April 13, 2020
Minutes
Minutes
Attendees via Zoom: Mark Kemmerle, Kim Humphrey, Roberta Raymond, Ashleigh Barker, Betsy Mahoney, Shannon Crocker, David Cowing, Rachel Dyer, Janet Hamel, Diane Boas, Monique Stairs, Laura Cordes, Foxfire Buck, Angie Potter, Elizabeth Hopkins, Alli Vercoe, G Dwyer, Julie Brennan, Debbie Dionne, Kathy Adams, Jamie Whitehouse, Sierra Hillebrand, Craig Patterson, Maggie Hoffman, Kate Murray, Karen, Jennifer Putnam, Paula Bush, Lily Lin, Moira Leighton, Robin Levesque, J Richardson Collins, Darla Chafin, Ann Bentley, Frances Ryan, Linda Lee, Natalie Childs, Heidi, Brenda Smith, Teague Morris, Dee Karnofsky, Cullen Ryan, and Vickey Rand.
Cullen Ryan introduced himself and welcomed the group. Participants names were read by Cullen to save time. Minutes from the last meeting were accepted.
Cullen started the meeting acknowledging the challenges everyone is facing amidst the COVID-19 pandemic, including and especially the challenges faced by people with ID/DD. He noted that this is a very challenging time for every aspect of the world for people with ID/DD, including parents, providers, and DHHS. Everyone was thanked for their efforts during this time and for being here today.
DHHS – Office of Aging and Disability Services (OADS) - www.maine.gov/dhhs/oads
Cullen: We’re going to move the agenda around slightly because Betsy can only stay for the first hour of the meeting, and we both want to ensure OADS updates are provided to the group. Thank you for being here today, Betsy!
Betsy Hopkins - Associate Director, Developmental Disability and Brain Injury Services: Thank you for having me! We are still holding our weekly stakeholder meetings, every Tuesday from 3-4pm through Zoom; there is a link on our website for more information. Usually we’re joined by someone from Maine CDC, and we provide all updates we can about everything going on with OADS and COVID-19. We’ll be joined by Kelly Osborn with Goodwill Northern New England this week, who will be discussing how they’ve been working through having a number individuals test positive.
DHHS is open, and all OADS staff are working remotely. We’re all available by email and we all have cell phones. I want to echo Cullen’s thanks for everything everyone is doing, to the individuals going through this, their family members, and the agencies who are providing support. This is unlike anything anyone has ever been through. All of our interactions have been productive and helpful, ultimately getting people connected with the help they need. We have six individuals being served by our agency who have tested positive. When someone does test positive, we work very closely with the agency and the individual to ensure they’re connected with the CDC. Because most of the folks we’re talking about live in some type of congregate living setting, the CDC assigns an epidemiologist that does a contact trace report. That’s very important because we know there are a number of individuals who work in a variety of different agencies, so we’ll know who people have been in contact with throughout the previous two weeks. The CDC is amazing to work with, which you likely get a sense of with Dr. Shah’s daily updates; but the entire agency has been great.
The Appendix K Waiver is an opportunity whenever there’s a national or state emergency for states to put in alternative funding mechanisms and/or lift certain restrictions. Specifically, this Appendix K Waiver will talk about a service location, or the way a service is being provided, for instance remotely, which is allowed with the K waiver. Or, if the family decides to bring their loved one home to avoid them being in a congregate living setting throughout this, the K Waiver allows for them to get funding. Agencies have reported that it’s been difficult to retain and find staff. The K Waiver allows leeway and flexibility to agencies as they onboard staff, provides grace periods for recertifications, permits reimbursement for extra staffing and costs related to COVID-19, and so on. We’ve been madly working on this K Waiver. I wish it were ready to go out the door today, as our goal is to get it out as soon as possible. We’re working with a lot of different entities, and the last thing we want to do is put something in a waiver we can’t actually do. We’re trying to figure out how we can provide this funding well and quickly. That’s why it’s taking longer.
Another question we’ve received from agencies is how we’re working towards compliance with the HCBS Settings Rule. Doing a validation to see how someone is accessing the community is not the best thing to be doing right now, because people aren’t accessing the community, in fact they’re being told specifically not to with the stay at home orders. As such, we’ve put a pause on the individual experience assessments and reviews that were happening for agencies. This is all paused for the next 60 days. We just made this decision last week. We don’t have the ability to extend the deadline for coming into compliance with the HCBS Settings Rule, that’s at the federal level. We’ll reevaluate after 60 days and see where we are, and where the federal government has landed regarding this.
On the reform side, I wanted to say that I’ve received all of the nominations for the stakeholder’s groups discussed at last month’s meeting. I still hope to finalize those groups with the goal of starting that work by mid-June. Those are the overarching updates I have.
Discussion:
-It was stated that there has been a fair amount of input at the weekly stakeholder meetings regarding what’s included in the Appendix K Waiver. It appears other states have had those waivers approved already. It was asked when OADS expects to file it and if people would have the opportunity to review what is included.
Betsy: We will file it as soon as we can; I wish I had a date for you. We will share it as soon as we can. I’m sorry I can’t be more specific than that. We’re working with OMS (Office of MaineCare Services) and Licensing (Division of Licensing and Certification). We’ve gotten a lot of input regarding what needs to be included in the K Waiver, and we still welcome that feedback. And, I can share a link to find out more information about Appendix K Waivers in general after the meeting. I should note that the Appendix K Waiver is very specifically for service provision for individuals with ID/DD.
-It was asked why the Appendix K Waiver submission has been delayed.
Betsy: State Departments and Offices are trying to do things in concert with each other, which takes more time. And, we want to ensure what we say we can do can indeed be done and be done quickly and smoothly. For instance, we have an outdated management system that we’re having to do a lot of work around. As soon as we get the word that we can share it’s being submitted we will certainly do so.
Cullen: Thank you very much for that update and thank you as well for all of the work OADS is doing to be transparent and communicative with all of us!
Featured Speakers: Rachel Dyer, Associate Director, Maine Developmental Disabilities Council. www.maineddc.org and Kate Murray, Principal, Applied Self-Direction. www.appliedselfdirection.com Topic: Self Direction 102.
Cullen: Today we have Rachel Dyer, Associate Director, Maine Developmental Disabilities Council, and Kate Murray, Principal with Applied Self-Direction, providing part two of their presentation on self-direction. Thank you for coming back to provide the second part of this informative presentation!
Rachel Dyer: Thank you very much for having us back this month to discuss self-directed services. This is the first non-COVID-19 thing I’ve done in a month! To discuss something that’s not directly related to that feels odd, but it’s been great preparing for it because we know the world will return to some semblance of normalcy at some point. Kate Murray will lead the discussion again today. We’re excited to have as many people here that we do today, it’s so great to see and hear everyone!
Kate Murray: Thank you all for taking the time today. I’m going to try to move through content quickly, and for logistics we’ll save the discussion until the end. The presentation also includes what’s going on nationally in terms of self-direction and COVID-19.
Begin Presentation (Click here for the presentation)
Kate: Amid the pandemic, we’re seeing people returning home from congregate living settings, due to concerns about the spread of COVID-19. This is exciting because it might help people to see if self-direction might be a good fit long-term. CMS (Centers for Medicare and Medicaid Services) encourages increasing the use of self-direction in emergencies like pandemics and natural disasters, as the model affords certain flexibility needed in these circumstances.
Discussion:
- It was asked if the consumer writes staff job descriptions and hires/trains their own staff.
Kate: Generally, yes, the consumer or someone they designate writes their own job descriptions for the people they hire, takes the lead on interviewing and training staff, and so on. There may be some agency involvement, but generally regardless of the model chosen, the consumer will take the lead on these activities, with varying levels of assistance.
- It was asked if more consumers are using assistive technology and smart home technology in their lives to enhance their ability to self-direct.
Kate: Absolutely, iPads rank at the top of things people buy with their budget! The next is smartphones. We’re seeing more and more use of these devices all of the time. We’re seeing a lot of interest in and successes with people using smart technology. It’s becoming an increasingly integral part of self-direction.
-It was asked how many states have self-directed waivers?
Kate: All states have self-direction included in some shape or form. Forty-five states have self-direction specifically for individuals with ID/DD.
Kate: My email is [email protected] if anyone has any questions after today's meeting and would like to get in touch. Thank you again for having me!
Cullen: Kate and Rachel, I want to thank you for taking the time to present this in-depth information over the past two months. Well done!
End Presentation (round of applause)
Services:
Betsy Mahoney: Last week I was on a call with our national agency, and I hadn’t been following closely what OADS was doing with the Appendix K Waiver, if anything at all. I later found out we are in the process of completing an Appendix K Waiver in Maine. (Betsy Mahoney provided information on Appendix K waivers for the group, which Betsy Hopkins also referenced in her update. For more information on 1915c Appendix K click here. For information on Coronavirus waivers from CMS click here. For Medicaid’s disaster response toolkit for states, including HCBS 1915c waiver, click here.)
Craig Patterson – DHHS/OADS: Betsy touched on this a little, but we’ve had multiple meetings several times each week, looking at a variety of measures. I couldn’t even provide a complete list of every specific measure we’ve discussed. It involves multiple parts of state government. We’ve been looking at a variety of measures that would make it easier for providers to maintain health and safety of the individuals served. Some measures would relax requirements that make hiring and retaining staff more difficult, etc. Another mechanism we’re focusing on is opportunity for people to move. We’ve had multiple instances in which providers have had to adjust. We’ve had multiple people move back home. Providers have expressed concern about payments in these circumstances. We want to make these moves easier and not endanger providers financially, as much as possible at least. We’ve addressed training as well. I know I’m leaving out huge pieces of the waiver we’ve been working on, as it’s been a large project. I can also take back any suggestions people have.
Laura Cordes – MACSP (Maine Association for Community Service Providers): The provider network has been working very closely with OADS over the past month, looking at staffing ratios and flexibility in order to support people across the state, and to protect people, both the individuals receiving services and the DSPs providing those services. The uncertainty right now is hard, providers have to make decisions trusting with good will where the state is going. This will be the fourth week we’ve thought the Appendix K Waiver was being submitted. Having that information makes all the difference in how people can manage during this difficult time.
-It was asked if the Appendix K waivers would just be in effect during the civil state of emergency.
Craig: Yes, that would be the case. There could be some retroactivity involved. Essentially, the idea is for the Appendix K Waiver to encompass services provided during the emergency.
Laura: MACSP has asked for it to be retroactive to March 1st and go 90 days past the end of the emergency.
Craig: I can take that request back. These approvals from CMS are very quick and tend to be pretty overarching so we want to ensure we have it right, we have various state entities in agreement, and we can make it all work financially. If someone comes up with something that they feel makes sense to be included in the K Waiver, please reach out. We’re getting down to the final stages, so I can’t make promises that a request could be included at this point, but we continue to want to really get this right, so we appreciate all feedback. As Betsy said, we’ve exclusively been in COVID-19 response mode. Working remotely has been challenging, and communication has been a struggle at a time when it really needs to be at its best.
Cullen: I want to take a moment to commend OADS on its transparency through this, especially with the weekly calls. OADS staff have obviously been putting in a ton of hours as a group of people who are in charge of caring for a very vulnerable population; I really want to commend you all for your work.
Craig: Thank you, I will share that with Betsy and Paul. That weekly call has been very valuable to us as well, but also extremely labor-intensive and time-consuming.
Cullen: Information brings peace to people at a time of great worry, so thank you!
SMACT (Southern Maine Advisory Council on Transition) Update:
Kathy Adams: SMACT had a great meeting, via Zoom, at the beginning of this month featuring Laura Abbott from Port Resources on their independent living and skills program, which produced an excellent conversation. The May 1st presentation will be Carrie Woodcock speaking about Supported Decision Making. You can stay up-to-date with SMACT meetings and events through its Facebook page.
Disability Rights Maine (DRM) Update:
Foxfire Buck: DRM staff are still working and fulfilling our various roles for people with disabilities in Maine. Our website is updated frequently so check it out for more information and sign up for our email list to stay up to date. We’re going to start doing outreach to individuals, to ensure they’re doing okay. We’re trying to reach out to as many people as we can. I have provided a few handouts and documents for inclusion in the minutes. (Click here for the DRM is Open flyer. Click here for a plain-language document on COVID-19. Click here for navigating benefits related to COVID-19. Click here for DRM’s letter to DHHS Commissioner Lambrew and Maine CDC Director Dr. Shah on medical rationing).
Federal & Housing Updates:
Cullen: Congress and the Administration have taken measures regarding the COVID-19 pandemic. Three stimulus packages have been signed into law, with Congress currently in negotiations on a fourth stimulus package. The President signed the third stimulus package, the nearly $2 trillion CARES Act, to combat the economic fallout of the coronavirus outbreak, including direct payments to most Americans and a half-trillion-dollar fund to shore up struggling companies. Also included within the CARES act was additional funding for HUD, stressing the importance of Section 8 especially at this time. There is a push from advocates across the country for the fourth stimulus package to include robust funding for Section 8 Housing Choice Vouchers (from $60 to $100 billion), and a large investment in sorely needed affordable housing through the passage of the Affordable Housing Credit Improvement Act of 2019 (S 1703/HR 3077). Additionally, the Administration had finalized a Rule which would have cut off people’s access to SNAP after three months of utilizing the benefit. In Maine, 1200 people would have lost their access to SNAP through this Rule change. A judge overturned that, so it did not go into effect on 4/1 as planned. I also want to thank Maine’s entire Delegation because they have truly been champions for what Maine needs amid the COVID-19 pandemic.
State Legislature Update:
Laura Cordes – MACSP (Maine Association for Community Service Providers): The 129th Legislative Session ended early due to the COVID-19 crisis. A special session may be held, though it’s too early to know when. All bills with the exception of those that had already died in committee will be carried over to the special session, but only a few will likely be considered. The emergency budget which passed did not include Section 21 or 29 DSP rate increases, nor recommendations of the Commission to Study Long-term Care Workforce Issues to raise rates to 125% of the minimum wage. These two bills did pass:
-LD 1974 An Act to Promote Telehealth Sponsor: Senator Geoffrey Gatwick. Summary: This bill would allow Section 13 Targeted Case Management Services to be reimbursed for case management services delivered through telehealth to targeted populations.
-LD 1874 An Act to Amend the Laws Governing the Subminimum Wage Sponsor: Representative Ryan Fecteau Summary: This bill eliminates current exemptions from the minimum wage law that allow the payment of wages at less than the minimum wage rate to certain individuals with disabilities.
Featured Speaker: Dee Karnofsky, Local Solutions. Topic: It Takes a Community, a documentary featuring Parish House, a permanent supportive housing project for adults with ID/DD in Bar Harbor.
Dee Karnofsky: Thank you for having us. I’m here with Roberta Raymond, and we’re both Local Solutions Board Members. This film is a very abbreviated story about how a nonprofit we started on Mount Desert Island created supportive housing for a group of young adults with special needs. We made the movie because we wanted people to know they could do it. We worked on the house for seven years before it opened. Along the way there were a lot of highs and lows, but we always knew we had to get it done. This documentary presents that story.
Cullen: Working hard is an understatement. I watched this firsthand and it was remarkable!
Robert Raymond: CHOM’s involvement with this project was really the first bit of hope that we had, so thank you Cullen. It was hard but it’s been a wonderful process, and everyone is well there, and that’s an achievement in itself!
Cullen: Thank you for that, but we played a very small role. It was the ingenuity and perseverance of the parents involved that saw this project through to completion.
(Click here for the documentary)
Other Business:
Monique Stairs – Speaking Up For Us (SUFU): Speaking Up For Us Self-Advocates sent a letter to the Governor asking her to make sure that civil rights are upheld and discrimination is prevented in any guidelines for health care workers in Maine. This letter is due to the very real concern that people with disabilities are already discriminated against in health care settings, and are at increased risk of getting the COVID-19 virus, and being denied healthcare (Click here for SUFU’s letter to Governor Mills).
The next meeting will be on Monday, May 11, 2020, 12-2pm, via Zoom.
Featured Speakers and Topic TBD.
Unless changed, Coalition meetings are on the 2nd Monday of the month from 12-2pm.
The Maine Coalition for Housing and Quality Services provides equal opportunity for meeting participation. If you wish to attend but require an interpreter or other accommodation, please forward your request two weeks prior to the monthly meeting to [email protected].
Cullen Ryan introduced himself and welcomed the group. Participants names were read by Cullen to save time. Minutes from the last meeting were accepted.
Cullen started the meeting acknowledging the challenges everyone is facing amidst the COVID-19 pandemic, including and especially the challenges faced by people with ID/DD. He noted that this is a very challenging time for every aspect of the world for people with ID/DD, including parents, providers, and DHHS. Everyone was thanked for their efforts during this time and for being here today.
DHHS – Office of Aging and Disability Services (OADS) - www.maine.gov/dhhs/oads
Cullen: We’re going to move the agenda around slightly because Betsy can only stay for the first hour of the meeting, and we both want to ensure OADS updates are provided to the group. Thank you for being here today, Betsy!
Betsy Hopkins - Associate Director, Developmental Disability and Brain Injury Services: Thank you for having me! We are still holding our weekly stakeholder meetings, every Tuesday from 3-4pm through Zoom; there is a link on our website for more information. Usually we’re joined by someone from Maine CDC, and we provide all updates we can about everything going on with OADS and COVID-19. We’ll be joined by Kelly Osborn with Goodwill Northern New England this week, who will be discussing how they’ve been working through having a number individuals test positive.
DHHS is open, and all OADS staff are working remotely. We’re all available by email and we all have cell phones. I want to echo Cullen’s thanks for everything everyone is doing, to the individuals going through this, their family members, and the agencies who are providing support. This is unlike anything anyone has ever been through. All of our interactions have been productive and helpful, ultimately getting people connected with the help they need. We have six individuals being served by our agency who have tested positive. When someone does test positive, we work very closely with the agency and the individual to ensure they’re connected with the CDC. Because most of the folks we’re talking about live in some type of congregate living setting, the CDC assigns an epidemiologist that does a contact trace report. That’s very important because we know there are a number of individuals who work in a variety of different agencies, so we’ll know who people have been in contact with throughout the previous two weeks. The CDC is amazing to work with, which you likely get a sense of with Dr. Shah’s daily updates; but the entire agency has been great.
The Appendix K Waiver is an opportunity whenever there’s a national or state emergency for states to put in alternative funding mechanisms and/or lift certain restrictions. Specifically, this Appendix K Waiver will talk about a service location, or the way a service is being provided, for instance remotely, which is allowed with the K waiver. Or, if the family decides to bring their loved one home to avoid them being in a congregate living setting throughout this, the K Waiver allows for them to get funding. Agencies have reported that it’s been difficult to retain and find staff. The K Waiver allows leeway and flexibility to agencies as they onboard staff, provides grace periods for recertifications, permits reimbursement for extra staffing and costs related to COVID-19, and so on. We’ve been madly working on this K Waiver. I wish it were ready to go out the door today, as our goal is to get it out as soon as possible. We’re working with a lot of different entities, and the last thing we want to do is put something in a waiver we can’t actually do. We’re trying to figure out how we can provide this funding well and quickly. That’s why it’s taking longer.
Another question we’ve received from agencies is how we’re working towards compliance with the HCBS Settings Rule. Doing a validation to see how someone is accessing the community is not the best thing to be doing right now, because people aren’t accessing the community, in fact they’re being told specifically not to with the stay at home orders. As such, we’ve put a pause on the individual experience assessments and reviews that were happening for agencies. This is all paused for the next 60 days. We just made this decision last week. We don’t have the ability to extend the deadline for coming into compliance with the HCBS Settings Rule, that’s at the federal level. We’ll reevaluate after 60 days and see where we are, and where the federal government has landed regarding this.
On the reform side, I wanted to say that I’ve received all of the nominations for the stakeholder’s groups discussed at last month’s meeting. I still hope to finalize those groups with the goal of starting that work by mid-June. Those are the overarching updates I have.
Discussion:
-It was stated that there has been a fair amount of input at the weekly stakeholder meetings regarding what’s included in the Appendix K Waiver. It appears other states have had those waivers approved already. It was asked when OADS expects to file it and if people would have the opportunity to review what is included.
Betsy: We will file it as soon as we can; I wish I had a date for you. We will share it as soon as we can. I’m sorry I can’t be more specific than that. We’re working with OMS (Office of MaineCare Services) and Licensing (Division of Licensing and Certification). We’ve gotten a lot of input regarding what needs to be included in the K Waiver, and we still welcome that feedback. And, I can share a link to find out more information about Appendix K Waivers in general after the meeting. I should note that the Appendix K Waiver is very specifically for service provision for individuals with ID/DD.
-It was asked why the Appendix K Waiver submission has been delayed.
Betsy: State Departments and Offices are trying to do things in concert with each other, which takes more time. And, we want to ensure what we say we can do can indeed be done and be done quickly and smoothly. For instance, we have an outdated management system that we’re having to do a lot of work around. As soon as we get the word that we can share it’s being submitted we will certainly do so.
Cullen: Thank you very much for that update and thank you as well for all of the work OADS is doing to be transparent and communicative with all of us!
Featured Speakers: Rachel Dyer, Associate Director, Maine Developmental Disabilities Council. www.maineddc.org and Kate Murray, Principal, Applied Self-Direction. www.appliedselfdirection.com Topic: Self Direction 102.
Cullen: Today we have Rachel Dyer, Associate Director, Maine Developmental Disabilities Council, and Kate Murray, Principal with Applied Self-Direction, providing part two of their presentation on self-direction. Thank you for coming back to provide the second part of this informative presentation!
Rachel Dyer: Thank you very much for having us back this month to discuss self-directed services. This is the first non-COVID-19 thing I’ve done in a month! To discuss something that’s not directly related to that feels odd, but it’s been great preparing for it because we know the world will return to some semblance of normalcy at some point. Kate Murray will lead the discussion again today. We’re excited to have as many people here that we do today, it’s so great to see and hear everyone!
Kate Murray: Thank you all for taking the time today. I’m going to try to move through content quickly, and for logistics we’ll save the discussion until the end. The presentation also includes what’s going on nationally in terms of self-direction and COVID-19.
Begin Presentation (Click here for the presentation)
Kate: Amid the pandemic, we’re seeing people returning home from congregate living settings, due to concerns about the spread of COVID-19. This is exciting because it might help people to see if self-direction might be a good fit long-term. CMS (Centers for Medicare and Medicaid Services) encourages increasing the use of self-direction in emergencies like pandemics and natural disasters, as the model affords certain flexibility needed in these circumstances.
Discussion:
- It was asked if the consumer writes staff job descriptions and hires/trains their own staff.
Kate: Generally, yes, the consumer or someone they designate writes their own job descriptions for the people they hire, takes the lead on interviewing and training staff, and so on. There may be some agency involvement, but generally regardless of the model chosen, the consumer will take the lead on these activities, with varying levels of assistance.
- It was asked if more consumers are using assistive technology and smart home technology in their lives to enhance their ability to self-direct.
Kate: Absolutely, iPads rank at the top of things people buy with their budget! The next is smartphones. We’re seeing more and more use of these devices all of the time. We’re seeing a lot of interest in and successes with people using smart technology. It’s becoming an increasingly integral part of self-direction.
-It was asked how many states have self-directed waivers?
Kate: All states have self-direction included in some shape or form. Forty-five states have self-direction specifically for individuals with ID/DD.
Kate: My email is [email protected] if anyone has any questions after today's meeting and would like to get in touch. Thank you again for having me!
Cullen: Kate and Rachel, I want to thank you for taking the time to present this in-depth information over the past two months. Well done!
End Presentation (round of applause)
Services:
Betsy Mahoney: Last week I was on a call with our national agency, and I hadn’t been following closely what OADS was doing with the Appendix K Waiver, if anything at all. I later found out we are in the process of completing an Appendix K Waiver in Maine. (Betsy Mahoney provided information on Appendix K waivers for the group, which Betsy Hopkins also referenced in her update. For more information on 1915c Appendix K click here. For information on Coronavirus waivers from CMS click here. For Medicaid’s disaster response toolkit for states, including HCBS 1915c waiver, click here.)
Craig Patterson – DHHS/OADS: Betsy touched on this a little, but we’ve had multiple meetings several times each week, looking at a variety of measures. I couldn’t even provide a complete list of every specific measure we’ve discussed. It involves multiple parts of state government. We’ve been looking at a variety of measures that would make it easier for providers to maintain health and safety of the individuals served. Some measures would relax requirements that make hiring and retaining staff more difficult, etc. Another mechanism we’re focusing on is opportunity for people to move. We’ve had multiple instances in which providers have had to adjust. We’ve had multiple people move back home. Providers have expressed concern about payments in these circumstances. We want to make these moves easier and not endanger providers financially, as much as possible at least. We’ve addressed training as well. I know I’m leaving out huge pieces of the waiver we’ve been working on, as it’s been a large project. I can also take back any suggestions people have.
Laura Cordes – MACSP (Maine Association for Community Service Providers): The provider network has been working very closely with OADS over the past month, looking at staffing ratios and flexibility in order to support people across the state, and to protect people, both the individuals receiving services and the DSPs providing those services. The uncertainty right now is hard, providers have to make decisions trusting with good will where the state is going. This will be the fourth week we’ve thought the Appendix K Waiver was being submitted. Having that information makes all the difference in how people can manage during this difficult time.
-It was asked if the Appendix K waivers would just be in effect during the civil state of emergency.
Craig: Yes, that would be the case. There could be some retroactivity involved. Essentially, the idea is for the Appendix K Waiver to encompass services provided during the emergency.
Laura: MACSP has asked for it to be retroactive to March 1st and go 90 days past the end of the emergency.
Craig: I can take that request back. These approvals from CMS are very quick and tend to be pretty overarching so we want to ensure we have it right, we have various state entities in agreement, and we can make it all work financially. If someone comes up with something that they feel makes sense to be included in the K Waiver, please reach out. We’re getting down to the final stages, so I can’t make promises that a request could be included at this point, but we continue to want to really get this right, so we appreciate all feedback. As Betsy said, we’ve exclusively been in COVID-19 response mode. Working remotely has been challenging, and communication has been a struggle at a time when it really needs to be at its best.
Cullen: I want to take a moment to commend OADS on its transparency through this, especially with the weekly calls. OADS staff have obviously been putting in a ton of hours as a group of people who are in charge of caring for a very vulnerable population; I really want to commend you all for your work.
Craig: Thank you, I will share that with Betsy and Paul. That weekly call has been very valuable to us as well, but also extremely labor-intensive and time-consuming.
Cullen: Information brings peace to people at a time of great worry, so thank you!
SMACT (Southern Maine Advisory Council on Transition) Update:
Kathy Adams: SMACT had a great meeting, via Zoom, at the beginning of this month featuring Laura Abbott from Port Resources on their independent living and skills program, which produced an excellent conversation. The May 1st presentation will be Carrie Woodcock speaking about Supported Decision Making. You can stay up-to-date with SMACT meetings and events through its Facebook page.
Disability Rights Maine (DRM) Update:
Foxfire Buck: DRM staff are still working and fulfilling our various roles for people with disabilities in Maine. Our website is updated frequently so check it out for more information and sign up for our email list to stay up to date. We’re going to start doing outreach to individuals, to ensure they’re doing okay. We’re trying to reach out to as many people as we can. I have provided a few handouts and documents for inclusion in the minutes. (Click here for the DRM is Open flyer. Click here for a plain-language document on COVID-19. Click here for navigating benefits related to COVID-19. Click here for DRM’s letter to DHHS Commissioner Lambrew and Maine CDC Director Dr. Shah on medical rationing).
Federal & Housing Updates:
Cullen: Congress and the Administration have taken measures regarding the COVID-19 pandemic. Three stimulus packages have been signed into law, with Congress currently in negotiations on a fourth stimulus package. The President signed the third stimulus package, the nearly $2 trillion CARES Act, to combat the economic fallout of the coronavirus outbreak, including direct payments to most Americans and a half-trillion-dollar fund to shore up struggling companies. Also included within the CARES act was additional funding for HUD, stressing the importance of Section 8 especially at this time. There is a push from advocates across the country for the fourth stimulus package to include robust funding for Section 8 Housing Choice Vouchers (from $60 to $100 billion), and a large investment in sorely needed affordable housing through the passage of the Affordable Housing Credit Improvement Act of 2019 (S 1703/HR 3077). Additionally, the Administration had finalized a Rule which would have cut off people’s access to SNAP after three months of utilizing the benefit. In Maine, 1200 people would have lost their access to SNAP through this Rule change. A judge overturned that, so it did not go into effect on 4/1 as planned. I also want to thank Maine’s entire Delegation because they have truly been champions for what Maine needs amid the COVID-19 pandemic.
State Legislature Update:
Laura Cordes – MACSP (Maine Association for Community Service Providers): The 129th Legislative Session ended early due to the COVID-19 crisis. A special session may be held, though it’s too early to know when. All bills with the exception of those that had already died in committee will be carried over to the special session, but only a few will likely be considered. The emergency budget which passed did not include Section 21 or 29 DSP rate increases, nor recommendations of the Commission to Study Long-term Care Workforce Issues to raise rates to 125% of the minimum wage. These two bills did pass:
-LD 1974 An Act to Promote Telehealth Sponsor: Senator Geoffrey Gatwick. Summary: This bill would allow Section 13 Targeted Case Management Services to be reimbursed for case management services delivered through telehealth to targeted populations.
-LD 1874 An Act to Amend the Laws Governing the Subminimum Wage Sponsor: Representative Ryan Fecteau Summary: This bill eliminates current exemptions from the minimum wage law that allow the payment of wages at less than the minimum wage rate to certain individuals with disabilities.
Featured Speaker: Dee Karnofsky, Local Solutions. Topic: It Takes a Community, a documentary featuring Parish House, a permanent supportive housing project for adults with ID/DD in Bar Harbor.
Dee Karnofsky: Thank you for having us. I’m here with Roberta Raymond, and we’re both Local Solutions Board Members. This film is a very abbreviated story about how a nonprofit we started on Mount Desert Island created supportive housing for a group of young adults with special needs. We made the movie because we wanted people to know they could do it. We worked on the house for seven years before it opened. Along the way there were a lot of highs and lows, but we always knew we had to get it done. This documentary presents that story.
Cullen: Working hard is an understatement. I watched this firsthand and it was remarkable!
Robert Raymond: CHOM’s involvement with this project was really the first bit of hope that we had, so thank you Cullen. It was hard but it’s been a wonderful process, and everyone is well there, and that’s an achievement in itself!
Cullen: Thank you for that, but we played a very small role. It was the ingenuity and perseverance of the parents involved that saw this project through to completion.
(Click here for the documentary)
Other Business:
Monique Stairs – Speaking Up For Us (SUFU): Speaking Up For Us Self-Advocates sent a letter to the Governor asking her to make sure that civil rights are upheld and discrimination is prevented in any guidelines for health care workers in Maine. This letter is due to the very real concern that people with disabilities are already discriminated against in health care settings, and are at increased risk of getting the COVID-19 virus, and being denied healthcare (Click here for SUFU’s letter to Governor Mills).
The next meeting will be on Monday, May 11, 2020, 12-2pm, via Zoom.
Featured Speakers and Topic TBD.
Unless changed, Coalition meetings are on the 2nd Monday of the month from 12-2pm.
The Maine Coalition for Housing and Quality Services provides equal opportunity for meeting participation. If you wish to attend but require an interpreter or other accommodation, please forward your request two weeks prior to the monthly meeting to [email protected].