DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF DEVELOPMENTAL DISABILITIES SERVICES
GOVERNOR’S ADVISORY COUNCIL
TO THE
DIVISION OF DEVELOPMENTAL DISABILITIES SERVICES
July 16, 2013
The Governor’s Advisory Council to the Division of Developmental Disabilities Services met on July 16, 2013, at the 1056 Woodbrook Conference Room, Dover.
COUNCIL MEMBERS PRESENT:Timothy F. Brooks, Ed.D., Acting Chair
Jamie Doane
Thomas Rust
Angela Sipple
COUNCIL MEMBERS ABSENT:Anthony Horstman, Chair
STAFF MEMBERS PRESENT:Jane Gallivan
Warren Ellis
Frann Anderson
Marissa Catalon
Vicky Gordy - recording
GUEST PRESENT:Vicki Haschak
CALL TO ORDER:The meeting was called to order at 1:05 p.m.
NEXT MEETING:September 19, 2013, 10:00 a.m.–12:00 p.m.,
1056 Woodbrook Conference Room, Dover
APPROVAL OF MINUTESTim made a motion to approve the minutes,
Angela seconded the motion.
Minutes approved.
Additions to the Agenda
Judge Rotenberg Center (placed on agenda continuously)
DDDS Vacancies
Jane reported the total vacancies are currently at 30 (4%). Of the vacancies 23 are group homes, 9 are ARC homes (1%) and 7 are CLA’s. The ARC vacant homes have existed for some time. A profile of the homes where vacancies have existed for a period of time will be examined.
Overview of Employment Services Public Hearings
DDDS held Public Hearings to discuss the final proposed changes to the HCBW in all counties. Differences in attendance was substantial (Kent/Sussex = 2 family members and 6 providers; NCC = 40 family members and 2 providers). Families did not appear to have much concern for the change in supported employment definitions but showed more interest in what is to become of sheltered workshops. It was revealed to the public that DDDS is currently not moving forward with redefining other services. The primary discussion was explaining the difference of the roles of DDDS and DVR. Discussion about the evolution of Medicaid occurred. Provider Fairs may be an avenue DDDS will take to help families/individuals understand the different roles of DDDS and DVR. It appears that families/individuals are sensing that changes are occurring in DDDS, which seems to be reinvigorating involvement. The Public Hearings were helpful and a productive tool for DDDS to hear public concerns.
The goal of the draft service definition “Community Participation” is to enhance community participation by helping the individual integrate into the community, while rehabilitation services are to help the individual have independence in the community. DDDS plans to continue to define services in an effort to provide more services to the individuals we serve.
The question of was DDDS pressuring Elwyn to move client’s from pre-vocational services to day habilitation services was raised. This is not happening. The challenge providers may face with continuing pre-vocational services may be establishing a work skills goal.
DDDS April, May & June Census
April, May and June Census reports were distributed to the Council. The June census is in a “draft” form and may need slight revisions after reviewed by Lennie Warren. During the September Council meeting, Lennie will provide the Council with a FY13 Census Report.
The Council questioned if the two placements at the Delaware Psychiatric Center (DPC) were long-term placements. The two individuals reflected in the census are continuously admitted and discharged to DPC (if admitted at end of month, they are counted in census). Two long-term male clients from DPC have been placed at other locations, recently.
Judge Rotenberg Center
DDDS continues to have a client at the Judge Rotenberg Center (JRC) in Massachusetts. DDDS is developing a strategy to handle this situation. It was reported that CMS in Boston sent a letter stating that the Massachusetts DDDS Waiver will not be renewed due to treatment practices at the JRC. Delaware’s DDDS (with help from the Attorney General) is creating a letter citing the out of compliance issues revealed by CMS and if they would like to remain an “approved provider” in Delaware, the cited treatment practices must stop immediately. JRC will be removed as an “approved provided” in Delaware and the client will be removed from JRC if they do not comply. Once a reply is received from JRC, DDDS will act accordingly with family.
The Council recommended keeping this on the agenda, ongoing.
Volunteer Driver Program
Reportedly, many states support a “volunteer driver program” and other states contract with a single vendor for door-to-door transportation. Kent and Sussex Industries (KSI) and Easter Seals (ES) are present in meetings being held by the Department of Transportation (DOT) to begin to look at alternative transportation models. Jane is not aware if a portal is available via Delaware’s website to provide feedback but will provide the Council with a contact name from DOT in the future.
Discussion surrounded that many families are fearful of utilizing DART to transport family members due to the security risks (i.e. family member may wander, driver qualifications, etc.).
The Council questioned if it would be possible to collaborate with KSI, to utilize their fleet vehicles to provide transportation of clients supported by families. KSI currently provides transportation to at least 200 individuals who they serve. Jane does not believe that agencies have an interest in providing “door to door” service for others due to logistic difficulties and the ongoing increases in the cost of transportation.
Family Support Waiver Plan - Respite House (to serve families without residential services)
The Legislature mandated that the plan for a future “Family Support Waiver” is due by April 1, 2014. Jane interprets this as having a "plan" based on feedback meetings with families. Jane met with stakeholder groups who agreed that to determine the wants/needs of clients is to speak to them in their natural surroundings within smaller groups in an effort to provide individuals with a comfort level to voice their wants/needs. DDDS continues to examine models “statewide” and may seek support of national experts.
Jane recently toured a house, across the street from Emily P. Bissell Hospital in New Castle County that was donated to Delaware. The house is structurally intact, may provide up to four available beds and is very open. DDDS would like this house to be a “respite house”, which could be used for planned respites. An RFP may be necessary to provide staffing. The Council spoke of the need for a “respite house” in Sussex County also. Stockley Center is currently holding public meetings to determine the use of acreage at the Stockley Campus. It was revealed that a recommendation was made to develop a “respite house” on the Campus during the public meetings. Structures on the Campus are not structurally sound which would become costly. A suggestion of a respite house being in the community may be better for clients. Transportation should not be an issue due to the respites being planned. Everyone agreed that a “respite house” is a terrific idea and reminded that “respites” not only provide a break for the family but also for the individual to get a break!
National Core Indicators Project
Frann Anderson, Director of the Office of Quality Improvement was introduced to the Council. Frann is spearheading the National Core Indicators (NCI) Project. The NCI Project is a joint project, bringing together multiple state DDS agencies (41) throughout the United States. Information gathered will be used to improve client services for individuals and family members of the DD community, nationwide. DDDS was able to rejoin NCI via being awarded a grant from AIDD. NCI has the largest DDDS informational database in the world.
The first phase is the mailing of the brochure that explains the NCI Project to individuals and families. The brochure was distributed to the Council for review. Suggestions included placing an “attention grabber” to help define the NCI Project on the cover of the brochure, make clear that selection in the survey is random and to include a small definition of each performance measure. The brochure will be reformatted in an effort to grab the participant’s attention. Frann plans to send the brochure to the print shop by the end of the week with a two week anticipated turnaround time.
Frann will meet with the DDDS case manager supervisors to establish training curriculum for case managers identified to collecting survey information; training will begin in September. Individuals participating in the survey will be contacted to schedule a face-to-face meeting in October. Family surveys will be mailed in November.
Interviewees will be randomly selected, by numbering clients 1 through 5, and pulling numbers 1 and 5, next 2 and 5, etc. until the mark is reached.
DDDS has contracted with University of Delaware, Center for Disabilities Studies for students and self-advocates to perform the face-to-face portion of the survey; this survey will be “paperless” as interviewers will be using laptops. Delaware is the first state to contract with a college for this type of survey.
The Council discussed the return rate of any survey being relatively low (25% - 30%). Frann believes that if DDDS does not receive as many surveys as targeted (400 for each) it will be used as a learning tool to get a better rate of return for future surveys.
Discussion revealed that data surrounding “community inclusion” is very limited and that we need to engage more with self-advocates.
Frann is to send a draft survey for Council review.
DelDOT ADA Title II Transition Plan
The upcoming public hearing information was distributed to the Council. A suggestion was made to have a DelDOT ADA representative give a presentation to explain the process and plan during a future Council meeting. Jane will explore possibility.
Waiver Amendment Update – Supported Employment
Changes to amend the Waiver regarding Supported Employment definitions are complete. Once CMS receives, they have 90 days to respond.
Develop Specialized Dual Diagnosis Clinic
DDDS has been discussing with Dr. Gerald Gallucci, DHSS Medical Director the possibility to develop a specialized centrally located unit regarding clients with dual diagnosis. Frann may be helpful to this process, due to her experience with the Division of Substance Abuse and Mental Health. Dr. Gallucci ran a similar program during his employment at Johns Hopkins Hospital. The mental health system is not prepared to offer dual diagnosis services presently. This is partly due to the management of medication in the mental health industry is sometimes non-existent. Polypharmacy issues continue in the mental health field. Statistics reveal that nationally 30% of the population is prescribed psychotropic medication (Delaware’s percent rate is close 30%).
Day Services
The Council reviewed the March, April, May and June Day Service Data Sheets for 2013. Data is separated by agencies and day services categories. A shift in service categories is expected in November.
Currently upcoming school graduates receive funding for 10 months (beginning September and ending in June) which may be altered in the future. Most school graduates qualify for funding of summer programs, which helps individuals who struggle without consistency. Currently this data does not capture services received by age groups although it is safe to presume that individuals participating in sheltered workshops are in a high age bracket.
This data may be available on the DDDS Website in the future.
College of Direct Support
Allan Zaback accepted (and is doing a great job) the task of directing the management of the College of Direct Support (CDS). The roll out of the CDS began, as targeted, on July 1st. More than 25 provider agencies are uploading employee information. Allan reported that agencies are getting familiar with CDS, and are contacting Elsevier with questions. Allan has not experienced any negative feedback from agencies.
Newly Appointed Committee Members
Both Tony Horstman and Tim Brooks was contacted by the Governor’s Office via e-mail asking which of the two applicants they would prefer to be appointed to the Council due to both having the same political party affiliation. Tim gave his opinion. Bottom line is one member will be appointed; another will be needed. Council members whose terms expired have reapplied.
Electronic Case Management System
DDDS continues to anticipate the completion of the RFP. Due to not having an estimated timeframe, Jane will e-mail the Council when updates are available.
Announcements and Informational Items
Council read thank you cards from both Roy Lafontaine and Barbara Ross.
Adjournment
The meeting adjourned at 2:35 p.m.
1
Governor’s Advisory Council Minutes
July 16, 2013