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Official Minutes
Resource Connections of Oregon
Salem, Oregon 97305
January 25, 2008
- PATH Planning February 21, 2008, 9:30am – 3:30pm, with Jack Pearpoint and Lynda Kahn, at the Church Street SPD Building—676 Church Street NE, Salem, OR 97301.
- Meetings for 2008—March 19, 2008, May 23, 2008, July 25, 2008, September 26, 2008, November 19, 2008
In Attendance: Cynthia Owens, Judy Cunio, Carol Simonds, Cindy Helvington, Arlene Jones, Marcie Ingledue, Bill Lynch, Dianne Duerscheidt, Dan Peccia, JoAnne Fuhrman, Jim Wrigley, Mary Lee Fay, Howard Miller, Anne Zaccardi, Pam Ring, Mike Maley, Kathryn Weit, Patrice Botsford, Tim Kral, Diana Buell
Jasper Smith was unable to attend due to inclement weather conditions and Nona Scott was unable to attend due to a prior commitment. Kathy Holmquist and Kristi Holmquist have indicated that they are stepping down from the SIG due to time conflicts.
Meeting was called to order by facilitator, Bill Lynch, at 9:35am. Notes taken by Arlene Jones and Howard Miller.
Introductions and Announcements
Clarification was received as to the change of date for the SIG PATH Planning, from information received at the November 30, 2007, SIG meeting. The SIG PATH Planning will be held on Thursday, February 21, 2008, 9:30am – 3:30pm, at the Church Street SPD Building in Salem.
Review & Approval of Minutes
JoAnne Fuhrman motioned and Howard Smith seconded approval of the November 30, 2007, minutes. Minutes were approved by consensus.
Monitoring/Updates
SPD Updates
- Data Report: Enrollment/trends, etc.
Mike Maley distributed material that will be part of an annual report. Data has remained consistent. With regard to Attachment #1 Adult Support Services Summary of Total Enrollments and Terminations in Brokerages (11/1/01 through 10/31/07), although more customers are entering into the brokerage system, the numbers of terminations (exiting out of the brokerage system) has remained constant (averaging 13 per month). The consistency is also reflected in Attachment #2 Enrollment and Termination Summary by County. Currently, there is no tracking of the number of customers who leave the support services system and re-enter back into the system, but this number is felt to be very low. The contracted capacity information contained in the Enrollment and Termination Summary by Brokerage (11/1/01 – 10/31/07) document has been corrected since the last SIG meeting. Mentor Oregon Mid-Valley brokerage is not included on this document as they had not begun services during the reporting period. Their capacity is set at 350.
The two new brokerages (Independence Northwest and Mentor Oregon Mid-Valley) will be increasing enrollments from March through July. The state will be entering into contract for a fourth brokerage in the Metro region, which will be serving customers at capacity by July 2008. Due to the short timeframe, there will not be a request for proposal (RFP) process. The SIG was told that the State legally does not need to RFP.
Contract capacity for a number of the brokerages will increase during the biennium. FAB, ISN, Mentor Oregon Mid-Valley, SORB, and Eastern Oregon would be increasing contract capacity by 50 for the rest of the biennium. The increase would occur on a staged basis. As an example, for ISN this would be January 2009. The total capacity for FAB and ISN would then be 750, so as to meet the projected need for the coastal and central Oregon areas where there are no brokerages. The SIG felt that it would be good to have a mapping of the number of offices under each brokerage. Conversation will be entertained in the next few years with regard to building capacity by having brokerages establish multiple offices and then creating new brokerages through “spin-offs.”
The Client Process Monitoring System (CPMS) is being looked at for vagaries, so that actual numbers can be determined. Mike related that clarification is close to being achieved.
With regard to brokerage outreach to high school transition students, most brokerages are in the process of providing outreach. Dan Peccia related that in the Metro region, the three Metro brokerages have been involved with the development of materials for outreach to school districts. Request was made that the materials be shared with the SIG and other brokerage directors.
ACTION ITEM—Dan to send high school transition outreach materials developed by the Metro region brokerages to the SIG and other brokerage directors.
Diana distributed a document on the Comp 300 rules. The Eastern region being developed first and will be ready to proceed in July 2008. The housing piece is still being developed dependent on the level of support needed. Cascade region is next and has been less inclined to do joint planning. More counties (such as Wheeler and Morrow), which had not participated the last period, have indicated the desire to participate this time. Grant, Douglas, and Coos Counties are also starting. Although Lake County is not participating, a new provider, Southern Oregon Goodwill, has become available.
Availability and sharing of information in the larger counties is less of a problem, as compared to the smaller counties. Recent data on interested individuals is important for advocacy so that it can be brought to the attention of planners. Concern was raised that there does not seem to be a real planning process. Planning meetings are limited in number and have not been seen to be occurring outside of the county structure. It was felt that there would be a broader stakeholder group than just county representation. Priority appears to be for out-of-home placements with a limited number of in-home comp. Diana reported that she has sent out messages as to the local meetings. Although there is a meeting on February 1, 2008, 12pm – 3pm in Salem, which SIG representatives are welcome to attend; availability at the March 7, 2008, would be better for SIG representatives. Because of the late development in the biennium, representation at the March 7, 2008 would still be effective. Suggestion was made as to the formation of a workgroup between county service coordinators and the brokerages.
ACTION ITEM—SIG representation at the March 7, 2008 meeting for discussion as to Comp 300 implementation (out-of-home placements versus in-home comp, broader stakeholder group representation in county outreach, and workgroup development between county DD service coordinators and brokerages).
Discussions continue with the State Department of Housing with regard to promotion of barrier free buildings and initial communication process when things are approved, so that strategies can be presented to Seniors and People with Disabilities (SPD).
- Workgroup Update on the incorporation of individuals who are DD only
It was reported that the workgroup is behind in convening, due to the logistics of time availability. Jim Wrigley and Mike Maley are working to pull this workgroup together which would deal with crisis. List has been received from the brokerage directors and DD service coordinators.
- Workgroup Update on the caseload ratio—Best Practices Workgroup
The Caseload Ratio Workgroup has evolved into the Best Practices Workgroup, which is made up of brokerage Assistant Directors and Lead Personal Agents (PAs). Anne Zaccardi will take back to the workgroup the topic around conflict of interest and obtain example as to the various situations encountered.
ACTION ITEM—Best Practices Workgroup to obtain examples of various situations where conflict of interest occurs.
- Grievance Materials Workgroup
The materials require review, which will be accomplished electronically. Tim Kral, Judy Cunio, Jim Wrigley, Kathryn Weit, JoAnne Fuhrman, and a brokerage representative (to be identified by Dan) will review the fact sheet on grievance. Kathryn will send out the initial material.
ACTION ITEM—Kathryn to send out grievance material/fact sheet for review by the Grievance Workgroup.
- Changes from CMS on Targeted Case Management (TCM)
All states are out of compliance, so this is not an issue specific to Oregon. There are a number of features which are problematic. Centers for Medicare and Medicaid Services (CMS) are concerned with states not paying attention, as over the past 6 years, expenditures have increased. Clarification that TCM can not be involved in direct service—i.e. can not build TCM into transportation or case managing around support and being an advocate in educational setting, unless representing the Medicaid portion of the service. TCM will probably be okay for high school transition, but not strictly for representation at an Individual Education Program (IEP) meeting. More problematic will be treating most Medicaid items as Medicare does with regard to health—timed increments and monthly billing. The infrastructure changing of database will present issues. Whether this is for both county service coordination and brokerage is debatable. Although county service coordination is not used in the brokerage, there are many activities that are indicative of service coordination. Can not pay for eligibility, which may be an administrative function. Individual can only have one service coordinator, for children, will need to sort out CaCOON nurses or nurses for TCM. The exceptional care coordinator would be a different function.
The process will take time and effort out of the state office, so in all likelihood, the State will be busy dealing with this. The process is scheduled to begin in March 2008, but there is a push to delay the start (deficit reduction act, there is no congressional authority to delay).
- Securing Meaningful Employment
Basic training on Individual Development Accounts (IDAs) will be held on February 6, 2008 from 10:00am – 3:00pm in Salem. An individual with DD can set up an IDA, which in Oregon would be matched 1:3. The funds can be used for up to 6 things, including housing, assistive technology, post-secondary education, small business opportunities, home modification and vehicle modification; for 3 years at a time. Individual is able to start an IDA from 12-14 years of age. In order to participate, the individual would have to pass a fiscal training management class. Contributions need to be made on a monthly basis. This allows for the development of wealth to reach goals. State funds are out of the tax credit program. Brokerage can serve as a potential provider of these.
Issue Discussion and Action Steps
SIG sponsored training for brokerages in Hood River and Newport on April 8th and April 10th respectively—Person-Centered Planning (PCP)—targeted at brokerages and boards, and self-advocates. Training would go beyond strict PCP mechanics. How to make PCP feasible within a brokerage; incorporate the PCP philosophy into daily functions of brokerages. Need to have a commitment from the brokerages to PCP.
The committee needs projections of actual attendees from the brokerages. A deadline should be forwarded to brokerages. Attendees should include customers, families, etc, identified by brokerages. It’s so important that customers really know the benefits of PCP and what it can do for them and why they need to demand it.
DD Council has been seeking funds for video of PCP in job training. Chemeketa College has contracted to provide technical support. Six hours of filming.
Oregon Series on Direct Supports Provider Training—series of six 4 hour videoconferenced trainings held around the state. Brochure forthcoming; email notification has gone out. David Pitonyak, Norm Kunc, Kathie Snow, Cathy Ficker-Terrell will be leading four of the trainings. Still seeking regional coordinators in Bend and Portland areas.
Oregon Disability MegaConference—to be held May 29-31, 2008 at the Riverhouse Resort and Conference Center in Bend. The website is up and call for presenters has been issued. Presenters will be selected in February 2008. Registration should be available in late February. www.oregonmegaconference.org is the URL for the conference.
- Agency With Choice Workgroup
As the group has not met yet, there is no report.
ACTION ITEM: Dan will schedule meeting.
- Jack Pearpoint and Lynda Kahn on February 21, 2008
PATH planning—at Church Street SPD office 676 Church Street NE Salem, OR 97303. PATH stands for Planning Alternative Tomorrow with Hope. The goal will be to create new vision of support service. Recommendation is for good representation at this table. Lunch to be provided by the Oregon Council on Developmental Disabilities, and Oregon Technical Assistance Corporation (OTAC) will provide boards and writing implements.
Considerations—
- Future of on-going services and what is the role of the SIG (what do we want to be like when we are done)
- A good strategic plan is a PATH plan
- What will “Roadmap to Support Services” look like
- Although this is not a “what’s working and what’s not working meeting,” once the above has been addressed, then “what’s working and what’s not working” may be looked at
ACTION ITEM—send out information on PATH planning to all SIG members.
Policy Option Packages (POPs)—In planning for the next biennium, there will be four SPD issues: REBAR, county infrastructure (especially service coordination), support services, and paying for comprehensive.
Monitoring/Updates—continued
Brokerages
- Conflict of interest—Directors have discussed conflict of interest policy. The Best Practice Workgroup will also be discussing and will bring information back to the SIG. Also discussed ensuring that Counties are not setting up unsustainable situations (i.e.—paying people who can’t be paid) that the brokerages inherit.
SIG hoped that brokerages would come up with situations which would help to illuminate the discussion and come up with guidelines. The Best Practices Workgroup has taken up this issue and is putting the subject to PA’s to stimulate such discussions. Financial conflict of interest while a primary issue is not the only issue. How to deal with conflicts between desires of the customer and of the family.
ACTION ITEM—report on discussion and examples at the May SIG meeting.
- A PA representative is being sought to be a member of the SIG. There was a request for updated information about Brokerage representatives to the SIG.
- Disability Compass website should be up in mid-February. Disability Compass is Disability Navigators Inc searchable website—www.disabilitycompass.org will be available to families and customers to use the searchable provider database. The University of Minnesota has a similar LifePages PICs http://www.lifepages.org/.
Counties
Customer/Family/Advocates
- Items previously covered within the agenda.
Providers
- The 10% COLA for Comp service provider staff will not be available to provider agencies serving brokerage customers. This will result in staff receiving disparate reimbursement.
- Absenteeism data and policy/Vacancy issues—reimbursement also varies depending on customer absence between comp and support service customers.
Review Meeting and Plan Next Meeting
- Next meeting is the PATH Planning—Thursday, February 21, 2008 with Jack Pearpoint and Lynda Kahn at the Church Street SPD office in Salem from 9:30am – 3:30pm.
- Next SIG meeting, Wednesday, March 19, 2008, at Resource Connections of Oregon in Salem from 9:30am – 3:00pm. The Customer/Family/Advocate group will meet from 8:30am – 9:30am.
- Meetings for 2008—May 23, 2008, July 25, 2008, September 26, 2008, November 19, 2008
Agenda items for next meeting
Debriefing of PATH Planning
February Legislative Session
Plan Authorization Project
Agency with Choice Workgroup—update
Best Practices Workgroup—update
Report from Grievance Group
Securing Meaningful Employment
PARKING LOT
- SERT data reports for Support Services and Comprehensive In-home Support Services to be revisited on a bi-annual basis. Next reporting—May 23, 2008
- Information from Eva Kutas on Protective Services Data and Information (Comprehensive vs. Support Services) on a bi-annual basis. Next reporting—March 19, 2008
- Caseload Ratio Workgroup
- Inadvertent foster care development
- Order of Enrollment (in year prior to end of roll-out)
- Pros and Cons of brokerages having multiple offices/mapping of brokerage offices statewide
Adjournment
- The meeting was adjourned 12:50 PM.
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