May 10, 2021
Minutes
Minutes
Attendees via Zoom: Alexandria Twombly, Alli Vercoe, Amanda Hodgkins, Andrea Liming, Andrew Cassidy, Annmarie Mayberry, Anne Ryan, Ben Rayer, Betsy Hopkins, Beth Morse, Betsy Mahoney, Brenda Smith, Bryan Gordon, Carol Snyder, Cathy Curtis, Chris Call, Craig Patterson, David Cowing, Debbie Dionne, Jodi Benvie, Mark Kemmerle, Teresa Barrows, Heidi Bechard, Robin Levesque, J Richardson Collins, Janet Hamel, Jessica Cavanaugh, Heidi Mansir, Kim Humphrey, Laura Cordes, Lauren Wille, LyAnn Grogan, Linda Lee, Lorraine DeFreitas, Nancy Peavy, Sue Murphy, Nancy Gavel, Samantha, Sarah Delano, Trena Jackson, Pam Pendleton, Margaret Cardoza, Simon Hayward, JH, Helen Hemminger, Sarah Robinson, Paula Bush, Rachel Dyer, Julie Brennan, Ed & Suellen Doggett, Geoff Bush, Bonnie Robinson, Vickey Rand, Cullen Ryan, and a few people who joined the meeting in progress and/or left prior to its conclusion.
Click here for a link to a recording of this meeting
Cullen Ryan introduced himself and welcomed the group. It was stated that this is the 15th anniversary of the Coalition. Cullen thanked the group for all its efforts throughout the past 15 years! Participants names were read by Cullen to save time. Minutes from the last meeting were accepted.
Featured Speaker: Betsy Hopkins, Associate Director, DHHS-OADS Disability Services. www.maine.gov/dhhs/oads Topic: Continued discussion on the HCBS Settings Rule and Maine’s path towards compliance.
Cullen: Our first featured speaker today is Betsy Hopkins, Associate Director, DHHS-OADS Disability Services, who generously offered to attend today to provide a follow-up presentation to last month’s topic, continuing the discussion on the HCBS Settings Rule and Maine’s path towards compliance. Thank you all for being here, Betsy!
Betsy Hopkins: I’m honored to be talking and sharing with you all on the 15th anniversary of this group’s formation! This topic falls into the bucket of things that we update regularly. It’s a topic that the Department, and I’m sure many of you, has been learning about in various stages. We’re in the updating stage and appreciate the ability to talk this through a little bit and share some information. I’m joined by my colleague Heidi Bechard, who’s working on this as well.
Begin Presentation (Click here for the presentation) Betsy and Heidi read through the presentation.
Heidi Bechard: The Department has a dedicated page regarding the HCBS Settings Rule change and includes FAQs.
Betsy: As you can see this is a very complex process, with many parts. We want to acknowledge all of the immense work done by our partners, providers, people served, Disability Rights Maine (DRM), and Department staff. We hold regular provider meetings every month, which have been extended to an hour and a half at the request of providers. We have a HCBS training and resources page on the website. We have a lot of training to do between now and the time we meet the compliance deadline in March of 2023. I want to thank everyone for their work on this, as the end result will be very important so people can access their communities in ways that will be meaningful and beneficial.
Cullen: Thank you Betsy and Heidi, that was a lot of information!
Discussion:
-It was asked if “minimum” expectations mean a reduction in quality, integration, access, and/or rights to a person served.
Betsy: We are trying to meet the requirements of this rule and help providers to comply. Having said that, we talk with many providers, I know Laura will attest to this, and many providers are very clearly going above and beyond compliance. Right now, we’re really focusing on the compliance aspect of the law. At the same time, we’re providing a lot of trainings and resources and sharing best practices from other states.
Laura Cordes: I think that’s certainly true. The challenges currently are the time constraints, the direction to meet those minimums, and waiting for the State to promulgate its HCBS Rules. I do know that our members aim to exceed the minimum standards.
-It was asked if HCBS includes transportation accommodations for the individual and the provider in regard to integration.
Heidi: Transportation has been an area of great concern for most everyone. As I understand it, this is an element that’s included as part of the rates, but more importantly as part of HCBS. Keep in mind the intention is that providers are assisting individuals in creating relationships to the greater community. As a natural reaction to that, in developing relationships you may then develop transportation options to various activities in the community. This isn’t specific to a provider providing transportation, but opening up an individual’s world to be able to catch a ride with someone to an activity, etc.
-It was asked if some examples could be given of what might require remediation.
Heidi: Clearly transportation is one of those. It doesn’t mean that at the drop of a hat a provider must stop everything to give someone a ride. It does mean that providers are responsible to ensure that the individuals they serve are fully aware of all transportation options available to them in the community. There may be transportation options about which people don’t know, so there should be a place within the setting that has that information available to people. This also ties into the PCP process – maybe someone has a goal related to learning how to utilize public transportation. It ties into the person’s ability to control their own personal resources. We’re finding many people don’t have a safe, individualized place to keep their personal resources, and that they don’t have access to those without having to ask someone. Another area we see that meets remediation is around employment. Maine is an employment first state, people have the right to explore competitive employment opportunities. We’re not asking providers to start job development activities. We’re simply asking providers to have conversations with individuals about different job opportunities. Having conversations about potential employment opportunities out in the community, helping people to plan to get ready for employment.
-It was stated that there are many settings that have not been reviewed and/or validated but it doesn't appear to be reflected in the numbers. It was asked if OADS has completed all reviews.
Heidi: All of our residential settings reviews have been completed. The delay is getting the settings findings reports out. By 7/31, all of the settings reports should be issued to providers.
-Heidi and Betsy were thanked for their great presentation of complicated material. It was asked if there are materials available from OADS that are designed for use by new programs/settings, to serve as guides for these new entities as they begin their new programs/settings going forward.
Heidi: All of the information posted on the OADS webpage could be utilized for new providers to embrace and implement. The training and resources page on the OADS HCBS webpage, is where we house a lot of material. We also created a sub-category for individuals, families, and guardians (click the link above and scroll down to this section). Please check that page out. In January, there were two trainings specific to individuals, families, and guardians; the PowerPoints and recordings are on the webpage.
From that section of the website:
-It was asked how EconSys was selected for their role.
Betsy: That was through an RFP.
Heidi: Many of the people reviewing the reports based on validation findings are actually people who have been providers in the past in other states. They certainly have seen both sides of this work and bring a lot of knowledge to their positions.
-It was asked how many Residential settings need to be completed by June 30, 2021.
Heidi: All of our residential settings have been validated. It’s the findings reports that are being created now, which should all be issued by 7/31.
-It was asked if an individual enjoys and is invested in Special Olympics participation in various settings whether that would be considered noncompliant with HCBS.
Heidi: I would not say that’s considered non-compliant. That’s a separate issue. What the Settings Rule is intending is that individuals are also offered opportunities in the greater community with individuals who live in the greater community, and not necessarily always tied to a paid staff member.
Cullen: Thank you, Betsy and Heidi, for continuing this great, informative discussion. This presents an opportunity for further dialogue between everyone and the Department so that we ensure we get this right. Thank you again for being here today!
End Presentation (round of applause would have occurred were it not for everyone being muted and on Zoom)
Featured Speaker: Dr. Anne Ryan, STRIVE Online Program Director, PSL STRIVE. www.pslstrive.org Topic: Overview of STRIVE WorldWIDE, an online program that teaches independent living skills to individuals with intellectual disabilities and Autism.
Cullen: Our second featured speaker is Dr. Anne Ryan, STRIVE Online Program Director, with PSL STRIVE. Anne will be providing an overview of STRIVE WorldWIDE, an online program that teaches independent living skills to people with ID/DD. Thank you all for being here, Anne!
Dr. Anne Ryan: What you’re seeing now is Live Caption through Google Slides, which is one of the features we use to make our seminars more accessible to our learners. As Cullen stated, I am Dr. Anne Ryan, STRIVE Online Program Director, with PSL STRIVE. We launched our program in 2019, pre-COVID. At that time, all online learning programs were targeted to the supporter rather than the individuals themselves. All of my notes are included in the presentation which will be linked in the minutes. This is the commercial version of the presentation; I will be hosting a longer version, the infomercial version, of this presentation on 5/18 at 11:30am. You can also reach out to me directly if you want more information ([email protected]).
Begin Presentation (Dr. Ryan provided an in-depth, interactive presentation, and all of her comments are included in the notes on both the PowerPoint and PDF versions of her presentation. Please note the PDF version is not interactive. Click here for the PowerPoint version of the presentation; click here for the PDF version with notes)
Anne: If you have feedback about this presentation you can provide that at this link. If you’re interested in the informational session on 5/18 that I mentioned earlier, you can register online.
Discussion:
-It was asked if STRIVE is accredited, and if the courses are transferable for credit to a college degree.
Anne: These are not college-level course, so no. We do offer people certificates for completing one or more courses.
-It was asked if STRIVE WorldWIDE works with a student’s IEP transition plan.
Anne: We certainly can and have in the past, it just involves working with the school departments. I happened to be married to a Special Education Administrator so I’m familiar with the process. We have some examples of what this could look like, but of course everyone’s IEP is different.
-A parent and special educator asked if they do anything around relationships, sexuality, reproductive health, etc. She stated that it’s sensitive information, but it’s important.
Anne: We have a healthy relationships course. We don’t do the biological pieces, but we talk about what healthy relationships look like, about sexual relationships, healthy and unhealthy boundaries, etc.
Cullen: This was a dazzling presentation and I can see how it would be an interactive and engaging learning experience. Thank you, Anne, and well done!
End Presentation (round of applause would have occurred were it not for everyone being muted and on Zoom)
DHHS – Office of Aging and Disability Services (OADS) - www.maine.gov/dhhs/oads
Betsy Hopkins – Associate Director, DHHS-OADS Disability Services: There are a number of provider agencies who have offered to host a number of vaccine clinics around the state. I have been having them posted on the Coalition website as they come up. I want to thank OHI for hosting the first clinic, and the follow-up clinic this Friday; Living Innovations, which recently hosted a clinic in Caribou; Woodfords Family Services which recently hosted a clinic; JF Murphy Homes which is hosting a clinic in Auburn on 5/14; PSL Services STRIVE which is hosting a clinic on Saturday, 5/15 and is providing a choice of two different vaccines – Pfizer and the Johnson & Johnson vaccine; and Independence Association which will be scheduling one as well in the near future. I really want to thank these providers and the vaccine providers working with them to host these clinics. As far as other things to share, our world has mostly been about HCBS. We’re waiting on information from CMS (Centers for Medicare and Medicaid Services) to let us know what is and is not covered in the American Recovery Plan Act (ARPA) funds. More to follow on this.
-It was asked, without waiting for the CMS guidance, what the Department’s position is because we know the funding can be used to fund waitlists and for rates for providers. It was stated that it was surprising that the Department, through testimony delivered by Paul and others (not Betsy), has not appeared to be supportive of bills to address the waitlists and rate increases. A Coalition member read a portion of the Department’s testimony regarding a DSP rate increase bill (paraphrased for the purposes of these minutes): ‘The Department does not believe an increase in rates is warranted at this time, DSPs have either received rate increases over the past year or are scheduled to in the next few months.’
Betsy: I can’t comment on someone else’s testimony. I will say that in general when we talk about rates – there are rate increases scheduled for 7/1. I’ve heard Paul (Saucier) describe this as helping us bridge the need as we continue to look at rates over the course of the next couple of years. We do not think the rate increases on 7/1 are the end of the story of what’s needed for people to provide these services. That’s the start of our conversation, and Paul has been candid about that. As far as the ARPA funds, there are a lot of ideas about what will and will not be allowed. Until we get specific guidance from CMS, we’re not in a position to discuss what we would do with the funding. The funds are for one year. What happens after that one year if we were to use those funds to provide rate increases, for example? I know there are a lot of conversations, in other states as well, for bonuses and sign-on opportunities as one-time financial incentives to reach the DSPs.
-It was stated that the rate increase appears to just bring wages up to minimum wage.
Betsy: The rates are more than minimum wage; the rates are based on minimum wage but there is more taken into consideration as well.
Laura Cordes: Thank you for the dialogue about the rates. I appreciate the comments on where the Department is, and that it is looking at what other states are doing and has potentially using these funds to stabilize the workforce on its radar. At present, the relief we need is urgent as we’ve lost more than 16% of our workforce in the last year alone. Regarding bringing up the rates to minimum wage – one thing that would be helpful would be for the Department to release the rates scheduled start on 7/1. Knowing what those rates will be would be very beneficial for providers to recruit staff.
Betsy: I will follow-up on that. I’m not sure where that is, but I will look into this further.
-It was stated that the HCBS Settings Rule is about choice, which is dependent upon staffing. In order to reach compliance, other states are funding workforce incentives. It was asked what consideration is there for providing funding to help come into compliance with the HCBS Settings Rule.
Betsy: I would say rates are an important part of that. We know there has been a workforce shortage even before COVID, and it has only gotten worse since COVID. There are different pieces of the work we’re looking at around the workforce piece. I would see hopefully being able to use some of the ARPA funds to incentivize different areas of the workforce in general. When we receive the guidance, we’ll know more about what we can and cannot move ahead.
-It was asked if Maine could somehow develop the DSP workforce by looking at having an AmeriCorps volunteers’ study, perhaps using the ARPA funds. It was stated that AmeriCorps volunteers require an existing nonprofit to take the lead in developing.
Betsy: That is also something to consider, thank you for mentioning it.
Cullen: Thank you very much, Betsy, for being here! This Coalition is about having an open dialogue and providing an inclusive forum for these healthy robust, and respectful discussions, and thank you [to the person asking questions] for modeling how to do that with those questions. Direct dialogue on these hard topics is important. Thank you again for being here, Betsy.
DHHS – Office of Child and Family Services (OCFS) - www.maine.gov/dhhs/ocfs
Teresa Barrows had to leave the meeting early and sent an email update:
Amanda Hodgkins: The resource guide Teresa mentioned in her email update is designed to be for anyone transitioning to adulthood. including people transitioning to OADS, and for people transitioning to OBH (Office of Behavioral Health). Often times case managers aren’t as aware of those resources. We can’t include every resource in the guide, but we’re hoping it’s a good starting point. We did a survey regarding what training people would like to see; we’re looking at the data from those responses which has been informative about what we need to cover for trainings.
Cullen: Thank you for being here today, Amanda!
Special Education – No update
SMACT (Southern Maine Advisory Council on Transition)
Nancy Peavy: SMACT meetings occur on the first Friday of each month, currently via Zoom, at 1pm. The May meeting, the last meeting of the year, was on May 7th and featured Cullen presenting on the Blueprint for Effective Transition. SMACT’s new website is up and running and includes recordings. The SMACT website and the Coalition website are cross-linked for convenience and information-sharing. As a reminder, if you want to be on the email list feel free to email Nancy Peavy ([email protected]). The next meeting is in the fall on 10/1.
Cullen: I was very happy to present. SMACT includes such a diverse group of people, who are far more knowledgeable on transition than I! I’ll just reiterate that it is great that the Coalition’s website and the SMACT website are cross-linked, so you can easily find information from either site.
Disability Rights Maine (DRM) Update:
Laura Wille: We’ve been having a large push for outreach to people receiving services to ensure they’re informed and knowledgeable about the HCBS Settings Rule. The webinar from November on HCBS is finally posted on the website. I’ve been invited to a number of SUFU meetings recently to answer a lot of questions about the HCBS Settings Rule and what that means for their lives. All of our trainings have been recorded and are on our website here.
Federal & Housing Updates:
Cullen:
State Legislature Update:
Cullen: It has been a very busy stretch! Laura has done an immense amount of work following various bills in the Legislature that pertain to the ID/DD world. Thank you, Laura, for your work to keep us up to date on what’s going on in the Legislature!
Laura Cordes – MACSP (Maine Association for Community Service Providers): I think this group is aware of the document containing the bills we’ve been tracking. (Click here for the document Laura reviewed.)
Laura’s 130th Legislative Session Bills and & Key Committees document was shared with the group, which also includes information on the different budget processes:
Back to Basics Budget for FY 22:
Announcements:
The next meeting will be on Monday, June 14, 2021, 12-2pm, via Zoom.
Featured Speaker: Mark Kemmerle, Executive Director, Maine Developmental Services Oversight and Advisory Board (MDSOAB). Topic: MDSOAB Annual Forum – feedback for DHHS, including feedback on the availability, accessibility, and quality of services for persons with intellectual disabilities or autism and their families.
Unless changed, Coalition meetings are on the 2nd Monday of the month from 12-2pm.
(in 2021 the October meeting will be the 3rd Monday due to the holiday)
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].
Click here for a link to a recording of this meeting
Cullen Ryan introduced himself and welcomed the group. It was stated that this is the 15th anniversary of the Coalition. Cullen thanked the group for all its efforts throughout the past 15 years! Participants names were read by Cullen to save time. Minutes from the last meeting were accepted.
Featured Speaker: Betsy Hopkins, Associate Director, DHHS-OADS Disability Services. www.maine.gov/dhhs/oads Topic: Continued discussion on the HCBS Settings Rule and Maine’s path towards compliance.
Cullen: Our first featured speaker today is Betsy Hopkins, Associate Director, DHHS-OADS Disability Services, who generously offered to attend today to provide a follow-up presentation to last month’s topic, continuing the discussion on the HCBS Settings Rule and Maine’s path towards compliance. Thank you all for being here, Betsy!
Betsy Hopkins: I’m honored to be talking and sharing with you all on the 15th anniversary of this group’s formation! This topic falls into the bucket of things that we update regularly. It’s a topic that the Department, and I’m sure many of you, has been learning about in various stages. We’re in the updating stage and appreciate the ability to talk this through a little bit and share some information. I’m joined by my colleague Heidi Bechard, who’s working on this as well.
Begin Presentation (Click here for the presentation) Betsy and Heidi read through the presentation.
Heidi Bechard: The Department has a dedicated page regarding the HCBS Settings Rule change and includes FAQs.
Betsy: As you can see this is a very complex process, with many parts. We want to acknowledge all of the immense work done by our partners, providers, people served, Disability Rights Maine (DRM), and Department staff. We hold regular provider meetings every month, which have been extended to an hour and a half at the request of providers. We have a HCBS training and resources page on the website. We have a lot of training to do between now and the time we meet the compliance deadline in March of 2023. I want to thank everyone for their work on this, as the end result will be very important so people can access their communities in ways that will be meaningful and beneficial.
Cullen: Thank you Betsy and Heidi, that was a lot of information!
Discussion:
-It was asked if “minimum” expectations mean a reduction in quality, integration, access, and/or rights to a person served.
Betsy: We are trying to meet the requirements of this rule and help providers to comply. Having said that, we talk with many providers, I know Laura will attest to this, and many providers are very clearly going above and beyond compliance. Right now, we’re really focusing on the compliance aspect of the law. At the same time, we’re providing a lot of trainings and resources and sharing best practices from other states.
Laura Cordes: I think that’s certainly true. The challenges currently are the time constraints, the direction to meet those minimums, and waiting for the State to promulgate its HCBS Rules. I do know that our members aim to exceed the minimum standards.
-It was asked if HCBS includes transportation accommodations for the individual and the provider in regard to integration.
Heidi: Transportation has been an area of great concern for most everyone. As I understand it, this is an element that’s included as part of the rates, but more importantly as part of HCBS. Keep in mind the intention is that providers are assisting individuals in creating relationships to the greater community. As a natural reaction to that, in developing relationships you may then develop transportation options to various activities in the community. This isn’t specific to a provider providing transportation, but opening up an individual’s world to be able to catch a ride with someone to an activity, etc.
-It was asked if some examples could be given of what might require remediation.
Heidi: Clearly transportation is one of those. It doesn’t mean that at the drop of a hat a provider must stop everything to give someone a ride. It does mean that providers are responsible to ensure that the individuals they serve are fully aware of all transportation options available to them in the community. There may be transportation options about which people don’t know, so there should be a place within the setting that has that information available to people. This also ties into the PCP process – maybe someone has a goal related to learning how to utilize public transportation. It ties into the person’s ability to control their own personal resources. We’re finding many people don’t have a safe, individualized place to keep their personal resources, and that they don’t have access to those without having to ask someone. Another area we see that meets remediation is around employment. Maine is an employment first state, people have the right to explore competitive employment opportunities. We’re not asking providers to start job development activities. We’re simply asking providers to have conversations with individuals about different job opportunities. Having conversations about potential employment opportunities out in the community, helping people to plan to get ready for employment.
-It was stated that there are many settings that have not been reviewed and/or validated but it doesn't appear to be reflected in the numbers. It was asked if OADS has completed all reviews.
Heidi: All of our residential settings reviews have been completed. The delay is getting the settings findings reports out. By 7/31, all of the settings reports should be issued to providers.
-Heidi and Betsy were thanked for their great presentation of complicated material. It was asked if there are materials available from OADS that are designed for use by new programs/settings, to serve as guides for these new entities as they begin their new programs/settings going forward.
Heidi: All of the information posted on the OADS webpage could be utilized for new providers to embrace and implement. The training and resources page on the OADS HCBS webpage, is where we house a lot of material. We also created a sub-category for individuals, families, and guardians (click the link above and scroll down to this section). Please check that page out. In January, there were two trainings specific to individuals, families, and guardians; the PowerPoints and recordings are on the webpage.
From that section of the website:
- HCBS Settings Rule: Basics and Advocacy by Disability Rights Maine (YouTube)
- HCBS Choice of Settings Requirement for Individuals/Families/Guardians (PowerPoint)
- HCBS Choice of Settings Requirement for Individuals/Families/Guardians (Webinar) Password: fGuT@9?@
- HCBS Rights Modifications for Individuals/Families/Guardians (PowerPoint)
- HCBS Rights Modifications for Individuals/Families/Guardians (Webinar) Password: =Qvuf+3*
- Your Right to a Community Life 2-28-2020 (PDF)
- HCBS Settings Rule Introductory Overview (PowerPoint)
- Download and open the PowerPoint
- From the Slide-Show tab, select "From the Beginning" to start the recorded slideshow
-It was asked how EconSys was selected for their role.
Betsy: That was through an RFP.
Heidi: Many of the people reviewing the reports based on validation findings are actually people who have been providers in the past in other states. They certainly have seen both sides of this work and bring a lot of knowledge to their positions.
-It was asked how many Residential settings need to be completed by June 30, 2021.
Heidi: All of our residential settings have been validated. It’s the findings reports that are being created now, which should all be issued by 7/31.
-It was asked if an individual enjoys and is invested in Special Olympics participation in various settings whether that would be considered noncompliant with HCBS.
Heidi: I would not say that’s considered non-compliant. That’s a separate issue. What the Settings Rule is intending is that individuals are also offered opportunities in the greater community with individuals who live in the greater community, and not necessarily always tied to a paid staff member.
Cullen: Thank you, Betsy and Heidi, for continuing this great, informative discussion. This presents an opportunity for further dialogue between everyone and the Department so that we ensure we get this right. Thank you again for being here today!
End Presentation (round of applause would have occurred were it not for everyone being muted and on Zoom)
Featured Speaker: Dr. Anne Ryan, STRIVE Online Program Director, PSL STRIVE. www.pslstrive.org Topic: Overview of STRIVE WorldWIDE, an online program that teaches independent living skills to individuals with intellectual disabilities and Autism.
Cullen: Our second featured speaker is Dr. Anne Ryan, STRIVE Online Program Director, with PSL STRIVE. Anne will be providing an overview of STRIVE WorldWIDE, an online program that teaches independent living skills to people with ID/DD. Thank you all for being here, Anne!
Dr. Anne Ryan: What you’re seeing now is Live Caption through Google Slides, which is one of the features we use to make our seminars more accessible to our learners. As Cullen stated, I am Dr. Anne Ryan, STRIVE Online Program Director, with PSL STRIVE. We launched our program in 2019, pre-COVID. At that time, all online learning programs were targeted to the supporter rather than the individuals themselves. All of my notes are included in the presentation which will be linked in the minutes. This is the commercial version of the presentation; I will be hosting a longer version, the infomercial version, of this presentation on 5/18 at 11:30am. You can also reach out to me directly if you want more information ([email protected]).
Begin Presentation (Dr. Ryan provided an in-depth, interactive presentation, and all of her comments are included in the notes on both the PowerPoint and PDF versions of her presentation. Please note the PDF version is not interactive. Click here for the PowerPoint version of the presentation; click here for the PDF version with notes)
Anne: If you have feedback about this presentation you can provide that at this link. If you’re interested in the informational session on 5/18 that I mentioned earlier, you can register online.
Discussion:
-It was asked if STRIVE is accredited, and if the courses are transferable for credit to a college degree.
Anne: These are not college-level course, so no. We do offer people certificates for completing one or more courses.
-It was asked if STRIVE WorldWIDE works with a student’s IEP transition plan.
Anne: We certainly can and have in the past, it just involves working with the school departments. I happened to be married to a Special Education Administrator so I’m familiar with the process. We have some examples of what this could look like, but of course everyone’s IEP is different.
-A parent and special educator asked if they do anything around relationships, sexuality, reproductive health, etc. She stated that it’s sensitive information, but it’s important.
Anne: We have a healthy relationships course. We don’t do the biological pieces, but we talk about what healthy relationships look like, about sexual relationships, healthy and unhealthy boundaries, etc.
Cullen: This was a dazzling presentation and I can see how it would be an interactive and engaging learning experience. Thank you, Anne, and well done!
End Presentation (round of applause would have occurred were it not for everyone being muted and on Zoom)
DHHS – Office of Aging and Disability Services (OADS) - www.maine.gov/dhhs/oads
Betsy Hopkins – Associate Director, DHHS-OADS Disability Services: There are a number of provider agencies who have offered to host a number of vaccine clinics around the state. I have been having them posted on the Coalition website as they come up. I want to thank OHI for hosting the first clinic, and the follow-up clinic this Friday; Living Innovations, which recently hosted a clinic in Caribou; Woodfords Family Services which recently hosted a clinic; JF Murphy Homes which is hosting a clinic in Auburn on 5/14; PSL Services STRIVE which is hosting a clinic on Saturday, 5/15 and is providing a choice of two different vaccines – Pfizer and the Johnson & Johnson vaccine; and Independence Association which will be scheduling one as well in the near future. I really want to thank these providers and the vaccine providers working with them to host these clinics. As far as other things to share, our world has mostly been about HCBS. We’re waiting on information from CMS (Centers for Medicare and Medicaid Services) to let us know what is and is not covered in the American Recovery Plan Act (ARPA) funds. More to follow on this.
-It was asked, without waiting for the CMS guidance, what the Department’s position is because we know the funding can be used to fund waitlists and for rates for providers. It was stated that it was surprising that the Department, through testimony delivered by Paul and others (not Betsy), has not appeared to be supportive of bills to address the waitlists and rate increases. A Coalition member read a portion of the Department’s testimony regarding a DSP rate increase bill (paraphrased for the purposes of these minutes): ‘The Department does not believe an increase in rates is warranted at this time, DSPs have either received rate increases over the past year or are scheduled to in the next few months.’
Betsy: I can’t comment on someone else’s testimony. I will say that in general when we talk about rates – there are rate increases scheduled for 7/1. I’ve heard Paul (Saucier) describe this as helping us bridge the need as we continue to look at rates over the course of the next couple of years. We do not think the rate increases on 7/1 are the end of the story of what’s needed for people to provide these services. That’s the start of our conversation, and Paul has been candid about that. As far as the ARPA funds, there are a lot of ideas about what will and will not be allowed. Until we get specific guidance from CMS, we’re not in a position to discuss what we would do with the funding. The funds are for one year. What happens after that one year if we were to use those funds to provide rate increases, for example? I know there are a lot of conversations, in other states as well, for bonuses and sign-on opportunities as one-time financial incentives to reach the DSPs.
-It was stated that the rate increase appears to just bring wages up to minimum wage.
Betsy: The rates are more than minimum wage; the rates are based on minimum wage but there is more taken into consideration as well.
Laura Cordes: Thank you for the dialogue about the rates. I appreciate the comments on where the Department is, and that it is looking at what other states are doing and has potentially using these funds to stabilize the workforce on its radar. At present, the relief we need is urgent as we’ve lost more than 16% of our workforce in the last year alone. Regarding bringing up the rates to minimum wage – one thing that would be helpful would be for the Department to release the rates scheduled start on 7/1. Knowing what those rates will be would be very beneficial for providers to recruit staff.
Betsy: I will follow-up on that. I’m not sure where that is, but I will look into this further.
-It was stated that the HCBS Settings Rule is about choice, which is dependent upon staffing. In order to reach compliance, other states are funding workforce incentives. It was asked what consideration is there for providing funding to help come into compliance with the HCBS Settings Rule.
Betsy: I would say rates are an important part of that. We know there has been a workforce shortage even before COVID, and it has only gotten worse since COVID. There are different pieces of the work we’re looking at around the workforce piece. I would see hopefully being able to use some of the ARPA funds to incentivize different areas of the workforce in general. When we receive the guidance, we’ll know more about what we can and cannot move ahead.
-It was asked if Maine could somehow develop the DSP workforce by looking at having an AmeriCorps volunteers’ study, perhaps using the ARPA funds. It was stated that AmeriCorps volunteers require an existing nonprofit to take the lead in developing.
Betsy: That is also something to consider, thank you for mentioning it.
Cullen: Thank you very much, Betsy, for being here! This Coalition is about having an open dialogue and providing an inclusive forum for these healthy robust, and respectful discussions, and thank you [to the person asking questions] for modeling how to do that with those questions. Direct dialogue on these hard topics is important. Thank you again for being here, Betsy.
DHHS – Office of Child and Family Services (OCFS) - www.maine.gov/dhhs/ocfs
Teresa Barrows had to leave the meeting early and sent an email update:
- OCFS is continuing to see youth in extended stays in Emergency Departments without safe, appropriate discharge options. The two main Psychiatric Hospitals have been at capacity and unable to take new admissions. The hospitals are also having difficulty discharging youth from an inpatient stay due to a lack of capacity in residential settings, crisis stabilization units (CSU) and with in-home support services. The lack of capacity is related to the staffing shortage across the state.
- OCFS is expanding a “pilot program” to Augusta, Lewiston and Bangor that is currently active on Aroostook County where a youth is able to be discharged home from the Emergency Departments, Hospitals and/or CSUs with intensive crisis services in the home for a period of time to stabilize the youth and family. This has been very successful in Aroostook County and are hope is that it will help with this current crisis for youth that are able to go home with this extra support.
- OCFS/CBHS continues to work on many long-term and short-term strategies to improve the children’s behavioral health system of care.
- OCFS is continuing work on our strategy to improve transition to adulthood and adult services
- OCFS is working with adult services and other entities on drafting a Resource Guide (still in the very early stages) for parents and guardians for youth in transition.
- OCFS will continue to work on creating training modules with adult services for children’s case manager’s on transition to adulthood resources.
Amanda Hodgkins: The resource guide Teresa mentioned in her email update is designed to be for anyone transitioning to adulthood. including people transitioning to OADS, and for people transitioning to OBH (Office of Behavioral Health). Often times case managers aren’t as aware of those resources. We can’t include every resource in the guide, but we’re hoping it’s a good starting point. We did a survey regarding what training people would like to see; we’re looking at the data from those responses which has been informative about what we need to cover for trainings.
Cullen: Thank you for being here today, Amanda!
Special Education – No update
SMACT (Southern Maine Advisory Council on Transition)
Nancy Peavy: SMACT meetings occur on the first Friday of each month, currently via Zoom, at 1pm. The May meeting, the last meeting of the year, was on May 7th and featured Cullen presenting on the Blueprint for Effective Transition. SMACT’s new website is up and running and includes recordings. The SMACT website and the Coalition website are cross-linked for convenience and information-sharing. As a reminder, if you want to be on the email list feel free to email Nancy Peavy ([email protected]). The next meeting is in the fall on 10/1.
Cullen: I was very happy to present. SMACT includes such a diverse group of people, who are far more knowledgeable on transition than I! I’ll just reiterate that it is great that the Coalition’s website and the SMACT website are cross-linked, so you can easily find information from either site.
Disability Rights Maine (DRM) Update:
Laura Wille: We’ve been having a large push for outreach to people receiving services to ensure they’re informed and knowledgeable about the HCBS Settings Rule. The webinar from November on HCBS is finally posted on the website. I’ve been invited to a number of SUFU meetings recently to answer a lot of questions about the HCBS Settings Rule and what that means for their lives. All of our trainings have been recorded and are on our website here.
Federal & Housing Updates:
Cullen:
- The President signed the $1.9 trillion American Rescue Plan Act, which was welcome news. This bill included an additional $5 billion in rental subsidies, which is a major investment in affordable housing and very much needed.
- On 3/31, President Biden released details on his “American Jobs Plan,” an approximately $2 trillion infrastructure and recovery package. This package includes $213 billion to produce, preserve, and retrofit more than two million affordable and sustainable places to live, through grants, formula funding, targeted tax credits, and project-based rental assistance. It is very evident that the Administration is very dedicated to increasing the supply of affordable housing, which as many of you know is sorely lacking in Maine and across the country.
- On 4/23, Senate Republicans released a $568 billion infrastructure proposal in response to President Biden’s $2 trillion “American Jobs Plan.” The Republican plan would provide funding to repair the nation’s roads, bridges, public transit systems, ports and waterways, and airports, as well as investments in broadband expansion and water storage. The proposal includes no funding to address the affordable housing crisis.
- President Biden released details on his “American Families Plan,” a $1.8 trillion companion bill to the $2.5 trillion American Jobs Plan. The American Families Plan would invest in education, childcare, and paid leave, among other priorities. The proposal calls for making community college free, expanding Pell grants for students, investing in universal preschool, expanding nutrition assistance for children, providing paid family and medical leave, permanently extending enhancements to the childcare tax credit, earned income tax credit, and Affordable Care Act, and keeping the expanded child tax credit though 2025.
- President Biden released his “budget blueprint” previewing his full FY 22 budget request, which is expected to be released in the coming weeks. The President’s blueprint proposes a $9 billion or a 15% increase to HUD’s budget from FY 2021. If enacted, the budget would provide substantial federal investments in affordable homes and increase the availability of housing assistance to families with the greatest need. Importantly, the FY 22 budget is the first annual budget bill in a decade that is not confined by the arbitrary spending caps required by the Budget Control Act.
- On 4/12, House Financial Services Committee Chairwoman Maxine Waters (D-CA) released an updated discussion draft of the “Housing is Infrastructure Act.” The Act:
- Invests $70 billion to preserve public housing for current and future generations
- Provides $45 billion through the national Housing Trust Fund to build new homes
- $2 billion to address urgent housing needs in tribal nations, and $2 billion to preserve affordable homes in rural America.
- $5 billion to address lead-hazards and other unsafe housing conditions.
- Resources to help build and preserve homes, through the HOME Investment Partnerships program, Capital Magnet Fund, and programs that serve seniors and people with disabilities.
- Down payment assistance for homebuyers.
- Promotes fair and equitable development: The bill directs several federal agencies – including HUD, Treasury, FEMA, and Agriculture – to require grantees to consult with qualified fair housing enforcement organizations and local fair housing government agencies when applying for investments.
- There are various efforts in Congress to increase the National Housing Trust Fund, which funds the development of housing for people with very low incomes and is the primary funding mechanism for permanent supportive housing in Maine.
State Legislature Update:
Cullen: It has been a very busy stretch! Laura has done an immense amount of work following various bills in the Legislature that pertain to the ID/DD world. Thank you, Laura, for your work to keep us up to date on what’s going on in the Legislature!
Laura Cordes – MACSP (Maine Association for Community Service Providers): I think this group is aware of the document containing the bills we’ve been tracking. (Click here for the document Laura reviewed.)
Laura’s 130th Legislative Session Bills and & Key Committees document was shared with the group, which also includes information on the different budget processes:
Back to Basics Budget for FY 22:
- The House and Senate passed a pared down “back to basics” budget for FY 22 on March 30th that was signed into law by the Governor the same week.
- This was a way for lawmakers to move things forward.
- We learned that there is a $460 million surplus for the next fiscal year, on top of the billions coming into Maine from the Federal government. The Governor is expected to hold a press conference on Wednesday, and a hearing in the Legislature on Friday at 1:00pm, on her budget proposal. The budget hasn’t been released, and likely won’t be until approximately 24 hours before the hearing. The budget may be broken up into other additional budgets because they’re waiting for guidance on numerous things pertaining to the Federal money.
- LD 1573 – This bill was amended and became an omnibus rate bill. The Health & Human Services Committee (HHS) Committee members took all of the rate bills and put them into one. The details aren’t out yet, but it passed unanimously in Committee and provides an across the board rate increase to 125% of minimum wage. This looks comprehensively at the workforce issues in Maine, to get the workforce up and beyond minimum wage. However, the Committee decided not to support an oversight committee to work with DHHS and DOL to take the bipartisan Long-Term Care Workforce Commission recommendations and work on them long-term. The compromise is that the Department will report to the Legislature each year.
- LD 1360 – Similar to what happened with LD 1573, this bill was amended and became an omnibus waitlist bill. The official language combining the related bills into one isn’t out yet. More information to follow.
- LD 415 – This is the bill that increases the rates for Targeted Case Management. The bill passed unanimously out of Committee. Those rates haven’t been touched in well more than a decade, so this is welcome news.
- Upcoming Work Sessions:
- LD 854 – This is the bill that would carve out preschool-aged children with ID/DD pertaining to the Department promulgating rules related to school-based services 9Section 28 and 65). You may remember that the Department had release, then pull the Section 106 rule. They are looking at the rule and looking to reintroduce it, combining Section 65 and Section 28. This bill would ensure that any changes to services for 3-5-year-olds would be considered major substantive, meaning it would go before the Legislature and have a public hearing. The bill also requires the Department to create a workgroup to participate in this rulemaking. Work Session: HHS Committee, 5/11 at 10am.
- LD 1373 – This is the bill that would restrict seclusion and restraint in schools. The entire bill was amended and replaced by the sponsor. The amendment says that any kind of seclusion in schools is prohibited. The bill would not prohibit all restraint, just more severe restraint. Maine is out of step with other states regarding seclusion, and hopefully will be remedied with this bill. Work Session: Education Committee, 5/11 at 1pm.
- LD 1574 – This is the bill which asks the Department to consider in the rates people with high behavioral needs. Work Session: HHS Committee, 5/11 at 10am.
Announcements:
- After the meeting Libby Stone-Sterling, Director, Division of Vocational Rehabilitation, Maine DOL, reached out to share the following information: There is an opportunity this summer for high school students with ASD who are interested in going on to college. This will be the third year that Voc Rehab is offering this program in conjunction with the University of Maine. More information will be posted to the Coalition website when it’s available. For more information contact Libby: [email protected]
The next meeting will be on Monday, June 14, 2021, 12-2pm, via Zoom.
Featured Speaker: Mark Kemmerle, Executive Director, Maine Developmental Services Oversight and Advisory Board (MDSOAB). Topic: MDSOAB Annual Forum – feedback for DHHS, including feedback on the availability, accessibility, and quality of services for persons with intellectual disabilities or autism and their families.
Unless changed, Coalition meetings are on the 2nd Monday of the month from 12-2pm.
(in 2021 the October meeting will be the 3rd Monday due to the holiday)
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].