State Council for Persons Wth Disabilities

STATE COUNCIL FOR PERSONS WTH DISABILITIES

FULL COUNCIL MEETING MINUTES

January 25, 2010 – 1:30 PM

AppoquiniminkStateServiceCenter, Middletown

MEMBERS PRESENT

Sandy Tuttle, Vice-Chair (chaired the meeting in Daniese’s absence);Bob Goodhart, DVI; Brian Hartman, DLP/DDC; Bonnie Hitch, DART; Tony Horstman, Council on DDDS/Parent; Christine Long, DDDS/DHSS; Don Moore, Consumer; Dan Muterspaw, AAB; Alisa Olshefsky, DPH; Loretta Sarro, DOL/DVR; DODHH & CODHHE; Liz Schantz, Consumer;Debra Veenema, National MS Society/DE Chapter;Jamie Wolfe, Consumer;Lois Steele and Mona Slivar, Interpreters, Nick Fina, Hearing Loss Association of Delaware/CERTS; Wendy Strauss, GACEC; Kyle Hodges, Staff and Jo Singles, Support Staff.

MEMBERS ABSENT

Daniese McMullin-Powell, Chair; Jack Akester, GACSAMH; Ray Brouillette, Easter Seals; Ernest Cole, Freedom Center for Independent Living; Susan Cycyk, DSCYF; Lisa Furber, State Rehabilitation Council;Connie Hughes, DelARF;Janet Leitch, Consumer; Dale Matusevich, DOE; Carolanne O’Brien, DOL; Susan Cycyk, DCMHS/DSCYF; Regina Byers, GCAAPD;Ann Phillips, Parent.

GUESTS

Dina Sanz, JEVS Supports for Independence

Greg Manz, JEVS Supports for Independence

Anthony Carter, JEVS Supports for Independence

CALL TO ORDER

Sandy Tuttlecalled the meeting to order at 1:40 pm. Everyone introduced themselves.

ADDITIONS DELETIONS TO THE AGENDA

Add: Proposed changes to Paratransit – Bonnie Hitch

Delete: .Adult Dental Services

APPROVAL OF MINUTES

Motion was made, seconded and approved to accept the September 21, 2009 minutes.

Business

PAS Common Paymaster

Dina Sanz, Greg Manz and Anthony Carter of JEVS (Jewish Employment and Vocational Service) gave a presentation to the Council. JEVS Supports for Independence would like to receive the Council’s support to getting the Common Paymaster provision amended in the DOL policy (Employment Handbook & Forms) and Division of Revenue Regulation-Employers Guide - Section 3: Duties of Employers (handout). JEVS is asking for the Council’s support and advocacy so JEVS can function as a fiscal agent for the consumer if they choose. JEVS is asking for support in soliciting a waiver of those prohibitions specifically for Personal Attendant Services (PAS) consumers. Anthony handed out a paper (entitled Attachment A – Definition of Financial Management Services)which describes 21 tasks the paymaster can perform with the participant’s authorization. In the 18 months JEVS has been in Delaware as a provider, they have noticed repetitive errors (even with provider support) made that put the consumer at risk and some of these are: 20 errors in filing Unemployment Compensation taxes, 3 errors in filing offederal employment taxes, 14 errors in managing bank accounts in paying wages correctly (gross and net), 5 errors in the area of Worker’s Compensation. He listed out the risk to the consumer and stated that these errors could be minimized or eliminated if JEVS acted as the fiscal agent. Anthony explained that the PAS participants still would have full control of their operation (hiring, firing, etc.). JEVS would help with arranging Worker’s Compensation, issuing paychecks to personal care assistants (including tax withholding), maintaining local, state, and federal tax records for the participant and their assistant. JEVS currently provides this service in Pennsylvania and would like to do so in Delaware, as the consumer is at risk for not reporting to the IRS and can be heavily fined for not doing in a timely manner.

Sandy commented that the original concept was that the consumer this would self-direct their care. Don commented that Easter Seals should be part of this discussion. Currently, JEVS is working with 3,700 consumers in Pennsylvania and they have selected them as theirFiscal Agent (no one has selected the option to do this themselves). Don questioned the cost of doing this. Brian stated that JEVS and Easter Seals both do consumer satisfaction surveys and this would be a good time to get the consumers’ input. Brian also asked if JEVS would be compensated for the work and would it take away from the consumer’s services. Anthony commented that the service would actually reduce costs and administrative labor. Don commented that the only reservation he had was the way it is done now, the attendant gets paid directly right away and this proposed option would involve red tape and delay. Greg added that there is a direct deposit option for the attendant. Nick commented that this seems to be proactive rather than reactive. Kyle added that this Council is the advisory group for this program. Dina commented that when JEVS is the agent and a mistake is made or a delay in paying the tax, they have to pay the penalty and “eat” that cost.

A recommendation was made to use consumer satisfaction surveys and add several questions regarding this issue to see if consumers would like this as an option. JEVS will create this part and run it past the Council and distribute. Kyle suggested that JEVS contact Tom at Easter Seals and possibly add this issue to their consumer satisfaction survey. Kyle will find out whom to contact at Division of Revenue (DOR), saying this may be an internal policy, rather than a regulation; he will do the same with Department of Labor (DOL). Council endorsed the concept of amending the appropriate policy to allow JEVS to act as the fiscal agent if the consumer so chooses. Anthony will contact Easter Seals and DSAAPD to coordinate. It was agreed that DSAAPD should be the agency to solicit the DOR and DOL.

Polling Place Legislation

Brian stated that in 1979 the Architectural Accessibility Act gave the Architectural Accessibility Board (AAB) jurisdiction over any leased or financed buildings by the State; it also had a provision giving them jurisdiction over any facility designated by the Board of Election of any county as a polling place. There was also a provision that the polling places were to submit their plans for review prior to being designated. Those features were taken out by amendment prior to enactment of the original bill and they substituted an actual exclusion that made polling places exempt. Brian stated that since 1979 there have been federal laws (one was Help America Vote Act) enacted that states polling places have to be accessible for federal elections; the State law also says this. Brian stated that not all polling places are accessible despite the mandate. Brian stated that the Election Commission had a survey conducted in 2006-07. There are 140 private polling sites and 170 public polling sites. The State subsequently offered funds to the 140 private polling sites to take care of deficiencies. No money was offered to the 170 public sites based on the rationale that they should be accessible anyway. Brian made a recommendation to change the code. The alternatives are: to remove that exemption mentioned above; restore the original legislation so that polling places would have to submit their plans prior to being designated (Brian commented that this alternative may not be good since the plans are expensive and this could be a deterrent.); amend the voting code that says they will treat as a priority accessibility and will only have readable accessible polling places: If the Department of Election is uncertain of the accessibility of a proposed or existing polling place, or receives written notice of the deficiency from the State Council for Persons with Disabilities or registered voter, it shall request a site assessment from the Architectural Accessibility Board and defer to the findings of the Board.. No Department shall issue more than 10 such requests on an annual basis without the consent of the Board. Also a statement would be added to the Architectural Accessibility Board’s jurisdictional statute that says they would have the authority and duty to conduct a polling place accessibility assessment upon referral from Department of Elections and implementation of this section of the voting code. Brian stated the advantage of this last alternative is that they would have to defer to the findings of the Board and it keeps the numbers down on the amount of referrals to the Board. This also would prevent the County Department of Elections from doing nothing on their polling places because the Board or registered voter can file a complaint with the Department of Election. Brian commented that these concepts are still draft and he presented to the AABand they seemed open to considering some of these options.

Dan stated that Brian is correct and the Board would like to have the exemption removed from the Delaware Code, although they have not seen the 4th alternative. Dan added that the AAB would handle any matters they are called upon to review, assess, survey, etc. They do this now for the State Lottery and emergency shelters. Dan brought up that when HAVA did a survey of facilities, one of the problems that the AABencountered that HAVA did not look at toilet facilities when doing the survey; they only looked at parking, getting into the polling place, getting to the polling booth, registration table and leaving. The AAB brought this omission to their attention. Dan commented that the Board did not think they were doing anybody a service by saying you are partially-accessible. If that restriction is removed from the Code, they will be able to go in and do what they need to do. Sandy asked if there would be much opposition to doing Alternative 1. Brian commented that he did not know, since the power seems to be with the CountyElections, not the State Elections. There are no regulations available. Kyle commented that there are still HAVA funds available. While there are not been legal challenges, there have been complaints. The federal and state level both say there has to be accessibility. Dan added that the Board’s position was that they should be compliant firstbefore declaring a site accessible. Brian asked for the Council’s endorsement for modifying the law so we can promote accessibility of polling places. The motion was made to endorse this endorsement; it was seconded and approved.

Health Care Acts Delegation

Kyle stated that recently a group including himself, Jamie Wolfe, Jean Mullen (Bayada Nursing), Ruth Hanson (The Commission of Community-Based Health Care), Easter Seals and Brian met with the Board of Nursing regarding the issue of assistance with self-administration of medications and delegation of health care acts. Kyle said they wanted to know how the Board of Nursing was interpreting the Nurse Practice Act (Senate Bill 261), which allows delegation of most health care acts except for very invasive procedures. There is anecdotal evidence which suggest agencies are only allowing nurses or skilled care to provide such services and provide assistance with self administration of medications (AWSAM). Kyle stated that what he derived from that meeting was that you can delegate health care tasks when it is a consumer directed program (for example, HB 30), but if someone is going through an agency (for example, the E&D Waiver), they are not supposed to be doing that, including assistance with self-administration of medications. Kyle stated that there are other regulations that need to be looked at this pointincluding the PASA regulations, skilled nursing regulations, home health only regulations—all of these need to be looked at because there may be provisions in each one that may be limiting what people in the community can delegate. Kyle stated that he had talked to Secretary Landgraf who suggested contacting the DHSS Policy Advisor to coordinate the appropriate path forward. Kyle is in the process of scheduling a meeting with Debbie Gottschalk to determine the best way to move forward with this issue. Kyle added that he is waiting for Jean Mullen to send him their position paper on AWSAM. Brian added that while the statute may allow CNA’s to do some of these tasks, some agencies do not allow it. Brian also said the bill should cover the authority of a consumer to delegate to CNAs, although the Board of Nursing may not interpret it that way. It was agreed to move forward and meet with the DHSS Policy Advisor and look into these other regulations.

Commission on Community Based Services Update

Sandy stated that Secretary Landgraf had called a meeting of the Chairs and staff of the Commission Committees. Sandy said that one of the topics at this meeting was if the Commission should continue and it was fairly unanimous by those attending that this Commission has a definite and defining role to play and needs to be continued. Secretary Landgraf is soliciting input on membership, if it should change and how would it change. Each Committee updated its plan; these plans will be formatted and printed and given to Legislators, etc. Kyle asked the group if they had any thoughts about membership and gave a brief review of the membership of 19. Wendy commented that she had contacted Secretary of Education Lowery and someone should follow-up with her or Martha Toomey to have a DOE representative. It was also recommended that DMMA should be included, although they attended several meetings when requested, they need to be formally added. Kyle will send out the list of membership and the mission of the Executive Order, which gives the duties and responsibilities. Chris commented that it could be a problem-solving board since the Division Directors are already there; the Governor could empower the Commission with this responsibility. Bonnie recommended that DART be included in the other Committees because transportation ties into their roles. Kyle will forward meeting schedules of the other Committees to Bonnie. Tony asked a question about the functional difference between this Commission and the State Council. Kyle commented that he thought both were in line with the same goals and objectives. Kyle added that he already staffs two of the Committees of this Commission. Kyle questioned if there was a better way to collaborate. Brian commented that the Commission was set up not to be consumer-controlled, while the Council is majority consumer-controlled. Kyle commented that there is an advantage to having the decision-makers at the table. Sandy commented that the execution and update of the strategic plan is critical. Tony commented that the Council is a product of a law and the Commission is a product of an Executive Order; he asked which comes first or should they collaborate. Kyle commented that this may be a good time to discuss bringing the two groups together. Kyle suggested speaking to Secretary Landgraf about this or having her attend a Council meeting. Brian commented that the State Council has the legislative mandate, which includes advising the Legislature, local governments and the Governor; and the Council has a very broad mandate. Kyle commented that this may be an opportunity to strengthen the Council. Sandy mentioned that the Housing Committee of this Council and the Commission’s Housing Committee merged into one, although it took some adjustment. Chris commented that the State Council has credibility and more direct ongoing communication with the Legislature. Nick questioned whether the Commission has the ability to do things that the State Council cannot. Kyle added that Secretary Landgraf wants to speak to the Executive Committee regarding her budget and this may be a good time to bring this up, then bring this back to the full Council and explore options. Kyle will be setting up this meeting.

Committee Reports

Kyle stated that the Division of Public Health (Alisa) applied for a Brain Injury implementation grant and they hope to hear soon if they are awarded the grant. The Brain Injury Committee (BIC) was on the advisory council when they applied previously and did not get the grant. Alisa is also on the BIC.

Sandy stated that the Housing Committee is meeting with the Delaware Housing Coalition to see if there is a common message on affordable housing that the Committee can buy into and go to the Legislature with a common message.

OTHER BUSINESS

Bonnie gave an overview of the proposed changes to Paratransit (handout). Bonnie stated that the role and demandof Paratransit continues to grow each year. Bonnie stated that the Governor and Secretary Wicks have given them the responsibility to come up with a program that is sustainable for the future. The two main proposed changes are:

• Identify ADA required services from other services provided

• Inside the Service Area

• Trip origin and destination must be within ¾ mile of a fix route area
• Travel time comparable to same trip on fixed route, taking into consideration walk times and transfer times (excluding express routes)
• Available during all days/hours that fixed route is operation and/or core operating hours

• Outside the Service Area

• Trip origin and/or destination is outside ¾ mile of a fixed route area
• Travel times dependent on travel distance
• Available during core operating hours
• Established schedule for Paratransit buses

• Change the qualifying age on Paratransit Elderly services from age 60 to 65 to agree with all other DART program. Individuals currently certified as elderly between the ages of 60-64 will be grandfathered. (KentSussexCounty only)

Bonnie showed a map of the routes throughout the State. Bonnie commented that Sussex is impacted the most in the context of fixed route v. commuter routes. For the purposes of Paratransit services, a commuter route will be considered a fixed route. Bonnie added that there will be public hearings throughout the state near the end of March. They will also be notifying Paratransit customers and agencies serving persons with disabilities and the aging population of changes by mail along with notice of how to provide comments; this should go out the end of February. Bonnie stated that if people want to comment, they can use the following link: Bonnie commented that this will allow them to group more people together. She said they have done test scenarios and it requires a lot less resources. There will be a Google map on the DART website with the proposed changes where the address of where you want to go is entered and it will pinpoint it, so people will know if it is in or out of the service area (this will be available the end of February). Kyle questioned whether DHSS has been contacted in regard to how this will affect service for their clients. Bonnie commented that Secretaries Landgraf and Wicks have been talking about transportation issues. Bonnie added that the federal government has complimented them on continuing to try and serve the entire state. Bonnie will send the handout to Kyle so he can forward appropriately. Don asked how this will affect the connectorsites and also asked about prioritization. Bonnie stated that if resources get really tight, DART reserves to the right to do ADA required service first; prioritization will only be for outside the service area (ensuring medical, work, school); the rest of the trips would be negotiated, with different time slots, etc. Bonnie said the connector will still be there, and the travel time from origin to destination would be comparable to the fixed route. Don commented that would be a good thing. The projected implementation date is July 1, 2010. Sandy commended Bonnie on the difficult work she does with transportation and noted that she works so hard and well in doing so.