December 9, 2019
Minutes
Minutes
Present: Laura Cordes, Jennifer Putnam, Foxfire Buck, Lisa Wesel, Brenda Smith, Betsy Mahoney, Mary Chris Semrow, David Cowing, Mark Kemmerle, Debbie Dionne, Kim Humphrey, Jamie Whitehouse, Jenn Brooking, Barry Schklair, Diane Boas, Rachel Dyer, Margaret Cardoza, Tammy Pike, Kimberly Rose, Alexandria Twombly, Luc Nya, Ashleigh Barker, Ann-Marie Mayberry, Julie Brennan, Sally Mileson, Glenda Wilson, Rob, Longacre, Esmeralda Grunglasse, Brad Antenore, Erin Vogel, Beth MyLroie, Paul Saucier, Betsy Hopkins, Cullen Ryan, and Vickey Rand. Via Zoom – (Auburn): Ann Bentley and Darla Chafin. (Orono): Bonnie Robinson and Janet Hamel. (Brunswick): Ray Nagel and Teague Morris. (Winthrop): Cathy Dionne. (Belfast): Linda Lee. (Blue Hill) Julie Benson, Steve Johnson, and Gregory Bush. (Benton): Victoria Copp, Natalie Child, and Jillian. Misc. sites: Shelley Zielinkski, Helen Hemminger, Robin Levesque, Alli Vercoe, Maggie Hoffman, Kathy Adams, and Craig Patterson.
Cullen Ryan introduced himself and welcomed the group. Participants introduced themselves. Minutes from the last meeting were accepted.
Featured Speakers: Paul Saucier, Director, DHHS Office of Aging and Disability Services (OADS), and Betsy Hopkins, Associate Director of Developmental Disabilities and Brain Injury Services DHHS-OADS. www.maine.gov/dhhs/oads Topic: An open-ended discussion with OADS.
Cullen: Today we have Paul Saucier, Director of OADS, and Betsy Hopkins, Associate Director of Developmental Disabilities and Brain Injury Services, providing an update on all things OADS. Just a few weeks ago we had a series of questions, with some that Derek Fales was able to answer and some he could not. Thank you for your willingness and availability to be here today to answer those remaining questions, and present more on what’s going on at OADS!
Paul Saucier: We’re very glad to be here. Betsy is two months into the job of Associate Director; we are very glad to have her with us. We do want to get to the questions you asked last time, but we wanted to begin with a few slides that include the direction in which we want to go at OADS. We’ve had a lot of listening sessions and have received a lot of feedback. We totally understand why most of the interest right now is on the waitlist. The basic premise is if we don’t make some changes to the system we’ll always be wrestling with the waitlist. We need to figure out how we’re going to make progress and get services to the people who need them and how we’re going to change the system to make it more inclusive.
Begin Presentation (Click here for the presentation)
Paul: After the closure of Pineland, the group home model was believed to be what was needed. Each year we have approximately 400 new people coming into the system in need of services. As such, we need to expand what we’re doing, and ideally into some new and innovative models that are more responsive to people’s needs. We don’t want to expand out the group home model; we don’t want to eliminate it either, we want to keep it where it is because we need that capacity in the system, but also grow and expand other parts of the system. We’d like to see a more flexible array of services that can change over a person’s lifespan and be more responsive to people’s individual needs. We believe that can also be less expensive. If you look at the pie chart on the Residential Settings slide, you’ll see that group homes remain the most utilized type of residential setting – though it has decreased over the years. Our hope is that this slice of the pie chart continues to get smaller as other more flexible and innovative options are included. Maine’s fiscal effort is high relative to the rest of New England. Fiscal effort is defined as State spending for services per thousand dollars of personal income. We’re spending $9.36 for every thousand dollars of personal income. Our spending is on the high side, but our personal income is low. If we were to increase incomes or decrease costs that bar would go down. On the other hand, we spend relatively little on support for families in comparison to other states – we need to increase that bar. And by this we mean spending outside of the waiver. We have a very small program to support families not on the waiver for people who are either not interested in or not in need of waiver services, we can provide services to them, such as respite, etc., and this is underutilized.
Looking at the Section 21 and Section 29 data, it includes how many people are served on each waiver, and how many people are on the waitlist. The percent with other services figure – when we looked at the data for the Section 21 waitlist, we found that 68% of people are receiving some other service. This includes a variety of different services, which is included in the quarterly update. For example some people are getting services through the elderly and adult disability waiver (Section 19), a number are receiving children’s services, and 978 people on the Section 21 waitlist are receiving Section 29. There’s been a reaction about presenting these numbers. The raw numbers at the top, 3,186 people served and 1,639 people waiting for Section 21 – it’s not an accurate statement to say that those 1,639 people are getting nothing. Are they getting services at the level they need? Probably not, but in the interest of having an honest conversation about this, a large number of people are getting something.
-It was asked how current the data is.
Paul: This data is as of 10/1/2019. I’m going to have Betsy talk about the reforms to the system we’re hoping to make to ensure people get what they need.
Betsy Hopkins: It’s a pleasure to be here. As Paul mentioned this is what we’re putting forward as our direction, on which we’re asking feedback. Our overarching goal as we consider reforming the system is for us to enhance and expand flexible and responsive supports, while balancing group home models as well as other models. Hopefully this will result in an equitable, flexible system that will serve people well. We have heard a lot that we ought to turn our work around, including providing some direct support to families, including respite options. That’s something that has faded over the past several years, and something into which we’re looking.
We’re in the process of overhauling our behavioral and crisis support system. That system needed overhauling in many ways, and one way in which we’ve enhanced this is by adding the eight additional positions to the crisis intake system, created through legislation. This will allow us to be able to be more responsive to the needs in the community, but more importantly be more proactive about how we’re doing crisis work – rather than responding to crises looking at moving towards preventing them in the first place.
We’re also looking at services through the START model, used in other states and developed at the University of New Hampshire Institute on Disability. We’ve signed a contract to work with them to get our crisis team aligned with the START philosophy and service delivery model, including training for crisis workers, with a train the trainer model incorporated as well. We’re looking forward to that.
We talked a little bit in the DD CoC meeting prior to this about how people don’t know how to find information – we want to make information and resources more accessible and easier to find. When we look at our waivers, we want to encourage inclusion-enhancing technology, which also assists families and might be able to help individuals stay at home with some different kinds of supports.
We’ve also looked at the Charting the LifeCourse framework, done at the University of Missouri, as a way to contemplate service needs throughout the entire lifespan (Click here for the Charting the LifeCourse Experiences and Questions Booklet). This was created by families in ensure people had the type and level of services needed to lead a fulfilling life. We’re including some of this framework in our Person-Centered Planning process, as it speaks to where we want to go, especially about needing to enhance our services for transition-age youth.
A lifespan waiver is something we’re considering. We have a siloed system currently and we’re talking with other states about a lifespan waiver. We’re early in the process about what it would look like if we combined the waivers into a lifespan waiver. However, it might be more flexible for people and their families. We’re talking with Maryland which has shown a lot of progress with its lifespan waiver.
Discussion:
-It was asked if Betsy was referring to children’s and adult services or just adult services with a lifespan waiver.
Betsy: We’re talking about what that transition would look like with OCFS, but for our purposes we’re just talking about the adult waivers.
Paul: As far as next steps, we continue to serve Priority 1 applicants under Section 21, and we do that by reserving attrition for Priority 1. We’re also able to reach some Priority 2 people. On Friday we had made about 90 of the 167 offers that the Legislature funded, and we plan to make the rest by the end of this month. As new resources become available our priority would be to fund additional opportunities in Section 29. If it’s a matter of choosing, the reality is we can serve many more people through Section 29 than we can on Section 21 for the same amount of money. These are ideas, some of which we’ve started to implement, some of which are multi-year goals. We’re definitely looking at how to prioritize these ideas over time. I love the Coalition because it’s broad-based, and every type of stakeholder is represented; however, it’s too big a group to work on a rule change for instance. We’re looking for something that’s as broad-based as the Coalition, but smaller so we can do some work sessions. We’ll continue to engage with all of the groups we do, as it’s been very helpful.
-A self-advocate stated that Paul spoke about a lot of ideas from other states, but that Maine might offer great ideas as well.
Paul: I agree, and we’re open to ideas from anywhere. If there are good things going on in Maine, we would love to hear them. The reality is that the last Administration pulled back and didn’t interact with Maine or other states and a lot has been going on in the meantime. I would love to do an innovation conference where we all attend, and we invite people from other states and come up with new ideas together.
-It was asked if the Department has looked at the self-directed service model. There was also a question about the conflict-free assessment.
Paul: We’re very interested in adding a self-directed model. For some people it will be the most flexible, adaptable model. The DD Council has pulled a group together to look at that concept; we’re watching that work and anxious for the results. We see it as an option that would be added inside of both waivers. You’d have the option of traditional or self-directed services, it would be a choice the individual would make. It’s more work for the individual, but they’ll be able to do it their way. We do feel strongly we have to implement a conflict-free assessment process so that we have consistent information on which we all can rely. I understand how controversial the SIS (Supports Intensity Scale) was. This is not a budget initiative, it’s about getting objective information from which we can plan. People want to do tiered shared living; right now, there’s a flat rate for shared living and we’d like to have two or three levels of different intensities. However, in order to do this, we’d need some form of assessment. That’s just one example. The system doesn’t have the transparency and integrity it needs to have because we don’t have that objective assessment up front.
-It was asked if they’re looking into more flexibility with the shared living model, as currently shared living can only support one individual – there is no incentive for more than one person.
Paul: I think there are many reasons and situations where everyone would agree that having more than one person supported in a shared living environment would be appropriate – siblings, couples, friends, etc. We have the shared living rate study and we’re looking at what that incentive should be for that second person. Tiering would also be about the needs of the individual – for instance Tier 1 could be someone who doesn’t have extraordinary needs, whereas Tiers 2 and 3 could have increasingly more significant behavioral challenges. We don’t think of those people going into shared living these days, but it could be an option if the necessary level of support was provided.
-It was stated that looking at other, more innovative and flexible residential options is advantageous; however, one barrier is the cost of rental housing in Maine. It was stated that no matter what system you create, people will still need to find a place to live, and with people with ID/DD, likely living on SSDI, and perhaps some employment income, it is nearly impossible to find an apartment in the current rental market.
Paul: For some of the residential models, the staffing costs are more than the cost of the physical home. We know there are parts of the state where people are getting priced out. Where people live will continue to be a challenge.
-It was stated that currently Section 21 and Section 29 don’t include specialized or individualized supports for people with more complex needs. It was asked if they are looking at higher rates for people with more complex needs, as this could be another way in which crises are prevented.
Paul: We’re looking at that as its own issue based on legislation that passed last session. We’re going to report back to the Legislature in January. We agree; if the providers had reasonable incentives to manage those significant behaviors, they wouldn’t have to make referrals to crisis or send people to the ER. All we can do today is authorize more hours, but it’s just more hours of the same services. We’re talking about a different level of reimbursement for someone who has specialized skills.
-It was asked if they’re considering expanding the number of hours available for Section 29, so that people could do shared living and community-based services.
Paul: This isn’t on our short list but is one of the things we’re looking at for the next biennium. Eventually the idea would be to bring Section 21 and Section 29 together into one waiver. We need that assessment to understand the category of need someone has. With a lifespan waiver you could fall between the level of services offered in Section 21 and Section 29 and still get what you need. If we can’t get to a lifespan waiver in the next biennium, we’d love to see an expansion of Section 29, as there should be an option where you do shared living and some other type of services.
Betsy: We are looking at all of this. Right now, we’re paying less for employment services then we are for day programming, and we’d like to encourage more people to think about entering employment. We would like to get back to the tenets of the Employment First law and really think about employment, especially as youth are transitioning to adult services.
Paul: I want to ensure we don’t run out of time before answering the questions that this group had at last month’s meeting (the questions from last month’s meeting are bulleted and in italics, with Paul’s response identified in bold below):
Mark Kemmerle – Maine Developmental Services Oversight and Advisory Board (MDSOAB): I would like to agree on a set of measurements that will help us see if we’re doing better each quarter. Figure out what you trust in terms of dates (date approved for eligibility, etc.), and establish something we can track monthly or bi-monthly, so we’ll know if we’re reducing the time families are without services.
Paul: I agree, we’re trying to get better data. It is a complicated calculation, and when we settle on a date that’s fair and reliable it makes sense for the MDSOAB to review that data.
-It was stated that the SIS was one single assessment to determine a person’s level of support. It was stated that if the Department is looking at a single assessment to be the single determinant of care, it ought to look at Minnesota which implemented this and has experienced great problems. The result of the assessment depends on a number of variables, including who completes the assessment, training, etc. This would be like saying someone is going to get into college based entirely on their SAT score, regardless of their grades, transcript, extracurricular activities, etc.
Paul: One advantage we have in Maine is not having a county-based system, from which mid-west states suffer. I agree it shouldn’t be this is it, all or nothing. I would envision there being re-assessments around significant changes, and we’re open to thinking about what would supplement the assessment. However, I don’t want to get back to what supplements the assessment being five of six subjective assessments/opinions.
-A parent stated that her daughter is living in a very supportive environment, supported by others not her family. When she was preparing to answer the SIS questions, she was unsure how to answer whether her daughter was supported or not.
Paul: We would modify any of the standard tools out there for Maine, and we would want any tool we select to be thoroughly tested. When we go down this road again don’t be surprised if you’re asked this question again, but we’d want to ensure the tool is tested thoroughly before it affects people’s services.
-It was stated it’s exciting they’re looking at a variety of models. A parent stated that though 68% of people on the Section 21 waitlist are receiving services through other means, 32% are receiving no services at all, including her daughter. It was stated that when you have limited funds, which is the case, the way to get more people services would be to divide those funds up. She wondered where helping people who want to leave their family home and move elsewhere fits into the Department’s planning. This is not easy to accomplish with Section 29.
Paul: That is a very fair question and it relates to the other question about increasing the Section 29 cap. Yes, it won’t happen in the short-run, but in the next biennium we’d look at increasing the cap so you can fit more services in Section 29. What are some models that aren’t groups homes? Some variations of shared living, but there must be other models as well. However, there’s no escaping the fact that residential services cost money. Betsy and her team will be considering a whole host of things over the next couple of years and we want to get all of the ideas in the mix. I called it an innovation conference, maybe it could be a series of meetings, but it would be great to have some focused discussions on the topic of innovation.
-A parent stated that she supports improvements to the current system, but there are still people not getting services.
Paul: You have encapsulated the entire dilemma. Somehow, we have to find a balance to get services to people who need them, while we also improve the system.
-It was asked if there’s any data left from the previous SIS assessments.
Paul: We do have all of the files from the SIS roll out and we’ll be looking at those as well. Thank you all for having us; we appreciate your time and we’re happy to come back!
Cullen: Paul and Betsy, thank you both for being here today, presenting, answering all of the group’s questions, and being at the table asking for our assistance and feedback as you look to make changes to the system. This is exactly the type of inclusivity and openness this group has longed for and it’s a breath of fresh air to engage in this dialogue with the Department with regularity.
End Presentation (round of applause)
DHHS – Office of Child and Family Services (OCFS) - www.maine.gov/dhhs/ocfs
Luc Nya: There has been a lot of discussion regarding transition – that’s a big focus of OCFS and the Children’s Cabinet. As Paul mentioned in his update, there are a lot of folks between 18 and 21 receiving children’s services. OCFS is also doing a lot of work around limiting the number of children going out of state, based on LD 984 which passed the Legislature.
Cullen: The Blueprint for Effective Transition is getting revisited, and with OADS and OCFS working together closely, we look forward to working with them both on that. When the Blueprint for Effective Transition was originally created a lot of thought went into not only the transition into adult services, but all of the transitions that occur throughout a person’s life.
SMACT (Southern Maine Advisory Council on Transition) Update:
Beth MyLroie: SMACT has been going on since 2000, and it functions more as a venue for information sharing for case managers and parents who don’t know about transition planning. Transition into VR (Voc Rehab) and into adult services and looking at having job experiences or internships have become bigger topics of interest, to better prepare 8th grade and high school age students to be able to operate more independently in work settings, as it’s difficult to find staff to support them. The most recent SMACT meeting was on Friday, 12/6, and featured Sandra Lynham, Director of Counseling and Disability Services, Southern Maine Community College discussing transition and the skills necessary to for a college setting.
Kathy Adams: Coming up on Friday, 1/3, we’ll have Libby Newport from Social Security presenting an update on Social Security programs and benefits as they relate to transition.
Cullen: It’s great to see a lot of energy and work around transition happening across the state!
Developmental Services Stakeholders Continuum of Care
Cullen: The Developmental Services Stakeholders Continuum of Care group has been working on a more user-friendly diagram for the Developmental Services Lifelong CoC (DD CoC), which almost finalized and is designed to be a simple overview and an effective tool for the Legislature. The layout is much more linear and illustrates the entire lifespan, and the Principles for Developing a Continuum of Supports is designed to accompany the diagram.
-It was stated that the PCP obscures that fact that there are so few programs in some areas of the state. If there is not capacity, then people sit at home.
Cullen: Those are excellent points. It’s on us to ensure a system with person-centered planning, but to also flesh out everything people need in the community so we can have a roadmap to illustrate what we have and what is missing.
Disability Rights Maine (DRM) Update:
Foxfire Buck: We continue to serve on many stakeholder groups, including the stakeholder groups for HCBS (Home and Community-Based Services), transportation, and self-directed services. DRM is still offering trainings around the state on people’s rights and Supported Decision-Making. The bulk of our work continues to be around individual advocacy, so please feel free to direct people to us if they have questions about their rights.
Federal & Housing Updates:
Cullen: On 11/21 President signed another short-term CR to fund the government through 12/20. If Congress doesn’t pass budget bills for the offices and agencies not yet funded for FY 20 before the CR runs out, or pass another CR, there could be a partial government shutdown. The House and Senate T-HUD budgets look very favorable and aren’t far off, but it remains to be seen if there is appetite in Congress to pass a mini Omnibus budget bill. There are a few bills that affect the Low-Income Housing Tax Credit (LIHTC) program – one bill on the federal level will increase the supply of affordable housing dramatically. There’s a state bill, considered last year and will be reconsidered early in the upcoming legislative session, that adds a state LIHTC to be combined with the federal LIHTC. This year there were 16 projects that applied for the LIHTC program in Maine; it’s a very competitive process, and only five were funded in this past round. That’s it for affordable housing development for an entire year. If the LIHTC were to be doubled that would increase affordable housing development dramatically in Maine. Also, the Section 811 Mainstream voucher program now operates as a Section 8 voucher program for people who are non-elderly with a disability. There are roughly sixty HUD 811 Section 8 vouchers in the state, 35 of which were awarded to Westbrook Housing Authority.
-It was stated that Westbrook, Portland, and South Portland have a combined Section 8 waitlist.
Cullen: That effort actually has grown into Maine having a statewide centralized waiting list.
-It was stated that when Maine went to a statewide centralized waiting list, it had to merge duplicate applications and “purge” the list, which entailed sending letters to everyone on the waitlist asking if they’re still interested in remaining on the list. If you know of someone who had been on the waitlist, it would be advantageous to follow up and ensure they’re still on it.
Cullen: Section 8 makes housing affordable because you pay 30% of your income towards the rent and the voucher pays the difference. This helps to level the playing field for people who don’t have the resources to afford housing.
Teague Morris, Senator King’s Office, provided an update after the meeting for inclusion in the minutes: I wanted to share two press releases from Senator King’s office. The press release from 12/4 details Senator King joining 45 of his colleagues on a letter to U.S. Department of Housing and Urban Development (HUD) Secretary Ben Carson, urging him to reject a proposed rule that would make it more difficult for victims of discrimination to seek justice under the Fair Housing Act (FHA). The press release from 12/9 details Senators Collins and King joining a bipartisan group of Senate colleagues in sending a letter to the U.S. Department of Education urging the Department’s Acting Inspector General, Sandra Bruce, to investigate the federal student loan discharge process for Americans with total and permanent disabilities (TPD). Additionally, there is an upcoming webinar which might of interest to this group:
State Legislature Update:
Gregory Bush: LD 852 is a carry-over bill from the last legislative Session, which will be considered when the Legislature resumes. This bill would establish a Task Force for post-secondary young adults with intellectual disabilities, examining programs and needs throughout the state. It was sponsored by Representative Pebworth and Senator Luchini and was passed overwhelmingly in both houses of the Legislature last spring. However, it was lost in the shuffle in the final night of the session. We are hoping that other interested folks and legislators can weigh in with their support. (Click here for more information on LD 852. Click here for a draft letter of support template for legislators for LD 852.)
Linda Lee: One of the things the task force will be looking at is data regarding kids transitioning into and through adulthood – it’s much more than a task force.
Laura Cordes – Maine Association for Community Service Providers (MACSP): I am the new Executive Director for MACSP. I moved here from Connecticut and started about a month ago. Thank you to many of you in this room who helped get me up to speed, though I still have much to learn! In terms of a quick update – most of you are likely familiar with there being additional funding in the State budget; however, what the Governor includes in a supplemental budget remains to be seem.
Jennifer Putnam: There are a couple bills that this group has been following which were carried over:
Two pieces of legislation that moved forward through the Legislative Council, were approved to be submitted as emergency bills in this Legislative Session, and will be assigned LD numbers:
-It was stated that the Long-Term Care Workforce Commission is having its last meeting tomorrow. There are some more immediate recommendations they’re looking at tomorrow, and a full report will be forthcoming sometime this month. It was stated that they appear to be listening fairly well, and that it will be interesting where things fall after the discussion tomorrow.
Announcements/Handouts:
Kim Humphrey – Community Connect: Community Connect Maine is initiating the second year of the Collaborative Postcard Project, sponsored by Maine Developmental Disabilities Council. The goal of the project is to encourage constituents to feel comfortable contacting legislators about issues that they care about. Several organizations are participating by encouraging their members to reach out. Learn who your legislators are and let them learn about you. Then after you have reached out to your legislators, we would love to have your feedback on the experience. (Click here to share your feedback). It’s very easy to find your legislators based on your address on the Community Connect website.
Cullen: Consistently this Coalition has had action alerts throughout the Legislative Session. Peter Stuckey has provided a lot of tips about the Legislature over the years. If a Legislator hears from three of their constituents on a single issue it leaps off the page as being important – and these individualized notes will have an even larger effect. Thank you, Kim, and well done!
-It was stated that some of the language used and treatment of people at one of the transportation forums was less than professional. It was also stated that it appears the Department has re-entered into the transportation broker contract with LogistiCare.
The next meeting will be on Monday, January 13, 2020, 12-2pm, Burton Fisher Community Meeting Room, located on the First Floor of One City Center (food court area, next to City Deli), Portland.
Featured Speaker: Kim Humphrey, Community Connect. Topic: Planning for the Legislative Session and ways in which you can contact your Legislators.
Unless changed, Coalition meetings are on the 2nd Monday of the month from 12-2pm.
Burton Fisher Community Meeting Room, 1st Floor of One City Center in Portland (off of the food court).
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 introduced themselves. Minutes from the last meeting were accepted.
Featured Speakers: Paul Saucier, Director, DHHS Office of Aging and Disability Services (OADS), and Betsy Hopkins, Associate Director of Developmental Disabilities and Brain Injury Services DHHS-OADS. www.maine.gov/dhhs/oads Topic: An open-ended discussion with OADS.
Cullen: Today we have Paul Saucier, Director of OADS, and Betsy Hopkins, Associate Director of Developmental Disabilities and Brain Injury Services, providing an update on all things OADS. Just a few weeks ago we had a series of questions, with some that Derek Fales was able to answer and some he could not. Thank you for your willingness and availability to be here today to answer those remaining questions, and present more on what’s going on at OADS!
Paul Saucier: We’re very glad to be here. Betsy is two months into the job of Associate Director; we are very glad to have her with us. We do want to get to the questions you asked last time, but we wanted to begin with a few slides that include the direction in which we want to go at OADS. We’ve had a lot of listening sessions and have received a lot of feedback. We totally understand why most of the interest right now is on the waitlist. The basic premise is if we don’t make some changes to the system we’ll always be wrestling with the waitlist. We need to figure out how we’re going to make progress and get services to the people who need them and how we’re going to change the system to make it more inclusive.
Begin Presentation (Click here for the presentation)
Paul: After the closure of Pineland, the group home model was believed to be what was needed. Each year we have approximately 400 new people coming into the system in need of services. As such, we need to expand what we’re doing, and ideally into some new and innovative models that are more responsive to people’s needs. We don’t want to expand out the group home model; we don’t want to eliminate it either, we want to keep it where it is because we need that capacity in the system, but also grow and expand other parts of the system. We’d like to see a more flexible array of services that can change over a person’s lifespan and be more responsive to people’s individual needs. We believe that can also be less expensive. If you look at the pie chart on the Residential Settings slide, you’ll see that group homes remain the most utilized type of residential setting – though it has decreased over the years. Our hope is that this slice of the pie chart continues to get smaller as other more flexible and innovative options are included. Maine’s fiscal effort is high relative to the rest of New England. Fiscal effort is defined as State spending for services per thousand dollars of personal income. We’re spending $9.36 for every thousand dollars of personal income. Our spending is on the high side, but our personal income is low. If we were to increase incomes or decrease costs that bar would go down. On the other hand, we spend relatively little on support for families in comparison to other states – we need to increase that bar. And by this we mean spending outside of the waiver. We have a very small program to support families not on the waiver for people who are either not interested in or not in need of waiver services, we can provide services to them, such as respite, etc., and this is underutilized.
Looking at the Section 21 and Section 29 data, it includes how many people are served on each waiver, and how many people are on the waitlist. The percent with other services figure – when we looked at the data for the Section 21 waitlist, we found that 68% of people are receiving some other service. This includes a variety of different services, which is included in the quarterly update. For example some people are getting services through the elderly and adult disability waiver (Section 19), a number are receiving children’s services, and 978 people on the Section 21 waitlist are receiving Section 29. There’s been a reaction about presenting these numbers. The raw numbers at the top, 3,186 people served and 1,639 people waiting for Section 21 – it’s not an accurate statement to say that those 1,639 people are getting nothing. Are they getting services at the level they need? Probably not, but in the interest of having an honest conversation about this, a large number of people are getting something.
-It was asked how current the data is.
Paul: This data is as of 10/1/2019. I’m going to have Betsy talk about the reforms to the system we’re hoping to make to ensure people get what they need.
Betsy Hopkins: It’s a pleasure to be here. As Paul mentioned this is what we’re putting forward as our direction, on which we’re asking feedback. Our overarching goal as we consider reforming the system is for us to enhance and expand flexible and responsive supports, while balancing group home models as well as other models. Hopefully this will result in an equitable, flexible system that will serve people well. We have heard a lot that we ought to turn our work around, including providing some direct support to families, including respite options. That’s something that has faded over the past several years, and something into which we’re looking.
We’re in the process of overhauling our behavioral and crisis support system. That system needed overhauling in many ways, and one way in which we’ve enhanced this is by adding the eight additional positions to the crisis intake system, created through legislation. This will allow us to be able to be more responsive to the needs in the community, but more importantly be more proactive about how we’re doing crisis work – rather than responding to crises looking at moving towards preventing them in the first place.
We’re also looking at services through the START model, used in other states and developed at the University of New Hampshire Institute on Disability. We’ve signed a contract to work with them to get our crisis team aligned with the START philosophy and service delivery model, including training for crisis workers, with a train the trainer model incorporated as well. We’re looking forward to that.
We talked a little bit in the DD CoC meeting prior to this about how people don’t know how to find information – we want to make information and resources more accessible and easier to find. When we look at our waivers, we want to encourage inclusion-enhancing technology, which also assists families and might be able to help individuals stay at home with some different kinds of supports.
We’ve also looked at the Charting the LifeCourse framework, done at the University of Missouri, as a way to contemplate service needs throughout the entire lifespan (Click here for the Charting the LifeCourse Experiences and Questions Booklet). This was created by families in ensure people had the type and level of services needed to lead a fulfilling life. We’re including some of this framework in our Person-Centered Planning process, as it speaks to where we want to go, especially about needing to enhance our services for transition-age youth.
A lifespan waiver is something we’re considering. We have a siloed system currently and we’re talking with other states about a lifespan waiver. We’re early in the process about what it would look like if we combined the waivers into a lifespan waiver. However, it might be more flexible for people and their families. We’re talking with Maryland which has shown a lot of progress with its lifespan waiver.
Discussion:
-It was asked if Betsy was referring to children’s and adult services or just adult services with a lifespan waiver.
Betsy: We’re talking about what that transition would look like with OCFS, but for our purposes we’re just talking about the adult waivers.
Paul: As far as next steps, we continue to serve Priority 1 applicants under Section 21, and we do that by reserving attrition for Priority 1. We’re also able to reach some Priority 2 people. On Friday we had made about 90 of the 167 offers that the Legislature funded, and we plan to make the rest by the end of this month. As new resources become available our priority would be to fund additional opportunities in Section 29. If it’s a matter of choosing, the reality is we can serve many more people through Section 29 than we can on Section 21 for the same amount of money. These are ideas, some of which we’ve started to implement, some of which are multi-year goals. We’re definitely looking at how to prioritize these ideas over time. I love the Coalition because it’s broad-based, and every type of stakeholder is represented; however, it’s too big a group to work on a rule change for instance. We’re looking for something that’s as broad-based as the Coalition, but smaller so we can do some work sessions. We’ll continue to engage with all of the groups we do, as it’s been very helpful.
-A self-advocate stated that Paul spoke about a lot of ideas from other states, but that Maine might offer great ideas as well.
Paul: I agree, and we’re open to ideas from anywhere. If there are good things going on in Maine, we would love to hear them. The reality is that the last Administration pulled back and didn’t interact with Maine or other states and a lot has been going on in the meantime. I would love to do an innovation conference where we all attend, and we invite people from other states and come up with new ideas together.
-It was asked if the Department has looked at the self-directed service model. There was also a question about the conflict-free assessment.
Paul: We’re very interested in adding a self-directed model. For some people it will be the most flexible, adaptable model. The DD Council has pulled a group together to look at that concept; we’re watching that work and anxious for the results. We see it as an option that would be added inside of both waivers. You’d have the option of traditional or self-directed services, it would be a choice the individual would make. It’s more work for the individual, but they’ll be able to do it their way. We do feel strongly we have to implement a conflict-free assessment process so that we have consistent information on which we all can rely. I understand how controversial the SIS (Supports Intensity Scale) was. This is not a budget initiative, it’s about getting objective information from which we can plan. People want to do tiered shared living; right now, there’s a flat rate for shared living and we’d like to have two or three levels of different intensities. However, in order to do this, we’d need some form of assessment. That’s just one example. The system doesn’t have the transparency and integrity it needs to have because we don’t have that objective assessment up front.
-It was asked if they’re looking into more flexibility with the shared living model, as currently shared living can only support one individual – there is no incentive for more than one person.
Paul: I think there are many reasons and situations where everyone would agree that having more than one person supported in a shared living environment would be appropriate – siblings, couples, friends, etc. We have the shared living rate study and we’re looking at what that incentive should be for that second person. Tiering would also be about the needs of the individual – for instance Tier 1 could be someone who doesn’t have extraordinary needs, whereas Tiers 2 and 3 could have increasingly more significant behavioral challenges. We don’t think of those people going into shared living these days, but it could be an option if the necessary level of support was provided.
-It was stated that looking at other, more innovative and flexible residential options is advantageous; however, one barrier is the cost of rental housing in Maine. It was stated that no matter what system you create, people will still need to find a place to live, and with people with ID/DD, likely living on SSDI, and perhaps some employment income, it is nearly impossible to find an apartment in the current rental market.
Paul: For some of the residential models, the staffing costs are more than the cost of the physical home. We know there are parts of the state where people are getting priced out. Where people live will continue to be a challenge.
-It was stated that currently Section 21 and Section 29 don’t include specialized or individualized supports for people with more complex needs. It was asked if they are looking at higher rates for people with more complex needs, as this could be another way in which crises are prevented.
Paul: We’re looking at that as its own issue based on legislation that passed last session. We’re going to report back to the Legislature in January. We agree; if the providers had reasonable incentives to manage those significant behaviors, they wouldn’t have to make referrals to crisis or send people to the ER. All we can do today is authorize more hours, but it’s just more hours of the same services. We’re talking about a different level of reimbursement for someone who has specialized skills.
-It was asked if they’re considering expanding the number of hours available for Section 29, so that people could do shared living and community-based services.
Paul: This isn’t on our short list but is one of the things we’re looking at for the next biennium. Eventually the idea would be to bring Section 21 and Section 29 together into one waiver. We need that assessment to understand the category of need someone has. With a lifespan waiver you could fall between the level of services offered in Section 21 and Section 29 and still get what you need. If we can’t get to a lifespan waiver in the next biennium, we’d love to see an expansion of Section 29, as there should be an option where you do shared living and some other type of services.
Betsy: We are looking at all of this. Right now, we’re paying less for employment services then we are for day programming, and we’d like to encourage more people to think about entering employment. We would like to get back to the tenets of the Employment First law and really think about employment, especially as youth are transitioning to adult services.
Paul: I want to ensure we don’t run out of time before answering the questions that this group had at last month’s meeting (the questions from last month’s meeting are bulleted and in italics, with Paul’s response identified in bold below):
- How long are people waiting for Section 29, from when the application is complete to when an offer is made?
- Paul: We can’t literally answer that question because we start measuring from when a person is found eligible. It’s one of the many data issues we have with this. We feel quite certain that, though the terminology was different, and the word waitlist wasn’t used in the previous Administration, a waitlist started developing a little more than a year ago. We assume there are people who have been waiting a year or more. We receive approximately 30 applications for Section 29 each month. So, it’s reasonable to assume people have been waiting more than a year, with one caveat – we’ve looked at the turnover data and we’ve had about an 11% turnover for Section 29 between October 2018 and October 2019, and we did back fill those slots. Though there has been a waitlist, the people at the very front have been served as we’ve replaced those slots.
- What dollar amount would eliminate the waitlist(s)?
- Paul: We’re not prepared to answer that today, though it is a number on which we’re working. This is not something that anyone should quote, but even looking at a gross estimate the State’s share would be extremely high, an estimate that is extremely unlikely to be achieved which is why we need to reform the system.
- -It was asked if the funding for Section 29 is still roughly $50,000-$55,000 per person.
- Paul: The average is a little lower than that, it depends on if shared living is being used.
- It was stated that the Commissioner mentioned the Section 21 waitlist, including the number of people served versus the numbers on the waitlist in her report to the HHS Committee. She also mentioned that people on the waitlists sometimes receive other services while waiting, including children’s services. What did the Commissioner mean with this statement? Also, a Legislator asked the Commissioner, during her presentation to the Committee, what effect, if any, the increase in minimum wage effective in January would have on providers’ ability to recruit and hire staff, to which the Commissioner responded that some agencies have the resources but can’t find trained people to hire. Could more information on this be provided by the Department?
- Paul: I think she was commenting on the general workforce shortage, acknowledging that even if we fully funded the Section 21 waitlist, providers wouldn’t be able to absorb that type of growth; it would have to ramp up over time. And, regarding people waiting for Section 21 and Section 29 receiving children’s services in Maine, people between 18 and 20 years of age can access children’s or adult services – there are 132 people on the waitlist receiving children’s services.
- Could the Department provide an update on the RCSS (Residential and Community Support Services) residential homes closing?
- Paul: Activities to place RCSS residents with other agencies were temporarily suspended on Friday. More information will be provided this week. As always, any resident who wishes to move may do so, and as of Friday RCSS had 12 residents.
- Could the Department comment further on Director Saucier’s Op Ed on public guardianship?
- Paul: Many of you saw the Op-Ed written by Gerald Petuccelli and Bruce McGlauflin which argued that there were inherent conflicts of interest with Maine’s Public Guardian Representatives. My Letter to the Editor was designed to let people know about changes to how we do our district staff assignments. Public Guardian Representatives make their recommendations based on the needs they see. In our new assignment system, our district staff will have one singular function – if you’re a Public Guardian Representative in the South Portland district office, that is all you’ll do, you won’t do any other case work. Likewise, if you’re an APS (Adult Protective Services) Investigator. Betsy is co-chairing a committee with Erin Salvo, Associate Director of APS, and the plan is to have the new assignments in place in mid-January. If you interact with district staff don’t be surprised if there are transitions once those assignments are finalized, and representative will communicate changes out to their clients.
Mark Kemmerle – Maine Developmental Services Oversight and Advisory Board (MDSOAB): I would like to agree on a set of measurements that will help us see if we’re doing better each quarter. Figure out what you trust in terms of dates (date approved for eligibility, etc.), and establish something we can track monthly or bi-monthly, so we’ll know if we’re reducing the time families are without services.
Paul: I agree, we’re trying to get better data. It is a complicated calculation, and when we settle on a date that’s fair and reliable it makes sense for the MDSOAB to review that data.
-It was stated that the SIS was one single assessment to determine a person’s level of support. It was stated that if the Department is looking at a single assessment to be the single determinant of care, it ought to look at Minnesota which implemented this and has experienced great problems. The result of the assessment depends on a number of variables, including who completes the assessment, training, etc. This would be like saying someone is going to get into college based entirely on their SAT score, regardless of their grades, transcript, extracurricular activities, etc.
Paul: One advantage we have in Maine is not having a county-based system, from which mid-west states suffer. I agree it shouldn’t be this is it, all or nothing. I would envision there being re-assessments around significant changes, and we’re open to thinking about what would supplement the assessment. However, I don’t want to get back to what supplements the assessment being five of six subjective assessments/opinions.
-A parent stated that her daughter is living in a very supportive environment, supported by others not her family. When she was preparing to answer the SIS questions, she was unsure how to answer whether her daughter was supported or not.
Paul: We would modify any of the standard tools out there for Maine, and we would want any tool we select to be thoroughly tested. When we go down this road again don’t be surprised if you’re asked this question again, but we’d want to ensure the tool is tested thoroughly before it affects people’s services.
-It was stated it’s exciting they’re looking at a variety of models. A parent stated that though 68% of people on the Section 21 waitlist are receiving services through other means, 32% are receiving no services at all, including her daughter. It was stated that when you have limited funds, which is the case, the way to get more people services would be to divide those funds up. She wondered where helping people who want to leave their family home and move elsewhere fits into the Department’s planning. This is not easy to accomplish with Section 29.
Paul: That is a very fair question and it relates to the other question about increasing the Section 29 cap. Yes, it won’t happen in the short-run, but in the next biennium we’d look at increasing the cap so you can fit more services in Section 29. What are some models that aren’t groups homes? Some variations of shared living, but there must be other models as well. However, there’s no escaping the fact that residential services cost money. Betsy and her team will be considering a whole host of things over the next couple of years and we want to get all of the ideas in the mix. I called it an innovation conference, maybe it could be a series of meetings, but it would be great to have some focused discussions on the topic of innovation.
-A parent stated that she supports improvements to the current system, but there are still people not getting services.
Paul: You have encapsulated the entire dilemma. Somehow, we have to find a balance to get services to people who need them, while we also improve the system.
-It was asked if there’s any data left from the previous SIS assessments.
Paul: We do have all of the files from the SIS roll out and we’ll be looking at those as well. Thank you all for having us; we appreciate your time and we’re happy to come back!
Cullen: Paul and Betsy, thank you both for being here today, presenting, answering all of the group’s questions, and being at the table asking for our assistance and feedback as you look to make changes to the system. This is exactly the type of inclusivity and openness this group has longed for and it’s a breath of fresh air to engage in this dialogue with the Department with regularity.
End Presentation (round of applause)
DHHS – Office of Child and Family Services (OCFS) - www.maine.gov/dhhs/ocfs
Luc Nya: There has been a lot of discussion regarding transition – that’s a big focus of OCFS and the Children’s Cabinet. As Paul mentioned in his update, there are a lot of folks between 18 and 21 receiving children’s services. OCFS is also doing a lot of work around limiting the number of children going out of state, based on LD 984 which passed the Legislature.
Cullen: The Blueprint for Effective Transition is getting revisited, and with OADS and OCFS working together closely, we look forward to working with them both on that. When the Blueprint for Effective Transition was originally created a lot of thought went into not only the transition into adult services, but all of the transitions that occur throughout a person’s life.
SMACT (Southern Maine Advisory Council on Transition) Update:
Beth MyLroie: SMACT has been going on since 2000, and it functions more as a venue for information sharing for case managers and parents who don’t know about transition planning. Transition into VR (Voc Rehab) and into adult services and looking at having job experiences or internships have become bigger topics of interest, to better prepare 8th grade and high school age students to be able to operate more independently in work settings, as it’s difficult to find staff to support them. The most recent SMACT meeting was on Friday, 12/6, and featured Sandra Lynham, Director of Counseling and Disability Services, Southern Maine Community College discussing transition and the skills necessary to for a college setting.
Kathy Adams: Coming up on Friday, 1/3, we’ll have Libby Newport from Social Security presenting an update on Social Security programs and benefits as they relate to transition.
Cullen: It’s great to see a lot of energy and work around transition happening across the state!
Developmental Services Stakeholders Continuum of Care
Cullen: The Developmental Services Stakeholders Continuum of Care group has been working on a more user-friendly diagram for the Developmental Services Lifelong CoC (DD CoC), which almost finalized and is designed to be a simple overview and an effective tool for the Legislature. The layout is much more linear and illustrates the entire lifespan, and the Principles for Developing a Continuum of Supports is designed to accompany the diagram.
-It was stated that the PCP obscures that fact that there are so few programs in some areas of the state. If there is not capacity, then people sit at home.
Cullen: Those are excellent points. It’s on us to ensure a system with person-centered planning, but to also flesh out everything people need in the community so we can have a roadmap to illustrate what we have and what is missing.
Disability Rights Maine (DRM) Update:
Foxfire Buck: We continue to serve on many stakeholder groups, including the stakeholder groups for HCBS (Home and Community-Based Services), transportation, and self-directed services. DRM is still offering trainings around the state on people’s rights and Supported Decision-Making. The bulk of our work continues to be around individual advocacy, so please feel free to direct people to us if they have questions about their rights.
Federal & Housing Updates:
Cullen: On 11/21 President signed another short-term CR to fund the government through 12/20. If Congress doesn’t pass budget bills for the offices and agencies not yet funded for FY 20 before the CR runs out, or pass another CR, there could be a partial government shutdown. The House and Senate T-HUD budgets look very favorable and aren’t far off, but it remains to be seen if there is appetite in Congress to pass a mini Omnibus budget bill. There are a few bills that affect the Low-Income Housing Tax Credit (LIHTC) program – one bill on the federal level will increase the supply of affordable housing dramatically. There’s a state bill, considered last year and will be reconsidered early in the upcoming legislative session, that adds a state LIHTC to be combined with the federal LIHTC. This year there were 16 projects that applied for the LIHTC program in Maine; it’s a very competitive process, and only five were funded in this past round. That’s it for affordable housing development for an entire year. If the LIHTC were to be doubled that would increase affordable housing development dramatically in Maine. Also, the Section 811 Mainstream voucher program now operates as a Section 8 voucher program for people who are non-elderly with a disability. There are roughly sixty HUD 811 Section 8 vouchers in the state, 35 of which were awarded to Westbrook Housing Authority.
-It was stated that Westbrook, Portland, and South Portland have a combined Section 8 waitlist.
Cullen: That effort actually has grown into Maine having a statewide centralized waiting list.
-It was stated that when Maine went to a statewide centralized waiting list, it had to merge duplicate applications and “purge” the list, which entailed sending letters to everyone on the waitlist asking if they’re still interested in remaining on the list. If you know of someone who had been on the waitlist, it would be advantageous to follow up and ensure they’re still on it.
Cullen: Section 8 makes housing affordable because you pay 30% of your income towards the rent and the voucher pays the difference. This helps to level the playing field for people who don’t have the resources to afford housing.
Teague Morris, Senator King’s Office, provided an update after the meeting for inclusion in the minutes: I wanted to share two press releases from Senator King’s office. The press release from 12/4 details Senator King joining 45 of his colleagues on a letter to U.S. Department of Housing and Urban Development (HUD) Secretary Ben Carson, urging him to reject a proposed rule that would make it more difficult for victims of discrimination to seek justice under the Fair Housing Act (FHA). The press release from 12/9 details Senators Collins and King joining a bipartisan group of Senate colleagues in sending a letter to the U.S. Department of Education urging the Department’s Acting Inspector General, Sandra Bruce, to investigate the federal student loan discharge process for Americans with total and permanent disabilities (TPD). Additionally, there is an upcoming webinar which might of interest to this group:
- Resources for Integrated Care (RIC) Webinar: Supporting Individuals with Intellectual and Developmental Disabilities as They Age, Wednesday, December 18, 2019, 12:30 PM - 1:45 PM ET. (Click here to register.) Information on the webinar: The number of U.S. adults with intellectual and developmental disabilities (I/DD) over the age of 60 is steadily increasing. By 2030, the number of adults with I/DD aged 60 and older is projected to reach 1.2 million people. The physical, cognitive, functional, and behavioral changes associated with aging typically present earlier and in different ways for individuals living with I/DD. There are emerging opportunities for health plans and providers to support aging individuals living with I/DD and their families and caregivers through integrated care that addresses the needs of the whole person across the life span.
State Legislature Update:
Gregory Bush: LD 852 is a carry-over bill from the last legislative Session, which will be considered when the Legislature resumes. This bill would establish a Task Force for post-secondary young adults with intellectual disabilities, examining programs and needs throughout the state. It was sponsored by Representative Pebworth and Senator Luchini and was passed overwhelmingly in both houses of the Legislature last spring. However, it was lost in the shuffle in the final night of the session. We are hoping that other interested folks and legislators can weigh in with their support. (Click here for more information on LD 852. Click here for a draft letter of support template for legislators for LD 852.)
Linda Lee: One of the things the task force will be looking at is data regarding kids transitioning into and through adulthood – it’s much more than a task force.
Laura Cordes – Maine Association for Community Service Providers (MACSP): I am the new Executive Director for MACSP. I moved here from Connecticut and started about a month ago. Thank you to many of you in this room who helped get me up to speed, though I still have much to learn! In terms of a quick update – most of you are likely familiar with there being additional funding in the State budget; however, what the Governor includes in a supplemental budget remains to be seem.
Jennifer Putnam: There are a couple bills that this group has been following which were carried over:
- LD 1178 would create a separate waiver for children with ID/DD, pulling those children currently in the behavioral health system into a new system of care which would provide for their specific needs. We’re trying to set up a meeting with the Office of MaineCare Services regarding this.
- LD 399, the bill which would set DSP rates at 125% of minimum wage. This bill passed the Legislature but is sitting on the Special Appropriations Table awaiting funding.
- LD 1377, An Act To Enhance and Improve the Maine Developmental Services Oversight and Advisory Board and To Establish the Aging and Disability Mortality Review Panel, is the MDSOAB bill looking at a mortality and independent review panel, examining at deaths and serious injuries of people with ID/DD and Autism. This bill, which had Department support, would provide a framework for an independent panel with a nurse housed in the Maine CDC to vet all of those reports and be a facilitator/chair of this panel. This is also is sitting on the Special Appropriations Table awaiting funding. This bill has a very small fiscal note, less than $100,000, and may be incorporated in a Supplemental Budget, but that remains to be seen.
Two pieces of legislation that moved forward through the Legislative Council, were approved to be submitted as emergency bills in this Legislative Session, and will be assigned LD numbers:
- LR 2894, An Act Regarding the Implementation of Federal Requirements for Electronic Visit Verification of Personal Care and Home Health Assistance. This would align providers with the State regarding expectations, and not to punish providers for not being ready to be up and running when the state isn’t either
- LR 2895, Resolve, Directing the Department of Health and Human Services To Increase MaineCare Reimbursement Rates for Targeted Case Management To Reflect Inflation. There hasn’t been a rate increase in Targeted Case Management (TCM) for more than a decade. TCM services were left out of the Section 21 and Section 29 rate increases that were passed in the Legislature a couple years ago. The state is starting the new child protective case workers at $18 per hour and many community case managers are opting to apply for those positions instead due to the higher rate of pay. The increase to the TCM rate would help with this.
-It was stated that the Long-Term Care Workforce Commission is having its last meeting tomorrow. There are some more immediate recommendations they’re looking at tomorrow, and a full report will be forthcoming sometime this month. It was stated that they appear to be listening fairly well, and that it will be interesting where things fall after the discussion tomorrow.
Announcements/Handouts:
Kim Humphrey – Community Connect: Community Connect Maine is initiating the second year of the Collaborative Postcard Project, sponsored by Maine Developmental Disabilities Council. The goal of the project is to encourage constituents to feel comfortable contacting legislators about issues that they care about. Several organizations are participating by encouraging their members to reach out. Learn who your legislators are and let them learn about you. Then after you have reached out to your legislators, we would love to have your feedback on the experience. (Click here to share your feedback). It’s very easy to find your legislators based on your address on the Community Connect website.
Cullen: Consistently this Coalition has had action alerts throughout the Legislative Session. Peter Stuckey has provided a lot of tips about the Legislature over the years. If a Legislator hears from three of their constituents on a single issue it leaps off the page as being important – and these individualized notes will have an even larger effect. Thank you, Kim, and well done!
-It was stated that some of the language used and treatment of people at one of the transportation forums was less than professional. It was also stated that it appears the Department has re-entered into the transportation broker contract with LogistiCare.
The next meeting will be on Monday, January 13, 2020, 12-2pm, Burton Fisher Community Meeting Room, located on the First Floor of One City Center (food court area, next to City Deli), Portland.
Featured Speaker: Kim Humphrey, Community Connect. Topic: Planning for the Legislative Session and ways in which you can contact your Legislators.
Unless changed, Coalition meetings are on the 2nd Monday of the month from 12-2pm.
Burton Fisher Community Meeting Room, 1st Floor of One City Center in Portland (off of the food court).
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].