Vermont’s Developmental Services System

And what you really need to know about its System of Care Plan.

Presented by Karen Schwartz, VT Developmental Disabilities Council

About the Presenter

• Executive Director of the VT Developmental Disabilities Council since 2004.

• Parent of a 22 year old young man with a developmental disability.

• Involved with the developmental service system since son was about 8

• Worked for the Birth to 3 early intervention program for 11 years as family resource specialist and service coordinator.

What is the Vermont Developmental Disabilities Council?

• There is a Council in every state, D.C, and U.S. territories.

• Funded for the last 40 years through a federal grant to do “systems advocacy”

• Key role is to – Monitor what is going on for people and families – Support people with developmental disabilities and their families

to have a voice about services and supports that affect them

• We hope you will learn more about how developmental services work, and get involved in making changes you want to see.

What this Webinar will cover

• In a nutshell, how Vermont’s developmental system works, who it covers, and what services it can provide

• What the System of Care Plan is and how it affects who is served and what services can be provided.

• How you can get involved if you think it needs to change.

What this Webinar will cover

That’s a lot to cover in an hour!

We’ll get started, and you will find out ways to follow up and learn more.

Let’s make this interactive

Even if we can’t see each other you can use the type-in feature to let me know– what you are interested in

– what you need explained .– any questions.

Vermont’s “System of Care” for people with intellectual disabilities

• Intent is to be a “System” that provides comprehensive services in the community instead of care in an institution.

• Set up by Vermont’s 1996 Developmental Disabilities Act (which needs a webinar of its own)

• Put in place after the closing of Vermont’s institution, the Brandon Training School, closed.

• Funded by Medicaid. Currently federal government pays 58% of the cost.

What is the System of Care Plan?

In a nutshell:• Required by the VT Developmental

Disabilities Act

• Written by the State of Vermont’s Division of Disabilities every 3 years, and updated each year

• Framework for how services are funded and provided.

What is the System of Care Plan?

In a nutshell:• Required by the VT Developmental

Disabilities Act

• Written by the State of Vermont’s Division of Disabilities every 3 years, and updated each year

• Framework for how services are funded and provided.

Currently it serves• 2,539 people with home & community based

funding packages –332 children under 21• 1,068 people with Flexible Family Funding

– 975 children under 21.• 422 people through limited services like

Targeted Case Management (adults); Bridge Program (children). [2% of total funding.]

Data is from the VT Developmental Services Annual Report 2012, just released.

Who does the System of Care serve?

Who is eligible?

There are 2 gates to go through for home and community based services

1. You must be eligible ~ meet Vermont’s definition, which is limited to intellectual disabilities

• IQ of 70 or below or autism diagnosis, who have difficulties with skills of daily living

2. And you must also meet a funding priority. This is the

hard part!

So, what is a funding priority?

• It is a way to decide who will be funded for a home and community based package, and who will not.

What sets the funding priorities?

The System of Care Plan!

What are the current priorities?Key current priorities are:

• Age 18, with imminent risk to personal health and safety ~ danger, injury or harm

• Age 18 and pose risk of endangering others• Age 19, to maintain a job on high school

graduation• Any age, to prevent or end long term stays in

psychiatric hospital or institution or nursing home.

Limited Priorities = Limited Services

Summary of Priorities:

• The only non-emergency priority is for students age 19 leaving school who already have a job lined up.

• Since 2001, the only priority for children under 18 is being on the brink or being admitted to a psychiatric facility.

What do you get if you are eligible, but don’t meet a priority?

• Flexible Family Funding ~ capped at $1,000, which is less than 15 years ago

• For kids, Bridge program case management, which is capped at 393.

• For adults, Targeted Case Management, which provides check-ins. NOTE ~ TCM is not available in all regions of the state.

What services can you get if you are eligible?

Based on individual budgets & can include

•Up to 25 hours combined–Community supports –Job supports, including job coach to help at work

•Home supports ~ typically pays for shared living provider, although it can cover group home & help to live independently

Services, continued

•Respite ~ typically managed by family or home provider•Service Coordination•Clinical Interventions ~ could be therapy groups, behavioral consults, therapeutic riding, etc.

NOTE: Prior to 2010 people could have a Goods line of up to $1,000 to use flexibly including for purchases. Some regions cover some of the items formerly covered by goods. Others do not.

What describes any limits to the services you can get?

THE SYSTEM OF CARE PLAN!!

Who decides who is eligible,and what services you get?

• You need to apply at the regional developmental service agency, which is a non-profit designated by the State.

• They decide eligibility and whether you meet a priority.

• If you are eligible and don’t meet a priority you are supposed to be sent a decision you can appeal. Often people get Flexible Family Funding instead.

Here are the regional agencies

Their official name is Designated Agencies

Map is from the Annual Report.

Who decides, continued

• If you are eligible a funding package of services is put together that needs to be approved by

– the regional agency’s Equity Committee

– the state-wide Equity Committee, and finally by the state Division for Disabilities & Aging Services ~ D-DAS

What sets up and describes the Equity Committees?

THE SYSTEM OF CARE PLAN!!

Do priorities affect what services you get?

• Initial funding packages will be affected by the priority that gets you in the door.– Example. If you get into the system through the

funding priority of having a job when you leave school you will probably be limited to job supports and service coordination.

• However, once you are in the system you can add services by applying through the Equity Committee process.

Do priorities affect what services you get?

Summing Up, the System of Care Plan [SOCP]

1. Sets the funding priorities

2. Sets limits on services & supports

3. Sets up the Equity Committees that allocate funding

Let’s find out more about the SOCP

And how you can help change it.

How the SOCP works

Vermont’s Developmental Disabilities Act spells out what the System of Care Plan is and does:

• It needs to include√ Priorities for continuing programs &

developing new ones√ Criteria for receiving services√ Process for evaluating success

AND needs to be based on

Information from people with developmental disabilities and their families and providers

A comprehensive needs assessment Demographic information AND information on

services being used underserved and unserved individuals and

populations reasons for gaps in services varying community needs and resources.

Who decides the priorities?

• The Commissioner of the Dept. of Disabilities, Aging & Independent Living [DAIL]

• Based on funds available

• Any proposed changes need to be presented to the State Standing Committee on Developmental Services at least 60 days before they go into affect

So, what can you do?

• Make sure you know about any changes that could affect you or your family member

• Let the State agency [D-DAS] and Committee members know what changes you think should be made.

• You can also insist that D-DAS consider all of the information it is supposed to when it writes the Plan.– For example, the last Plan mentioned aging parents

but the current Plan leaves them out.

How can you do that?

• Attend and present at the Standing Committee meetings, held the 3rd Thursday of the month

• Submit written comments to D-DAS about your concerns

** Also remember ~ You can get to know the people you elect – senators, legislators and the Governor – and keep them informed.

When is this happening?

Right now!

• Any changes this year will be effective September 30, 2012

• Next Standing Committee meetings are June 21, July 19 and Sept. 20.

• The agency D-DAS will present proposals for change by July 19

How can you learn more?

• Ask to be on the Standing Committee list, and to get more info on SOCP changes, by e-mailing chuck.bruder@state.vt.us

• Send an e-mail to me at karen.schwartz@state.vt.us

• Contact Vermont Family Network’s developmental disability specialist at 1-800-800-4005.

Links to Resources •VT’s Developmental Disabilities Act~ 18 V.S.A. 8721www.leg.state.vt.us/statutes/fullchapter.cfm?Title=18&Chapter=204A

•VT’s System of Care Plan for FY2012-14

www.ddas.vermont.gov/ddas-programs/programs-dds/programs-dds-default-page#policies

•VT Developmental Services 2012 Annual Report ~ www.ddas.vermont.gov/ddas-publications/publications-dds/publications-dds-documents/dds-publications-annual-report/dds-annual-report-2012

VT Developmental Services website ~ www.ddas.vermont.gov/ddas-programs/programs-dds/programs-dds-default-page

We are here to help

• VTDDC website ~ www.ddc.vermont.gov

• VT Family Network Developmental Disability web pages ~ www.vermontfamilynetwork.org/i-need-help-with/developmental-disabilities/

Feedback always appreciated!

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