November 8, 2021
Minutes
Minutes
Attendees via Zoom: Linda Lee, Bryan Gordon, Mary Chris Semrow, Michaela York, Sharon, Todd Goodwin, Sarah Robinson, Carol Snyder, Amy Moller, Cathy Dionne, J Richardson Collins, Kristin McPherson, John Tabb, Teresa Barrows, Brenda Smith, Julie Brennan, Maggie Hoffman, Regan, Trena Jackson, Ray Nagel, Sue Murphy, Bonnie Robinson, Mark Kemmerle, Rob, Stephanie Capano Hatcher, Betsy Hopkins, Paul Saucier, Laura Cordes, Alli Vercoe, Jamie Whitehouse, Kim Humphrey, Janet Hamel, LyAnn Grogan, Libby Stone-Sterling, Lucas Cuellar, David Cowing, Debbie Dionne, Heidi Mansir, Helen Hemminger, Paula Bush, Ryan NRS, Stacy Lamontagne, Amanda Hodgkins, Jim Collins, Cathy Curtis, Rachel Dyer, Staci Converse, Spring, Sharon DelSanto, Darla Chafin, Vickey Rand, Cullen Ryan, and about five 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. Minutes from the last meeting were accepted. For the sake of time, Cullen read the names of participants.
Cullen: Today is a chance for us to continue the dialogue we had with Paul and Betsy last month. Paul will be joining us at 1:00 PM, so we’ve set the agenda up to have other updates first. I think the discussion last month was great and I’m very happy we get the opportunity to continue it this month.
DHHS – Office of Child and Family Services (OCFS) - www.maine.gov/dhhs/ocfs
Teresa Barrows: The work we’re doing currently is very exciting. We’re working very hard with Betsy and her team at OADS to develop an implementation plan to make smoother transitions between OCFS and OADS. We’ve looked at all barriers, the pie in the sky what it should look like, etc. We’ve come up with a real need for education for children’s community providers, case managers specifically. We have a way to go but we’re doing a lot of intense work. We’re currently meeting weekly.
Betsy Hopkins: It is a lot of work. A lot of this work started with the recommendations that came from this group’s Blueprint for Effective Transition. We’ll be circling back for stakeholder involvement and responses to what we come up with for the implementation plan. There will be plenty of opportunity for people to weigh in. We’re looking at short, medium, and long-term goals and plans. We hope to have this finalized by the end of December and will then share that with this group and other stakeholders.
Teresa: I think folks are struggling right now with children not having resources to go to in many areas, and children receiving higher levels of care without the ability to transition other resources due to capacity issues in the system. There’s a lot of workforce shortages, and with the pandemic still continuing it’s making staffing a real challenge.
Cullen: Thank you for being here, Teresa, and for these updates!
DOL – Division of Vocational Rehabilitation - www.maine.gov/rehab/dvr
Libby Stone-Sterling: Just a couple quick things. The first is, we have restarted Bureau of Rehabilitation Services (BRS) Stakeholder calls.
Bureau of Rehabilitation Services Stakeholder Meetings – ASL and CART will be available.
This is an opportunity to learn more about programs and services as well as offer your feedback! Meetings occur the 2nd Monday of each month from 9-10 am. The meeting schedule is as follows: Dec 13, 202, Jan 10, 2022, Feb 14, 2022, March 14, 2022, April 11, 2022, and May 9, 2022. Join Zoom Meeting:
https://mainestate.zoom.us/j/85030661047?pwd=dXpnRXhNREMwRy81bnhySVUramM0Zz09
Additionally, we’ve created Division of Vocational Rehabilitation & Division for the Blind and Visually Impaired
DHHS – OADS Liaisons. These individuals will have additional knowledge and resources to help with warm handoffs. We’re very excited to be putting that into place. (Click here for the list of liaisons).
Cullen: Thank you, Libby!
Disability Rights Maine (DRM) Update:
Staci Converse: I wanted to introduce Lucas Cuellar our new Lewiston Advocate. He has a background in immigration and civil law in general, and we’re very happy to have him join us! DRM, along with our partner developmental disabilities network organizations - University of Maine Center for Community Inclusion and Disability Studies, Maine Developmental Disabilities Council and Speaking Up For Us - are collaborating on a series of COVID-19 vaccination public service announcements to help increase the vaccination rate among individuals with disabilities and the people who support them. These are airing in Aroostook county now, but they’re also available on our website. This could be a great tool to assist people with the dialogue around vaccines.
Cullen: Speaking of vaccinations, the Governor put out a vaccine mandate, and there were some concerns that this could affect service delivery. How is this playing out where the rubber meets the road?
-A parent stated that after a lot of anxiety about it, and hearing that staffing would be very low, all but one person was vaccinated in her son’s house. No one had to relocate which was a huge sigh of relief. It’s still a little shaky, but it’s still a huge relief.
Cullen: I’m relieved to hear that your son still has staff surrounding him and that he’s well.
-A parent stated that they lost a staff member in his son’s house. He had a long conversation with the staff person regarding her decision not to get vaccinated. It was very instructive and helpful to have that conversation. Those conversations are really important. He stated that a DSP who works with his son had her building sold and will be losing her apartment. This was eye-opening in terms of how the affordable housing crisis affects DSPs. It’s worth noting that there could be many DSPs who are dealing with the lack of affordable housing and could be affected by the eviction moratorium ending.
Cullen: I’ve heard of an organization who is creating housing for their staff to ensure they have housing – it’s a huge issue and one we ought to delve into more at a future meeting.
-A parent stated that agencies are having to make some very difficult choices. Staff from day programs have been shifted to residential staffing to ensure people don’t lose their homes. But that creates a different conflict and people are losing access to community services. Agencies going through this and the families losing services are in really difficult positions. It’s a “wait and see” type of scenario to see if increased wages, sign-on bonuses, etc. will help build back the DSP workforce.
-A provider stated that there are other forces affecting agencies as well, such as transportation, including in-agency transportation. It’s 6-8 weeks for a vehicle to get repaired because garages are short on parts or staff or both. This is across the board for any type of service. There are multiple things that are affecting service delivery beyond the DSP staffing shortage.
SMACT (Southern Maine Advisory Council on Transition)
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 ([email protected]). SMACT meetings occur the first Friday of each month throughout the school year. The 11/5 meeting featured Jordan Cardone, Coordinator, Brunswick Area Teen Center, and Tina Burns and Timissa Chambers, Coordinators, My Place Teen Center in Westbrook, presenting on teen centers.
Updates/Other Business:
Cathy Dionne: I had reached out to OADS because families have been struggling not knowing what resources are available, especially as programs are reducing hours or closing. I reached out to Betsy saying it would be helpful to have a list of what’s available in one place. Betsy and her staff put together a Resources and Information quick guide, which I found very helpful and wanted to share with this group. (Click here for the DHHS-OADS Resources and Information for families document, which outlines information, resources, and services currently available.). It would be helpful to add more to this, such as agencies who are hiring family members.
Betsy: We do know there are some shared living agencies that have hired family members to be shared living providers. I can look to see if we can find that list. I’m not certain we track it that way, but I’ll see what I can do.
Cathy: It would be helpful for people to take this list of resources to providers to ask if it’s something they’re offering.
-A provider stated that the OADS website has done a great job with including providers and what services they provide on the website, and you can search per service and region. Including this would be helpful as well.
Cullen: That you Cathy and Betsy for this great information!
Announcements:
Federal & Housing Updates:
Cullen:
State Legislature Update:
Laura Cordes – Executive Director, MACSP (Maine Association for Community Service Providers): We’re headed towards the Second Session of the 130th Legislature, known as the short session, which starts the first Wednesday of January, and is scheduled to end the second Wednesday in April. There were a number of bills that were carried over from the First Session. The Legislative Council met at the end of last month to look at the approximately 300 emergency bills submitted by legislators; about 100 of those bills got through. There is a period in which Legislators can contest bills that did not make it through the Legislative Council. There will be a final list of bills, then we’ll start to see language for those bills. Those carry-over bills, which I’m happy to go over in December, will not have public hearings, but I know this group will be interested in how they proceed throughout the Legislative Session. There were also bills covering topics that this group has followed over the past couple of years that established workgroups that will have reports that will lead to further bills to implement those recommendations. We’ll keep our eye out for those as well.
Kim Humphrey – Community Connect: This is a very good time to reach out to legislators, before they get inundated with the Legislative Session. The Community Connect website is a great source of information, and includes a section on policy and advocacy which makes reaching out to your legislators easy – including the postcard options we’ve previously offered (click here for more information). Community Connect is a grassroots advocacy network of families which aims to make the disability community more visible by creating relationships and sharing stories.
Housing Innovation Subgroup:
Cullen: We have Janet Hamel and Mary Chris Semrow with us today who participated in the Housing Innovation Subgroup that just finalized its recommendations. I was hoping that we could review a little of that today since we have time.
Janet Hamel: We’ve been working as a Subgroup for over a year to develop three recommendations to bring back to the DS Innovation Work Group. (Click here for the Housing Innovation Recommendations). The DS Innovation Work Group has a number of subgroups that came up with recommendations in their areas, which will be combined into a summary version to be presented to the Commissioner in January.
LD 924 Task Force Update:
Linda Lee: LD 924, Resolve, To Establish a Task Force To Study the Coordination of Services and Expansion of Educational Programs for Young Adults with Intellectual or Developmental Disabilities To Identify Barriers to Full Societal Integration, is the bill to establish a task force to look at the transition process. A few parents came together to work with legislators on this bill for the past three years, and it finally passed this year. The first meeting of the taskforce is tomorrow. A few of the parents who initiated the bill will be on the task force, but we want to bring as many parent voices to that work as possible. We’re working on a parent-to-parent survey to gather stories and create an inventory of what’s happening – both what is and is not working. If anyone would like to email me with questions they’d like to see on the survey, please feel free: [email protected]
Featured Speaker: Paul Saucier, Director, DHHS-Office of Aging and Disability Services (OADS), and Betsy Hopkins, Associate Director, Disability Services DHHS-OADS. www.maine.gov/dhhs/oads. Topic: Part 2 of what’s going on at OADS, including additional updates and a question/answer session with Paul and Betsy.
Cullen: Today we have Paul Saucier, Director, and Betsy Hopkins, Associate Director, Disability Services DHHS-OADS, following up from last month’s meeting by presenting part two of what’s going on at OADS, including additional updates with an opportunity for a question/answer session after. Paul and Betsy, I appreciate you coming back and taking the time to continue the discussion from last month. It’s wonderful to have you!
Paul Saucier: Thank you all for being here again today. Particularly in these tough times it’s helpful for us to hear direct feedback from folks, so this is very helpful. Thank you.
Begin Presentation (Click here for the presentation)
Paul:
Mission – There’s tension in the mission, and there always has been, between fostering independence and ensuring safety. When you add in a pandemic and staffing shortages that tension just increases.
Staffing – I want to thank everyone for their hard work over the past month as we ran up against the deadline for workers to be vaccinated. People were extremely flexible and understanding. Providers’ schedules were turned on their head on almost a daily basis. I want to thank everyone for helping all of us get through this deadline without a major disruption to residential programs. I did want to second the comment about their being a secondary impact to this – for at least one agency most of their community support programs had to close to ensure that people’s homes could be maintained. We understand this is a major impact on families. We will continue to work with families to bring services back up as quickly as possible. There are glimmers of hope though, for instance that one agency was able to hire four new staff last week, but people need to come to this work in greater numbers than that for us to get programs up and running. We continue to monitor closures and movement quite closely. We’re working with our colleagues in other parts of the Department to monitor all of this. We have had 18 homes that have closed temporarily or permanently, with a total capacity of 53 beds, the average size being just under three. Most of them have chosen to retain their license and have indicated they want to bring their homes back online when they can get the staffing necessary to do so, but that’s not true of all of them. There are a few that indicated a very unique reason for closure. Most of the agencies worked very hard at retaining people within their agencies. Mostly we’ve seen consolidations within agencies. That still reduces capacity, especially for people coming in, but to be able to stay within the agency you know with many of the people you know around you is a positive outcome. The closures happened across the state, from rural to more urban, the numbers remained fairly consistent.
Aging and Disability Mortality Review Panel – This came from the OIG recommendations from 2017. This will be an important addition to our quality improvement infrastructure, and many thanks to the MDSOAB (Maine Developmental Services Oversight and Advisory Board) and others around this table for their advocacy efforts on this. In the meantime, while awaiting this, we set up a process in response to the OIG report, where APS reviews all deaths and refers all those that may be suspicious to the Office of the Chief Medical Examiner.
Betsy Hopkins: I was happy to hear the Housing Innovations Subgroup work shared earlier. As you know we’ve had three on-going reform work groups made up of a broad array of stakeholders. The meetings have been very well attended and the participation of all of the members has been wonderful. We were meeting during the heart of the pandemic when there were so many challenges around COVID, both professionally and personally. It was invigorating to have a group of people come together and discuss the future of the programs. I found it very valuable, and I loved the engagement and the work the groups did. We have two work groups finishing up their work and have sent their recommendations to us. We just received those and we’re compiling the, and we’ll share that publicly, and present those recommendations to the Commissioner’s Office later in January. I wanted to shar a little bit of what we focused on in each of those groups:
Community Membership Work Group: Final Recommendations sent to OADS.
Innovation Work Group: Final Recommendations sent to OADS.
Quality Assurance and Quality Improvement Work Group: Began in March of 2021 and will be continuing their work until March of 2022.
Communication: Has not started yet.
Two Upcoming Stakeholder Meetings:
Cullen: Thank you both again, for this presentation and continuing the discussion from last month!
Discussion:
-A parent thanked Paul and Betsy for the information. He asked if there’s a date set for the Communication Work Group to begin meeting.
Betsy: We don’t have an actual date yet. I have the two people who will facilitate the group established and the plan is for the first meeting to be held in mid-December. I will get that date out this week once it’s finalized.
Laura Cordes: I was glad to see the meeting on 11/19 about the assessment. I wondered if you could speak to the timeline as you know it when you’d imagine these assessments would start in Maine. My recollection is it might be in the earlier part of FY 23.
Paul: We don’t want to scoop the Innovation Work Group too much, but we did receive money in this legislative session to complete a round of assessments in the current fiscal year. But we need to issue an RFP. We’re hoping to have a contract award to the assessor in February or March and start the assessments in April of this fiscal year. We’re not likely to get them all done this fiscal year. We’re going to start with a representative sample and look at the batch of results for analysis.
-A parent asked how close they work with the Division of Family Independence.
Paul: I have to be honest on this one, we talk with them but they’re not one of our frequent partners. When we have specific issues around MaineCare eligibility we do. If there’s an issue I’d love to know about it though.
-A parent stated that she discovered that a lot of people are being investigated by them off-and-on, which is likely necessary, but people shouldn’t have to go through that kind of stress. She stated that so much time is wasted trying to verify things. Her daughter’s case manager spent several months convincing them she was indeed her case manager, then the parent had to spend an equal amount of time convincing them she had guardianship of her daughter, etc. Add this to the general stresses and anxieties people are experiencing and it’s very overwhelming, and a lot of wasted time and frustration. There must be a way to improve this process and streamline it.
Paul: I’m very sorry for your frustration and your experience. I’m sure we all know that they don’t want to give information out to people who shouldn’t have it. But I definitely understand your frustration, and I’m sorry on behalf of the Department.
-She stated that she’s gone through this process a few times now, so the time invested, and the frustration is duplicative – they had it in their records. She added that there was staff turnover in her daughter’s home which has been challenging.
-A parent asked how the vaccine mandate, the staffing shortage, etc. interrelate with the implementation of the HCBS Settings Rule.
Paul: I’ve been very impressed with providers’ responses to the HCBS Settings Rule and the transition plans. The staffing challenge is yet another challenge, but I’m confident that with people’s willingness and intent to get it done that we will. Regarding the new Federal mandates coming down – there are two that the Biden Administration announced last week, and they do interact. The CMS that requires healthcare workers to be vaccinated, and it’s a narrower application than we expected – we thought it could apply to any provider that receives Medicare/Medicaid, but it only applies to federally certified facilities which Maine had already addressed it in its mandate. The way it interacts with the OSHA Rule, which says if you’re subject to the CMS mandate then you can just comply with that. The OSHA (Occupational Safety and Health Administration) Rule is for employers of 100 or more. These larger employers will be required to have their staff either vaccinated or subject to testing. The way Maine’s workplace safety rules work is that federal rule has to be digested by the Maine Occupational Safety Board, which has 30 days to do, then we’ll get Maine-specific details. Both rules are set to take effect 1/4/22. However, a federal court blocked the OSHA Rule from going into effect, so more to follow on that. I don’t see a lot of additional impact in Maine for the ID/DD community of providers, unless you’re a very large employer.
-Someone unable to attend the meeting today wanted to express her gratitude to Paul and Betsy for their willingness to share in the inclusive common good of helping each other by attending today’s meeting and speaking. She asked how the transportation system will be improved for the direction to the person served. And how can those who are eligible for services but are on a waiting list obtain a network of support, such as peer-to-peer support for parents and self-advocates. As an example, this meeting offers great support to people, lets them know they are not alone, and provides information and opportunities to learn about community resources.
Paul: The transportation question – there’s nothing to say about that now. As you know we have a transportation project proposed. When CMS approves our FMAP projects, which includes a more self-directed transportation benefit for people in waiver programs, we will be able to provide more information. So more to follow on that. The second question is a great one. If you’re on a waitlist you qualify for case management services. The Resources and Information Guide that Cathy Dionne reviewed earlier will have some information that is helpful in getting connected with a case manager. Case managers should be able to direct people to groups across the state. We rely on case management heavily to identify these resources for folks while they’re waiting for services.
-A provider stated group homes don’t appear to be affected by the CMS mandate.
Paul: My reading of the CMS Rule is similar to yours; it wouldn’t affect group homes.
-A provider stated that most transportation companies have honored transportation requests if it’s documented in the PCP. The company that used to be LogistiCare has stated it has to have a +3 number. He stated that he doesn’t have any information on the company that bought out LogistiCare and as such has no one to contact about this issue.
Paul: I’ll get you that information. I wasn’t aware that they had changed their operational protocols, but you never know. If that’s what you’re experiencing, it definitely needs to be addressed. We’ll get you someone to contact. Thank you for bringing this up.
Paul: I appreciate all of your feedback. We have a lot going on, and we’ll have more in the new year. We look forward to coming back with more to share in the future.
Cullen: Thank you very much, Paul and Betsy, for providing this information, for putting us all at ease, and for the great question and answer session. This type of transparent, open dialogue is critical, so please keep coming back so we can continue to work together!
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 - No additional updates
The next meeting will be on Monday, December 13, 2021, 12-2pm, via Zoom*.
Featured Speaker & Topic TBD.
Unless changed, Coalition meetings are on the 2nd Monday of the month from 12-2pm.
(in 2022 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. Minutes from the last meeting were accepted. For the sake of time, Cullen read the names of participants.
Cullen: Today is a chance for us to continue the dialogue we had with Paul and Betsy last month. Paul will be joining us at 1:00 PM, so we’ve set the agenda up to have other updates first. I think the discussion last month was great and I’m very happy we get the opportunity to continue it this month.
DHHS – Office of Child and Family Services (OCFS) - www.maine.gov/dhhs/ocfs
Teresa Barrows: The work we’re doing currently is very exciting. We’re working very hard with Betsy and her team at OADS to develop an implementation plan to make smoother transitions between OCFS and OADS. We’ve looked at all barriers, the pie in the sky what it should look like, etc. We’ve come up with a real need for education for children’s community providers, case managers specifically. We have a way to go but we’re doing a lot of intense work. We’re currently meeting weekly.
Betsy Hopkins: It is a lot of work. A lot of this work started with the recommendations that came from this group’s Blueprint for Effective Transition. We’ll be circling back for stakeholder involvement and responses to what we come up with for the implementation plan. There will be plenty of opportunity for people to weigh in. We’re looking at short, medium, and long-term goals and plans. We hope to have this finalized by the end of December and will then share that with this group and other stakeholders.
Teresa: I think folks are struggling right now with children not having resources to go to in many areas, and children receiving higher levels of care without the ability to transition other resources due to capacity issues in the system. There’s a lot of workforce shortages, and with the pandemic still continuing it’s making staffing a real challenge.
Cullen: Thank you for being here, Teresa, and for these updates!
DOL – Division of Vocational Rehabilitation - www.maine.gov/rehab/dvr
Libby Stone-Sterling: Just a couple quick things. The first is, we have restarted Bureau of Rehabilitation Services (BRS) Stakeholder calls.
Bureau of Rehabilitation Services Stakeholder Meetings – ASL and CART will be available.
This is an opportunity to learn more about programs and services as well as offer your feedback! Meetings occur the 2nd Monday of each month from 9-10 am. The meeting schedule is as follows: Dec 13, 202, Jan 10, 2022, Feb 14, 2022, March 14, 2022, April 11, 2022, and May 9, 2022. Join Zoom Meeting:
https://mainestate.zoom.us/j/85030661047?pwd=dXpnRXhNREMwRy81bnhySVUramM0Zz09
Additionally, we’ve created Division of Vocational Rehabilitation & Division for the Blind and Visually Impaired
DHHS – OADS Liaisons. These individuals will have additional knowledge and resources to help with warm handoffs. We’re very excited to be putting that into place. (Click here for the list of liaisons).
Cullen: Thank you, Libby!
Disability Rights Maine (DRM) Update:
Staci Converse: I wanted to introduce Lucas Cuellar our new Lewiston Advocate. He has a background in immigration and civil law in general, and we’re very happy to have him join us! DRM, along with our partner developmental disabilities network organizations - University of Maine Center for Community Inclusion and Disability Studies, Maine Developmental Disabilities Council and Speaking Up For Us - are collaborating on a series of COVID-19 vaccination public service announcements to help increase the vaccination rate among individuals with disabilities and the people who support them. These are airing in Aroostook county now, but they’re also available on our website. This could be a great tool to assist people with the dialogue around vaccines.
Cullen: Speaking of vaccinations, the Governor put out a vaccine mandate, and there were some concerns that this could affect service delivery. How is this playing out where the rubber meets the road?
-A parent stated that after a lot of anxiety about it, and hearing that staffing would be very low, all but one person was vaccinated in her son’s house. No one had to relocate which was a huge sigh of relief. It’s still a little shaky, but it’s still a huge relief.
Cullen: I’m relieved to hear that your son still has staff surrounding him and that he’s well.
-A parent stated that they lost a staff member in his son’s house. He had a long conversation with the staff person regarding her decision not to get vaccinated. It was very instructive and helpful to have that conversation. Those conversations are really important. He stated that a DSP who works with his son had her building sold and will be losing her apartment. This was eye-opening in terms of how the affordable housing crisis affects DSPs. It’s worth noting that there could be many DSPs who are dealing with the lack of affordable housing and could be affected by the eviction moratorium ending.
Cullen: I’ve heard of an organization who is creating housing for their staff to ensure they have housing – it’s a huge issue and one we ought to delve into more at a future meeting.
-A parent stated that agencies are having to make some very difficult choices. Staff from day programs have been shifted to residential staffing to ensure people don’t lose their homes. But that creates a different conflict and people are losing access to community services. Agencies going through this and the families losing services are in really difficult positions. It’s a “wait and see” type of scenario to see if increased wages, sign-on bonuses, etc. will help build back the DSP workforce.
-A provider stated that there are other forces affecting agencies as well, such as transportation, including in-agency transportation. It’s 6-8 weeks for a vehicle to get repaired because garages are short on parts or staff or both. This is across the board for any type of service. There are multiple things that are affecting service delivery beyond the DSP staffing shortage.
SMACT (Southern Maine Advisory Council on Transition)
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 ([email protected]). SMACT meetings occur the first Friday of each month throughout the school year. The 11/5 meeting featured Jordan Cardone, Coordinator, Brunswick Area Teen Center, and Tina Burns and Timissa Chambers, Coordinators, My Place Teen Center in Westbrook, presenting on teen centers.
Updates/Other Business:
Cathy Dionne: I had reached out to OADS because families have been struggling not knowing what resources are available, especially as programs are reducing hours or closing. I reached out to Betsy saying it would be helpful to have a list of what’s available in one place. Betsy and her staff put together a Resources and Information quick guide, which I found very helpful and wanted to share with this group. (Click here for the DHHS-OADS Resources and Information for families document, which outlines information, resources, and services currently available.). It would be helpful to add more to this, such as agencies who are hiring family members.
Betsy: We do know there are some shared living agencies that have hired family members to be shared living providers. I can look to see if we can find that list. I’m not certain we track it that way, but I’ll see what I can do.
Cathy: It would be helpful for people to take this list of resources to providers to ask if it’s something they’re offering.
-A provider stated that the OADS website has done a great job with including providers and what services they provide on the website, and you can search per service and region. Including this would be helpful as well.
Cullen: That you Cathy and Betsy for this great information!
Announcements:
- Autism Society of Maine – 5th Annual Fall Conference is this Saturday, 11/13, at the Cross Insurance Center in Bangor, doors open at 8am. Safety protocols will be followed. There are a number of great sessions planned, it’s free, and there’s still time to register if people are interested. Click here for more information, including how to register.
- Specialized Housing, Inc. is having a virtual Info Session on the opening at E Street. (Click here for more information).
- Thanks to Bangor Savings Bank, ABLE Act accounts are finally open in Maine through Bangor Savings Bank ABLE Benefit Checking Accounts. Autism Society of Maine and Bangor Savings Bank are hosting an information webinar on 11/19 at noon. (Click here to register for the webinar).
Federal & Housing Updates:
Cullen:
- Federal Budget: On 9/30 Congress passed and the President signed a short-term Continuing Resolution (CR) to keep the government open through 12/3. The CR maintains current federal funding levels through 12/3. The bill also includes $28.6 billion for communities hit by natural disasters over the past 18 months and $6.3 billion to help support resettlement for Afghan refugees. On 10/14 the President signed a separate measure raising the nation's debt limit until early December, delaying potentially defaulting on the nation’s debts. Advocates are working to ensure that the final FY 22 budget includes the highest possible funding for HUD programs, including Section 8.
- Senate FY 22 T-HUD Budget: On 10/19 the Senate Appropriations Committee released its FY 22 THUD bill. Overall, the bill increases funding for HUD programs in FY22, although at levels lower than those proposed in the House. The Senate bill funds HUD at $65.4 billion, or $5.7 billion above FY21 enacted levels. Unfortunately, the Senate bill does not include the major expansion of rental assistance proposed by both President Biden and the House.
- Congress’ Budget Resolution & “Build Back Better Act” Infrastructure Reconciliation Package: On 11/5, instead of voting on the Build Back Better Act as planned, the House instead passed the $1.2 trillion bipartisan infrastructure bill, which the House had previously tied to the passage of Build Back Better as leverage to get the broader social spending bill passed. An agreement was reached the evening of 11/5 to vote on the Build Back Better Act during the week of 11/14.
- $25 billion in rental assistance for hundreds of thousands of households.
- $65 billion to preserve our nation’s public housing infrastructure.
- $15 billion for the national Housing Trust Fund (HTF) to build and preserve over 150,000 homes affordable to extremely low-income households.
- $150 billion for Home and Community-Based Services.
- The Decent, Affordable, Safe Housing for All (DASH) Act: On 8/18 Senate Finance Committee Chair Ron Wyden (D-Ore.) announced the DASH Act, legislation to make a generational investment to which would tackle the housing affordability crisis, among various other important measures. Pertinent to this group, the legislation increases funding for low- and middle-income housing development and provides $10 billion in the Housing Trust Fund (HTF) for the next ten years to states to acquire, develop, or rehabilitate deeply affordable housing. In Maine, resources from the HTF are the primary funding mechanism for supportive housing development.
State Legislature Update:
Laura Cordes – Executive Director, MACSP (Maine Association for Community Service Providers): We’re headed towards the Second Session of the 130th Legislature, known as the short session, which starts the first Wednesday of January, and is scheduled to end the second Wednesday in April. There were a number of bills that were carried over from the First Session. The Legislative Council met at the end of last month to look at the approximately 300 emergency bills submitted by legislators; about 100 of those bills got through. There is a period in which Legislators can contest bills that did not make it through the Legislative Council. There will be a final list of bills, then we’ll start to see language for those bills. Those carry-over bills, which I’m happy to go over in December, will not have public hearings, but I know this group will be interested in how they proceed throughout the Legislative Session. There were also bills covering topics that this group has followed over the past couple of years that established workgroups that will have reports that will lead to further bills to implement those recommendations. We’ll keep our eye out for those as well.
Kim Humphrey – Community Connect: This is a very good time to reach out to legislators, before they get inundated with the Legislative Session. The Community Connect website is a great source of information, and includes a section on policy and advocacy which makes reaching out to your legislators easy – including the postcard options we’ve previously offered (click here for more information). Community Connect is a grassroots advocacy network of families which aims to make the disability community more visible by creating relationships and sharing stories.
Housing Innovation Subgroup:
Cullen: We have Janet Hamel and Mary Chris Semrow with us today who participated in the Housing Innovation Subgroup that just finalized its recommendations. I was hoping that we could review a little of that today since we have time.
Janet Hamel: We’ve been working as a Subgroup for over a year to develop three recommendations to bring back to the DS Innovation Work Group. (Click here for the Housing Innovation Recommendations). The DS Innovation Work Group has a number of subgroups that came up with recommendations in their areas, which will be combined into a summary version to be presented to the Commissioner in January.
LD 924 Task Force Update:
Linda Lee: LD 924, Resolve, To Establish a Task Force To Study the Coordination of Services and Expansion of Educational Programs for Young Adults with Intellectual or Developmental Disabilities To Identify Barriers to Full Societal Integration, is the bill to establish a task force to look at the transition process. A few parents came together to work with legislators on this bill for the past three years, and it finally passed this year. The first meeting of the taskforce is tomorrow. A few of the parents who initiated the bill will be on the task force, but we want to bring as many parent voices to that work as possible. We’re working on a parent-to-parent survey to gather stories and create an inventory of what’s happening – both what is and is not working. If anyone would like to email me with questions they’d like to see on the survey, please feel free: [email protected]
Featured Speaker: Paul Saucier, Director, DHHS-Office of Aging and Disability Services (OADS), and Betsy Hopkins, Associate Director, Disability Services DHHS-OADS. www.maine.gov/dhhs/oads. Topic: Part 2 of what’s going on at OADS, including additional updates and a question/answer session with Paul and Betsy.
Cullen: Today we have Paul Saucier, Director, and Betsy Hopkins, Associate Director, Disability Services DHHS-OADS, following up from last month’s meeting by presenting part two of what’s going on at OADS, including additional updates with an opportunity for a question/answer session after. Paul and Betsy, I appreciate you coming back and taking the time to continue the discussion from last month. It’s wonderful to have you!
Paul Saucier: Thank you all for being here again today. Particularly in these tough times it’s helpful for us to hear direct feedback from folks, so this is very helpful. Thank you.
Begin Presentation (Click here for the presentation)
Paul:
Mission – There’s tension in the mission, and there always has been, between fostering independence and ensuring safety. When you add in a pandemic and staffing shortages that tension just increases.
Staffing – I want to thank everyone for their hard work over the past month as we ran up against the deadline for workers to be vaccinated. People were extremely flexible and understanding. Providers’ schedules were turned on their head on almost a daily basis. I want to thank everyone for helping all of us get through this deadline without a major disruption to residential programs. I did want to second the comment about their being a secondary impact to this – for at least one agency most of their community support programs had to close to ensure that people’s homes could be maintained. We understand this is a major impact on families. We will continue to work with families to bring services back up as quickly as possible. There are glimmers of hope though, for instance that one agency was able to hire four new staff last week, but people need to come to this work in greater numbers than that for us to get programs up and running. We continue to monitor closures and movement quite closely. We’re working with our colleagues in other parts of the Department to monitor all of this. We have had 18 homes that have closed temporarily or permanently, with a total capacity of 53 beds, the average size being just under three. Most of them have chosen to retain their license and have indicated they want to bring their homes back online when they can get the staffing necessary to do so, but that’s not true of all of them. There are a few that indicated a very unique reason for closure. Most of the agencies worked very hard at retaining people within their agencies. Mostly we’ve seen consolidations within agencies. That still reduces capacity, especially for people coming in, but to be able to stay within the agency you know with many of the people you know around you is a positive outcome. The closures happened across the state, from rural to more urban, the numbers remained fairly consistent.
Aging and Disability Mortality Review Panel – This came from the OIG recommendations from 2017. This will be an important addition to our quality improvement infrastructure, and many thanks to the MDSOAB (Maine Developmental Services Oversight and Advisory Board) and others around this table for their advocacy efforts on this. In the meantime, while awaiting this, we set up a process in response to the OIG report, where APS reviews all deaths and refers all those that may be suspicious to the Office of the Chief Medical Examiner.
Betsy Hopkins: I was happy to hear the Housing Innovations Subgroup work shared earlier. As you know we’ve had three on-going reform work groups made up of a broad array of stakeholders. The meetings have been very well attended and the participation of all of the members has been wonderful. We were meeting during the heart of the pandemic when there were so many challenges around COVID, both professionally and personally. It was invigorating to have a group of people come together and discuss the future of the programs. I found it very valuable, and I loved the engagement and the work the groups did. We have two work groups finishing up their work and have sent their recommendations to us. We just received those and we’re compiling the, and we’ll share that publicly, and present those recommendations to the Commissioner’s Office later in January. I wanted to shar a little bit of what we focused on in each of those groups:
Community Membership Work Group: Final Recommendations sent to OADS.
- Community Support Service Reform
- Implementation of Employment First Statute
- Person Centered Planning Improvement, including self-determination and advocacy
- Home and Community Based Service Setting Rule, post 2023
Innovation Work Group: Final Recommendations sent to OADS.
- Innovative Housing
- Crisis Prevention and De-escalation
- Self-Directed Services
- Technology
- Implementation of a Standardized Needs Assessment
- Services Across a Lifespan
Quality Assurance and Quality Improvement Work Group: Began in March of 2021 and will be continuing their work until March of 2022.
- Definition of Quality
- What Data Will Help Inform our Decisions?
- How Do we Move From Quality Assurance (Compliance) to Quality Improvement?
Communication: Has not started yet.
Two Upcoming Stakeholder Meetings:
- Standardized Needs Assessment – This is an opportunity for us to share what we’ve learned and our plans moving forward. This is the first step of stakeholder engagement, there will be other opportunities to provide feedback.
- Listening Session 14-197 Chapter 3 – Chapter 13 is the regulation that includes the definition of an individual with mental retardation – this is very out of date language/terminology that needs to be updated but it is the language included in the rule. The rule must be updated to come into compliance with the HCBS Settings Rule, but we want to update it to use the correct DSM (Diagnostic and Statistical Manual of Mental Disorders) language. This would be an opportunity for people to provide their feedback on that rule. It’s helpful for us to have those listening sessions as we hear the key areas in which people have concerns, which we can keep in mind as we work on updating the rules.
Cullen: Thank you both again, for this presentation and continuing the discussion from last month!
Discussion:
-A parent thanked Paul and Betsy for the information. He asked if there’s a date set for the Communication Work Group to begin meeting.
Betsy: We don’t have an actual date yet. I have the two people who will facilitate the group established and the plan is for the first meeting to be held in mid-December. I will get that date out this week once it’s finalized.
Laura Cordes: I was glad to see the meeting on 11/19 about the assessment. I wondered if you could speak to the timeline as you know it when you’d imagine these assessments would start in Maine. My recollection is it might be in the earlier part of FY 23.
Paul: We don’t want to scoop the Innovation Work Group too much, but we did receive money in this legislative session to complete a round of assessments in the current fiscal year. But we need to issue an RFP. We’re hoping to have a contract award to the assessor in February or March and start the assessments in April of this fiscal year. We’re not likely to get them all done this fiscal year. We’re going to start with a representative sample and look at the batch of results for analysis.
-A parent asked how close they work with the Division of Family Independence.
Paul: I have to be honest on this one, we talk with them but they’re not one of our frequent partners. When we have specific issues around MaineCare eligibility we do. If there’s an issue I’d love to know about it though.
-A parent stated that she discovered that a lot of people are being investigated by them off-and-on, which is likely necessary, but people shouldn’t have to go through that kind of stress. She stated that so much time is wasted trying to verify things. Her daughter’s case manager spent several months convincing them she was indeed her case manager, then the parent had to spend an equal amount of time convincing them she had guardianship of her daughter, etc. Add this to the general stresses and anxieties people are experiencing and it’s very overwhelming, and a lot of wasted time and frustration. There must be a way to improve this process and streamline it.
Paul: I’m very sorry for your frustration and your experience. I’m sure we all know that they don’t want to give information out to people who shouldn’t have it. But I definitely understand your frustration, and I’m sorry on behalf of the Department.
-She stated that she’s gone through this process a few times now, so the time invested, and the frustration is duplicative – they had it in their records. She added that there was staff turnover in her daughter’s home which has been challenging.
-A parent asked how the vaccine mandate, the staffing shortage, etc. interrelate with the implementation of the HCBS Settings Rule.
Paul: I’ve been very impressed with providers’ responses to the HCBS Settings Rule and the transition plans. The staffing challenge is yet another challenge, but I’m confident that with people’s willingness and intent to get it done that we will. Regarding the new Federal mandates coming down – there are two that the Biden Administration announced last week, and they do interact. The CMS that requires healthcare workers to be vaccinated, and it’s a narrower application than we expected – we thought it could apply to any provider that receives Medicare/Medicaid, but it only applies to federally certified facilities which Maine had already addressed it in its mandate. The way it interacts with the OSHA Rule, which says if you’re subject to the CMS mandate then you can just comply with that. The OSHA (Occupational Safety and Health Administration) Rule is for employers of 100 or more. These larger employers will be required to have their staff either vaccinated or subject to testing. The way Maine’s workplace safety rules work is that federal rule has to be digested by the Maine Occupational Safety Board, which has 30 days to do, then we’ll get Maine-specific details. Both rules are set to take effect 1/4/22. However, a federal court blocked the OSHA Rule from going into effect, so more to follow on that. I don’t see a lot of additional impact in Maine for the ID/DD community of providers, unless you’re a very large employer.
-Someone unable to attend the meeting today wanted to express her gratitude to Paul and Betsy for their willingness to share in the inclusive common good of helping each other by attending today’s meeting and speaking. She asked how the transportation system will be improved for the direction to the person served. And how can those who are eligible for services but are on a waiting list obtain a network of support, such as peer-to-peer support for parents and self-advocates. As an example, this meeting offers great support to people, lets them know they are not alone, and provides information and opportunities to learn about community resources.
Paul: The transportation question – there’s nothing to say about that now. As you know we have a transportation project proposed. When CMS approves our FMAP projects, which includes a more self-directed transportation benefit for people in waiver programs, we will be able to provide more information. So more to follow on that. The second question is a great one. If you’re on a waitlist you qualify for case management services. The Resources and Information Guide that Cathy Dionne reviewed earlier will have some information that is helpful in getting connected with a case manager. Case managers should be able to direct people to groups across the state. We rely on case management heavily to identify these resources for folks while they’re waiting for services.
-A provider stated group homes don’t appear to be affected by the CMS mandate.
Paul: My reading of the CMS Rule is similar to yours; it wouldn’t affect group homes.
-A provider stated that most transportation companies have honored transportation requests if it’s documented in the PCP. The company that used to be LogistiCare has stated it has to have a +3 number. He stated that he doesn’t have any information on the company that bought out LogistiCare and as such has no one to contact about this issue.
Paul: I’ll get you that information. I wasn’t aware that they had changed their operational protocols, but you never know. If that’s what you’re experiencing, it definitely needs to be addressed. We’ll get you someone to contact. Thank you for bringing this up.
Paul: I appreciate all of your feedback. We have a lot going on, and we’ll have more in the new year. We look forward to coming back with more to share in the future.
Cullen: Thank you very much, Paul and Betsy, for providing this information, for putting us all at ease, and for the great question and answer session. This type of transparent, open dialogue is critical, so please keep coming back so we can continue to work together!
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 - No additional updates
The next meeting will be on Monday, December 13, 2021, 12-2pm, via Zoom*.
Featured Speaker & Topic TBD.
Unless changed, Coalition meetings are on the 2nd Monday of the month from 12-2pm.
(in 2022 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].