domiciled in Massachusetts this is on page 1 of the application really it's something like a utility bill or some proof of residency in Massachusetts that has an address that matches and that which is listed on the application the reason we do this and domicile is really one of the first things we do look at is to ensure that folks that are truly residing in Massachusetts the folks that are if found eligible receiving services so child eligibility criteria a child applying to DDS should have an intellectual diagnosis of an intellectual disability or a closely related developmental condition such as autism or a substantial development to delay if applying under the age of 5 and as I mentioned before this is something we'll say throat child applying also needs to demonstrate substantial functional limitations and at least three of those areas that were on the previous slide the adult eligibility eligibility criteria for intellectual disability is different from that of developmental disability so I'll talk about each separately when an adult applies the DDS eligibility I mentioned adult services begin at age 22 in reality though someone can apply for adult eligibility as early as age 17 and a half 17 or 18 again for all applicants an adult child they need to be domiciled in Massachusetts and in adult applying under intellectual disability should have a diagnosis of intellectual disability and we focus very much the major criteria for intellectual disability is somebody's IQ so for adults applying under ID what we'll look at is a comprehensive history of IQ testing between the ages of 5 and 18 and DDS has a threshold if you will an IQ of approximately 70 or below so that's what we'll want to see if somebody applies with a 90 IQ there may be some other factors certainly we would look at but the most part that is well outside the range of our IQ criteria for intellectual disability again it's worth mentioning somebody must meet both the IQ the criteria for intellectual disability and they also have to move the adaptive functioning criteria as well if somebody has a 60 IQ but their adaptive functioning is outside of our range then they very likely might be found eligible and vice versa so before discussing the criteria for developmental disability just some quick information about the ASD population that DDS supports the autism omnibus bill was signed into law by Governor Patrick in August of 2014 prior to the death DDS was supporting primarily individuals with intellectual disability but this bill and this law directed DDS to intelligibility to also include adults with ASD autism spectrum disorder and the aforementioned prader-willi syndrome in Smith McGinnis syndrome when somebody applies for autism or or Praetorius McGuiness DDS recognizes that adults with these disabilities may have IQ scores higher than 70 but we do still look at the adaptive functioning piece so I get this question all the time from families somebody playing with autism we've seen I choose from 50 all the way through 130 our main focus is for somebody applying up with autism is focusing on that diagnosis of autism by within nd a medical doctor or a licensed psychologist approximately 60% of the applications we receive these days doing food diagnosis of autism in addition to other diagnoses often the adult eligibility criteria for developmental disability again age 22 and death is when Adult Services begins the folks that have found eligibility with DD but again they may apply as early as age 17 and a half again we need to be domiciled in Massachusetts they need to demonstrate the substantial functional limitations on this slide it's somewhat repetitive but it bears repeating all these bullets and I wanted to just highlight again that autism criteria in order for someone to be eligible child or adult we need to have a diagnosis of autism spectrum disorder it needs to be by a qualified practitioner which for DDS is purposes is an MD a dealer or a licensed psychologist and they have to address the clinical criteria from the dsm-5 the diagnostic and you know that a doctor or psychologist would use so there needs to be some supporting documentation of that ASD diagnosis in order to be found eligible so I would also touch on the eligibility process I know this is something families are always interested in so an application is submitted to DDS for eligibility it's submitted to the regional office there is some basic required documentation that we ask for up front this includes a copy of the applicant Social Security card birth certificate health insurance card and then as much documentation that someone can send up front supporting the diagnosis and the type of disability is beneficial to the process upon receipt of an application we will assign the case to wanted for eligibility specialists that we have in the office they remove a file they will reach out to the family with an introductory phone call and really their job is twofold the first thing is to communicate to the family if we have all the documentation we need and if we don't to work with the family to get the remaining documentation that we would need to make a determination the wording is really on the applicant and the family to submit the documentation but as long as we have a signed release form we're happy to work on behalf of the family and quite honestly we do that in probably the majority of cases so we are there to help Franca's process just get the documentation that we need once we have all the documentation the only other thing that needs to occur is an intake meeting which I think I mentioned at the start of this presentation this meeting most often occurs at the regional office and middle bar although again if there's a hardship for a family and they don't have the ability to travel or car issues behaviors whatever it may be we are happy to be at a local DDS area office that's more convenient for the family the intake interviewing meeting is about a about an hour hour and 15 minute meeting and again it's at that meeting that we will administer the adaptive assessment so once we have the paperwork a daily intake the file is considered complete it is forwarded to us I caught the regional psychologist for a clinical determination but we'll quickly I just wanted to touch on the chapter 688 process this is essential when a school system will identify an adult agency to hopefully facilitate a successful transition from school to adult services so there's several boards here which folks folks concerning a meeting I did list a website at the bottom go up there which will talk a little bit more about the chapter six EDA process essentially what happens as a school system will submit electronically a referral to DDS once we receive that would be an application out to the family they can apply to us if somebody's found eligible through the chapter 688 process they are also adult eligible that's important to know and the other piece is the chapter 688 process for those folks that are in school and the loan and then IEP it's very important often to have the offer sent to the appropriate stage agency not only does it involve us in the transition but it also has the state legislature involved as it relates to future needs such as funding and things of that nature so jumping that quickly just to the determination process and the eligibility process the file has been forwarded to the regional psychologist they now have it they have two potential outcomes the first is obviously they could find somebody not eligible or ineligible what happens is we would know a letter to the applicant and our family it would contain appeal rights and the applicant does have the right to appeal any not eligible decision there are two stages of this process the first is an informal conference and then the second is a more formal fair hearing but at both of these both of these appeals stages the psychologist or the fair hearing officer do have the opportunity to overturn and not eligible determination so I learned to n decide on something a little more positive for folks that are eligible with yes if it's determined that somebody is eligible we will fill with the applicants file to the local area office so again those seven area offices depending on where someone lives it is at the local area office where a Service Coordinator is assigned and it's essentially service delivery is essentially through that local area office so there's a prioritization process that occurs at the local area office level that determines the level of need and services to be offered so just to give a little closure here you will apply to DDS at the regional office and middle Bell must go through the eligibility process once found eligible the service delivery supports and services occurs at the local DDS area office level so I think I have like a minute left so I just wanted to say one other thing which is the intake and eligibility and we we try to be very very family friendly we try it we certainly understand this is we are often the first face of a state agency that an applicant and our family talks to and we also acknowledge that the process can be very overwhelming and sort of anxiety provoking for folks to go through the process so we try to be again very transparent very communicative my contact information is Ross mentioned on the very first slide is listed on that slide and you can contact me with any questions you have whatsoever and we're happy to talk to you further so at this point that concludes my presentation on eligibility I would like to turn it over to Ed Wilson now we'll talk about service delivery and options hi I'm glad to be with you today my name is Alyssa yellow digital manager for self-directed services in Southeast Region so today I will be providing an overview of both traditional and self-directed service models as well as service offerings above available for myself Department of Developmental Services files traditional services as well as self directed services and the MassHealth funded services that I will be briefly reviewing today adult fairly care personal character lutz and day habilitation programs the list of DDS traditional services shown here is a sampling rather than a complete list your local area office for DDS or which will detailed information on providers as well as services when I talk about services now I talk about the in terms of a continuum of service delivery that continuum from traditional agency to agency a choice to the participant directed program that continuum is a continuum of control and responsibility as you go down this continuum you from traditional to the participant directed program that you receive we have more control and more flexibility but at the same time there's more responsibilities that must be taken in the administering and managing of the services self-directed services themselves are not the services themselves are not new what's new about self-directed services are how they are delivered to the individual in or to their family so it's important to keep aligned as we go forward and it is important to make sure that we keep linked control and responsibility whatever we you know only when one party has that control and the other party has responsibility there's oftentimes friction that can arise so it's important to keep control and responsibility linked as we go down this is really known as consumer sumo-style with an overview of traditional the traditional models of service three years ago people with disabilities were either able to had two options they were either stay home or they were placed in an institution it wasn't really until the seventies or eighties that seventies and eighties that community services really began to become available the traditional model of service delivery currently makes up the overwhelming majority of service delivery it's been around for nearly 50 years since the closing of some of our larger state institutions now delivery method is based is agency based with some 250 plus or minus nonprofit providers that DDS contracts with to provide any number of services essentially the Commonwealth contracts with nonprofit from and specifies how many people will be served so the Comelec will have a contract for XYZ agency to provide a full person group or more for a letter agency to provide 25 people supported employment and so on and within the traditional service model there's a huge continuum of services that are available we have blue pins that are staffed to awake overnight with a hundred hours of Nursing all the way to services for folks who are for three or four hours on a Friday to get them through the weekend and everything in between thing to understand is that DDS is contracting with the agency and within that living that contract your son or daughter is served your link is the individual service plan and you're typically working with the service coordinator helps you to develop an individual service plan in addition to providing information about services that are available in how they work they make referrals negotiate and troubleshoot problems and move to the service delivery so a service 20 the service coordinator is very much what point person and that is also true in self-directed services so talk a little bit about how self-directed services differ from traditional services so self-directed services differs in these questions these who what where when and how questions you know when traditional services who's going to be hired what the individual is going to do where the service is going to take place when it's going to begin an end and how those services get delivered whether are the responsibility of the agency and so therefore they have control over answering those questions in self-directed services however who is going to be hired but you get to determine who you may hire what what the individual is going to do you get to determine that where the service is going to take place indicated the afternoon of work the church a gym etc one of those services happen will is up to you to decide and when when those services happen if the person is interested we wanted to start their day at ten am perfectly fine if the person is interested in wanting to has a night job and needs support early evening that's perfectly fine as well so services are when the services are provided or up to you and how those services get provided as well as a question that you get to answer so the difference is really why in those who what when where how questions why wherever service levels develop others individuals and families wanted more of a say more of a voice and coming up with ideas that fell outside the traditional service miles when the services to be more tailored to the needs of this on the daughter they were enormous a in those who what when where and how questions when I first started working in families and self-directed services back in 2003 2004 a holiday was on in 1997 that DBS was awarded a self-determination demonstration there and the methodology for self-directed support program was developed a person-centered approach individuals budgets and the creation of a failure to Land Management Service to provide pendulum to the county was created in the pilot program focused ambassador in velocity northeast regions was initiated in the 2013 recommendations of that pilot was led is what has led to the participant directed program that we have today the agency the choice for new design in 2010 is a self-directed option for individuals and families to share responsibilities with a qualified provider those recently the runner are thought completed dedenne dedenne that's a request to fill our responses and that was completed in June for those of 2018 it was added to the list of qualified providers now we also have your lives law from having trouble just advancing the slide [Music] so one will it please just technically to do well there we go so the real lives law passed in 2014 promotes self directed support options for individuals receiving DDS services and it shows that self Direction information of each training are provided it established a 20 turnover advisory committee representing multiple stakeholders and that's on a regular basis to improv publicize their influence self-directed services in accordance with the law so other in building this job for going on for years prior to that and card that the position didn't exist challenged to be able to an angel if it's limited only for Massachusetts and I for the position that's living in the existed before so I find this very exciting and very exciting work to be doing so I new start talking to you a little bit about the agency with choice and consider agency with choice to be a current employment model what does that mean exactly it means that our failures and individuals can recruit select or recommend workers to the agency that they believe are a good fit for the individual agencies who need to see the choice model will help to also provide some assistance not recruiting employees as well the agency's responsibilities are to handle the payroll the taxes or to hibbity what we call the employer of record responsibilities sort of little time sheets and process expenses and so on the individual and Families responsibilities need Azur choice model is primarily the supervision of the workers the daily supervision of the workers ensure that those workers are doing what announced you want them to do that you want them to do it well when you're able to proffer up candidates employees who would want the agency to to hire the agency what does have to establish whether they'd meet the agency's qualifications for Hani they have a driver's license u.s. the US citizen Casa Corrie and perhaps complete some other trainees as well and really for the agency to be as a hire that person to be a list model there's an agreement that is crafted which spells out what the agency is able to do and what its responsibilities are and one was not going about what the individual and their family is required and expected to do in this model could in particular developing a healthy and solid form of communication with the agency is key checking in with them to let them know what's going on is critical if there's a problem arises nowhere let anything linger so in this model of service you typically are working with what we call a mountaineer that's a person with any agency who is familiar with the agency with Choice Program and that person can help with recruiting employees helping to guide you through the individual service plan and someone so that's just agency of a choice as an overview the agency a choice services that are offered are individual home supports individual day supports such flexible funding and fairly service navigation it's important that was doing that individual day supports are also able to be used for employment so as we are the four separate services that agency the choice does offer so with regard to the participant directed program as I mentioned it's the option furthest down on the continuum it's the most flexible option providing the most control but also requires some responsibility to manage and to administer participant directed program model that there is no agency doesn't mean that you're not supported but there is no agency involved in them all you have to work with the budget and within a budget which is provided to you and there are certain rules and certain limits but you can design supports that can be very flexible very individualized in this model all these sources are considered so Social Security food stamps housing a person's wages and income are all with you because what we're looking to do is to stretch that those resources as far as we can we want to ensure but if there's something that needs to be paid for that we and there's another way of paying for that we're not paying for out of the allocation itself in this model various of the phones are not least in a checkbook they are held by a financial intermediary currently that financially to EDI is known as public partnerships United and they're the ones who are responsible for handling the payroll taking out taxes and issuing paychecks and processing invoices and expenses in this model you would have responsibilities related to recruiting your support workers and placing ads and you get to determine and negotiate pay rates you can't pay any less than minimum wage and you can't pay any more then some of those services have caps in terms of rates that can be paid but anywhere in between the living of the maximum rate of cap you be able to negotiate with your employees is where you receive a monthly statement detailing the expenses and you also have view our view only access to the portal online meaning you can see your budget right there and you are able to take a look at your budget and then make decisions about how you might one-ninth money from one line to another so for example if you have a support worker who might be taking some time off then we would be able to use to me out of that line item into another line image or perhaps purchase our gym membership and so on so it's important to understand that within the participant directed program when it can move throughout the fiscal year from one way or into another so changes that in terms of how you're making purchases can can happen pretty readily now should be a good communication however with the service coordinator um so how it would work is you'll be looking at a budget and making notes about the changes that you want to make in terms of the funds but then you would be calling your service coordinator or support broker probably to actually then go out and make that she did changes by living the line items within the budget so with the participant directed program there are four parties who are the main parties who have to collaborate in order for it to work on smoothly the individual and the family the individual family develops the vision and determines the answers to those who what where when and how questions there's public partnerships public/private ships limited who pays support staff and provides financial monitoring and of course there's the support worker or service coordinator who cups with the ISP and and helps to wage the budget with the new allocated resources and develop supports and certain supports and services now they get by asking their questions about what it is you know what can I purchase because in addition just to support workers purchases that can be made on behalf of participants those purchases we think such as gym memberships of the like those purchases should really be looked at as strategies rather than goes on to themselves so for example if you to be purchasing a Julian Bishop then the gym membership wouldn't necessarily be the goal or the objective of the ISP but rather the goal our objective would be strength training range of motion or weight loss and what gym membership would be the strategy toward that end so any purchases that are made have to have a strategy toward a goal or objective there are four things that we're trying to accomplish by within self-directed services most especially we're looking to help people build skills develop relationships create memberships yeah and maintain their health and safety so any any purchases we be late against because those four things and certainly learning to help of that person's vision forward there are things that we absolutely can't pay for things that are disallowed for example we can't pay mortgages or legal fees or we can't add on to people's homes we don't have a list of things that are available things we can purchase there really does have to be justification and rationale for the purchases that I made that has to make sense with with regard to the person person's disability and and also their vision so it is important however to be in communication with the local area office when it comes to making purchases typically ask that that there's purchases are a greater point in advance so we certainly don't want to be putting that in one under the assumpti n that you can't reimburse you've got to have that pre agreed upon by the local area office so that's on answering the questions what can I purchase well one thing that's important to understand is that self-directed and traditional services can work together it's not all or nothing so these are examples here on this slide of house of directed and traditional services can work together them typically someone could have as a third example 30 hours a week of individual individual supports while attending a community-based day support program or somebody could be receiving adult family care and still receiving 12 hours of supportive employment from the self-directed program so you can also start small if you feel like you couldn't manage our whole 30 or 40 hour a week or you can start smiling just start with one day so somebody could go to a day out one day when they Thursday and Friday's maybe they have more flexible kind of schedule more creative kind of schedule they want so it's a work that's important to understand that traditional in self-directed services can work together and in combination there are some limits but generally they work together pretty well so when we talk about non DDS funded services we're talking about MassHealth funded services and these are medically these services of medical eligibility requirements so adult family care is considered a residential service there are agencies who provide this service you need to check with your local area office but the agency will assist in recruiting a provider could be a single person a family a couple or so on depending on the preferences and availability the individual then moving to the home of that provider who's paid a monthly stipend amount which conveyed and the individuals needs and the portion of the individual's social security is utilized as part of that payment typically there are alternative monthly visits made by a nurse or a social worker even the DDS Service Coordinator will also visit the invitation programs offer recreational community activities and therapies such as physical therapy occupational therapy and speech these programs are typically operated Monday through Friday from 8:30 - Threepio lastly those personal care attendants personal care attendants required by the assessment be complete to determine how many hours of service the person receives be responsible for recruiting scheduled and directing the person is hired and PCs are utilized for us specific bodily needs such as bathing toileting going and eating etc there are other generic resources that you should be exploring that can be applied for such as the mobile housing voucher subsidized apartments food stamps peeler assistance discounts on electricity maximizing supports and having a diversity of sources related to the selection service you're receiving is not important thing so the last thing we the last point here this is the good things of life it's a something that come from a dr. Wolfensberger so the big day survive buy into this because it's important to understand that good services are in fact a strategy that they're not necessarily outcome the good things of life are are things that all human beings look to obtain and to acquire whether it's a home work friends family respects a sense of belonging these are the things that that services should be supporting individuals to have these are the woman this is the end game so to speak these are the things that you're looking for services to be able to help provide you enjoy your family member so it's important to just understand and visit these are the outcomes that you're looking for when we talk about it about the good things of life and when we talk about services being a strategy when I contact information in the contact information of my counterparts and other regions is listed here phone if you should have questions please feel free to reach out to me or to integrate other parts I want to thank you every deck so thank you very much dad and Tracy for a very informative presentation once it is a lot of information that's presented and one of the benefits of course of having less recorded is you can listen to this bit of this presentation on other occasions as well but I don't party sure though if I didn't have questions to type them in and we'll get back to you with the answers or the content information on for Tracy later on that yeah the first slide this I would encourage you to either email or call them as well so I thank you for coming today in Tracy this actually is the soil event is current series of thoth event feel like a mix I would suggest that if you have topics that you'd like us to present on please also see in a comment and we'll be happy to try and accommodate that request as well and so I thought that with that it's time to wrap up and I wish you all a great opportunity and I look forward to having participate in the next series of three head