March 9, 2020
Minutes
Minutes
Present: Mary Chris Semrow, Rachel Dyer, Mark Kemmerle, David Cowing, Debbie Dionne, Betsy Hopkins, Margaret Cardoza, Foxfire Buck, Kim Humphrey, Jamie Whitehouse, Joanna Bulger, Ashleigh Barker, Olivia Blom, Cullen Ryan, and Vickey Rand. Via Zoom – (Orono): Bonnie Robinson. (Bangor-OHI): Bonnie-Jean Brooks and Charlie Shafer. (Auburn): Ann Bentley. (Benton): Natalie Childs. Misc. sites: Shelley Zielinski, Maggie Hoffman, Linda Lee, Craig Patterson, Megan McCollor, Kate Murray, Noel Thibodeau, and S Leuschner.
Cullen Ryan introduced himself and welcomed the group. Participants introduced themselves. Minutes from the last meeting were accepted.
DHHS – Office of Aging and Disability Services (OADS) - www.maine.gov/dhhs/oads
Cullen Ryan: We’re going to move the agenda around slightly because Betsy can only stay until 1:00pm and has important information to share. Thank you for being here today, Betsy, and thank you for providing an update to this group!
Betsy Hopkins - Associate Director, Developmental Disability and Brain Injury Services: Thank you for having me! We appreciate your feedback with where we have landed with our Community 2.0 work. Paul and I were here a few months ago and provided a brief overview of where we envisioned the system going (click here for the minutes from that meeting). What I’m going to present today came from that work and the feedback received. It outlines our plan moving forward with some of the reform work we want to do. We’ve broken it down into four separate topics, and those will end up having dedicated work groups, which I’ll talk more about, including how to join those work groups. (Click here for the DHHS Reform Plan for Intellectual and Developmental Services, which Betsy reviewed in its entirety). We used this document at the Work Session for LD 1984, so it may look familiar to some folks.
Discussion:
-It was asked what was meant by provider on-boarding.
Betsy: That’s a good question. We’ve had a number of people step forward saying they want to be providers, and we want to be consistent about the way in which this is done, which is also a requirement of the HCBS Settings Rule.
-It was asked who the consultant is for the Quality Assurance (QA) and Quality Improvement (QI) reform topic.
Betsy: Her name is Gail Grossman. She retired from the DD agency in Massachusetts, specializing in QA and QI, and she comes highly recommended. We just started working with her a few months ago. She’s doing a lot of work looking at all of our rules, etc. She’ll be meeting with us soon regarding overarching ways in which we can improve the system.
-It was stated that MACSP (Maine Association for Community Service Providers) is having a two-day, two-track conference in November, with one of the tracks being innovation. It was stated that having two innovation conferences might be confusing, and perhaps partnering would be beneficial.
Betsy: What you’re doing sounds really great, and hopefully we can at least participate.
-It was asked if Betsy could provide more information on the Shared Living Pilot.
Betsy: We’re still in the process of writing the parameters around it, so I would feel more comfortable sharing more information when we have it better fleshed out. We’re looking at different ways to provide shared living for individuals who have requested it, yet currently their needs cannot be met with the shared living model.
-It was asked if Betsy could elaborate more on the lifespan waiver.
Betsy: We would love to have a waiver where when someone comes on board and they need some level of services that person could get those services, and then have them be flexible to ebb and flow over the person’s life as needs change. This would create a more flexible, one-waiver system that would better meet the needs of individuals.
Betsy: We have put together an invitation that has started circulating for people to nominate themselves or others to the work groups. (Click here for the invitation for nominations to the work groups, from Betsy, which includes detailed information on the process and how to submit nominations). We hope to have those groups established in May or June, covering the four areas we just discussed. We’d like those nominations to come to the [email protected] email address, with a nomination due date of 3/31. The goal is to have 12-15 members per work group. We know everyone has lot on their plates; we ask if someone is nominated, that they really have the time to dedicate to this.
-It was asked if you could select more than one of the reform topics when submitting a nomination.
Betsy: If you’re interested in more than one topic, I would say include you’re preferred choice and perhaps others in which you have interest. I want to make sure we have broad representation for all of these work groups.
-It was stated that having an educator or transition specialist in each of those work groups to report what they’re seeing in schools, the barriers, on what case management ought to focus, etc., would be beneficial.
Betsy: That’s great feedback. We’re also going to invite someone from the Department of Labor (DOL) for the work we’re doing on employment.
-It was asked what CRT stood for in the document. It was stated that it stands for Clinical Review Team.
-There was a question regarding self-direction and its inclusion in the reform areas.
Betsy: We are really interested in including self-direction as a component in the work we’re doing. What we’re really looking for is for people to join the work groups, bringing whatever lens they have to the work, whatever that may be. If that lens is self-direction, then that’s great!
-It was stated that self-direction isn’t one of the services mentioned in the most recent Waiver Renewal Application to CMS (Centers for Medicare and Medicaid Services). It was asked if the Department ends up going in the direction of self-direction, would the waiver be amended to include it as a service.
Betsy: Absolutely, we can amend the waivers every year.
-It was asked if they had contemplated a work group for people with dual diagnoses.
Betsy: We thought long and hard about what these work groups would be, and we could have easily added many more. We want to focus on these four areas now. If someone comes with the lens of dual diagnosis, we definitely want to include that lens. However, we’re not going to add any more work groups at this time.
Betsy: As far as additional OADS update, we’re working with the Office of MaineCare Services on some things that we think this will become public later this month. We appreciated the work that came out of LD 1984, and we’re gathering some fiscal information that will speak to the Health and Human Services Committee recommendations for the bill, which include funding slots for people on the Section 29 waitlist, creating some funding slots for people on the Priority 2 waitlist who are not receiving any other services, and increasing the Section 29 spending cap. I’ve also sent around the invitation for the upcoming quarterly family stakeholder meeting, which is occurring on 3/17, at 109 Capitol Street in Augusta. And, OMS (Office of MaineCare Services) released its Notice of Statewide Transition Plan (STP) for Home and Community-Based Services (HCBS) Settings. (Click here for more information). There is a Public Hearing scheduled for 3/12 at 1:00pm, at DHHS 109 Capitol Street, Room A/B, in Augusta. The deadline for public comments on the Plan is 3/31 by 11:59pm. Comments may be submitted in writing online (click here), to the agency contact person (Thomas Leet, [email protected]), or by emailing [email protected].
-It was asked is there had been an announcement about the self-advocacy RFP.
Betsy: I think it’s in the final stages, but the contract award hasn’t been publicly announced.
Cullen: Thank you for being here and sharing all of these updates! I encourage people to consider joining one of these work groups, as this is where systems change work will be done. Thank you again, Betsy, for being at the table to disseminate this important information and have these interactive dialogues.
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 101.
Cullen: Today we have Rachel Dyer, Associate Director, Maine Developmental Disabilities Council, and Kate Murray, Principal with Applied Self-Direction, providing part one of a two-part presentation on self-direction. Thanks for being here today and presenting! I had the pleasure of seeing this presentation and am glad that the Coalition will as well.
Rachel Dyer: Kate is the subject matter expert, so she will be the one to present on today’s topic. As Cullen said, Kate is with Applied Self-Direction. We have engaged Applied Self-Direction as consultants for our work on self-direction. The DD Council has been very interested, for a very long time, about what self-direction would look like for adults with ID/DD. We’re excited to have this moving along finally and appreciate that Cullen has worked to set this up as a two-part presentation. Next month Kate will come here in person and continue this discussion. There are many ways in which this program could work in Maine, and we’re excited to be developing a program with the folks who would be using it. The Self-Direction Stakeholder Group has met a few times; it is not an exclusive group. Once we get into the weeds, we will welcome new people to the table who are happy to start where we’re at in the process. We’ll be presenting this at a few conferences over the next year, but we wanted to get this information out to a broader group for the first time.
Kate Murray: Thank you for the introduction, Rachel, and thank you so much for having me today. As Cullen and Rachel said, I’m a Principal with Applied Self-Direction. We are a membership-based technical Assistance and training organization. Applied Self-Direction provides practical expertise intended to create and operate self-direction programs that run effectively and efficiently for individuals, states, managed care entities, Financial Management Services (FMS) providers, and other stakeholders. The mission of Applied Self-Direction is to promote self-direction, so individuals have the choice and control to live the lives they want. Most of my time is spent working with states to design new self-direction programs or improve existing ones. Self-direction went from being this controversial idea, which many people thought would fail, to being mainstream. Self-direction is based on the principal that the participant knows their needs better than anyone and should have a say in what services they receive, how they’re delivered, and who provides them. The participant is the ultimate arbiter of quality of services. I’m hoping in April we can start digging through how self-direction is designed through the waivers’ perspective. Today I’m going to provide a broad overview of self-direction, including its history.
Begin Presentation (Click here for the presentation)
Kate: People living in a variety of settings can access self-direction; it’s not just a model for people who live at home and have involved family members. Anyone can self-direct if they have the right services and supports. Some people only self-direct certain services; it doesn’t have to be all or nothing. There’s a lot of variation out there.
Discussion:
- It was suggested that the assessment process for whatever self-directed service options are developed for Maine ought to contemplate individualization, and perhaps look to what other states are doing in this regard.
Kate: Yes absolutely. We can certainly compare and contrast models in other states, as assessment processes across the country vary greatly.
-It was asked if states have allowed families, friends, or the person receiving services to supplement funds for these services, such as paying a higher wage to workers.
Kate: I haven’t heard of that exact scenario. However, I have heard of some combination of Medicaid dollars and private-pay funds, where perhaps the family member doesn’t pay a higher wage, but through private-pay they receive more hours of support, etc.
-It was asked how employer authority works, including if people are required to have worker’s compensation insurance, etc.
Kate: That’s a great question. If there is employer authority and the participant is the legal employer, worker’s comp is required in most states, and the FMS (Financial Management Services) would be responsible to paying that, the cost for which would be factored into the spending plan. There are some complex regulatory requirements and labor laws that need to be followed; however, the FMS and the support broker would be the experts in this.
Rachel: One statistic that comes up later the presentation, that we didn’t quite get to, is that for states that are pursuing this as a new program the target would be about 10% of participants utilizing it. As such, the development of a self-direction model doesn’t set up a huge change to the structure of services.
Kate: Yes, 10% is generally a good ballpark for the percentage of participants who are likely to choose this service delivery model. In general, it’s an option for families for whom traditional services don’t work well. This is a great option for someone who wants more than what traditional services provide. However, traditional services work well for many people, and some families don’t have the bandwidth to engage in this kind of effort, because it is a lot of work.
Cullen: Having heard this presentation before, I was hoping you could speak to micro-boards.
Kate: Yes. They’re not very common, but they’re out there, and are more common with ID/DD services. If we wanted to incorporate micro-boards, we would want to make sure the program allows for it and incorporate that in our plans. (Micro-boards are generally small non-profit organizations managed and operated by people with disabilities, their family members and friends. Acting almost like a Board of Directors for an individual).
-A self-advocate asked how Money Follows the Person and self-direction are related and differ.
Kate: Money Follows the Person has been a non-Medicaid funded mechanism for self-direction.
Cullen: You’ll be providing part-two of this presentation next month. Can you give us a preview of what we can expect?
Kate: Yes! My plan for Self-Direction 102, is to go through the 1015c Waiver step-by-step, discussing the tradeoffs, what we want this program to look like, and how it would be structured. By presenting and getting feedback from people on the ground, we are better poised to provide the Department with a clear guide for how this ought to work.
Cullen: Thank you for presenting, well done! This was a very informative presentation and we look forward to continuing the presentation and discussion next month.
End Presentation (round of applause)
SMACT (Southern Maine Advisory Council on Transition) Update: You can stay up-to-date with SMACT meetings and events through its Facebook page. The most recent meeting, held on 3/6, included a presentation from Robert Lucas, Federal Program Coordinator for Maine DOE (Department of Education), sharing information about the transition issues that arise as DOE monitors and supports Maine’s public schools. Due to the snow on 2/7, Carrie Woodcock’s presentation on Supported Decision Making has been rescheduled for the 5/1 meeting.
Disability Rights Maine (DRM) Update:
Foxfire Buck: DRM is serving on the Maine Complete Count Committee for the Census, and I have a few handouts regarding that (click here for handout 1, click here for handout 2).
Cullen: There are approximately $4 billion dollars that come into Maine from the federal government, all of which is dependent upon the Census. As such, ensuring the word is out there about the Census is imperative. Apparently, the most under-counted group are children within families.
State Legislature Update:
Rachel Dyer: LD 1874, An Act To Amend the Laws Governing the Subminimum Wage, passed the Labor and Housing Committee, however it was a dived report (majority report Ought to Pass as Amended/minority report Ought Not to Pass). The discussion in the Committee regarding this was a little painful for a service that isn’t being used and hasn’t been for a few years. DOL and OADS came in supporting the bill, and SUFU was there in force; however, it still was not as smooth sailing as it might have been. Also, a handful of people met with representatives from Bangor Savings Bank and DOL about the stalled effort to bring ABLE accounts to Maine. Apparently, because of the model they’re proposing, it’s been a very long process of getting Social Security, the SEC (the US Securities and Exchange Commission), etc. to agree. They finally received all of the permissions needed, so eventually there will be a state program. It’s still a way down the road, but there has been positive movement.
Mark Kemmerle – MDSOAB (Maine Developmental Services Oversight and Advisory Board): I attended the LD 1984 Work Session. The bill includes a four-year plan, which instructs the Department to eventually eliminate the Section 21 and 29 waitlists. In order to address serving people with immediate needs in the interim, modifications were made to the bill: Providing funding offers for anyone on to the Section 29 waitlist through the end of June 2021; and increasing the cap on 29 services to $70,000. They quoted the average expenditure for Section 29 as $41,000, but they thought that with this spending flexibility it would get them through the timetable included within LD 1984.
Kim Humphrey – Community Connect: The Long Term Care Workgroup recommendation for a $2 rate increase across the board was included as an emergency measure, which received unanimous support from the HHS Committee.
Federal & Housing Updates:
Cullen: The Legislature passed, and the Governor enthusiastically signed, a bill establishing a State Low-Income Housing Tax Credit (LD 1645), which will create $80 million worth of affordable housing development over the next eight years – approximately 1,000 units. This bill will definitely help increase the supply of affordable housing in Maine, which is critical. Additionally, we continue to watch proposed rules on the federal level which would jeopardize resources.
Announcements/Handouts:
The next meeting will be on Monday, April 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 Speakers: Rachel Dyer, Associate Director, Maine Developmental Disabilities Council, and Kate Murray, Principal, Applied Self-Direction. Topic: Self Direction 102. And, 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, will be shown, with discussion to follow.
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.
DHHS – Office of Aging and Disability Services (OADS) - www.maine.gov/dhhs/oads
Cullen Ryan: We’re going to move the agenda around slightly because Betsy can only stay until 1:00pm and has important information to share. Thank you for being here today, Betsy, and thank you for providing an update to this group!
Betsy Hopkins - Associate Director, Developmental Disability and Brain Injury Services: Thank you for having me! We appreciate your feedback with where we have landed with our Community 2.0 work. Paul and I were here a few months ago and provided a brief overview of where we envisioned the system going (click here for the minutes from that meeting). What I’m going to present today came from that work and the feedback received. It outlines our plan moving forward with some of the reform work we want to do. We’ve broken it down into four separate topics, and those will end up having dedicated work groups, which I’ll talk more about, including how to join those work groups. (Click here for the DHHS Reform Plan for Intellectual and Developmental Services, which Betsy reviewed in its entirety). We used this document at the Work Session for LD 1984, so it may look familiar to some folks.
Discussion:
-It was asked what was meant by provider on-boarding.
Betsy: That’s a good question. We’ve had a number of people step forward saying they want to be providers, and we want to be consistent about the way in which this is done, which is also a requirement of the HCBS Settings Rule.
-It was asked who the consultant is for the Quality Assurance (QA) and Quality Improvement (QI) reform topic.
Betsy: Her name is Gail Grossman. She retired from the DD agency in Massachusetts, specializing in QA and QI, and she comes highly recommended. We just started working with her a few months ago. She’s doing a lot of work looking at all of our rules, etc. She’ll be meeting with us soon regarding overarching ways in which we can improve the system.
-It was stated that MACSP (Maine Association for Community Service Providers) is having a two-day, two-track conference in November, with one of the tracks being innovation. It was stated that having two innovation conferences might be confusing, and perhaps partnering would be beneficial.
Betsy: What you’re doing sounds really great, and hopefully we can at least participate.
-It was asked if Betsy could provide more information on the Shared Living Pilot.
Betsy: We’re still in the process of writing the parameters around it, so I would feel more comfortable sharing more information when we have it better fleshed out. We’re looking at different ways to provide shared living for individuals who have requested it, yet currently their needs cannot be met with the shared living model.
-It was asked if Betsy could elaborate more on the lifespan waiver.
Betsy: We would love to have a waiver where when someone comes on board and they need some level of services that person could get those services, and then have them be flexible to ebb and flow over the person’s life as needs change. This would create a more flexible, one-waiver system that would better meet the needs of individuals.
Betsy: We have put together an invitation that has started circulating for people to nominate themselves or others to the work groups. (Click here for the invitation for nominations to the work groups, from Betsy, which includes detailed information on the process and how to submit nominations). We hope to have those groups established in May or June, covering the four areas we just discussed. We’d like those nominations to come to the [email protected] email address, with a nomination due date of 3/31. The goal is to have 12-15 members per work group. We know everyone has lot on their plates; we ask if someone is nominated, that they really have the time to dedicate to this.
-It was asked if you could select more than one of the reform topics when submitting a nomination.
Betsy: If you’re interested in more than one topic, I would say include you’re preferred choice and perhaps others in which you have interest. I want to make sure we have broad representation for all of these work groups.
-It was stated that having an educator or transition specialist in each of those work groups to report what they’re seeing in schools, the barriers, on what case management ought to focus, etc., would be beneficial.
Betsy: That’s great feedback. We’re also going to invite someone from the Department of Labor (DOL) for the work we’re doing on employment.
-It was asked what CRT stood for in the document. It was stated that it stands for Clinical Review Team.
-There was a question regarding self-direction and its inclusion in the reform areas.
Betsy: We are really interested in including self-direction as a component in the work we’re doing. What we’re really looking for is for people to join the work groups, bringing whatever lens they have to the work, whatever that may be. If that lens is self-direction, then that’s great!
-It was stated that self-direction isn’t one of the services mentioned in the most recent Waiver Renewal Application to CMS (Centers for Medicare and Medicaid Services). It was asked if the Department ends up going in the direction of self-direction, would the waiver be amended to include it as a service.
Betsy: Absolutely, we can amend the waivers every year.
-It was asked if they had contemplated a work group for people with dual diagnoses.
Betsy: We thought long and hard about what these work groups would be, and we could have easily added many more. We want to focus on these four areas now. If someone comes with the lens of dual diagnosis, we definitely want to include that lens. However, we’re not going to add any more work groups at this time.
Betsy: As far as additional OADS update, we’re working with the Office of MaineCare Services on some things that we think this will become public later this month. We appreciated the work that came out of LD 1984, and we’re gathering some fiscal information that will speak to the Health and Human Services Committee recommendations for the bill, which include funding slots for people on the Section 29 waitlist, creating some funding slots for people on the Priority 2 waitlist who are not receiving any other services, and increasing the Section 29 spending cap. I’ve also sent around the invitation for the upcoming quarterly family stakeholder meeting, which is occurring on 3/17, at 109 Capitol Street in Augusta. And, OMS (Office of MaineCare Services) released its Notice of Statewide Transition Plan (STP) for Home and Community-Based Services (HCBS) Settings. (Click here for more information). There is a Public Hearing scheduled for 3/12 at 1:00pm, at DHHS 109 Capitol Street, Room A/B, in Augusta. The deadline for public comments on the Plan is 3/31 by 11:59pm. Comments may be submitted in writing online (click here), to the agency contact person (Thomas Leet, [email protected]), or by emailing [email protected].
-It was asked is there had been an announcement about the self-advocacy RFP.
Betsy: I think it’s in the final stages, but the contract award hasn’t been publicly announced.
Cullen: Thank you for being here and sharing all of these updates! I encourage people to consider joining one of these work groups, as this is where systems change work will be done. Thank you again, Betsy, for being at the table to disseminate this important information and have these interactive dialogues.
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 101.
Cullen: Today we have Rachel Dyer, Associate Director, Maine Developmental Disabilities Council, and Kate Murray, Principal with Applied Self-Direction, providing part one of a two-part presentation on self-direction. Thanks for being here today and presenting! I had the pleasure of seeing this presentation and am glad that the Coalition will as well.
Rachel Dyer: Kate is the subject matter expert, so she will be the one to present on today’s topic. As Cullen said, Kate is with Applied Self-Direction. We have engaged Applied Self-Direction as consultants for our work on self-direction. The DD Council has been very interested, for a very long time, about what self-direction would look like for adults with ID/DD. We’re excited to have this moving along finally and appreciate that Cullen has worked to set this up as a two-part presentation. Next month Kate will come here in person and continue this discussion. There are many ways in which this program could work in Maine, and we’re excited to be developing a program with the folks who would be using it. The Self-Direction Stakeholder Group has met a few times; it is not an exclusive group. Once we get into the weeds, we will welcome new people to the table who are happy to start where we’re at in the process. We’ll be presenting this at a few conferences over the next year, but we wanted to get this information out to a broader group for the first time.
Kate Murray: Thank you for the introduction, Rachel, and thank you so much for having me today. As Cullen and Rachel said, I’m a Principal with Applied Self-Direction. We are a membership-based technical Assistance and training organization. Applied Self-Direction provides practical expertise intended to create and operate self-direction programs that run effectively and efficiently for individuals, states, managed care entities, Financial Management Services (FMS) providers, and other stakeholders. The mission of Applied Self-Direction is to promote self-direction, so individuals have the choice and control to live the lives they want. Most of my time is spent working with states to design new self-direction programs or improve existing ones. Self-direction went from being this controversial idea, which many people thought would fail, to being mainstream. Self-direction is based on the principal that the participant knows their needs better than anyone and should have a say in what services they receive, how they’re delivered, and who provides them. The participant is the ultimate arbiter of quality of services. I’m hoping in April we can start digging through how self-direction is designed through the waivers’ perspective. Today I’m going to provide a broad overview of self-direction, including its history.
Begin Presentation (Click here for the presentation)
Kate: People living in a variety of settings can access self-direction; it’s not just a model for people who live at home and have involved family members. Anyone can self-direct if they have the right services and supports. Some people only self-direct certain services; it doesn’t have to be all or nothing. There’s a lot of variation out there.
Discussion:
- It was suggested that the assessment process for whatever self-directed service options are developed for Maine ought to contemplate individualization, and perhaps look to what other states are doing in this regard.
Kate: Yes absolutely. We can certainly compare and contrast models in other states, as assessment processes across the country vary greatly.
-It was asked if states have allowed families, friends, or the person receiving services to supplement funds for these services, such as paying a higher wage to workers.
Kate: I haven’t heard of that exact scenario. However, I have heard of some combination of Medicaid dollars and private-pay funds, where perhaps the family member doesn’t pay a higher wage, but through private-pay they receive more hours of support, etc.
-It was asked how employer authority works, including if people are required to have worker’s compensation insurance, etc.
Kate: That’s a great question. If there is employer authority and the participant is the legal employer, worker’s comp is required in most states, and the FMS (Financial Management Services) would be responsible to paying that, the cost for which would be factored into the spending plan. There are some complex regulatory requirements and labor laws that need to be followed; however, the FMS and the support broker would be the experts in this.
Rachel: One statistic that comes up later the presentation, that we didn’t quite get to, is that for states that are pursuing this as a new program the target would be about 10% of participants utilizing it. As such, the development of a self-direction model doesn’t set up a huge change to the structure of services.
Kate: Yes, 10% is generally a good ballpark for the percentage of participants who are likely to choose this service delivery model. In general, it’s an option for families for whom traditional services don’t work well. This is a great option for someone who wants more than what traditional services provide. However, traditional services work well for many people, and some families don’t have the bandwidth to engage in this kind of effort, because it is a lot of work.
Cullen: Having heard this presentation before, I was hoping you could speak to micro-boards.
Kate: Yes. They’re not very common, but they’re out there, and are more common with ID/DD services. If we wanted to incorporate micro-boards, we would want to make sure the program allows for it and incorporate that in our plans. (Micro-boards are generally small non-profit organizations managed and operated by people with disabilities, their family members and friends. Acting almost like a Board of Directors for an individual).
-A self-advocate asked how Money Follows the Person and self-direction are related and differ.
Kate: Money Follows the Person has been a non-Medicaid funded mechanism for self-direction.
Cullen: You’ll be providing part-two of this presentation next month. Can you give us a preview of what we can expect?
Kate: Yes! My plan for Self-Direction 102, is to go through the 1015c Waiver step-by-step, discussing the tradeoffs, what we want this program to look like, and how it would be structured. By presenting and getting feedback from people on the ground, we are better poised to provide the Department with a clear guide for how this ought to work.
Cullen: Thank you for presenting, well done! This was a very informative presentation and we look forward to continuing the presentation and discussion next month.
End Presentation (round of applause)
SMACT (Southern Maine Advisory Council on Transition) Update: You can stay up-to-date with SMACT meetings and events through its Facebook page. The most recent meeting, held on 3/6, included a presentation from Robert Lucas, Federal Program Coordinator for Maine DOE (Department of Education), sharing information about the transition issues that arise as DOE monitors and supports Maine’s public schools. Due to the snow on 2/7, Carrie Woodcock’s presentation on Supported Decision Making has been rescheduled for the 5/1 meeting.
Disability Rights Maine (DRM) Update:
Foxfire Buck: DRM is serving on the Maine Complete Count Committee for the Census, and I have a few handouts regarding that (click here for handout 1, click here for handout 2).
Cullen: There are approximately $4 billion dollars that come into Maine from the federal government, all of which is dependent upon the Census. As such, ensuring the word is out there about the Census is imperative. Apparently, the most under-counted group are children within families.
State Legislature Update:
Rachel Dyer: LD 1874, An Act To Amend the Laws Governing the Subminimum Wage, passed the Labor and Housing Committee, however it was a dived report (majority report Ought to Pass as Amended/minority report Ought Not to Pass). The discussion in the Committee regarding this was a little painful for a service that isn’t being used and hasn’t been for a few years. DOL and OADS came in supporting the bill, and SUFU was there in force; however, it still was not as smooth sailing as it might have been. Also, a handful of people met with representatives from Bangor Savings Bank and DOL about the stalled effort to bring ABLE accounts to Maine. Apparently, because of the model they’re proposing, it’s been a very long process of getting Social Security, the SEC (the US Securities and Exchange Commission), etc. to agree. They finally received all of the permissions needed, so eventually there will be a state program. It’s still a way down the road, but there has been positive movement.
Mark Kemmerle – MDSOAB (Maine Developmental Services Oversight and Advisory Board): I attended the LD 1984 Work Session. The bill includes a four-year plan, which instructs the Department to eventually eliminate the Section 21 and 29 waitlists. In order to address serving people with immediate needs in the interim, modifications were made to the bill: Providing funding offers for anyone on to the Section 29 waitlist through the end of June 2021; and increasing the cap on 29 services to $70,000. They quoted the average expenditure for Section 29 as $41,000, but they thought that with this spending flexibility it would get them through the timetable included within LD 1984.
Kim Humphrey – Community Connect: The Long Term Care Workgroup recommendation for a $2 rate increase across the board was included as an emergency measure, which received unanimous support from the HHS Committee.
Federal & Housing Updates:
Cullen: The Legislature passed, and the Governor enthusiastically signed, a bill establishing a State Low-Income Housing Tax Credit (LD 1645), which will create $80 million worth of affordable housing development over the next eight years – approximately 1,000 units. This bill will definitely help increase the supply of affordable housing in Maine, which is critical. Additionally, we continue to watch proposed rules on the federal level which would jeopardize resources.
Announcements/Handouts:
The next meeting will be on Monday, April 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 Speakers: Rachel Dyer, Associate Director, Maine Developmental Disabilities Council, and Kate Murray, Principal, Applied Self-Direction. Topic: Self Direction 102. And, 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, will be shown, with discussion to follow.
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].