DD Advocate Magazine - Issue 3 by Ohio Association of County Boards of DD

Summer 2012

DD Advocate Magazine

SELF Waiver 101 Learn the basics about Ohioâ&#x20AC;&#x2122;s newest waiver

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Delaware DDâ&#x20AC;&#x2122;s remote monitoring success

Disability Housing Network promoting tax credit

Medicaid managed care raises questions

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Page 8

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CREATING CONNECTIONS OHIODD.COM COUNTY BOARDS • One keystroke in Gatekeeper activates a provider’s OhioDD.com account. • Gatekeeper effortlessly transmits data to OhioDD.com with no additional work. • Decreases support calls, payment processing time, and postage costs. • Gives providers next-day electronic access to service authorizations and payment information. SERVICE PROVIDERS • Access electronic service authorizations. • Track utilization and submit billing for locally-funded services. • Submit locally-funded billing with a user-friendly billing tool. • Download county payment files directly into your billing software.

County boards and service providers have an essential partnership. Primary Solutions created OhioDD.com to support and strengthen that connection. You serve the same individuals. You work together. You need each other. The challenge is how to be effective working partners. How do you efficently communicate vital service information? Your phone rings constantly. You’re busy and can’t always meet face-to-face. You’re already spending too much time emailing and too much money on postage. Primary Solutions has created the ideal solution. OhioDD.com links county boards and service providers, allowing you to exchange information with ease. No maintenance. No fuss.

INVESTIGATE OHIODD.COM • Contact Primary Solutions – the only software vendor dedicated exclusively to the needs of Ohio’s DD community. 6665 Busch Blvd. Columbus, Ohio 43229 614.430.0355 www.primarysolutions.net

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Introduce your staff to an easier way to work.

Summer 2012 / Volume 1, Issue 3

table of Contents

DD Advocate Magazine

In This Issue

Blaine Brockman President, Board of Trustees | blaine@brockmanlegal.com

Dan Ohler Publisher | dohler@oacbdd.org

Adam Herman

3 President’s Letter

Managing Editor | aherman@oacbdd.org

4 Transitions 5 New Staff Profile: Leslie McClain, Ph.D.

Jeff Vanik Art Director, Vanik Design LLC | jeff@vanikdesign.com

Lisa Brewer Production Assistant | lbrewer@oacbdd.org

DD Briefing

Ad Sales adsales@ddadvocate.com

Medicaid managed care raises questions for disability advocates

Ohio Association of County Boards Serving People with Developmental Disabilities

DD Leaders

8 Housing network’s effort could create more affordable homes for people with DD Remote monitoring allows greater independence while saving board money

Dan Ohler Executive Director | dohler@oacbdd.org

DD Worldview

Peter J. Moore Service Initiatives Director | pmoore@oacbdd.org

Adam Herman

12 Peru: Disability Rights in the Voting Booth

SELF Waiver 101

Kim D. Linkinhoker Associate Director | klinkinhoker@oacbdd.org

Learn the basics about Ohio’s newest waiver

Communications Director | aherman@oacbdd.org

Kristen Helling Service Initiatives Coordinator, Bridges to Transition khelling@oacbdd.org

Willie Jones PCI Coordinator | wjones@oacbdd.org

Leslie McClain, Ph.D. Children’s Services coordinator | lmcclain@oacbdd.org

Dustin McKee Legislative Services Coordinator | dmckee@oacbdd.org

Ann Neu Events Coordinator | aneu@oacbdd.org

Lori Stanfa Medicaid Services Coordinator | lstanfa@oacbdd.org

Lana Beddoes Executive Assistant | lbeddoes@oacbdd.org

Lisa Brewer Communications Assistant | lbrewer@oacbdd.org

18 Person of the Quarter: Michael “Andy” Hummel DD Artists

19 Clark County’s Quest Art Studio offers outlet for creative energy

Danielle Driscoll Transition Services Assistant, Bridges to Transition ddriscoll@oacbdd.org

Betsy Galvin adminIstrative Assistant | bgalvin@oacbdd.org

Scott Marks Transition Services Assistant, Bridges to Transition smarks@oacbdd.org

DD News

20 News in a Nutshell DD Words of Wisdom

28 Elizabeth Prather

ON THE COVER:

Ohio Department of Developmental Disabilities senior staff, including Director John Martin (left), Family Advocate Peggy Martin (middle-left), Medicaid Health Systems Administrator Christina Miller (middle-right), and Deputy Director Patrick Stephan (right) were photographed for the cover of DD Advocate in the DODD executive offices on the 12th floor of the Rhodes State Office Tower in Columbus.

Summer 2012

DD Advocate Magazine is the official publication and registered trademark (™) of the Ohio Association of County Boards – Serving People with Developmental Disabilities (OACB). All content is copyright ©2012 OACB unless otherwise noted. Written permission is necessary to reproduce any material for which OACB is the owner. Every effort is made to ensure accuracy of content prior to publication. OACB is not responsible for inaccuracy that arises after the magazine has published. OACB is not responsible for information contained within advertisements and does not endorse the products or services advertised. Inquiries regarding material contained within should be directed to feedback@ddadvocate.com or to: DD Advocate Magazine c/o Adam Herman, Managing Editor 73 E. Wilson Bridge Road, Suite B1 Worthington, OH 43085 For an up-to-date advertising rate card, visit www.ddadvocate.com. All other inquiries may be directed via e-mail to feedback@ddadvocate.com.

President’s Letter Dear Colleagues:

or many years, a staggering number of people with developmental disabilities who received government support in the state of Ohio had no option but to reside in an institution. In too many cases, these were also people who – if given proper assistance – were perfectly capable of being active participants in our communities.

monitoring solution (page 10) to provide a former institution resident with the freedom and flexibility of independent living without compromising his safety or privacy.

After the establishment of the Medicaid waiver system in the 1980s, we slowly began moving away from this institutional mindset in favor a home and community-based service option. Our efforts would later be fast-tracked by the 1999 landmark US Supreme Court decision Olmstead vs L.C., which established a precedent that governments can be held liable for discrimination against people with developmental disabilities if they fail to deliver services in a community-based setting when it is possible to do so.

Last, but certainly not least, we sit down to ask several key staff members at DODD (Feature, page 14) some of the most frequently asked questions we’re hearing in preparation for the launch of the new SELF waiver on July 1.

Writing for the majority in the decision, Justice Ruth Bader Ginsburg confirmed what many of us had long believed – that institutional placement “perpetuates unwarranted assumptions” that people with developmental disabilities are either “incapable or unworthy of participating in community life.” The Court also found that “institutional confinement severely diminishes individuals’ everyday life activities” – something any person walking through one of these institutions could easily confirm with even the most casual of observations. Unfortunately, while the Court came to the right conclusion, it did not outline how we were supposed to make this transition away from an institutional system, nor did it identify how cash-strapped governments should go about finding the resources that would be necessary do so. In this issue of DD Advocate, we explore several ways in which county boards and their allies in Ohio’s DD service delivery system are working to continue moving our state down the path toward greater community integration. On page 8, we learn how the Disability Housing Network is working with the Ohio Housing Finance Agency to find creative ways to fund community housing for people with disabilities using tax credits. We also learn how the Delaware County Board of DD is using a remote

Contributors

Ohio has come a long way toward fulfilling the legal mandates of Blaine Brockman Olmstead as well as the moral and Madison Co. Board of DD ethical mandates of our own collective conscience in promoting the integration of people with developmental disabilities into our communities. But, as these articles will show, there is still plenty of room for improvement before we can consider our work complete. To my friends and colleagues in Ohio’s DD service delivery system, thank you for all you do to help us achieve this goal. With your continued dedication, we will improve the lives of people with developmental disabilities for years to come.

Yours in service,

Blaine Brockman President, Board of Trustees

Summer 2012

Annette Ferraro

Jacalyn Slemmer

Adam Herman

Artists / Page 19

Leaders / Page 8

Leaders / Page 10

Annette Ferraro is the Community Inclusion and Volunteer Supervisor for Developmental Disabilities of Clark County, where she helps manage the QUEST Art Studio and Gallery. An avid photographer, she operates her own commercial studio where she seeks to capture the spirit and joy of people with disabilities. She has also previously worked for Children’s Hospital in Los Angeles. In her first contribution to DD Advocate, she writes about the many exciting events taking place at the QUEST Art Studio in Springfield.

Jacalyn Slemmer is the Executive Director of Disability Housing Network, a member-driven state organization that promotes and supports best practices for housing development and management. She worked in the service coordination area with the Franklin County Board of Developmental Disabilities before holding positions with the Ohio Housing Finance Agency and the Ohio Capital Corporation for Housing. In her first contribution to DD Advocate, she writes about DHN’s efforts to work with the Ohio Housing Finance Agency to secure housing funds for people with DD.

Adam Herman is Communications Director for the Ohio Association of County Boards of DD and Managing Editor of DD Advocate Magazine. Prior to joining OACB, he worked in various communications roles in state and local government, including the Ohio House of Representatives, the City of Canton, and the election campaign of former Attorney General Richard Cordray. In his fourth contribution to DD Advocate, he writes how a person served by Delaware DD is experiencing more personal independence while utilizing fewer waiver services thanks to a remote monitoring solution from an OACB Affiliate Member.

DD Advocate Magazine

Transitions

The past three months have been a time of transformation for many Ohio county boards of DD, with staff transitions, promotions, retirements, and appointments taking place in 12 counties. Have you recently made a big transition at your county board? Tell us at feedback@ddadvocate.com we’ll be happy to share the news!

Retired Don Daye, as Wayne DD business manager. Christina Hurr, as Butler DD superintendent. John Mitchem, as Franklin DD adult services director.

Hired Randy Beach, as Scioto DD interim superintendent. Carrie Beier, former Erie DD director of early childhood services, as Erie DD interim superintendent. Kim Eichler, as Ashland DD business manager. Andrew Garber, as Columbiana DD assistant director of education. Deb Guilford, executive director of Northwest Ohio Waiver Administration Council (NOWAC), as Williams DD interim superintendent. Lisa Guliano, former Erie DD superintendent, as Butler DD superintendent. Michelle Hawthorne, as Geauga DD ICF manager and behavior support specialist. Ben Hollinger, former Scioto DD superintendent, as Assistant Deputy Director of Policy and Strategic Direction at the Ohio Department of Developmental Disabilities. Teresa Kobelt, formerly of the Ohio Department of Developmental Disabilities, as Franklin DD adult services director. Anna Marshall, as Wayne DD business manager. Mira Pozna, as Summit DD finance director.

Appointed Betsy Baugh, of Springfield Township, to the Hamilton DDS board. Steve Jagers, Julie Dragoo, and Don Pearce, all residents of Gallipolis, to the Gallia DD board.

Summer 2012

Ohler receives top award from national disability organization

photo by adam herman

At a special event held at the Washington Hilton during this year’s Annual Legislative Conference, the National Association of County Behavioral Health and Developmental Disability Directors (NACBHDD) presented OACB Executive Director Dan Ohler with its highest honor – the Robert Egnew Award. NACBHDD Board President Patrick Fleming (Salt Lake County, UT) said that Ohler’s leadership came at a time of great transition for the organization, noting that, “he not only oversaw the hiring of a new executive director, but more importantly, his advocacy and persistence ensured that our organization increased its focus on developmental disabilities.” A board member of NACBHDD since Above: OACB Executive Director Dan 2006, Ohler served a two-year term Ohler was recently presented with the as Vice President in 2008-09, followed Robert Egnew Award, pictured here. by two years as President in 2010-11. He was the first president to come from an organization solely dedicated to services within the developmental disabilities system. During Ohler’s tenure, NACBHDD led a successful collaborative effort to block the implementation of proposed federal rules on targeted case management, a move that saved county systems millions of dollars and developed a collaborative partnership with CMS that has assured county behavioral health and DD agencies a seat at the table on policy and rule development. Ohler remains a member of the Executive Committee as the group’s Immediate Past President. Congratulations, Dan, on your award!

About the Award: Robert Egnew was the founder of NACBHDD and served as its first President. The award bearing his name is presented annually in Washington, DC. Ohler is the first Ohioan to have received the award. About NACBHDD: NACBHDD is the only national voice for county and local behavioral health and developmental disability authorities in Washington, DC. Through education, policy analysis, and advocacy, NACBHDD brings the unique perspective of its members to Congress and the Executive Branch and promotes national policies that recognize and support the critical role counties play in caring for people affected by mental illness, addiction, and developmental disabilities.

would argue that county boards have some of the best programs in Ohio for providing services and supports to children with DD. But we also need to be realistic - no system is perfect. We do many things very well, but some boards are stronger than others at handling particular aspects of children’s services. DD: What do you think is causing that? LM: I don’t think any of our county boards will say they don’t care about children’s services, or that there isn’t room for improvement. But if they are unaware of what other options are out there, they don’t know what they could be doing to provide better services. My job will be to help everyone realize what has worked elsewhere, expose people to new ideas, and help develop best practices that will provide more consistency in children’s services and raise the bar across the state.

DD Profiles

Leslie McClain, Ph.D. Children’s Services Coordinator

photo by adam herman

Earlier this year, OACB was proud to announce that Dr. Leslie McClain (pictured above) had agreed to join the Association as its first-ever Children’s Services Coordinator. Since that time, Leslie has been crisscrossing Ohio and meeting with children’s services providers at county boards of DD across the state. DD Advocate decided to catch up with Leslie to chat about the many opportunities that lay ahead for county boards that provide services to children with developmental disabilities. To learn more about Leslie, visit her bio page on our Web site: www.oacbdd.org/leslie-mcclain

DD: First off, how are you enjoying your new position? LM: I’m really enjoying working at the Association - I can already see that this is going to be very rewarding, both for me and for the county boards that will benefit from having a person fully focused on their needs in the area of children’s services. If I’m not mistaken, OACB has not had a full-time staff person for children’s services until now, so there is nearly endless potential for a person in my position to make a real difference. It is going to be challenging, but exciting at the same time. DD: What do you find exciting about it? LM: Working with children has been a passion of mine since I began in this field, so being offered the chance to work with other passionate people on an area of mutual interest is a real treat. But it’s also exciting because of the real impact we can have in these kids’ lives.

DD: How do you think services to children will improve by having a dedicated staff member at OACB? LM: The potential for sharing data and collaborating on different models is limitless. As a clinician, I’ve never used one approach - it’s about finding the most effective way to help these children on a case-by-case basis. I think counties often find themselves isolated when it comes to children’s services, or at least limited to their geographic region. Having someone looking at this subject from the state level - seeing all the moving parts and possibly even some missing pieces - will help all counties improve their services in the end. DD: You mention some missing pieces - how do you think county boards are doing right now at providing services to children?

DD: That’s a pretty lofty goal. How will you know if you’ve succeeded? LM: I think it’s going to take some time - we must continue collecting data and using it to drive our decisions. But that’s another exciting part of my job that I didn’t mention earlier - the use of data. Being the first person in this position at OACB means that I can start collecting all the data that’s out there on what has worked and what hasn’t worked so we can help boards make solid, fact-based, data-driven decisions. Gathering data for the purpose of better understanding our field and following up with benchmarks for measuring our success will ultimately show whether or not we’ve been effective. DD: It sounds like you have your work cut out for you then? LM: I could talk about so many best-kept secrets that I’ve already seen at county boards... there is so much happening already, not to mention all that’s coming up over the next few months, that everyone should know about. Yes, there is a lot to do, and I’m ready for the challenge. I’m little Mary Sunshine - I always try to see the good in things, and I can see so many opportunities to help county boards collaborate with each other to improve the services we offer to children. I’m finding so many talented individuals in our system as I travel the state. I want to help them share their talents with others. We have done such a great job to this point - I think we can really take it to the next level by working together and sharing information.

LM: There is no doubt that county boards provide these services quite well. In fact, I

DD Advocate Magazine

DD Briefing

Medicaid managed care raises questions for disability advocates BY Dustin McKee / OACB

While managed care plans have already become the norm for low-income Medicaid enrollees in a majority of states across the country, a debate is currently underway over whether or not to expand these plans to include people with disabilities. Such a move is raising several questions among health policymakers, for it could significantly change how benefits are administered for long-term services and supports for people with DD. In this edition of Briefing, we explore the many different facets of this issue in an effort to better prepare Ohio’s DD professionals for future discussions on the subject.

What is Medicaid Managed Care? Medicaid managed care is an alternative to traditional, fee-for-service (FFS) Medicaid. In FFS Medicaid, beneficiaries must find providers that accept Medicaid reimbursements for the services they need, which are then billed directly to the program by providers. In managed care Medicaid, beneficiaries access care through a network of providers. These networks are administered and overseen by managed care organizations (MCO), which are responsible for ensuring quality and coordination of a patient’s care, as well as billing and other paperwork for both providers and beneficiaries.1 Medicaid managed care can result in overall cost reductions. Like a private insurer, an MCO can negotiate better rates for services with 6

Summer 2012

providers in their networks. Also, states pay MCOs using a “capitated” model, providing them with a fixed, up-front rate per person (i.e., per capita), from which the MCO is contractually obligated to provide an entire year of care. Under what is referred to as a “full-risk” capitated plan, the MCO is responsible for any expenses over and above that fixed annual rate per person. Understandably, this gives an MCO a major financial incentive to keep the cost of care at or under that amount.2 Health policymakers are increasingly turning to the managed care model to reduce costs while maintaining or increasing quality of care for beneficiaries. To keep costs low, MCOs frequently try to: (1) increase care coordination and preventative care, (2) reduce or eliminate unnecessary procedures, or (3) some combination of both.2

Policymakers also like the managed care model because, unlike FFS Medicaid, managed care offers states an increased level of predictability when budgeting for Medicaid expenses.

A boon for states States have traditionally reserved Medicaid managed care plans for low-income families and children. In fact, the percentage of Medicaid enrollees participating in some type of managed care program has increased in every year except one over the last two decades. In 2009, 71.7% of Medicaid beneficiaries were enrolled in some form of managed care.1 However, as managed care programs have become more established, some states have taken the next step by enrolling children and adults with disabilities – and not just for medical care, but also for long term services and supports (LTSS).1,3 According to a recent survey of all 50 states conducted by the Kaiser Commission on Medicaid and the Uninsured, one of the most common managed care delivery system changes in state fiscal year 2012 was the inclusion of people with disabilities into managed care programs. As of 2010, 11 states were operating some type of capitated Medicaid managed care program

to deliver long-term services and support to individuals with disabilities, and 27 more states were considering this option. The reason for this trend is clear. According to recent data, people with disabilities represent 17% of the total Medicaid enrollment but account for 44% of Medicaid spending. With limited resources available in the current budget environment, policymakers must find ways to reduce Medicaid spending. The high cost of providing care to people with disabilities is proving to be an enticing target.

Some benefits, but many risks In theory, Medicaid managed care programs offer advantages that traditional, FFS Medicaid cannot. For example, in FFS Medicaid there is no way of making sure that enrollees will be able to locate providers that are willing to accept the low reimbursement rates set by the Medicaid program. In a managed care arrangement, states have the ability to contract with established networks of providers that agree to provide care to Medicaid enrollees at the program’s relatively low reimbursement rates. Through these managed care contracts, states can also stipulate that MCOs and/ or providers meet certain quality standards related to patient access (e.g., care must be provided within a certain amount of time, provider networks must be adequate, etc.). Furthermore, states can also require that MCOs/providers track their performance and meet certain benchmarks.1 While some have expressed optimism that managed care programs will result in decreased costs, increased access, and improved care coordination for people with disabilities, disability advocates have expressed significant concerns about moving in this direction.4,5,6 States and Medicaid MCOs have relatively little experience providing specialized services to people with disabilities through managed care, which is especially problematic given the population’s diverse and complex set of care needs.1 Additionally, people with disabilities often require LTSS, which are services that states and MCOs are particularly inexperienced in providing through managed care programs. Because of this inexperience in providing LTSS, there is a relative lack of basic quality measures that states can use to ensure that the care needs of this very vulnerable population are being met by managed care plans. When one considers the lack

of established quality measures as well as the current lack of state resources and downsizing of the public sector, there is significant risk that the incentive in managed care to reduce service utilization may not be adequately balanced by rigorous state oversight of the comprehensiveness and quality of care for people with disabilities.7 Aside from issues related to inexperience and lack of quality measures in managed care for persons with disabilities, health policy experts are also careful to point out that short-term savings are unlikely to be achieved in such an arrangement. Although research regarding the efficacy of managed care in reducing costs for this population exists, there is speculation that the reimbursement rates set in the Medicaid FFS system are already so low that it is unlikely managed care capitation rates can be fixed at a level that saves money for states. Furthermore, reduction in utilization, at least initially, is also an unlikely means for states to achieve near-term savings because of the significant backlog of consumers in need of primary and specialty care services in the FFS Medicaid system.2 In short, can any more efficiency be expected from a system already stretching pennies? And if so, how do we balance the benefit of meager savings with the significant risk of reducing the quality of care for people with developmental disabilities?

Considerations for the future Since a significant number of states have indicated they are exploring the option of moving people with disabilities into managed care plans, it is likely that the

expansion of managed care Medicaid for this population will continue. In light of this fact, it is important for policymakers to include stakeholders from the disability and provider communities as they develop managed care plans to address this group’s unique needs. Also, the establishment of contracts between states and MCOs must not be rushed, and should involve the establishment of strong performance standards and mechanisms to ensure that providers are keeping services accessible while continuing to meet the complex needs of this diverse population. Successfully doing so will require states to invest enough financial resources to establish sufficient capitation rates, as well as institute adequate oversight measures to protect the interests of people with disabilities.1,3,7,8 As more special needs populations are moved into managed care plans, more states may become interested in exploring this option for people with intellectual and developmental disabilities. Currently, a handful of states are serving people with developmental disabilities through managed care, including: Arizona, Michigan, Vermont, and Wisconsin.9 Other states, such as Ohio, have decided to exempt people with DD from their managed care programs for the general disability population, due to their unique and diverse care needs, as well as the complexity of integrating these individuals into a managed care program. As states continue to expand their use of managed care, OACB will continue to provide information to its members regarding national developments in this and other important policy areas.

Cited Resources / Further Reading 1 Kaiser Commission on Medicaid and the Uninsured (2011 February). Issue brief: People with disabilities and Medicaid managed care--Key issues to consider. (Publication No. 8278). Retrieved from http://www.kff.org/medicaid/8278.cfm 2 Smith, V.K., Gifford, K., Ellis, E., Rudowitz, R. and Snyder, L., (2011 October). Issue brief: Moving ahead amid fiscal challenges: A look at Medicaid spending, coverage and policy trends—Results from a 50-State Medicaid budget survey for state fiscal years 2011-2012; Kaiser Commission on Medicaid and the Uninsured (Publication No. 8248). 3 Gifford, K., Smith, V.K., Snipes, D., Paradise, J. (2011 September). A profile of Medicaid managed care programs in 2010: Findings from a 50-state survey; Kaiser Commission on Medicaid and the Uninsured (Publication No. 8220). 4 Vestal, C. PEW (May 31, 2011). Managed Care Explained: Why a Medicaid innovation is spreading. Pew Center on the States: Stateline News Service. Retrieved from http://www.pewstates.org/projects/stateline/headlines/managed-careexplained-why-a-medicaid-innovation-is-spreading-85899375050 5 Bosse, G. (2012, April 2). Should some services be carved out of a managed care deal?—Developmentally disabled at risk. Concord Monitor. Retrieved from http://www.concordmonitor.com/article/321029/should-some-services-be-carved-out-ofmanaged-care-deal?SESS49f6693af8de54bba5f2c204babfdddf=google&page=full 6 Lefler, D. (2012, April 25). Gov. Sam Brownback agrees to delay placing disability services under managed care. The Wichita Eagle. Retrieved from http://www.kansas.com/2012/04/25/2310128/advocates-for-developmentally.html 7 Kaiser Commission on Medicaid and the Uninsured (2011October). Issue brief: Examining Medicaid managed long-term service and support programs: Key issues to consider (Publication No. 8243). 8 National Council on Disability (February, 2012). Analysis and recommendations for the implementation of managed care in Medicaid and Medicare programs for people with disabilities. Retrieved from http://www.ncd.gov/publications/2012/ CMSFebruary272012/ 9 Health Management Associates (2010 October). Final Report: Pilot to serve persons with intellectual and developmental disabilities. Retrieved from http://www.hhsc.state.tx.us/reports/Managed-Care-Pilot.pdf

DD Advocate Magazine

DD Leaders

Housing network’s effort could create more affordable homes for people with DD BY Jacalyn Slemmer / Disability Housing Network In late 2011, the Disability Housing Network (DHN) began a conversation with staff members at the Ohio Housing Finance Agency (OHFA) about ways the two entities could work together to create more affordable housing options for people with developmental disabilities (DD). Using one of the few development sources available today, the Housing Tax Credit program, DHN members hope to encourage OHFA to develop additional housing options beyond those offered by Ohio Department of Developmental Disabilities Capital Housing Program for people with DD.

What is the Housing Tax Credit program? The Housing Tax Credit (HTC) program was first established by Congress in 1986 (later made permanent in 1993) to federally subsidize the construction and rehabilitation of affordable rental housing. Lawmakers created the program to encourage private developers and investors to provide more 8

Summer 2012

affordable housing options when creating new developments or revitalizing old neighborhoods. Without the incentive, affordable rental housing does not generate sufficient profit to warrant the investment. The HTC gives investors a dollar-for-dollar reduction in federal tax liability in exchange for providing up-front financing to develop affordable rental housing. Investors’ equity contribution subsidizes tax credit housing development, thereby allowing some units to rent at below-market rates. In return, investors receive tax credits paid in annual amounts, generally over a 10-year period. Within general guidelines set by the Internal Revenue Service (IRS), state housing agencies (such as OHFA) administer the Housing Tax Credit program. State agencies review tax credit applications submitted by developers and allocate the credits. The IRS requires that state allocation plans prioritize projects that serve the lowest-income tenants and ensure affordability for the longest period.

Helping low-income people with disabilities This past December, an advisory committee was created to explore whether it would be feasible for OHFA to implement a set-aside unit requirement for people with disabilities in the agency’s tax credit development projects. Although there are accessible tax credit units available across the state of Ohio, affordability remains an issue. This is due to the fact that many people with disabilities have a very low level of income. Over the years, it has become apparent that special accommodations are needed to make the program accessible to low-income people with disabilities. The Technical Assistance Collaborative and the Consortium for Citizens with Disabilities released a national study – Priced Out in 2010 – which found that a person with a disability in Ohio received SSI benefits equal to $674 per month. This income – equal to 18.8% of median income of people in the general workforce – would require a person with a disability to pay 73% of their income

A recent national study found people with disabilities who rely on SSI income must spend between 73% and 85% of their monthly income on housing.

to rent an efficiency apartment and 85% of their monthly income to rent a one bedroom. This is major impediment to people living in community-based housing and far exceeds federal guidelines, which recommend that a person spend no more than 30% of their income on housing. Set-asides similar to the one proposed by DHN are already in place in other states. In North Carolina, for example, developers are required to set aside 10% of the units in the property for people with disabilities. In order to meet this goal, the North Carolina Department of Health and Human Services facilitates the application process by verifying eligibility and providing training to referring agencies, which include county mental health and developmental disabilities agencies as well as non-profit organizations that serve people with disabilities.

Many options to support disability housing In light of these income statistics mentioned above, it is easy to see the challenge in providing affordable housing to people receiving SSI or SSDI. However, several options have presented themselves as potential solutions to this problem. First, in North Carolina’s model, the General Assembly makes an appropriation to the Department of Health and Human Services for a rental subsidy to use in conjunction with the set aside of units. In Ohio, this would require disability advocates to join together in support of a public funding option, which would provide a rental subsidy to low-income people with DD. The subsidy would not be used to pay 100% of a person’s housing; instead, it would serve as a way to make rents affordable – whether in a tax

credit development, market rate housing, or in housing developed with Community Capital Assistance funds through the Department of DD. OHFA is also currently evaluating a second option, which is to determine the amount of housing credit gap financing needed to set aside 5% of units for people with disabilities, as well as the impact such a set aside would have on meeting OHFA’s goals for developing 3,000 new tax credit units per year. In the absence of a rental subsidy, this would provide the necessary funding to pay the reduced rental income expected from unit residents who were unable to pay more than 30% of their SSI income. The primary housing tax credit gap financing sources include a federal source (likely HOME Investment Partnership Funds) as well as a state source (likely the Ohio Housing Trust Fund). Recipients may use these funds as low-interest, deferred payment loans, or in some cases, as grants. In yet a third option, recent HUD Section 811 program legislation has created an opportunity for states to apply for a rental subsidy for people with disabilities to be used with other affordable housing development resources – including units developed with the tax credit program. Unfortunately, this rental subsidy is expected to be available for

only 2,500 units across the nation during the current federal budget year, which would not address the major housing needs of Ohio’s low-income disability population. In addition, the unpredictability of the federal budgeting process mixed with limited ability to support such programs with local funds would not offer a long-term solution to the overall challenge.

Working together on a solution As governments continue to explore ways to spend their limited resources more efficiently to provide the greatest impact, discussions like this one will be essential among stakeholders in search of practical, real-world solutions to pressing challenges. The Disability Housing Network will continue to partner with OHFA, DODD, and the Ohio Association County Boards of DD in finding ways to develop expanded housing opportunities for people with disabilities in Ohio.

DHN and OACB welcome your input feel free to send us your thoughts on this article at feedback@ddadvocate.com. Your comments may appear in a future issue of the magazine!

The Disability Housing Network (DHN) is a non-profit organization dedicated to providing support and assistance to county boards of DD and housing boards that manage and operate homes for individuals with disabilities in Ohio. By leveraging its members’ experience and intellect, DHN has developed “best practice” resources while creating a collective voice for advocacy. For more information, visit www.disabilityhousingnetwork.org.

Disability Housing Network Board of Directors: Jill LaRock, President Homecroft, Inc.

Stephanie Lowe Ottawa Residential Services

Patrick Rafter, Vice President Creative Housing, Inc.

Dianne DePasquale-Hagerty Medina Creative Housing, Medina County

Steve McPeake, Past President North Coast Community Homes

Greg Williamson Frontier Development, Inc., Ross County

Kim Linkinhoker OACBDD

Lisa Guliano Butler County Board of DD

Robert Morgan Delaware County Board of DD

Alice Pavey Hamilton County Board of DDS

Michael Mehalik Jefferson County Board of DD

DD Advocate Magazine

DD Leaders

Remote monitoring allows greater independence while saving money in Delaware County

photo courtesy Rest Assured

BY Adam Herman / oacb Eric Brewer hates thunderstorms. During storm season, you can regularly find him flipping back and forth between his favorite TV shows and the Weather Channel. When heavy rains are predicted, or the sky starts to darken before nightfall, he quickly gets to work preparing for the lightning and thunder that will surely follow. Prior to last August, this included chatting with his home care staff until the rains had come and gone. But on days when the sun was shining and there were no clouds on the horizon, Eric had grown tired of 24/7 staffing. Before living alone, he spent nearly a decade in institutions and foster care. Now that he is living in his own apartment, he thought, shouldn’t he be able to spend more time alone? Is it possible to be truly independent if you have to share your home with a stranger who watches your every move? Ready to take the next step, Eric asked his SSA what they might be able to do to reduce the amount of time his in-home staff would be present. Reluctant to eliminate staffing altogether, they agreed to test out a part-time

Summer 2012

remote monitoring solution. After nearly a year, both are extremely happy with their decision. Eric receives remote monitoring services from Rest Assured, an OACB Affiliate Member located in East Lafayette, Indiana. Every day, Eric’s in-home care provider arrives in the morning and spends the afternoon with him until it’s time for work. Shortly before he’s scheduled to come home, a Rest Assured technician comes online to check in on the apartment and chat with Eric when he returns. On days that Eric does not work, the provider leaves late in the afternoon and Eric is able to spend the rest of the day completely alone until Rest Assured comes on at their scheduled time. While he may be the only human being in his apartment at night, Eric is never truly alone. Sitting in the corner of his living room is an inconspicuous but solid-looking end table. Inside, a sophisticated computer system and back-up power supply runs continuously, hard-wired to the Internet and ready to activate at a moment’s notice. Cords sneak out

the back of the unit, connecting it to a bubble surveillance camera on the ceiling, from which staff members at Rest Assured can keep tabs on Eric in real-time. Also connected to the unit are a set of external speakers, a dedicated phone line, and a remote-control lamp, all of which allow the monitoring staff to communicate with him (or illuminate the room) at any time. It’s a sunny day when I sit down with Eric to find out what he thinks about his high-tech service. He’s cautious and a bit shy at first, though his good-natured dislike of in-home staff is immediately apparent. “It’s pretty cool,” he says, motioning to his in-home staff person, who is using our interview as an opportunity to catch up on paperwork. “Anything not to have them around.” Detecting Eric’s a bit hesitant to open up, his SSA jumps in. “Would you rather have someone sleeping here?” The question has its intended effect, for in a moment Eric’s shyness is gone. “No.”

photo by adam herman

another benefit – reduced cost – is something that Tiedt can’t help bringing up several times throughout our conversation. “Remote monitoring costs the board at least half as much as an in-home caregiver,” he explains. “Plus, it offers us the chance to reduce his dependence on caregivers little by little. If we had someone spending the night here, we couldn’t really do that.” Tiedt puts his point in perspective with a practical question that shows just how flexible remote monitoring can be when tailored to an individual’s specific needs.

Above: Eric Brewer is seen here pictured with his remote monitoring equipment.

“If you were a caregiver, would you want to come over, sleep for a few hours, and then have to wake up in the middle of the night and leave?” he asks. “With remote monitoring, they’re off the clock with a flip of a switch. It offers us a great way to reduce the service when it’s not needed. Otherwise, we are just paying people to sleep, which isn’t helping Eric or the board.”

“Do you like living alone?” I ask, encouraged by his quick response. “Not having someone here living with you?”

Both Eric and his SSA envision a time in the not-too-distant future when Eric will not need any monitoring, or possibly only use it sparingly, like during emergency situations or during those dreaded storms.

Left: Technicians at Rest Assured are able to monitor and control various cameras and devices from their offices in Indiana.

“Yeah, it’s fun,” he responds. “I can go out and do whatever I want whenever I want.” It’s this independent spirit that helped Eric and his SSA, Delaware DD’s Aaron Tiedt, decide that remote monitoring was worth a shot. “Eric is a very bright and capable person. We were searching for a way to reduce his high level of staffing to something more appropriate, but we had to deal with the fact that Eric didn’t like being alone at night or during storms,” Tiedt says. “Remote monitoring seemed like a nice compromise between the two.” When asked if his remote monitors are able to help him get through thunderstorms, it’s obvious that Eric has become comfortable with the current setup. “Yeah, when there’s storms I can call and be like ‘hey, what’s up,’ or if I’m watching something on TV, I can be like ‘hey, you should watch this show, this show’s pretty cool,’” he responds. “Sometimes I can even call on my way home from work, be like ‘what’s the weather going to be like,’ and they’ll go on the Internet and look it up.” While Eric’s increased independence and greater comfort level with being home alone are clear benefits from remote monitoring,

“We have already started reducing his cutoff time from 6 a.m. to 4 a.m. We hope that one day Eric will not need any monitoring and have staff simply check in with him once in a while to make sure everything is OK,” Tiedt says. “If so, Eric will be able to live a much more independent life – something that is good for both him and the board.” The high cost of in-home care staff combined with the increasing pressure to place individuals in less restrictive environments has led county boards to increasingly take note of remote monitoring solutions over the past few years. Add in recent advances in both the sophistication and affordability of remote monitoring technology solutions, and it’s easy to see why these systems are becoming more and more attractive to boards looking to provide better quality services more efficiently. Technology, however, is not a solution in and of itself, and even remote monitoring

providers will caution against viewing the equipment in such a way. Dustin Wright, general manager of Rest Assured, wants people to understand that – while technology does play a huge part in the service – remote monitoring is still primarily a person-to-person interaction. “Remote monitoring is about connecting a human being who needs a support service to a human being who is providing that support service, and it just so happens that technology is the medium that connects them,” Wright said. “Technology is definitely a huge part of it, but it’s more about how we use technology to create individualized and customized services for each person that makes the whole concept effective.” Under his company’s various service options, Wright can create very active monitoring solutions as well as passive ones. Frequently, it ends up being a combination of both. “We can have active monitoring where the camera is always on, or we can do drop-in monitoring to make sure a person is safe or accomplish specific tasks, like a morning wake-up or to take scheduled medications,” Wright said. “When the cameras are off, we can still monitor carbon monoxide levels, smoke detectors, and a variety of other sensors that can be installed according to a person’s specific needs. We listen to a person’s story, and then build the technology system around them.” For people like Eric, this means gaining independence while making it easier for the county board to provide effective support – both for Eric, and for the other people they serve. In the end, Eric is very supportive of remote monitoring – so much so that he would even recommend it to his friends if they expressed an interest. “If only they could make food on my stove, then it would be perfect,” he says with a smirk. But for now, he’s happy with what they’ve been able to offer him – a chance to live truly on his own, even if for only part of the day. That, for many, will likely be enough reason to at least give it a try.

Are there people served by your county board of developmental disabilities that could benefit from a remote monitoring solution? Contact us at feedback@oacbdd.org to be connected with OACB Affiliate Members (like Rest Assured and Wynn-Reeth, Inc.) for more information.

DD Advocate Magazine

DD Worldview

In May, a bipartisan group of United States Senators came together to urge their colleagues to ratify the United Nations Convention on the Rights of Persons with Disabilities, a document the United States signed but did not fully ratify in 2009. In this edition of Worldview, we explore how one of the convention’s original signatories – Peru – is struggling to fulfill the goals of the agreement in an area of particular interest this election year - the right of people with disabilities to vote.

Peru should remove significant barriers preventing people with disabilities from exercising their right to vote and other civil rights, Human Rights Watch said in a report released in May. The failure to dismantle the obstacles is undermining Peru’s leadership as one of the first countries to ratify, in 2008, the Convention on the Rights of Persons with Disabilities. The 89-page report, “‘I Want to be a Citizen Just Like Any Other’: Barriers to Political Participation for People with Disabilities in Peru,” documents the legacy of a policy, changed only in October 2011, that arbitrarily denied people with sensory, intellectual, and psychosocial disabilities their right to vote, considering them legally incompetent to exercise such a decision. Human Rights Watch also examined the barriers that people with these and other 12

Summer 2012

disabilities face when exercising their political rights, including the difficulty of getting identity documents essential for voting, and the absence of support mechanisms to help people with disabilities make voting decisions. “Peruvians with disabilities are no-less citizens than anyone else,” said Shantha Rau Barriga, disability rights researcher and advocate at Human Rights Watch. “Everyone is equally entitled to vote and participate in society – and the law and government policy should see to it that they have the support they need and that no one is arbitrarily and unjustifiably excluded.” The report is based on interviews with more than 100 people with disabilities and their families, as well as with Peruvian government officials and disability advocates. The report examines how the country’s system of judicial interdiction – which

Above: Maria S., the mother of Javier, a 22-year old man with a mild intellectual disability, told us about her son’s experience at the bank, when they asked him for his identity card. “They check for the voting number and the sticker. When there is no sticker, it’s like they ignore them, their capacity as an adult, as a person.”

places people under guardianship – and public records that officially identify people as “mentally disabled” create obstacles in practically all spheres of life. Such policies can: prevent people from opening a bank

Left: A national identity card is required for voting as well as for financial matters, such as opening a bank account. Human Rights Watch interviewed people with disabilities who have been unable to obtain these cards or have cards marked with the phrase ”mentally disabled” and do not designate a polling station.

The Organization of American States’ (OAS) Committee for the Elimination of all Forms of Discrimination against Persons with Disabilities has called on states parties, including Peru, to ensure the recognition of everyone’s legal capacity, including people with disabilities, for example by replacing interdiction and related practices with supported decision-making. Peru has no system in place to support people with disabilities in making their own decisions. In the absence of such a mechanism, Human Rights Watch found that family members of people with disabilities had sought guardianship because they perceived it to be the only way under Peruvian law to protect their property or legal interests, including their right to a pension or social security benefits.

Above: Members of a non-governmental organization that advocates for people with disabilities march to a municipal government office to demand their rights as citizens.

account, getting a job, owning or inheriting property, getting married, or signing official documents on behalf of their children. Under the system of interdiction, Peru’s civil code allows a judge to declare a person with certain intellectual or mental disabilities incompetent to take care of his or her self and property and to impose another person as guardian to act on the person’s behalf. The process effectively suspends the civil rights of the person placed under guardianship, Human Rights Watch said. However, Article 12 of the Disability Rights Convention states that people with disabilities should “enjoy legal capacity on an equal basis with others in all aspects of life.” The committee that monitors the Disability Rights Convention has called on the Peruvian government to “abolish the practice of judicial interdiction.” “I have the right to vote; I have the right to work,” said Maria Alejandra Villanueva, a leader of the Peruvian Association of People with Down Syndrome. “It’s not someone else’s decision.”

People with disabilities in Peru may also face physical and other barriers when they seek to exercise their right to vote. Peru’s election law requires officials to provide accessible voting facilities. However, the government has a mixed record in this regard, Human Rights Watch found. People with physical disabilities and election monitors told Human Rights Watch that many polling places were inaccessible. Silvia, a woman with a physical disability in Puno, told Human Rights Watch, “The polling stations are not prepared for people with disabilities, or even people who had an accident a few days earlier,” she said. “They are on the second and third floor. They are not accessible for someone in a wheelchair.” Human Rights Watch also received reports that braille ballots, which must be provided by law, were not available in some polling places during the 2010-2011 municipal and presidential elections. Some people with disabilities who had asked for assistance in voting were not able to get help, they told Human Rights Watch. People with psychosocial and intellectual disabilities face additional barriers and challenges in voting, Human Rights Watch found. The government has produced no election materials to facilitate their participation. And government officials, civil society organizations, and citizens who administer or monitor elections have little guidance on how to ensure that these voters can reach the polls and cast their vote. “The government needs to make sure that election staff are able to support the right of people with disabilities to vote,” said Barriga. “Otherwise, the voices of thousands of Peruvians will continue to be excluded from the political process.”

To meet Peru’s obligations under international law, Congress should act promptly to pass new legislation to ensure compliance with the Disability Rights Convention, Human Rights Watch said. The government should also take swift steps to guarantee that all people with disabilities have equal legal capacity, including by amending the civil code and restoring civil rights to those under guardianship. In addition, Peruvian government ministries and agencies should systematically work with people with disabilities and organizations that represent people with disabilities to develop new approaches to supported decision-making and the implementation of legal reforms, Human Rights Watch said. Over the past decade, the Peruvian authorities systematically excluded over 23,000 people with intellectual or psychosocial disabilities from the voter registry, Human Rights Watch said. The people were excluded either because they were unable to obtain a national identity card, which is required for voting, or because they were issued identity cards that designated them “mentally disabled” and thus not entitled to vote or make other legal, financial, and even personal decisions. In October 2011, after years of pressure from disability organizations and intervention by the ombudsman’s office, the National Registry for Identification and Civil Status (RENIEC), one of the government agencies responsible for elections, issued a resolution to nullify this policy and pledged to work with relevant government agencies to address this situation promptly. International civil society, donors, and United Nations agencies active in the area of good governance, civic engagement, and democracy building in Peru should include people with disabilities as part of their analysis or as a focus of their work. Human Rights Watch said. “The government has declared its intentions to give people with disabilities their full rights,” Barriga said. “Now it needs to follow through so that Peruvians with disabilities can exercise their citizenship rights just like everyone else.”

DD Advocate Magazine

Summer Feature

SELF Waiver 101

Learn the basics about Ohio’s newest waiver a dd advocate special report

DD Advocate sat down with Ohio Department of Developmental Disabilities Director John Martin, Deputy Director Patrick Stephan, Medicaid Health Systems Administrator Christina Miller, and Family Advocate Peggy Martin to learn more about the new SELF Waiver prior to its official launch on July 1. Portions of these interviews have been assembled into a primer of sorts to give our readers a better sense of the history, purpose, and future implications of Ohio’s first-ever participantdirected waiver. While every aspect of the SELF Waiver cannot be covered in this venue due to space limitations, we hope this article will allow readers to develop a basic understanding of the state’s newest waiver service option for people with developmental disabilities. We also hope it will set the stage for further discussion on the topic in future issues of this magazine. So, without further ado…

Summer 2012

what is a waiver? Waivers are vehicles states can use to test new or existing ways to deliver and pay for health care and support services under the Medicaid program. In Ohio, people with developmental disabilities can access their care services through a Level One Waiver, an Individual Options (IO) Waiver, and now – a SELF Waiver.

What is the SELF Waiver? The SELF Waiver – an acronym for Self-Empowered Life Funding Waiver (see outset on this page) – traces its history back more than a decade. What makes this waiver different from traditional waivers (such as the Level One or Individual Options/IO Waiver) is that it empowers people with DD and their families to directly manage nearly all aspects of their waiver services. This includes, but is not limited to: hiring and firing service providers, negotiating rates for services, and overseeing the quality of services provided. The establishment of the SELF Waiver marks a significant shift in waiver policy, for it moves most of the responsibility for the day-to-day management and oversight of waiver services away from county boards of DD and toward the person who receives services. The SELF Waiver was approved by the Centers for Medicaid and Medicare Services (CMS) in late 2011, and is now accepting applications as of July 1.

Who is eligible to receive a SELF Waiver? Those who are interested in applying for a SELF Waiver must be Medicaid-eligible and require an Intermediate Care Facility (ICF) level of care. They must also require at least one service covered by the SELF Waiver (see a full list in the outset on page 16), and be able to fulfill the responsibilities of participant direction. To be considered participant-directed, a person must exercise budget authority (the ability to manage waiver finances) or employer authority (the

ability to hire, fire, and manage service providers) for at least one of their waiver services. To apply as a child, a person must be under the age of 22, currently receive services from a local school district, and not be eligible for adult services (i.e., adult day support, integrated employment, supported employment-enclave, or vocational rehabilitation services). To apply as an adult, a person must be over the age of 22, have formally exited from a local school district, and be eligible for the above-named services. Regardless of these age and service requirements, a person must be able to have their health and welfare needs met through the SELF Waiver and other formal and informal supports.

How is this different from other waivers (like the Individual Options/IO Waiver or the Level One Waiver)? The SELF Waiver is different than the other waivers currently available because participants can control nearly all aspects of services paid for by the waiver. While people who access their services through an IO or Level One Waiver are able to work with their service and support administrator (SSA) to choose their providers and offer feedback, they have little responsibility in managing the administration of services (for example, controlling budgets, negotiating independent provider rates, and directly hiring/firing/ managing providers of waiver services). The SELF Waiver is also different because funding for services is capped at an annual rate.

What are the dollar caps on services? For children, SELF Waiver services are capped at $25,000 per year, and for adults, the cap is $40,000 per year. There are also caps on how much can be spent on each type of service within the waiver – for example, support brokers ($8,000/year) and remote monitoring equipment ($5,000/year).

“It’s important for participants to have a lot of freedom within the waiver, but it’s also important to have some basic guidelines that protect its long-term financial sustainability. We think the cost caps do a good job balancing both of these priorities.” Christina Miller Medicaid Health Systems Administrator

photo by Vicki Rich

How was the SELF Waiver named? The Self-Empowered Life Funding (SELF) Waiver is the first Medicaid waiver in the state of Ohio to be named by people with developmental disabilities. In late 2010, participants at the Annual Conference of the Ohio Self-Determination Association (OSDA) were asked to come up with several potential names for the waiver, which were then voted upon by those in attendance. The winning entry was selected overwhelmingly (see photo at right).

“Many of the people who were interested in applying for the waiver thought the names of the other waivers sounded too impersonal and bureaucratic. Because this waiver was so revolutionary for Ohio, they wanted its name to have a unique meaning. I think the name they came up with accomplishes that perfectly.” – John Martin, Director Photo courtesy OSDA

DD Advocate Magazine

Summer Feature

Who creates and monitors the Individual Service Plan (ISP) in a SELF Waiver? County board SSAs will still be responsible for creating a person’s ISP, monitoring services and supports, and completing all level of care and functional assessments. They will also be responsible for all other requirements of service and support administration required by rule or statute. That said, the person served will have much greater control over the day-to-day management of their waiver services, and will be able to work closely with their support broker to make sure their services and supports are being delivered in line with their personal preferences.

Who is a typical SELF Waiver applicant? While all SELF Waiver applicants must be willing and able to perform the duties associated with participant direction, there are no common or unifying factors among potential applicants.

“Each person’s plan will be different, and there are no cookie-cutter solutions under which participants will have to operate. The only tie that binds all SELF Waiver participants is that they are directing their own services. That’s the beauty of this waiver – it allows people to take charge of their services regardless of why they need them.” Peggy Martin Family Advocate

How will the waiting list operate for the SELF Waiver? A person interested in applying for a SELF Waiver simply needs to speak with his or her county board SSA to have his/her name added to the board’s waiting list (or to a SELF Waiver sub-list, if a county board maintains multiple lists within its general waiver waiting list). If a person is already on the waiting list for another waiver, that person’s earliest date of entry on the waiting list (for any waiver) will be used to determine priority for accepting SELF Waiver applications.

If a person is currently on an IO Waiver or Level One Waiver and moves to a SELF Waiver, he or she will be permitted to return to their old waiver as long as they do so within six months (180 days) of making the switch.

Support brokerage Community inclusion

Participant and family

stability assistance

(including personal assistance and transportation)

Remote monitoring service

Integrated employment

respite

Functional behavioral

Adult day supports

intervention Participant-directed goods

and services

Summer 2012

photo by Vicki Rich

covered What serVices are iver? under the self wa

Clinical/therapeutic

Patrick Stephan Deputy Director

What if a person moves from an existing waiver to a SELF Waiver but later decides they want to go back?

assessments

photo by Vicki Rich

“We don’t want a person to feel like they’ll have to start over if they want to give the SELF Waiver a try. It’s a big decision that needs to be taken seriously, but we don’t want people to feel like they are risking everything to become self-directed.”

charges and equipment Residential and community

Vocational rehabilitation Supported

employment-Enclave Non-medical transportation

When can people start applying? The first year’s waivers are available beginning July 1, 2012. An additional 500 will become available in the waiver’s second fiscal year of operation (July 2013 to June 2014).

“By June 2014, we hope to have 1,000 people directing their own services on this waiver. I’ve heard some wonder if we’re going to be able to get this many people enrolled so quickly, but I think there are a lot of folks who have been waiting a long time to get this.” John Martin Director

How many SELF Waivers are available? During the first fiscal year of the program, children with “intensive behavioral needs” will be eligible to apply for one of 100 state-funded waivers. The way the waiver establishes the criteria for determining intensive behavioral needs will likely result in a large number of these waiver slots’ being filled by children with autism. That said, having an autism spectrum diagnosis is not a requirement of the first 100 waivers, so children with intensive behavioral needs who do not have an autism diagnosis are equally eligible. In addition to the 100 state-funded slots, an additional 400 waivers funded by local match have been approved statewide during the first state fiscal year of the waiver (July 1, 2012 to June 30, 2013). These slots are not reserved for any particular diagnosis, age group, or geographical area of the state –

counties will be able to request the waivers on a first-come, first-served basis, with both children and adults eligible to apply.

Are there a limit on how many SELF Waivers each county will receive? For the first 100 state-funded waivers, each county will receive at least one. After that, the remaining 12 (in addition to those that may be declined by county boards during the first round of funding) will be allocated based upon the county’s tax equity status. The remaining 400 waivers, funded by local match, will be filled on a first-come, first-served basis.

How does a person on the SELF Waiver obtain participantdirected goods and services? A person must first attempt to access goods or services through the Medicaid State Plan before purchasing them through their SELF Waiver. If goods or services are not available in the state plan, a person may then use their SELF Waiver funds to pay for them, so long as they are identified as needs in the person’s ISP and meet one or more of these three criteria: (1) reduce the need for other Medicaid services, (2) promote that person’s inclusion in the community, or (3) increase the person’s safety in their home environment. Examples of these expenses include home modifications (such as ramps, grab bars, door widening, etc.) as well as items that increase the individual’s independence. Using a support broker (that is, a person chosen by an individual to assist him or her in managing waiver services), a SELF Waiver participant can find, select, communicate directly with, and negotiate rates with providers of SELF Waiver services. It should be noted that an SSA at a county board of DD cannot act as a support broker.

who may not be immediately convinced, there are other tangible benefits to the SELF Waiver for county boards. For instance, it can help boards cut down on waiting lists by moving capable individuals off of waivers that would be better used by people who are unable to make decisions about their future. Also, because the waiver has a hard cap on expenses, it allows boards to make better long-term decisions when making budgets and anticipating future waiver enrollees. Without the risk and uncertainty that comes with uncapped waivers, boards can confidently invest in more waivers and further reduce their waiting lists for services.

How does a person find out more about the SELF Waiver if they are interested? The SELF Waiver process is very similar to the other waiver application processes. Individuals who are interested in putting themselves or a member of their family on the SELF Waiver should contact their local county board of developmental disabilities – specifically, the person’s service and support administrator (assuming one has been assigned) – to learn more about the waiver before beginning the application process. OACB members (including board members, staff, and affiliate members) who have questions about the SELF Waiver can also contact our main office at (614) 431-0616 to learn more.

Have a question not answered by this article? Check out DODD’s Web site for the most up-to-date SELF Waiver info at www.dodd. ohio.gov by clicking the “SELF Waiver” link under the Medicaid tab. Readers can also contact us at feedback@ddadvocate.com with your inquiry – we will do our best to connect you with the information you’re searching for as soon as possible.

How does the SELF Waiver benefit county boards of DD? There are many reasons to support the SELF Waiver, not least of which is giving people with DD the ability to make decisions about their own futures. For many, this is simply “the right thing to do” from a moral, ethical, and individual rights perspective – with no other explanation necessary. But for those

DD Advocate Magazine

photo © Elizabeth Nihiser/The Logan Daily News

Left: Amy Beam, employment specialist with The Employment Connection, sits alongside Michael “Andy” Hummel, who is a client of The Employment Connection of Hocking, Perry, and Fairfield Counties. Hummel now works two days a week at Cherry’s Tire & Service Inc., thanks to a six-week training program that showed him the ropes.

Person of the Quarter: Michael “Andy” Hummel BY Gretchen Gregory / Logan Daily News If you visit Cherry’s Tire & Service Inc. on a Wednesday or Friday, Michael “Andy” Hummel, 19, might rotate your tires, change your oil, or realign your front end. Hummel looks like any other mechanic in the garage, with one exception — he’s a client of Hocking County Development Disabilities — and the staff at Cherry’s has trained him to learn the ropes. “Whoever Andy picks when he comes in in the morning is who he’s hanging out with,” said fellow employee Derek Bownes. “He just walks in and starts working.” On this particular day Hummel is changing the oil and filter on a Volkswagen that’s long overdue. Hummel works alongside Bownes until he learns the process enough that he can do it on his own.

for individuals with developmental disabilities. As part of the Lifeworks Program, Hummel was given opportunities to work at various work sites until he found one he really enjoyed. Amy Beam is an employment specialist for The Employment Connection, and helped Hummell find a job he was comfortable with. They first worked in the Logan High School Cafeteria, but Hummel found working with his hands at Cherry’s was a much more fulfilling experience.

That was in November, and Hummel’s been working there ever since. “I spent probably two weeks actually working in here with him, showing him what they showed me, but they’ve pretty much taken on the role of showing him how to do all this,” Beam said from the garage last week.

“He’s a great kid,” said Cherry’s assistant manager Chris Lowery. “He’s learning a lot. He’s doing really well, and he loves it.”

Hummel says he knew a little about cars, but has learned a lot since working there.

Hummel learned of the job opening through Hocking County DD’s Employment Connection, which helps find local employment opportunities

On this day, Bownes directs Hummel to add another half quart of oil in the car because four quarts isn’t enough. He shows him how

Summer 2012

“We brought Andy here to do a six-week rotation, and after his rotation he applied for a job,” Beam said.

He changes tires, does oil changes and front alignments, but when asked what his favorite part of work is, he replied the semi tires.

to pour the oil slowly from the bottle so it doesn’t make a chugging noise as it goes into the engine. And then Hummel checks the fluid levels, closes the hood, and then Bownes backs the car out of the garage as another happy customer awaits.

People like Andy are proving that community employment is not just a goal – it is reality – for many people with developmental disabilities in Ohio. Programs like The Employment Connection and others are successfully placing individuals in meaningful jobs in communities across the state. For demonstrating how community employment is a realistic and attainable goal for people with developmental disabilities, Andy has been named the DD Advocate Person of the Quarter for Summer 2012 – congratulations!

DD Artists

Clark County’s Quest Art Studio offers outlet for creative energy Story and photos by annette ferraro There is a delightful energy that welcomes visitors to the new Quest Art Studio in Springfield. Pollock-like designs spatter the floor. Wide swaths of color adorn worktables. Artworks made by people with developmental disabilities in various stages of completion can be seen throughout the room. It is a perfectly imperfect space, where imaginations run wild and people are free to express their creativity and emotions without limits. Quest Adult Services, a service of Developmental Disabilities of Clark County, celebrated the grand opening of the Quest Art Studio and Gallery in March. In operation since the beginning of this year, the studio has helped more than 85 artists create both individual and collaborative pieces that are now available for purchase at highly affordable prices (between $10 and $50) by members of the general public. Staff mentors work hard to create a dynamic atmosphere where the environment helps artists find fresh perspective for their creative inspiration. The studio is a place of enjoyment and self-expression, offering

people with developmental disabilities the opportunity to create art and share their view of the world with others. The studio accommodates each artist’s schedule by offering classes at various times, ensuring everyone who wants to put their creative talents to work is able to participate. Many different styles and tools are available for program participants, including acrylic paint, pastels, watercolor, sculpture clay, and ceramic. Recycled material, such as tiles, carpet samples, and wood scraps, are also frequently used depending on the artistic vision of each individual. Once pieces are completed, artists are able to display and sell their work in entry foyer of the Quest Adult Services building. All sales proceeds go directly to studio artists – offering them the chance to earn a modest paycheck while enjoying a quiet retreat from the hustle and bustle of daily activities at the center. Program participants enjoy the calming atmosphere the studio offers, and frequently play various types of music to get the creative juices flowing. Classic country, blues,

“I wanted to do something different and the art studio helps me do that. It helps me share my happy feelings. It’s wonderful!” – Rosa white

Top: Studio artist Erika Moore enjoys using crayons and pastels to express her artistic vision. Middle: Shirley Perkins works on her signature piece, “House and Flowers.” Below: Katie Castle is seen here with the Quest Art Studio Wood Sculpture Display, an example of one of the many mixed-media projects created by program participants.

pop, and even a touch of reggae from time to time can be heard trickling out of the studio, with artists frequently finding themselves moving their brushes to the beat of music. Future plans for the Quest Art Studio and Gallery include contracting with professional artists to mentor studio artists and develop a product line to support studio activities. The artists and employees at Quest hope to continue to provide a profitable program by increasing community exposure and awareness through traveling art shows, festivals, and fairs. The gallery is open to the public, where artwork can be purchased during normal business hours (8:00 a.m. to 4:30 p.m. Monday through Friday) at Quest Adult Services, located at 110 W. Leffel Lane in Springfield.

DD Advocate Magazine

News in a Nutshell Allen Aktion Club members with Allen County Commissioners

The Aktion Club of Lima held a cupcake sale fundraiser to help fund many of the group’s service projects. The event, which took place just before Easter, raised more than $300 for the club. Cupcakes were given to local officials, including the Mayor of Lima, Lima’s police chief, Allen County Commissioners, and the County Sheriff, among others. The club also held a Disability Awareness Walk on March 29, in which many of the same local officials participated.

Ashtabula

community. Participants ranged from high school students with no work experience to adults with developmental disabilities who have years of work experience. Job Club earned PersonnelPlus approximately $11,000 in revenue. There were also a number of events that took place in recognition of Awareness Month, including: PersonnelPlus Advocacy and Advisory Council presented self-advocacy awards, Athens City Commission on Disabilities presented service achievement awards and the Atco Bell Choir and Atco Vocal Choir performed. In conjunction with the Disability Awareness Festival, Beacon School teachers and staff held an open house displaying the array of educational services and therapies provided to Athens County children with developmental disabilities. Nearly 300 people attended this year’s celebration.

Ashtabula DD celebrated Awareness Month with open houses and tours of its facilities. A week of free shredding at Ash/Craft Industries was provided to members of the community and students at Happy Hearts School distributed handmade souvenirs to all visitors. The Ashtabula County Commissioners conducted their meeting at the DD board office in celebration and acknowledgment of individuals receiving services and their families in Ashtabula County.

Belmont

Athens

Butler PersonnelPlus recently held two Job Club meetings, during which Stephanie Howell facilitated a class of 13 students who wanted to both prepare and keep a job in their

Summer 2012

Compiled and edited by Lisa Brewer / OACB

During Autism Awareness Month in April, PACE (Parents for Autism Community Education) and Belmont DD teamed up to help the public understand autism and how it affects the community as a whole. According to the Centers for Disease Control and Prevention (CDC), more children are affected by autism than are by diabetes, AIDS, cancer, cerebral palsy, cystic fibrosis, muscular dystrophy, and Down syndrome combined.

In March, Butler DD hosted its 18th Annual Community Recognition Dinner. More than 300 guests honored families, individuals, volunteers, businesses and organizations for their work to provide support, friendship and encouragement to people with disabilities. The board’s 2012 Awareness Month theme – “Because of You” – highlights the ways taxpayer funding helps support people with disabilities to live full

lives. The awareness video can be viewed online at http://www.butlerdd.org/news/ butlerdd_videos.php.

Carroll Carroll DD eliminated payroll step increases and created salary ranges for all staff as part of a recent review of personnel policies and procedures. Their next goal is the creation of a “pay for performance” system, which will likely be included in a future update. In other news, the board was awarded a 4-year accreditation from the Ohio Department of DD. Staff members believe this is due in no small part to them recently adopting the “positive culture” philosophy.

Champaign Champaign DD celebrated Awareness Month by hosting an open house on March 8. People who receive services from the board demonstrated how to make pottery, complete jobs on the production floor, and have fun in the enrichment area to those who attended. Attendees were also entered into a drawing to win ceramic art pieces created by Art on Main artists.

Clark QUEST Adult Services of Clark County recently celebrated the grand opening of the QUEST Art Studio and Gallery. Since January, 85 QUEST artists have created both individual and collaborative pieces from recycled materials like tiles, carpet samples, and wood scraps. Other mediums include acrylic paint, pastels, watercolor, and ceramic. The average price of artwork ranges from $10-$50, with all earnings going directly to the artist. The gallery is open to the public and artwork can be purchased at QUEST Adult Services, 110 W. Leffel Lane, Springfield, Ohio 45506, M-F 8:00 a.m. - 4:30 p.m.

Clermont Just three hours after an EF-3 tornado finished its path of destruction in Clermont County this past March, Clermont DD staff members were hard at work answering calls

and placing volunteers at three donation centers across the county. As an official Volunteer Reception Center (VRC) for the disaster area, Clermont DD was proud to be giving back to the communities that had given so much to the board over the years. Staff members worked for up to 14 hours a day during busy periods, staying on hand to assist recovery efforts until volunteers were no longer needed. When all was said and done, Clermont DD had registered and placed more than 1,000 caring citizens as volunteers in one week.

Columbiana Congressman Bill Johnson (OH-6) recently toured Columbiana DD facilities, including both the sheltered workshop and the Beaver Creek Candle Company. During his tour, he spoke with employees, observed candle production, and discussed the board’s efforts to create jobs for people with developmental disabilities with the superintendent and senior staff.

Coshocton More than 150 guests recently gathered for the first ever “Hopewell Showcase” at Coshocton DD’s adult program – Hopewell Industries. The showcase featured an art walk of pieces created by Hopewell artists. In addition to the art walk, Coshocton DD hosted a dessert theatre featuring more than 20 individuals who demonstrated their on-stage talent in front of a very enthusiastic crowd. It was a very successful event and plans are underway for the 2nd annual showcase in 2013. Coshocton DD also recently held is 10th annual Hopewell Auction, which over the past decade has generated more than $240,000 to support a variety of efforts (such as the building of a state-of-the-art playground and trips for program participants). Plans are underway to break ground for a Community Pavilion on the grounds of Hopewell School this summer,

which will afford the opportunity for more activities for people served by the board and their families and be available for the community to use.

Crawford Several Crawford County high school students with disabilities had an opportunity to visit Crawford DD for a Student Expo sponsored by the board, where they were introduced to the different resources offered to them and their families as they transition to the adult world. Students thoroughly enjoyed the event and teachers found it very useful. Crawford DD recently hosted its first Community Expo/Business After-hours to showcase all aspects of services provided by Crawford DD. The event was a huge success, drawing more than 300 people to the board facilities. A highlight of the evening was when people who receive services from the board demonstrated many of their work-related abilities as local business owners observed.

Cuyahoga DD Awareness Month was absolutely full of activities this year at Cuyahoga DD. Flame, a rock band from upstate New York made up of 10 people who have developmental/ physical disabilities, kicked off the month with a sold-out show at the House of Blues in downtown Cleveland. Throughout the month, 20 billboards featuring two best friends reminded passersby that “Our Community Is Better Together.” Also running throughout the month were spots on local radio and television stations that reinforced the message. The month concluded with a Sprout Film Festival at Cuyahoga Community College’s Black Box Theatre.

Delaware Delaware DD recently hosted a Boy Scout Disability Awareness merit badge training at the county board facility. More than 40 Scouts went through the training and received a merit badge at completion. Participants were placed into five groups that rotated through a variety of classes that included: Wheelchair Accessibility, Myths and Misconceptions, Employment, Housing, Provider Services, Safety and Special Needs Registry, and Technology Assistance. This is the second year Delaware DD has hosted this

class, co-sponsored by the Simon Kenton Council of the Boy Scouts of America. In other news, Focus on Abilities is gearing up for its 4th Annual Variety Show. This year’s theme is “Surfin’ USA,” and will consist of music and acts depicting the Sixties era. More than 50 people with and without disabilities will perform on July 20. Tickets will go on Sale May 1 and can be obtained from a link on the Delaware DD website. Get your tickets quickly – last year’s event sold out with a crowd of 340 people!

Erie Erie DD recently presented its 2012 awards for advocacy and support of people with developmental disabilities. The Bilger family of Sandusky was honored with the Steve Lippert Award, which recognizes individuals for their service to people with developmental disabilities through advocacy and support. Lisa Bilger is an adult receiving services from Erie County DD. The self-determination group at Erie DD nominated Lisa, her parents and her sisters.

Fairfield Fairfield DD welcomed more than 425 community and business leaders, elected officials, staff, friends, family, and people receiving services to the 4th Annual Celebration of Possibilities awards banquet. Awards were presented to individuals, businesses, and organizations in seven categories. The agency also established the Fairfield DD Hall of Fame. Actress and author Geri Jewell closed the evening with a humorous and inspirational look at her career as an actress with a disability.

Franklin Franklin DD recently awarded graduate certificates to 50 self-advocates who have completed the Project STIR (Steps Toward Independence and Responsibility) program. The graduation took place at the Franklin County Board of DD’s administrative offices, where friends and family gathered to watch the advocates accept their award and listen to elected officials.

DD Advocate Magazine

News in a Nutshell Gallia Below: To celebrate DD Awareness Month, Gallia County Commissioners Harold Montgomery, Lois Snyder, and Howard Joe Foster, as well as Terry Hemby of the Commissioners’ Office and County Administrator Karen Sprague, visited the Guiding Hand School and Preschool at the Gallia County Early Childhood and Family Center. Preschool students treated the guests to their rendition of “Pete the Cat.” Also pictured is Rosalie Durbin, Gallia DD Superintendent.

Geauga Geauga DD showed their appreciation to first responders (police, EMT, fire departments, FBI, Sheriff’s office, and the Geauga County Park District) who all contributed to the response efforts associated with the Chardon High School tragedy. They all did an amazing job that day and the Adult Services Department wanted to send them a big thank you. People receiving adult services traced their hands and placed the shapes on poster board. Some created hearts, angel wings, or a thank you in sign language. The signs, along with fresh cookies, were hand delivered by people receiving services and staff directly to the many agencies that responded. Everyone was very grateful and the signs can be seen hung up in many stations all around the area!

Greene Greene DD recently received a three-year accreditation, the highest obtainable, from CARF (Commission on Accreditation of Rehabilitation Facilities). Out of 970 standards, the board received only two recommendations for improvement and was told its programs for children and adults with autism spectrum disorder were excellent.

Guernsey Guernsey DD recently enrolled 10 youth in the Bridges to Transition program’s summer

Summer 2012

program. These youth will gain valuable work experience and job readiness over their summer break. For more information about the Bridges to Transition program, visit www.oacbdd.org/bridges.

Hamilton Hamilton DD Superintendent Alice Pavey recently recognized eleven officers of the Cincinnati Police Department for extraordinary service to people with disabilities. These officers cooperated with Hamilton DD in quick response to and investigations of several situations that involved people with disabilities who were victims of crime. Cincinnati police have also worked closely with MUI Prevention Department staff to provide mutually beneficial training and education about interacting effectively with people with disabilities. In addition to Chief James Craig, those recognized were: Captain Kimberly Frey; Lieutenant Christine Briede; Sergeants Dwayne Wilson, Lisa Crisafi, Ron Hale, Brent McCurley, David Simpson; Specialist Laurie Kramer; and Officers Charles Zopfi and William Holthaus. Also recognized for efforts that led to convictions were Hamilton DD Investigators Holly Mott and Jennie Flowers. Cincinnati Police Lieutenant Colonel Richard Janke presented Hamilton DD with a plaque in recognition of the two agencies’ successful partnership.

Hancock Hancock DD hosted a variety of events to celebrate DD Awareness Month. Miss Ohio (Ellen Bryan) came to Blanchard Valley School to present awards to third graders from each county school that were selected as winners of the first annual Coloring Contest. Later that month, Mayor Lydia Mihalik read a proclamation from the City of Findlay recognizing March as DD Awareness Month to an assembly of children and adults, and shook hands with each attendee. Mayor Mihalik also wrote an article for Findlay Now, a local news magazine, highlighting Hancock DDs 60th anniversary celebration. Blanchard Valley School hosted a parent/grandparent breakfast in March as well. In other news, DODD Director John Martin kicked off the public/private partnership between Blanchard Valley Center and Special Kids Therapy (SKT). SKT moved its multi-sensory playroom, valued at more than $50,000, to the Blanchard Valley Center campus.

The playroom offers children and adults the opportunity to interact with multi-sensory equipment. Since their recent move to BVC, SKT reports that the use of the playroom has increased by more than 300%. SKT also offers a one-of-a-kind Summer Day Camp for students using BVC facilities. Last but not least, SKT provides scholarships and grants to pay for services and products that cannot be covered by other programs and insurance.

Holmes Holmes DD Awareness Month activities began with a community luncheon and finished with a Bucks basketball victory over the community All-Stars. Other activities included a show by The Bubble Lady, a talent show, community presentations by people using assisted communication devices, and visits from local high school students to the Training Center. Holmes DD also provided tours of its facilities to Amish schools as part of the month’s activities.

Huron Self-advocates Nate Lucal and Christina Rogers are shown welcoming Shawn Dickerson of the Norwalk Fire Department to Christie Lane’s third annual Community Awareness Breakfast on March 16.

More than 190 runners and walkers participated in the Christie Lane 5K Walk & Run - Path to Destruction on March 24. The race is held annually in conjunction with Christie Lane Industries’ document destruction weekend where individuals can bring in up to 500 pounds of personal documents to be destroyed free of charge. In addition to the document destruction activities, awards were given out in 16 categories. Christie Lane Industries is AAA certified by the National Association for Information Destruction. In other news, Huron DD Self Advocates Club hosted its

annual DD Awareness Month Community Breakfast. The theme of this year’s breakfast was, “Spread Some Self Advocacy in Your World,” and featured a video of individuals who receive services at Christie Lane and staff answering the question, “What does advocacy mean to you?” The breakfast provides community leaders and individuals interested in developmental disabilities the opportunity to visit Christie Lane and be served breakfast by the Self Advocates Club.

Knox Knox County celebrated DD Awareness Month with the County Commissioners reading a proclamation to a room packed full of people with disabilities and their supporters, including the Transition Mission class from Mount Vernon High School. Five community members were honored with awards and Jen Odenweller of the United Way was honored for her long time partnership with Knox DD. Close to 130 community leaders attended this year’s Awareness Month Kickoff Luncheon, where a short video featuring people who receive services from Knox DD premiered. Other Awareness Month activities included a celebrity omelet and pancake dinner that raised more than $2,000 and a bowling benefit that raised approximately $600, both of which benefited Citizens Supporting Developmental Disabilities.

Lake Celebrating DD Awareness Month is serious business in Lake County. Every program area either hosted or sponsored a special event to increase awareness, celebrate partnerships and build stronger community relationships. From presentations and special resolutions at the County Commissioners meeting through the Finale of Deepwood Idol, Lake County demonstrated how its community is better ‘together!’ Local school students came to the Vocational Guidance Center and Willoughby Workshop (WWS) to celebrate Dr. Seuss’s birthday and NEA Read Across America Day. Willoughby Workshop Advocacy Committee held its 5th Annual Chili Cook-Off and donated the proceeds to the Cleveland Sight Center. Vocational Guidance Center sponsored ‘Stuff the Bus,’ collecting 1600 pounds of food and toiletry donations for the local Salvation Army. The undefeated Broadmoor Bobcats held their

annual game against the Lake County Coaches, where money raised through ticket and reverse raffle sales was donated to the Broadmoor Physical Education Program and victims of the Chardon school shooting. In addition to the schools, a local restaurant, radio station and newspaper columnist were instrumental in planning, supporting and holding this great event.

Lawrence Lawrence County’s 2nd Annual 5K Run/Walk for Developmental Disabilities in South Point attracted 177 participants during the county’s DD awareness events this past March.

Licking Licking DD volunteers had plenty of reason to celebrate following this year’s primary election, as their campaign to pass a onemill, five-year renewal levy won the support of 63% of voters on March 6. Congratulations to Licking DD staff, volunteers, and families who worked so hard to make it happen! Fundraisers to replenish PAC funds have already taken place, with the largest – April’s LICCO Spring Fitness 5K Run/Walk – also providing additional opportunities for community participation and awareness. In other news, upcoming public outreach efforts will concentrate on educating the public about transition-age services for teens as well as employment services for adults. The focus is on getting people ready to tackle the job market! If you’re a Facebook user, be sure to check “Like” Licking DD on Facebook – at least one update is posted each weekday at facebook.com/LCountyDD.

Lorain Earlier this year, Murray Ridge Center received a generous donation of weaving looms and yarn. The equipment was quickly put to work teaching twelve people who receive services how to make warm winter hats for donation to homeless shelters in Lorain County. As a result of this activity, the Warm Hats, Warm Hearts Club was formed. As their collection of finished products grew, so too did the interest in helping others. Testing their newfound skills, they also began weaving hats for newborn babies that will be donated to local hospitals. “Helping People…For a Lifetime” is the motto of Murray Ridge Center and its Elyria Opportunity/Vocational Center.

The Warm Hats, Warm Hearts Club embodies that motto, and has started a cycle of giving that will have an immediate positive impact on the Lorain County community.

Madison As regular readers of DD Advocate already know, Ann Slanker spent her entire professional life healing others before her untimely passing last December (See: In Memoriam, Spring 2012). On March 22, Slanker’s positive nature, natural leadership abilities, and inspiring personality were recognized as she was posthumously awarded the prestigious Dorothy Allison Lifetime Achievement Award. Named after Madison DD’s founder, the presentation capped off an emotional night at the 22nd Annual Appreciation Awards, coinciding with March’s statewide DD Awareness Month. Her family was on hand to accept the award on her behalf, and expressed their gratitude to those in attendance. Also at the event, consumer awards went to adult enrollees Charlie Elliott (pictured with OACB Board President Blaine Brockman, Rep. Bob Hackett, and Superintendent Jim Canney) and Rebecca Dozier. Elliott was acknowledged for his strong work ethic and Dozier was commended for her personal growth through her job, artwork, and relationships. Among other awards, staff members Jamie Canney (Service Coordinator) and Roger Morris (Madison County Ride driver) were recognized for their contributions.

Mahoning Senator Joe Schiavoni presented guest of honor Dominic Medina with a special resolution.

As part of DD Awareness Month celebrations, Mahoning DD honored its “Veterans of the Valley” with a luncheon at Meshel MASCO. The program honored Mr. Dominic Medina, who served our country as a veteran, our DD Advocate Magazine

News in a Nutshell community as Mayor of Campbell, and our county as a board member for Mahoning DD. The veterans viewed a patriotic video, a military display of flight logs and memorabilia from World War II and had the opportunity to meet new and old friends. The event drew more than 100 participants, including local politicians, media, and friends of the program to pay tribute to those who have served the United States in military service of all branches.

Marion Marion DD recently hosted its 4th Annual Advocacy Conference at Tri-Rivers Career Center. Approximately 150 people, including individuals served in Marion and surrounding counties, all Marion DD staff, residential provider staff, family members, and other advocates for people with developmental disabilities had the pleasure of participating in presentations. The event, which started as a creative staff in-service day, always focuses on advocating for the rights of people with DD, while also considering the responsibilities that go along with those rights.

Medina Medina DD recently held its annual adaptive art festival. This year’s theme, “Come Fly with Me,” celebrated flight by creating works of art that featured things that fly. The program was provided to students at the Windfall School and to special education students from area schools. The program provided a wide assortment of hands-on art activities for people of all ages: painting, drawing, crafting, sewing, and coloring. Art stations to help students with projects were staffed by local artists and volunteers. A performance by Applause, a local show choir and a visit from a local news helicopter highlighted the day. Throughout the month of March the Medina County Aktion Club sponsored the “Help Chardon Heal” fundraiser. Participants from the Community Integration (CI) department of Adult Services helped organize this month-long event. Easter baskets were made to sell and raffle and use the proceeds to make a monetary donation to the Chardon Healing Fund. In addition, the fundraiser provided five individual baskets for the five families affected. This turned out to be a true “community” effort with an overwhelming response! People receiving services, their families and staff donated 24

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everything from Easter grass to candy and toys. CI participants helped shop, assemble baskets, and sell raffle tickets. Eight baskets and more than 660 raffle tickets were sold.

Meigs Meigs Industries, the Adult Services component of Meigs DD, recently hosted a “Business After Hours” event in conjunction with the local Chamber of Commerce. Twelve area businesses were represented, and in addition to some great food & music and a chance to network with each other, people enjoyed touring Carleton School and Meigs Industries. David Jackson, Adult Services Director for Meigs Industries, was able to share information about janitorial, lawn maintenance and other services that Meigs Industries can provide for businesses in Meigs County. Executive Director Kay Davis was pleased to let business leaders know that as they are recruiting employees who may be new to the community or courting new businesses, Meigs DD provides high quality specialized educational, habilitation, and vocational services for people with developmental disabilities throughout their life span.

Mercer Mercer DD recently created a new adult service – a self-determination system for individuals living in nursing facilities. 70% of those living in nursing facilities chose the new opportunity over the previous routine of traditional adult services. Those choosing the new system have access to an account that they decide how to best use for their lives. The only restriction is that they must choose community support services as opposed to center-based services. The board is able to fund this system with savings from not filling vacancies in center-based adult services, allowing the board to put the money saved in other areas where it is needed. In what can only be described as a “win-win” scenario, the adults who chose this new option get more meaningful services and supports while the board gets to provide more services to others with its limited resources.

Miami In order to foster the teamwork necessary to implement the Primary Service Provider Model system, Miami DD’s Early Intervention program brought in the authors of The Early Childhood Coaching Handbook, Dathan D. Rush, Ed.D., CCC-SLP and M’Lisa L. Shelden, PT, Ph.D.

Representatives of Help Me Grow, Miami DD’s Early Intervention team, and therapy professionals attended the two-day training held this spring. The training was very successful in equipping attendees with techniques and skills for implementation of this new approach for families in Miami County who are served by the program.

Montgomery The Commission on Accreditation of Rehabilitation Facilities (CARF) has once again accredited Montgomery DD for the quality services and supports it provides to people with disabilities. The comprehensive review was conducted by a team of surveyors that looked at service and support areas, including: community integration; how persons served by the county board are treated; the conscientiousness of staff members; enhancing the quality of older adults’ independent lives; accessibility; medication monitoring and management; behavioral health services; employment services; facility maintenance; creating a safe and healthy environment for persons served, staff, and visitors; and that the county board is dedicated to listening to its shareholders along with many others. The results of the review found that the Montgomery DD achieved substantial compliance with all standards and subsequently obtained a 3-year period of accreditation.

Morgan Morgan DD recently hosted Dr. John McGee for a conference on Gentle Teaching. Awareness Month events included: a staff in-service at the Stockport Mill attended by several employees of the Morgan Local School District and service providers; an open house for the public at the Mary Hammond Workshop; and attendance at the M&M Rotary Club meeting.

Muskingum Muskingum DD (Starlight Programs) is a proud supporter of Operation Feed and March of Dimes. Several fundraisers were held and non-perishable food items were collected at the school, workshop and administration building. Other events included a raffle, an ice cream social, a pie sale and a catalog sale to help raise money for the cause. The Starlight Steppers participated in the March for Babies Walk at the Zanesville campus of

Ohio University to support March of Dimes. Operation Feed and March of Dimes are both important foundations and Muskingum DD is excited to be involved and be contributors to the cause!

Ottawa For years, David Kaiser collected aluminum cans and turned them in for cash. He had a few friends and family members who saved cans for him. David had a part-time job for a local car dealer, but due to the declining economy, David’s position was eliminated. At an ISP meeting David told his team he would like to look for another job. His team kept circling around to David’s hobby of collecting cans. David liked the idea of expanding the can collection business, so he and his provider, John, designed a business card he can leave with local business owners and pass out to people in the community. David is very involved in community events and having a card to carry with him would help him promote his business to a large audience. David is not only collecting the aluminum cans for recycling, but also hauling away scrap metal and other items. David’s Can and Scrap Hauling can be reached at (419) 898-2233. If the job’s too big, David will let you know.

Perry Pictured Left to Right: Joey Kirk, Senator Tim Schaffer, Superintendent David Couch, Bobby Brunton, and Sam Layton.

Perry DD kicked of this year’s Awareness Month by welcoming State Senator Tim Schaffer, who presented a proclamation before the annual DD Awareness Community Game, which pits the Perry County Cougars against a team of community members. The community team’s efforts were no match for the Cougars, who won a convincing victory!

Pickaway Pickaway DD has recently begun collaborating with Pickaway Diversified, Inc. and Village Chapel United Methodist Church

to open a retail skate parts store. The store is located in The Way, an indoor skate park in Ashville. The store operates five days a week and participants spend a portion of their shift learning an array of community employment skills such as resume writing and fundamental money management.

Portage Portage DD’s Special Olympics basketball team, The Thunder, won the Special Olympics Division IV State Basketball Championship in a thrilling contest against the Hardin County Pioneers with a score of 52-46. The Thunder were down by 16 points going into the fourth quarter but rattled off 18 unanswered points and were able to hold off the Pioneers until the buzzer, bringing Portage County its first ever Special Olympics state basketball championship! Congratulations to Coach George Paroz and the team members, who were recognized by the board during a regular meeting.

Preble Preble County Commissioner David Wesler received the Ohio Public Images (OPI) Award of Merit in the Community/Elected Official category for his contributions supporting Preble DD and the people it serves. Wesler, a long-time supporter of Preble DD, received the recognition during the OPI Annual Awareness Awards Luncheon in Columbus and thanked the board for their support. Whether it’s volunteering for Special Olympics or supporting the important work and projects the board does, Wesler said he enjoys advocating for people with developmental disabilities through fundraisers, official recognitions, and community involvement. He was nominated by Preble DD Superintendent Diane Knupp and Public Relations/Community Development Coordinator Corey Mangan, who said Wesler “has been very instrumental” to Preble DD, offering “vocal support during commission meetings and in the community.” Congratulations Commissioner Wesler! Pictured left to right: Preble DD Superintendent Diane Knupp, Preble Commissioner David Wesler, Preble DD Board President Jean Fitzwater Bussell, and Public Relations/Community Development Coordinator Corey Mangan.

Putnam Putnam DD’s Brookhill Center is again the recipient of funds raised through the Sons of American Legion. This year, as in previous years, the civic organization has a bowling event that generates close to $10,000. Much of the proceeds directly benefit Brookhill’s Special Olympic programs. Both people served by the board and staff members enjoy participating in this community event.

Richland Richland Newhope was very busy during DD Awareness Month. In keeping with tradition, the board once again held their Annual Third Grade Coloring Contest – celebrating its 19th year – in which 530 students from 18 schools demonstrated their coloring abilities. Ms. Wheelchair Ohio 2011 Margaret Long joined the winners at a special luncheon in their honor. Later in the month, 25 people from the Mansfield-Richland Area Chamber of Commerce’s Leadership Unlimited class participated in Richland Newhope’s 11th Annual Community Awareness Day. Each participant was given a simulated disability for two hours and was paired with a staff member and an individual supported by Newhope. Each of the participants talked about their experience during a luncheon that followed. Capping off the month of activities was the 2nd Annual Bringing the Elements Together Art and Talent Exhibition at the Richland Mall. The seven-hour event featured artwork by individuals of all ages and performances by 45 people who sang, danced, and played musical instruments throughout the day. Other awareness month activities included a display at the main branch of the Mansfield-Richland County Public Library, a window display at the Richland Mall, and distribution of 5,500 pamphlets to 51 churches, five billboards, and 10 proclamations from communities in Richland County. DD Advocate Magazine

News in a Nutshell Ross

Seneca

Ross DD/The Pioneer Center has formed a partnership with Chillicothe City Schools (at the district’s request) to operate three special needs classrooms within the school system – one high school class with eight students, and two preschool multiple disabilities classes with thirty to forty students – starting in the 2012-2013 school year. As part of the arrangement, Pioneer will manage all personnel efforts for recruiting, hiring, evaluating, training, and regularly providing on-site monitoring by a licensed special education administrator. The school district will provide transportation except for community-based instructional outings that are a normal part of Pioneer School’s activities. Students will have the same curriculum and services that Pioneer School currently provides, including OT/PT/SL sessions, music therapy, use of technology, and character/social development. The curriculum, while including ODE Academic Content Standards, will heavily reflect communication, social, and daily living skill development based on individual needs. Auxiliary services will include specialized autism resources and job development coordination for transition aged students. Pioneer Center’s goal is to continue providing quality services that are an extension of what is currently provided to further meet the needs of Ross County families and children. Adding these community collaborative classes is a great example of a partnership that works for all stakeholders.

The Seneca County Opportunity Center hosted its 11th Annual Celebrity Basketball Game to celebrate Awareness month. More than 500 people attended the game at Heidelberg University. Many Heidelberg University football players who volunteer at the Opportunity Center during basketball season played in the game along with Opportunity Center Special Olympians and local celebrities including: board members, commissioners, judges, the mayor of Fostoria, the Bellevue city prosecutor, WTOL Meteorologist Ryan Wichman, staff members, and a few players from our 1991 State Championship team. During half time the Opportunity Center’s Seneca Arrows 1991 Division IV Special Olympic State Championship team members were recognized. Russ Snyder from WTTF radio station broadcasted the game live and interviewed many participants during the game. There were many opportunities to celebrate and share with the community DD Awareness 2012.

Shelby Pictured below: Tia Braun front row 3rd from the right, and Brian Stotler back row 4th from the right.

Sandusky The Commission on Accreditation of Rehabilitation Facilities (CARF) recently announced that Sandusky DD and Sandco Industries has been accredited for a period of three years, the highest level of accreditation that can be granted to an organization. Sandusky DD received certification in the following areas: Behavioral Consultation Services; Child and Youth Services; Community Integration; Community Integration (Older Adults); Community Services Coordination; Employment Transition Services; and Governance Standards Applied. Sandco Industries was surveyed in the area of Organizational Employment Services. First accredited by CARF in 2007, Sandco Industries also is CARF accredited in the area of Community Employment Services – Job Development, Job Support, and Job-Site Training.

Summer 2012

Twenty-two members of the Shelby County chapter of People First of Ohio recently attended the 2012 People First of Ohio Conference in Wilmington. The convention offered guest speakers and training sessions for people with developmental disabilities to help them gain employment, learn to vote, transition from school to the workplace and secure transportation. The conference hosted a “Dancing with the People First Stars” and a “People First Talent Show,” as well as a dance with the theme “Party like a Cowboy” and an election and crowning of a King and Queen of the conference. Elections were held for People First of Ohio state open board positions, with candidates for these positions delivering a campaign speech. Shelby DD and the Shelby County Chapter of People First

are very proud of Tia Braun, who was elected to the office of Vice President this year. Tia is also the President of the Shelby County Chapter. Brian Stotler of Shelby County also serves on the state board of People First Ohio.

Stark Stark DD celebrated Awareness Month from start to finish sharing the many talents of its staff and individuals with disabilities living in the community. Success stories of individuals with disabilities integrated into the community were shared through newspapers, radio stations, and billboards across the county. Awareness activities kicked off with the Annual Arc Awareness Dinner, where Stark DD Intervention Specialist Ann Slagle was honored as Educator of the Year. Adult artists working for The Workshops, Inc. promoted their talents with a special art display at the Main Branch of the Stark County Public Library. “Just Imagine What We Can Do Together” featured life size figures designed and decorated by the artists. Special Olympians from both the Stark DD Men’s Red and the Stark Public Blue Knights basketball teams took their talents to the court playing a halftime exhibition game during the Canton Charge/Ft. Wayne Mad Ants game of the NBA Development League. Awareness Month concluded with an annual fundraiser at the Glenmoor Country Club. The event, which raised more than $52,000 for Citizens Who Care for People with Developmental Disabilities PAC, took guests back to the era of ballrooms and big bands. The highlight of the dinner/auction event was the live entertainment by The John Trapani Big Band and musicians with developmental disabilities. Highlights from all the awareness month activities can be found at www.facebook.com/StarkDD.

Summit Summit DD commissioned a work group that will use a data-driven process to determine whether or not sheltered work centers contribute to reduced employment for people with developmental disabilities and low wages. Representatives from Summit DD, private providers, persons served, DODD, OACB and The Arc of Summit and Portage Counties serve on a steering committee that will evaluate the results of a research study comparing outcomes of three peer groups. One group is made up of individuals who choose to remain in sheltered work settings, a second group is individuals who have recently been placed in integrated employment, and a third group

will be volunteers who have traditionally been thought of as “unemployable” but will be placed into integrated work settings with supports. The goal of the study is to determine from the perspective of individuals and their parents or guardians what the relative benefits and drawbacks are to integrated employment, facility-based work and facility-based non-work services. Outcomes will be measured in quality of life, satisfaction, wages and benefits, health and safety and cost to serve. Results from this study will serve as an input to the next long range strategic plan and will assist in the implementation of the Ohio Employment First Initiative. For more information about this project please contact Bill Payne, Senior Director of Board Supports and Services, at bpayne@summitdd.org.

Tuscarawas Tuscarawas County recently hosted the 2012 Special Olympics Ohio State Basketball Tournament. Twenty-six teams in 8 divisions from all four corners of the state competed for the gold medal in their Final 4 during DD Awareness Month. An additional 350 athletes competed in the individual skills competition at Claymont High School, marking the fourth time Tuscarawas County has had the opportunity to host the state tournament. Through tremendous partnership with local public schools, the games were hosted by Strasburg City Schools, Dover Middle School, New Philadelphia High School and Kent State University Tuscarawas. Opening ceremonies were held at Strasburg High School with Tuscarawas DD Superintendent Natalie Lupi and Tuscarawas County Commissioner Kerry Metzger welcoming everyone.

Union Honda of America recently honored U-CO Industries, Inc. for the company’s Excellence In Delivery Award at Honda’s major conference for its North American parts suppliers. U-CO Industries was 1 of only 20 suppliers who received this esteemed award. U-CO Industries is part of Honda’s network of more than 600 original equipment manufacturer (OEM) and service parts suppliers, providing parts to 14 Honda manufacturing plants in North America for the production of Honda and Acura automobiles, all-terrain vehicles (ATVs) and other utility products.

Van Wert Van Wert DD became a Bridges to Transition partner with the Ohio Rehabilitation Services Commission (RSC). The program is designed “to expand and enhance career exploration and community employment opportunities for transition youth, ages 14 to 22, who are eligible for county board services, RSC services and educational services under an IEP.” Coordinator Chris Feichter has begun working with the local school districts in identifying eligible students, and plans are underway for summer activities related to the project.

Warren Individuals enrolled in the Warren County Adult Services day program made homemade dog treats, bought jugs of water, and brought dog and cat toys to donate to a community effort sponsored by the Warren County Child Support Enforcement Agency that donated all of the proceeds from the event to the Warren County Animal Shelter.

Wood Wood Lane will be celebrating the 50th anniversary of employment opportunities on August 25. On August 31, 1962, Ohio Secretary of State Robert Brown approved the incorporation of the “Wood County Sheltered Workshop Association.” The articles of incorporation stated that the purpose of the association was to “establish, explore, and initiate a program to seek employment, gainful or otherwise, for young people whose limitations preclude their obtaining employment and to do all things necessary, convenient, or proper toward the accomplishment of the same.” In 1973, the name was changed to Wood Lane Industries with the construction of the new workshop that year. A dinner and recognition program is planned. For more information, contact Liz Sheets at lsheets@woodlane.us.

DD Advocate Magazine

Words of Wisdom DD Advocate recently sat down with

Elizabeth Prather

Richland County Board of DD (Richland

Superintendent

think we should feature next in our

Richland Newhope

Newhope) Superintendent Elizabeth “Liz” Prather and asked fifty questions about her views on life, leadership, and lessons learned for this issue’s Words of Wisdom profile. Ten of her responses have been selected to appear below without their prompts. Which superintendent do you Words of Wisdom series? Send us your suggestions at feedback@ddadvocate.com.

Photo by Adam Herman

Success is finding balance. Most days, I feel that I have that. Some days, it escapes me.

I need a thicker skin. When I first started, I was assigned a workgroup with adults that had been identified with severe behavior problems. Behavior management was how I had been trained to support them, and though it was evident it worked, it seemed too manipulative. Finding an alternative that works for people in these situations is exciting. Working on a project in the late eighties, I believed that we would have figured out community jobs for everyone by 2012. Unfortunately, I was wrong. The hardest part of my job is when bad things happen to people and I am powerless to fix it.

Summer 2012

I can really identify with Alice from Alice in Wonderland sometimes. The phrase “curiouser and curiouser” has applied to my situation in more instances than I can remember. In Ohio, I think we are doing many things well for people with developmental disabilities. Can we do better? Absolutely. And that is what is great – people continue to do better.

Find joy in your life. With whatever you do and whomever you are with. Playing and exploring outside reminds me of my childhood. Of course it helps to be with children, but I can be childlike by myself.

I love what I do and feel very fortunate to have stumbled into this career.

DD Advocate Magazine

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Turning Your Obstacles Into Opportunities

David A. Myers Elena A. Lidrbauch Judith C. Saltzman Mary B. McKee Amanda M. Buzo Lisa Montoni Garvin Andrea Aycinena