Real Choice Systems Change Grants Compendium Fifth Edition Cover with pictures of persons with disabilities and DHHS logo

Logo for Centers for Medicare & Medicaid Services U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES
Centers for Medicare & Medicaid Services
7500 Security Boulevard, Mail Stop S2-14-26
Baltimore, Maryland 21244-1850

Center for Medicaid and State Operations
Disabled and Elderly Health Programs Group (DEHPG)


March 2006

Dear Reader:

Since 2001, CMS has awarded approximately $287 million in Systems Change Grants for Community Living to 50 States, 2 Territories, and the District of Columbia. We have prepared this Fifth Edition of the Compendium of the Real Choice Systems Change Grants to be an ongoing user-friendly reference tool for our Grantees and others interested in these systems change grants.

The Compendium will help you learn more about how these grants will be used to allow more people of all ages with a disability or long-term illness to live and participate in their communities. We hope that Real Choice Systems Change Grantees will also find it useful to identify other Grantees with similar goals and activities. A Web-based edition of the Compendium will be made available on the CMS Web site at http://www.cms.hhs.gov/RealChoice/ as well as on the Clearinghouse for the Community Living Exchange Collaborative Web site at http://www.hcbs.org.

The Compendium contains basic information about each of the Real Choice Systems Change Grantees. It is divided into sections corresponding to the different types of grants and year of award. Each section is arranged alphabetically by state. Information for each grant includes the name of the grantee organization, the title of the grant, the type of grant, the amount awarded and fiscal year awarded, the primary contacts for each grant, the target populations to be served under the grant, the primary goals and activities of each grant project, and a brief description of the grant activities. For grants that received a no-cost time extension, we have included the expected completion date. Those grantees who have completed their grant activities are listed as completed.

With the assistance of our contractors, RTI International and Abt Associates, we will also be preparing additional reports that will provide more comprehensive descriptions of the Grantees' goals and activities and progress.

Sincerely,

 

Gale P. Arden
Director, Disabled and Elderly Health Programs Group

 


This document was developed under a contract from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, Contract No. 500-00-04. However, these contents do not necessarily represent the policy of the U.S. Department of Health and Human Services, and you should not assume any endorsement by the federal government.


 

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Table of Contents

Community-Integrated Personal Assistance Services and Supports Grants (CPASS)
2001

ALASKA
ARKANSAS
GUAM
MICHIGANImage representing dagger directing the reader to a footnote
MINNESOTA
MONTANA
NEVADA
NEW HAMPSHIRE
OKLAHOMAImage representing dagger directing the reader to a footnote
RHODE ISLANDImage representing dagger directing the reader to a footnote

Community-Integrated Personal Assistance Services and Supports Grants (CPASS)
2002

COLORADOImage representing dagger directing the reader to a footnote
DISTRICT OF COLUMBIAImage representing dagger directing the reader to a footnote
HAWAII
INDIANAImage representing dagger directing the reader to a footnote
KANSAS
NORTH CAROLINAImage representing dagger directing the reader to a footnote
TENNESSEE
WEST VIRGINIAImage representing dagger directing the reader to a footnote

Nursing Facility Transitions Grants (NFT)
2001

ALABAMA
ALASKA
COLORADOImage representing dagger directing the reader to a footnote
CONNECTICUT
GEORGIA (ILP)
GEORGIA
INDIANAImage representing dagger directing the reader to a footnote
MARYLAND (ILP)
MARYLAND
MASSACHUSETTS
MICHIGAN
NEW HAMPSHIRE
TEXAS
WASHINGTON
WEST VIRGINIA
WISCONSIN (ILP)
WISCONSIN

Nursing Facility Transitions Grants (NFT)
2002

ALABAMA
ARKANSAS
CALIFORNIA
DELAWARE (ILP)
DELAWARE
LOUISIANA
MINNESOTA
NEBRASKAImage representing dagger directing the reader to a footnote
NEW JERSEY (ILP)
NEW JERSEY
NORTH CAROLINAImage representing dagger directing the reader to a footnote
OHIO
RHODE ISLAND
SOUTH CAROLINAImage representing dagger directing the reader to a footnote
UTAH
WYOMINGImage representing dagger directing the reader to a footnote

Real Choice for Systems Change Grants (RC)
2001

ALABAMA
ARKANSAS*
DELAWARE
FLORIDA
GUAM
HAWAIIImage representing dagger directing the reader to a footnote
IDAHO
ILLINOISImage representing dagger directing the reader to a footnote
IOWA*Image representing dagger directing the reader to a footnote
KENTUCKY
MAINEImage representing dagger directing the reader to a footnote
MARYLAND*Image representing dagger directing the reader to a footnote
MASSACHUSETTS*Image representing dagger directing the reader to a footnote
MICHIGANImage representing dagger directing the reader to a footnote
MINNESOTAImage representing dagger directing the reader to a footnote
MISSOURIImage representing dagger directing the reader to a footnote
NEBRASKA
NEW HAMPSHIRE
NEW JERSEYImage representing dagger directing the reader to a footnote
NORTH CAROLINA
OREGON
SOUTH CAROLINAImage representing dagger directing the reader to a footnote
TENNESSEE
VERMONT
VIRGINIA*

Real Choice for Systems Change Grants (RC)
2002

ALASKA
CALIFORNIA
COLORADOImage representing dagger directing the reader to a footnote
COMMONWEALTH OF NORTHERN MARIANA ISLANDS
CONNECTICUTImage representing dagger directing the reader to a footnote
DISTRICT OF COLUMBIA
GEORGIA
INDIANA
KANSAS
LOUISIANAImage representing dagger directing the reader to a footnote
MISSISSIPPI
MONTANA
NEVADAImage representing dagger directing the reader to a footnote
NEW MEXICOImage representing dagger directing the reader to a footnote
NEW YORK
NORTH DAKOTAImage representing dagger directing the reader to a footnote
OHIOImage representing dagger directing the reader to a footnote
OKLAHOMAImage representing dagger directing the reader to a footnote
PENNSYLVANIA
RHODE ISLAND
TEXAS
UTAHImage representing dagger directing the reader to a footnote
WASHINGTON
WEST VIRGINIAImage representing dagger directing the reader to a footnote
WISCONSIN

Feasibility Studies and Development Grants
2003

Respite for Adults (RFA)

CALIFORNIA
NEW YORK
OHIO
RHODE ISLAND

Respite for Children (RFC)

ALABAMA
ARKANSAS
MARYLANDImage representing dagger directing the reader to a footnote
MICHIGAN
OREGON
RHODE ISLAND

Community Based Treatment Alternatives for Children (CTAC)

ILLINOIS
MARYLAND
MASSACHUSETTS
MISSISSIPPI
MISSOURI
TEXAS

Research and Demonstration Grants
2003

Quality Assurance and Quality Improvement in Home and Community Based Services (QA/QI)

CALIFORNIA
COLORADOImage representing dagger directing the reader to a footnote
CONNECTICUTImage representing dagger directing the reader to a footnote
DELAWARE
GEORGIA
INDIANA
MAINEImage representing dagger directing the reader to a footnote
MINNESOTA
MISSOURI
NEW YORK
NORTH CAROLINA
OHIOImage representing dagger directing the reader to a footnote
OREGON
PENNSYLVANIA
SOUTH CAROLINA
TENNESSEE
TEXASImage representing dagger directing the reader to a footnote
WEST VIRGINIA
WISCONSINImage representing dagger directing the reader to a footnote

Independence Plus Initiative (IP)

COLORADO
CONNECTICUT
FLORIDA
GEORGIA
IDAHOImage representing dagger directing the reader to a footnote
LOUISIANAImage representing dagger directing the reader to a footnote
MAINEImage representing dagger directing the reader to a footnote
MASSACHUSETTSImage representing dagger directing the reader to a footnote
MICHIGAN
MISSOURIImage representing dagger directing the reader to a footnote
MONTANA
OHIO

Money Follows the Person Rebalancing Initiative (MFP)

CALIFORNIA
IDAHO
MAINEImage representing dagger directing the reader to a footnote
MICHIGANImage representing dagger directing the reader to a footnote
NEVADA
PENNSYLVANIAImage representing dagger directing the reader to a footnote
TEXASImage representing dagger directing the reader to a footnote
WASHINGTON
WISCONSIN

Community-Integrated Personal Assistance Services and Supports (C-PASS)

ARIZONAImage representing dagger directing the reader to a footnote
CONNECTICUT
LOUISIANA
MASSACHUSETTS
NEBRASKA
OREGONImage representing dagger directing the reader to a footnote
TEXASImage representing dagger directing the reader to a footnote
VIRGINIAImage representing dagger directing the reader to a footnote

Technical Assistance to States, State Advisory Committees and Families
2003

Family-to-Family Health Care Information and Education Centers (FTF)

ALASKA
COLORADOImage representing dagger directing the reader to a footnote
INDIANAImage representing dagger directing the reader to a footnote
MARYLAND
MONTANA
NEVADA
NEW JERSEY
SOUTH DAKOTA
WISCONSIN

Feasibility and Demonstration
2004

LIFE Accounts Feasibility and Demonstration (LIFE)

NEW HAMPSHIREImage representing dagger directing the reader to a footnote
WISCONSINImage representing dagger directing the reader to a footnote

Research and Demonstration Grants
2004

Mental Health: Systems Transformation (MHST)

DELAWARE
MAINE
MASSACHUSETTS
MICHIGAN
MINNESOTA
NEW HAMPSHIREImage representing dagger directing the reader to a footnote
NORTH CAROLINAImage representing dagger directing the reader to a footnote
OHIOImage representing dagger directing the reader to a footnote
OKLAHOMAImage representing dagger directing the reader to a footnote
OREGON
PENNSYLVANIA
VIRGINIAImage representing dagger directing the reader to a footnote

Quality Assurance and Quality Improvement in Home and Community Based Services (QA/QI)

ALASKA
ARIZONA
ARKANSAS
FLORIDA
MASSACHUSETTS
NEBRASKAImage representing dagger directing the reader to a footnote
NEW HAMPSHIRE
NEW JERSEYImage representing dagger directing the reader to a footnote
VERMONT

Integrating Long-Term Supports with Affordable Housing (HOUSE)

ARKANSAS
DISTRICT OF COLUMBIA
MISSISSIPPIImage representing dagger directing the reader to a footnote
NEW HAMPSHIREImage representing dagger directing the reader to a footnote
NORTH CAROLINA
OREGONImage representing dagger directing the reader to a footnote
PENNSYLVANIA
VERMONTImage representing dagger directing the reader to a footnote

Rebalancing Initiative (REBAL)

ILLINOISImage representing dagger directing the reader to a footnote
LOUISIANAImage representing dagger directing the reader to a footnote
MISSISSIPPI
NORTH CAROLINAImage representing dagger directing the reader to a footnote
NORTH DAKOTA
TENNESSEE
VIRGINIAImage representing dagger directing the reader to a footnote

Portals from EPSDT to Adult Supports (PORT)

DISTRICT OF COLUMBIA
NEBRASKA

Comprehensive Systems Reform (COMP)

VERMONT
WISCONSIN

Assistance to States, State Advisory Committees and Families
2004

Family-to-Family Health Care Information and Education Centers (FTF)
2004

ARIZONA
KENTUCKY
LOUISIANA
MASSACHUSETTS
NEW MEXICOImage representing dagger directing the reader to a footnote
NEW YORKImage representing dagger directing the reader to a footnote
NORTH CAROLINA
NORTH DAKOTA
UTAH
WEST VIRGINIA

Systems Transformation Grants
2005

ARKANSAS
IOWA
LOUISIANA
MAINE
MASSACHUSETTS
MISSOURI
NEW HAMPSHIRE
NEW MEXICO
OREGON
SOUTH CAROLINA

Family-to-Family Health Care Information and Education Centers (FTF)
2005

CONNECTICUT
IDAHO
MICHIGAN
NEW HAMPSHIRE
OREGON
RHODE ISLAND
SOUTH CAROLINA
TEXAS
VIRGINIA
WASHINGTON

* Grantee received a supplemental award in FY 2002.

Image representing dagger directing the reader to a footnote Goals/activities/abstract modified since last edition.

Alphabetical Listing of States

ALABAMA (NFT-ILP)
ALABAMA (NFT-SP)
ALABAMA (RC)
ALABAMA (RFC)
ALASKA (C-PASS)
ALASKA (FTF)
ALASKA (NFT-SP)
ALASKA (QA/QI)
ALASKA (RC)
ARIZONA (C-PASS)
ARIZONA (FTF)
ARIZONA (QA/QI)
ARKANSAS (C-PASS)
ARKANSAS (HOUSE)
ARKANSAS (NFT-SP)
ARKANSAS (QA/QI)
ARKANSAS (RC)
ARKANSAS (RFC)
ARKANSAS (ST)
CALIFORNIA (MFP)
CALIFORNIA (NFT-ILP)
CALIFORNIA (QA/QI)
CALIFORNIA (RFA)
CALIFORNIA (RC)
COLORADO (C-PASS)
COLORADO (FTF)
COLORADO (IP)
COLORADO (NFT-SP)
COLORADO (QA/QI)
COLORADO (RC)
COMMONWEALTH OF NORTHERN MARIANA ISLANDS (RC)
CONNECTICUT (C-PASS)
CONNECTICUT (FTF)
CONNECTICUT (IP)
CONNECTICUT (NFT-SP)
CONNECTICUT (QA/QI)
CONNECTICUT (RC)
DELAWARE (MHST)
DELAWARE (NFT-ILP)
DELAWARE (NFT-SP)
DELAWARE (QA/QI)
DELAWARE (RC)
DISTRICT OF COLUMBIA (C-PASS)
DISTRICT OF COLUMBIA (HOUSE)
DISTRICT OF COLUMBIA (PORT)
DISTRICT OF COLUMBIA (RC)
FLORIDA (IP)
FLORIDA (QA/QI)
FLORIDA (RC)
GEORGIA (IP)
GEORGIA (NFT-ILP)
GEORGIA (NFT-SP)
GEORGIA (QA/QI)
GEORGIA (RC)
GUAM (C-PASS)
GUAM (RC)
HAWAII (C-PASS)
HAWAII (RC)
IDAHO (FTF)
IDAHO (IP)
IDAHO (MFP)
IDAHO (RC)
ILLINOIS (CTAC)
ILLINOIS (RC)
ILLINOIS (REBAL)
INDIANA (C-PASS)
INDIANA (FTF)
INDIANA (NFT-SP)
INDIANA (QA/QI)
INDIANA (RC)
IOWA (RC)
IOWA (ST)
KANSAS (C-PASS)
KANSAS (RC)
KENTUCKY (FTF)
KENTUCKY (RC)
LOUISIANA (C-PASS)
LOUISIANA (FTF)
LOUISIANA (IP)
LOUISIANA (NFT-SP)
LOUISIANA (RC)
LOUISIANA (REBAL)
LOUISIANA (ST)
MAINE (IP)
MAINE (MFP)
MAINE (MHST)
MAINE (QA/QI)
MAINE (RC)
MAINE (ST)
MARYLAND (CTAC)
MARYLAND (FTF)
MARYLAND (NFT-ILP)
MARYLAND (NFT-SP)
MARYLAND (RC)
MARYLAND (RFC)
MASSACHUSETTS (C-PASS)
MASSACHUSETTS (CTAC)
MASSACHUSETTS (FTF)
MASSACHUSETTS (IP)
MASSACHUSETTS (MHST)
MASSACHUSETTS (NFT-SP)
MASSACHUSETTS (QA/QI)
MASSACHUSETTS (RC)
MASSACHUSETTS (ST)
MICHIGAN (C-PASS)
MICHIGAN (FTF)
MICHIGAN (IP)
MICHIGAN (MFP)
MICHIGAN (MHST)
MICHIGAN (NFT-SP)
MICHIGAN (RC)
MICHIGAN (RFC)
MINNESOTA (C-PASS)
MINNESOTA (MHST)
MINNESOTA (NFT-ILP)
MINNESOTA (QA/QI)
MINNESOTA (RC)
MISSISSIPPI (CTAC)
MISSISSIPPI (HOUSE)
MISSISSIPPI (RC)
MISSISSIPPI (REBAL)
MISSOURI (CTAC)
MISSOURI (IP)
MISSOURI (QA/QI)
MISSOURI (RC)
MISSOURI (ST)
MONTANA (C-PASS)
MONTANA (FTF)
MONTANA (IP)
MONTANA (RC)
NEBRASKA (C-PASS)
NEBRASKA (NFT-SP)
NEBRASKA (PORT)
NEBRASKA (QA/QI)
NEBRASKA (RC)
NEVADA (C-PASS)
NEVADA (FTF)
NEVADA (MFP)
NEVADA (RC)
NEW HAMPSHIRE (C-PASS)
NEW HAMPSHIRE (FTF)
NEW HAMPSHIRE (HOUSE)
NEW HAMPSHIRE (LIFE)
NEW HAMPSHIRE (MHST)
NEW HAMPSHIRE (NFT-SP)
NEW HAMPSHIRE (QA/QI)
NEW HAMPSHIRE (RC)
NEW HAMPSHIRE (ST)
NEW JERSEY (FTF)
NEW JERSEY (NFT-ILP)
NEW JERSEY (NFT-SP)
NEW JERSEY (QA/QI)
NEW JERSEY (RC)
NEW MEXICO (FTF)
NEW MEXICO (RC)
NEW MEXICO (ST)
NEW YORK (FTF)
NEW YORK (QA/QI)
NEW YORK (RC)
NEW YORK (RFA)
NORTH CAROLINA (C-PASS)
NORTH CAROLINA (FTF)
NORTH CAROLINA (HOUSE)
NORTH CAROLINA (MHST)
NORTH CAROLINA (NFT-SP)
NORTH CAROLINA (QA/QI)
NORTH CAROLINA (RC)
NORTH CAROLINA (REBAL)
NORTH DAKOTA (FTF)
NORTH DAKOTA (RC)
NORTH DAKOTA (REBAL)
OHIO (IP)
OHIO (MHST)
OHIO (NFT-SP)
OHIO (QA/QI)
OHIO (RC)
OHIO (RFA)
OKLAHOMA (C-PASS)
OKLAHOMA (MHST)
OKLAHOMA (RC)
OREGON (C-PASS)
OREGON (FTF)
OREGON (HOUSE)
OREGON (MHST)
OREGON (QA/QI)
OREGON (RC)
OREGON (RFC)
OREGON (ST)
PENNSYLVANIA (HOUSE)
PENNSYLVANIA (MFP)
PENNSYLVANIA (MHST)
PENNSYLVANIA (QA/QI)
PENNSYLVANIA (RC)
RHODE ISLAND (C-PASS)
RHODE ISLAND (FTF)
RHODE ISLAND (NFT-SP)
RHODE ISLAND (RC)
RHODE ISLAND (RFA)
RHODE ISLAND (RFC)
SOUTH CAROLINA (FTF)
SOUTH CAROLINA (NFT-SP)
SOUTH CAROLINA (QA/QI)
SOUTH CAROLINA (RC)
SOUTH CAROLINA (ST)
SOUTH DAKOTA (FTF)
TENNESSEE (C-PASS)
TENNESSEE (QA/QI)
TENNESSEE (RC)
TENNESSEE (REBAL)
TEXAS (C-PASS)
TEXAS (CTAC)
TEXAS (FTF)
TEXAS (MFP)
TEXAS (NFT-ILP)
TEXAS (QA/QI)
TEXAS (RC)
UTAH (FTF)
UTAH (NFT-ILP)
UTAH (RC)
VERMONT (COMP)
VERMONT (HOUSE)
VERMONT (QA/QI)
VERMONT (RC)
VIRGINIA (C-PASS)
VIRGINIA (FTF)
VIRGINIA (MHST)
VIRGINIA (RC)
VIRGINIA (REBAL)
WASHINGTON (FTF)
WASHINGTON (MFP)
WASHINGTON (NFT-SP)
WASHINGTON (RC)
WEST VIRGINIA (C-PASS)
WEST VIRGINIA (FTF)
WEST VIRGINIA (NFT-SP)
WEST VIRGINIA (QA/QI)
WEST VIRGINIA (RC)
WISCONSIN (COMP)
WISCONSIN (FTF)
WISCONSIN (LIFE)
WISCONSIN (MFP)
WISCONSIN (NFT-ILP)
WISCONSIN (NFT-SP)
WISCONSIN (QA/QI)
WISCONSIN (RC)
WYOMING (NFT-SP)

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Community-Integrated Personal Assistance Services and Supports

ALASKA

Grant Information

Name of Grantee
Department of Administration, Division of Senior Services
Title of Grant
Alaska's Personal Assistance Services and Supports Project
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$900,000
Year Original Funding Received
2001
Completed

Contact Information

Susan Cook, Associate Coordinator
3601 C Street, Suite 310
Anchorage, AK 99503
907-269-3653
Susan_Cook@admin.state.ak.us

Phillip Jones, Program Coordinator
PO Box 110620
Juneau, AK 99811-0620
907-465-3370
Phillip_Jones@health.state.ak.us

Subcontractor(s)

Center for Human Development, University of Alaska, RSA
Governor's Council on Disabilities and Special Education, RSA

Target Population(s)

Individuals with disabilities or long-term illnesses, provider agencies, and other key stakeholders.

Goals

Activities

Abstract

Alaska's Personal Assistance Services and Supports (PASS) project will be used to improve personal assistance services that are consumer-directed or controlled. The project will build upon existing and planned changes to Alaska's personal assistance programs, administered by the Division of Senior Services (DSS). The consumer-directed program (CDPAS), which provides consumers with the option to hire, train, and supervise their personal assistants, with the support of a fiscal intermediary agency, was implemented in October of 2001. Changes are also being proposed to the agency-based program, which will result in greater consumer choice and availability of services. These changes are scheduled for implementation in 2002.

Project funds will be used to develop training programs and provide technical assistance to provider agencies to improve consumer control and input for those individuals receiving agency-based services. Training will also be made available to individuals with disabilities or long-term illnesses and other key stakeholders to advance the concepts of individual choice and consumer control. Funds will also be used to implement strategies to increase the recruitment and retention of personal assistants.

Note: This Compendium form was not reviewed by the Grantee prior to publication.

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Community-Integrated Personal Assistance Services and Supports

ARKANSAS

Grant Information

Name of Grantee
Department of Health and Human Services (DHHS),
Division of Developmental Disabilities (DDS)
Title of Grant
DDS Pass Grant
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$900,000
Year Original Funding Received
2001
Completed

Contact Information

Carole Cromer, Administrator
PO Box 1437, Slot N502
Little Rock, AR 72203-1437
501-682-8689
carol.cromer@arkansas.gov

Gerald Hodge, Grants Coordinator II
2920 McClellan Drive, Suite 1078
Jonesboro, AR 72401
870-268-2246
gerald.hodge@arkansas.gov

Subcontractor(s)

Partners for Inclusive Communities (formerly UAP)
Karan Burnette
501-682-9000

Oregon Technical Assistance Corporation
Jean Tuller
503-364-9943

Independent Living Services
Jackie Fliss
501-327-5234

Ouachita Industries, Inc.
Sandra Kennedy
870-836-3056

Rainbow of Challenges, Inc.
Patti Manus
870-777-4501

Bost Inc.
Kent C. Jones
479-478-5551

Board of Trustees, University of Arkansas/People First
Kim Worlow
870-488-9000

Advocates Needed Today, Inc.
Syed Ali
870-543-7123

Arkansas Independent Living Council
Rebecca Riggs
501-372-0607

Target Population(s)

Individuals who meet the definition of having developmental disabilities as defined by Arkansas State statute.

Goals

Activities

Abstract

The DDS Services through the PASS Grant seeks to promote a change in the way services are provided to individuals with developmental disabilities. Our current model of cursory input as "consumer control" is no longer acceptable to many individuals who request and/or receive services through DDS. Concepts of independence, self-determination, and consumer control will be included as we move to design a more flexible and responsive system.

Through the PASS Grant, DDS will develop an advisory council, train and support self-advocacy networks, and create an interactive Web site and handbook. These accomplishments will create an environment that will empower individuals and families to advocate for changes to the system, from initial design to implementation. The development of new service delivery system options that expand consumer choice and control and enhance quality is also a goal of this grant.

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Community-Integrated Personal Assistance Services and Supports

GUAM

Grant Information

Name of Grantee
Department of Integrated Services for Individuals with Disabilities
Title of Grant
Inadanñá para Tinilaika—Partners for Change
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$300,000
Year Original Funding Received
2001
Completed

Contact Information

Rosanne Ada, Project Director
Division of Support Services
1313 Central Avenue
Tiyan, Guam 96913
671-642-0014
disid@ite.net

Monica Flores Limtiaco
Project Coordinator/Facilitator
PO Box FN
Hagatna, Guam 96932
671-477-1760/1505
monical@ite.net

Subcontractor(s)

Catholic Social Services
Cerila Rapadas
671-635-1410

Guam Center for Excellence in Developmental Disabilities Education, Research and Services
Heidi San Nicolas
671-735-2480/81

Service Coordinator to be decided.
Resource Developer to develop a Creative Funding Task Force to be decided.

Target Population(s)

Ten individuals with disabilities in need of personal assistance services who will participate in a 6-month pilot project. These individuals may include individuals who currently reside in group home settings, individuals who are inappropriately placed in institutions, and individuals who have minimal support systems.

Goals

Activities

Abstract

Guam's citizens with significant disabilities are in compelling need of personal assistance services. Although personal assistance is the most frequently used long-term care service throughout the United States, there are no personal assistance services available on Guam to enable persons with disabilities to live integrated and meaningful lives in the community. Due to the lack of personal assistance services, persons with disabilities are inappropriately placed in treatment facilities, continue to remain in congregate settings, and experience prolonged waiting periods for housing and supportive services. This problem is also aggravated because Guam is ineligible for funding under SSI and there is a cap on federal expenditures for Guam's Medicaid program.

Established in 1997, the Department of Integrated Services for Individuals with Disabilities (DISID) has experienced a rapid influx of persons with disabilities in need of supportive services. With a shortage of funding levels coupled with program overloads, there has been little or no hope for assistance or funding to develop an infrastructure to expand much-needed services.

DISID in partnership with two housing support providers, Guma' Mami and Catholic Social Services, proposes to create a model demonstration individualized budgeting program entitled Inadanñá para Tinilaika—Partners for Change for individuals with disabilities who require supports to live in the most integrated community setting to meet their needs and preferences. This pilot project will develop Guam's individualized budgeting infrastructure for persons with significant disabilities; implement an individualized budgeting pilot program; enhance interagency and natural support partnerships by sustaining a network of valuable supports, and develop consumer-directed quality assurance/personal outcomes measures that promote consumer/family involvement, to name a few activities.

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Community-Integrated Personal Assistance Services and Supports

MICHIGAN

Grant Information

Name of Grantee
Department of Community Health, Office of Consumer-Directed Home and Community Based Services
Title of Grant
Community-Integrated PASS Grant
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$755,972
Year Original Funding Received
2001
Expected Completion Date
March 2006

Contact Information

Michael Daeschlein, Project Coordinator
Michigan Department of Community Health
Baker-Olin West, Room 217
3423 N. Martin Luther King Boulevard
PO Box 30195
Lansing, MI 48909
517-335-5106
daeschleinm@michigan.gov

Subcontractor(s)

Susan Steinke, Executive Director
Quality Community Care Council
1115 South Pennsylvania Street
Lansing, MI 48912
800-979-4662
ssteinke@mqccc.org

RoAnne Chaney
Michigan Disability Rights Organization
roanne@sprynet.com

Target Population(s)

All Michigan residents who receive Medicaid-funded personal assistance services.

Goals

To enhance and expand the provision of personal care services by

Activities

Abstract

Individuals with disabilities, including the elderly, often require assistance and support to carry out the tasks of daily living. For many, the inability to access such assistance places them at risk of deterioration of their health, safety, and quality of life. They may then require placement in a residential or institutional setting. With proper assistance, many can remain in their own homes and communities. Michigan's Medicaid-funded Home Help program provides eligible persons with the ability to locate, select, and directly employ a person who will provide the needed home care while assuring payment to the worker.

As part of the grant project, a work group consisting of state officials and consumer advocates will develop a model for creating a public authority to function as co-employer with consumers. This model, if successful, will replace the current independent consumer-employer arrangement. The public authority will provide improved access to qualified direct care workers and support both consumers and workers in achieving quality outcomes.

The major functions of the MQCCC will include

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Community-Integrated Personal Assistance Services and Supports

MINNESOTA

Grant Information

Name of Grantee
Department of Human Services, Continuing Care for Persons with Disabilities
Title of Grant
Pathways to Choice: Minnesota's Consumer-directed Personal Assistance Program
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$900,000
Year Original Funding Received
2001
Completed

Contact Information

Ann Roscoe, Project Team Leader
651-431-2395
ann.roscoe@state.mn.us

MaryAlice Mowry
Disability Services Division
Department of Human Services
PO Box 64969
St. Paul, MN 55164-0969
651-431-2395
maryalice.mowry@state.mn.us

Subcontractor(s)

Center for Independent Living of Northeastern MN
1101 E. 37th Street, Mesabi Mall, Suite 25
Hibbing, MN 55746
218-262-6675
kim@accessnorth.net

Home Advantage Health Services, Inc.
720 University Avenue
St. Paul, MN 55401
651-645-5595
HAHShomecare2000@aol.com
612-588-9410
siyadabdul@yahoo.com

People Enhancing People
1064 Felix Street
West St. Paul, MN 55118
651-455-8691
Carlisle1231@msn.com

Vietnamese Minnesotans Association
1030 University Avenue, Suite 160C
St. Paul, MN 55104
651-290-4791
john.tranberg@spps.org

Target Population(s)

Consumers of all ages with all types of disabilities, especially communities of color.

Goals

Activities

Abstract

For people of all ages with disabilities or long-term illnesses, Minnesota has developed a community-based system of comprehensive services with an array of options to keep people in the community. In its Medicaid State Plan and waiver services, the State offers personal assistance services or PCA. Minnesota has a specific consumer-directed option with this service. Since 2001, when the grant was written, the number of agencies and consumers using consumer-directed options has increased dramatically. PCA consumers are still having difficulties finding PCAs, especially in ethnic and rural communities.

Minnesota seeks to both increase consumer direction and control of PCA services and address the worker shortage problem through the development of a consumer-initiated partnership and support (CIPS) networks model. Through CIPS, consumers will access each other's natural supports, such as family and neighbors, to provide PCA services, as well as to create backup options. Networks will offer members opportunities for cooperative training, support, respite, service management, and group insurance policies.

By using CIPS members as an interactive test group, the State will develop training materials that more effectively promote consumer-directed options among all service consumers. With collaboration from the Medicaid Infrastructure Grant and the Home and Community Based Services section, a consumer guidebook will be developed that describes all the PCA options and gives information and tool supports for consumer direction.

A Web site will be developed to serve as an online PCA worker listing. PCAs will be able to post job skills, preferences, licenses, and experience onto a secure database. Consumers will then have access to search the database for potential PCAs. This listing broadens the grant's "worker registry" concept from a local effort to a statewide initiative.

DHS has identified a need to create a comprehensive provider manual to complement the consumer guidebook for PCA services. Grant staff will, in collaboration with the Home and Community Based Services, Provider Enrollment and Aging, develop a PCA provider manual, which will be both paper and Web-based. The CIPS agencies' experience will be used to develop the guidebook.

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Community-Integrated Personal Assistance Services and Supports

MONTANA

Grant Information

Name of Grantee
Department of Public and Human Services, Senior & Long-term Care Division
Title of Grant
Montana CHOICE
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$850,000
Year Original Funding Received
2001
Completed

Contact Information

Denise King, Program Officer
406-444-4064
dking@state.mt.us

Karen Antonick
Montana CHOICE Coordinator
PO Box 4210
Helena, MT 59604-4210
406-444-6995
kantonick@state.mt.us

Subcontractor(s)

Spectrum Medical
Rick Bourne
800-870-9322
Terry Preite
800-870-9322

Area II Agency on Aging
Karen Erdie
406-323-1320

Area X Agency on Aging
Evelyn Havskjold
406-265-5464

Banik Communications
Ronda Banik
406-454-3422
Joe Caouette
406-454-3422

Summit Independent Living Center
Mike Mayer
406-728-1630

Target Population(s)

Consumers of all ages and disabilities.

Goals

Activities

Abstract

Montana CHOICE is based upon and stands for Consumers Having Options in Community Environments. The grant project comprises a series of activities that will lead Montana's consumers and providers to understand, emulate, and promote integrated community living through the use of personal assistance services. We focus on three key areas: education, workforce, and services. Each area has specific projects that are interrelated to one another.

The grant's purpose is to change the average person's view of home-based long-term care and to provide participants (consumers, providers, or family members) with the knowledge base to participate fully in personal assistance services. Montana will manage a public relations campaign and a training program to meet this goal.

Montana CHOICE proposes two specific projects to address workforce issues. First, in collaboration with two Area Agencies on Aging, we seek to develop a program to attract older workers to the direct care pool. Second, our largest project is to create and blueprint ACCESS (Attendant Center for Communication, Education and Support Services). This central point for recruitment, training, education, and support will enable collaboration in addressing the workforce issue. Instead of competing for attendants, service organizations will participate in focused efforts to improve the system as a whole.

During our planning process, focus groups indicated the need to evaluate, enhance, and potentially modify the program. Evaluation will be through a consumer group who will look at all issues relating to personal assistance service and make the tough administrative recommendations normally reserved for state personnel. Enhancement will come through caregiver support groups, continuation of focus groups, and a Web-based attendant management program. Together these groups will create or suggest modifications to the program to help make it work for all parties involved.

Consumers, advocates, family members, and providers of long-term care services will all participate in Montana CHOICE. Summit Independent Living Center will be the technical advisor on all projects to ensure we work towards community integration. The continuation of consumer focus groups will allow the State to receive honest input regarding grant activities, evaluations, and quality throughout the grant period. An integrated oversight committee will monitor overall grant activities.

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Community-Integrated Personal Assistance Services and Supports

NEVADA

Grant Information

Name of Grantee
Department of Employment, Training & Rehabilitation, Office of Community Based Services
Title of Grant
Community-Integrated Personal Assistance Services and Supports
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$655,988
Year Original Funding Received
2001
Completed

Contact Information

Todd Butterworth, Chief
775-687-4452
tbutterworth@dhr.state.nv.us

Paul Haugen, Long-term Care Specialist
775-687-4452
phaugen@dhr.state.nv.us

Sherry Manning
Project Coordinator (primary contact)
3656 Research Way, Suite 32
Carson City, NV 89706
775-687-4452
smanning@dhr.state.nv.us

Subcontractor(s)

Southern Nevada CIL
Mary Evilsizer
702-889-4216

Northern Nevada CIL
Lisa Erquiaga
Home: 775-329-3008
Office: 775-353-3599

Target Population(s)

People with disabilities in need of or at risk of needing personal assistance services (PAS).

Goals

Activities

Abstract

Through the efforts of Nevadans with disabilities, the 2001 Legislature mandated that all Nevadans requiring assistance with bathing, toileting, and eating must be identified and that planning for their needs must begin. The law also established a consumer-directed Personal Assistance Council to guide the State's efforts in providing access, consumer choice and control, training, and systems change related to all PAS.

The project is a collaboration of the PAS Council, State Aging Services, Medicaid, Family Health Services and Community based Services Agencies, Nevada Universities, the Nevada Community Enrichment Center, the Council and CILs, and the Associations for Retarded Citizens.

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Community-Integrated Personal Assistance Services and Supports

NEW HAMPSHIRE

Grant Information

Name of Grantee
Granite State Independent Living
Title of Grant
ACCESS Consumer Controlled and Empowered Support
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$900,000
Year Original Funding Received
2001
Completed

Contact Information

Jill Burke, Project Director
603-228-9680
jill.burke@gsil.org

David Robar, Project Director
21 Chenell Drive
Concord, NH 03301
603-228-9680
david.robar@gsil.org

Subcontractor(s)

Franklin Pierce Law Center
Institute for Health, Law & Ethics
Michele Winchester
603-228-1541

EP&P Consulting, Inc.
Susan Flanagan
202-628-1134

Target Population(s)

Consumers on the State's Elderly and Chronically Ill Medicaid Waiver, and children with special health care needs and their families.

Goals

Activities

Abstract

The central goal of this project is to create comprehensive cross-disability and cross-age-group access to consumer-directed personal care. The project will expand consumer-directed personal care to large groups of people with disabilities in New Hampshire who have historically been denied access to such services.

New categories of eligible consumers will include people on the State's Elderly and Chronically Ill Medicaid Waiver, and children with special health care needs and their families. Additionally, the project will expand the availability of direct care workers and backup coverage for all consumer-directed personal care programs.

The project will also work with consumers to identify and implement improvements to the entire community support system to provide more choices and control over service options.

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Community-Integrated Personal Assistance Services and Supports

OKLAHOMA

Grant Information

Name of Grantee
Oklahoma Department of Human Services
Title of Grant
Oklahoma's CD-PASS Project
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$850,000
Year Original Funding Received
2001
Completed

Contact Information

Carey Garland
Interim Director
Oklahoma Department of Human Services Aging Services Division
2401 NW 23rd, Suite 40
Oklahoma City, OK 73107-2413
405-522-4509
carey.garland@okdhs.org

Patrice Pratt, Project Manager
Long-Term Care Authority of Tulsa
130 North Greenwood
Tulsa, OK 74120
918-583-3336
ppratt@ltca.org

Subcontractor(s)

Long-Term Care Authority (LTCA) of Tulsa
Deborah Karns
918-583-3336

Target Population(s)

Frail elderly and adults with physical disabilities.

Goals

Activities

Abstract

The Oklahoma Department of Human Services (DHS) Aging Services Division and Developmental Disabilities Service Division are the state agencies responsible for administering Oklahoma's 1915(c) waiver programs. The LTCA of Tulsa is a local public trust authority that is the administrative agent for the ADvantage Program, the statewide waiver that serves over 11,000 frail elderly and adults with physical disabilities and developmental disabilities without cognitive impairment. Ability Resources is an ILC that has been a case management provider in the ADvantage Program since 1995. These entities are partnering to provide leadership to achieve the goals and objectives of this project, which will focus on four major areas.

Consumer/community valued service delivery system. The project will promote accountability of the service delivery system to consumers, providers, and policy makers through development of infrastructure modifications that afford consumer/community control in the design, implementation, and quality monitoring of personal assistance services (PAS) and CD-PASS service delivery.

Consumer-directed personal assistance services. The project will create an infrastructure that supports the availability of personal assistance services in a manner that affords consumers maximum control over the selection of individuals working on their behalf and the manner in which services are provided. Infrastructure includes development of the ILC-based ISOs to serve as consumers' business agent and consultant for employer responsibilities.

Available, reliable, appropriate, and quality CD-PASS. The project will produce a service delivery infrastructure that supports a CQI system that accords premium value for ISO provider and program evaluation and improvement of CD-PASS service delivery.

Flexible, accountable delegation of nursing tasks. The project will recommend Nurse Practice Act language that supports appropriate delegation of nursing tasks to unlicensed staff or to family or friends who have received training from, and demonstrated skill attainment to, a registered nurse.

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Community-Integrated Personal Assistance Services and Supports

RHODE ISLAND

Grant Information

Name of Grantee
Department of Human Services
Title of Grant
Rhode Island's Community-Integrated Personal Assistance
Services and Supports
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$539,730
Year Original Funding Received
2001
Completed

Contact Information

Deborah Florio, Chief
401-462-0140
dflorio@dhs.ri.gov

Ruth Schennum, Ph.D.
Project Coordinator
Family Health Systems
600 New London Avenue
Cranston, RI 02920
401-462-0137
RSchennu@dhs.ri.gov

Subcontractor(s)

Rick Jacobsen, Ph.D.
Affiliated Consumer Systems/Birch and Davis
401-462-6357
rjacobse@dhs.ri.gov

RFP issued for PASS Grant activities (7/1/02–9/30/04).

Target Population(s)

Medicaid-eligible children with special health care needs.

Goals

Activities

Abstract

Rhode Island is committed to the development of home and community-based support systems for families of children with special health care needs that reflect the values of self-determination and independence. These values guide the development of services and supports to enable children and youth with special health care needs to grow, develop, and live as independently as possible in their homes and community. These supports and services will maximize opportunities to succeed in the least restrictive and most natural settings. As these children and youth mature into adulthood, the skills developed through these services will help them take greater responsibility and control of their own care. PASS is implemented through consumer-directed models of care calling for greater levels of parent/guardian and family involvement and responsibility than is typical with agency-directed services.

To promote these community-based support systems and services, the Department of Human Services (DHS) has certified the Northern ARC of Rhode Island as a PASS agency and is currently reviewing applications from additional organizations. These PASS services will fill a large void in Rhode Island. By the end of the grant period, approximately 50 to 100 families will access consumer-driven PASS services. Funded as a service benefit under early and periodic screening, diagnosis, and treatment (EPSDT) rules, the services developed through this grant will continue to be supported beyond the period of this grant.

State PASS certification standards are available online on the DHS Web site reached at http://www.dhs.ri.gov.

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Community-Integrated Personal Assistance Services and Supports

COLORADO

Grant Information

Name of Grantee
Department of Health Care Policy and Financing
Title of Grant
Colorado Community Personal Assistance Services and Supports (COmPASS)
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$725,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

George Good-deCurnou
COmPASS Grant Administrator
Colorado State Department of Health Care Policy and Financing, Systems Change Section
1570 Grant Street
Denver, CO 80203-1818
303-866-2704
George.Good-deCurnou@state.co.us

Subcontractor(s)

Consumer trainers
Research design consultant
Project evaluator

Target Population(s)

Adults, adolescents, and parents of children with disabilities.

Goals

Activities

Abstract

Colorado is recognized as a national leader and innovator in long-term care services, including PASS. However, Colorado faces a number of PASS-related challenges that come from uneven geographic population distribution, jobs, economic prosperity, services, and resources. These statewide challenges include chronic provider and worker shortages, measurement issues related to assessing and monitoring the quality of PASS, and the various training needs of PASS clients, providers, workers, and case managers.

Colorado seeks to connect clients to PASS options that enable them to live in the most integrated community settings appropriate to their individual support requirements and preferences. The project provides extensive training at all levels to promote the philosophy of consumer direction across all PASS options. The project also identifies and seeks to remedy any regulatory, statutory, or program obstacles.

COmPASS focuses primarily on training and materials development. However, other systems changes are necessary to ensure the improvement of PASS quality and the promotion of client independence.

The COmPASS Project supports enduring systems changes in the areas of access, availability and adequacy of services, quality of services, and value. The Consumer-directed Attendant Support demonstration waiver addresses provider shortages and access issues by broadening the potential PASS labor pool. In addition to client training, consumer direction marketing and outreach provides an infrastructure of community awareness and support for improved service quality and enhanced client independence. Planned project evaluation will formally analyze "client-directedness," health and safety concerns, client independence, and satisfaction.

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Community-Integrated Personal Assistance Services and Supports

DISTRICT OF COLUMBIA

Grant Information

Name of Grantee
Department of Health, Medical Assistance Administration
Title of Grant
Consumer-Directed Attendant Care Services
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$725,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Robert Cosby, Project Director
Office on Disabilities and Aging
825 N. Capitol Street NE
Suite 5135
Washington, DC 20002
202-442-5972
robert.cosby@dc.gov

Subcontractor(s)

Oregon Technical Assistance Corporation
Assist Guide

Target Population(s)

Elderly persons and individuals with physical disabilities 18 to 64 years of age.

Goals

Activities

Abstract

As more elderly persons and individuals with physical disabilities choose to live in home and community based settings, consumer choice and preferences have become increasingly critical public policy issues. Consequently, the District has developed a PASS program to provide community supports to the elderly and individuals with physical disabilities.

The project will focus on improving access to HCBS by creating a PASS program that is consumer-directed. To accomplish this, an Advisory Committee that is composed of consumers, providers, and representatives across District agencies will be established. The PASS project is designed to (1) build the infrastructure for the delivery of cost-effective personal assistance services that will provide self-determination in the selection and delivery of services; (2) streamline the eligibility determination process; (3) disseminate information to consumers regarding HCBS; and (4) recruit, train, and support personal assistants and mentors.

The outcome of the project will be to increase the availability of HCBS with subsequent reduction in institutionalized services. A quality assurance and continuous quality improvement mechanism will be created for monitoring of the services.

Significant and sustainable outcomes will include a system that fosters greater consumer control and choice in the selection of services and the recruitment, hiring, training, and management of the providers of those services.

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Community-Integrated Personal Assistance Services and Supports

HAWAII

Grant Information

Name of Grantee
State of Hawaii, Department of Health
Title of Grant
Hawaii Systems Change for Community Living: Community
Personal Assistance Services and Supports
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$725,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

David Fray, Chief
Developmental Disabilities Division
1250 Punchbowl Street, Room 463
Honolulu, HI 96813
808-586-5840
dffray@mail.health.state.hi.us

Subcontractor(s)

The Center on Disability Studies at the University of Hawaii is contracted to administer the CPASS grant.

Target Population(s)

Persons (18+) with developmental disabilities.

Goals

Activities

Abstract

The Hawaii Personal Assistance Services and Supports (PASS) grant will pilot and demonstrate person-directed personal assistance by linking individuals with disabilities to personal support agents/brokers and helping them explore supports offered by intermediaries. The project will combine best practice methodologies for developing community connections, person-directed planning, community awareness, and the development of social equality. The interventions (trainings) and methodologies will facilitate and build community connections and make available community resources, including the development of sustainable self-advocate, parent-identified stakeholder councils (self-advocate-majority, i.e., 51 percent) at the three demonstration sites and development of a system of natural supports for participating project self-advocates. Just as significantly, this project will identify and customize tools to assess the impact of self-directed services. Individual participants will take part in surveys before and after participation in the demonstration project. A self-advocate-majority, statewide CPASS Council will be a resource to the site councils. The project will lay a framework and make recommendations for a systems change.

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Community-Integrated Personal Assistance Services and Supports

INDIANA

Grant Information

Name of Grantee
Family and Social Services Administration
Title of Grant
Indiana C-PASS Grant (Community-Integrated Personal Assistance Services and Supports)
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$725,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Carole Surratt-Bradley, M.A.
Program Director
Indiana Division of Aging
Indiana Family and Social Services Administration
402 W. Washington Street, Room W-454, MS 21
PO Box 7083
Indianapolis, IN 46207-7083
317-232-1759
carole.surratt-bradley@fssa.in.gov

Subcontractor(s)

Contracts are in process to hire five consultants.

Target Population(s)

Consumers of the Indiana Aged & Disabled Medicaid Waiver, the State's largest waiver program.

Goals

Activities

Abstract

This project is designed to maximize consumer choice and self-determination within Indiana's Aged & Disabled Medicaid Waiver. The Family and Social Services Administration (FSSA) will serve as the lead agency and will implement the following changes:

Consumers may select a consumer-directed care option when the Indiana Consumer-Directed Care Program Infrastructure is in place. Once C-PASS is operating successfully within the Indiana Aged & Disabled Waiver, Indiana may consider adding a consumer-directed care option to other waivers.

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Community-Integrated Personal Assistance Services and Supports

KANSAS

Grant Information

Name of Grantee
The University of Kansas Center for Research, Inc.
Title of Grant
Community-Integrated Personal Assistance Services and Supports
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$725,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Sara Sack
Associate Professor in Research
Kansas University, Center on Disability
2601 Gabriel
Parsons, KS 67357
620-421-8367
ssack@ku.edu

Shelia Nelson Stout and Sidney Hays
K-PASS Grant Coordinators
Occupational Center of Central Kansas
1710 W. Schilling Road
Salina, KS 67401
785-827-9383

Subcontractor(s)

Kansas Association of Centers on Independent Living (KACIL)

Shawnee County Community Developmental Disabilities Organization of the Topeka
Association of Retarded Citizens (TARC)
2701 SW Randolph
Topeka, KS 66611

Center for Independent Living in Southwest Kansas
111 Grant Avenue
Garden City, KS 67846

OCCK
1710 West Schilling Road
Salina, KS 67401

Target Population(s)

Kansans with mental retardation (MR) or developmental disabilities (DD) who are served on the MR/DD waiver and who use personal attendant services.

Goals

Activities

Abstract

This effort focuses on increasing PCA options for persons who have mental retardation or developmental disabilities and who are eligible for the Kansas Medicaid waiver program. This program will support individuals served on the MR/DD waiver in personally managing their attendant care services. In order to live and participate fully in their communities, PCAs must be available in an individual's home, at work, and when away from home. Objectives include (1) sharing consistent information regarding the range of activities that an individual might self-direct in regard to their personal attendant services and (2) increasing the availability of PCA services across the State. Currently, agreement on self-directed services is lacking and contributes to the impression that agencies or PCAs are driving plans of care for persons with mental retardation or developmental disabilities.

This goal will also work towards giving consumers maximum control in exercising choice over all aspects of personal assistant services and to have sufficient training to direct these services. A pilot program with service providers and consumers served by three Community Developmental Disability Organizations (CDDOs) will be conducted. Project staff will work with the pilot programs to develop a model that encourages reimbursement of self-directed plans of care for persons with developmental disabilities based on the consumer's needs, including evaluation of rates paid.

This program will develop an infrastructure to support individuals with developmental disabilities or their families/guardians to develop and exercise management skills, obtain and evaluate customer feedback, use customer feedback to identify and correct problems, and create a plan for dealing with recurring issues. Data will be collected regarding the range of activities persons are currently self-directing and their satisfaction with these services. Data from the consumers, the pilot agencies, and a control group will be collected annually. The stakeholder group will consider changes that could be made in reporting systems to annually collect information regarding quality indicators. An additional review of a random sample of plans of care from persons served on the MR/DD waiver will be conducted to review the range of services utilized, the range of entities providing these services, and customer satisfaction with the self-directed care process.

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Community-Integrated Personal Assistance Services and Supports

NORTH CAROLINA

Grant Information

Name of Grantee
Department of Health and Human Services
Title of Grant
Community PASS
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$725,000
Year Original Funding Received
2002
Completed

Contact Information

Jackie Sheppard
Assistant Secretary for Long-Term Care and Family Services
2001 Mail Service Center
Raleigh, NC 27699-2001
919-733-4534
jackie.sheppard@ncmail.net

Ann Eller
Grant Coordinator
3005 Mail Service Center
Raleigh, NC 27699-2001
919-715-2774
Ann.Eller@ncmail.net

Subcontractor(s)

Oregon Technical Assistance Corporation created and field-tested public education and training materials regarding consumer-directed supports and provided technical assistance to increase consumer-directed options.

The Center for Urban Affairs at NC State University conducted a study of the effects of three of the systems change grants on North Carolina's ability to provide consumer-directed supports.

Human Services Research Institute conducted a legislative and rule analysis for regulatory reform. The community demonstrations went through an RFA process and four pilot agencies were chosen—First in Families of North Carolina, The Arc of Mecklenburg County, Stevens Foundation, and Exceptional Children's Assistance Center/Powerful Youth Friends United.

Target Population(s)

Consumers of all ages and types of disabilities.

Goals

Activities

Abstract

North Carolina has few options for persons who seek to direct their own supports and services. The state's fiscal regulations and programmatic policies promote facility-based, professionally directed care. The State relies on the private sector to provide most of the personal assistant-type services and supports and providers establish business practices consistent with that regulatory framework. This grant addressed both of these issues and, in combination with North Carolina's Real Choice Grant, has created a foundation to change the infrastructure of the human services system to enable our citizens with disabilities and long-term illnesses to live where and with whom they choose.

North Carolina's human service delivery system is undergoing a variety of reforms in both scale and scope. This project connected many of these initiatives designed to increase options for consumer choice, service, support, and self-direction. A policy analysis was conducted and initial plans to address issues in statute, rules, and regulations have been developed. Initiatives to adjust the regulatory framework will continue beyond the 3-year grant period.

The State is poised to undertake a training and technical assistance effort to change business practices statewide and encourage new and nontraditional provider development. A consumer-directed "toolbox" of educational materials has been developed, and approximately 50 people representing numerous divisions and disability and long-term care populations have been oriented to use the materials. Training and technical assistance have been offered within the public system to continue building consumer-directed options, particularly around implementation of self-directed components within Medicaid waivers. The consumer-directed toolbox will also offer tools to support consumers, families, and personal assistants to enhance consumer choice and self-determination and protect the health and safety of consumers.

The final component was the establishment of demonstration models in four communities that increased consumer leadership in local reform efforts. It is our belief that only people with disabilities and long-term illnesses can lead the movement to make communities places that welcome and embrace diversity and sustain options in services and supports. Individuals who remain in or return to the community need natural supports and many community resources in addition to personal assistants if they are to lead successful and productive lives. Consumers and their chosen partners created consumer leadership teams, assessed their local communities, and developed strategies to address local obstacles to reform.

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Community-Integrated Personal Assistance Services and Supports

TENNESSEE

Grant Information

Name of Grantee
Department of Finance and Administration
Title of Grant
Tennessee PASS
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$725,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Brenda Clark
Division of Mental Retardation Services
Andrew Jackson Building, 15th Floor
500 Deaderick Street
Nashville, TN 37243
615-253-6811
brenda.clark@state.tn.us

Subcontractor(s)

The Arc of Tennessee
Michelle Taylor, Project Director
44 Vantage Way, Suite 550
Nashville, TN 37228
615-248-5878
mtaylor@thearctn.org

Target Population(s)

People of all ages whose disabilities of any type result in a need for personal assistance services.

Goals

Activities

Abstract

A Consumer Task Force in Tennessee worked with the Division of Mental Retardation Services (DMRS) and other state agencies to develop this project. This project represents Tennessee's first effort to establish a system of consumer-directed Personal Assistance Services and Supports. Tennessee has traditionally relied heavily on institutional care as its primary model of publicly funded long-term care. Tennessee ranks 50th among states in its provision of home and community based long-term care services. Limited Medicaid waivers for elderly and disabled adults provide some access to personal assistance in a few geographic areas. Program design limits the flexibility of the services, as well as the number of people affected, and the amount of service that is available. Consumer-directed services are currently not available through these waivers.

Tennessee seeks to develop an enduring system of accessible, quality-responsive, consumer-designed and directed personal assistance. The effort is designed to develop consumer and provider confidence and competence. Because virtually nothing exists now, this project will begin, build, modify, and sustain these services through the leadership of consumers in partnership with individual, community, and systems stakeholders who are capitalizing on a variety of available technologies.

The project has focused on developing tools and resources for people who want to direct their own services and supports in community settings, including deciding what services are needed; writing a plan for services and supports; directing payment of service providers; and hiring, training, and supervising staff. The project will also include a pilot program to begin October 1, 2004, so people with disabilities can test and use the tools and resources developed to help them manage their own services. The pilot will also allow the State to build and test policies, procedures, and infrastructure needed to establish a new and workable long-term care system for the State.

A consumer-based Project Oversight Committee is primarily responsible for implementing, managing, and evaluating the project. The committee works with a state multiagency Coordinating Council and the DMRS Project Coordinator.

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Community-Integrated Personal Assistance Services and Supports

WEST VIRGINIA

Grant Information

Name of Grantee
West Virginia University Research Corporation
Title of Grant
C-PASS—Community Integrated Personal Assistant Services and Supports Grant
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$725,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Sherry Shuman, Principal Investigator
304-293-4692
sshuman@hsc.wvu.edu

Sally Burchfiel, Project Manager
959 Hartman Run Road
Morgantown, WV 26505
304-293-4692
sburchfiel@hsc.wvu.edu

Subcontractor(s)

Start-up costs for a fiscal intermediary and outreach may require a subcontract agreement.

Target Population(s)

Persons of all ages with disabilities or those with long-term care needs who require and are eligible for personal assistance services (PAS) in the home or in the community.

Goals

Activities

Abstract

The Center for Excellence in Disabilities at West Virginia University, in partnership with state agencies, consumers, and provider groups, has collaborated to establish opportunities for individuals to fully participate in the community through the expansion of PAS. The project has worked to increase knowledge and options for consumer control and direction of their services and supports within Medicaid services. Through the partnership and collaboration with existing initiatives in West Virginia, a consumer-directed system of services and supports for persons receiving services within Medicaid's A/D waiver was created. Personal Options, a self-directed option, will be available by July 2005.

West Virginia provides PAS for persons with disabilities or those needing long-term care through the Medicaid State Plan, waiver programs, and state-funded programs in the Division of Rehabilitation. None of these services are provided in a manner that fully reflects informed consumer choice, control, and direction. Based on consumer, agency, and provider input and direction, Project CPASS collaboratively designed and developed the Personal Options model for offering consumer choice in the A/D waiver and opportunities that enhance recruitment and provision of services by personal assistants. The project's outcome objectives were initiated by the creation of a CPASS Advisory Board that assisted with project direction, activities, and outcomes. The CPASS Advisory Board participates in all activities and ensures that goals, objectives, and outcomes promote enduring improvement in the infrastructure to support consumer-directed, community-integrated PAS and promotes the maximum ability of individuals to direct their services.

Action steps in accomplishing these goals include the development and delivery of a training manual to guide service providers in shifting their value systems to maximize consumer direction; the design and delivery of a complete training package to prepare consumers for person-centered, consumer-directed services; the construction of a sustainable model for maximum consumer control within the state's A/D waiver that offers a range of choice in consumer control and direction; the development of a data collection system that provides tracking information; data analysis to assist with recommendations for project or statewide systems change and sustainability; and the development of strategies for recruitment and retention of personal assistants. Evaluation data from these project activities will be compiled into publications that will be used to promote public and consumer awareness and legislative initiatives for systems change that will ultimately impact the quality of life for persons with disabilities and those needing long-term care services and supports.

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Nursing Facility Transitions

ALABAMA

Grant Information

Name of Grantee
Mid-Alabama Chapter of the Alabama Coalition of Citizens with Disabilities, DBA Birmingham Independent Living Center
Title of Grant
Partnerships to Independence
Type of Grant
Nursing Facility Transitions, Independent Living Partnership
Amount of Grant
$450,000
Year Original Funding Received
2001
Completed

Contact Information

Daniel Kessler
Birmingham Independent Living Center
206 13th Street South
Birmingham, AL 35233-1317
205-251-5403
dgkessle@bellsouth.net

http://www.birminghamilc.org

Subcontractor(s)

No subcontractors planned.

Target Population(s)

People with disabilities who wish to transition from nursing homes to the community. The population includes residents of Jefferson, Shelby, St. Clair, Walker, and Blount Counties in Alabama.

Goals

Activities

Abstract

Birmingham Independent Living Center (BILC), in collaboration with its partners, proposes to expand services to persons with disabilities in Alabama with an Independent Living Partnership Nursing Facility Transitions program entitled Partnerships to Independence. The cost of nursing home care in the State of Alabama is spiraling out of control. By the end of 2001, nursing home costs will exceed $600 million. At the same time, nursing home residents who desire to live in the community are given little opportunity to weigh community options. This project will develop the infrastructure, partnerships, and community services that will be required to offer the choice of community living to nursing home residents across the State.

The target population will include nursing home residents in the Birmingham service areas who express a desire to return to the community, regardless of age or disability. Contact with participants will be made at nursing homes. All potential participants will benefit from peer support, which means people with disabilities, older people, and family members who are familiar with the community will conduct outreach. A full-time Community Transitional Advocate will assist nursing home residents to plan their moves and obtain required supports. Plans will be developed according to independent living and person-centered principles. Community supports that will be put in place include personal assistance, housing, home modification, advocacy, peer support, transitional subsidies, and other resources. It is anticipated that 25 people will transition to the community during the 3-year project period.

Partnerships at the local and state level are a key to the success of this program. The Director of Alabama Medicaid's Long-Term Care Program will convene a group of statewide partners to advise on project direction and assist in the development of policy and sustainable resources for implementation. A local implementation team will be developed to enhance service planning and the development of local resources.

Note: This Compendium form was not reviewed by the Grantee prior to publication.

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Nursing Facility Transitions

ALASKA

Grant Information

Name of Grantee
Department of Administration, Division of Senior Services
Title of Grant
Alaska's Nursing Facility Transitions Project
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$800,000
Year Original Funding Received
2001
Completed

Contact Information

Patrick Reinhart, Executive Director
Alaska Statewide Independent Living Council
1016 W 6th Avenue, Suite 105
Anchorage, AK 99501
907-269-3571
Patrick_Reinhart@labor.state.ak.us

Phillip Jones, Program Coordinator
PO Box 110620
Juneau, AK 99811-0620
Phillip_Jones@health.state.ak.us

Subcontractor(s)

Kenai Peninsula Independent Living Center
Alzheimers Resource Agency
Center for Human Development

Target Population(s)

Medicaid eligible individuals or those determined to be within 6 months of Medicaid eligibility who want to make the transition from a nursing facility to the community.

Goals

Activities

Abstract

The NFT project staff will help identify individuals who want to make the transition from nursing facilities to the community, and to ensure there is a system in place to provide supports and services needed for the transitions or diversion.

The State Independent Living Council (SILC), under supervision of the Division of Senior Services, will manage the project and employ a project coordinator responsible for education, information dissemination, outreach, and coordination of the transition process. The project coordinator will also work with nursing facility staff to identify targeted individuals. Once individuals are identified, the project coordinator will assess each individual's transition/ community needs, provide care counseling, and arrange for peer counseling if desired by the individual. The project coordinator will then convene a planning team to assist the consumer to determine needed services and resources.

In order to develop the infrastructure and programs to support the transition and ongoing support needs of participants, activities will be coordinated with Division of Senior Services staff. We are fortunate that the Rural Long-term Care Development staff members are located within the Division. These two staff persons are knowledgeable about housing efforts going on statewide and are a resource to staff.

Rural Long-term Care Development staff are part of a number of statewide committees looking at housing options. Feedback to the other organizations listed in the grant to partner and coordinate efforts will be a priority. The Division of Senior Services (DSS), as well as the other participating stakeholder organizations, such as the Governors' Council on Disabilities and Special Education, will be able to make policy recommendations to DSS, who in turn will work with the Department of Health and Social Services and, specifically, the Division of Medical Assistance (Medicaid single state agency), to develop a strategy for policy change, including how to fund and how to implement new policies and/or benefits.

Note: This Compendium form was not reviewed by the Grantee prior to publication.

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Nursing Facility Transitions

COLORADO

Grant Information

Name of Grantee
Department of Health Care Policy and Financing, Office of Medical Assistance
Title of Grant
Colorado Transitions Project
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$800,000
Year Original Funding Received
2001
Completed

Contact Information

Viki Manley
1570 Grant Street
Denver, CO 80203-1818
303-866-2991
viki.manley@state.co.us

Subcontractor(s)

Center for People With Disabilities
David Bolin
303-442-8662

Target Population(s)

Individuals of any age with disabilities in nursing facilities, particularly individuals with cognitive disabilities or mental illness.

Goals

Activities

Abstract

The Colorado Transitions Project created a state infrastructure for transition efforts and provided choice information to 942 individuals in nursing facilities resulting in 124 transitions to the community. The approach created a structure at the state level and in 10 communities to link resources, address barriers, and expand communication among providers to maximize the supports for community transitions.

The existing Olmstead Planning Group collaborated to design the grant project and continued, with added members, as the State Resource Team. The Project included representatives from Independent Living Centers, several people with disabilities, a nursing facility administrator, a representative from the Ombudsman program, and representatives from the Department of Human Services.

A new product created through this project was a developmentally appropriate approach to informed consent for individuals with developmental disabilities, cognitive disabilities, brain injuries, language/literacy barriers or mental illness, or who are affected by strokes. An informational DVD and communication board overlay were developed to assist individuals with limited communication to participate in transitions. These reach individuals in a respectful manner and can be replicated in other states.

The Project resulted in systemic change for long-term care recipients in Colorado's Medicaid program. With legislation from the Colorado General Assembly and approval from the Centers for Medicare & Medicaid Services, the Colorado Department of Health Care Policy and Financing (HCPF) added Community Transition Services to the Home and Community Based Services—Elderly, Blind and Disabled Waiver. The addition of Community Transition Services to the waiver will provide critical support to eligible residents in nursing facilities to move back into the community.

An HCPF State Transition Coordinator (0.5 full-time equivalent [FTE]) coordinated the state infrastructure development, and the Center for People with Disabilities hired a Project Coordinator (1.0 FTE) to implement the Colorado Transitions Project through the network of 10 Independent Living Centers across the State. The project complemented existing state programs and identified and transitioned a variety of consumers from nursing facilities to the community.

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Nursing Facility Transitions

CONNECTICUT

Grant Information

Name of Grantee
Department of Social Services, Health Care Financing
Title of Grant
Nursing Facility Transitions to Independent Living
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$800,000
Year Original Funding Received
2001
Completed

Contact Information

David Parrella, Medicaid Director
860-424-5116
david.parrella@po.state.ct.us

Dawn Lambert, Program Administrator
25 Sigourney Street
Hartford, CT 06106-5033
860-424-4897
dawn.lambert@po.state.ct.us

Subcontractor(s)

Connecticut Association of Centers for Independent Living, Inc. (CACIL)

Paul C. Ford
860-656-0430
paulatcacil@megahits.com

Target Population(s)

Nursing facility residents who want to return to independent community living.

Goals

Activities

Abstract

CACIL will be responsible for the overall management and administration of grant activities including the provision of financial support for project staff in the five CILs that will implement the project's activities.

This grant grew out of an awareness that there is a lack of training and education about the needs of persons with disabilities living in the community and that this has led to a long-term care system that is not responsive to the needs of consumers or their families. Connecticut does not have a system in place to identify nursing facility residents who are appropriate for transition to the community. Connecticut nursing facility residents do not have information about the choices available to them or a way to identify themselves as possible transition candidates. Systems fragmentation and the eligibility requirements of community-based programs leave many people unable to find adequate community support.

To address these issues, the grant will be used to develop a variety of products to better inform state agency staff, professionals in the community, and nursing facility residents about the concepts of independent living and self-direction. Best practices and policies will be identified and made available. A self-assessment tool and a "step-by-step" guide to community transition will be developed so that nursing facility residents and their families can assess their readiness for a successful transition. A professional assessment tool along with a procedures and marketing plan for distributing information to nursing facility residents will be developed. A Common Sense Fund will be established to help pay for items that are usually not covered by government programs, such as rental deposits, utility deposits, and household goods. All of these products will form the foundation of the system being designed to transition nursing home residents back to community living.

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Nursing Facility Transitions

GEORGIA

Grant Information

Name of Grantee
disABILITY LINK
Title of Grant
TRANSITIONS: Introducing Institutionalized People with Disabilities to Community Living Alternatives
Type of Grant
Nursing Facility Transitions, Independent Living Partnership
Amount of Grant
$400,000
Year Original Funding Received
2001
Completed

Contact Information

Rebecca Ramage-Tuttle, MSRS
CEO
disABILITY LINK
755 Commerce Drive, Suite 415
Decatur, GA 30030
404-687-8890
rrtuttle@disabilitylink.org

http://www.disabilitylink.org

Subcontractor(s)

Disability Connections
Jerilyn Leverett
478-741-1425

Target Population(s)

Persons of all ages with disabilities who are currently residing in nursing homes.

Goals

Activities

Abstract

Georgia will use this grant to build state capacity to reach out and support the transition of individuals to a community-integrated living arrangement consistent with their needs and preferences, and assure that these individuals have the supports necessary to sustain long-term residence and participation in the community. A considerable amount of matching resources will also be allocated to this project.

disABILITY LINK in Atlanta will serve as the fiscal agent for the grant, house the project director, and contract with one other consumer-controlled nonprofit center for independent living (CIL) to accomplish the goals, objectives, and deliverables of this grant.

The project's goals will be accomplished by securing a project director, securing transition team leaders in two regions of the State through the CILs, supporting the participation of consumers in transition planning, providing information and training to all consumers and staff, developing resource materials, and evaluating the project.

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Nursing Facility Transitions

GEORGIA

Grant Information

Name of Grantee
Georgia Department of Community Health, Division of Medical Assistance, Aging & Community Services
Title of Grant
Nursing Facility Transitions Grant
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$627,211
Year Original Funding Received
2001
Completed

Contact Information

Bonnie Hurd, Program Specialist
New Initiatives
2 Peachtree Street, NW, 37th Floor
Atlanta, GA 30303
404-463-8365
bhurd@dch.state.ga.us

Subcontractor(s)

LH Kendall Consulting
Linda H. Kendall
828-259-9834

disABILITY LINK
Rebecca Ramage-Tuttle
404-687-8890

Three Rivers Area Health
Education Centers*
Jan Pittman
706-660-2499

Foothills Area Health
Education Centers
Sheila Griffin
770-533-6866

Target Population(s)

Twenty-four Medicaid-eligible individuals residing in 18 rural and underserved counties in the State.

Goals

Activities

Abstract

The purpose of this project is to build state capacity to provide outreach and support the transition of people residing in nursing homes to a community-integrated living arrangement consistent with their needs and preferences and to assure that these individuals have the support necessary to sustain long-term residence and participation in the community. This will be accomplished through careful study and recommended changes to state policy, development of community services and the direct care workforce, and relocation of 24 individuals presently residing in nursing homes to the community. Grant activities will focus on a service area of 18 rural and primarily underserved counties.

We will accomplish the goals of this project through collaboration with a diverse workgroup consisting of consumers, advocates, state agencies, and providers, including two of the three largest providers of nursing home services in the State of Georgia. By demonstrating that providers of nursing home services can encourage community placement, this project will establish a lasting legacy and true systems change. In essence, the project seeks to demonstrate that effective systems change can be a "win-win" situation for both consumers and providers.

Grant staff will work in close partnership with disABILITY LINK, a Georgia Center for Independent Living, which was also awarded a nursing facility transitions grant. Working together will enable the two grant projects to have greater impact on building state capacity and support for community living.

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Nursing Facility Transitions

INDIANA

Grant Information

Name of Grantee
Family and Social Services Administration
Title of Grant
Comprehensive Plan for Community Integration and Support of Persons with Disabilities
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$770,000
Year Original Funding Received
2001
Completed

Contact Information

Jacqueline Bouyea, Director
Division of Aging
PO Box 7083
Indianapolis, IN 46207-7083
317-232-7123
Jackie.Bouyea@fssa.in.gov

Subcontractor(s)

Independent Living Center of Eastern Indiana
Lewin Group
Four Area Agency on Aging organizations

Target Population(s)

Individuals currently residing in nursing facilities and individuals who are at risk of entering a nursing facility.

Goals

Activities

Abstract

The grant focuses on transitioning nursing facility residents for reintegration into their communities. The project also targets individuals who are at risk of entering a nursing facility. The funds will be used to implement the following changes. Using the preadmission screening process, minimum data set assessment data, and outreach, we will identify appropriate candidates for participation. The grant will help develop a system to identify individuals for the long term. By bringing the Family and Social Services Administration, Long-Term Care Ombudsman, Area Agencies on Aging, Independent Living Centers, consumers, advocates, assisted living facilities, and the nursing home industry together, we will address barriers to success at the local level.

The intent is to make changes that are needed, which vary from place to place, and to bring about the most noticeable changes in each area. Case management functions will be extended to include more immediate and frequent communication, as well as onsite monitoring and contacts with service providers. An evaluation will be completed on the efficacy of the coalitions and enhanced quality activities.

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Nursing Facility Transitions

MARYLAND

Grant Information

Name of Grantee
Making Choices for Independent Living, Inc.
Title of Grant
Independent Living Partnership
Type of Grant
Nursing Facility Transitions, Independent Living Partnership
Amount of Grant
$450,000
Year Original Funding Received
2001
Completed

Contact Information

Andrea Buonincontro, Executive Director
3011 Montebello Terrace
Baltimore, MD 21214
410-444-1400
andreab@mcil-md.org

http://www.mcil-md.org

Subcontractor(s)

Resources for Independence
Lori Magruder
301-784-1774

Center for L.I.F.E.
Gene Potts
301-884-4498

Eastern Shore CIL
Shirl Tarbox
410-221-7701

Independence Now, Inc.
Cathy Raggio
301-277-2839

The Freedom Center
Jamey George
301-846-7811

Target Population(s)

Persons with disabilities who live in nursing homes throughout the State who wish to explore the option to live independently in the community.

Goals

Activities

Abstract

Making Choices for Independent Living, Inc. (MCIL), Maryland's oldest and largest center for independent living (CIL), proposes to work in partnership with Maryland's network of CILs to conduct outreach and assistance to over 2,800 Medicaid beneficiaries currently residing in 231 nursing facilities across the State. Originally established in 1978, MCIL has an extensive and impressive history of assisting interested people to come out of nursing homes and return to the community. In 2000, MCIL was nationally recognized for its efforts.

This project, entitled the Independent Living Partnership (ILP), will be a unique and collaborative effort. It will partner with the other statewide CILs and State Medicaid Home and Community Based Services programs to supplement and improve existing services for the duration of the project and beyond. The results of the project could be replicated nationwide and will serve as a model for CILs in other states to use. In Maryland, the project will enable the rest of the CILs to gain valuable experience and expertise which can be used to expand on the grants' successes.

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Nursing Facility Transitions

MARYLAND

Grant Information

Name of Grantee
Department of Human Resources (DHR), Office of Personal Assistance Services1
Title of Grant
Nursing Facility Transitions Grant
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$800,000
Year Original Funding Received
2001
Completed

Contact Information

Rhonda Simms, Acting Project Director
410-767-6025
rsimms@mdod.state.md.us

Rhonda Workman, Director
Maryland Department of Disabilities
217 E. Redwood Street, Suite 1300
Baltimore, MD 21202
410-767-7901
rworkman@mdod.state.md.us

Subcontractor(s)

Six Maryland Centers for Independent Living:

  1. Making Choices for Independent Living
  2. Center for L.I.F.E.
  3. Eastern Shore CIL
  4. Independence Now, Inc.
  5. Resource for Independence
  6. The Freedom Center

Target Population(s)

Individuals with physical disabilities, 65 years and younger, who are currently residing in nursing facilities and want to move into the community.

Goals

Activities

Abstract

The Maryland Nursing Facility Transitions Grant was a statewide program designed to (1) identify and expand affordable, appropriate, and safe housing for persons desiring to move from nursing facilities to the community and (2) assist with transition-related activities and costs including security deposits, utility hook ups, furnishings, environmental modifications, and procuring community-based support services. Federal funding was used to develop a team, the Home Team, for coordination/collaboration with local housing authorities and housing providers, outreach workers, and case managers to assist in obtaining housing for a minimum of 150 Medicaid beneficiaries currently residing in 231 Maryland nursing facilities.

The following agencies collaborated in this project: the Maryland Department of Housing and Community Development, the Department of Health and Mental Hygiene, the Department of Human Resources, Department of Aging, Governor's Office for Individuals with Disabilities, the six Maryland Centers for Independent Living (CILs), the Coordinating Center, Public Housing Authorities, and other housing providers. This interagency collaborative program was administered through the Department of Human Resources, Office of Personal Assistance Services, which also provided program coordination. The CILs provided Housing Transition Services. The Nursing Facility Transitions State Program Grant was closely linked with Maryland's Independent Living Partnership Grant through coordinated outreach and peer counselors to target individuals with physical disabilities, 65 years and younger, who are living in nursing facilities and want to move into the community. To maximize collaboration and resources, the two programs, in addition with the Real Choice System Change Grant, formed one advisory committee, comprising individuals with disabilities and agency representatives. Through implementation of these programs, Maryland expected to develop an extensive peer outreach program, reach well over 2,000 people, and build community housing capacity. Major gaps related to affordable accessible housing, lack of education pertaining to community resources, and funding needed to assure successful transitioning was targeted.


1 The grant's administrating entity, the Office of Personal Assistance Services within the Department of Human Resources was transferred via legislation to the Maryland Department of Disabilities on July 1, 2005. New contact information for the staff familiar with this grant is noted above.

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Nursing Facility Transitions

MASSACHUSETTS

Grant Information

Name of Grantee
Department of Mental Retardation
Division of Systems Integration
Title of Grant
The Massachusetts Bridges to Community Project
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$770,000
Year Original Funding Received
2001
Completed

Contact Information

Margaret Chow-Menzer
Assistant Commissioner
500 Harrison Avenue
Boston, MA 02118
617-624-7703
mailto:margaret.chow-menzer@dmr.state.ma.us

Jacqueline Dunaway
Project Director
24 Southbridge Street
Worcester MA 01608
508-792-5200
jacqueline.dunaway@state.ma.us

http://www.dmr.state.ma.us

Subcontractor(s)

University of Massachusetts
Medical School/Shriver Center
Emily Saunders
617-966-5576

Seven Hills Foundation
Celia Brown
508-755-2340

Massachusetts Advocates Standing Strong
Ed Bielecki
781-585-2422

Clark University
Laurie Ross
508-793-9711

Target Population(s)

Individuals with a significant disability residing in nursing facilities in the greater Worcester area. This includes primarily persons who fall within the "H, J, K" case mix ( i.e., individuals representing the least severe medical/nursing acuity levels as rated on the Management Minutes Questionnaire [MMQ], which is the system by which Massachusetts establishes payment to nursing facility providers).

Goals

Activities

Abstract

The Massachusetts Department of Mental Retardation, with the cooperation and support of the Division of Medical Assistance, Massachusetts Rehabilitation Commission, Department of Public Health, Department of Mental Health, Executive Office of Health and Human Services, Executive Office of Administration and Finance, and Executive Office of Elder Affairs will use the grant to transition individuals with a significant disability from nursing facilities in the greater Worcester area to community living.

The 3-year project, known as the Massachusetts Bridges to Community Project, will examine the impact that three specific variables might have on the success of transitioning individuals out of nursing facilities and having them remain in community settings. The three variables are a dedicated interdisciplinary case management team approach; a focused housing search along with expansion of housing options; and participation of individuals in the project management structure along with inclusion of peer mentoring, self-advocacy organizations, and community education.

Year 1 of the project will include the following activities: establishing the project team; hiring the peer mentoring and self advocacy organizations; establishing the local citizen advisory committee and the interagency steering committee that will oversee policy direction; reviewing the Minimum Data Set in the State and other information to identify the individuals who will be targeted for this project; developing a working and collaborative relationship with the nursing home industry as well as local town and city officials, community service agencies, housing agencies, providers and developers, and faith-based organizations; and creating the methodology to evaluate the implementation of the project.

Years 2 and 3 will be focused on transitioning individuals out of nursing facilities, securing adequate and appropriate supports to assure success in the community, identifying community service gaps (including housing), and compiling data to evaluate project process and outcomes.

Note: This Compendium form was not reviewed by the Grantee prior to publication.

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Nursing Facility Transitions

MICHIGAN

Grant Information

Name of Grantee
Department of Community Health, Long-term Care Initiative
Title of Grant
Nursing Facilities Transition Initiative
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$770,000
Year Original Funding Received
2001
Completed

Contact Information

David T. Verseput, Director
517-373-8091
verseput@michigan.gov

Sue Eby
517-241-7060
ebys@michigan.gov

MDCH, Community Living and Long-Term Care Planning
Lewis Cass Building, 5th Floor N
320 S. Walnut Street
Lansing, MI 48913

Subcontractor(s)

Corporation for Supportive Housing
Lisa Chapman
810-229-7712

University of Michigan
Turner Geriatric Clinic
Katherine Supiano (no current contact information)

Target Population(s)

Persons who reside in nursing facilities who either no longer require nursing facility care or no longer wish to remain in a nursing facility; persons leaving hospitals who do not wish to enter a nursing facility or who require only a short-term nursing facility stay.

Goals

Activities

Abstract

There are four basic components to the grant activity: transition, diversion, education, and evaluation. In addition, grant activities will be linked with activities of a state-funded housing initiative designed to promote the development of affordable, accessible housing.

Transition. Activities under the housing initiative are designed to educate housing consortia in communities regarding the needs of special populations and to assist in the development of strategies to meet the needs of individuals requiring complex care in community housing. Communities already engaged in creating supportive housing for persons with special needs will be the primary targets. This will allow for coordination with existing programs, which is viewed as the most effective way to provide linkage to those services needed and to identify those persons wishing/requiring alternative housing, with the ability to match them to housing units. The Department is aware of approximately 150 persons identified through the PASARR process who are in need of alternative living arrangements and who could form an initial referral pool of nursing home residents to benefit from this effort. We will develop strategies not only to provide housing for this population, but also to access the supports needed to enable persons to live independently. The state housing initiative expects at least 150 units of newly available housing after 3 years of effort. It is expected with the linkage to the Nursing Facility Transitions Grant activities that additional units will be identified and specifically targeted to the nursing facility population. A last-resort transition fund, provided for in the grant, will help defray moving costs for extremely indigent individuals where other sources of public or private funds are not available.

Diversion. Two efforts will be piloted. First, the University of Michigan's Turner Geriatric Program will work to link hospital personnel with transition activities and local resources, and to assist individuals being discharged to return to, or to find an alternative home in, the community. The second effort will be funded by the state housing authority to assist residents of state-financed housing to "age in place," and, in coordination with the transition component and with Turner Clinic, work to fill vacancies in existing state-financed housing.

Education. This component will provide education, training, and technical assistance on specific aspects of the initiative to persons and entities identified through the other components.

Evaluation. We will develop a prototype for evaluating the effort, focused on cost/benefit analysis, changes in quality of life, and "lessons learned."

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Nursing Facility Transitions

NEW HAMPSHIRE

Grant Information

Name of Grantee
DHHS, Bureau of Behavioral Health
Title of Grant
Community Wrap: Older Adult Wraparound Services
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$770,000
Year Original Funding Received
2001
Completed

Contact Information

Todd Ringelstein, Project Director
603-271-5094
tringels@dhhs.state.nh.us

Linda Bimbo, Project Coordinator
105 Pleasant Street, Main Building
Concord, NH 03301
603-271-8558
lbimbo@dhhs.state.nh.us

Subcontractor(s)

Dartmouth Psychiatric Research Center
Keith Miles
603-271-5747

Riverbend Community Mental Health, Inc.
Carrie Hughes
603-228-2101

University of New Hampshire – Institute on Disability
Susan Fox
603-228-2084

Consumer Peer Support Outreach to be decided.

Target Population(s)

Individuals in the Concord region with mental illness who are currently in a nursing home, or in the state psychiatric facility receiving a nursing home level of care but are no longer in an acute phase of their psychiatric illness.

Goals

Activities

Abstract

The Department of Health and Human Services' Division of Behavioral Health, in collaboration with the Dartmouth Psychiatric Research Center, Institute on Disability, Riverbend Community Mental Health Center, the New Hampshire Housing Finance Authority, and Pathways to Recovery Peer Support Program, will work together to transition older adults with mental illness from nursing facilities to the community.

This 3-year program contains two interrelated initiatives targeted at Wraparound Services for transitioning older adults with mental illness from nursing facility settings to community-based settings and expanding housing opportunities for people with mental illness and other disabilities in the Concord community and statewide. The wraparound approach has proven to be very effective in coordinating and delivering care when used with children diverted from, or transitioned out of, institutional placements, and has recently been shown to be similarly effective with older adults.

The goal of the project is to ensure that adequate and appropriate services and housing are delivered to ensure stable community residence for older adults with complex, multiple problems who are currently residing in nursing homes or are receiving a nursing home level of care in the state psychiatric facility.

Year 1 of the project will include a review and analysis of service gaps for individuals seeking community-based residency. In Year 2, we will plan the Wraparound Services demonstration. In Year 3, we will implement and evaluate the Wraparound Team that includes a local Mental Health Peer Support Group with 10 individuals from the Concord region.

Throughout the 3 years, a regional and statewide strategy to improve the availability of affordable and accessible housing will be implemented. Also over the 3-year period, the project process and outcomes will be documented in an evaluation provided by the New Hampshire Dartmouth Psychiatric Research Center.

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Nursing Facility Transitions

TEXAS

Grant Information

Name of Grantee
ARCIL
Title of Grant
Texas Independent Living Partnership
Type of Grant
Nursing Facility Transitions, Independent Living Partnership
Amount of Grant
$308,178
Year Original Funding Received
2001
Completed

Contact Information

John Meinkowsky, Project Director
512-832-6349
johnm@arcil.com

Jack Stratton, Deputy Director
825 E. Rundberg Lane, Suite A-1
Austin, TX 78753
http://www.arcil.com/arcilsitefiles/silcnews/txsilc.html

Subcontractor(s)

None.

Target Population(s)

People with all types of disabilities, of all ages, in nursing facilities and those at risk of nursing facility placement.

Goals

Activities

Abstract

The Texas Independent Living Partnership is a cooperative effort of the Texas Association of Centers for Independent Living (TACIL), the Texas Health & Human Services Commission (HHSC), and the Texas Department of Human Services (TDHS). CILs in Texas and state agencies assist people with disabilities who want to move from nursing facilities to their own homes in the community. The project will work with state agencies, community organizations, and advocacy groups who serve children and adults of all ages with all types of disabilities.

TACIL represents 11 organizations operating CILs in 18 communities. HHSC is the State Medicaid Agency and leads the State's "Promoting Independence" initiative. TDHS is the state agency that funds nursing facilities and many of the State's community-based, long-term care programs. Organizations serving children with disabilities, individuals with specific disabilities, and elderly individuals have agreed to help with outreach materials, training activities, and recommendations for changes to the long-term care system.

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Nursing Facility Transitions

WASHINGTON

Grant Information

Name of Grantee
Department of Social and Health Services
Title of Grant
Supported Transitions
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$770,000
Year Original Funding Received
2001
Completed

Contact Information

Rosemary Biggins, Program Manager
Aging and Disability Services Administration
PO Box 45600
Olympia, WA 98504-5600
360-725-2466
biggire@dshs.wa.gov

Subcontractor(s)

None.

Target Population(s)

Individuals under the age of 65 living in nursing facilities throughout the State.

Goals

Activities

Abstract

Washington State Department of Social and Health Services—Aging and Adult Services Administration will use grant funds to further its efforts in moving clients from nursing homes to less restrictive settings in the community. We expect to support up to 300 people under the age of 65 who have a variety of disabling conditions or chronic illnesses. Funds will be used to develop a system of supports aimed at removing the barriers that keep these people in nursing homes.

We will develop relationships with housing authorities and related entities throughout the State to share information and collaborate in developing systems for referral and support. Three housing authorities in the State share the Access 2000 Section 8 vouchers that are dedicated to people leaving nursing facilities. Processes and practices developed in those communities will provide a foundation for improving access to housing throughout the State.

A second thrust of the grant is to cultivate and support the capacity of independent living consultants to provide individualized support focused on living in the community. This will be accomplished through contracted services on a fee-for-service basis. Nursing facility social workers will develop a plan with the resident to achieve desired outcomes in moving to the community and connect individuals with consultants best suited for particular needs. The consultants will provide peer mentoring, skills training, advocacy, and technical assistance on an array of topics, such as managing personal assistants, budgeting, paying bills, etc.

Third, we will augment the provision of durable medical equipment so that people are able to obtain an appropriate type and quality of assistive and adaptive equipment before leaving the nursing facility. This effort also includes a study of the durable medical equipment program to determine utilization rates, regional differences, and systems issues.

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Nursing Facility Transitions

WEST VIRGINIA

Grant Information

Name of Grantee
Department of Health and Human Resources
Title of Grant
Transitioning to Inclusive Communities (TIC)
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$551,678
Year Original Funding Received
2001
Completed

Contact Information

Cynthia Beane, Program Manager
Office of Behavioral Long-Term and Alternative Health Care
Bureau for Medical Services
350 Capitol Street, Room 251
Charleston, WV 25301-3706
304-558-5962
cynthiabeane@wvdhhr.org

http://www.cedwvu.org

Subcontractor(s)

Sally Burchfiel
304-293-4692
sburchfiel@hsc.wvu.edu

Center for Excellence in Disabilities
West Virginia University

Target Population(s)

Individuals of all ages with disabilities or long-term illness who reside in nursing facilities and/or segregated settings or are at risk of segregated placements.

Goals

Activities

Abstract

The Transitioning to Inclusive Communities (TIC) project will enable individuals who reside in nursing facilities or other segregated environments to transition to community residences and those who are at risk of moving to such facilities to remain in the community. This goal will be accomplished through a number of activities. TIC will provide information resources for people with disabilities or long-term illnesses and their families, including a toll-free telephone line, a Web site, training, and a public awareness multimedia campaign. This information will assist the individuals considering transition to make informed choices regarding community living options.

TIC will identify individuals interested in transition through referrals and responses to disseminated information and training, as well as through a readiness tool. TIC will use minimal funds to support individuals who need supports to transition or be diverted. Self-determination and self-advocacy skills will be enhanced through collaboration with advocacy organizations, providers and State long-term care ombudsmen, and through statewide training. Community transition options will be increased through contracts with advocacy and consumer support groups that provide model peer supports and "trial" community transition choice options.

Discharge and intake planning will be augmented with a person-centered system of supports. Transition Support Teams will be modeled and implemented at all levels of the transition process—at nursing homes, congregate settings, and in the community—to support individuals who wish to be diverted from placement. This interdisciplinary support team is made up of the individual transitioning, professionals, family and friends, community members, and volunteers. Technical assistance will be provided so that a selected number of individuals can develop their own consumer-directed Transition Support Team.

Finally, the TIC project will build additional community supports through funding nonprofit advocacy, consumer, or community groups to demonstrate the use of peer supports and services in the transitioning and diversion processes. Small amounts of additional funds will demonstrate the importance of assistive technology or home start-up funds as people transition.

Consumer direction and evaluation for the TIC project is provided through a 25-member COC, ongoing follow up, and a consumer satisfaction survey in the last year of the grant.

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Nursing Facility Transitions

WISCONSIN

Grant Information

Name of Grantee
Independent Living Resources
Title of Grant
Nursing Facility Transitions Project
Type of Grant
Nursing Facility Transitions, Independent Living Partnership
Amount of Grant
$450,000
Year Original Funding Received
2001
Completed

Contact Information

Kathie Knoble Iverson
Executive Director of Independent Living Resources
608-787-1111
kathie.ki@ilresources.org

Michelle Olson
Assistant Director
4439 Mormon Coulee Road
La Crosse, WI 54601
608-787-7777
michelle.olson@ilresources.org

http://www.ilresources.org

Subcontractor(s)

Access to Independence
Tracy Miller
608-242-8484

Center for Independent Living of Western Wisconsin
Kay Sommerfeld
715-233-1070

IndependenceFirst
Deb Langham
414-291-7520 ext. 204

Midstate Independent Living Consultants
Jennifer Fasula
715-344-4210 ext. 17

North Country Independent Living Center
Dee Truhn
715-392-9118 ext. 19

Options for Independent Living
Kathryn Barry
920-490-8270 ext. 183

Society's Assets
Karen Olufs
262-637-9128

Target Population(s)

Any person with a disability or long-term illness residing in a nursing facility, ICF-MR, or state center for 90 days or more, who would like to receive services in the community.

Goals

Activities

Abstract

The Transitions Project will create an effective methodology and practice to reduce and eliminate the existing barriers to relocation from nursing facilities to community living throughout the State of Wisconsin. Funds will also be used for training and to support a cadre of transition specialists and peer support volunteers.

As an ILC, Great Rivers provides services to individuals of all ages with all types of disabilities. All of the eight ILCs in Wisconsin have successfully participated in the previously-funded Nursing Home Relocation Project (Homecoming) over the past 2 years and bring a great deal of knowledge and expertise to this new project. They have extensive experience in providing outreach to relevant agencies and nursing facility residents who desire community living, and in providing technical assistance on home modifications and assistive technology. Additionally, they have in-depth knowledge of required community resources such as local housing authorities, personal care providers, transportation services, and local, state, and federal funding options. They also have a successful partnership with the Wisconsin DHFS.

The eight ILCs have experience working within Wisconsin's long-term care system, which includes the Community Options Program (COP), Medicaid state plan services, Medicaid Waiver Programs, Family Care, Badger Care, and Pathways to Independence. All ILCs currently have a list of identified residents living in nursing facilities who are waiting for community living. The ILC staff are knowledgeable of the barriers that prevent their relocation and have access to information and services that could reduce or eliminate those barriers. The Transitions Project will identify and recommend how to implement the changes needed to address the relocation barriers and provide the information and support to sustain a successful relocation.

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Nursing Facility Transitions

WISCONSIN

Grant Information

Name of Grantee
Department of Health and Family Services, Division of Supportive Living
Title of Grant
Homecoming II
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$800,000
Year Original Funding Received
2001
Completed

Contact Information

Gail Propsom
Long-term Care Policy Analyst
Project Director/Coordinator
1 West Wilson, PO Box 7851
Madison, WI 53707-7851
608-267-2455
propsgf@dhfs.state.wi.us

Subcontractor(s)

The following are recipients of grants to enhance housing opportunities for persons with disabilities who wish to live in the community:

  1. NEWCAP: Center for Self-Reliance, Robert Koller, Executive Director, 920-834-4621
  2. Stockbridge-Munsee Community, JoAnn Schedler, Project Director, 715-793-4876
  3. Foundation for Rural Housing, Inc., Char Thompson, Project Director, 608-238-3448
  4. Independent Living, Inc., Patricia Eldred, Director of Development, 608-274-7900
  5. Community Care Organization, Chris Hess, 414-902-2403

Target Population(s)

Individuals who are currently in a nursing home or other institution from any target group (frail elderly, physical disability, developmental disability, or serious mental illness) and who meet functional and financial eligibility criteria for available funding sources. The project will give special emphasis to working with individuals who have developmental disabilities or serious mental illness.

Goals

Activities

Abstract

Wisconsin's nursing home transition project, entitled Homecoming II, builds on the experiences of a nursing home transition grant received in 1999. The original projects focused on individuals with physical disabilities and frail elders and the development of relationships with Independent Living Centers as partners in outreach and relocation support. Wisconsin will build on the original Homecoming Grant by expanding the target groups and increasing focus on system building for future activities.

The Homecoming II project will improve community-integrated services in the short term for 400 consumers who are currently in institutions, and over the long term through systems changes that will facilitate the relocation of additional individuals in a more systematic way. Particular attention will be paid to persons with serious mental illness living inappropriately in nursing homes and to persons with developmental disabilities living in Intermediate Care Facilities for Mental Retardation, while continuing the activities that successfully relocated residents who are elderly or have physical disabilities. In the new project, the Independent Living Centers will continue their current role with their own Nursing Facility Transitions Grant from CMS.

The outcomes Wisconsin anticipates for Homecoming II are as follows:

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Nursing Facility Transitions

ALABAMA

Grant Information

Name of Grantee
Alabama Department of Senior Services, State Unit on Aging
Title of Grant
Nursing Facility Transportations Program Grant
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$770,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Marie Tomlin
770 Washington Avenue
RSA Plaza, Suite 470
Montgomery, AL 36130
334-242-5743
mtomlin@adss.state.al.us

Alan B. Stevens, Ph.D., Director
Dementia Care Research Program
UAB Gerontology and Geriatric Medicine
933 19th Street S., CH19, 218T
Birmingham, AL 35294-2041
205-934-7316
astevens@uab.edu

Subcontractor(s)

University of Alabama at Birmingham, Alabama Tombigbee Regional Commission (ATRC) (Area Agencies on Aging [AAA])

Jefferson County Office of Senior Citizens Services (AAA)

Target Population(s)

Persons currently enrolled in or eligible for the Alabama Department of Senior Services (ADSS) Medicaid Waiver program who are hospitalized and are at risk of nursing home placement, and persons recently admitted into Medicaid-eligible nursing home residences.

Goals

Activities

Abstract

The ADSS proposes to collaborate with the State's 13 AAAs, the Alabama State Nursing Home Association, the Alabama Hospital Association, Alabama Medicaid Department, Governor's Office on Disability, the Olmstead Core Workgroup, and the Dementia Care Research Program of the University of Alabama at Birmingham to enhance support services provided by the Elderly and Disabled Medicaid Waiver program to assist persons with dementia living in the community. The project institutes a comprehensive system to support enduring changes in the delivery of community-based assistance for Medicaid-eligible persons with dementia. The project targets two populations of Medicaid-eligible persons with dementia: (1) community dwelling persons with a recent admission to the hospital and (2) recently admitted Medicaid-eligible nursing home residents. We have chosen two AAAs because they provide both rural and urban settings; a significant number of low-income, minority residents; and sufficient staff capacity for program management. Our program will integrate ADSS Medicaid Waiver services into other formal care services and into family caregiving, maximizing the benefit of both formal and informal services available to Medicaid Waiver participants.

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Nursing Facility Transitions

ARKANSAS

Grant Information

Name of Grantee
Department of Human Services Division of Aging and Adult Services
Title of Grant
Your Choice
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$598,444
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Kris Baldwin, Program Administrator
PO Box 1437, Slot S-530
Little Rock, AR 72203-1437
501-682-8509
kris.baldwin@arkansas.gov

Subcontractor(s)

Independent Living Centers of Arkansas
Eight Area Agencies on Aging of Arkansas

Target Population(s)

Individuals who are at high risk of entering a nursing facility or individuals currently residing in nursing facilities that wish to return to the community.

Goals

Activities

Abstract

"Your Choice" focuses on diverting individuals at high risk of institutionalization by placing social workers in pilot programs in two hospitals in Arkansas, one rural and one urban. Currently, the Division of County Operations determines eligibility for Medicaid long-term care services (nursing home and home and community based services). Eligibility determinations for nursing home care are made post-admission. The average time to process a Medicaid waiver application is 45 days. Because of the 45-day lag time, inpatient hospital providers have historically not been able to arrange for services in the home prior to discharge and found it much easier to arrange for nursing home admission. A collaborative effort will be made with the Real Choice Grant to develop a "fast-track" process to reduce the eligibility wait time for Medicaid waiver applications. Consumers will have quick entry, timely eligibility determination, and consistent medical eligibility criteria and access to services. Data will be complied to show the comparison of nursing facility placements in prior years with those in project years.

Another component of the diversionary process will be the development of a statewide Web-based consumer information resource, personal assessment form, and directory of services for people who are aging and people with disabilities, including developmental disability and mental illness. An ombudsman program for persons who receive waiver services will also be developed to assist in the diversion of persons from institutions. Consumers with disabilities and advocates have often expressed concern about a voice for individuals in the community who have difficulties with services they are receiving from a Home and Community Based waiver.

Another initiative of this grant is to build a blueprint for interagency collaboration to identify, develop, and coordinate community housing. The ADFA has agreed to set aside $300,000 of its annual HOME program allocation for bridge rental subsidies. A collaborative effort with AFDA will be made to recruit and identify individuals currently at high risk of being institutionalized, or those currently in nursing homes and capable of living in the community, and to assess the housing and support service needs of those individuals and to link those persons with support service providers.

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Nursing Facility Transitions

CALIFORNIA

Grant Information

Name of Grantee
Community Resources for Independence (CRI)
Title of Grant
Transitions Independent Living Partnership Grant
Type of Grant
Nursing Facility Transitions, Independent Living Partnerships
Amount of Grant
$337,500
Year Original Funding Received
2002
Expected Completion Date
March 2006

Contact Information

Sandy Hobart, Executive Director
707-528-2745
shobart@sonic.net

Nancy Hall
980 Hopper Avenue
Santa Rosa, CA 95403
707-528-2745
nhall@sonic.net

Subcontractor(s)

Have not subcontracted with anyone at this time.

Target Population(s)

Native Americans and Hispanic individuals with cognitive, mental/emotional, physical, hearing, vision, and multiple disabilities; families; and health clinics statewide.

Goals

Activities

Abstract

CRI will develop a replicable statewide program improving community options to assist individuals with disabilities to make appropriate transitions from institutions into integrated community settings. Through outreach, training, technical assistance, and public policy recommendations, CRI will design a program to strengthen California's infrastructure to support nursing facility transitions. CRI, an Independent Living Center established in 1976, serves individuals with disabilities in Sonoma, Mendocino, Lake, and Napa Counties (Northern California), representing diverse urban and rural communities.

CRI will form partnerships with key local, state, and federal organizations, including California Department of Health Services, Area Agencies on Aging, State Independent Living Council (SILC), California Foundation for Independent Living Centers (CFILC), local housing authorities, Coalition of Californians for Olmstead (COCO), Department of Rehabilitation, consumers, and other community organizations. CRI will contract with Independent Living Centers in San Diego, San Francisco, and Grass Valley for training and technical assistance to ensure that statewide issues, barriers, and opportunities are addressed.

CRI will also conduct outreach, education, and training; develop and distribute information and materials; and organize focus groups to alter individual, public, and professional expectations. It will also expand local, state, and federal opportunities and choices for individuals transitioning from nursing facilities into their communities.

A statewide model of transition will be designed, including resources, quality services, and policy recommendations for Independent Living Centers in California. Working with The Access Center in San Diego, ILRC in San Francisco, and FREED in Grass Valley, CRI will develop a proposal to support a statewide funding mechanism for the implementation of this Independent Living Center "Transitions" model.

We will also address barriers to successful transitions in local, state, and federal policy, regulations, and initiatives (i.e., housing, employment, personal assistance services, emergency funding, as well as access to and availability of home modifications, assistive technology, and equipment).

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Nursing Facility Transitions

DELAWARE

Grant Information

Name of Grantee
Independent Resources, Inc.
Title of Grant
Community Works Partnership
Type of Grant
Nursing Facility Transitions, Independent Living Partnerships
Amount of Grant
$270,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Larry Henderson
Executive Director
302-765-0191
lhenderson@independentresources.org

Nate Beasley, Project Director
Two Fox Point Centre
6 Denny Road, Suite 101
Wilmington, DE 19809
302-765-0191
Nbeasley@independentresources.org

Subcontractor(s)

None.

Target Population(s)

The population targeted in the Community Works Partnership will be any individuals with a disability currently residing in a nursing facility, Intermediate Care Facility, etc., living in New Castle County (northern Delaware) who desire to change their living situation and become more independent in a community setting of their choosing.

Goals

Activities

Abstract

Independent Resources, Inc. (IRI) will hire two additional staff people to conduct activities for the project. One person will specialize in locating accessible housing and/or modifying inaccessible housing. The other person will specialize in identifying people with disabilities or chronic long-term illness in nursing facilities who wish to live in the community. We will act in partnership with, and with the active participation of, the state agency administering home and community based waivers under Section 1915(c) of the Social Security Act, Division of Services for Aging and Adults with Physical Disabilities (DSAAPH). Together, we will identify 30 individuals with disabilities in nursing facilities who want to live in the community. We are calling this project the Community Works Partnership (CWP) because we are forging alliances with public and private groups to make community living work for people with disabilities currently in nursing facilities.

After identifying individuals who want community living, IRI will work with many public and private organizations to make certain the transition from facility to community is smooth, secure, and lasting. We will locate housing and, if modification to existing housing is necessary, we will secure the necessary materials and volunteer labor to make that possible. IRI has received a HUD grant with the goal of increasing accessible, affordable housing for people with disabilities through outreach and education.

For years, IRI has provided advocacy, peer counseling, independent living skills training and information, and referral services to people with disabilities of all ages on a cross disability, consumer-driven basis. With CWP, we will improve community-integrated services and enable more people to live in the community rather than in institutions.

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Nursing Facility Transitions

DELAWARE

Grant Information

Name of Grantee
Delaware Health and Social Services, Division of Services for Aging and Adults with Physical Disabilities (DSAAPD)
Title of Grant
Delaware Passport to Independence Initiative
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$566,772
Year Original Funding Received
2002
Expected Completion Date
March 2006

Contact Information

Victor Orija, Project Manager
302-255-9377
victor.orija@state.de.us

Allan Zaback, Division Director
Administrative Building, First Floor Annex
1901 N. DuPont Highway
New Castle, DE 19720
302-255-9351
allan.zaback@state.de.us

Subcontractor(s)

None.

Target Population(s)

Medicaid nursing home eligible adults.

Goals

Activities

Abstract

This project will identify individuals within long-term care facilities wishing to transition to an integrated community setting and select an initial group of 15 participants. During the assessment and identification process, statewide outreach to educate professional staff and the public about the initiative and transition-related issues will be implemented. Ongoing training topics will include areas to lay the philosophical foundation for self-determination, independent living, and personal decision making within a person-centered model. Ongoing project data collection and input from stakeholders will provide the foundation for the evaluation process to monitor program effectiveness, allow for flexibility and change, and contribute to lasting improvements of service provision and support. A multidisciplinary interagency Grant Oversight Committee (GOC) will guide all project-related activities, information sharing, project updates, and reports to their agency. Critical issues to be examined are the following: affordable and accessible housing availability, transition-related policies and regulations, support services, training, outreach, and sustainability. DSAAPD will coordinate activities with other agencies with Systems Change funding and welcomes the opportunity to interface common efforts, goals, strategies, and partnerships to increase access to services with a continuum of supports.

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Nursing Facility Transitions

LOUISIANA

Grant Information

Name of Grantee
Louisiana Department of Health and Hospitals
Title of Grant
Louisiana Community Choice Access
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$600,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Marguerite D. Adams, R.N.
Department of Health and Hospitals
Division of Long Term Supports and Services
446 N. 12th Street
Baton Rouge, LA 70802
225-219-0230
madams@dhh.la.gov

Subcontractor(s)

None.

Target Population(s)

Adults in nursing facilities.

Goals

Activities

Abstract

Department of Health and Hospitals (DHH) has developed and will implement a statewide initiative to change perceptions among the general public and health care providers regarding appropriate care choices for the elderly and individuals living with disabilities. The initiative will establish processes for transition from institutional care to the community, and will identify and assist 150 appropriate Medicaid nursing facility residents to transition to the community. This initiative is designed to work with existing state and local agencies and germane grants in partnership to assure that individuals have meaningful choices in viable community support systems. The grant will fund a serious, concerted attempt to institute true systems change by addressing cultural expectations as well as identification and relocation of nursing facility residents.

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Nursing Facility Transitions

MINNESOTA

Grant Information

Name of Grantee
Metropolitan Center for Independent Living
Title of Grant
Systems Change Grants for Community Living; Nursing Home Transition Grant
Type of Grant
Nursing Facility Transitions, Independent Living Partnerships
Amount of Grant
$400,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

David Hancox, Executive Director
1600 University Avenue W., Suite 16
St. Paul, MN 55104-3825
651-603-2012
davidh@mcil-mn.org

Subcontractor(s)

None.

Target Population(s)

Individuals with disabilities currently residing in nursing homes and individuals with disabilities living in community settings with housing needs.

Goals

Activities

Abstract

MCIL, in close collaboration with the Minnesota Association of Centers for Independent Living (MACIL) and the eight Centers it represents, will systemically change the way nursing facility transitions are implemented in Minnesota's local communities. By working in partnership with the Minnesota DHS and other community partners, MCIL/MACIL is confident their voice, and the voice of the consumers they represent, will be heard.

This project is threefold. It will (1) increase awareness of residents of nursing facilities and their caregivers of the possibilities of living interdependently in the community and provide them with information, referrals, and support; (2) train CIL and other paraprofessional and professional staff in successful nursing facility transitions; and (3) ensure the availability of affordable and accessible housing for individuals choosing to live interdependently in the community of their choice.

MCIL/MACIL will develop tangible products such as a training manual on successful nursing facility transitions, informational and educational brochures, and a housing survey and assessment model. Other less tangible outcomes include a strong influence on public policy decisions, enhanced public/private partnerships, positive and constructive relationships with nursing facility representatives, and the development of a cadre of community specialists, consumers, and advocates to work in a collaborative effort.

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Nursing Facility Transitions

NEBRASKA

Grant Information

Name of Grantee
Department of Health and Human Services, Finance and Support
Title of Grant
Creating Systems Change in the Transition Process
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$600,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Mary Jo Iwan, Administrator
402-471-9345
maryjo.iwan@hhss.state.ne.us

Mike Laughlin, NFT Grant Coordinator
Office of Aging and Disability Services
301 Centennial Mall South
PO Box 95044
Lincoln, NE 68509
402-471-9174
mike.laughlin@hhss.state.ne.us

Subcontractor(s)

(Years 1, 2 and 3) Eastern Nebraska Office on Aging, Lincoln Area Agency on Aging, and Northeast Nebraska Area Agency on Aging.

(Years 2 and 3) Aging Office of Western Nebraska, Blue Rivers Area Agency on Aging, Midland Area Agency on Aging, South Central Nebraska Area Agency on Aging, and West Central Nebraska Area Agency on Aging.

Target Population(s)

Current Medicaid clients and children with developmental disabilities residing in nursing facilities who meet criteria for potential transition to home and community-based settings. Children with developmental disabilities currently residing at home identified at risk for nursing facility placement.

Goals

Activities

Abstract

Nebraska's project will capitalize on momentum already building in the State around enhancing the long-term care system. A previous 1-year Nursing Facility Transition Grant allowed the State to conduct qualitative research, which revealed weaknesses in both the message sent to consumers about long-term care options, as well as the mechanism through which consumers are offered alternatives to nursing facility placement. As a result, the State has developed marketing materials and strategies believed to be effective with targeted audiences, and has also devised strategies to expand and better link home and community-based services into a more cohesive system.

This project has the potential for significant and sustainable impact on Nebraska's long-term care system, both lowering costs for the State's Medicaid program and, perhaps most importantly, creating greater awareness and better options for consumers.

To assure statewide acceptance of this revolutionary (for Nebraska) plan for cultural and systems shift in long-term care, the project was divided into two phases. In the first year, the Department of Health and Human Services and three pilot Area Agencies on Aging operationalized the plan. During the second and third years, the project expanded statewide. During a no-cost extension year, the project will develop strategies to counter a trend in increased requests for nursing home placement for children with developmental disabilities.

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Nursing Facility Transitions

NEW JERSEY

Grant Information

Name of Grantee
Resources for Independent Living, Inc. (RIL)
Title of Grant
Nursing Facility Transitions
Type of Grant
Nursing Facility Transitions, Independent Living Partnerships
Amount of Grant
$400,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Lisa Smith
Executive Director
609-747-7745
lsmith@rilnj.org

Liz Willson
Nursing Facility Transition Manager
351 High Street, Suite 103
Burlington, NJ 08016
609-747-7745 (b)
609-747-1870 (f)
lwillson@rilnj.org

Subcontractor(s)

Eleven Independent Living Centers (ILCs) in addition to Resources for Independent Living, Inc. (RIL)

Target Population(s)

Individuals under the age of 65 currently living in nursing facilities who have the desire and capacity to live in community-based housing situations.

Goals

Activities

Abstract

The overall goal of this project is to conduct an assessment of individuals with disabilities who are under age 65 and reside in nursing facilities, and transition 200 individuals to the community over the 3-year grant period. Staff will coordinate an assessment process of 3,000 individuals with disabilities now residing in nursing facilities and help identify the types of community supports and services needed to transition individuals to the community. The project will recruit, hire, and train one full-time Community Living Specialist and one part-time Community Living Specialist.

Consumer involvement in planning and direction are critical elements of the project. Consumer advocates will be instrumental in the transition of the Olmstead Stakeholders Task Force to the New Jersey Systems Change Advisory Council and the formation of an RIL Advisory Panel. Consumers will also participate in mentoring and peer support programs.

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Nursing Facility Transitions

NEW JERSEY

Grant Information

Name of Grantee
Department of Health and Senior Services (DHSS)
Title of Grant
Young Adult Nursing Facility Resident Transition Initiative
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$600,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Nancy Day, Project Director
609-943-3428
Nancy.Day@doh.state.nj.us

Bette Sorrento, Project Coordinator
Office of ADRC Grant Administration
Division of Aging and Community Services
PO Box 807
Trenton, NJ 08625-0807
609-943-5248
Bette.Sorrento@doh.state.nj.us

Subcontractor(s)

Barbara Parkoff, Principal
SP Consultants, L.L.C.
23 Clive Hills Road
Edison, NJ 08820
732-494-8268
Barbara.parkoff@verizon.net

Target Population(s)

Children and adults under the age of 65 with disabilities or a long-term illness.

Goals

Activities

Abstract

The New Jersey DHSS, Division of Consumer Support (now the Division of Aging and Community Services) began the Community Choice program on August 1, 1998. It is designed to identify appropriate Medicaid NF residents and help them find community-based alternatives.

Community Choice has been successful in transitioning a large number of beneficiaries in NFs to the community, primarily individuals over age 65. We need to try a different approach to work with the 3,000 children and adults under age 65 who have a disability or long-term illness and remain in NFs. Barriers to community re-entry include a lack of adequate, affordable, and accessible housing and a lack of understanding of their special needs and of the social and economic activities of community life they desire.

This grant will permit New Jersey to

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Nursing Facility Transitions

NORTH CAROLINA

Grant Information

Name of Grantee
North Carolina Department of Health and Human Services
Title of Grant
Transitions
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$600,000
Year Original Funding Received
2002
Expected Completion Date
March 2006

Contact Information

Lynne Perrin, Section Chief
919-857-4047
Lynne.Perrin@ncmail.net

Larry Nason
Contract Manager/Evaluator
Health Policy Analyst
Facility and Community Care Section
2501 Mail Service Center
Raleigh, NC 27699-2501
919-857-4221
Larry.Nason@ncmail.net

Subcontractor(s)

Linda Kendall, Program Director
L.H. Kendall Consulting Services
PO Box 28814
Asheville, NC 28814
828-712-4003
lkfields@mindspring.com

Target Population(s)

Adults with disabilities who are residents of North Carolina nursing facilities who wish to move back into the community.

Goals

Activities

Abstract

The NC Division of Medical Assistance's primary partners in this program are the Division of Vocational Rehabilitation's statewide ILRP and Centers for Independent Living (CILs). The program, called Transitions, will utilize the experience of ILRP and CIL Counselors/Service Coordinators to help identify the needs and goals of nursing facility residents interested in transitioning to community living, facilitate residents' development of transition plans, and coordinate supports and services needed for successful transition. Pathways CIL and its fully functional satellite office, Western Alliance CIL, will train peer mentors in western service areas to support transition candidates and help them fully reintegrate into their communities.

In the first year of the grant, the Asheville and Rocky Mount ILRP regional offices will pilot the program. The results of a program evaluation will be used to refine the transition model before statewide expansion of Transitions in the second and third years of the grant. The success of Transitions, however, will be highly dependent upon active community partners. Examples of partners who have committed to be active participants in the pilot areas include

Grant funding will pay for program staff and evaluation. More importantly, however, grant funds will be used for transition expenses not normally covered by public assistance programs such as utility deposits, furniture, household goods, and clothing. Grant funds will be also used to develop and distribute educational materials about community services and supports and provide CEU training to nursing facility staff about Transitions and community resources.

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Nursing Facility Transitions

OHIO

Grant Information

Name of Grantee
Ohio Department of Job and Family Services
Title of Grant
Ohio Access Success Project
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$600,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Laurie Damon, Project Manager
Ohio Department of Job and Family Services
Bureau of Home and Community Services
30 E. Broad Street, 33rd Floor
Columbus, OH 43215-3414
614-644-1820
mailto:damonl@odjfs.state.oh.us

Subcontractor(s)

Easter Seals of Central and Southeast Ohio

Target Population(s)

Identified adult nursing home residents who desire to move from the nursing home to a community–based setting.

Goals

Activities

Abstract

The "Ohio Access Success Project" has created a coordinated nursing facility transition protocol to identify and support the successful relocation to community-based settings of 100 consumers living in nursing homes. The protocol incorporates an interdisciplinary team consisting of a social worker, nurse, and peer coach. A housing coordinator is available to relocation teams for consultation and to provide assistance to the transition teams in finding appropriate housing for participating consumers.

Consumers who have relocated to a community-based setting receive follow-up visits from the relocation team to assess their satisfaction with the relocation protocols and their continued well-being after their relocation. Feedback on this will be provided to the State, to members of the project's stakeholder work group, and to the Ohio Olmstead Task Force.

As Ohio works through the process of transitioning nursing home residents back to a community-based setting, resources and linkages in a community that assist in a consumer's successful transition are being identified with the goal of developing similar resources and linkages in other communities. Barriers to a consumer's successful transition are also being identified.

The program will be evaluated by the contractor. It is hoped that Ohio will be able to sustain a nursing facility transition program after the end of the grant period.

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Nursing Facility Transitions

RHODE ISLAND

Grant Information

Name of Grantee
Department of Human Services, Center for Adult Health
Title of Grant
Transitioning to the Rhode to Independence
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$600,000
Year Original Funding Received
2002
Completed

Contact Information

Dianne Kayala, Chief
Family Health Systems
Department of Human Services
600 New London Avenue
Cranston, RI 02920
401-462-6303
dkayala@gw.dhs.state.ri.us

Subcontractor(s)

None.

Target Population(s)

Any institutionalized person in Rhode Island.

Goals

Activities

Abstract

Rhode Island estimates that there are approximately 400 people currently placed in an institutional setting who would likely benefit from discharge to a more integrated community setting if their needs could be met. Some of these people went to a nursing facility following a hospitalization and did not realize community supports are available. Others had some supports in place but not enough to maintain their health and safety. Still others fell through the cracks in the delivery system and were unable to qualify for services they needed in the community.

This statewide program will build upon Rhode Island's 1998 "Date Certain" Nursing Home Transition Program. It will be directed and monitored by a diverse oversight committee made up of consumers, state and quasi-state agencies, private agencies, and service providers. The Rhode Island Housing Resource Commission will serve as the critical link to housing resource opportunities statewide.

The Shared Vision for Long-term Care developed by a group of Rhode Island state agencies, community providers, nursing homes, and consumers is that Rhode Islanders will have a dynamic long-term care system that supports high quality, independence, choice, and coordination of services with the necessary public and private funding. Implementation of this proposal will be a significant step toward making this vision a reality.

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Nursing Facility Transitions

SOUTH CAROLINA

Grant Information

Name of Grantee
Department of Health and Human Services, Office of Senior and Long-Term Care
Title of Grant
South Carolina Home Again
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$600,000
Year Original Funding Received
2002
Expected Completion Date
June 2006

Contact Information

Kara Lewis, Project Officer
803-898-2590
lewis@dhhs.state.sc.us

Joi Martinez Farrow, Project Manager
DHHS
CLTC, 7th Floor
PO Box 8206
Columbia, SC 29202-8206
803-898-2590
farrow@dhhs.state.sc.us

Subcontractor(s)

None.

Target Population(s)

All populations in nursing facilities, with the exception of clients diagnosed as solely mentally retarded.

Goals

Activities

Abstract

This project is directed in joint partnership with two state agencies, the SC Department of Mental Health (DMH) and the SC Department of Disabilities and Special Needs (DDSN). This grant was prepared with the objective of identifying and transitioning nursing home clients wanting to reside in the community, as well as implementing system changes needed indefinitely. The target population for this grant includes the elderly, individuals with disabilities, and clients with mental health conditions, excluding those solely diagnosed with mental retardation.

Newly hired grant staff will be responsible primarily for developing a comprehensive assessment instrument for targeting appropriate transition clients. The State intends to use the instrument with a transition team comprised of a community transition nurse (RN), the nursing facility social service worker and other nursing facility staff, the community long-term care (CLTC) case manager (or DDSN Service Coordinator), and the client/family.

For transition clients with immediate needs, the State intends to use grant funds to assist with the short-term provision of rent deposits, furniture procurement, groceries, etc. Transition clients will be immediately enrolled into a waiver and then offered expanded supports. The RN will address pertinent medical issues and provide intensive caregiver/client training.

A process will be developed to transition clients diagnosed with mental illness. This process will use supports already available in the state mental health system. These supports will be expanded in scope and in frequency in recognition of anxiety associated with transition experienced by this population.

Working in collaboration with the previously approved Real Choice for Systems Change Grant, the nursing home transition project plans to use South Carolina Access and South Carolina Choice. South Carolina Access will be a statewide information and referral system database. South Carolina Choice is a demonstration waiver to test an enhanced method of offering self-directed care to clients served by CLTC in the Spartanburg area. It will provide greater options with regard to the types of services and providers allowed to receive Medicaid reimbursement.

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Nursing Facility Transitions

UTAH

Grant Information

Name of Grantee
Utah Independent Living Center
Title of Grant
Independent Living Partnership Grant for Nursing Home Transition
Type of Grant
Nursing Facility Transitions, Independent Living Partnership
Amount of Grant
$400,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Debra Mair, Executive Director
3445 South Main Street
Salt Lake City, UT 84115-4453
801-466-5565
uilc@xmission.com

Subcontractor(s)

Five Independent Living Centers (ILCs): Options for Independence CIL, Active Re-Entry ILC, Tri-County ILC, Central Utah CIL, Red Rock CIL

Association for Independent Living of Utah

Target Population(s)

Individuals of all ages statewide with significant physical disabilities, representing various ethnic and socioeconomic groups living in nursing homes. Individuals with severe dementia, mental illness, or mental retardation will not be targeted through this proposal. Targeted individuals will be further identified by expressing their desire to live elsewhere.

Goals

Activities

Abstract

The Utah ILC will partner with five other ILCs strategically located throughout the State of Utah to bridge a substantial gap in services available to significantly physically disabled residents of nursing homes that receive Medicaid funding. This ILC network will provide the mechanism to implement one-to-one skill building transition services to participants while still living in the nursing home and will assist participants to reintegrate to less restrictive community settings. Six public and private partnerships will be developed to bridge information and service gaps in Utah's community service infrastructure. Sustainability and a consumer-driven service structure are features built into the overall program.

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Nursing Facility Transitions

WYOMING

Grant Information

Name of Grantee
Wyoming Department of Health, Aging Division
Title of Grant
Project Out
Type of Grant
Nursing Facility Transitions, State Program
Amount of Grant
$600,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Dorothy Thomas, Project Director
6101 Yellowstone Road, Room 259B
Cheyenne, WY 82002
307-777-8566
dthoma@state.wy.us

Subcontractor(s)

Wyoming Independent Living Rehabilitation, Inc.
305 West 1st Street
Casper, WY 82601

Target Population(s)

Institutional residents who could reside in a community setting.

Goals

Activities

Abstract

The purpose of this project is to develop a model in Wyoming for assisting nursing home residents who desire to transition into a less-restrictive environment/community living. The project will identify existing supports and barriers to transitions, develop infrastructure within the State, and develop pilot projects at two centers for independent living. These two ILCs will assist 10 individuals in transitioning from nursing homes in the first year of the project, 30 individuals in Year 2, and 45 individuals in Year 3. They will also conduct education and outreach to communities, professional service providers, and consumers. The Department of Health will develop statewide transition services to prepare individuals for a change in placement and evaluate project consumer satisfaction and cost-effectiveness of the transition program. The grant will be utilized to identify and develop adequate resources and authority to implement long-term care services and supports "in the most integrated setting." The Aging Division will subcontract with the centers for independent living in the State in a collaborative effort to include multiple partners in the process of developing and implementing transition plans for nursing home residents. Working with consumers, private service providers, and multiple government agencies, "Project OUT" will identify barriers and the costs associated with transitioning residents from nursing homes. The project will continue attempts to secure improved funding for housing, transportation, and community health and support services.

Ultimate outcomes of the project include an increase in new and/or changes in Medicaid waivers/waiver slots and enlargement of the provider base; Housing and Urban Development (HUD) Section 8 voucher changes statewide for housing; State of Wyoming Department of Transportation commitments for improved transportation programs for individuals with disabilities; and state general funds to allow for the sustainability and continuation of the Aging Division's Olmstead efforts.

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Real Choice Systems Change

ALABAMA

Grant Information

Name of Grantee
Alabama Medicaid Agency, Long-Term Care Division
Title of Grant
Sweet Home Alabama: Under Construction
Type of Grant
Real Choice Systems Change
Amount of Grant
$2,000,000
Year Original Funding Received
2001
Completed

Contact Information

Marilyn Chappelle, Director
334-242-5009
mchappelle@medicaid.state.al.us

Hattie Nettles, Project Manager
Project Development/Program Support Unit
Long-Term Care Division
Alabama Medicaid Agency
501 Dexter Avenue
Montgomery, AL 36103
334-242-5644
hnettles@medicaid.state.al.us

Subcontractor(s)

Alabama Department of Senior Services
Anne Coffin
334-242-5786

Alabama Department of Mental Health and Mental Retardation
Anne Evans
334-242-3706

Volunteer and Information Center
Camilla Prince
334-264-4636

Governor's Office on Disability
Barbara Crozier
334-353-0355

Target Population(s)

Persons with disabilities regardless of age or type of disability.

Goals

Activities

Abstract

Our proposal was developed in conjunction with the State's Olmstead planning process. This process is comprehensive, addressing the needs of people with disabilities and their families regardless of age or type of disability. It is also consumer-based, substantially involving people with disabilities and family members in planning and decision making. The Olmstead Core Workgroup is a 40-member group, comprising state agencies, advocates, providers, and consumers and family members, with the Alabama Medicaid Agency serving as lead agency.

The Workgroup has drafted a unifying theme as a title for the Olmstead plan, designed to catch the imagination of the state's citizenry and policy makers: Sweet Home Alabama: Under Construction. It is an apt metaphor for the work we must do to build a cohesive system of supports that is predicated on community, real choice, and consumer direction. The architects of the proposed systems changes are its stakeholders, with special emphasis on the substantial and meaningful participation of people with disabilities and family members. The proposed grant activities are our building blocks, targeted to achieve enduring systems change in three areas: access, consumer choice/control, and expanded resources for home and community based services.

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Real Choice Systems Change

ARKANSAS

Grant Information

Name of Grantee
Department of Human Services (DHS), Division of Aging and Adult Services
Title of Grant
Real Choice for Enduring Change in Arkansas
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,025,000
Year Original Funding Received
2001
Amount of Supplemental Grant
$360,000
Supplemental Award Received
2002
Completed

Contact Information

Kris Baldwin, Program Administrator
501-682-8059
kris.baldwin@arkansas.gov

Cindy Young, Project Coordinator
PO Box 1437, Slot S530
Little Rock, AR 72203-1437
501-682-8231
cindy.young@arkansas.gov

Subcontractor(s)

Partners for Inclusive Communities/University of Arkansas for Medical Sciences
Area Agency on Aging of South West Arkansas
RTZ Associates, Inc.
National Academy of State Health Policy
University of Minnesota

Target Population(s)

Adults age 19 and older.

Goals

Activities

Abstract

The Real Choice project will address a number of problems Arkansas experiences in delivering long-term care services. Relevant agencies have come together with consumer groups and other public and private partners to plan for systems change that will promote informed consumer choice and higher quality services. The project will address issues related to access, availability, quality, value, and consumer participation.

The Real Choice Grant for Arkansas will address the need for a single point of contact for home and community based care, timely and flexible eligibility determination, ease of access to services, and appropriate determination of services people want and need. Strategies we intend to employ are the use of federal options over more restrictive state options, a feasibility study to integrate Medicare and Medicaid services for seniors, training staff across divisions of the DHS to promote understanding of alternatives available, an education outreach program to community resource staff, development of new assessment tools to determine optional settings for people entering the system and those already institutionalized, a study to explore the options for providing insurance to front line workers, a public awareness campaign to elevate the status of such occupations with the general public, development of a state worker registry, and strengthening of individual consumers and consumer advocacy groups in effective action at the law and policy-making levels.

Significant and sustainable outcomes will include a system that encourages greater consumer control and choice and services that will enable people to enjoy improved overall health and long-term care in their communities for a longer period.

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Real Choice Systems Change

DELAWARE

Grant Information

Name of Grantee
Delaware Health and Social Services
Title of Grant
Assistive Technology Access: Infrastructure for Community Living
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,200,000
Year Original Funding Received
2001
Completed

Contact Information

Joseph B. Keyes, Ph.D.
Director, Professional Services
Division of Developmental Disabilities Services
Woodbrook Professional Center
1056 S. Governor's Avenue
Dover, DE 19904
302-744-9600
Joseph.Keyes@state.de.us

Subcontractor(s)

Delaware Assistive Technology Initiative
University of Delaware
Beth Mineo Mollica, Ph.D.
302-651-6836

Center for Disabilities Studies
University of Delaware
Jim Salt, Ph.D.
302-831-6735

Target Population(s)

People with one or more disabling conditions. A more specific subpopulation is individuals with a disability currently receiving services through various state agencies.

Goals

Activities

Abstract

AT often makes it possible for people with disabilities to move from institutional to community living arrangements or to continue to live in their own homes as their support and service needs change. Numerous studies and stakeholder polls reveal that Delaware residents with disabilities encounter barriers in their attempts to obtain the AT they need. With this project, the State of Delaware will strengthen its support infrastructure for people with disabilities by increasing access to AT devices and services. Doing so expands the options afforded to consumers—a central tenet of person-centered planning—and enables the service infrastructure in Delaware to become increasingly consumer responsive.

Building on several extensive planning processes undertaken in the past year (involving consumers, providers, state agencies, and advocates)—and using a groundbreaking initiative led by the Delaware Division of Developmental Disabilities Services as a model—a work group comprising key stakeholders developed a 3-year plan. Grant activities over the 3 years will lead to significant increases in awareness of the benefits of technology options; opportunities to explore technology options prior to making purchase decisions; provider sophistication in facilitating technology selection and use; consumer sophistication in selecting and using AT; the comprehensibility and comprehensiveness of policies impacting AT access; consumer and provider access to a range of supports that facilitate efficient and appropriate AT access; and accessibility of state information and services for people with disabilities.

The activities of this project will improve stakeholder awareness, knowledge, and skills relative to AT and to the infrastructure supporting technology exploration, acquisition, and use. These improvements will help ensure that AT will become a readily available component of community-based supports and services in the years following project completion.

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Real Choice Systems Change

FLORIDA

Grant Information

Name of Grantee
Florida Department of Management Services, Americans with Disabilities Act Working Group
Title of Grant
Real Choice Partnership Project
Type of Grant
Real Choice Systems Change
Amount of Grant
$2,000,000
Year Original Funding Received
2001
Completed

Contact Information

Lloyd J. Tribley, Program Director
4050 Esplanade Way, Suite 160
Tallahassee, FL 32399-0950
850-922-4103
lloyd.tribley@myflorida.com

Subcontractor(s)

Health Management Associates (Medicaid Waiver Analysis)

United Way of Palm Beach County—Model Community (Healthy Community) pilot site serving Palm Beach County (urban/rural mix)

Gulf Coast Jewish Family Services, Inc.—Model Community (Healthy Community) pilot sites (2) serving Hillsborough and Pinellas Counties (urban) and Pasco County (rural)

University of Florida, Shimberg Center for Affordable Housing—Affordable and Accessible Housing Demographic Research (a component of a comprehensive coalition-driven research agenda)

Target Population(s)

Children and adults of any age who have a disability or long-term illness, who currently rely on long-term support systems, and who may be at risk due to insufficient community supports and/or who may be inappropriately placed in a restrictive setting.

Individuals of any age residing in three regional pilot project sites who have a disability or long-term illness, and who are eligible for services or at risk of institutionalization.

Goals

Activities

Abstract

Florida's Real Choice Partnership Project is designed to implement improvements in community long-term support systems that will enable people of all ages with disabilities or long-term illnesses to live and participate in their communities. The project is organized around four primary goals or objectives: create operational linkages among the key state agency stakeholders and service providers; streamline the delivery of services to consumers by increasing access to providers and coordinating services covered under Medicaid Waiver Programs; create a comprehensive single point of contact/inquiry for people with disabilities and/or long-term illnesses, caregivers, and service providers to obtain information and links to state and local resources (Clearinghouse on Disability Information); and develop community support networks and resources to assist people with disabilities and long-term illnesses to live in an integrated community setting.

Note: This Compendium form was not reviewed by the Grantee prior to publication.

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Real Choice Systems Change

GUAM

Grant Information

Name of Grantee
Department of Public Health and Social Services, Division of Public Health
Title of Grant
Real Choice Program
Type of Grant
Real Choice Systems Change
Amount of Grant
$673,106
Year Original Funding Received
2001
Completed

Contact Information

PeterJohn D. Camacho, Director
671-735-7102
director@dphss.govguam.net

Alvin R. Berg
Real Choice Program Coordinator
Department of Public Health and Social Services
PO Box 2816
Hagatna, Guam 96932
671-735-7295
arberg@dphss.govguam.net

Subcontractor(s)

Department of Integrated Services for Individuals with Disabilities
The Guam Developmental Disabilities Council

Target Population(s)

Persons with disabilities and long-term illnesses.

Goal

Increase community inclusion for persons with disabilities through comprehensive community services planning and reform.

Activities

Abstract

The Guam Real Choice Program will address the challenges that the current service delivery of care system faces. The one most often-repeated concern is the fragmented nature of the system that provides services to persons with disabilities. There are a host of governmental and nongovernmental organizations that provide services for individuals with disabilities. These services are offered based on the respective agency's perception of what services may be needed and the resources it has available to provide those services. This agency-centered model is useful but often does not meet all the needs of the individual and the family. Another concern is that consumers may not have been involved in the planning and development stages prior to implementation of the service.

The Guam Real Choice Program, along with the major stakeholders in the services delivery arena including consumers, will develop a comprehensive system of services and supports that will be person-centered in all aspects. One important component of this endeavor will be to develop a system to accurately identify individuals with developmental disabilities. The island's Chief Executive, Legislators, and others can use this registry in developing related policies. Another focus area for the project is to develop an on-island training capacity to ensure a readily available pool of support resources for consumers. Additionally, it is also critical to develop a program that provides health care clinicians with the appropriate knowledge base to ensure a holistic continuum of care across the life cycle. It is critical that public awareness also be addressed to ensure successful community inclusion of persons with disabilities.

Note: This Compendium form was not reviewed by the Grantee prior to publication.

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Real Choice Systems Change

HAWAII

Grant Information

Name of Grantee
Department of Human Services (DHS)
Title of Grant
Hawaii Real Choices Partnership
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,350,000
Year Original Funding Received
2001
Completed

Contact Information

Aileen Hiramatsu
Division Administrator, DHS
Office of Youth Services
820 Mililani Street
Honolulu, HI 96813
808-587-5721
ahiramatsu@dhs.hawaii.gov

Rebecca Rude Ozaki, Ph.D.
Project Coordinator
Real Choices ACCESS
808-956-9376 (b)
808-956-7878 (f)
rozaki@hawaii.edu

http://www.RealChoices.org

Subcontractor(s)

University of Hawaii
Center on Disability Studies
Robert A. Stodden
808-956-9199

Target Population(s)

Persons of all ages with disabilities and those with long-term care needs that require supports to live meaningfully in their communities.

Goals

Activities

Abstract

The Hawaii Real Choices Partnership will involve all key stakeholder groups in developing, demonstrating, and institutionalizing one of the nation's first cross-agency Web-based SEP that will provide consumers with in-depth, up-to-date information on available community options, including those offered by private as well as public agencies.

This innovative virtual one-stop information system will employ the latest computer networking and Web technologies to provide the following consumer-friendly features: in-depth information about daily living issues and topics; smart E-forms; an interactive assessment process to help consumers identify services for which they are eligible; a unified database showing all long-term care services offered by the state, counties, and private organizations, with open slots listed according to geographical location; and a quality assurance component that will identify service gaps by tracking service requests and allow consumers to rate the services they receive.

To maximize consumer input into all aspects of the project and promote collaboration and coordination among all stakeholders, a collaborative systems improvement process, as demonstrated to be effective in numerous other systems change efforts, will be implemented. This process will be used to guide the activities of a Partnership Governing Council, which will have directive authority over the project and will establish work groups to address critical topics.

The council and work groups will be chaired by a consumer (coprincipal investigator for the project) and will have at least 51 percent consumer membership (consumer members will include primary consumers, family members or others concerned for their well-being, and representatives of consumer and family organizations). Other council members will include the heads of the public and private service-providing agencies, including the DHS Director serving as principal investigator, heads of four DHS divisions, two Department of Health divisions, and the Executive Office on Aging.

The overall objective of the Hawaii ACCESS Project is to design and implement effective and enduring improvements in community long-term support systems for all children and adults with disabilities or long-term illness, reflecting increased access to information, choice, and quality services and supports consistent with their community living preferences and priorities.

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Real Choice Systems Change

IDAHO

Grant Information

Name of Grantee
Department of Health and Welfare, Division of Family and Community Services, Idaho State University Institute of Rural Health
Title of Grant
Real Choices
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,102,148
Year Original Funding Received
2001
Completed

Contact Information

Beth Hudnall Stamm, Ph.D.
Principal Investigator
208-282-4436
bhstamm@isu.edu

Dan Wolfley
Institute of Rural Health
Idaho State University Boise Center
Campus Box 8174
Pocatello, ID 83209
208-282-4436
dwolfley@isu.edu

Cameron Gilliland
Planner/Contract Monitor
Idaho Department of Health and Welfare
Division of Family and Community Services
450 W. State Street, 5th Floor; PO Box 83720
Boise, ID 83720
208-334-5700
gillilac@idhw.state.id.us

http://www.isu.edu/irh

Subcontractor(s)

Idaho State University Institute of Rural Health
Dr. Beth Stamm
208-282-4074

Target Population(s)

All people with disabilities and long-term illness.

Goals

Activities

Abstract

This project will create enduring systems change in two phases: Phase 1—a statewide anti-stigma campaign and a needs and resources assessment, culminating in a plan for change; and Phase 2—an effectiveness study to test and refine the plan. There are four objectives: increase access in all forms, increase availability and adequacy of services, increase (or maintain) the value of services across the system, and increase (or maintain) the quality of services across the system.

The objectives will be achieved by an anti-stigma campaign that will pave the way for more successful community integration. A statewide assessment of needs and resources will establish a baseline of needs and resources. An economic analysis of the current system, including the Medicaid program, will seek to maximize appropriate funding strategies and leverage available funds. A community development project to examine the political and fiscal feasibility of addressing inadequate access to resources will approach this as a community development problem, not a health care problem, and an effectiveness study will determine the quality and value of the project. The final product will be a plan for statewide implementation, to obtain consumer and stakeholder input, and a monitoring system for continuous quality improvement.

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Real Choice Systems Change

ILLINOIS

Grant Information

Name of Grantee
Illinois Department of Human Services
Title of Grant
Illinois Systems Change Project
Type of Grant
Real Choice Systems Change
Amount of Grant
$800,000
Year Original Funding Received
2001
Completed

Contact Information

Audrey McCrimon
Assistant to the Secretary (of IDHS)
Office of Compliance Access and Workplace Safety
312-793-1573
312-793-2354 (TTY)
dhse020@dhs.state.il.us

Martha Younger-White
Grant Coordinator
401 S. Clinton, 4th Floor
Chicago, IL 60607
312-793-1565
312-793-3597 (TTY)
dhse021@dhs.state.il.us

Krista Culbertson
Assistant Grant Coordinator
217-557-5564 (TTY)
425 S. 4th Street
Springfield, IL 62701
217-785-9008
dhse039@dhs.state.il.us

http://www.dhs.state.il.us/ircs (Olmstead Web site)

Subcontractor(s)

Southern Illinois Center for Independent Living
(Southern IL Grant Project—Fiscal Agent Program Agent and Project Coordinator)
2135 W. Ramada Lane
Carbondale, IL 62901

Northwestern Illinois Area Agency on Aging
(Rockford Grant Project—Fiscal Agent)
2576 Charles Street
Rockford, IL 61108-1605

Community Service Options, Inc.
(Home Ownership Project)
7575 S. Kostner Avenue
Chicago, IL 60652

Access Services Northern Illinois
(Rockford Grant Project—Program Agent)
7399 Forest Hills Road
Loves Park, IL 61111

NAMI member
(Rockford Grant Project—Project Coordinator)
4312 Alpine Court
Rockford, IL 61107

Illinois Statewide Independent Living Council
(Home Ownership Coalition Project)
122 South 4th Street
Springfield, IL 62701

University of Illinois at Chicago (Grant Evaluation)
Institute on Disability and Human Development
1640 W. Roosevelt Road (mc 626)
Chicago, IL 60608

Peer Success Center—Thresholds
(Serves persons with mental illness)
2700 North Lakeview Avenue
Chicago, IL 60614

Target Population(s)

People with physical disabilities, people with developmental disabilities, people with mental illness, and elderly people with all types of disabilities.

Goals

Activities

Abstract

This grant will enable the Illinois Department of Human Services to enhance the existing system of long-term supports and services by emphasizing a consumer-driven approach to community integration with the Systems Change Project. The grant project is targeted to 13 Southern Illinois counties of a largely rural and economically challenged area of the State, and Rockford, a medium-sized city near the northern border of the State.

The Systems Change Project will foster ongoing communication between the various state agencies and CSDAs and establish processes whereby the CSDAs use self-assessment to identify areas in need of change, inform all partners of the need for change, and modify procedures and policies on an ongoing basis. It will create more effective strategies for developing, locating, and maintaining affordable, accessible housing resources and assistive technology. The project will identify and develop tools for consumers and CSDAs to assist people who choose to move to successfully transition from institutional settings to appropriate community settings and will establish a framework for successful long-term community supports for people once they have transitioned.

Putting consumers at the center of all efforts to redesign systems and improve access to community-based living opportunities is key to Illinois' ability to sustain any advances achieved in this project. The outcome is a coordinated system of long-term support that is person centered and provides an array of services based on a persons' strengths, desires, and needs.

This project will lay the groundwork for an enhanced quality of life for individuals at risk of moving to, or currently living in, institutional settings. Its most significant outcome will be to enable individuals to remain in or return to the community. A Consumer Task Force will be involved in this project and has been since its inception. It is made up of people with different types of disabilities or parents of people with disabilities.

A number of partnering agencies will also be involved as part of a State Inter-Agency Team. They include IDHS' Divisions of Rehabilitation Services, Developmental Disabilities, Mental Health, and Alcoholism and Substance Abuse; and the Office of Child Care and Family Services (Homeless Services and Supportive Housing); the Illinois Department on Aging; the Illinois Housing Development Authority; and the Illinois Department of Healthcare and Family Services, the State's Medicaid funding authority. The Team will serve as the primary vehicle of coordination among and between the government partners, CSDAs, and consumers.

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Real Choice Systems Change

IOWA

Grant Information

Name of Grantee
Iowa Department of Human Services, Division of MH/DD
Title of Grant
Iowa's Real Choice Program
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,025,000
Year Original Funding Received
2001
Amount of Supplemental Grant
$360,000
Supplemental Award Received
]
2002
Completed

Contact Information

Jim Overland, Project Director
515-281-8908
joverla@dhs.state.ia.us

Lila P. M. Starr, Olmstead Coordinator and Adult Mental Health Specialist
Hoover State Office Building
1305 E. Walnut, 5th Floor
Des Moines, IA 50319-0114
515-281-7270
lstarr@dhs.state.ia.us

http://www.dhs.state.ia.us

Subcontractor(s)

Bob Bacon, Director
Center for Excellence on Disabilities
University of Iowa, Center for Disabilities and Development
Iowa City, IA

Target Population(s)

All individuals with disabilities, including persons with developmental and/or other disabilities, individuals with chronic mental illness, and people who are elderly—all at risk of institutionalization, but who could live in the community with appropriate supports.

Goals

Activities

Abstract

The grant will be used to develop and improve community support systems by establishing a flexible, consumer-centered, individual assessment process that will assist in preventing inappropriate institutionalization. The grant will also increase consumer choice and flexibility in Iowa's HCBS system by adding self-direction to all six of Iowa's waivers and contributing to the development of the infrastructure needed to implement it. Access to community services will be enhanced through improvements to Iowa's statewide information and referral system. Supporting all these efforts is implementation of an Executive Order from Iowa's Governor relating to Olmstead that calls upon all state agencies to identify and remove barriers to community living faced by Iowans with disabilities and their families.

The project will draw on the expertise and experiences of numerous state agencies, local governments and providers, consumers and their family members, and advocates of the disability system. The project is guided by the "Olmstead Real Choices Consumer Taskforce," which has been operational since June 2001 and has been involved in development of the original and amended grant applications. More than 50 percent of the membership is made up of people with disabilities who are also consumers of disability-related services or family members of adults and children with disabilities.

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Real Choice Systems Change

KENTUCKY

Grant Information

Name of Grantee
Kentucky Cabinet for Health and Family Services
Title of Grant
Real People: Real C.H.O.I.C.E.S—Citizen Monitoring, Housing Options and Investing in Creative Educational Solutions
Type of Grant
Real Choice Systems Change
Amount of Grant
$2,000,000
Year Original Funding Received
2001
Completed

Contact Information

Timothy Hawley, Ph.D.
Real Choices Project Manager
100 Fair Oaks Lane, 4E-D
Frankfort, KY 40621-0001
502-564-4448
timothy.hawley@ky.gov

Subcontractor(s)

Center for Accessible Living
Jan Day
502-589-6620

Council on Mental Retardation
April Duval
502-584-1239

ARC of Kentucky
Patty Dempsey
502-875-5225

University of Kentucky/IHDI
Kathy Sheperd-Jones
859-257-1714

Eastern Kentucky University/TRC
Elizabeth Wachtel
859-622-2262

Kentucky Housing Corporation
Natalie Hutcheson
502-564-7630

Target Population(s)

The general target population is individuals with disabilities. Each of the three major initiatives is targeting a specific population:

Goals

Activities

Abstract

The Citizen Monitoring Initiative has three components: (1) developing a protocol and training volunteer advocates, (2) recruiting and training two-person interview teams to solicit consumer satisfaction, and (3) engaging consumers and family members of services and supports to enhance current standard survey instruments.

The Housing and Nursing Home Transition Initiative (conducted by the Center for Accessible Living, a Center for Independent Living) will establish two pilot projects in an urban and rural site to assist individuals with disabilities making the transition from a nursing home or other institutional setting to the community. The initiative will support the development of protocols and resources necessary to make this transition. Additionally, two specific projects at the state level involving the state housing finance agency (Kentucky Housing Corporation) will support this local effort. Grant funds will be used to develop a "standard plans" publication incorporating universal design principles, as well as to provide home modification funds to qualified individuals with disabilities through an existing program (the Kentucky Assistive Technology Loan Fund).

The Workforce Initiative will develop a comprehensive credentialing system based on a common set of standards and training methods. This will be accomplished by hiring a full-time project director and the establishment of a consortium of institutions of higher education, persons with disabilities, and community service providers.

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Real Choice Systems Change

MAINE

Grant Information

Name of Grantee
Maine Department of Health and Human Services, Office of MaineCare Services, Bureau of Medical Services
Title of Grant
Quality Choices for Maine
Type of Grant
Real Choice Systems Change
Amount of Grant
$2,300,000
Year Original Funding Received
2001
Completed

Contact Information

Christine Zukas-Lessard
Deputy Director
Office of MaineCare Services, Department of Health and Human Services
11 State House Station
Augusta, ME 04333
207-287-3828
chris.zukas-lessard@maine.gov

Subcontractor(s)

Danny Westcott
Institute for Health Policy 800-800-4876
Muskie School of Public Service
University of Southern Maine
207-228-8083
westcott@usm.maine.edu

http://www.mainerealchoices.org

Target Population(s)

Generally, no specific target population. Some demonstrations will target specific populations, as yet undetermined. One project (evaluating wraparound services provided in schools) targets children with serious emotional disabilities.

Goals

Activities

Abstract

Maine has already developed a good community services system with a wide array of community living supports. This grant project, Quality Choices for Maine, seeks to take this system to the next level where consumers have more choice and control; community-relevant quality management structures are built into Maine's community-based living options and incorporate consumer perspectives; identified gaps are addressed (access to information, direct care workers, housing, transportation, and recreation); and integrated interdepartmental data support interdepartmental collaboration.

The grant's focus is largely interdepartmental. It will be used to develop consistency across programs and the infrastructure for supporting a shared interdepartmental vision for serving persons with disabilities, as well as to address access barriers common to multiple population groups.

Quality Choices for Maine directly responds to and continues the work performed under Maine's Olmstead initiative, which has been a collaborative process involving representatives from four departments (Health and Human Services Behavioral and Developmental Services, Education, Labor, and Corrections) and a broad cross-section of consumer representatives.

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Real Choice Systems Change

MARYLAND

Grant Information

Name of Grantee
Department of Mental Health and Hygiene
Title of Grant
Increasing Access, Service Availability, and Quality in Maryland's Long-Term Care System
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,025,000
Year Original Funding Received
2001
Amount of Supplemental Grant
$360,000
Supplemental Award Received
2002
Expected Completion Date
June 2006

Contact Information

Mark Leeds, Director
410-767-6770
leedsm@dhmh.state.md.us

Lisa Kelemen, Administrator
201 W. Preston Street, Room 122-F
Baltimore, MD 21201
410-767-5095
kelemenl@dhmh.state.md.us

Subcontractor(s)

Mental Hygiene Administration; University of Baltimore Schaefer Center for Public Policy; University of Maryland, Baltimore County; and several local health departments

Target Population(s)

People of all ages with disabilities. One grant initiative is designed specifically for children with serious emotional disturbances.

Goals

Activities

Abstract

The Real Choice Systems Change Grant will build on Maryland's commitment to providing home and community based services to individuals in the community. The funding will enable Maryland to address a number of issues in delivering long-term care services. Maryland has an active Consumer Advisory Board (CAB), which convenes regularly, that was built on the consumer workgroup established to develop the Real Choice Systems Change Grant initiatives in summer 2001. The CAB will offer advice and recommendations in the process of the implementation of the grant initiatives. The CAB will work collaboratively with Maryland's Nursing Facility Transition Grant.

The grant includes four initiatives:

  1. Implementation of a pilot project to provide outreach and information to persons of all ages with disabilities in acute care hospitals to ensure that they have comprehensive information about community-based long-term care options and how to access them, particularly when planning for discharge from acute care settings. This initiative has also expanded to include outreach and information to discharge planning professionals. Additionally, a continuing education unit course for discharge planners was developed based on lessons learned from hospital outreach activities.
  2. Focus on implementing activities designed to attract and retain long-term care direct care workers and mitigate the long-term care worker shortage.
  3. Development and implementation of a managed care demonstration program to provide coordinated long-term care services to children with SED who would otherwise likely "fall through the system cracks" and languish in long-term care facilities or psychiatric hospitals. Development and implementation oversight would be grant-funded. Services would be state-funded.
  4. Development of quality indicators for long-term care services, a comprehensive satisfaction survey, and survey approach to be administered to home and community waiver participants and establishment of a quality measurement and improvement process that would be maintained after the grant period concludes.

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Real Choice Systems Change

MASSACHUSETTS

Grant Information

Name of Grantee
Center for Health Policy and Research, University of Massachusetts Medical School
Title of Grant
Massachusetts Real Choice Systems Change: Enhancing Community Based Services
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,025,000
Year Original Funding Received
2001
Amount of Supplemental Grant
$360,000
Supplemental Award Received
2002
Expected Completion Date
September 2006

Contact Information

Dee O'Connor, Director
Long-Term Care Unit
508-856-8148
darlene.oconnor@umassmed.edu

Erin Barrett
Real Choice Project Director
Center for Health Policy and Research
222 Maple Avenue, Higgins Building
Shrewsbury, MA 01545
508-856-8496
erin.barrett@umassmed.edu

http://www.massrealchoices.org

Subcontractor(s)

Southeast Center for Independent Living (Support Brokerage Support in Pilot Project)
Elder Services of Worcester Area (Support Brokerage Support in Pilot Project)
Stavros Center for Independent Living (Fiscal Intermediary Support in Pilot Project)
Consumer Quality Initiatives, Inc. (Consumer-Driven Evaluation)

Target Population(s)

Adults with diverse disabilities and long-term illnesses not served by the current PCA program.

Goals

Activities

Abstract

Coordinated by the UMASS Medical School Center for Health Policy and Research (UMMS/CHPR), the Real Choice Grant is designed to enhance the quality and accessibility of the present array of home and community based long-term supports available to individuals of all ages with disabilities and long-term illnesses.

The grant is in the second and third phases of a three-phased approach. The first phase was to examine five project areas: assessment, information infrastructure, service coordination, education on disability issues, and consumer-defined quality. The second phase is to implement a pilot project designed by a collaborative group of state and consumer representatives. The third phase is to evaluate the process and the results of the pilot, and to provide recommendations for next steps.

The primary goal of the pilot project, created by the Real Choice Collaborative Team in collaboration with the Real Choice Consumer Planning and Implementation Group and State partners, is to increase the quality of life and independence of participants (adults diverse in disability and age) through flexible funding. UMMS/CHPR is currently administering the pilot on behalf of state and consumer partners through two support brokerage subcontracts and one fiscal intermediary subcontract.

A review committee of state and consumer partners rated and recommended subcontractors to UMMS/CHPR through an open Request for Proposals process. The pilot began in the spring of 2005 and will be evaluated by UMASS/CHPR in collaboration with Consumer-Quality Initiatives, Inc., a consumer-driven mental health participatory action research organization.

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Real Choice Systems Change

MICHIGAN

Grant Information

Name of Grantee
Department of Community Health, Office of Consumer-Directed Home and Community-Based Services
Title of Grant
Michigan's Real Choice Systems Change Grant
Type of Grant
Real Choice Systems Change
Amount of Grant
$2,000,000
Year Original Funding Received
2001
Expected Completion Date
March 2006

Contact Information

Michael Daeschlein, Project Coordinator
Michigan Department of Community Health
Baker Olin West, Room 217
3423 N. Martin Luther King Boulevard
PO Box 30195
Lansing, MI 48909
517-335-5106
daeschleinm@michigan.gov

Subcontractor(s)

Michigan Disability Rights Coalition (for work within the Quality Initiative)
University of Michigan Institute on Gerontology (Quality Initiative)
DYNS Services (Quality Initiative)
Center for Outcome Analysis (Quality Initiative)
Michigan Quality Community Care Council
Lifeways Community Mental Health Service Provider (Michigan Cooperative)

Target Population(s)

The first two initiatives target the general long-term care (LTC) population: working-age adults with disabilities and elderly adults. The Consumer Cooperative Initiative targets individuals with developmental disabilities or mental illness within a pilot community.

Goals

The grant has three distinct components: the LTC Outcomes and Evaluation Systems (OES) Initiative, the Virtual Organization Initiative, and the Consumer Cooperative Initiative.

Activities

Abstract

The grant proposal builds upon Michigan's plan for developing an integrated LTC system. The LTC Outcomes and Evaluation System Initiative seeks to strengthen our quality assurance and improvement systems by expanding the roles of consumers and family members in system design, implementation, and evaluation; developing outcomes and quality indicators for the continuum of services; developing effective methods for assessing consumer satisfaction; and supporting quality improvement initiatives in local agencies.

The Quality Community Care Council is an Internet-based registry for direct care workers. Its purpose is to improve consumer access to qualified direct care workers within Michigan's program for personal care services. The registry will provide support services and training for direct care workers.

The Consumer Cooperative Initiative will develop a model in which consumers and family members will collectively assume responsibility for their outcomes and take control of the resources needed to achieve them. The Co-op will allow members to design and obtain the services they prefer with more creativity, responsiveness, and cost effectiveness. This model offers an exciting advancement in systems changes in support of consumer-directed services.

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Real Choice Systems Change

MINNESOTA

Grant Information

Name of Grantee
Department of Human Services (DHS), Continuing Care for Persons with Disabilities
Title of Grant
Pathways to Choice: Minnesota's System Change Initiative Grant
Type of Grant
Real Choice Systems Change
Amount of Grant
$2,300,000
Year Original Funding Received
2001
Completed

Contact Information

Karen Langenfeld, Project Team Leader
651-431-2399
karen.langenfeld@state.mn.us

Lesli Kerkhoff, Project Consultant
Minnesota Department of Human Services
Disability Services Division
PO Box 64967
St. Paul, MN 55164-0967
651-431-2396
lesli.kerkhoff@state.mn.us

Subcontractor(s)

Metropolitan Center for Independent Living (MCIL)
David Hancox (contact)
1600 University Avenue, Suite 16
St. Paul, MN 55104-3825
651-646-8342 (voice)
651-603-2201 (TTY)
651-603-2006 (fax)
davidh@mcil-mn.org

Southeastern Minnesota Center for Independent Living (SEMCIL)
Vicki Dalle Molle (contact)
2720 North Broadway
Rochester, MN 55906
507-285-1815 (voice/TTY)
507-288-8070 (fax)
vickidm@semcil.org

Target Population(s)

People with disabilities and chronic illnesses of all ages who are underserved such as people from communities of color, people who are low income, people with severe disabilities, and people from tribal nations.

Goals

Activities

Abstract

Minnesota intends to create an exemplary delivery system of services for people of all ages with disabilities or long-term illnesses. The State has a comprehensive set of traditional, prescriptive services, and in recent years has built a partial patchwork of consumer-centered service options. To transform Minnesota's services array into a replication model for other states, a fundamental change in thinking is needed. Minnesota proposes a strategy that uses new sources of leadership, new forms of service organizations, and new methods of training to instill a consumer-centered philosophy throughout the system network. The strategy includes

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Real Choice Systems Change

MISSOURI

Grant Information

Name of Grantee
Department of Social Services
Title of Grant
Flexible Choices for Independence
Type of Grant
Real Choice Systems Change
Amount of Grant
$2,000,000
Year Original Funding Received
2001
Completed

Contact Information

Sherl Taylor, Medicaid Manager
Division of Medical Services
615 Howerton Court, PO Box 6500
Jefferson City, MO 65102-6500
573-751-9290
sherl.taylor@dss.mo.gov

Subcontractor(s)

University of Missouri-Kansas City
Dr. Christine Rinck
816-235-1760

Target Population(s)

Consumers of all ages who have a disability or long-term illness.

Goals

Activities

Abstract

The objective of Flexible Choices for Independence is to enhance the lives of people with a disability or long-term illness through systems change to allow them to live in the most integrated community setting, exercise meaningful choices about their lives, and obtain quality services. The outcome of the activities of this grant will be that people with a disability or long-term illness will have a significant voice in choices about their life and be able to shape the services that they receive. In addition, services will be more consumer-driven and better serve people with a disability or long-term illness.

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Real Choice Systems Change

NEBRASKA

Grant Information

Name of Grantee
Nebraska Department of Health and Human Services Finance and Support
Title of Grant
Real Choice for Nebraskans
Type of Grant
Real Choice Systems Change
Amount of Grant
$2,000,000
Year Original Funding Received
2001
Completed

Contact Information

Mary Jo Iwan, Deputy Administrator
402-471-9345
maryjo.iwan@hhss.state.ne.us

Joni Thomas
System Change Grants Coordinator
Office of Aging and Disability
301 Centennial Mall S, 5th Floor
PO Box 95044
Lincoln, NE 68509-504
402-471-1764
joni.thomas@hhss.state.ne.us

Subcontractor(s)

University of Nebraska
Public Policy Center
Nancy Shank, M.B.A.
402-472-5687

University of Nebraska Medical Center
Munroe Meyer Institute
Barbara Jackson, Ph.D.
402-559-5765

Target Population(s)

Children and adults of all ages with physical disabilities, developmental disabilities, or behavioral health problems.

Goals

Activities

Abstract

Nebraska's current service delivery system comprises programs that provide services and supports through consumer-directed, as well as state-directed, philosophies, and variations in between. Many of these programs operate in isolation from one another, even though consumers often need services across programs. Consumers and policymakers have become aware of, and are advocating for, systemwide adoption of a consumer-directed philosophy.

Nebraska is struggling with the challenge of moving from an inspection and certification-based philosophy to one that gives consumers more responsibility in monitoring and quality assurance. In the realm of consumer-directed services, the state's process of identifying, approving, and monitoring providers must be revisited to ensure that consumers have real choices, are provided with full disclosure, and are provided necessary safeguards. For consumers to have real choices, consumers need to have easy, consistent, and timely access to information on available programs, resources, and services.

Nebraska proposes to implement a consumer-directed philosophy across populations—children and adults of all ages with physical disabilities, developmental disabilities, or behavioral health problems—with consumer choice and risk defined and incorporated into services, delivery, regulations, quality assurance, and practices. Consumers, agency, and program staff, will collaborate to design and implement effective and enduring improvements in a culturally competent community long-term service and support system. They will also collaborate to identify quality measures and to design and implement a sustainable quality management system to monitor the efficiency of services in achieving the client outcomes desired and the delivery of services in a manner that meets consumers' expectations and preferences.

Consumers, services coordinators, providers, and other stakeholders participating in long-term support systems will have needed information about services and supports at the right time to effectively make informed choices regarding services that are appropriate, effective, and user responsive through improved access to long-term support systems.

Through consumer role enhancement, skill building, training, and support, consumers will have the necessary skills, knowledge, and supports to successfully live in the most integrated community settings chosen; exercise meaningful choices; and obtain quality services.

Services coordinators across programs will embrace a consumer-directed philosophy and have the necessary knowledge and skills to effectively support consumers, exercising meaningful choices in obtaining quality services through services coordination role redefinition, skill building, training, and support.

Note: This Compendium form was not reviewed by the Grantee prior to publication.

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Real Choice Systems Change

NEW HAMPSHIRE

Grant Information

Name of Grantee
Department of Health and Human Services
Title of Grant
Facilitating Lifespan Excellence (FLEX)
Type of Grant
Real Choice Systems Change
Amount of Grant
$2,300,000
Year Original Funding Received
2001
Completed

Contact Information

Susan Fox
Project Director
Institute on Disability
10 Ferry Street, Unit 14
Concord, NH 03301
603-228-2084
swfox@cisunix.unh.edu

Subcontractor(s)

University of New Hampshire Institute on Disability
Mary Schuh
603-228-2084

Institute on Health Law and Ethics Franklin Pierce Law Center
Michelle Winchester
603-228-1963

Town of Littleton
Jason Hoch
603-444-3996

Mentorship, Inc.
Robin Daning
603-226-4470

Granite State Monarchs
Wayne Husted
603-352-5093

Target Population(s)

Older adults and persons with disabilities.

Goals

Activities

Abstract

Governor Jeanne Shaheen, with support and leadership from the New Hampshire Department of Health and Human Services, Granite State Independent Living, the University of New Hampshire Institute on Disability, Franklin Pierce Law Center, numerous consumer groups, and other stakeholders, proposes to "improve health and long-term care service systems and supports for people with disabilities and long-term illness to live in the community."

This proposal, developed collaboratively by the disability and aging communities, is designed to create and implement improvements in community long-term care systems. Several specific projects are proposed, each of which is designed to fill an identified gap or weakness in the current infrastructure of long-term supports. These projects will then be implemented in one model community or region that will serve as a laboratory for change.

In addition, we will develop a policy center to review all laws and regulations that create barriers to full community integration and to make recommendations for change. The Policy Center will also provide education and training to the public, legislators, providers, and advocates. The project will be led by a consumer advisory council that has broad cross-disability representation across all age spans.

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Real Choice Systems Change

NEW JERSEY

Grant Information

Name of Grantee
New Jersey Department of Human Services
Title of Grant
New Jersey Real Choice Systems Change Project
Type of Grant
Real Choice Systems Change
Amount of Grant
$2,000,000
Year Original Funding Received
2001
Expected Completion Date
March 2006

Contact Information

William A. B. Ditto, Director
Project Director
609-292-7800
William.Ditto@dhs.state.nj.us

Edward Heaton, Project Manager
NJ Division of Disability Services
222 South Warren Street, PO Box 700
Trenton, NJ 08625-0700
609-984-1639
Edward.Heaton@dhs.state.nj.us

http://www.state.nj.us/humanservices/dds

Subcontractor(s)

Boggs Center UCE, University of Medicine & Dentistry of NJ
Rutgers Center for State Health Policy
NJ Department of Health & Senior Services
NJ Housing Mortgage Finance Agency
Rewarding Work Resources Inc.

Target Population(s)

Multiple populations of persons with disabilities, including elderly persons, persons with developmental disabilities, persons with serious mental illness, children with disabilities, and persons with adult-onset disabilities. Residents at the State's developmental centers, psychiatric hospitals, and nursing facilities are the initial priority populations as we redesign and enhance our long-term care system to increase community options.

Goals

Activities

Abstract

New Jersey's Real Choice Systems Change Grant is designed to make enduring changes in our system of long-term care for people of all ages with a wide variety of disabling conditions. Through a series of pilot programs and contracts, we have sought to address issues related to access, quality, adequacy, availability, and responsiveness of our system of community-based care. The grant activities build on current ongoing state efforts and seek to deal with gaps in services and areas of weakness identified by our Olmstead Stakeholder Task Force.

The Real Choice Systems Change Grant efforts are monitored and guided by a Systems Change Advisory Council composed of consumers, family members, and advocates, with government agency representatives serving as liaisons to the Council. This Council also serves as the advisory body for New Jersey's other Systems Change grants, including the Aging and Disability Resource Center Grant. Consumer involvement throughout the project has been critical and essential to its success.

The benefit of undertaking these grant-funded activities is an improved and effective system of long-term community supports and services that provides maximum flexibility and choice to persons with disabilities needing long-term care in New Jersey. Projects undertaken under the auspices of the grant include: (1) the New Jersey Housing Resource Center Web site, currently averaging 2,800 site users per day with 1,104 apartments rented since inception; (2) the customized New Jersey version of Rewarding Work, a direct care worker recruitment program used by 62 employers with over 2,000 workers applying for work since inception; (3) Promoting Consumer Direction in Aging Services: New Jersey, a report written in collaboration with the Department of Health and Senior Services, released to CMS at the end of May 2005; (4) a study comparing Adult Daycare Health Services (ADHS) in other states with New Jersey's ADHS services for persons with developmental disabilities; (5) the development of a Nurse Delegation Pilot, which currently involves meetings with insurers of home health providers in New Jersey to determine what concerns they have about nurse delegation in order to develop a protocol for the pilot; and (6) the creation of an independent assessment process for individuals in New Jersey's Developmental Centers, using a standardized assessment tool to gather information for a statewide database regarding consumers' abilities and needs, to facilitate a match with existing resources in the community.

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Real Choice Systems Change

NORTH CAROLINA

Grant Information

Name of Grantee
NC Department of Health and Human Services
Title of Grant
Direct Care Workforce Recruitment and Retention
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,600,000
Year Original Funding Received
2001
Completed

Contact Information

Jackie Sheppard, Assistant Secretary
919-733-4534
Jackie.sheppard@ncmail.net

Jan Moxley, Project Manager
NC Department of Health and Human Services
Office of Long-term Care
2001 Mail Service Center
Raleigh, NC 27699-2001
919-855-4429
Jan.Moxley@ncmail.net

Subcontractor(s)

Direct Care Workers Association of North Carolina
Janet McQueen
919-715-3952

North Carolina Board of Nursing
Polly Johnson
919-782-3211

McGlynn and Associates
Maggie McGlynn
919-968-7953

Target Population(s)

All populations needing home and community based services.

Goals

Activities

Abstract

Grant activities will focus on several major areas: reducing institutional bias, developing a career ladder for direct care workers; implementing public education and awareness efforts to promote recruitment and retention of direct care workers; and designing a consumer-directed care model and related accountability requirements, reimbursement policies, and policies covering fiscal intermediaries for clients.

Addressing direct care workforce issues will require a multipronged approach. Our project will develop competency-based training models (e.g., working with persons with complex medical needs, developmental disabilities, dementia, and other cognitive impairments; and developing skills in mentoring, supervision, effective communication, etc.). We will develop curricula and in-service and continuing education programs in support of core and specialized training (including supervisory training and mentoring) and develop appropriate training outlets, opportunities for Web-based training, etc.

To recruit and retain direct care workers, it is necessary to enhance the image of this workforce. We will implement a range of public education and awareness efforts to promote information about direct care worker opportunities (paid and volunteer) focused on home and community care. These efforts will include the development of promotional and training materials for use in high school allied health programs. We will also convene a Task Force of direct care staff to get input on recruitment, retention, and marketing efforts; develop public service announcements, video spots, feature articles, and flyers for use with the media, general public, high schools, Hispanic and nontraditional populations, disabled populations, Job Corps, etc.; and participate in job fairs to address the image and importance of this workforce. Additionally, we will promote the development of a direct care worker association in the State and help the association to transition to a freestanding organization by the end of the grant. We will also compile and disseminate information about innovative strategies being used to address recruiting and retaining direct care workers.

We will collect and analyze data about the direct care workforce that will inform our efforts to recruit and retain workers.

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Real Choice Systems Change

OREGON

Grant Information

Name of Grantee
Oregon Department of Human Services
Title of Grant
Advancing Consumer Direction Through Enhanced Infrastructure
Type of Grant
Real Choice Systems Change
Amount of Grant
$2,000,996
Year Original Funding Received
2001
Expected Completion Date
March 2006

Contact Information

Michael Hlebechuk
Residential Supports Coordinator
500 Summer Street NE, E-86
Salem, OR 97301-1118
503-947-5536
Michael.Hlebechuk@state.or.us

Karl Reer
Residential Supports Coordinator
503-947-5540
Karl.V.Reer@state.or.us

Subcontractor(s)

Oregon Technical Assistance Corporation—Person-Centered Planning Pilot Projects; Empowerment Initiatives Mental Health Brokerage

Oregon Health & Sciences University, Center for Self Determination, Technical Assistance to Pilot Brokerage Project, and Consumer-Run Drop-In Center Survey

Target Population(s)

Adults and children with disabilities, with a particular focus on persons with psychiatric disabilities for several initiatives (e.g., person-centered planning, development of a pilot brokerage, increasing residential capacity).

Goals

Activities

Abstract

The Advancing Consumer Direction Through Enhanced Infrastructure grant is intended to refocus and reorient people with disabilities and the workforce towards the outcome of maximizing consumer self-determination. A grant coordinator and two housing staff will coordinate the efforts of four main work groups composed of consumers, family representatives, stakeholders, and agency staff in implementing 24 specific goals identified in the grant.

The grant will pilot a consumer-run brokerage in one Oregon county and assist in the development and strengthening of drop-in centers demonstrating new models of consumer-directed choice. Cross-disability and cross-discipline events and conferences conducted during the grant period will foster new partnerships and service integration. Many educational and training activities are planned to change service provider culture across the range of services to adopt consumer-directed approaches, to enhance the skills of the personal assistance workforce, and to increase the number of nurses trained to support persons with disabilities living in the community.

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Real Choice Systems Change

SOUTH CAROLINA

Grant Information

Name of Grantee
Department of Health and Human Services (transferred to Lieutenant Governor's Office on Aging July 2004)
Title of Grant
Options for Community Living
Type of Grant
Real Choice Systems Change
Amount of Grant
$2,300,000
Year Original Funding Received
2001
Completed

Contact Information

Barbara S. Kelley, Deputy Director
Lieutenant Governor's Office on Aging
1301 Gervais Street, Suite 200
Columbia, SC 29201
803-734-9899
kelleyb@aging.sc.gov

Roy Smith, Director
Community Long-Term Care Waiver Management
SC Department of Health and Human Services
PO Box 8206
Columbia, SC 29202-8206
803-898-2590
smithroy@dhhs.state.sc.us

Subcontractor(s)

Kathy Mayfield-Smith
University of South Carolina
School of Medicine (2001-2004)

Carol Cornman
University of South Carolina
School of Public Health
803-777-5337

Target Population(s)

SC Access targets persons of all ages with a disability or long-term illness, their families, and caregivers. SC Choice targets elderly and disabled Home and Community Based waiver beneficiaries (i.e., seniors and working-age adults with physical disabilities), adults with mental illness, and children with severe emotional disabilities in two geographic regions of the State.

Goals

Activities

Abstract

The SC Department of Health and Human Services (SCDHHS) and the Lieutenant Governor's Office on Aging are partnering with the SC Department of Mental Health and the Continuum of Care for Children to develop a project known as Options for Community Living.

There are two components under the Options for Community Living grant: SC Access and SC Choice. SC Access developed, implemented, and will maintain a database of comprehensive information and assistance services for persons of any age with a disability, long-term illness or need. SC Access is housed at the Lieutenant Governor's Office on Aging and is available online (at http://www.scaccesshelp.org) in real time at local, regional, and state levels to agencies and organizations serving persons with disabilities, including the Aging Network, Medicaid waiver programs, disability agencies, and consumer and advocacy groups.

SC Choice will create the infrastructure to support more consumer-directed services, including the development of support coordination, fiscal intermediaries, and the use of cash equivalencies. This program has been piloted in two areas of the State, across disability groups, and will enable the consumer, in consultation with a care advisor, to perform many of the duties currently performed by a case manager.

State and local advisory committees have assisted with the design and implementation of SC Access and SC Choice, including the development of consumer satisfaction measures.

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Real Choice Systems Change

TENNESSEE

Grant Information

Name of Grantee
Department of Mental Health & Developmental Disabilities
Title of Grant
Housing within Reach
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,768,604
Year Original Funding Received
2001
Expected Completion Date
March 2006

Contact Information

Gregory Fisher, CMSW
Project Director
Real Choice Systems Change Grant
615-532-4651
Gregory.Fisher@state.tn.us

David Sherman
Administrative Assistant
Tennessee Department of Mental Health and Developmental Disabilities
Office of Housing, Planning and Development
3rd Floor, Cordell Hull Building
425 5th Avenue, N
Nashville, TN 37243
615-532-6746
David.Sherman@state.tn.us

Subcontractor(s)

Foundations Associate
Michael Cartwright
615-256-9002

Target Population(s)

Individuals with mental illness who are currently in need of permanent, safe, affordable, quality housing and support service options.

Goals

Activities

Abstract

This project will make a long-term change in housing and support services access for people diagnosed with serious and persistent mental illness. All too often these individuals are ostracized, stigmatized, and left to fend for themselves—unwelcome within the communities in which they live. Key project goals include designing and implementing a more effective, consumer-directed, and accessible housing resource system for people with mental illness; increasing the number of persons in quality, affordable housing; and reducing the stigma of mental illness statewide.

Project goals will be addressed through multifaceted activities, including employment of four consumer housing specialists in targeted communities; the development of a housing resource Web site accessible throughout the State; hardware strategically installed at key community drop-in centers to promote access to the Web site; facilitation of an annual week-long housing academy and biannual housing summits; formation of a statewide housing hotline; development of a high-quality anti-stigma mass media campaign; and a research initiative to evaluate efforts of meeting the needs of consumers as they transition to community-based housing and supports.

These activities will result in an enduring change to the state's current mental health housing system by increasing the availability and accessibility of housing resources for consumers and providers, increasing consumer involvement in housing development and their choice in housing decisions, increasing opportunities to live in the most integrated and preferred community setting, and changing community attitudes to decrease stigma and create a more welcoming environment. The grant funds will be supplemented by additional in-kind funding of over $400,000. This modest investment will produce a sustainable change in available community supports that enable individuals with mental illness to live and participate fully in their communities.

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Real Choice Systems Change

VERMONT

Grant Information

Name of Grantee
Agency for Human Services
Title of Grant
Vermont Real Choice Systems Change Grant
Type of Grant
Real Choice Systems Change
Amount of Grant
$2,000,000
Year Original Funding Received
2001
Completed

Contact Information

Ms. Joan Haslett, Project Director
Department of Disabilities, Aging and Independent Living
103 South Main Street
Waterbury, VT 05671-1601
802-241-4529
joan.haslett@dail.state.vt.us

Subcontractor(s)

Information and Assistance—Flint Springs Consulting
Para Professional Caregiver Association—Community of Vermont Elders (COVE)
Workforce Council—COPE Associates

Target Population(s)

Elders (age 60 and over), younger persons with physical disabilities, adults with mental illness, and adults with developmental disabilities.

Goals

Activities

Abstract

Vermont's Department of Aging and Independent Living, the Division of Developmental Disabilities, and the Division of Mental Health will work collaboratively to increase community integration, real choice and control for elders, younger adults with physical disabilities, people with developmental disabilities and their families, and adults with severe mental illness.

The three systems that are partners in this project have evolved separately and differ in the amount of community integration, choice, and control offered to the populations they serve. Consumers continue to experience lack of choice and control over their service options.

The goals of the project are to effect enduring systems changes that

The project objectives are to

To address the identified problems, the project will undertake activities to

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Real Choice Systems Change

VIRGINIA

Grant Information

Name of Grantee
Department of Medical Assistance Services, Long-term Care & Quality Assurance
Title of Grant
Consumer Choices for Independence
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,025,000
Year Original Funding Received
2001
Amount of Supplemental Grant
$360,000
Supplemental Award Received
2002
Completed

Contact Information

Diana Thorpe, Project Director
804-371-8490
diana.thorpe@dmas.virginia.gov

Teja Stokes
600 E. Broad Street, Suite 1300
Richmond, VA 23219
teja.stokes@dmas.virginia.gov

Subcontractor(s)

Virginia Partnership for People with Disabilities
Dr. Fred Orelove, Director
804-828-3908

Virginia Tech Center for Gerontology
Dr. Karen Roberto, Director
540-231-7657

Virginia Geriatric Education Center
Dr. Elizabeth Welleford, Director
804-828-1565

Target Population(s)

Beneficiaries of Virginia's Home and Community Based Services (HCBS) waivers and their families and caregivers.

Goals

Ensure that individuals and their families and caregivers may realize full and meaningful participation, choice, and control of needed supports through Virginia's Medicaid waivers by

Activities

Abstract

Virginians of all ages with disabilities and long-term illnesses have, in multiple forums, related their hopes and dreams to become active participants in communities and to exercise greater choice and control over the decisions that have an impact on their lives. When the Consumer Task Force met to discuss an application for a Real Choice Systems Change Grant, waiver consumers once again stated their desire to (1) have supports available to live, work, go to school, play, and grow old in their own neighborhoods and (2) be instrumental in the design of those supports. The Department of Medical Assistance Services (DMAS), in coordination with a Consumer Task Force and a wide range of agencies and organizations, developed the grant application to create enduring and effective improvements to HCBS in Virginia.

Successful project implementation will lead to increased ease of access to services available through waivers; methods for informing consumers about choices and options for support; greater understanding and use of consumer-directed services; and increased consumer satisfaction with and quality of services.

DMAS will work with affected individuals and their caregivers and will partner with individuals within the disability community and with the Virginia Partnership for People with Disabilities at Virginia Commonwealth University, the Virginia Geriatric Education Center at Virginia Commonwealth University, Commonwealth Autism Services, and the Center for Gerontology at Virginia Tech to accomplish the above goals. The grant activities will be coordinated through a steering committee made up of state agencies and members of the advisory task force. A Consumer Task Force of individuals and their caregivers and providers will provide direction throughout the 3 years of the grant activities.

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Real Choice Systems Change

ALASKA

Grant Information

Name of Grantee
Department of Health and Social Services, Division of Mental Health and Developmental Disabilities
Title of Grant
Real Choice Systems Change Project for Community Living
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

David Maltman
Program Administrator
907-465-3370
David_Maltman@health.state.ak.us

Phillip Jones, Program Coordinator
PO Box 110620
Juneau, AK 99811-0620
phillip_jones@health.state.ak.us

Subcontractor(s)

To be determined.

Target Population(s)

Children and adults with developmental disabilities, children with complex medical conditions, adults with physical disabilities, and seniors in need of in-home and long-term care.

Goals

Activities

Abstract

This project will design and implement enduring improvements in Alaska's long-term care system for the target population that will result in better participation by recipients in planning and controlling the services they receive.

Particular attention will be paid to developing a consumer-driven care coordination system. The roles, performance, and training of care coordinators will be assessed and refined as needed. The project will design and implement reforms necessary to ensure coherent and timely access to needed services and supports. Reforms will be made to eligibility determination, plans of care, and billing procedures.

By linking a person's level of need, service mix, and costs, an individual budget can be developed and placed under the control of the recipient. Funds from the project will be used to pilot and evaluate this process for self-directed care

Note: This Compendium form was not reviewed by the Grantee prior to publication.

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Real Choice Systems Change

CALIFORNIA

Grant Information

Name of Grantee
California Department of Social Services
Title of Grant
IHSS Enhancement Initiative
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Eva Lopez, Chief
916-229-4582
eva.lopez@dss.ca.gov

Martha Bracha, Grant Coordinator
Adult Programs Branch
744 P Street, MS 19-96
Sacramento, CA 95814
916-229-4023
martha.bracha@dss.ca.gov

Subcontractor(s)

California State University, Sacramento
Institute for Social Research
6000 J Street
Sacramento, CA 95819
Carole Barnes, Director
916-278-5138
Sandie Sutherland, Project Specialist
916-278-5737

Target Population(s)

Approximately 300,000 Medicaid-eligible aged, blind, and disabled individuals in the In-Home Supportive Services (IHSS) program, as well as roughly 250,000 care providers.

Goals

Activities

Abstract

Although the vast majority of Medicaid consumers in the IHSS program recruit, hire, train, and supervise their own care providers, there is no statewide assistance or training available to support them in undertaking these potentially difficult responsibilities that are critical to service delivery.

To accomplish the project's goals, grant funds will be used to finance extensive needs assessments of IHSS consumers and providers. Based on those assessments, project staff will locate, obtain, or design training and educational materials, work aids, and other supportive resources. Grant funds will also be used to fund a diverse stakeholder taskforce that will routinely advise the State on the project.

The expected improvements enabled by grant funding will make the IHSS program more effective, with higher consumer satisfaction, greater provider participation and retention, and improved quality of care.

By January 2003, all California counties must, by law, have implemented an employer of record for employer/employee relations with IHSS providers including collective bargaining. As of January 1, 2003, almost all of California's 58 counties have established a Public Authority (PA) that, by law, must make consumer and worker training available. Counties and PAs will sustain the materials, work aids, and other products developed under this project. This assures that the grant-funded products of this project will be an enduring aspect of the IHSS program throughout the State. The products of this project would also be available to be shared with other states that have programs similar to IHSS.

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Real Choice Systems Change

COLORADO

Grant Information

Name of Grantee
Department of Health Care Policy and Financing
Title of Grant
Systems Change for Real Choices
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,120,147
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Viki Manley, Project Director
303-866-2991
Viki.Manley@state.co.us

Laura Hershey, Project Administrator
1570 Grant Street
Denver, CO 80203-1818
303-866-5309
Laura.Hershey@state.co.us

Subcontractor(s)

Kaia Gallagher, Ph.D.
The Center for Research Strategies, LLC
225 E. 16th Avenue, Suite 1150
Denver, CO 80203
303-860-1705

Sandra Rossi
17908 E. Bellewood
Aurora, CO 80015
303-548-8754

Colorado West Regional Mental Health Inc.
Cooper Corner Adult Day Center
Southeast Mental Health Services
Timberline Adult Day Services
Anne Stanwick

Target Population(s)

Persons of all ages with a disability or long-term illness.

Goals

Activities

Abstract

Colorado's overall objective is to improve and expand sustainable community-based support services to allow children and adults of any age who have a disability or long-term illness to live in the most integrated setting appropriate to their individual needs. In order to meet this goal effectively, Colorado will work in partnership with a consumer task force consisting of a diverse group of consumers, advocates, and service providers to implement all grant activities. The consumer task force will provide advice to agency staff and subcontractors on all project goals through monthly meetings of the full task force or meetings of one of four subgroups related to the four major goals of the project. We anticipate that the research and policy recommendations that follow from the project activities will build upon past and current efforts by the State to improve and expand community-based services and will inform future efforts by the State to meet this goal.

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Real Choice Systems Change

COMMONWEALTH OF NORTHERN MARIANA ISLANDS

Grant Information

Name of Grantee
Governor's Council on Developmental Disabilities
Title of Grant
Real Choice Systems Change
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Antonio Chong
Acting Executive Director
CNMI Council on Developmental Disabilities
PO Box 502565
Saipan, MP 96950-2565
670-664-7007
tchong@cnmiddcouncil.org

Gus Omar
PO Box 502565
Building 1210, Capital Hill
Saipan, MP 96950
670-664-7004
aomar@cmniddcouncil.org

Subcontractor(s)

CNMI Center for Independent Living
Northern Marianas College

Target Population(s)

Persons with developmental disabilities.

Goals

Activities

Abstract

The Governor's Council on Developmental Disabilities (GCDD) will conduct a needs assessment and develop or implement model programs for long-term care planning to facilitate community living. These programs will include assistive technology demonstrations, respite care and personal assistance services, nursing facilities, and assisted living and hospice programs. GCDD will conduct needs assessment surveys and provide recommendation for accessible transportation services supporting inclusive living, including school busing, taxicab and public transportation modifications, and voucher and financial support methods.

To address longer term needs, the Task Force believes it is necessary to develop personal assistance capacity among the local community. Capacity development will include development of an assistive care certificate curriculum that will target CNMI family caregivers and other local job seekers to fill longer-term demand.

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Real Choice Systems Change

CONNECTICUT

Grant Information

Name of Grantee
Connecticut Department of Social Services
Title of Grant
Real Choice Systems Change Grant
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

David Parrella, Medicaid Director
860-424-5116
david.parrella@po.state.ct.us

Michele Parsons, Project Director
25 Sigourney Street
Hartford, CT 06106-5033
860-424-5177
michele.parsons@po.state.ct.us

Subcontractor(s)

Center for Excellence in Developmental Mary Beth Bruder 860-679-1500
Disabilities, Education, Research & Services

Target Population(s)

Persons with disabilities of all ages living in communities in Connecticut.

Goals

Activities

Abstract

The Real Choice project will build the capacity within the State of Connecticut to support informed decision-making, independent living, and a meaningful quality of life for persons with disabilities across the lifespan. The project will (1) conduct a statewide assessment and (2) build capacity in three specific communities concurrently over a 3-year period.

First, the Real Choice project will conduct a statewide assessment of the 169 towns in the State to determine the level of inclusion available in those communities. This assessment will examine the extent to which persons with disabilities living in Connecticut are able to receive an inclusive education (including early intervention), participate in community life, seek and obtain employment and housing, and generally access the supports and services they need in a manner that enhances their fullest community participation and independence. We will produce a report summarizing the opportunities and barriers experienced by persons with disabilities and their families across the State and develop a resource inventory.

Second, we will select and build capacity through technical and financial assistance in three specific communities that are already demonstrating good progress in this area. The grant provides for $75,000 across these communities to be awarded in order to strengthen an already demonstrated commitment to community inclusion in all aspects of community life. We will do this by developing a task force in each community that includes consumers, families, and representatives of the public sector; the private sector; and the private, nonprofit sector. We will also assess areas of need in each selected community and develop a community action plan. Other methods of building capacity in each of the three target communities include facilitating expansion of the paraprofessional workforce; increasing the availability of affordable, accessible and safe housing; building collaborative partnerships that will assist with implementation; developing peer support networks; and providing targeted training to disseminate information and resources to community leaders and other community members.

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Real Choice Systems Change

DISTRICT OF COLUMBIA

Grant Information

Name of Grantee
Department of Health, Medical Assistance Administration
Title of Grant
DC Coordinating Community Care Options for Individuals who are Disabled or Aging (DC C3ODA)
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Robert Cosby, Project Director
Office on Disabilities and Aging
825 North Capitol Street NE
Suite 5135
Washington, DC 20002
202-442-5972
robert.cosby@dc.gov

Subcontractor(s)

To be determined by the RFP process.

Target Population(s)

Elderly and adults with physical disabilities, ages 18 to 64 years.

Goals

Activities

Abstract

The DC C3ODA project will address strategies for responding to the desires of the elderly and individuals with physical disabilities to live in and receive services in appropriate home and community-based settings. The project will focus on the development of the infrastructure to build a cost-effective HCBS system and address issues related to establishment of an Advisory Committee to ensure community and government participation in the decision-making process, information dissemination to consumers, streamlining the eligibility determination process, access to services and other publicly funded programs, and building capacity for access, adequacy, availability, appropriateness, and quality of services along the continuum of care.

The DC C3ODA program will develop a Resource Center that will serve as a single point of entry for accessing the long-term care system and provide consumers with the tools and supports to manage their care. The system will maximize the ability of HCBS to target individuals at high risk for institutionalization, empower individuals to make informed choices about their long-term care options, and channel those in need of long-term care services to the most effective and medically appropriate settings of their choice. The project will also establish a care coordination system that incorporates financial incentives for providers in order to increase flexibility, improve quality of life and care, and control costs.

Significant and sustainable outcomes will include a system that fosters greater consumer control and choice, service provision that will enable the elderly and individuals with physical disabilities to be integrated into the social mainstream, and methods to allow individuals to be appropriately served in the settings of their choice and to have control over the delivery of those services.

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Real Choice Systems Change

GEORGIA

Grant Information

Name of Grantee
Georgia Department of Human Resources
Title of Grant
Real Choice Systems Change Grant
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Betti Knott, Project Director
2 Peachtree Street, NW
Suite 23-232
Atlanta, GA 30303
404-657-2111
bhknott@dhr.ga.gov

Subcontractor(s)

Valdosta State University
Georgia State University
Janet Rechtman and Associates
Brown Consulting
Georgia Governor's Council on Developmental Disabilities
Alice P. Lin, Ph.D.
The Technical Assistance Collaborative
Georgia Consumer Network
Larry Rhodes, Ph.D.
James Cooney, Ph.D., Public Consulting Group
Joy Eason Hopkins

Target Population(s)

Individuals of all ages who have a disability or long-term illness.

Goals

Activities

Abstract

The Real Choice Systems Change Grant represents Georgia's commitment to design and implement effective and enduring improvements in community long-term support systems. These improvements will enable individuals of all ages who have a disability or long-term illness to live and participate in their communities.

The project will address system barriers to community-integrated living, develop an ongoing mechanism for consumer involvement in all aspects of the integrated community service delivery system for people of all ages and disabilities, develop a process for effective communication and collaboration to enhance planning and implementation of integrated community services system changes, and sustain an accessible integrated community service system.

This project represents Georgia's commitment to enact real systems change by effectively changing the provision of services to people of all disabilities and ages. The project's products will be accomplished by building on current initiatives, such as the work on direct care staff improvements. The Supported Housing Demonstration Project training and evaluation will be supplementary to the current housing initiative funded by a Center for Mental Health Services grant. This grant will build synergies with current Centers for Medicare and Medicaid Services initiatives, such as the Nursing Home Transition grants previously awarded.

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Real Choice Systems Change

INDIANA

Grant Information

Name of Grantee
Family and Social Services Administration
Title of Grant
Indiana Real Choice Systems Change Grant
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Completed

Contact Information

Peter Bisbecos, Director
Division of Disability and Rehabilitative Services
PO Box 7083
Indianapolis, IN 46207-7083
317-232-1147
Peter.Bisbecos@fssa.in.gov

Subcontractor(s)

HealthEvolutions—to staff the Governor's Commission on Home and Community Based Services

Various entities selected for "mini-grants."

Target Population(s)

Children, adults, and senior citizens.

Goals

Activities

Abstract

The Indiana Family and Social Services Administration (FSSA) is using this funding to create an enduring infrastructure to support consumer-directed and controlled community based services and supports for persons with disabilities in Indiana. The federal funds will be used to implement the following objectives:

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Real Choice Systems Change

KANSAS

Grant Information

Name of Grantee
Department of Social and Rehabilitation Services, Resource Development
Title of Grant
Kansas 21st Century Long-Term Care Project
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Brent Widick, Grant Manager
Docking State Office Building, 6th Floor
915 SW Harrison Street
Topeka, KS 66612
785-296-4723
BAZW@srskansas.org

Subcontractor(s)

Rucker, Powell and Associates, Ltd.
Mental Health Association of the Heartland
North Central-Flint Hills Area Agency on Aging, Inc.
Kansas Association of Centers for Independent Living

Target Population(s)

Individuals of all ages with disabilities or long-term illness.

Goals

Activities

Abstract

The Real Choice Systems Change project seeks to build upon the incremental improvements in long-term care, which Kansas has implemented through Medicaid Home and Community Based Services waivers. The primary purpose of the project is to make home and community based services as accessible to individuals with disabilities or long-term illness as institutional care.

A Strategic Planning Committee including consumer, provider, funding, and regulatory stakeholders will address legal, regulatory, and policy barriers to a community-first long-term care system, including funding issues, capacities of service providers to provide access to necessary supports and services, and employment-related issues. The 3-year action plan seeks to expand self-determination by providing additional control over supports and services for all individuals with disabilities or long-term illness based on the premise of self-determination, independent living, and personal autonomy.

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Real Choice Systems Change

LOUISIANA

Grant Information

Name of Grantee
State of Louisiana Department of Health and Hospitals
Title of Grant
Real Choice for Louisiana
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Helene Robinson
Deputy Assistant Secretary
Bureau of Policy Research and Program Development
Department of Health and Hospitals
1201 Capitol Access Road, Bin 30
PO Box 2870
Baton Rouge, LA 70821-2870
225-342-6316
hrobinso@dhh.la.gov

Subcontractor(s)

Matt Rovira, Executive Director
Governor's Office of Disability Affairs
365 N. Fourth Street
Baton Rouge, LA 70801

Target Population(s)

All populations with disabilities.

Goals

Activities

Abstract

The ultimate outcome of the proposed activities will be to identify and implement enhancements to the long-term care services infrastructure that will dramatically move Louisiana away from a reliance on institutional care. By demonstrating cost efficiencies, improved consumer satisfaction and outcomes, and increased integration of a full continuum of long-term care services, the proposed project will play a role in producing enduring systems change to benefit all citizens of Louisiana.

The vehicles to achieve this shift will begin with a collaborative process both to inform consumers about the options for long-term care systems change and to obtain their input into the planning process. Other systems change capabilities to be developed through this grant will enhance the array of available services and the way in which they are delivered, focusing on consumer direction, direct care staff professionalism, and local housing coalitions.

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Real Choice Systems Change

MISSISSIPPI

Grant Information

Name of Grantee
Department of Mental Health
Title of Grant
Person Centered Planning
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Matt Armstrong, Division Director
601-359-1288
marmstrong@msdmh.org

Jake Hutchins
Division of Community Services
1101 Robert E. Lee Building
239 N. Lamar Street
Jackson, MS 39201
601-359-1288
jhutchins@msdmh.org

Subcontractor(s)

Region 6
Life Help
Madolyn Smith
662-455-5243

Region 12
Pine Belt Mental Health
Jerry Mayo
601-544-4641

Region 13
Gulf Coast Mental Health Center
Jeff Bennett
228-865-1700

Region 15
Warren Yazoo Mental Health
Steve Roark
601-638-0031

The University of Southern Mississippi
Department of Curriculum, Instruction & Special Education
Dr. Linda McDowell
601-266-5135

The University of Mississippi
Department of Psychology
Dr. Paul Deal
662-915-7383

NAMI Mississippi
411 Briarwood Drive, Suite 410
Jackson, MS 39206
Teri Brister
601-899-9058

Target Population(s)

Transition individuals between 17 and 26 years of age who have a serious mental illness or dual diagnosis (mental illness/substance abuse or mental illness/mental retardation).

Goals

Activities

Abstract

The Mississippi State Department of Mental Health in collaboration with the Division of Medicaid and the Office of the Governor, propose a pilot with the Real Choice Systems Grant to introduce the PCP process to MIMS and Intensive Case Management by providing a Regional Support Coordinator and other support staff to create effective, enduring improvements in Mississippi community long-term support systems. The project would demonstrate that this alternative approach increases the possibility that transition individuals 17 to 26 years of age, who have a serious mental illness or dual diagnosis, can self-manage their illness and participate in their community to the best of their ability with the support necessary to allow them to achieve their expressed goals and accomplish their highest level of independence.

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Real Choice Systems Change

MONTANA

Grant Information

Name of Grantee
Department of Public Health and Human Services
Title of Grant
Montana Real Choice Systems Change
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

John Zeeck
Quality Assurance Specialist
Department of Public Health and Human Services
PO Box 4210
111 North Sanders
Helena, MT 59604
406-444-2995
jzeeck@state.mt.us

Subcontractor(s)

Support and Techniques for Empowering People (STEP), Inc.
Joan Grauman, Evergreen Center
406-248-2055
joang@step-inc.org

Montana Home Choice Coalition
Michael O'Neal, AWARE, Inc.
406-459-0281
ONeil_Michael@msn.com

Western Transportation Institute
Montana State University—Bozeman
Lisa Ballard
406-994-6529
Lballard@coe.montana.edu

Target Population(s)

All persons with disabilities in Montana.

Goals

Activities

Abstract

Three programs or divisions within the Montana Department of Public Health and Human Services will collaborate to build systems to promote real choice in Montana. The Developmental Disabilities Program will completely change the way that services are offered to persons with developmental disabilities. The Program will become one in which services are funded for an individual based on that person's needs. Each person will be able to purchase and pay for their own services from their choice of qualified providers. Extensive training, consulting, and information will be presented to families and consumers to inform them about systems change, and a software system will be created to implement the individualized services system.

The Addictive and Mental Disorders Division will coordinate the development and use of accessible and affordable housing in four communities in Montana with the Montana HomeChoice Coalition. The coordinator will work with local, state, and federal resources to find affordable and accessible housing for all persons with disabilities.

Montana Vocational Rehabilitation will coordinate with the Montana Transportation Partnership and the Western Transportation Institute to develop and implement a coordinated transportation system in two communities in Montana. The system will provide transportation services to all persons with disabilities and will provide a replicable model for the State.

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Real Choice Systems Change

NEVADA

Grant Information

Name of Grantee
Nevada Department of Human Resources
Title of Grant
Real Choices: Improving Community Services and Supports for Special Needs Children in Nevada
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Judith Wright, Bureau Chief
775-684-4285
jwright@nvhd.state.nv.us

Debra Wagler, Program Manager
775-684-3479
dwagler@nvhd.state.nv.us

Sean Crowley, Management Analyst
3472 Goni Road, Suite 108
Carson City, NV 89701-4792
775-684-3480
scrowley@nvhd.state.nv.us

Subcontractor(s)

None.

Target Population(s)

Children with Special Health Care Needs (CSHCN) aged 0 to 22 in Nevada and their families.

Goal

Improve community-integrated, family-focused services and supports for CSHCN in Nevada.

Activities

Abstract

Nevada seeks to improve community-based services and supports for children with special health care needs. The primary goal of these activities is enduring systems improvements in Nevada that will increase access to community-based programs, services, and supports for CSHCN and their families.

This project was developed with the consultation of the following state agencies: the Nevada State Department of Human Resources (DHR); three divisions and one office within the DHR—Division of Health Care Financing and Policy (DHCFP), Division of Mental Health and Developmental Services (DMHDS), the Nevada State Health Division (SHD), the Community Connections office; and the Nevada State Department of Employment, Training, and Rehabilitation (DETR). Project activities were also developed with the broad, collaborative input of parents of CSHCN, private service providers, advocacy groups, and treatment professionals in Nevada. The project will be administered by the Nevada State Health Division and will be coordinated with an ongoing, legislatively mandated initiative within the DHR to develop a "Strategic Plan for Services to Persons with Disabilities" in Nevada.

The project will address two well documented needs in Nevada—the absence of a coordinated system of community-based and family-focused programs, services, and supports for CSHCN in Nevada, and an essentially nonexistent statewide resource planning system for CSHCN and families in Nevada. Activities will result in (1) generation of data during Years 1 through 3 of the proposed budget period that provide a better understanding of the nature and magnitude of challenges facing CSHCN in Nevada; (2) development of a permanent data collection system during Year 1 that allows state policymakers, service providers, advocates, and families of CSHCN to evaluate service delivery models and planning approaches developed in other states and regions; (3) development of public policy initiatives and a long-term strategic plan that provides concrete solutions to the medical care and service needs of CSHCN in Nevada; (4) implementation of a statewide multimedia campaign on issues affecting CSHCN and their families in Nevada; (5) establishment of a permanent Nevada Advisory Council on Children with Special Health Care Needs that will guide project activities and serve as an ongoing forum for issues addressing community-based services and supports for CSHCN once the funding period of the proposed project has been completed; and (6) development and implementation of a multicommunity demonstration during Year 2 of the proposed budget period that is based on lessons learned from activities in Year 1 of the project.

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Real Choice Systems Change

NEW MEXICO

Grant Information

Name of Grantee
Aging & Long Term Services Department
Title of Grant
Individual Choices
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Expected Completion Date
March 2007

Contact Information

Marise McFadden, Director
Elderly & Disability Services Division
2550 Cerrillos Road
Santa Fe, NM 87505
505-476-4799
marise.mcfadden@state.nm.us

Subcontractor(s)

None.

Target Population(s)

All populations with disabilities.

Goals

Activities

Abstract

New Mexico is reforming its Medicaid long-term service delivery system. This project will serve as a means to develop and implement a statewide self-directed 1915(c) Medicaid waiver (Mi Via) for individuals with disabilities, both young and old, to gain choice, control, and direction over long-term services. The project will provide training, resources, and information on how to access services and supports, and how to make effective choices about community living and service provision. The project will include training on consumer-controlled and directed selection and management of service providers for consumers, family members, and service providers, and a training program for individuals with disabilities to lead systems change of long-term services.

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Real Choice Systems Change

NEW YORK

Grant Information

Name of Grantee
New York Department of Health
Title of Grant
Real Choice Systems Change Grant
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Expected Completion Date
December 2006

Contact Information

Betty Rice, Director
518-474-9138
brr02@health.state.ny.us

Charlotte Mason, Project Coordinator
Division of Consumer & Local District Relations
One Commerce Plaza, Room 826
Albany, NY 12260
518-474-5271
cmm24@health.state.ny.us

Subcontractor(s)

The Real Choice Systems Change Grant is being used by the New York State Department of Health and the Office of Mental Retardation and Developmental Disabilities (OMRDD). The Department of Health has identified five consortiums as subcontractors: Northeastern Adirondack Health Care Network; Center for Disability Rights, Inc.; Fulton County Office of Aging; Broome County Community Alternative Systems Agency; and Eldersource. The OMRDD has identified the Self-Advocacy Association of NYS, Inc. as a subcontractor. A certain number of person-centered planning experts will also be identified as subcontractors.

Target Population(s)

The Department of Health's project will target individuals of all ages and disabilities. The OMRDD will focus on transitioning persons with developmental disabilities from intermediate care facilities (ICFs) to more integrated residential settings.

Goals

Activities

Abstract

New York will conduct two related projects, each designed to help individuals with disabilities live in the most integrated setting appropriate to their needs. The OMRDD will focus on transitioning persons with developmental disabilities from ICFs to residential settings. The DOH, in partnership with other state agencies, will focus on diverting individuals from nursing homes. DOH will award grant funds to applicants to develop new, or enhance existing, IA&A systems which will facilitate entry into community-based care by providing consumers, caregivers, and human services professionals with accurate and impartial information and assistance in accessing New York State's broad spectrum of long-term care services. Proposals must demonstrate cooperation and planning between government, providers, consumers, and other appropriate long-term care stakeholders. Applicants from private and/or public community-based organizations, as well as consumer organizations will be sought who have the capacity and experience to provide ongoing IA&A to persons, regardless of disability, age, or payer.

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Real Choice Systems Change

NORTH DAKOTA

Grant Information

Name of Grantee
State of North Dakota
Title of Grant
Real Choice Systems Change in North Dakota
Type of Grant
Real Choice Systems Change
Amount of Grant
$900,000
Year Original Funding Received
2002
Completed

Contact Information

Bonnie Selzler, Ph.D.
Olmstead Coordinator
Department of Human Services
600 S. 2nd Street, Suite 1D
Bismarck, ND 58504
701-223-5375
bselzler@btinet.net

Subcontractor(s)

None.

Target Population(s)

All ages.

Goals

Activities

Abstract

The Governor's Commission on the Olmstead Decision received $900,000 that will be used to ensure that the consumer is actively involved in decision making regarding development and implementation of services. Multiple systems are involved in providing services to persons with disabilities, therefore, memorandums of agreement and policies must be created that empower the consumer to have a strong voice in service decision.

The first phase of the project is a white paper that describes the current system and existing studies of the systems of care. That portion will be completed in April 2003. Because North Dakota has an aging population and the majority of services for persons with a disability tend to be within long-term care facilities, studies involving payment and services in long-term care facilities are especially informative to this project. The long-term care facilities have joined other community agencies to explore service delivery options.

Specific tasks, such as improved access to information and greater consumer input into development of services will be achieved through pilot projects in rural North Dakota. A request for proposals will be sent out to agencies to develop creative projects that demonstrate and provide a model for persons with a disability to direct their services.

Early analysis of data indicated a need for system changes in the areas of finance, outreach, transportation, workforce, service gaps, and service coordination. The pilot projects are expected to address these areas.

Currently, there are multiple telephone numbers one would need to have to access all the possible services available. One project is aimed at a simplified access system for services. That particular project uses the 211 number as a statewide information and referral number. That project will compile service provider numbers and access information in order to better serve those calling for services available in the community.

The grant will develop two projects to focus on increased awareness of Olmstead and the specific initiative within the State. These two projects provide information to rural areas where both providers and consumers with disabilities have few resources.

The Governor's appointed Commission is the governing body for the grant. A project coordinator was hired to oversee the day-to-day operation and report to the Commission.

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Real Choice Systems Change

OHIO

Grant Information

Name of Grantee
Ohio Department of Job and Family Services
Title of Grant
ConnectMeOhio.org
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Roland Hornbostel, Deputy Director
614-466-9927
rhornbostel@age.state.oh.us

Sharon Evanich, MBA
Grant Coordinator
Real Choice Systems Change Grants
Ohio Department of Aging
50 W. Broad Street, 9th Floor
Columbus, OH 43215
614-644-5192
sevanich@age.state.oh.us

Subcontractor(s)

Ohio Department of Aging

Target Population(s)

People with disabilities, caregivers, and providers.

Goals

Activities

Abstract

ConnectMeOhio.org is designed to give consumers consistent, reliable, and up-to-date information about services and supports available to them regardless of their point of contact with the formal delivery system. A consumer desiring to access services through a County Department of Job and Family Services, an Area Agency on Aging, an Alcohol Drug Addiction and Mental Health Board, or a County Mental Retardation/Developmental Disabilities Board should have access to the same information. There would be "no wrong door" into the system.

This objective can best be accomplished by the creation of a centralized body of information that is accessible to all agencies and consumers equally. The information on services and supports will be both comprehensive and reliable. Reliability becomes an issue even with the simple passage of time. What is reliable today is history tomorrow. The problem with printed guides to services and supports is that they are often outdated before they can be printed. For that reason, this centralized body of information should be available in electronic form over the Internet to ensure that it remains reliable and can be easily updated.

We recognize that not all consumers have access to Internet-based information sources. We will build mechanisms into the project to ensure that information on services and supports is widely available through public and private sector agencies that serve people with disabilities.

Training professional agency staff that work with consumers is an equally important step in ensuring that consumers have the opportunity to make informed choices. During the community forums, we heard consistently that even when consumers were in contact with professional agency staff, often these staff had an incomplete understanding of the forms of assistance available to consumers and the eligibility requirements for accessing services and supports. If professionals themselves lack access to reliable information, consumers are ultimately denied the right to make an informed choice. Therefore, the ConnectMeOhio.org project will also include information and training targeted at professional agency staff who work directly with consumers.

An additional important concern is the difficulty consumers encounter in finding suitable housing. Ohio will involve a housing coordinator to work with consumers as well as public and private providers of housing to increase consumer choice.

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Real Choice Systems Change

OKLAHOMA

Grant Information

Name of Grantee
Oklahoma Department of Human Services, Aging Services Division
Title of Grant
Real Choice Systems Change in Oklahoma
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Carey Garland, Interim Director
ODHS/ASD
2401 NW 23rd, Suite 40
Oklahoma City, OK 73107-2413
405-522-4509
carey.garland@okdhs.org

Patrice Pratt, Project Manager
Long Term Care Authority of Tulsa
130 N. Greenwood
Tulsa, OK 74120
918-583-3336
ppratt@ltca.org

Subcontractor

Long Term Care Authority of Tulsa
Deborah Karns, Chief Executive Officer
918-583-3336
dkarns@ltca.org

Target Population(s)

Frail elderly and adults with physical disabilities.

Goals

Activities

Abstract

Oklahoma's Real Choice project will build on the achievements of the first year in our CD-PASS Grant by promoting accountability of the service delivery system to consumers and the State through a CQI system. It will create supports for consumers transitioning from institutional settings back into the community. It will also develop a specialty managed care program model of service delivery, which relies on managed care principles but applies them in a manner that serves people with disabilities and long-term illnesses more flexibly and effectively, and will provide consumer choice of providers in rural Oklahoma.

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Real Choice Systems Change

PENNSYLVANIA

Grant Information

Name of Grantee
Department of Public Welfare
Title of Grant
Real Choice Systems Change Grant
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Virginia Rogers
Department of Public Welfare
PO Box 2675
Harrisburg, PA 17105-2675
717-346-4481
virrogers@state.pa.us

Subcontractor(s)

None.

Target Population(s)

Older Pennsylvanians, adults with disabilities, and children.

Goals

Activities

Abstract

This grant program will address the identified weaknesses or barriers of Pennsylvania's current long-term home and community based system of care through the implementation of specific strategies designed to provide the foundation for enduring and effective systems change. Specifically, involvement of individuals with disabilities, older individuals, families, and advocates will be the keystone of this program. The Home and Community Based Governance Structure will play a vital role in the overall management of the grant program, while the existing expertise of agency staff and community providers will be tapped to capitalize on available knowledge of promising practices in the implementation of HCBS and supports. Attention will be given to improving Pennsylvania's system of access, developing better informational materials that are culturally competent, and performing a feasibility analysis of an Independence + demonstration to begin to address the existing barriers by allowing for a consumer-directed cross-disability approach that is driven by need rather than diagnosis.

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Real Choice Systems Change

RHODE ISLAND

Grant Information

Name of Grantee
Department of Human Services, Center for Adult Health
Title of Grant
Rhode Island Real Choices Systems Change Grant
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Frank Spinelli, Administrator
Center for Adult Health
600 New London Avenue
Cranston, RI 02920
401-462-1892
Fspinell@dhs.ri.gov

Subcontractor(s)

None.

Target Population(s)

Elders, adults with disabilities, and children with special needs.

Goals

Activities

Abstract

The principle objective of this grant is to construct the enduring system changes that will allow all Rhode Islanders meaningful choice and control about where they reside and that will help them gain access to the services they need. Rhode Island has a long history of developing new policy initiatives by bringing together various interested parties to identify relevant concerns, barriers, and roadblocks regarding health and social support services. The State, in collaboration with consumers, advocates, providers, and other representatives of the private sector, has been developing the foundation for the infrastructure that will help realize substantial improvements in health care and community support services.

Current efforts to improve care and services for persons needing long-term care in Rhode Island are shaped by three goals:

  1. to expand capacity to provide services,
  2. to increase informed choice for consumers, and
  3. to improve the integration of health and social services.

To address these goals, we will conduct the above activities aimed at implementing long-term change and sustained improvement. Each activity addresses one or more of the project goals.

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Real Choice Systems Change

TEXAS

Grant Information

Name of Grantee
Texas Health and Human Services Commission, Texas Department of Aging and Disability Services
Title of Grant
Texas Real Choice Grant: Creating a More Accessible System for Real Choices in Long-Term Care Services
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Jeff Kaufmann
Lead Grants Coordinator
Center for Policy and Innovation
Texas Department of Aging and Disability Services
PO Box 149030
Austin, TX 78714-9030
512-438-4329
jeffrey.kaufmann@dads.state.tx.us

Subcontractor(s)

Heart of Texas Council of Governments
Heart of Central Texas Regional Access Group
Texoma Council of Governments
Texoma Area Information and Access Center

Target Population(s)

Consumers of all ages with disabilities and children with disabilities and/or special health care needs.

Goals

Activities

Abstract

Texas administers numerous long-term services and programs across several state agencies. Many more related support services are operated within and without the health and human services system. Over the years, the State has implemented various improvements to, and increased the capacity of, long-term services and supports, yet the system remains fragmented and difficult to access.

Thanks to strong and committed consumer participation, Texas is becoming more focused in its efforts to improve the long-term care system for persons of all ages with disabilities. Though stakeholders have offered many differing opinions regarding the need for a single point of access versus multiple points of access, everyone agrees that better system coordination and consumer navigation is needed.

Texas will evaluate the use of system navigators by testing two models: (1) navigators located within a single access point; and/or (2) navigators located across multiple, but highly coordinated access points. The target population for the Texas Project is consumers of all ages with disabilities and children with disabilities and/or special health care needs.

Two Texas communities will implement the two models and both will work to:

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Real Choice Systems Change

UTAH

Grant Information

Name of Grantee
Department of Human Services
Title of Grant
Real Choice Grant
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Marie Christman, Deputy Director
801-538-4116
mchristman@utah.gov

Donna L. Russell (Primary Contact)
Real Choice Project Manager
120 N. 200 West, Room 319
Salt Lake City, UT 84103
801-538-4608
dlrussell@utah.gov

Subcontractor(s)

None at this time.

Target Population(s)

Children, their families, and adults of any age that have a disability or long-term illness.

Goals

Activities

Abstract

The Real Choice Grant will redesign Utah's long-term care system to enable children, their families, and adults of any age that have a disability or long-term illness to meaningfully participate in the choice of their care, location, and residence. The Department of Human Services, Divisions of Aging and Adult Services, Services for People with Disabilities, Substance Abuse/Mental Health, as well as the Department of Health's Divisions of Healthcare Finance and Health Systems Improvement, have come together with consumer groups and other public and private partners to create a seamless long-term care service system for consumers and their families.

The Real Choice Grant awarded to Utah will address the need for long-term care user and provider information to include a 1-800 information and referral number, a transactional Web site that includes an eligibility wizard, a common eligibility process/assessment tool, and an information/public awareness campaign that will include training on newly developed resources. The goal is to create a "no wrong door" approach for the consumer. In addition, the Real Choice Grant will address the need to increase the capacity of informal caregivers through a public relations campaign, training, supports, respite, and recognition, which will facilitate community integration and choice of residence. Finally, the Real Choice Grant will assist in coordination of governmental, community, and private providers to educate and encourage the participation of consumers/families on policy and advisory boards as well as attend state and national conferences on long-term care issues.

Utah is committed to ongoing evaluation in order to sustain lasting changes to the long-term care system. Outcomes will include improved and coordinated service delivery that offers the necessary tools for consumers to make informed choices about all aspects of their care.

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Real Choice Systems Change

WASHINGTON

Grant Information

Name of Grantee
Department of Social and Health Services
Title of Grant
Community Living Initiative
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Completed

Contact Information

Cathy Cochran
Real Choice Grant Administrator
Dept. of Social and Health Services
PO Box 45060
Olympia, WA 98504-5060
360-902-8271
cochrca@dshs.wa.gov

Tim Brown, Assistant Secretary
Health and Rehabilitative Services Administration
PO Box 45130
Olympia, WA 98504-5130
360-902-7799
browntr@dshs.wa.gov

Subcontractor(s)

None at this time.

Target Population(s)

Individuals with disabilities served by the Washington State Department of Social and Health Services (DSHS).

Goals

Activities

Abstract

The Real Choice Systems Change Grant in Washington State will allow for the development of educational materials and training to enhance skills for individuals with disabilities to self-direct services. Consumers, families, providers, and others will share information developed by the grant, along with training opportunities, at a Community Living Conference for 500 in 2004. The materials from the conference will also be made available for those who cannot attend, and distributed to local agencies and providers for wider consumer access.

On a larger systems level, criteria and evaluation tools will be developed for cross-systems case management coordination models. Teams of multidisciplinary agencies in the community, along with consumers and families, will define successes and challenges with transitions to community living. This will include the coordination of multiple social and health systems to support individuals with disabilities to live in the community. Additionally, the grant will provide assistance with transition from state psychiatric hospitals and the appropriate system changes to increase community living options.

Consumer-directed services payment options, such as vouchers and cash and counseling methods, are systems changes that will result from the development of a community based case mix payment model, more accurately reflecting the care needs of individual consumers. Further, the Real Choice Grant will fund the development of a quality assurance, outcome measurement tool that is vital to the development of a consumer-directed service delivery model.

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Real Choice Systems Change

WEST VIRGINIA

Grant Information

Name of Grantee
Department of Health and Human Resources
Title of Grant
West Virginia: Real Choice
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,313,996
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Cynthia Beane, Program Manager
Bureau for Medical Services
350 Capitol Street, Room 251
Charleston, WV 25301
304-558-5962
cynthiabeane@wvdhhr.org

http://www.cedwvu.org/programs/realchoice/

Subcontractor(s)

Jeanne Grimm
Real Choice Program Manager
WVUCED
304-293-4692 ext. 1105

Target Population(s)

Individuals of any age who have a disability or long-term illness.

Goals

Activities

Abstract

The West Virginia Real Choice project has worked toward creating enduring improvements in community long-term support systems so that individuals of any age who have a disability or long-term illness have the choice and necessary supports to live and participate in their communities. The Real Choice Grant has worked to develop an infrastructure that helps agencies, providers, and consumers make the necessary system-level changes to support people with disabilities in the community. The PDSA evaluation model was used in Years 2 and 3 to monitor and make adaptations to the Real Choice work plan.

The Real Choice Partnership includes consumers and advocates (60 percent), public and private service providers, consultants, and points of contact from eight state agencies. The Partnership has collaborated on projects with the Medicaid Incentive grant (MWIN) and the other four Real Choice grants in West Virginia. The Real Choice staff convened meetings, is collecting data and resources, and producing reports and recommendation summaries. A Consumer Oversight Commission served as the evaluation body for model community-based mini-project applications. Several community-based mini-projects were funded as subcontracts of the project to demonstrate transportation, housing, recreation/leisure, and peer service models that are being evaluated through a study to identify common elements present for success or failure. Funding was leveraged from other sources to develop other models of community services and support integration. A one-stop electronic information resource that builds knowledge for providers and empowers consumers was constructed. Project staff compiled a curriculum and supported consumer-led training to prepare stakeholders for the new self-determination disability paradigm. Consumers received self-determination training that enabled them to be informed participants in committee work, policy and practice-development, and legislative impact. The Real Choice Consumer Work Group was facilitated by consumers and had subcommittees that developed position or white papers on issues of concern to consumers.

Real Choice disseminates information through a statewide collaborative conference with a focus on issues of concern to adults, and collaborates with other organizations and agencies to support consumer participation improvement in workshops, conferences, and advocacy activities.

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Real Choice Systems Change

WISCONSIN

Grant Information

Name of Grantee
Department of Health Family Services, Division of Supportive Living
Title of Grant
Real Choices for Real Life
Type of Grant
Real Choice Systems Change
Amount of Grant
$1,385,000
Year Original Funding Received
2002
Expected Completion Date
September 2006

Contact Information

Gail Propsom
Long-term Care Policy Analyst
Project Director/Coordinator
1 W. Wilson Street
Madison, WI 53702
608-267-2455
propsgf@dhfs.state.wi.us

Subcontractor(s)

ARC Wisconsin—operates Guardian Mentor program

Mental Health Association in Milwaukee County, Inc.—contract agency for contracted staff to do mental health planning

The Management Group—provides staffing for a project to increase the availability of consumer-directed supports in waiver and other Medicaid programs

Fourteen grants to county human service and aging departments to develop activities to increase elder choice

Area Agencies on Aging for projects related to workforce, chronic disease management, and end-of-life planning

Target Population(s)

Goals

Activities

Abstract

In 1997, Wisconsin engaged in a comprehensive planning process to redesign its long-term care system. The broad objectives established for this redesign are to

To achieve these objectives, Wisconsin is piloting a managed care pilot project called Family Care for persons with physical and developmental disabilities and frail elders. Parallel redesigns are underway for children and persons with serious mental illness. While these broader reforms are being piloted, Wisconsin intends to proceed incrementally toward the goals of redesign. The State will use grant funds to develop some of the building blocks needed to enhance its strong foundation of comprehensive, care-managed community-based services for people who are frail elderly or adults and children with lifelong disabilities.

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Respite for Adults

CALIFORNIA

Grant Information

Name of Grantee
California Department of Mental Health
Title of Grant
California Study on New Medi-Cal Respite Benefit for Caregivers of Adults With Cognitive Impairment
Type of Grant
Respite for Adults
Amount of Grant
$100,000
Year Original Funding Received
2003
Completed

Contact Information

Jane Laciste
TBI/CRC Program Administrator
Department of Mental Health
1600 9th Street
Sacramento, CA 95814
916-654-3529
jlaciste@dmh.ca.gov

Subcontractor(s)

Kathleen A. Kelly
Executive Director
Family Caregiver Alliance
690 Market Street, Suite 600
San Francisco, CA 94104
415-434-3388
kkelly@caregiver.org

Target Population(s)

Caregivers of individuals with adult-onset cognitive impairment.

Goal

The goal of this feasibility study is to develop recommendations for ways that California can implement and evaluate a new respite benefit under Medi-Cal for family and informal caregivers of individuals with adult-onset cognitive impairment.

Activities

Abstract

The project will bring together representatives from state departments, consumer groups, provider associations and academic institutions to develop a plan for expanding respite services to caregivers of persons with adult-onset cognitive impairments under Medicaid funding (Medicaid is called Medi-Cal in California).

The goal of the project is to develop recommendations on ways California can implement and evaluate a new respite benefit under Medicaid for family and informal caregivers of persons with adult-onset cognitive impairment. An Advisory Committee will identify the target population, project service use, analyze the potential impact of expanding respite services with the current infrastructure, identify protocols and procedures in existing state programs and outcome methodology currently in use in California and elsewhere, and establish procedures for data collection and evaluation of respite services to measure satisfaction, outcomes, cost, and utilization.

This study complements current efforts in the State regarding Olmstead planning, consumer direction, and long-term care integration by addressing key concerns, including supports for informal caregivers and the need for systems integration.

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Respite for Adults

NEW YORK

Grant Information

Name of Grantee
New York State Department of Health
Title of Grant
New York's Respite Care Feasibility Project
Type of Grant
Respite for Adults
Amount of Grant
$74,285
Year Original Funding Received
2003

Contact Information

Betty Rice, Director
Division of Consumer & Local District Relations
518-474-9138
brr02@health.state.ny.us

Charlotte Mason, Project Coordinator
Office of Medicaid Management
One Commerce Plaza, Room 826
Albany, NY 12260
518-474-5271
cmm24@health.state.ny.us

Subcontractor(s)

To be identified.

Target Population(s)

Caregivers of multiple adult populations including, but not limited to, consumers who are medically fragile, cognitively impaired, or physically disabled.

Goal

The goal of this study is to determine the feasibility of developing and implementing a model of respite care that supports both Medicaid eligible and non-Medicaid eligible individuals ability to remain in the community, by lessening the emotional and physical hardships of their caregivers.

Activities

Abstract

The study will determine which modality(ies) of community-based respite care for adults are feasible in New York. Data will be obtained by examining respite models currently used in other states. The analysis will include, but not be limited to, types of services available, target populations served, success in achieving relief of caregiver stress, and how the use of a community-based respite care system has deterred premature institutionalization.

In addition, the Department will obtain information regarding use of different types of financing mechanisms (e.g., capitated, direct payment, voucher) to allow consumers to exercise choice, control, and responsibility over needed respite services. The study will recommend revisions to statutes, regulations, and policies that must be made or implemented to support a community-based model of respite care.

The Department of Health staff will meet quarterly throughout the study with representatives of primary LTC stakeholders to involve them in the monitoring and evaluation of the activities, reports, and recommendations of the contractor.

The ultimate goal of the Department, based on the results of the feasibility study, is the development and implementation of a community-based respite care model that will enhance the state's community LTC system.

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Respite for Adults

OHIO

Grant Information

Name of Grantee
Ohio Department of Aging
Title of Grant
Ohio's Respite for Adults Project
Type of Grant
Respite for Adults
Amount of Grant
$73,854
Year Original Funding Received
2003
Completed

Contact Information

Sharon Evanich, Grants Project Manager
50 West Broad Street, 9th Floor
Columbus, OH 43215-5928
614-644-5192
sevanich@age.state.oh.us

Subcontractor(s)

The Miami University, SCRIPPS Gerontology

Target Population(s)

Caregivers of in-home care recipients.

Goal

The goal of this study is to examine the feasibility of providing respite services as a part of the PASSPORT (Pre-Admission Screening System Providing Options and Resources Today) program, the 1915(c) Medicaid waiver service for seniors.

Activities

Abstract

In keeping with national trends, Ohio has endeavored to restructure its long-term care delivery system with a renewed emphasis on providing home and community services. As the State moves to expand those services, the need to provide a community support network for families of those in home care is increasingly apparent. Ohio's Respite for Adults project will evaluate the feasibility of implementing an adult respite benefit as part of Ohio's PASSPORT program: the 1915(c) Medicaid waiver service for seniors age 60 and older. The study will also allow Ohio to identify and coordinate respite services currently in place to provide caregivers with the time off that they need and deserve.

The Ohio Department on Aging will contract with an outside entity to (1) conduct focus groups and independent research, (2) perform a thorough analysis of the State's existing caregiver support structure, both public and private, and (3) evaluate the impact a Medicaid respite benefit. Input from stakeholders and industry experts will be incorporated to develop the framework for this new service and implementation strategies.

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Respite for Adults

RHODE ISLAND

Grant Information

Name of Grantee
Rhode Island Department of Human Services (DHS)
Title of Grant
Respite Care for Adults Feasibility Study
Type of Grant
Respite for Adults
Amount of Grant
$100,000
Year Original Funding Received
2003

Contact Information

Frank Spinelli, Project Director
401-462-1892
FSpinell@dhs.ri.gov

Dianne Kayala
Chief, Family Health Systems
Project Coordinator
600 New London Avenue
Cranston, RI 02920
401-462-6303
dkayala@dhs.ri.gov

Subcontractor(s)

ACS

Target Population(s)

Working age adults and elderly persons with disabilities.

Goal

The goal of this study is to determine whether consumers and caregivers would accept respite care as an alternative to institutional or more costly home and community services.

Activities

Abstract

Rhode Island currently has six 1915(c) Home and Community Based Services waivers for elderly persons and younger adults with disabilities, only one of which includes respite services. The purpose of this project is to enable the Department of Human Services (DHS) to determine the nature, scope, and magnitude of the need for respite care in Rhode Island and to expand the respite services currently being provided to consumers by the Diocese of Providence.

This project will determine the need for respite services and assess the parameters and impact of providing respite care for adults with disabilities. Stakeholders will be involved in all phases of project activities, which include determining the needs criteria for respite services; estimating the number and characteristics of people needing respite services; identifying roadblocks and best practices; evaluating current respite initiatives; assessing unmet needs; determining system capacity to provide needed respite services; and designing a benefit that defines type, scope, settings, locations, and providers.

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Respite for Children

ALABAMA

Grant Information

Name of Grantee
Alabama Department of Mental Health and Mental Retardation
Title of Grant
Alabama's Respite for Children Project
Type of Grant
Respite for Children
Amount of Grant
$100,000
Year Original Funding Received
2003

Contact Information

Kim Hammack, Principal Investigator
RSA Union Building
100 N. Union Street
PO Box 301410
Montgomery, AL 36130-1410
334-353-9144
kim.hammack@mh.alabama.gov

Linda Champion, Project Coordinator
400 S. Union Street, Suite 270
Montgomery, AL 36140
334-240-0907 (f)
334-240-8437 (b)
lchampion@alfamilyties.org

http://www.alfamilyties.org

Subcontractor(s)

Alabama Family Ties
Censeo Research, Inc.

Target Population(s)

Caregivers of children with serious emotional disturbance.

Goals

Activities

Abstract

The Alabama Department of Mental Health and Mental Retardation (DMH/MR) is undertaking this study to determine the feasibility of developing and implementing a statewide respite care system for children with serious emotional disturbance and their families. The Department will focus on a capacity- and infrastructure-building process. With an estimated 87 percent of caregivers in need of respite services, the DMH/MR is committed to addressing their needs.

DMH/MR will conduct a full-scale needs assessment to identify the caregivers of children in need and determine the type and scope of currently available respite services. It will also develop preliminary cost projections, estimate the number of persons likely to use services, determine an appropriate cap for respite services that can be received by any one individual, and analyze the impact of that cap. The DMH/MR will also develop an implementation plan that will establish the necessary protocols, tools, procedures, and other elements of the infrastructure needed to implement a respite program, and work for an amendment to the State Medicaid Plan and All Kids Plan to include respite services as a reimbursable service.

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Respite for Children

ARKANSAS

Grant Information

Name of Grantee
Arkansas Department of Human Services
Title of Grant
Arkansas' Respite for Children Project
Type of Grant
Respite for Children
Amount of Grant
$75,000
Year Original Funding Received
2003

Contact Information

Nancy Holder, Project Supervisor
PO Box 1437, Slot S380
Little Rock, AR 72203
501-682-1464
Nancy.Holder@arkansas.gov

David Deere, Primary Contact
2001 Pershing Circle, Suite 300
North Little Rock, AR 72114
501-682-9917
DeereGlenD@uams.edu

Subcontractor(s)

University of Arkansas for Medical Sciences/Partners for Inclusive Communities

Target Population(s)

Caregivers of children with special health care needs.

Goal

The goal of this study is to expand the number of participants in Arkansas' respite program for children with special health care needs from 132 to 275, and to increase self-reported consumer satisfaction with the program.

Activities

Abstract

Children's Medical Services (ChMS), the Arkansas Title V program for children with special health care needs, is located in the Arkansas Department of Human Services. ChMS will conduct a feasibility study to determine how to increase participation in a State Medicaid respite project targeted to caregivers of children with special health care needs.

The goal of this project is to expand participation in the respite care program for children and adolescents with special health care needs. Another goal is to increase self-reported consumer satisfaction with the program and to reduce caregivers' stress.

ChMS operates two 1915(c) waivers that have combined funding to allow caregivers of 275 children not receiving waiver services to receive respite services. Eligible children must be under age 19 and eligible for either SSI or TEFRA. Out of 315 applications for the 275 slots, only 228 met eligibility requirements. Of the 228, only 132 caregivers have met Medicaid billing requirements. The remainder failed to send in required information—particularly a Plan of Care naming a registered nurse who will certify that the caregiver is qualified to take care of the child and can appropriately carry out nurse delegated duties.

Through a subgrant, Partners for Inclusive Communities will undertake the following major activities: (1) assess the existing needs for respite and barriers to program participation, (2) develop one or more proposals for additional funding for respite services, (3) implement a revised plan for the respite program, (4) evaluate the revised plan, and (5) recommend further modifications to the revised plan.

The Steering Committee, comprising consumers and family members and key stakeholders, will be involved in all aspects of the project, including analyzing the problem, planning changes to the current program, overseeing implementation of the revised program, and evaluating the program's activities and impact.

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Respite for Children

MARYLAND

Grant Information

Name of Grantee
Mental Hygiene Administration, Maryland Department of Health and Mental Hygiene
Title of Grant
Maryland Respite for Children
Type of Grant
Respite for Children
Amount of Grant
$100,000
Year Original Funding Received
2003

Contact Information

Joan Smith, Project Director
MHA/ESHC
PO Box 800
Cambridge, MD 21613
410-221-2529
joansmith@dhmh.state.md.us

Subcontractor(s)

Center for Health Program Development and Management, University of Maryland, Baltimore County

Target Population(s)

Children under 18 with developmental disabilities, mental health conditions, and special health care needs, who meet the SSI definition of disability and are eligible for Medicaid, and their family caregivers. In the beginning, the project will target children with serious emotional disturbance and then phase in youth with other disabilities.

Goals

Activities

Abstract

The Mental Hygiene Administration, a unit of the Department of Health and Mental Hygiene, is leading this project on behalf of the Maryland Caregiver Support Coordinating Council. The Council is a legislatively mandated coordinating body comprising public agencies, private providers, family and consumer representatives and their advocates, and other caregiver supports across the State. The Council will study respite care and make recommendations to the Governor concerning service improvement.

A major component of the project includes the development of a new cost model for respite care. To accomplish this goal, the need for regional versus statewide infrastructure will be examined and regulations and changes needed to support the demonstration will be reviewed. In addition, the project will develop social marketing strategies to achieve a number of specific aims. These include (1) recruiting providers, (2) expanding outreach to families to improve family access to services and increase family member involvement in policy making processes, (3) promoting a better understanding of family burden, (4) reducing the stigma of disabilities, and (5) increasing organizational buy-in to the system change.

The project will include the broadest possible targeted population within the established parameters—children under 18 with disabilities who meet the SSI definition of disability and are Medicaid eligible. Site selection will be based on the availability of current respite program infrastructure in a given community and community readiness to undertake a demonstration project. Family members and key stakeholders will be involved in all aspects of the planning, research, and evaluation.

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Respite for Children

MICHIGAN

Grant Information

Name of Grantee
Division of Mental Health Services for Children and Families, Michigan Department of Community Health
Title of Grant
Michigan's Respite for Children Project
Type of Grant
Respite for Children
Amount of Grant
$99,399
Year Original Funding Received
2003

Contact Information

Sheri Falvay, Director
517-241-5762
FALVAY@michigan.gov

Lori Irish, Project Director
517-241-5761
IrishI@michigan.gov

Audrey Craft, Project Coordinator
Department of Community Health
Lewis Cass Building, 5th Floor
320 S. Walnut Street
Lansing, MI 48913
517-241-5763
Craft@michigan.gov

Subcontractor(s)

Michigan Public Health Institute

Target Population(s)

Families of children with developmental disabilities (DD) and/or serious emotional disturbance.

Goal

The goal of this study is to support the increase of Medicaid-funded respite for children as a (b)(3) service when it is medically necessary and identified through a person-centered planning process in an Individual Plan of Service (IPOS).

Activities

Abstract

The Partnership Panel on Respite (PPR) was established by the Division of Mental Health Services for Children and Families (MHSCF), Michigan Department of Community Health (MDCH), to identify barriers to family choice and control over respite services, develop a list of strategies to improve family choice and control, and select the strategies to be included in the feasibility study. The PPR includes family members, respite providers, advocates, and MHSCF staff.

The primary goal of this project is to support the increase of Medicaid-funded respite for children as a (b)(3) service when it is medically necessary and identified through a person-centered planning process in an IPOS. Planned products of this project are (1) a feasibility study of providing respite as a Medicaid-covered mental health service, (2) a detailed implementation plan to phase in respite as a Medicaid-covered mental health service, (3) a detailed implementation plan to phase in a standardized array of respite services at Community Mental Health Service Programs (CMHSPs), and (4) an evaluation plan.

The project has several well-defined outcomes. The Medicaid-managed specialty services 1915b/c Waiver will be amended to include respite as a (b)(3) mental health service. State policy will be amended to require CMHSPs to provide an array of respite services. The state data collection system will be modified so that the impact of these changes can be evaluated.

The PPR will include the State Medicaid Agency, three to four community mental health service programs, the Michigan Developmental Disabilities Council, the Michigan Mental Health Planning Council, Michigan Protection and Advocacy, and ARC-Michigan. The Panel will provide guidance and feedback to MDCH and to the Michigan Public Health Institute, Systems Reform Office, which will carry out the feasibility study under contract with MDCH.

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Respite for Children

OREGON

Grant Information

Name of Grantee
Oregon Department of Human Services, Seniors and People with Disabilities
Title of Grant
Oregon's Respite for Children Feasibility Project
Type of Grant
Respite for Children
Amount of Grant
$99,274
Year Original Funding Received
2003

Contact Information

Toni Larson, Coordinator
Children with Disabilities and Family Support
Office of Home and Community Supports
Seniors and People with Disabilities
Oregon Department of Human Resources
500 Summer Street NE E10
Salem, OR 97301-1098
503-945-6117
toni.larson@state.or.us

Subcontractor(s)

Jaime Johnston Daignault
Project Coordinator
Human Services Research Institute (HSRI)
7420 Bridgeport Road, #210
Portland, OR 97224
503-924-3783 (b)
503-924-3789 (f)
jjohnston@hsri.org

Target Population(s)

Children with developmental disabilities and their primary caregivers.

Goals

The goal of this study is to determine the feasibility of, and develop an implementation plan for, using Medicaid funding to expand and improve existing respite care services for children with developmental disabilities.

Activities

Abstract

The Oregon Department of Human Services, Seniors and People with Disabilities (SPD), will conduct a feasibility study and develop an implementation plan for using Medicaid funds to provide respite care for children with developmental disabilities. The Department will examine current state respite care services and delivery systems to (1) obtain and evaluate data related to needs and capacity requirements, (2) research the risks and potential for service expansion and improvement through Medicaid State Plan or waiver services, and (3) develop a plan to implement recommendations obtained through grant activities.

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Respite for Children

RHODE ISLAND

Grant Information

Name of Grantee
Rhode Island Department of Human Services
Title of Grant
Real Choice Systems Change Grants for Community Living: Respite for Children
Type of Grant
Respite for Children
Amount of Grant
$100,000
Year Original Funding Received
2003

Contact Information

Sharon Kernan, Project Coordinator
401-462-3392
SharonK@dhs.ri.gov

Deborah Florio, Project Director
Center for Child and Family Health
Department of Human Services
600 New London Avenue
Cranston, RI 02920
401-462-0410
dflorio@dhs.ri.gov

Subcontractor(s)

None at this time.

Target Population(s)

Children with special health care needs and their families.

Goal

The goal of this project is to assess the need for and the feasibility of providing cost-effective respite care services for children with special health care needs and their caregivers.

Activities

Abstract

The Rhode Island Department of Human Services (DHS) has led the State in developing a system of care for children with special health care needs (CSHCN) that is responsive to consumer needs. Until recently, DHS and the Department of Mental Health, Retardation and Hospitals (MHRH) jointly administered, but MHRH actively managed, a Home and Community Based Services (HCBS) waiver to provide respite care and related services to persons with mental retardation and other developmental disabilities, including children. In addition, MHRH has provided respite care for approximately 300 children under a state-funded program. The Rhode Island General Assembly transferred responsibility for both programs to DHS effective July 1, 2003. DHS will now have an active role in assuring the provisions of respite care for a designated population.

This study will begin with a thorough analysis of the programs DHS has inherited from MHRH to determine who receives respite care, under what circumstances, provided by whom, and at what cost. DHS will also review more than 1,000 cases that have been assessed by the Comprehensive Evaluation, Diagnosis, Assessment, Referral, and Reevaluation (CEDARR) Family Centers to quantify the need for respite care and to update estimates from earlier focus groups. DHS will work with the Leadership Roundtable families and the CEDARR Interdepartmental Team to consider the benefit design options in providing respite care, to whom, at what cost, and with what potential for offsetting other costs. Particular attention will be paid to the possible role(s) of the CEDARR Family Centers in respite care.

This project may also be used to help develop tools necessary for implementing a more expansive respite care benefit, pending state budget approval. Activities may include drafting certification standards for providers, developing a recruitment and training program for providers, designing an outreach program for consumers, developing a monitoring and evaluation plan, outlining state legislation and State Plan amendments and/or waivers, and preparing an implementation and phase-in strategy.

Note: This Compendium form was not reviewed by the Grantee prior to publication.

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Community Based Treatment Alternatives for Children

ILLINOIS

Grant Information

Name of Grantee
Illinois Department of Human Service
Title of Grant
Illinois' Feasibility Study and Development Project for Community Based Treatment Alternatives for Children
Type of Grant
Community Based Treatment Alternatives for Children
Amount of Grant
$100,000
Year Original Funding Received
2003

Contact Information

Amy Starin, Principal Investigator
4200 N. Oak Park Avenue, Annex
Chicago, IL 60634
773-794-4850
dhsmha1@dhs.state.il.us

Subcontractor(s)

None at this time.

Target Population(s)

Children and adolescents with serious emotional disturbance who have been awarded Individual Care Grants (ICGs) and their families.

Goal

The State of Illinois, Department of Human Services, Division of Mental Health provides residential treatment services to children and adolescents with serious emotional disturbance (SED) through the ICG program. The goal of this study is to determine the feasibility of developing a Medicaid waiver to provide community services as a viable alternative to residential treatment under the State's ICG program.

Activities

Abstract

The goal of the Illinois Department of Human Services, Division of Mental Health feasibility study is to form a coalition to (1) address barriers to receiving respite services, (2) to develop an appropriate package of services to adequately support SED children and adolescents in their homes, and (3) avert residential treatment care (RTC). The coalition will comprise parent consumers, private, community-based mental health providers, the Illinois Federation of Families, and representatives of the state mental health authority. RTC would remain an option; however, families would have a choice regarding the location of their child's treatment.

The ICG Parent's Group will be a key partner, assisting with the development, implementation, and evaluation of this study. A parent will also serve as the co-principal investigator.

The data gathering and analysis involved in this study will be obtained through a contract with a health care consultant. The consultant will conduct focus groups and telephone interviews with ICG parents, community mental health agency providers, and ICG teen recipients. The consultant will also analyze the information and assess the financial feasibility of providing recommended services. The possibility of using a Medicaid waiver to provide these services will also be assessed.

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Community Based Treatment Alternatives for Children

MARYLAND

Grant Information

Name of Grantee
Mental Hygiene Administration, Maryland Department of Health and Mental Hygiene
Title of Grant
Maryland's Community Based Treatment Alternatives for Children
Type of Grant
Community Based Treatment Alternatives for Children
Amount of Grant
$100,000
Year Original Funding Received
2003

Contact Information

Albert Zachik, M.D.
Director of Child and Adolescent Services
55 Wade Avenue
Mitchell Building
Catonsville, MD 21228
410-402-8487
azachik@dhmh.state.md.us

Subcontractor(s)

University of Maryland School of Medicine, Center for Mental Health Services Research

Target Population(s)

Youth who meet the level-of-care requirements for admission to a psychiatric residential treatment facility (PRTF).

Goals

Activities

Abstract

The Mental Hygiene Administration, a unit of the Department of Health and Mental Hygiene, will conduct the study to fulfill a major recommendation of the Governor's Council on Custody Relinquishment. The Council was created to study alternatives to the forced or voluntary relinquishment of parental custody to gain access to health services. This problem has subsequently been identified in a General Accounting Office (GAO) report and acknowledged as a problem of major scope by the President's New Freedom Commission on Mental Health.

Maryland has played a major role in articulating the need for a program like Community Based Treatment Alternatives for Children (C-TAC) which will allow demonstrations of home and community services that provide a level of care comparable to a PRTF. The principal goals of the project include (1) completing a feasibility study, (2) developing an implementation plan for the demonstration, and (3) developing an evaluation plan.

A major focus of this project is on family involvement in all aspects of the planning, research, and evaluation development. The demonstration model will be based on the experience of "Wraparound Milwaukee" and other similar demonstration projects, and two Center for Mental Health Services Children's Imitative grants that have been implemented in Maryland.

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Community Based Treatment Alternatives for Children

MASSACHUSETTS

Grant Information

Name of Grantee
Executive Office of Health and Human Services
Title of Grant
Building and Financing Sustainable Systems of Care: A Feasibility Study and Development Grant for Community Based Alternatives for Children with SED in Massachusetts
Type of Grant
Community Based Treatment Alternatives for Children
Amount of Grant
$100,000
Year Original Funding Received
2003

Contact Information

Annette Shea
Director of Disability Policy and Home and Community Based Waiver Oversight
Executive Office of Health & Human Services
Office of Medicaid
One Ashburton Place, 11th Floor
Boston, MA 02108
617-573-1751
Annette.Shea@state.ma.us

Subcontractor(s)

University of Massachusetts Medical School, Center for Health Policy & Research

Target Population(s)

Children with serious emotional disturbance (SED) in out-of-home placement or imminently at risk for such placement.

Goals

Activities

Abstract

The project will evaluate the financial feasibility of expanding community treatment alternatives for children with SED. State staff will define the population of children currently served in out-of-home placement by systematically evaluating state agency expenditures for children with SED. In particular, the project will evaluate (1) the inpatient and residential services provided by other state agencies, and (2) state and local special education expenditures for children in residential placements pursuant to a behavior diagnosis on their Individualized Education Plan (IEP). A clinical analysis of children in out-of-home placements to determine the "universe" of children that could be safely served in a community setting will also be conducted.

The project will also evaluate the services currently provided and reimbursable as State Plan services under existing Medicaid guidelines and those community services that are "state only" funded. In addition, the project team will evaluate regulations or other limitations that apply to the population to determine the legal feasibility of applying for a 1915(c) waiver to serve children with SED. Other efforts to redeploy state funding or to use grant resources to expand community treatment alternatives for children with SED will be explored.

Finally, the Commonwealth will convene an interagency public-private group to evaluate community program models to determine the programmatic and financial structures that will provide the most effective and replicable community treatment alternatives for children with SED. This group will involve providers from all settings, families, medical and psychiatric professionals, and individuals from the special education system.

An interagency policy group, composed of senior staff from the relevant state agencies, will also meet regularly to ensure that the project coordinates with other efforts to address the needs of children with SED. Families and providers will be involved through specific work groups and focus groups and frequent reporting to the Mental Health Commission for Children.

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Community Based Treatment Alternatives for Children

MISSISSIPPI

Grant Information

Name of Grantee
Division of Medicaid
Title of Grant
Mississippi's Community Based Treatment Alternatives for Children Project
Type of Grant
Community Based Treatment Alternatives for Children
Amount of Grant
$99,000
Year Original Funding Received
2003

Contact Information

Kristi Plotner
Project Director
601-359-6698
lmkrp@medicaid.state.ms.us

Mike Gallarno
Bureau Director
239 N. Lamar Street, Suite 801
Jackson, MS 39201
601-359-6697
lmrmg@medicaid.state.ms.us

Subcontractor(s)

MS Families as Allies for Children's Mental Health
Vanderbilt University

Target Population(s)

Children with serious emotional disturbance (SED).

Goal

The goal of this project is to examine the feasibility of developing a waiver program that will provide home and community services for children with SED who have a history of placement at psychiatric residential treatment facilities (PRTFs) or who are at immediate risk for being placed in a PRTF.

Activities

Abstract

Over the past 5 years, many factors have occurred in Mississippi that have readied the State for a concerted effort to promote community treatment alternatives in a creative manner. A coordinated system of community-based treatment serves the majority of SED children in Mississippi. However, a small percentage of children, estimated from 1 to 3 percent, still are not served. For these children, the State plans to pursue flexible treatment options that will allow them to have access to a continuum of care to meet their specific needs.

This feasibility study will allow the Division to determine the potential costs and cost savings associated with a waiver program for this population. Families of children with high-intensity needs will be included so that their needs will be taken into account and addressed in the development of services. The Division of Medicaid will also develop an implementation plan for a potential waiver program and an evaluation plan that will determine if the goals of the program are being accomplished.

The ultimate goal of this project is to assess community based alternatives to residential treatment or institutionalization, which will position the State to make a successful application for a 10-year demonstration grant proposed in the President's FY 2004 budget to operate an HCBS waiver for children with SED.

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Community Based Treatment Alternatives for Children

MISSOURI

Grant Information

Name of Grantee
Department of Mental Health
Title of Grant
A Feasibility Study and Development Grant for Community Based Alternatives for Children with Serious Emotional Disturbance
Type of Grant
Community Based Treatment Alternatives for Children
Amount of Grant
$99,821
Year Original Funding Received
2003

Contact Information

Linda Roebuck, Executive Director
573-751-4970
linda.roebuck@dmh.mo.gov

Pamela Leyhe, Project Coordinator
Department of Mental Health
PO Box 687
Jefferson City, MO 65101
573-751-8118
pamela.leyhe@dmh.mo.gov

Subcontractor(s)

Alicia Smith and Associates

Target Population(s)

Families of children with serious emotional disturbance (SED).

Goal

The goal of the project is to conduct a feasibility study that will assist the State in the design and implementation of a comprehensive system of community services and supports for children with SED who would otherwise require care in a psychiatric residential facility.

Activities

Abstract

The activities under this feasibility study will assist the State's efforts to design and implement a comprehensive system of community services and supports for children with SED who would otherwise require care in a psychiatric residential facility. The State's goal is to expand services that will enable a child to stay in the home and organize those services in a comprehensive system that will provide a single point of entry regardless of how the child first contacts the system, provide a continuum of effective services, and blend disparate funding streams to support the system. The State hopes the revised system will result in

Note: This Compendium form was not reviewed by the Grantee prior to publication.

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Community Based Treatment Alternatives for Children

TEXAS

Grant Information

Name of Grantee
Texas Health and Human Services Commission
Title of Grant
Feasibility Study and Development Grant for Community Based Treatment Alternatives for Children
Type of Grant
Community Based Treatment Alternatives for Children
Amount of Grant
$93,600
Year Original Funding Received
2003

Contact Information

Kimberly McPherson
Project Director
Braker Center
11209 Metric, Building H
Austin, TX 78758
512-424-6562
kimberly.mcpherson@hhsc.state.tx.us

Subcontractor(s)

To be identified through an RFP process.

Target Population(s)

Children with serious emotional disturbances (SED).

Goal

The goal of this project is to identify alternatives to out-of-home placement that allow children to live in the most integrated community setting, to give families choices about treatment options, and to expand the quality array of intensive treatments and supports.

Activities

Abstract

Texas is under-serving children with SED, and those being served are not always in the most appropriate setting. The majority of the state's community mental health services are limited in type, amount, scope, and duration. Texas has little capacity for community services such as intensive in-home services and treatment, and foster care, which have been demonstrated to effectively manage and treat children with SED in home and community settings. Consequently, many children are placed away from their families and communities at higher costs than if appropriate treatment in the community had been available. In a time of limited resources, Texas needs to develop a strategy to redirect the use of institutional funds to home and community services. This project will study the feasibility of and the most appropriate plan for providing more effective home and community services to children with SED, whether via a waiver, demonstration project, or through a state-only approach. The study will assess which of the options best enhance existing efforts and will develop a detailed financing, implementation, and evaluation plan for each recommended option.

The ultimate goal of this feasibility study is to identify treatment mechanisms that allow children to live in the most integrated community setting, that give families choices about treatment options, and that expand the array of quality, intensive treatments, and supports. The study will produce feasible solutions for using a waiver or demonstration to integrate funding, coordinate services, and develop a comprehensive provider base to (1) increase the number of Texas children with SED who are provided quality treatment in their homes and communities and (2) decrease the number of Texas children placed in institutional settings.

Note: This Compendium form was not reviewed by the Grantee prior to publication.

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Quality Assurance and Quality Improvement in Home and Community Based Services

CALIFORNIA

Grant Information

Name of Grantee
State of California
Title of Grant
Bay Area Quality Enhancement Initiative
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$499,844
Year Original Funding Received
2003

Contact Information

Margaret Anderson
Department of Developmental Services
1600 Ninth Street, Room 340, MS 3-23
Sacramento, CA 95814
916-654-3681
manders6@dds.ca.gov

Subcontractor(s)

Kraig Nagel, MA, Ed.D.
Project Director
San Andreas Regional Center
300 Orchard City Drive, Suite 170
Campbell, CA 95008
405-341-3497
sakraig@sarc.org

Consultants to be hired.

Target Population(s)

Individuals with developmental disabilities.

Goals

Activities

Abstract

The California Department of Developmental Disabilities Services (DDS) has various initiatives and efforts underway to address systemic weaknesses identified through a self-assessment that compared the current Quality Assurance and Quality Improvement (QA/QI) system within the context of the HCBS Quality Framework. Through this project, DDS will target specific problem areas in two critical dimensions of home and community based service delivery: provider capacity and capabilities and participant outcomes and satisfaction. DDS will use the San Francisco Bay Area as a pilot area to test new models, methods, and processes and apply the lessons learned to make statewide reforms to the QA/QI system.

The Bay Area Quality Management System will be a collaborating consortium involving representatives of three regional centers, a developmental center, consumers and family members, service providers, advocacy organizations, and others. The model for the system will be designed using a quality management approach. Specific implementation plans will be developed to provide a blueprint of the necessary steps and resources needed to successfully launch system operations. Focus areas of the implementation plans include (1) a process in which performance expectations are specified and tied to the provider's ability to become certified to offer services and supports; (2) a system for providing training and technical assistance to providers to achieve higher levels of quality in their services and supports and meet their performance expectations; (3) a process for expanding the available network of generic resources and service providers; (4) activities to support consumers' and family members' involvement in decision-making, including a Quality Review Commission comprising stakeholders; and (5) identification of the resources and supports needed to support the operations of the Bay Area Quality Management System.

DDS will also institute new methods for assessing consumers' and family members' satisfaction with their services and supports to provide all levels of decision-makers with needed information to assess overall performance. Through this project, DDS will define an improved assessment process, including the assessment tool and sample selection methods. DDS will then partner with an organization or entity to conduct the actual assessment of consumer satisfaction.

Evaluation activities will be incorporated throughout the project so that midcourse corrections may be made, as well as decisions concerning application to other regions. At strategic points throughout the project, decision-makers will consider the readiness to make system improvements on a statewide basis.

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Quality Assurance and Quality Improvement in Home and Community Based Services

COLORADO

Grant Information

Name of Grantee
Colorado Department of Human Services, Division for Developmental Disabilities
Title of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services for Colorado's Citizens with Developmental Disabilities
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$499,851
Year Original Funding Received
2003

Contact Information

Matthew Solano, Project Director
Director of Program Quality
Division for Developmental Disabilities
Colorado Department of Human Services
3824 West Princeton Circle
Denver, CO 80236
303-866-7439
matthew.solano@state.co.us

Subcontractor(s)

None.

Target Population(s)

Colorado waiver participants with developmental disabilities.

Goals

Activities

Abstract

Colorado has a complex, decentralized developmental disabilities system that emphasizes small group living arrangements, promotion of individual and family choice of services/supports and providers, and a large number of providers. Colorado's incident management system is multitiered, with both county-based Community Centered Boards (CCBs) and service agencies having line responsibility for preventing, identifying, and following up on critical incidents. Colorado's baseline quality assurance standards and processes are fundamentally sound, but the challenge facing Colorado is to position QA/QI for HCBS to make smart use of IT to support quality management and improvement. The Division for Developmental Disabilities (DDD) does not currently have an efficient or effective system to capture information about critical incidents in real or near-real time, or to support trend and root cause analysis of such incidents. The lack of solid IT capabilities undermines the capacity to conduct performance appraisals, engage in effective quality improvement, and furnish important information to participants and families to aid them in selecting providers.

This project will provide the IT capabilities that DDD needs to efficiently and effectively identify trends and conduct root cause analysis regarding critical incidents. Further, this project will establish a statewide Project Advisory Committee to review critical incident data and will institute a review process to ensure that DDD and the CCBs demonstrate competence and diligence in responding to critical incident data. These efforts will enhance the efficiency and effectiveness of discovery, remediation, and systems improvement. The project will also provide a needed degree of standardization in information collection, without requiring administratively burdensome and costly changes to the systems that are already in place. DDD will seek only a subset of information, most of which is likely being collected already, and will provide an easily-accessible, automated data capture system to receive it.

The project also seeks to enhance the role and effectiveness of self-advocates as key guarantors of quality services. DDD has acknowledged the importance of self-advocacy in ensuring the quality of waiver services in Colorado and through this project will provide subgrants to local self-advocacy and family advocacy groups to support the development of new self-advocacy organizations or to expand the efforts of existing organizations (e.g., Speaking for Ourselves, Association for Persons in Supported Employment, etc.). This project will also reimburse travel expenses for self-advocates to attend and participate in DDD's Self-Advocate Advisory Council, which provides direct input to the DDD Director on statewide policy issues.

This project will position Colorado for sustained improvement in its QA/QI activities. The new systems and improvements to existing systems that the project will introduce are highly efficient and based on inexpensive, proven IT. Finally, the project will build the support of stakeholders for the information collection system through their involvement in the Project Advisory Committee and their continued involvement in an ongoing, statewide Quality Improvement Council.

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Quality Assurance and Quality Improvement in Home and Community Based Services

CONNECTICUT

Grant Information

Name of Grantee
Connecticut Department of Mental Retardation
Title of Grant
Connecticut Quality Review and Improvement
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$499,000
Year Original Funding Received
2003

Contact Information

Beth McArthur, Project Co-Director
860-418-6132
beth.mcarthur@po.state.ct.us

Laura Nuss, Project Co-Director
460 Capitol Avenue
Hartford, CT 06016
860-418-6130
laura.nuss@po.state.ct.us

Subcontractor(s)

Cynthia Gruman, Ph.D.
Assistant Professor of Medicine
University of Connecticut Health Center
Center on Aging
263 Farmington Avenue
Farmington, CT 06030
860-679-7960
gruman@uchc.edu

Project consultants to be decided.

Target Population(s)

All people served by the Connecticut Department of Mental Retardation (DMR).

Goals

Activities

Abstract

The Connecticut DMR is using Real Choices Grant funding to strengthen its quality review system by developing data applications to provide more timely, accurate, integrated, and comprehensive information that will identify trends and provide a foundation for improvement initiatives. The grant project also includes activities to involve consumers and family members in the design, implementation, and evaluation of DMR's new quality review and improvement system. As part of this effort, DMR will establish state-level review teams and regional and statewide quality improvement councils with consumer and family membership. Self-advocates will also be involved in a Leadership Institute, training them to assume influential roles in the quality system. The planned outcomes of this grant include

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Quality Assurance and Quality Improvement in Home and Community Based Services

DELAWARE

Grant Information

Name of Grantee
Division of Developmental Disabilities Services (DDDS)
Title of Grant
Consumer Centered Quality Assurance and Quality Improvement in Home and Community Based Services Protocol
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$351,702
Year Original Funding Received
2003

Contact Information

Joseph B. Keyes
Director, Professional Services
Woodbrook Professional Center
1056 S. Governor's Avenue, Suite 101
Dover, DE 19904
302-744-9600
Joseph.Keyes@state.de.us

Subcontractor(s)

June Rowe
Human Services Research Institute
Cambridge, MA
617-876-0426

Project consultant for information technology (IT) development phase still to be chosen.

Target Population(s)

Consumers with developmental disabilities.

Goals

Activities

Abstract

Building on DDDS participation in the National Core Indicators Project and in the Re-inventing Quality Conferences, a 3-year plan for developing a consumer-centered QA/QI system for HCBS has been developed. A Consumer/Stakeholder Task Force will be formed to direct the project, which uses the HCBS Quality Framework (National Quality Inventory Project) and the Consumer Experiences Survey (MR/DD version) to structure the changes to the Division's QA/QI system.

The project has three phases: (1) assess quality management functions in the current QA/QI HCBS system, (2) develop a QA/QI HCBS strategic plan around the HCBS Quality Framework focus areas and desired outcomes, and (3) implement the new QA/QI HCBS system. The activities of this project will lead to a fundamental alteration in the Division's QA/QI HCBS system, which will be person centered around the seven focus areas and related desired outcomes of the HCBS Quality Framework.

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Quality Assurance and Quality Improvement in Home and Community Based Services

GEORGIA

Grant Information

Name of Grantee
Georgia Department of Human Resources
Title of Grant
Georgia Quality Assurance and Quality Improvement in Home and Community Based Services
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$475,000
Year Original Funding Received
2003

Contact Information

Stephen Hall, Ph.D.
Director of Office of Developmental Disabilities
DHR
2 Peachtree Street, NW, 22.108
404-463-8037
srhall1@dhr.state.ga.us

Stacey Ramirez
Project Coordinator
Office of Developmental Disabilities
2 Peachtree Street, NW, 22-263
404-657-6405
saramirez@dhr.state.ga.us

Lori von Schmeling
Children and Family Program Specialist
Office of Developmental Disabilities
2 Peachtree Street, NW, 22-414
Atlanta, GA 30303-3142
404-657-6416
lvschmeling@dhr.state.ga.us

Subcontractor(s)

Connie Lyle O'Brien
770-987-9785
connielyleobrien@mac.com

Human Services Research Institute
617-876-0426 ext. 2319
vbradley@hsri.org

A consultant who specializes in developmental disabilities (DD) performance measurement and quality improvement (QI) systems (to be named).

A consultant to help create an interim system to collect, store, and disseminate DD performance, quality, and outcome information (to be named).

Target Population(s)

Persons with mental retardation and other developmental disabilities (MR/DD).

Goals

Activities

Abstract

The Department of Human Resources (DHR) is the primary human service agency of Georgia, and the Division of Mental Health, Developmental Disabilities and Addictive Diseases (DMHDDAD) is a division of DHR. Two separate home and community based services waiver programs based in DMHDDAD currently serve persons with MR/DD. DMHDDAD is planning to engage in a redesign process for these waivers to encourage services that are person-directed, person-centered, and afford greater flexibility to individuals served and providers.

Although Georgia is raising awareness of self-determination and self-directed services, a gap between knowledge and practice of these principles exists. Many providers have received person-centered training, but lack the skills to develop and implement a PCP. This project will test methods for implementing these principles and provide a provider guide.

Georgia currently maintains four databases, which collect, store, and track various issues that impact people with DD and their services. These systems, however, function independently and do not share information, making data entry and review cumbersome and repetitious. The project will link these systems and facilitate access to information.

The State currently uses the Schalock Quality of Life Questionnaire (QOL-Q) and an internally-developed individual and family survey to measure the quality of services provided to persons with MR/DD. However, many stakeholders believe that the Schalock QOL-Q may not accurately reflect the degree to which programs promote quality of life for all the people served. This project will enable Georgia to move to a system that measures quality by the achievement of personal outcomes that are important to the individual.

Georgia has long garnered and appreciated the input and participation of individuals served by DMHDDAD and their families, but has not had a mechanism with which to involve them in the QI process. Through this project, Georgia will promote their ongoing participation in quality committees and performance improvement teams.

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Quality Assurance and Quality Improvement in Home and Community Based Services

INDIANA

Grant Information

Name of Grantee
Indiana Family and Social Services Administration/Division of Disability, Aging and Rehabilitative Services
Title of Grant
The Indiana Quality Assurance/Quality Improvement System for Home and Community Based Services
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$500,000
Year Original Funding Received
2003

Contact Information

Ellen McClimans, Director
Bureau of Quality Improvement Services
317-234-1147
nmcclimans@fssa.state.in.us

Barbara Bates, Project Director
Indiana Family and Social Services Administration
402 W. Washington Street
PO Box 7083
Indianapolis, IN 46207-7083
317-234-0462
bbates@fssa.state.in.us

Subcontractor(s)

None.

Target Population(s)

Individuals receiving services funded by the Aged and Disabled Waiver, the Medically Fragile Children's Waiver, the Traumatic Brain Injury Waiver, and the Assisted Living Waiver administered by the Bureau of Aging and In-Home Services (BAIHS).

Goals

Activities

Abstract

The Indiana Division of Disability, Aging and Rehabilitative Services (DDARS)/BAIHS supports a statewide in-home services program. A recently passed statute laid the framework for shifting the State's long-term care spending from predominately nursing homes to a greater reliance on home and community services. In January 2000, the Bureau of Quality Improvement Services (BQIS) was established to develop and implement QA/QI systems for all programs within the DDARS.

This grant will (1) develop mechanisms to obtain participant input into the development of QA/QI systems and ongoing feedback about services; (2) create consistent standards by which all providers must abide; (3) institute uniform policies and procedures across the various state agencies and contractors who provide services; and (4) develop information technology systems that will improve data collection and the ability to review trend information, make recommendations, implement processes to be put into place, and reevaluate the effectiveness of the systems. Overall, the project will develop a QA/QI system that facilitates communication and provides effective protection and support for participants.

Consumers are represented on the Consumer/Community Advisory Council and its subcommittees, through the participation of the Indiana Home Care Task Force and the recruitment of individual consumers. Provider industry groups are also involved, as are numerous state agencies.

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Quality Assurance and Quality Improvement in Home and Community Based Services

MAINE

Grant Information

Name of Grantee
Maine Department of Health and Human Services
Title of Grant
Maine's Quality Assurance and Quality Improvement Project
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$500,000
Year Original Funding Received
2003

Contact Information

Chris Zukas-Lessard
Principle Investigator
State House Station #1
Kennebec County
Augusta, ME 04333-0011
207-287-2093
chris.zukas-lessard@maine.gov

Subcontractor(s)

Julie Fralich, Project Director
Edmund S. Muskie School of Public Service
University of Southern Maine
207-780-4848
julief@usm.maine.edu

Other contracts yet to be awarded.

Target Population(s)

Adults with disabilities, including older adults, adults with physical disabilities, adults with mental retardation (MR), and adults with physical disabilities who direct their own services.

Goals

Activities

Abstract

Under the Maine Department of Health and Human Services, as lead agency and applicant, the state offices will collaborate on this grant to design a cohesive and coordinated quality management system for home and community services for adults with disabilities, including older adults, adults with physical disabilities, adults with mental retardation, and adults with physical disabilities who direct their own services.

This grant provides the opportunity to build on the recommendations of Maine's Plan Development Work Group for Community-Based Living to (1) put in place a quality management system that is "consumer-driven, comprehensive, integrated, and value-based" and (2) create an environment and infrastructure to support sustainable interdepartmental collaboration.2 The Work Group for Community-Based Living is Maine's Olmstead planning group comprised of consumers and state officials.

The project will move efforts to improve quality by developing and implementing computer-based monitoring and reporting systems to assure the health and welfare of individuals who participate in HCBS waiver and related programs.


2 Maine's Plan Development Work Group for Community-Based Living, Communities, Individuals and Choices: A Roadmap for Meeting Individualized Needs in Integrated Settings and Programs, Draft, 10/2/02.

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Quality Assurance and Quality Improvement in Home and Community Based Services

MINNESOTA

Grant Information

Name of Grantee
Minnesota Department of Human Services Continuing Care Administration
Title of Grant
Minnesota's Quality Assurance and Quality Improvement Project
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$499,880
Year Original Funding Received
2003

Contact Information

Jolene Kohn, Project Director
Strategic Planner
Department of Human Services
540 Cedar Street
St. Paul, MN 55155
651-431-2579
jolene.kohn@state.mn.us

Subcontractor(s)

Four to be awarded.

Target Population(s)

Home and Community Based Services (HCBS) waiver participants.

Goals

Activities

Abstract

This project will improve the design of participant safeguards and the functions of discovery and remediation related to these safeguards. It will also enhance the capacity of the HCBS waiver system by improving the measurement of satisfaction and achievement of personal outcomes for participants. This measurement data will be integrated with other division and agency data into a comprehensive statewide QA/QI "data mart."

The Quality Design Commission is a consumer group created to establish valued outcomes and recommend systems improvement strategies. By gaining substantial consumer and stakeholder input through the Quality Design Commission, Minnesota will improve its ability to systematically review the efficacy of safeguards and the extent to which HCBS waiver services support individual quality of life.

The Minnesota Department of Human Services (DHS) is the lead agency for this grant. The Department's Continuing Care Administration will be responsible for overseeing all aspects of project planning, implementation, and evaluation and will partner with the DHS Disabilities Services and Information Technology Strategies divisions, Quality Design Commission, Minnesota Board on Aging, Minnesota Department of Health Office of Health Facility Complaints, and eight county-based Adult Protection divisions, to achieve the following outcomes: (1) improved response time between discovery and remediation, (2) better identification of "poor" providers, (3) discernment of patterns or trends in complaints and investigations and targeted technical assistance, (4) consistent data to inform program decisions that ensure higher quality, and (5) use of consumer-defined measures of quality in both service delivery and service outcomes.

Formative evaluation methods will be designed and used to assure the quality of program management, and will track the ongoing effectiveness of project development and implementation. Summative evaluation methods will be designed to document impact on consumers and evaluate the entire project at the end of the grant period. Data for this evaluation will be derived from monthly and quarterly project reports, financial records, participant surveys, anecdotal information, and oral interviews with project partners.

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Quality Assurance and Quality Improvement in Home and Community Based Services

MISSOURI

Grant Information

Name of Grantee
Department of Health and Senior Services
Title of Grant
Missouri's Quality Assurance and Quality Improvement Project
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$500,000
Year Original Funding Received
2003

Contact Information

Vicki Keller, Project Director
Bureau Chief
Department of Health and Senior Services
Division of Senior and Disability Services
3418 Knipp Drive
PO Box 570
Jefferson, MO 65102
573-526-8601
vicki.keller@dhss.mo.gov

Subcontractor(s)

To be determined by an RFP process in first year of the grant. The Department secured Rose International, through the RFP process, to assist with this project.

Target Population(s)

Participants in all the State's Home and Community Based Services (HCBS) waiver programs.

Goals

Activities

Abstract

The Department of Health and Senior Services will be the lead agency for the development and administration of this grant, in partnership with the Departments of Mental Health, Elementary and Secondary Education, and Social Services.

The overall objective of this project is to ensure the health and safety of persons who receive home and community services and those persons considering long-term care options for remaining in or returning to the community.

Grant funds will be used to support the interagency collaboration needed to develop a comprehensive, statewide system for tracking issues related to the HCBS waiver in community settings. Many state agencies have begun developing such systems or are in the initial stages of implementation of various quality assurance mechanisms. The ultimate goal of this project is to develop a consistent method of gathering quality assurance data for all HCBS waiver programs and use the data to identify and address problem areas. The system will also provide the basis for improved reporting capabilities to the State Medicaid agency.

The project will also develop a formal client survey to assess the needs and concerns of in-home service participants. This tool will be offered to all state agencies and administrative agents for use in obtaining data that can be put into their systems, the end result being to expedite complaints to ensure that client health and welfare are protected. The solicitation of input from program participants will be an integral part of the project.

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Quality Assurance and Quality Improvement in Home and Community Based Services

NEW YORK

Grant Information

Name of Grantee
New York State Department of Health, Office of Medicaid Management
Title of Grant
New York's Quality Assurance and Quality Improvement Project
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$495,811
Year Original Funding Received
2003

Contact Information

Betty Rice, Project Director
518-474-9138
brr02@health.state.ny.us

Charlotte Mason, Project Coordinator
Division of Consumer & Local District Relations
One Commerce Plaza, Room 826
Albany, NY 12260
518-474-5271
cmm24@health.state.ny.us

Subcontractor(s)

To be determined by an RFA process in first year of the grant.

Target Population(s)

Participants in the State's Traumatic Brain Injury (TBI) waiver program and in the Long-Term Home Health Care Program (LTHHCP), which provides services at home to elderly persons and individuals of all ages with disabilities.

Goals

Activities

Abstract

This project will assure participants' health and safety and will create enduring systems change in the waiver programs' QA/QI processes. The systems developed from this project will include the functions of discovery, remediation, and continuous improvement of the quality of services provided to waiver participants in the target populations.

The project will establish a QA/QI Board to address a number of quality issues related to the TBI waiver, including evaluating the current QA/QI program and making recommendations for changes. Information will be gathered in statewide forums, which will include participants, family members, providers, and other interested parties. Depending on the results of this Board's work, the project will also create a QA/QI Board for the LTHHCP.

This grant will allow the State to contract with an entity to administer the Participant Experience Survey to LTHHCP participants. The results of this survey will be analyzed, providing an independent source of information about participant satisfaction. The information collected will allow the Department to accomplish two goals: (1) to share the results of the survey with local districts, providers, and participants so that they will learn from best practices or jointly take action to correct specific issues that have been identified; and (2) to pursue systemwide changes that affect the total waiver population.

Finally, the project will develop a QA/QI database for use initially with the TBI waiver and, ultimately, with the LTHHCP. This database will capture data on participant demographics, provider information, participant satisfaction, and incidents reported. This information will be used to generate reports showing where quality improvement is needed, and identifying best practices to be used as models.

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Quality Assurance and Quality Improvement in Home and Community Based Services

NORTH CAROLINA

Grant Information

Name of Grantee
North Carolina Department of Health and Human Services
Title of Grant
From Institutions to Communities: Quality Management for North Carolina's Transitioning Populations
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$475,100
Year Original Funding Received
2003

Contact Information

Steven E. Hairston
919-733-7011
steven.hairston@ncmail.net

Shealy Thompson, Project Director
3003 Mail Service Center
Division of MH/DD/SA Services
Raleigh, NC 27699-3003
919-733-0696
shealy.thompson@ncmail.net

Subcontractor(s)

Yet to be awarded.

Target Population(s)

Individuals in psychiatric institutions, intermediate care facilities for mental retardation (ICF/MR), and child residential treatment facilities who are transitioning to community settings (i.e., "transitioning populations").

Goals

Activities

Abstract

This Quality Assurance/Quality Improvement project will create a model system to monitor and improve the quality of initiatives to help people transition to community settings ("transitioning populations") from psychiatric institutions, intermediate care facilities for people with mental retardation, and child residential treatment facilities. The project will also devise a plan to test this system and then expand it to all state users of long-term care.

The project will build on three current initiatives in the NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMHDDSAS):

  1. The State MHDDSAS Plan to reform the service system into one that has consumer-driven, outcomes-oriented services provided in the most integrated community settings possible; consumer and family involvement in design and implementation of the system; measurable standards of safety, quality, and clinical effectiveness; and a total quality management philosophy;
  2. The DHHS Olmstead Plan for transitioning individuals to communities from state psychiatric institutions, state- and community-based ICFs/MR, and nursing homes; and
  3. The DMHDDSAS Child Mental Health Plan, which includes transitioning children out of child residential treatment facilities and psychiatric hospitals to home and community settings.

A Quality Management Plan for the state mental health/developmental disability, and substance abuse service system will be developed by a team of DMHDDSAS staff, other state staff, consumers, family members, and local stakeholders. A demonstration project, focused on the transitioning populations, will be developed and implemented. For the demonstration, consumers and family members will be hired and trained to interview transitioning individuals about their satisfaction with the quality of their care, the transitioning process, and progress toward their personal goals. The data derived will be used to rectify problems in individual situations and improve the transition process and delivery of services and supports. Data will also be used to inform development of an ongoing quality management plan.

In preparation for the demonstration project, current outcome and satisfaction measures, tools, and methodologies will be reviewed to determine their fit with the goals of the quality management system. A Web-based data system that is currently being developed for collection and management of data on people transitioning out of psychiatric institutions will be enhanced to accommodate data about additional transitioning populations.

Finally, the project will develop a plan for expanding the model into a full Quality Management System for the North Carolina long-term care system.

Note: This Compendium form was not reviewed by the Grantee prior to publication.

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Quality Assurance and Quality Improvement in Home and Community Based Services

OHIO

Grant Information

Name of Grantee
Ohio Department of Mental Retardation and Developmental Disabilities
Title of Grant
Ohio's Quality Assurance and Quality Improvement Project
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$499,740
Year Original Funding Received
2003

Contact Information

Donald E. Bashaw, Project Director
614-728-2524
don.bashaw@dmr.state.oh.us

Suzzanne Reimold Freeze
Project Manager
Ohio DMRDD
35 E. Chestnut Street, 5th Floor
Columbus, OH 43215-2541
614-728-2518
suzzanne.freeze@dmr.state.oh.us

Subcontractor(s)

None.

Target Population(s)

Individuals with mental retardation and other developmental disabilities.

Goals

Activities

Abstract

The Ohio Department of Mental Retardation and Developmental Disabilities (ODMR/DD) is the repository of a considerable amount of data and information from Ohio's diverse county-based service delivery system. The Department collects extensive demographic information about individuals served as reported by each of 88 local county boards of mental retardation and developmental disabilities (hereafter, county board). More specifically, through "monitoring and compliance" reviews conducted by various offices of the Department, a considerable amount of data and information is amassed specific to local agencies' management and delivery of services and supports to individuals. Each of these review protocols is exhaustive in their evaluation of county boards' and private providers' compliance with federal and state law and regulation.

This project will design and implement a quality information management system in which data generated by the service system is used to develop an integrated knowledge profile. This profile will identify areas of improved effectiveness and efficiency in the management and delivery of services and supports to individuals with disabilities.

The State contends that enhanced use of information already collected by the service delivery system can be used to increase the efficiency and improve the effectiveness of the supports available to individuals with mental retardation and developmental disabilities. Successful execution of this project will yield (1) improved availability of useful information for individuals and families; (2) a comprehensive, statewide quality framework that outlines anticipated outcome measures for the service system; (3) data to determine training initiatives, technical assistance methodologies, public policy, effectiveness and efficiency measures, improved state and local resource deployment, and statistically-based trends and analyses; and (4) a system for reporting information/discoveries to local service providers, families, and individuals who use services and supports.

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Quality Assurance and Quality Improvement in Home and Community Based Services

OREGON

Grant Information

Name of Grantee
Oregon Department of Human Services, Seniors and People with Disabilities (SPD)
Title of Grant
Oregon's Quality Assurance and Quality Improvement Project
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$455,113
Year Original Funding Received
2003

Contact Information

DeAnna Hartwig
Administrator, Office of Federal Resources and Financial Eligibility
Department of Human Services
Seniors and People with Disabilities
500 Summer Street NE, E-02
Salem, OR 97301-1073
503-947-1180
deanna.j.hartwig@state.or.us

Subcontractor(s)

Human Services Research Institute

Target Population(s)

Persons of all ages with disabilities.

Goals

Activities

Abstract

Over 36 months, the Oregon Department of Human Services, SPD proposes to develop an improved and balanced approach to quality assurance and quality improvement for in-home, long-term care services delivered to persons who are aged, physically disabled, or developmentally disabled. The top priority is to improve the systems that help assure individual health and safety and address issues related to individual risk management.

This project addresses four quality assurance/quality improvement functions: design, discovery, remediation, and systems improvement. The project will produce more reliable, accurate, consistent, and useful information regarding health and safety matters. This information will be used for quality assurance purposes at the county, regional, and state levels, and also to ensure an effective system is in place to respond to critical incidents/events at the individual plan-level as they occur.

The project will also focus on remediation and systems improvements as better and more consolidated information becomes available. The plan for sustainability will address activities for continuing key grant-initiated activities and also prioritize the continual refinement of the remediation and systems improvement functions.

As a result of grant activities, by 2006 SPD will have developed the written tools and procedures and conducted the training needed to achieve and sustain an improvement in the quality of community-integrated services.

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Quality Assurance and Quality Improvement in Home and Community Based Services

PENNSYLVANIA

Grant Information

Name of Grantee
Department of Public Welfare
Title of Grant
Pennsylvania's Quality Project
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$498,650
Year Original Funding Received
2003

Contact Information

Heidi Adams
Executive Policy Analyst
Governor's Policy Office
Office of Health Care Reform
Harrisburg, PA 17120
717-346-7082
headams@state.pa.us

Subcontractor(s)

None.

Target Population(s)

Persons with disabilities served under all Medicaid Home and Community Based Services (HCBS) waivers.

Goals

Activities

Abstract

Pennsylvania is committed to assuring that older persons and persons of all ages with disabilities have the ability to live independently in the community and be able to direct their services. However, the State's HCBS quality assurance system is unevenly developed across waiver programs, with varying levels of automation and use of data tracking methods to assure adequate follow-up when things go wrong at the point of service provision.

The Governor's Office of Health Care Reform will address these identified problems through implementation of the Quality Assurance and Quality Improvement Grant project, which will execute specific tasks to improve the QM infrastructure for HCBS. These tasks include

Pennsylvania proposes to have this system operational statewide by the third year of the grant. The Office of Health Care Reform will work directly with consumers, advisory groups, and state agencies to ensure that grant goals are achieved.

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Quality Assurance and Quality Improvement in Home and Community Based Services

SOUTH CAROLINA

Grant Information

Name of Grantee
South Carolina Department of Disabilities and Special Needs
Title of Grant
Validating and Expanding the Use of Peer Review Organizations in Assessing Quality Assurance and Quality Improvement in State Developmental Disability Systems
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$500,000
Year Original Funding Received
2003

Contact Information

Darlynn Thomas
Director for Quality Assurance and Quality Improvement
SCDDSN
3440 Harden Street, Ext. 29203
PO Box 4706
Columbia, SC 29240
803-898-9691
dthomas@ddsn.sc.gov

Project Director to be decided.

Subcontractor(s)

National Association of State Directors of Developmental Disabilities, Inc.

Target Population(s)

Persons with mental retardation and related disabilities, autism, and head and spinal cord injuries.

Goals

Activities

Abstract

Over the past few years, SCDDSN has developed a sophisticated, multitiered, coordinated QA/QI program that contains state-of-the-art features, including various risk management activities, contract compliance reviews, personal outcome measures, and consumer and family satisfaction measures. A large and important portion of this program is performed by a PRO, First Health Services Corporation, with whom the State contracts.

SCDDSN believes that the current best thinking in QA/QI is incorporated in its programs, but this has not been validated externally. One goal of this grant is to use an external research organization to assess the validity and reliability of the work done by the contracted PRO.

Now that CMS has developed the Quality Framework, SCDDSN sees the need to make sure that each of the four functions and seven domains contained therein are addressed by its QA/QI system. Over the course of this grant, SCDDSN will externally validate that all components of the CMS Quality Framework are adequately addressed during the work done by the PRO.

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Quality Assurance and Quality Improvement in Home and Community Based Services

TENNESSEE

Grant Information

Name of Grantee
Tennessee Department of Finance and Administration
Title of Grant
People Talking to People: Building Quality and Making Change Happen
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$452,636
Year Original Funding Received
2003

Contact Information

Brenda Clark, Project Coordinator
Division of Mental Retardation Services
500 Deaderick Street, 15th Floor
Andrew Jackson Building
Nashville, TN 37243
615-253-6811
brenda.clark@state.tn.us

Subcontractor(s)

The ARC of Tennessee

Target Population(s)

Persons with mental retardation and other developmental disabilities, and elderly disabled persons.

Goals

Activities

Abstract

The grant's QA/QI home and community services project has been endorsed by TennCare, the Tennessee Medicaid agency. The project will be a crucial and integral component of a new system of QA/QI supporting individuals with disabilities.

The overall goal of the project is to create a consumer-driven QA/QI system that will result in timely remediation and systemwide quality improvement.

Measurable outcomes include

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Quality Assurance and Quality Improvement in Home and Community Based Services

TEXAS

Grant Information

Name of Grantee
Texas Department of Aging and Disability Services (DADS)
Title of Grant
Texas Quality Assurance and Quality Improvement Project
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$500,000
Year Original Funding Received
2003

Contact Information

Teresa Richard, Project Director
Center for Policy and Innovation
Quality Assurance and Improvement
701 West 51st Street
Austin, TX 78751
512-438-3518
teresa.richard@dads.state.tx.us

Subcontractor(s)

Shirley Zirkle, Business Analyst, began March 16, 2004
Kirk Jones, Data Analyst, began June 13, 2005

Target Population(s)

Persons with intellectual/physical disabilities and the aged served in the Texas Department of Aging and Disability Services (DADS) programs.

Goals

Activities

Abstract

The project will redesign and improve the State's information-gathering system to integrate DADS's existing QA/QI reporting mechanisms into a comprehensive data collection system. This system will ensure that DADS's methodology to measure the quality of services assures an accountable use of public resources and a balance between personal outcomes and flexible supports and regulatory requirements to improve the quality of the DADS programs.

The project will establish a Quality Assurance/Quality Improvement Task Force that will include participants and family members, advocacy groups, DADS program providers, local authorities, and other stakeholders. The integrated information-gathering system to be developed will

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Quality Assurance and Quality Improvement in Home and Community Based Services

WEST VIRGINIA

Grant Information

Name of Grantee
West Virginia Department of Health and Human Resources
Title of Grant
Quality Assurance and Quality Improvement Project
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$499,995
Year Original Funding Received
2003

Contact Information

Cynthia Beane, Program Manager
Bureau for Medical Services
350 Capitol Street, Room 251
Charleston, WV 25301-3707
304-558-5962
CynthiaBeane@wvdhhr.org

Subcontractor(s)

Marcus Canaday, Program Manager
Center for Excellence in Disabilities
West Virginia University
304-720-3200 ext. 218

Target Population(s)

Persons with mental retardation and other developmental disabilities (MR/DD), elderly persons, and persons with disabilities.

Goals

Activities

Abstract

The project will strengthen West Virginia's ability to assure the health, welfare, and dignity of individuals participating in the HCBS waiver, by developing an effective and systematic QA/QI system that enlists people with disabilities, their family members, advocates, and allies as active participants in the process. Current and former waiver participants will play an active role in implementing and monitoring this project. The project strengthens the four basic components of an effective and ongoing quality initiative: design, discovery, remediation, and system improvement.

The project will create a quality assurance process and improvement infrastructure with QA/QI councils and a quality improvement team. The QA/QI councils will provide guidance and feedback for the development of ongoing quality initiatives within their respective waiver programs. Each council will consist of current and former waiver participants (or their legal representatives), family members, direct care workers, providers, and advocates and allies of people with disabilities. A quality improvement team, comprising waiver staff, staff from the Bureau for Medical Services (BMS), and participant representatives from each waiver, will oversee and coordinate the efforts of both councils.

The project will strengthen West Virginia's ability to compile and use real time and retroactive data to assess the performance of both HCBS waiver programs. Approximately 300 participants in the A/D waiver will be surveyed to assess their experience in the program. All existing data will be compiled and organized to assess core measurement sets. The results of the project will be distributed to HCBS waiver stakeholders for their feedback. This will allow the project and both HCBS waivers to continually improve the quality assurance and improvement process in West Virginia.

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Quality Assurance and Quality Improvement in Home and Community Based Services

WISCONSIN

Grant Information

Name of Grantee
Department of Health and Family Services
Title of Grant
Quality Close to Home
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$500,000
Year Original Funding Received
2003

Contact Information

Karen McKim
Quality and Research Manager
One West Wilson Street
PO Box 7851
Madison, WI 53707
608-266-9304
mckimk@dhfs.state.wi.us

Subcontractor(s)

A quality systems consulting firm will design and develop quality measures. A university research center will assess consumer-experience measurement tools.

Target Population(s)

Populations served through the State's Home and Community Based Services (HCBS) waivers including elderly persons and adults with physical or developmental disabilities.

Goals

Activities

Abstract

The primary objective of this project is to improve local waiver agencies' QM practices, consistent with the CMS HCBS Quality Framework. The project will also improve the State's own HCBS QM program and its ability to enable, support, and empower more effective local QM practices. The Department wants to create sustainable improvements in state and local QM systems, with the ultimate goal of improved outcomes for consumers of HCBS in Wisconsin's waiver programs and consistency in the delivery of quality HCBS.

This project will create and provide to local agencies an improved package of standards, guidelines, and benchmarks for QM systems, and more effective training and technical assistance materials that are consumer-outcome oriented. A consulting firm with expertise in QM will assist in assessing current QA/QI efforts and developing improvements, and will help develop functional, clinical, and consumer-outcome measures for use in discovery and remediation. The project will also re-examine and revise state-level QM processes to identify and correct inefficient or contradictory requirements to develop better ways to administer consumer-experience measurement tools and to put the results of those measurements to use for improving results valued by consumers. The project will also identify and implement processes to improve effective collaboration between state facilities-regulation authorities and waiver program managers at both the state and local level.

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Independence Plus Initiative

COLORADO

Grant Information

Name of Grantee
Colorado Department of Health Care Policy and Financing
Title of Grant
Colorado Independence Plus Initiative
Type of Grant
Independence Plus Initiative
Amount of Grant
$391,137
Year Original Funding Received
2003

Contact Information

Diane M. King, Grant Administrator
303-866-5432
diane.king@state.co.us

Viki Manley, Division Director
Systems Change Section
Colorado State Department of Health Care Policy and Financing
1570 Grant Street
Denver, CO 80203
303-866-2991
viki.manley@state.co.us

Subcontractor(s)

Subcontracts will be developed for a focus group facilitator and consumer trainers.

Target Population(s)

Individuals of all ages with disabilities who are in current or future state consumer-directed waiver programs.

Goals

Activities

Abstract

The Colorado Health Care Policy and Financing (HCPF) and the Colorado Department of Human Services (DHS) are in various stages of designing, implementing, and supporting four consumer-directed programs within the State's long-term care system. The current systems for protecting consumers of the State's long-term care programs revolve around traditional agencies taking responsibility for critical incident reporting and tracking and for emergency backup measures. They do not allow consumers to take a significant role in defining and overseeing the protections that will support them in the community. The overall goals of the Independence Plus grant are to

The project will achieve these goals by identifying existing capacity, developing a consumer-derived definition of critical incidents and emergencies, implementing consumer-defined emergency backup and critical incident management systems, and modifying existing training curricula to include training around the new participant protection mechanisms and infrastructure.

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Independence Plus Initiative

CONNECTICUT

Grant Information

Name of Grantee
Department of Mental Retardation
Title of Grant
Level of Need and Individual Budgeting Project
Type of Grant
Independence Plus Initiative
Amount of Grant
$175,000
Year Original Funding Received
2003

Contact Information

Laura Nuss
Director of Strategic Planning, Development and Quality Management
460 Capitol Avenue
Hartford, CT 06016
860-418-6130
laura.nuss@po.state.ct.us

Subcontractor(s)

Cynthia Gruman, Ph.D.
Assistant Professor of Medicine
University of Connecticut Health Center
Center on Aging
263 Farmington Avenue
Farmington, CT 06030
860-679-7960
gruman@uchc.edu

Target Population(s)

All individuals who seek substantive funding from the Department of Mental Retardation (DMR).

Goals

Activities

Abstract

Connecticut DMR is engaged in discussions with the Single State Medicaid Agency, Department of Social Services, to develop and submit a second HCBS Mental Retardation waiver using the Independence Plus template.

The State has recognized that the flexibility and type of supports individuals and their families want from the DMR are not always best met under Connecticut's existing 1915(c) HCBS Mental Retardation waiver. Data gained from individuals using an Individual Support Agreement option are being gathered to prepare focus group meetings and solicit Web-based input from individuals and families about preferred services and supports, current problems or barriers in obtaining the support they need, and barriers to self-directing their own support plans. Likewise, DMR has been rapidly developing new quality review and improvement methods and systems to assure health, welfare, and positive personal outcomes for individuals supported in their personal or family homes. These efforts are all integral components for the State to prepare a new waiver under the Independence Plus Initiative.

This grant project will support this effort. To successfully apply for a second waiver, Connecticut must have a valid method to establish an individual's probable level of need. Completion of the Level of Need and Individual Budgeting Project will enable the DMR to (1) amend the existing waiver to clearly identify individuals in Connecticut who, if eligible, would be best supported under the current 1915(c) waiver and (2) delineate in the Independence Plus Initiative waiver a methodology to calculate individual budgets for waiver participants.

Grant products will include a database, an algorithm model, a training manual, an individual budget template, strategic plans and budget forecasts, policies and procedures, and a completed waiver application.

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Independence Plus Initiative

FLORIDA

Grant Information

Name of Grantee
Agency for Persons with Disabilities
Title of Grant
Florida Freedom Initiative
Type of Grant
Independence Plus Initiative
Amount of Grant
$501,801
Year Original Funding Received
2003

Contact Information

Shelly Brantley, Director DD
850-488-1559
shelly_brantley@dcf.state.fl.us

Tammy Smith, Project Administrator
Agency for Persons with Disabilities
4030 Esplanade Way, Suite 380
Tallahassee, FL 32399
850-488-9547
Tammy_Smith@apd.state.fl.us

Project Coordinator to be decided.

Subcontractor(s)

Center for Self-Determination

Target Population(s)

Individuals with developmental disabilities who are enrolled in Florida's Consumer-Directed Care Plus (CDC+) Program, self-advocates, and their families.

Goals

Activities

Abstract

Current income and asset limits for disability benefits and welfare programs often discourage beneficiaries from seeking employment because they fear losing their benefits. This grant will build on Florida's current 1115 Research and Demonstration Waiver, Consumer-Directed Care Plus, a cash and counseling demonstration program approved to serve 3,350 individuals statewide. Considering the principles of self-determination, the grant will be used to explore opportunities to reform the system by working with the Social Security Administration to obtain a waiver to allow an increase in income and asset limits. Such an increase would allow individuals with developmental disabilities to work and explore typical housing opportunities while maintaining their SSI/SSDI eligibility until resources increase over current allowable levels.

The grant will also be used to fund an initiative to train self-advocates to work with the 1115 waiver program. This training initiative will incorporate the principle of self-determination. If the SSI waiver is obtained, the training will be expanded to develop and implement a comprehensive training and technical assistance effort related to the new income and asset limits, including a train-the-trainer initiative for individuals with disabilities and family members.

This project is a cooperative effort of the Florida Department of Children and Families' Developmental Disabilities Program, the Florida Developmental Disabilities Council, the Center for Self-Determination, the Department of Elder Affairs, the Department of Health, the Agency for Health Care Administration, and the Florida self-advocacy movement.

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Independence Plus Initiative

GEORGIA

Grant Information

Name of Grantee
Georgia Department of Human Resources
Title of Grant
The Georgia Independence Plus Initiative
Type of Grant
Independence Plus Initiative
Amount of Grant
$432,108
Year Original Funding Received
2003

Contact Information

Darlene Meador, Project Director
Georgia Department of Human Resources
Division of Mental Health, Developmental Disabilities and Addictive Disease
Office of Developmental Disabilities
2 Peachtree Street, NW, Suite 22.102
Atlanta, GA 30303
404-657-1138
dmeador@dhr.state.ga.us

Subcontractor(s)

APS Healthcare Bethesda, Inc.
8403 Colesville Road, Suite 1600
Silver Spring, MD 20910

Target Population(s)

Individuals with disabilities (including those with physical disabilities, serious mental illness, developmental disabilities, and traumatic brain injury) and older adults.

Goals

Activities

Abstract

Since the 1980's, Georgia has employed waivers to offer HCBS services. Current HCBS services, such as personal supports, day support, and natural support enhancements, lay a foundation for self-determination. Existing personal supports systems include a variety of services ranging from traditional services to individualized services designed to support people with disabilities in their growth, development, and inclusion in all aspects of community life. Day support services assist people with developmental disabilities through a combination of supports to address the multiple needs of an individual on any given day. Natural support enhancement services maintain and strengthen the natural support provided in individuals' homes. Georgia's system requires significant redesign to move the State toward self-directed services and supports.

To fulfill the State's commitment to self-direction, policies and regulations must change because the current regulatory system is designed to support traditional residential and personal care home services. Under this grant, self-advocates, family members, advocates, providers, and state agency representatives will work together with technical advisors to design a comprehensive, self-directed service delivery system. The system will provide needed supports, including budgeting support, financial management services, support brokerage services, and protections such as incident management and emergency backup systems.

The master plan for self-determination developed through this collaborative process will enable Georgia to address the increasing demand for community services through improved access to and enhanced flexibility of services tailored to individual and family needs. As a part of this project, Georgia will review its current regulatory system and determine actions needed to transform this system to be consistent with self-determination, including modifying existing and developing new state policies.

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Independence Plus Initiative

IDAHO

Grant Information

Name of Grantee
Idaho Department of Health and Welfare, Division of Medicaid
Title of Grant
Idaho Independence Plus
Type of Grant
Independence Plus Initiative
Amount of Grant
$499,643
Year Original Funding Received
2003

Contact Information

David Rogers, Administrator
208-334-5747
rogersd@idhw.state.id.us

Leslie Clement, Project Director
208-364-1840
clementl@idhw.state.id.us

Ike Gayfield, Project Coordinator
3232 Elder Street
PO Box 83720
Boise, ID 83720-4711
208-364-1896
gayfieli@idhw.state.id.us

Subcontractor(s)

Marilyn Sword, Executive Director
Idaho Council on Developmental Disabilities
802 W. Bannock, Suite 308
Boise, ID 83702
208-334-2178
msword@icdd.state.id.us

Target Population(s)

Adult individuals with developmental disabilities.

Goals

Activities

Abstract

Idaho currently serves over 1,300 individuals aged 18 and older with severe or intermediate levels of developmental disability through HCBS waivers that place some individuals in their own homes, while most are placed in the homes of paid caregivers. A total of 14 services are available under the Developmental Disability waivers but habilitation services, provided either by paid in-home caregivers or supported living caregivers, account for approximately 94 percent of Medicaid total waiver expenditures. Private Intermediate Care Facility populations in Idaho are for the most part static, capped at 486 by the Idaho Legislature in 2000.

Services to individuals with developmental disabilities in Idaho are affected by geography, cultural values, and system architecture. With only 15.5 residents per square mile and minimal public transportation services, individuals with disabilities may easily be isolated. The amount, type, and scope of services offered depends on local availability. By developing a self-directed system of supports and services, isolation will be addressed by a team of family, friends, and others to assist and support the person in developing a plan that best addresses their needs and goals.

A key issue that this grant will address is the need to educate consumers and providers about self-directed services. This project will also create change within the current system by developing and building a more flexible infrastructure to enable individuals with developmental disabilities to exercise more choice and control over the services they receive. To accomplish this goal, this project will (1) develop and implement a self-directed Medicaid services and supports waiver, (2) develop an infrastructure to support self-directed care, with more flexible provider options, (3) conduct statewide public education and training for consumers and providers, and (4) develop a system of quality management and improvement employing the CMS Quality Framework.

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Independence Plus Initiative

LOUISIANA

Grant Information

Name of Grantee
Louisiana Department of Hospitals
Title of Grant
Louisiana's Independence Plus Initiative
Type of Grant
Independence Plus Initiative
Amount of Grant
$499,889
Year Original Funding Received
2003

Contact Information

Susan Jackson, Program Manager
225-219-0218
sljackson@dhh.la.gov

Joseph Hicks, Program Manager
446 North 12th Street
Baton Rouge, LA 70802
225-219-0216
jhicks@dhh.la.gov

Subcontractor(s)

Center for Outcome Analysis
Income Links

Target Population(s)

All individuals with cognitive and physical disabilities.

Goals

Activities

Abstract

Louisiana's Department of Health and Hospitals, Bureau of Community Supports and Services (BCSS) Independence Plus project will create a Home and Community Based Services (HCBS) waiver system based on the principles of self-determination. The State will revise the system based on empirical data collected and analyzed under the supervision of the Center for Outcome Analysis. The BCSS intends to develop a backup system, expand opportunities for any interested waiver recipient to earn income by owning a microenterprise business (thereby generating personal income), and make data-driven decisions based on objective analysis of data collected by the Center for Outcome Analysis.

The current NOW will also be the catalyst for change in the Children's Choice and Elderly and Disabled Adults waivers. BCSS will create an IPAC to oversee this initiative. At least 51 percent of the IPAC members will be HCBS waiver participants or family members.

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Independence Plus Initiative

MAINE

Grant Information

Name of Grantee
Department of Health and Human Services, Adult Mental Retardation Services
Title of Grant
Supporting Choice and Control for Maine Adults with Mental Retardation or Autism
Type of Grant
Independence Plus Initiative
Amount of Grant
$500,000
Year Original Funding Received
2003

Contact Information

Jane Gallivan, Principle Investigator
207-287-6642
jane.gallivan@maine.gov

David Goddu, Project Director
11 State House Station
2nd floor, Marquardt Building
Kennebec County
Augusta, ME 04333
207-287-6642
david.goddu@maine.gov

Subcontractor(s)

Vanessa Bell, Project Manager
207-632-8997
Vanessa.Bell@maine.gov

Edmund S. Muskie School of Public Service

The Center for Community Inclusion, University of Maine

The National Association of State Directors of Developmental Disabilities Services

STRIVE and Speaking Up For Us

Other consultants to be decided.

Target Population(s)

Adults with mental retardation or autism.

Goals

Activities

Abstract

Maine's Department of Health and Human Services is developing a new Independence Plus Initiative waiver program for adults with mental retardation or autism. The new program is intended to address the changing needs of people with mental retardation or autism in Maine by enhancing choice and control for consumers, and by offering different and more flexible supports within a philosophy of self-determination. The primary goal of the grant is to ensure that consumers and families have sufficient information, training, and support to manage their own services and supports as participants in the new program.

For consumers and family members to exercise greater choice and control, they must understand their options and responsibilities under the new Independence Plus Initiative waiver program, and must be given the tools and supports needed for successful self-direction. Likewise, people who have played traditional roles in the current system (i.e., case managers) must understand how roles change when consumers choose to direct their own supports.

This grant will support development and delivery of training and other supports to ensure that true system change occurs, initially in adult mental retardation services, and ultimately throughout the State's community-integrated services. Major partners include consumers, families, providers, and other state agencies.

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Independence Plus Initiative

MASSACHUSETTS

Grant Information

Name of Grantee
University of Massachusetts Medical School
Title of Grant
Massachusetts Independence Plus Initiative
Type of Grant
Independence Plus Initiative
Amount of Grant
$499,992
Year Original Funding Received
2003

Contact Information

Darlene (Dee) O'Connor
Director of the Long-Term Care Policy Unit
508-856-8148
darlene.oconnor@umassmed.edu

Erin Barrett, Project Director
Independence Plus Project Director
Center for Health Policy and Research
222 Maple Avenue, Higgins Building
Shrewsbury, MA 01545
508-856-8496
erin.barrett@umassmed.edu

http://www.massrealchoices.org

Subcontractor(s)

Kenneth Schlosser, LICSW

Target Population(s)

Individuals of all ages with all types of disabilities or long-term illnesses, including complex medical needs, developmental disabilities, cognitive disabilities, brain injury, sensory disabilities, mental illness, serious emotional disturbance, physical disabilities, and long-term disabling illnesses.

Goals

Activities

Abstract

With this grant project, the State will design key components of the infrastructure necessary to allow individuals (and their representatives if appropriate) to have flexibility and control over their community services and supports. The State will build on the existing infrastructure to meet federal expectations for an Independence Plus waiver. With the creation of such a waiver, participants will have flexible use of the allocated funds to meet their needs in the community.

The State will address the following infrastructure areas in this project: (1) person-centered planning, (2) fiscal management, (3) supports brokerage, (4) peer mentoring, and (5) participant protections with a participant-driven continuous quality improvement system. Massachusetts will also design the waiver application and ensure meaningful involvement of consumers in all phases of the grant.

The University of Massachusetts Medical School Center for Health Policy and Research (UMMS/CHPR) will subcontract with community partners to ensure that the tools and the program infrastructure created are applicable across all age, disability, and ethnic groups, and in all regions of the State.

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Independence Plus Initiative

MICHIGAN

Grant Information

Name of Grantee
Michigan Department of Community Health
Title of Grant
Michigan's Independence Plus Initiative
Type of Grant
Independence Plus Initiative
Amount of Grant
$478,600
Year Original Funding Received
2003

Contact Information

Michael Head, Project Director
Michigan Department of Community Health
Baker Olin West, Room 217
3423 N. Martin Luther King Boulevard
PO Box 30195
Lansing, MI 48909
517-335-0276
head@michigan.gov

Subcontractor(s)

Dr. Brant Fries
University of Michigan Institute of Gerontology
300 North Ingalls, Suite 935
Ann Arbor, MI 48109
734-936-2107
bfries@umich.edu

Dr. James Conroy
Center for Outcome Analysis
201 Sabine Avenue, Suite 100
Narberth, PA 19072
610-668-9001
jconroycoa@aol.com

ARC of Michigan
1325 S. Washington Avenue
Lansing, MI 48910
517-487-5426

Target Population(s)

Current or potential participants in State Community Mental Health Services Programs (CMHSPs), including adults with mental illness and persons with developmental disability.

Goals

Activities

Abstract

Michigan has adopted the principles and practices of PCP as the basis for planning and arranging consumer services. However, the adoption of these principles and practices throughout the State has occurred slowly.

This project will expand implementation of arrangements that support self-determination. It will identify and establish systemwide, self-determination options, creating effective and flexible consumer-controlled service arrangements in the Michigan mental health system. It will also incorporate the philosophy, information, methods and practices of self-determination, and consumer-controlled options to the MI Choice HCBS waiver system and building in methods to make flexible, consumer-directed options available to beneficiaries who are elderly or disabled. The project will also develop the framework for the approval of a Section 1115 Independence Plus Initiative waiver arrangement to demonstrate with a limited number of beneficiaries from the mental health and/or the LTC systems the option of receiving a cash allotment in lieu of formal Medicaid support services.

The project will involve consumers, advocates, and other stakeholders through a project work group, which will guide the project. Specific accomplishments will include (1) the development of a standardized model for individual budget development and fiscal intermediary services, (2) the development and testing of models for using independent facilitators and support brokers in PCP and consumer-directed care, (3) the development of options for emergency backup systems, and (4) the establishment of incident management systems.

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Independence Plus Initiative

MISSOURI

Grant Information

Name of Grantee
Missouri Department of Mental Health, Division of Mental Retardation/Developmental Disabilities
Title of Grant
Missouri Partnership for Self-Directed Support
Type of Grant
Independence Plus Initiative
Amount of Grant
$427,461
Year Original Funding Received
2003

Contact Information

Kay Green
Director of Federal Programs
Division of MRDD
1706 East Elm Street
Jefferson, MO 65102
573-751-8213
kay.green@dmh.mo.gov

Subcontractor(s)

Vim Horn
Project Coordinator
University Center for Excellence in Developmental Disabilities (UCE)
816-235-1756
hornW@umkc.edu

Additional consultants or small contracts may be needed.

Target Population(s)

Individuals with mental retardation and other developmental disabilities.

Goals

Activities

Abstract

The Missouri Division of Mental Retardation/Developmental Disabilities is seeking to enhance the choice and control individuals with disabilities and their families have over their lives. This project will allow the Division to make changes in its system so that it is prepared to implement self-directed support options associated with the Independence Plus Initiative model. The grant project will

A pilot incorporating the various aspects associated with self-directed support systems will be conducted with individuals with disabilities and/or their families. The pilot will be evaluated using several measures, including cost effectiveness, quality of life, incidence of abuse/neglect, and retention of personal care assistants. Successful components that are fiscally neutral will be implemented throughout the State under current laws. Documentation will be prepared for those that require legislative change. Pending state approval of funding through the appropriation process, features of the Independence Plus Initiative model, will be incorporated into existing waivers.

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Independence Plus Initiative

MONTANA

Grant Information

Name of Grantee
Department of Public Health and Human Services
Title of Grant
Big Sky Bonanza—Montana's Independence Plus Initiative
Type of Grant
Independence Plus Initiative
Amount of Grant
$499,963
Year Original Funding Received
2003

Contact Information

Denise King, Program Officer
406-444-4064
dking@mt.gov

Abby Hulme, Grant Coordinator
PO Box 4210
Helena, MT 59604
406-444-4376
ahulme@mt.gov

Subcontractor(s)

Mountain Pacific Quality Health Foundation
Summit Independent Living Center
Carl Eby

Target Population(s)

Persons with disabilities and persons with long-term care needs.

Goals

Activities

Abstract

The anticipated outcomes of Montana's Independence Plus project are expanded options, increased consumer control, and effective consumer protections. The first two outcomes will be accomplished by establishing a cash and counseling option for self-directed personal assistance services through the State Plan and the home and community based services waiver program for elderly and disabled persons. The third will be achieved through implementation of an emergency backup system, a disaster and emergency plan, caregiver background checks, and an improved incident management plan.

During the general grant activities, focus groups will be used to gather input regarding program design features. These groups will take place on Indian Reservations, in major cities, and in rural/frontier towns. Surveys will be mailed to collect data from those who do not attend the group meetings.

Consumers, advocates, family members, providers of services, and state agency partners will participate in the grant. Summit Independent Living Center will produce participant training materials and train participants, and the Native American Coordinator at the Montana Center on Disabilities, Montana State University, will spearhead outreach to Indian Nations and ensure cultural sensitivity in all phases of program development and implementation.

Montana's Quality Improvement Organization will collaborate in developing and implementing the capacity assessment protocol. Montana's Department of Labor will partner in developing a caregiver registry via the existing Job Service Web page. The Disaster and Emergency Services Division will collaborate on establishing the emergency backup system. The Montana Department of Justice will assist in implementing caregiver background checks.

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Independence Plus Initiative

OHIO

Grant Information

Name of Grantee
Ohio Department of Mental Retardation and Developmental Disabilities (ODMRDD)
Title of Grant
Ohio's Self-Determination Project
Type of Grant
Independence Plus Initiative
Amount of Grant
$500,000
Year Original Funding Received
2003

Contact Information

Dana Charlton, Project Director
614-752-8878
dana.charlton@dmr.state.oh.us

Kim Linkinhoker, Project Manager
614-466-7290
kim.linkinhoker@dmr.state.oh.us

Christina Miller, Project Coordinator
35 East Chestnut Street, 5th Floor
Franklin County
Columbus, OH 43215
614-644-5519
christina.miller@dmr.state.oh.us

Subcontractor(s)

Center on Self-Determination

Evaluation consultant to be decided.

Target Population(s)

Individuals with mental retardation and other developmental disabilities (MR/DD).

Goals

Activities

Abstract

The overall goal of the grant is to obtain approval of an Independence Plus HCBS waiver, titled "Self-Determination," and to demonstrate successful implementation in at least five counties in Ohio. Grant funds will be used to obtain training, facilitation, and technical assistance related to achieving the expectations in the Independence Plus Initiative template for the Self-Determination waiver. Grant funds will also provide reimbursement/stipends to individuals with MR/DD and families to cover the cost of their involvement at three levels of policy work: (1) the stakeholder work team in each of the demonstration counties; (2) the collaborative group representing all demonstration counties; and (3) the advisory committee, which includes persons with expertise or position authority to eliminate barriers and establish the infrastructure needed to support implementation of the waiver.

Each demonstration county will use their experience from previous local and state self-determination efforts to identify, for each individual receiving Self-Determination waiver services, (1) barriers that must be reduced or eliminated and (2) the infrastructure that must exist to achieve the major goals of person-centered planning, individual budgets, financial management services, support brokerage, and participant protections.

Several months following implementation of the Self-Determination waiver in the demonstration counties, an independent evaluation will be conducted of (1) the use of services covered by the waiver; (2) system capacities to successfully implement the waiver; and (3) the outcomes and quality of life of individuals with disabilities, their satisfaction, and the satisfaction of their families and other stakeholders.

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Money Follows the Person Rebalancing Initiative

CALIFORNIA

Grant Information

Name of Grantee
California Department of Health Services (DHS)
Title of Grant
California Pathways
Type of Grant
Money Follows the Person Rebalancing Initiative
Amount of Grant
$750,000
Year Original Funding Received
2003

Contact Information

Carol A. Freels
Chief, Office of Long-Term Care
PO Box 942732
MS 0018, Suite 71, 6031
Sacramento, CA 94234
916-440-7535
cfreels@dhs.ca.gov

Subcontractor(s)

Regents of the University of California–Los Angeles (UCLA), Borun Center for Gerontological Research

Target Population(s)

Adult Medicaid-eligible nursing facility residents.

Goals

Activities

Abstract

The California Department of Health Services (DHS) proposes to develop a pilot project called California Pathways in one location in California. A pilot project community will be chosen based on its potential for successful transitions to community living; for example, the availability of an array of housing and service options. The pilot project will depend heavily on a lead contractor, with DHS retaining final approval of all deliverables.

The lead contractor will use public/private partnerships to develop and implement the pilot project. The Long-Term Care Council's Olmstead Advisory Committee will serve as a mechanism to obtain statewide stakeholder input, in addition to input from local stakeholders and potential consumers in the pilot project.

The federal grant funding will enable research and analysis on the following core questions:

The pilot project will enable the State to map the assessment and transition process of NF residents by documenting transition cases, developing statewide protocols for future care planners, and costing out each element of the cases for the purpose of developing baseline data for Money Follows the Person models.

California Pathways will coordinate with other long-term care programs statewide that can benefit from the pilot project formative learning and outcomes, and will develop recommendations to build on the successes of the pilot project, including recommendations regarding care planning models and initiatives that enable the Money to Follow the Person.

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Money Follows the Person Rebalancing Initiative

IDAHO

Grant Information

Name of Grantee
Idaho Department of Health and Welfare, Division of Family and Community Services
Title of Grant
Idaho Money Follows the Person Project
Type of Grant
Money Follows the Person Rebalancing Initiative
Amount of Grant
$749,999
Year Original Funding Received
2003

Contact Information

Cameron Gilliland (Contract Monitor)
450 West State Street
PO Box 83720
Boise, ID 83720-0036
208-334-5536
gillilac@state.id.us

Subcontractor(s)

Beth Hudnall Stamm, Ph.D.
Project Director
208-282-4436
bhstamm@isu.edu

Dan Wolfley, B.Bus., CPA
Project Coordinator
Idaho State University Institute of Rural Health
Campus Box 8174
Pocatello, ID 83209-8174
208-282-4436
dwolfley@isu.edu

Target Population(s)

People of all ages with physical, mental, developmental, or aging-related disabilities and long-term care needs.

Goals

Activities

Abstract

Under this grant, the State will build on work begun under the 2001 Real Choice Grant by completing a research-validated plan for community integration in Idaho. The project will (1) continue the anti-stigma campaign designed to reduce stigma and facilitate community integration, (2) continue the economic analysis of the current Medicaid system to identify ways to reapportion and maximize funding, (3) expand community development project efforts to examine the political and fiscal feasibility of increasing living resources and create a more hospitable community for people who wish to live in it, and (4) expand the ongoing effectiveness study to test what best helps people of all ages with any disabilities reach their community integration goals.

Consumers will also be involved in the project implementation. The Community Integration Committee, which will oversee the project, is made up of people with disabilities, family members, and representatives of private organizations and public agencies. Community-to-Community Coalitions will be established in the research sites to involve a broad base of community members.

This project will produce sustained change by identifying implementation strategies for cost-effective, community-based care. Activities conducted under this grant will demonstrate the feasibility of providing such services in a cost-neutral manner to the maximum number of individuals with disabilities in the most integrated settings based on their wants and needs. Products will include a research-based community integration plan, evidence-based protocols for anti-stigma campaigns, community development projects, and community integration planning.

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Money Follows the Person Rebalancing Initiative

MAINE

Grant Information

Name of Grantee
Maine Department of Health and Human Services
Title of Grant
Shifting the Balance: Individual Choice and Community Options
Type of Grant
Money Follows the Person Rebalancing Initiative
Amount of Grant
$750,000
Year Original Funding Received
2003

Contact Information

David Goddu
Financial and Resources Manager
40 State House Station
Kennebec County
Augusta, ME 04333-0040
207-287-6642
David.Goddu@maine.gov

Subcontractor(s)

Eileen Griffin, Project Director
Muskie School of Public Service
509 Forest Avenue
PO Box 9300
Portland, ME 04104-9300
207-780-4813
eileeng@usm.maine.edu

Target Population(s)

Adults with mental retardation and autism, adults with brain injury, and persons with any type of disability in all age groups.

Goals

Activities

Abstract

With this grant project, the Maine Department of Health and Human Services (DHHS) will continue its current efforts to shift control to the consumer and to shift services to the community. Each of the grant's three goals responds directly to recommendations made by Maine's Work Group for Community-Based Living, a cross-disability, cross-age group consumer task force.

For persons with mental retardation and autism receiving waiver services, individual budgets are currently based on provider-negotiated cost reimbursement, answering the question "What does the provider need to support this individual?" rather than "What supports does the individual need?" To enhance individual choice and control, DHHS will adopt a standardized assessment and budgeting tool that will be used to produce consistent, fair, predictable, and truly portable budgets based on individual need rather than provider need.

For persons with brain injury, many of the services available are inadequate to make living in the community a meaningful option. DHHS will analyze and test the feasibility of offering cost-effective community options that redirect funding for individuals with brain injury to more integrated settings and develop strategies for stimulating new community service options to support such individuals.

DHHS will work with Maine's Work Group for Community-Based Living to identify cross-system performance measures that will be used to evaluate the State's success at shifting the balance to increased consumer choice and greater community options.

Products will include feasibility studies, implementation plans, and sustainability plans. Major partners include consumers, families, providers, and other state agencies.

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Money Follows the Person Rebalancing Initiative

MICHIGAN

Grant Information

Name of Grantee
Michigan Department of Community Health
Title of Grant
Michigan's Money Follows the Person Rebalancing Initiative
Type of Grant
Money Follows the Person Rebalancing Initiative
Amount of Grant
$746,650
Year Original Funding Received
2003

Contact Information

Michael Head, Project Director
Michigan Department of Community Health
Baker Olin West, Room 217
3423 N. Martin Luther King Boulevard
PO Box 30195
Lansing, MI 48909
517-335-0276
head@michigan.gov

Subcontractor(s)

Norm Delisle, Jr., Executive Director
Michigan Disability Rights Coalition
780 W. Lake Lansing Road, Suite 200
E. Lansing, MI 48823
517-333-2477 ext. 17
ndelisle@voyager.com

Michigan Association of Centers for Independent Living
1476 Haslettt Road
Haslett, MI 48840
517-339-0539

Target Population(s)

Individuals with disabilities and long-term illnesses.

Goals

Activities

Abstract

This project will develop and implement system changes to ensure that money follows the person, so that individuals' choices drive their services and that the aggregate choices of LTC consumers shape the State's use of resources. This work will be conducted by a partnership between state agencies and a LTC Community Roundtable, which will include consumers, families, advocates, and nursing facility and community providers. Consumer and family involvement will be supported by a Community Consortium for Advocacy and Technical Assistance. This support of and partnership with stakeholders represents a major commitment to inclusive planning for the development of LTC services.

At three local pilot sites, the project will develop an integrated model for LTC services, including nursing facility and home and community based services. These pilot sites will establish integrated, capitated models and address barriers to money follows the person in state regulations and financing. The pilot sites will adapt person-centered planning for LTC services and will have the flexibility to test strategies for (1) improving the direct service workforce, (2) developing housing options, and (3) meeting other challenges to providing effective community services.

Under this grant, the State will ensure enduring change through the work of the Community Consortium and LTC Roundtable, modifications to waiver programs, policy changes at the state level, and developing and implementing changes to nursing home regulations and funding methods.

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Money Follows the Person Rebalancing Initiative

NEVADA

Grant Information

Name of Grantee
Nevada Department of Human Resources
Title of Grant
Nevada Money Follows the Person Rebalancing Initiative
Type of Grant
Money Follows the Person Rebalancing Initiative
Amount of Grant
$749,999
Year Original Funding Received
2003

Contact Information

Todd Butterworth, Project Director
775-687-4452
tbutterworth@dhr.state.nv.us

Sherry Manning, Project Co-Coordinator
Office of Disability Services
3656 Research Way, Suite 32
Carson City, NV 89706
775-687-4452
smanning@dhr.state.nv.us

Subcontractor(s)

Lisa Erquiaga
Northern Nevada Center for Independent Living
999 Pyramid Way
Sparks, NV 89431
775-353-3599 (voice/TTY)

Target Population(s)

Nonelderly persons with disabilities served in nursing facilities or at risk of institutionalization in the absence of effective community services.

Goals

Activities

Abstract

Rebalancing the state's system to avoid unnecessary institutionalization requires changes in its policies and programs so money can follow institutionalized persons into the community. It is also necessary to assure that people with disabilities have ready access to effective, high-value services and supports in the community so that they need not seek institutional services. Another critical rebalancing dimension is to offer individuals with disabilities greater opportunities to direct their own services.

The Nevada Money Follows the Person Rebalancing Initiative is a collaboration of individuals with disabilities, advocates, Department of Human Resources agencies (Office of Disability Services, Division for Aging Services, the Division of Health Care Financing and Policy), the Nevada Developmental Disabilities Council, Nevada's two Centers for Independent Living, service providers, and community organizations.

The Initiative will link with other activities already under way to strengthen and improve community services for people with disabilities. The Initiative will

  1. lead to fewer individuals served in institutional settings;
  2. increase the number of people who are supported in the community;
  3. pave the way for a solid, sustainable system of effective, high-quality community services;
  4. improve individual and family access to information about community services; and
  5. afford individuals with disabilities real opportunities to direct and manage their own services and supports.

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Money Follows the Person Rebalancing Initiative

PENNSYLVANIA

Grant Information

Name of Grantee
Governor's Office of Health Care Reform
Title of Grant
Money Follows the Person Rebalancing Initiative
Type of Grant
Money Follows the Person Rebalancing Initiative
Amount of Grant
$698,211
Year Original Funding Received
2003

Contact Information

Jennifer Burnett
Forum Building
4th Floor, Room 439
Harrisburg, PA 17120
717-346-9712
jenburnett@state.pa.us

Subcontractor(s)

Bill Farley, Executive Director
Bradford, Sullivan, Susquehanna, Tioga Counties Area Agency on Aging
570-265-6121

Louis Colbert, Executive Director
Delaware County Office of Services for Aging
610-490-1300

Stan Holbrook, Executive Director
Three Rivers Center for Independent Living
412-371-7700 ext. 133

Target Population(s)

Persons with disabilities currently in a nursing home or other institution, paid for by Medicaid or state funds, who wish to transition into their own home in the community, and consumers in the community whose needs are not being met due to current state fiscal constraints.

Goals

Activities

Abstract

The Commonwealth of Pennsylvania is implementing the MFP Rebalancing Initiative project to examine the feasibility of the concept, and to demonstrate pooling of state long-term support service dollars to permit funding to follow consumers to the most appropriate and preferred setting. Grant funds will be used to engage consumers and providers in planning and implementing feasibility studies and three demonstration projects.

A statewide MFP Planning Group, comprising consumers and providers from the long-term care system, state staff, and aging and disability advocates, will (1) examine multiple issues related to reforming state financing and service design; (2) provide guidance to a contract consultant to conduct a feasibility analysis; and (3) finalize design, parameters, and location for three local demonstrations.

Local coordinators will assemble a local MFP Planning Group and coordinate the development and implementation of the three demonstration projects. The demonstrations will be located in one major metropolitan, one rural, and one suburban or small town setting. With the exception of the major metropolitan location, the demonstrations may be multicounty.

Projects will begin at the beginning of the third year. The State will appropriate a percentage of the overall long-term support service budget for the three demonstration projects.

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Money Follows the Person Rebalancing Initiative

TEXAS

Grant Information

Name of Grantee
Texas Department of Aging and Disability Services
Title of Grant
Promoting Independence
Type of Grant
Money Follows the Person Rebalancing Initiative
Amount of Grant
$730,422
Year Original Funding Received
2003

Contact Information

Lori Roberts, Manager
512-438-5391
lori.roberts@dads.state.tx.us

Lily Vela, Project Coordinator
Community Care Provider Services
701 West 51st Street
PO Box 149030, Mailcode W-521
Austin, TX 78714
512-438-2489
lilia.vela@dads.state.tx.us

Subcontractor(s)

Center on Independent Living (COIL)
4905 Center Park Boulevard
San Antonio, TX 78218

Target Population(s)

Individuals of all ages residing in nursing homes who want to live in the community.

Goals

Activities

Abstract

The purpose of this grant is to create a local system in each community that will allow the Texas Department of Aging and Disability Services (DADS) to more efficiently and effectively help clients transition from nursing homes to the community.

The DADS San Antonio Region has established a voluntary workgroup of caseworkers, advocates, other agency personnel, local government employees, profit and nonprofit organizations, home health providers, housing authority representatives, and others to look at each individual requesting transition from the nursing facility to the community. The workgroup looks at individual needs, establishes transition plans based upon those needs, offers technical assistance to group members and consumers, secures resources, and transitions individuals to the community.

A first step in replicating this model throughout the State is to educate DADS staff, consumers, advocates, and other stakeholders about the range of community care options available through DADS. Greater knowledge of the options available to enable people to live in the community will help transition individuals from nursing homes. The second step is to establish workgroups in the other 10 regions of the State.

Measurable outcomes include increased knowledge of community long-term care options available through DADS, community care coordination workgroups at the local level, and increased local resources to ensure a smooth transition and continued community supports.

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Money Follows the Person Rebalancing Initiative

WASHINGTON

Grant Information

Name of Grantee
Washington State Department of Social and Health Services (DSHS)
Title of Grant
Money Follows the Person Rebalancing Initiative
Type of Grant
Money Follows the Person Rebalancing Initiative
Amount of Grant
$608,008
Year Original Funding Received
2003

Contact Information

Bob Beckman, Project Director
360-725-2490
beckmrc@dshs.wa.gov

Leo Kapust, Project Manager
360-725-3454
kapuslj@dshs.wa.gov

Janet Adams, Stakeholder Coordinator
PO Box 45600
Olympia, WA 98504-5600
360-725-3408
adamsje@dshs.wa.gov

Subcontractor(s)

Starling Consulting
Laxmi Group

Target Population(s)

Adults and children with developmental disabilities.

Goals

Activities

Abstract

Through development of an automated comprehensive assessment and service planning tool, the Washington State DSHS will begin rebalancing its long-term support systems more evenly between institutional and community service options. This system will build on CARE, recently completed by the Department's Aging and Disability Services Administration (ADSA).

For this project, specific assessments will be developed within CARE.

Without an effective assessment tool it is not possible, in a systemic way, to give an individual with developmental disabilities the freedom to choose where he or she wants to live and for the funding to follow that choice. This Money Follows the Person Rebalancing Initiative will set the stage for rebalancing the currently-available funding and be linked with other major initiatives aimed at increasing options for self-directed services. The assessment tool will also be tied to a quality assurance process with automatic feedback, which is currently under development.

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Money Follows the Person Rebalancing Initiative

WISCONSIN

Grant Information

Name of Grantee
Department of Health and Family Services
Title of Grant
Wisconsin's Money Follows the Person Initiative
Type of Grant
Money Follows the Person Rebalancing Initiative
Amount of Grant
$743,813
Year Original Funding Received
2003

Contact Information

Thomas Swant
System Design Manager
Bureau of Long Term Support
One West Wilson Street, Room 418
PO Box 7851
Madison, WI 53707
608-266-3717
swanttj@dhfs.state.wi.us

Subcontractor(s)

County agencies
Consultants for training and consultation

Target Population(s)

Persons with developmental disabilities living in intermediate care facilities for persons with mental retardation (ICFs/MR) and persons with physical disabilities and frail elders living in nursing homes.

Goals

Activities

Abstract

This grant will develop mechanisms and supporting data systems to allow institutional funding to follow persons transitioning from ICFs/MR and nursing facilities to homes in the community. Judges and attorneys serving as guardians ad litem will be educated about community living options and needed resources. Grant staff will work with county officials to identify ICFs/MR for downsizing or closure.

The Department of Health and Family Services (DHFS) will provide professional technical assistance for county boards/administrators and other decision makers as they create community care plans. Wisconsin will transfer 200 individuals to the community from private or county ICFs/MR, and the money will follow them for support in the community. This transfer will enable the closing of at least three ICFs/MR, and another seven will significantly reduce beds as people move to the community.

The State is currently developing a plan to establish a Money Follows the Person mechanism for individuals in nursing homes. As part of this grant, DHFS will conduct a feasibility analysis of proposed mechanisms for transferring nursing home funds, work with the legislature to enact sponsoring legislation, implement the new funding mechanism, and work with counties to develop community resources for persons transitioned from nursing homes.

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Community-Integrated Personal Assistance Services and Supports

ARIZONA

Grant Information

Name of Grantee
Arizona Department of Economic Security, Division of Developmental Disabilities
Title of Grant
Arizona Human Service Cooperative Project
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$600,000
Year Original Funding Received
2003

Contact Information

Ric Zaharia
Assistant Director DES/DDD
602-542-0419
rzaharia@mail.de.state.az.us

Princess Lucas-Wilson, MSW
Project Manager (Grant Liaison)
Division of Developmental Disabilities
4th Floor NW
1789 West Jefferson
Phoenix, AZ 85007
602-542-0419
plucas-wilson@mail.de.state.az.us

Gale Bohling, Project Director
602-953-9012
bohlinginc@cox.net

Holly Bohling, Operations
Bohling, Inc.; PO Box 22120
Phoenix, AZ 85028
602-953-9012
hbohling@cox.net

Subcontractor(s)

Rescare, Inc.
Paul Dunn, Chief Development Officer
10140 Linn Station Road
Louisville, KY 40223
502-394-2311
pdunn@rescare.com

University of Colorado Health Sciences Center
Dr. David Braddock
303-735-2952
braddock@cu.edu
Richard E. Hemp
303-735-0252
rick.hemp@cu.edu
Diane Coulter
4001 Discovery Drive, Suite 210
Boulder, CO 80303
303-735-0457
diane.coulter@cu.edu

Target Population(s)

Medicaid-eligible persons with physical and developmental disabilities.

Goals

Activities

Abstract

For 15 years, Arizona has been operating its Long-term Care Service and Support System, including its Home and Community Based Services (HCBS) program, under a Medicaid Section 1115 Demonstration waiver. Under this program, eligible elders and persons with physical and developmental disabilities have access to a comprehensive array of HCBS options. This project builds on existing options in determining the feasibility of the HSC as a model for addressing the need for self-determination and empowerment, and for implementing self-directed services for persons with disabilities in Arizona. Under an HSC, member/owners who are service users provide the policy direction and leadership to an incorporated cooperative that is recognized and does business as a State-certified service provider.

Development of this project will involve partnerships of several public and private groups: (1) a group of individuals who use services and their families will partner to form an HSC, (2) the State of Arizona will partner with the HSC to contract for services, and (3) a service provider will contract with the HSC to provide funding for development and professional services. The University of Colorado Health Sciences Center will provide research expertise for the endeavor, and a consultant will provide HSC business development and implementation assistance and partnership coordination. With this HSC as a base, a Federated HSC will be created to assist other groups in developing additional HSCs, in particular one that addresses the needs of the Spanish-speaking population. The project will also provide education, training, and outreach/marketing materials for developing future HSCs.

Along with an implementation and sustainability plan and implementation of the first HSC and the Federated HSC, the primary outcomes/products of this project will be the information and experience obtained to guide public policy staff and private organizations regarding HSC planning and development techniques, education and training materials for HSC leadership, and planning for future contracting systems. The development process will also stimulate new and creative service delivery options such as individual asset development and micro-board support and assistance.

As an independent organization, the HSC will operate after the grant ends, continuing to provide state-funded, long-term care self-directed services. Grant activities will transition to the Federated HSC, which will be incorporated and will provide ongoing assistance to cooperatives and professionals throughout Arizona and potentially in other states.

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Community-Integrated Personal Assistance Services and Supports

CONNECTICUT

Grant Information

Name of Grantee
Department of Social Services
Title of Grant
CHOICE, Connecticut Has Opportunities for Independence, Choice and Empowerment
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$595,349
Year Original Funding Received
2003

Contact Information

Amy Porter, Project Director
Connect to Work Center, Bureau of Rehabilitation Services
25 Sigourney Street, 11th Floor
Hartford, CT 06101
860-424-4864
amy.porter@po.state.ct.us

Subcontractor(s)

Mary Beth Bruder, Principal Investigator
University of Connecticut
A.J. Pappanikou Center for Excellence in Developmental Disabilities Education, Research, and Service (UCEDD)
860-679-500
Bruder@nso1.uchc.edu

Media consultant to be hired.

Target Population(s)

People with disabilities and long-term illnesses.

Goals

Activities

Abstract

Although Connecticut has a long history of providing personal assistant services, not enough attention has been given to developing an adequate workforce. Currently, the demand for PAs in the State far exceeds the supply and recruitment efforts are fragmented. It is essential to the growth of self-determination initiatives in Connecticut that individuals and families have easy access to a pool of qualified staff who meet basic requirements. In addition, Connecticut needs an education and support system for employers of personal assistants that can prepare them to confidently direct and manage their services and supports.

The goal of this project is to develop an infrastructure and create products that will promote the effective recruitment and retention of personal assistants, and ensure that people with disabilities in Connecticut have the knowledge and resources to maximize choice and control in the use of personal assistance services.

Outcomes for the 3-year project include (1) a single-point-of-access recruitment tool, (2) a curriculum of training modules for employers on the management of personal assistant services, (3) provision of at least 250 in-home trainings for employers of PAs, and (4) development and implementation of a voluntary professional development program for PAs.

While the Connecticut Department of Social Services (DSS) will serve as the lead agency to administer the grant project, the application was developed collaboratively with various state agencies and the Real Choice Steering Committee, which comprises 15 individuals with disabilities, family members of persons with disabilities, and representatives of state agencies. These same state agencies and the Real Choice Steering Committee will continue to work collaboratively as a steering committee to design, implement, and evaluate grant activities.

DSS will subcontract with the University of Connecticut's A.J. Pappanikou Center for Excellence in Developmental Disabilities Education, Research, and Service (UCE) to implement grant activities. The UCE will supply the fiscal and administrative infrastructure for all project activities.

Note: This Compendium form was not reviewed by the Grantee prior to publication.

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Community-Integrated Personal Assistance Services and Supports

LOUISIANA

Grant Information

Name of Grantee
Department of Health and Hospitals
Title of Grant
Community-Integrated Personal Assistance Services and Supports Project
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$464,184
Year Original Funding Received
2003

Contact Information

Dr. Anthony Speier, Director
225-342-2543
aspeier@dhh.la.gov

Ann Darling
C-Pass Project Director/Grant Coordinator
Division of Program Development and Implementation
Louisiana Office of Mental Health
1201 Capitol Access Road
Baton Rouge, LA 70802
225-342-2563
adarling@dhh.la.gov

Subcontractor(s)

Boston University

Target Population(s)

Persons with serious and persistent mental illness (SPMI).

Goals

Activities

Abstract

In Louisiana, persons with SPMI have received PAS (called service integration) as a part of their service package under the Medicaid Psychiatric Rehabilitation Option. On a more limited basis, the Office of Mental Health provides funding for PAS (known as Act 378 funds) as required on an individual basis. Medicaid has recently finalized rules for a new Personal Assistance Services Employment Support Option in association with Louisiana's Ticket to Work Initiative. While the State of Louisiana maintains a strong commitment to providing a comprehensive system of flexible supports for persons with mental illness to achieve and maintain community living status, the usefulness of PAS with this population has not been fully explored and developed within the existing treatment programs.

The Community-Integrated Personal Assistance Services and Supports Project will finance (1) the development of an appropriate service delivery mechanism to provide support services, (2) the development of infrastructure enhancements, and (3) the employment of trained consultants and experts to educate the service provider network regarding the use of PAS for persons with mental illness to help maintain a high standard of community living. Consumers who choose to self-direct their care will have access to information and education materials about consumer service control.

Consumers' needs will be assessed and their feedback sought in each component of the grant project, but particularly regarding training.

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Community-Integrated Personal Assistance Services and Supports

MASSACHUSETTS

Grant Information

Name of Grantee
Massachusetts Department of Mental Retardation
Title of Grant
MASS C-PASS
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$579,178
Year Original Funding Received
2003

Contact Information

Margaret Chow-Menzer, J.D.
Assistant Commissioner for Systems Integration
617-624-7703
margaret.chow-menzer@state.ma.us

Nilka I. Alvarez-Rodriguez, D.A., M.A.
Project Coordinator
500 Harrison Avenue
Boston, MA 02118
617-624-7506
nilka.alvarez-rodriguez@state.ma.us

Subcontractor(s)

Public Consulting Group
The Arc of Massachusetts
Multicultural Services Center of the Pioneer Valley

Target Population(s)

Individuals of all ages with disabilities or long-term illnesses who are seeking personal assistance services.

Goals

Activities

Abstract

Massachusetts C-PASS is a comprehensive cross-disability, cross-age model designed to overcome the barriers to flexible, consumer-directed supports faced by persons who are elders and/or persons with disabilities. The overarching goal is to develop sustainable mechanisms that insure consumer choice and consumer direction of PASS. The grant manager will be the Department of Mental Retardation.

MASS C-PASS will build on work begun in two successful federally-funded CMS New Freedom projects designed to promote systems change in community-based long-term care.3 These two grants established an effective state-level interagency work group that identifies obstacles, develops strategies to overcome obstacles, and generates recommendations for long lasting systems change. This CPASS grant will fund three pilot projects that will produce new models of quality assurance, flexible supports, and consumer direction.

Benefits to consumers include an expanded menu of PASS options, increased flexibility of services, improved control and quality of life, increased self-direction, increased choice, and increased safeguards. Anticipated program outcomes include increased community capacity in long-term care, stable sources for personal assistance and supports, increased competency of assistants, a well-trained workforce, and technical assistance to providers. Benefits to society include new support networks and collaborations and a system for sharing information on available services and supports.

This is a consumer-driven project. Consumers have contributed to the design of this proposal. Through their membership in the grant's Coordinating Council—a collaborative partnership of consumers, Independent Living Centers (ILCs), advocates, agencies, and social service providers—consumers will participate in all aspects of project implementation, management, evaluation, and reporting.

The grant partners will incorporate successful strategies into existing programs and will disseminate information to encourage replication. The project's Coordinating Council will draft changes in regulatory, budgetary, and policy language to sustain the project's successes. The Project Collaboration Model will establish ongoing communication among the current initiatives in the State, including Olmstead and New Freedom.


3 Real Choices Systems Change (10/01-9/30/04) & Bridges to Community NF Transition Project (10/01–9/30/04).

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Community-Integrated Personal Assistance Services and Supports

NEBRASKA

Grant Information

Name of Grantee
Nebraska Department of Health and Human Services
Title of Grant
Quality Assurance and Improvement Application
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$600,000
Year Original Funding Received
2003

Contact Information

Mary Jo Iwan
Deputy Administrator
402-471-9345
maryjo.iwan@hhss.state.ne.us

Joni Thomas
Real Choice Coordinator and Project Director
Aging and Disability Services
The Nebraska Department of Health and Human Services
301 Centennial Mall South, 5th Floor
PO Box 95044
Lincoln, NE 68509-5026
402-471-1764
Joni.thomas@hhss.state.ne.us

Subcontractor(s)

University of Nebraska Medical Center (UNMC) Munroe-Meyer Institute (MMI)
4242 Farnam
Omaha, NE 68131

Susan Flanagan, MPH, Principal, The Westchester Consulting Group
4000 Cathedral Avenue, NW
Suite 225B
Washington, DC 20016

Target Population(s)

Consumers from the aging population and adults and children with developmental disabilities, behavioral health needs, physical disabilities, and complex medical needs.

Goals

Activities

Abstract

Under this grant, Nebraska will explore alternative mechanisms to enhance consumer control and choice in the delivery of PAS services. Specifically, the grant will establish the infrastructure for a financial management and support brokerage services system for a consumer-directed model of financing and delivering PAS. This system will offer support services to enable consumers to perform required employer tasks and ensure compliance with legal requirements related to employment of PAS workers.

In addition, the grant will develop a peer advocacy network that will support consumers through training and peer mentoring. A quality improvement process with consumer involvement will be developed to establish an ongoing mechanism for monitoring and improving the new model. This grant will have a wide scope, targeting consumers from the aging population and adults and children with developmental disabilities, behavioral health needs, physical disabilities, and complex medical needs. The Real Choice Consumer Task Force, which includes state, consumer, and provider representatives, will lead the design and implementation of grant activities.

The project will lead to substantial, ongoing system change in PAS services in Nebraska. The financial management services and supports brokerage services structure will be sustained by revising the Medicaid reimbursement process for PAS and through reduced costs from a decreased reliance on Medicaid Home Health services. The train-the-trainer technique provides an inexpensive and effective approach to train staff and consumers as part of a peer network, allowing for an ongoing system of education and supports to increase consumer capacity to manage their own services. Finally, the financial management services structure has the potential to promote increased wages and possibly the provision of benefits for personal assistants, which could attract more qualified individuals to the field, upgrade their status, and increase worker retention.

Note: This Compendium form was not reviewed by the Grantee prior to publication.

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Community-Integrated Personal Assistance Services and Supports

OREGON

Grant Information

Name of Grantee
Portland State University
Title of Grant
Oregon CPASS Project
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$585,007
Year Original Funding Received
2003

Contact Information

Laurie Powers, Principal Investigator
503-725-9605
powersl@pdx.edu

Rollin Shelton, Project Director
Regional Research Institute
Portland State University
PO Box 751
Portland OR 97207
503-725-8097
sheltonr@pdx.edu

Subcontractor(s)

None.

Target Population(s)

Persons with psychiatric disabilities.

Goals

Activities

Abstract

In Oregon, only about 300 persons currently use the consumer-directed PCS Program, which funds up to 20 hours per month of personal assistance for eligible individuals in the mental health system. For many individuals with psychiatric disabilities, achieving increasing levels of community inclusion, independence, and self-sufficiency requires having access to quality, consumer-directed personal assistance services.

The Oregon CPASS Project will improve community-integrated services by promoting mental health consumer access to and successful utilization of the PCS Program. The project is implemented collaboratively by the Office of Consumer/Survivor Technical Assistance (OCTA) and Portland State University in partnership with the State Office of Mental Health and Addiction Services, consumer/survivor and family leaders and organizations, Centers for Independent Living, and regional and county mental health programs.

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Community-Integrated Personal Assistance Services and Supports

TEXAS

Grant Information

Name of Grantee
Texas Department of Aging and Disability Services (DADS)
Title of Grant
Community-Integrated Personal Assistance Services and Supports Service Responsibility Project
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$599,763
Year Original Funding Received
2003

Contact Information

Elizabeth Jones, Project Director
DADS, Provider Services
701 West 51st Street
PO Box 149030, Mail Code W-521
Austin, TX 78714
512-438-4855
elizabeth.jones@dads.state.tx.us

Subcontractor(s)

Rebecca Wright and Associates
207 Summerhill Court
Clermont, FL 34711

Target Population(s)

Adults and children who are eligible for Medicaid State Plan personal assistance services. To be eligible, individuals must have health problems that cause functional limitations in their ability to perform activities of daily living.

Goal

To provide increased opportunities for consumers to exercise more choice and control in service management by implementing a service responsibility option (SRO), sometimes referred to as "agency with choice," in Primary Home Care services.

Activities

Abstract

While a consumer-directed services option has been available to individuals receiving Primary Home Care services since 2002, very few have exercised this option. The introduction of a SRO may increase the number of individuals exercising choice and control in the management of their personal assistance services. The SRO is a hybrid service management option that allows the consumer to select, train, and supervise his personal assistant but leaves the fiscal, personnel, and backup responsibilities with the provider agency. The option will be piloted in a rural and an urban region of the state prior to offering the option to Primary Home Care services consumers statewide.

The training for provider and DADS staff focuses on how to describe the differences among the service management options as well as how to discuss the benefits and risks of each. Pre- and posttraining surveys are being used to assess the effectiveness of the training. Consumer training, which ensures that participants understand their roles and responsibilities as well as their part in quality services management, is a requirement of SRO participation. Consumer surveys will be conducted to develop an understanding of why consumers choose particular options of service management and their satisfaction with those options.

Outreach materials, including a brochure, self-assessment tool, and video, have been developed to assist providers and case managers to inform consumers about their choices. Key stakeholders, including consumers, providers, and advocates, provide invaluable input and guidance related to all grant activities. The effectiveness of the SRO will be assessed and used along with lessons learned about implementation in order to improve the option as needed prior to statewide expansion. The project is expected to increase the number of Primary Home Care services consumers who are offered the expanded service management choices, increase the number of those using consumer-directed options, increase the understanding of service management options among providers and DADS staff, and provide a blueprint for offering SRO in other DADS community-based programs.

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Community-Integrated Personal Assistance Services and Supports

VIRGINIA

Grant Information

Name of Grantee
Partnership for People with Disabilities, Virginia Commonwealth University
Title of Grant
Increasing Understanding, Use, and Control of Consumer-Directed Personal Assistance Services in Virginia's Waivers
Type of Grant
Community-Integrated Personal Assistance Services and Supports
Amount of Grant
$513,557
Year Original Funding Received
2003

Contact Information

Tera Yoder, Co-PI/Project Director
Partnership for People with Disabilities
Virginia Commonwealth University
PO Box 843020
Richmond, VA 23284-3020
804-828-3879
tyoder@vcu.edu

Subcontractor(s)

None at this time.

Target Population(s)

Recipients of services under three waiver programs: the Elderly or Disabled with Consumer-Direction, the Mental Retardation Waiver, and the Individual and Family Developmental Disability Support Waiver.

Goals

Activities

Abstract

Although Virginia has taken steps to make consumer-directed personal assistance services available, individuals often need additional information about consumer-directed personal assistance services in order to make informed choices. Additionally, users of consumer-directed services do not have an opportunity to provide input on their experiences with obtaining and using consumer-directed services.

Through this grant, the Partnership for People with Disabilities will interview 150 waiver recipients who use personal assistance services, using a survey developed through the project, and seek active involvement from recipients, family members, case managers, and service facilitators to determine ways to increase knowledge about personal assistance services and options. This grant builds on the 2001 Real Choice System Change program, in which the Partnership designed and developed materials and resources about self-direction and consumer-directed services, and designed and implemented a technical assistance network to reach consumers on a statewide basis.

The project will (1) interview consumers of personal assistance services about their satisfaction with services; (2) develop educational and technical assistance materials and resources that promote awareness of the possibilities and options for personal assistance services, and that strengthen the ability of individuals to maximize the use of services and support; and (3) expand the existing technical assistance network by increasing the number of personal assistance service recipients in the network, providing additional information for members to share with consumers, and providing opportunities for members to increase their knowledge of consumer-directed services.

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Family-to-Family Health Care Information and Education Centers

ALASKA

Grant Information

Name of Grantee
Stone Soup Group
Title of Grant
Alaska's Family-to-Family Health Information Center Project
Type of Grant
Family-to-Family Health Care Information and Education Centers
Amount of Grant
$149,991
Year Original Funding Received
2003

Contact Information

Jayson Smart
Executive/Project Director
907-561-3701
jaysons@stonesoupgroup.org

Katy Parish
Project Manager
3350 Commercial Drive, Suite 100
Anchorage, AK 99501
907-561-3701
katyp@stonesoupgroup.org

Subcontractor(s)

The Center for Human Development, University of Alaska Anchorage
Governor's Council on Disabilities and Special Education

Target Population(s)

Children with special health care needs (CSHCN) and their families.

Goals

Activities

Abstract

Within the last 10 years, Stone Soup Group, an Anchorage-based, nonprofit organization, has been a catalyst for much of the development that has occurred in Alaska's services for CSHCN. Despite the efforts of Stone Soup Group, Alaska still has a long way to go to ensure that families of CSHCN have access to information and training on the resources and supports available to them. Alaska's Family-to-Family Health Care and Information Resource Center will fill this critical gap in Alaska's service system for families of CSHCN.

The project will focus on three primary goals. First, it will identify and compile existing information resources that are relevant to the needs of families of CSHCN. Throughout this identification and compilation process, the staff will identify outdated resources and update or produce new educational resources in order to provide the most comprehensive and up-to-date information warehouse for families of CSHCN in Alaska.

The project will also implement a peer-to-peer interactive network for families of CSHCN. This interactive network will provide an opportunity for families across the State to share their stories and find support among a group of their peers. The network will also provide a forum whereby professionals and other experts may respond to questions and provide information or feedback to families of CSHCN. Efforts to locate additional funding to support the Family-to-Family Information and Resource Center will also be initiated.

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Family-to-Family Health Care Information and Education Centers

COLORADO

Grant Information

Name of Grantee
Family Voices of Colorado
Title of Grant
Project CFTF
Type of Grant
Family-to-Family Health Care Information and Education Centers
Amount of Grant
$150,000
Year Original Funding Received
2003

Contact Information

Christy Blakely, Project Director
303-973-5780
christy957@comcast.net

Lorri Park, Project Coordinator
Cerebral Palsy of Colorado
2200 South Jasmine Street
Denver, CO 80222
303-973-5780
lparkpris@aol.com

Subcontractor(s)

Colorado's Health Care Program (HCP) for Children with Special Needs

Target Population(s)

Families of children with special health care needs (CSHCN), service providers who work with them, policymakers, and other support/advocacy groups.

Goals

Activities

Abstract

Project CFTF will organize its activities based on six core Healthy People 2010 outcome indicators: Family Participation and Satisfaction, Access to a Medical Home, Access to Insurance, Early and Continuous Screening, Easy-to-Access Community-Based Service Systems, and Services Necessary to Transition to Adulthood.

These indicators will guide the project to help Colorado CSHCN families (1) have access to a "medical home"; (2) secure health insurance coverage; (3) obtain early and continuous screening and intervention services for their CSHCN; (4) access public services and entitlements specific to Colorado and regions in Colorado; (5) participate, partner, and advocate at all levels of decision making; and (6) obtain guidance that promotes a seamless transition from youth to adult services in Colorado.

The project will coordinate information sharing with existing projects such as the Medical Home Initiative and statewide transition planning groups. By the end of the first year, Project CFTF will compile a compendium of resources that incorporates information relevant to the six core indicators. HCP Family Consultants will receive in-depth annual trainings (using a train-the-trainer model) on health care and related services systems and navigation of the systems. Other families, community members, and agencies will be invited to attend. Information distribution and outreach will be conducted through local communication mediums such as newsletters, listservs, Web sites, and other community networks. HCP Family Consultants will be prepared to disseminate information and provide trainings in their local communities on core issues impacting CSHCN.

HCP Family Consultants will help families access health care resources and information, including negotiating benefits in health payer systems, understanding changes to the State's delivery of services, participating in the Medical Home Model, and using effective communication mechanisms to bring about systems change. Many HCP Family Consultants serving large Spanish-speaking populations are bilingual and culturally competent; all consultants participate on multidisciplinary teams and receive access to key health care, nutrition, and social work professionals.

Project CFTF will also conduct a second and third year evaluation to determine its success.

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Family-to-Family Health Care Information and Education Centers

INDIANA

Grant Information

Name of Grantee
The Indiana Parent Information Network, Inc. (IPIN)
Title of Grant
The Indiana Family-to-Family Health Care Information and Education Center
Type of Grant
Family-to-Family Health Care Information and Education Centers
Amount of Grant
$150,000
Year Original Funding Received
2003

Contact Information

Rebecca Agness
Executive Director
4755 Kingsway Drive, Suite 105
Indianapolis, IN 46205
317-257-8683
rebecca@ipin.org

Subcontractor(s)

Donna Gore Olsen, Consultant

Target Population(s)

Children with special health care needs (CSHCN) and their caregivers.

Goals

Activities

Abstract

Over the past 10 years, Indiana has expanded its use of Medicaid to pay for services for children with disabilities and long-term health care needs. This has been accomplished through the State Children's Health Insurance Program (SCHIP) and development of new home and community based services (HCBS) waiver programs. To address the information needs of families of CSHCN, the Indiana Parent Information Network (IPIN) established The Indiana Family-to-Family Health Information and Education Center to (1) make information and materials available online; (2) establish two Parent Liaisons in two state regions; and (3) plan and conduct training statewide on health care financing issues.

Working with a Web design consultant, IPIN will expand and improve its current Web site by updating its online resource directory, responding to individual inquiries via the Internet, and providing downloadable materials. To place staff in regional sites, an advisory committee will help IPIN identify (1) target regions; (2) regional staff who are respected by families and professionals in their communities; (3) options for co-location with other community agencies or organizations; (4) critical issues facing families; and (5) possible clinic and/or hospital sites for partnerships to meet families' information, support, and education needs.

The Indiana Family-to-Family Health Information and Education Center will (1) improve access to accurate, timely information on health care financing options; (2) support both families and professionals through medical homes in local communities; and (3) provide additional opportunities for education and training for both parents and professionals. The advisory committee will help the project maintain links with other family-directed organizations, assure communication with state agencies and others who make or implement policies affecting families of CSHCN, and help identify emerging issues that are affecting these families.

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Family-to-Family Health Care Information and Education Centers

MARYLAND

Grant Information

Name of Grantee
The Parents' Place of Maryland
Title of Grant
Maryland Family-to-Family Health Information and Education Center
Type of Grant
Family-to-Family Health Information and Education Centers
Amount of Grant
$150,000
Year Original Funding Received
2003

Contact Information

Josie Thomas, Executive Director
410-768-9100
josie@ppmd.org

Kim McKay, Project Coordinator
801 Cromwell Park Drive, Suite 103
Glen Burnie, MD 21061
410-768-9100
kim@ppmd.org

Subcontractor(s)

None.

Target Population(s)

Individuals with disabilities and special health care needs and their families.

Goal

The goal of this project is to develop and implement statewide strategies to assure that families of children with special health care needs (CSHCN) have access to accurate, timely, and culturally appropriate information, to enable them to make wise health care decisions.

Activities

Abstract

The mission of Parent's Place of Maryland is to enhance the ability of persons with disabilities and special health care needs to participate as fully as possible in home, school, and community life by providing education, information and referral, technical assistance, and support activities for them and their families. The overall goal of this project is to ensure access to accurate, timely, and targeted information on health care options within the State of Maryland to enable families of CSHCN, including those from special populations, to make wise health care choices.

One project objective is to ensure that families of CSHCN better understand the home and community services and supports available in their communities. This will be accomplished through the provision of a toll-free number, the hiring of a part-time Family Health Partner, the training of staff and volunteers from the partnering organizations, the dissemination of health information, and other outreach activities.

The project will expand outreach for special populations, especially Spanish-speaking families of CSHCN, through training and translated materials developed by the project. In addition, a series of training workshops for families of CSHCN in three broad topic areas—Maryland's Public Health System, Private Health Insurance in Maryland, and Accessing Health Care for Children with Emotional and Behavioral Disorders—will be piloted, evaluated, and implemented. The resulting workshops will become an ongoing part of the Parents' Place of Maryland's workshop repertoire.

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Family-to-Family Health Care Information and Education Centers

MONTANA

Grant Information

Name of Grantee
Parents, Let's Unite for Kids (PLUK)
Title of Grant
Family-to-Family (F2F) Center Project
Type of Grant
Family-to-Family Health Care Education and Information Centers
Amount of Grant
$150,000
Year Original Funding Received
2003

Contact Information

Dennis Moore, Project Director
Parents, Let's Unite for Kids
516 N 32nd Street
Billings, MT 59101
406-255-0540
dmoore@pluk.org

Subcontractor(s)

Spotlight Productions

Target Population(s)

Adults and adolescents with disabilities, and parents of children with disabilities.

Goals

Activities

Abstract

Parent's Lets Unite for Kids (PLUK) is a nonprofit organization dedicated to helping children with special health care needs (CSHCN) reach their potential by insuring fair and equitable access to the educational system. PLUK uses a statewide team of well-trained parent volunteers who assist families by providing support and skill building for positive interactions with the educational system.

PLUK will use its current infrastructure for providing training, data collection, and information services to a statewide constituency to create a Family-to-Family Health Care Education and Information Center. Grant funds will be used to evaluate the information needs of families with CSHCN, conduct peer training to facilitate family-to-family support to meet information needs, and conduct a statewide conference for families by families.

An advisory committee will be established to bring together public and private stakeholders to advise, guide, and oversee the project. PLUK will conduct a survey to identify families who are willing to participate in the project and to determine their interest and skill level in various areas. The information gathered will be used to create an inventory of parental expertise. Topic areas with insufficient capacity will be identified and PLUK will create a plan to remedy the deficit. PLUK will also conduct a survey to determine the information needs of families with CSHCN.

PLUK will develop, test, evaluate, and implement family peer training, and will develop an outreach plan for providing training and disseminating information. A self-advocacy training track, which will be provided in other venues, will be developed for a CSHCN conference. The grant will also be used to establish CSHCN volunteer advisors for newborns in Billings, Helena, Great Falls, and Missoula, to increase the presence of family advocates in the health care system.

Note: This Compendium form was not reviewed by the Grantee prior to publication.

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Family-to-Family Health Care Information and Education Centers

NEVADA

Grant Information

Name of Grantee
Family TIES (Training, Information and Emotional Support) of Nevada, Inc.
Title of Grant
Nevada's Family-to-Family Health Care Information and Education Center Project
Type of Grant
Family-to-Family Health Care Information and Education Centers
Amount of Grant
$150,000
Year Original Funding Received
2003

Contact Information

Marcia O'Malley, Project Director
PO Box 50815
Sparks, NV 89435-0815
866-326-8437
momalley@familytiesnv.org

Subcontractor(s)

None.

Target Population(s)

Children and youth with special health care needs (CYSHCN) and their families.

Goals

Activities

Abstract

The overall goals of the project are to increase understanding of and utilization of appropriate health care resources for CYSHCN, and to promote family-centered and consumer-directed health care services and support. Family TIES' consumer-run organization, culturally diverse staff, and peer mentoring supports will educate, inform, and serve CYSHCN families and help create a network of informed consumers. By encouraging and developing family-friendly materials and approaches, and using peer counselors and parent leaders as mentors, culturally competent policies, practices, and values will become part of the health care system.

Health education and information sharing among families will help families understand the health care system and obtain referrals for early screening and information on how to find appropriate services. The development of self-advocacy skills will help families serve as a resource to other families and provide the center with a pool of consumer leaders who will continue to make significant improvements to the service system in the future.

A Web-based clearinghouse of health care information, being developed under the project, will make information, services, and supports more accessible to families who need them. Information will be translated into Spanish so that Spanish-speaking families will have a place to find quality health care information in their native language. Products developed for consumers will inform and assist CYSHCN families in their decision-making and advocacy roles and help them understand the need for future planning for adult life. Family TIES will also develop a data collection and reporting system that will directly link key constituencies to information regarding the project goals and family satisfaction with services received.

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Family-to-Family Health Care Information and Education Centers

NEW JERSEY

Grant Information

Name of Grantee
Statewide Parent Advocacy Network of New Jersey, Inc. (SPAN)
Title of Grant
Family-to-Family Health Center Project
Type of Grant
Family-to-Family Health Care Information and Education Centers
Amount of Grant
$150,000
Year Original Funding Received
2003

Contact Information

Diana Autin, Project Director
973-642-8100 ext. 105
diana.autin@spannj.org

Lauren Agoratus
Southern Region Coordinator
609-584-5779
agoratus@cs.com

Shirley Johnson
Northern Region Coordinator
35 Halsey Street
Newark, NJ 07120
973-642-8100
shirley.Johnson@spannj.org

Subcontractor(s)

None.

Target Population(s)

Parents of children with special health care needs (CSHCN).

Goal

The goal of this project is to improve access to quality care and supports for children with chronic and acute health conditions in their communities by empowering their families with information and advocacy skills.

Activities

Abstract

The overall goal of the project is to improve access to quality care and supports for children with special health care needs in their communities by empowering families with information and advocacy skills. The Family-to-Family Health Center will assist families to

  1. ensure that their children with special health care needs live at home or in the most integrated community setting appropriate to their needs;
  2. exercise informed choices about their children's living environment, service providers, types of supports, and manners in which supports are provided; and
  3. obtain quality services for their children with special health care needs.

The center will provide education, training, and information to families and providers; collaborate with national, New Jersey, and community agencies that benefit CSHCN and their families; and promote the philosophy of individual and family-directed supports.

Project activities and collaboration will increase the percentage of children with special health care needs whose families partner in decision making at all levels and are satisfied with the services; have access to adequate private and/or public insurance and community-based service systems; and can secure coordinated, ongoing, comprehensive care within a "medical home." The project will also increase informed participation of parents in local, county, and state health systems change activities.

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Family-to-Family Health Care Information and Education Centers

SOUTH DAKOTA

Grant Information

Name of Grantee
South Dakota Parent Connection, Inc.
Title of Grant
South Dakota's Family-to-Family Health Care Information and Education Center
Type of Grant
Family-to-Family Health Care Information and Education Centers
Amount of Grant
$150,000
Year Original Funding Received
2003

Contact Information

Dr. Lynn Fjellanger, Executive Director
605-361-3171
lynnbf@sdparent.org

Dina Castro, Project Coordinator
3701 W 49th Street
Suite 102
Sioux Falls, SD 57106
605-361-3171
dmicke@sdparent.org

Subcontractor(s)

None.

Target Population(s)

Families of children with special health care needs (CSHCN).

Goals

Activities

Abstract

The South Dakota Family-to-Family Health Care Information and Education Center will operate within the South Dakota Parent Connection, Inc. organization. South Dakota Parent Connection serves as the State's only Parent Training and Information (PTI) Center. The overall goal of the project is to build on the current infrastructure to increase access and choice for families with CSHCN and to establish new capacity without duplicating existing services. Information developed under the project will be easily accessible to underserved populations living in a frontier state and will help children remain in their home communities.

Project activities are designed to reach families through comprehensive programs including peer-training, parent-to-parent linking, training available through a variety of distance-education mediums, and individualized technical assistance, all with a strong emphasis on cultural competence and sensitivity toward the State's underserved populations. Collaboration with state, private, and local stakeholders will be the key to the success of building this parent-professional partnership.

Project activities will assist the State in its efforts to improve access to community services for families with CSHCN. The South Dakota Family-to-Family Health Care Information and Education Center will rely on a combination of staff, parent trainers, board members, advisory council members, collaborative partners, and Reservation/Regional Coordinators to complete its activities and meet its goals.

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Family-to-Family Health Care Information and Education Centers

WISCONSIN

Grant Information

Name of Grantee
Family Voices of Wisconsin
Title of Grant
Family Voices of Wisconsin Health Information Project
Type of Grant
Family-to-Family Health Care Information and Education Centers
Amount of Grant
$142,959
Year Original Funding Received
2003

Contact Information

Elizabeth Hecht, Project Director
1500 Highland Avenue
Madison, WI 53705
608-239-1364
liz@fvofwi.org

Subcontractor(s)

ABC for Health
Parent consultants

Target Population(s)

Children with disabilities and/or special health care needs (CDSHCN).

Goals

Activities

Abstract

Families in Wisconsin have consistently identified the need for access to timely, high-quality services and supports in the health and community system of care. The complexities of the current systems, multiple funding streams, and lack of coordination make it difficult for families to obtain the services their child needs. Families who have the information they need to support their child with a disability or special health care need are in the best position to ensure access to quality health and community supports for their child.

Key aspects of this project include involving families in leadership positions in all aspects of project design, implementation, and evaluation. Extensive linkages will be fostered with existing parent groups concerned with CDSHCN. Strategies for supporting and training a network of health benefits specialists will be defined and implemented. All materials and training will be offered to the existing information and assistance network. Project outcomes will be monitored and evaluated throughout the project period.

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LIFE Accounts Feasibility and Demonstration

NEW HAMPSHIRE

Grant Information

Name of Grantee
University of New Hampshire—Institute on Disability/University Center of Excellence in Disability
Title of Grant
Living with Independence, Equality, and Freedom Account Feasibility Study and Implementation Plan for Self-Directing Individuals and Families in New Hampshire
Type of Grant
LIFE Accounts Feasibility and Demonstration
Amount of Grant
$100,000
Year Original Funding Received
2004

Contact Information

For general information about grant activities, please call:

Mary Schuh, Principal Investigator
University of New Hampshire
10 West Edge Drive
Durham, NH 03824
603-862-4320
mary.schuh@unh.edu

Andrew Shepard
UNH—Office of Sponsored Research
51 College Road, Service Building
Durham, NH 03824
603-862-2436
andy.shepard@unh.edu

Subcontractor(s)

For detailed information about grant activities, please call:

Tobey Partch-Davies, Project Director
Southern New Hampshire University
School of Community Economic Development
2500 N. River Road
Manchester, NH 03106
603-644-3159
t.partch-davies@snhu.edu

Target Population(s)

Children and adults with disabilities responsible for self-directing their own services under the Home and Community Based Care waiver services through In-Home Supports, Consolidated Services, Elderly-Chronically Ill services, and Personal Assistance Services programs.

Goal

Develop an easy-to-use LIFE Accounts savings program that will address the needs of persons with all types of disabilities and their families.

Activities

Abstract

Many people with disabilities are deterred from accumulating personal savings because doing so may disqualify them from essential public benefits, such as Medicaid and Supplemental Security Income (SSI). Recent changes in the Social Security Improvement Act of 2003, and the establishment of a Medicaid Buy-In program for adult workers with disabilities demonstrates policy innovation to allow for savings accumulation. However, there remain significant program and policy barriers to saving for children, people who are temporarily unable to work, and for caregivers of the same household to purchase items that could substantially improve independence and community participation among citizens with disabilities.

The purpose of this project is to conduct a feasibility study and develop an implementation plan for the establishment of a savings program for children (i.e., parents) and adults with disabilities who self-direct their own Medicaid-funded, community-based, long-term care services without disqualifying beneficiaries from necessary medical or public benefit programs.

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LIFE Accounts Feasibility and Demonstration

WISCONSIN

Grant Information

Name of Grantee
Wisconsin Department of Health and Family Services
Title of Grant
LIFE Accounts
Type of Grant
LIFE Accounts Feasibility and Demonstration
Amount of Grant
$100,000
Year Original Funding Received
2004

Contact Information

John Reiser, Pathways Program Manager
608-266-3063
Reisejr@dhfs.state.wi.us

Donna McDowell, Director
608-266-3840
mcdowdb@dhfs.state.wi.us

Ralph Pelkey, Co-Director
608-267-9091
Pelkerj@dhfs.state.wi.us

Stuart Gilkison, Co-Director
One West Wilson Street, Room 1150
PO Box 7850
Madison, WI 53707
608-261-9311
gilkisl@dhfs.state.wi.us

Subcontractor(s)

APS Healthcare, Inc.
Attn: Amie Goldman
10 E. Doty Street, Suite 210
Madison, WI 53703
608-258-3350

Target Population(s)

Individuals with disabilities.

Goal

Develop a feasibility study and implementation plan for a Wisconsin Living with Independence, Freedom, and Equality (LIFE) Accounts savings program.

Activities

Abstract

The LIFE Accounts savings program for Medicaid recipients allows individuals to keep savings they have accumulated by self-directing their care. The savings accounts can be used to purchase equipment or home modifications that promote independence. Savings can be enhanced by an individual's earnings or by matched contributions from others.

The purpose of this feasibility study is to determine the number of individuals who are (1) currently eligible and likely to enroll in the LIFE Accounts program through their participation in a self-directed option in the three Home and Community Based Services waiver programs—Community Integration, Community Options, or Family Care—or (2) receiving personal care under the Medicaid State Plan through the Independent Living Center Model.

The grant will also be used to study systems and policy issues that may impact the implementation of a LIFE Accounts program and to develop guidelines regarding allowable purchases and required documentation.

Anticipated project outcomes include (1) greater consumer participation in self-directed care, (2) the creation of incentives for cost-effective use of consumer resources, and (3) the availability of more equipment and supports to assist consumers in maintaining their independence.

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Mental Health: Systems Transformation

DELAWARE

Grant Information

Name of Grantee
Department of Services for Children, Youth and Their Families, Division of Child Mental Health Services (DCMHS)
Title of Grant
Family Psycho-Education for Children and Their Families
Type of Grant
Mental Health: Systems Transformation
Amount of Grant
$300,000
Year Original Funding Received
2004

Contact Information

Ms. Nancy Widdoes
Managed Care Administrator
Delaware Youth and Family Center
1825 Faulkland Road
Wilmington, DE 19805
302-633-2603
nancy.widdoes@state.de.us

Subcontractor(s)

Project Director to be determined.

Michael Partie, Supervisor of P.D.
University of Delaware
Center for Disabilities Studies (CDS)
302-831-8374
partie@chepe.chep.udel.edu

Thomas L. Ragonese, Board President
Delaware Federation of Families for Children's Mental Health (DFFCMH)
302-678-4949
ragonese@delaware.net

Target Population(s)

Families and children served by the State's 1115 Medicaid waiver's public-private partnership for managed children's behavioral health care.

Goals

Develop, pilot, and disseminate for state and systemwide use a manualized, consumer-driven family psycho-education program relating to children's mental illnesses and severe emotional and behavioral disturbances.

Activities

Abstract

Under Delaware's 1115 Medicaid Waiver, there is a public-private partnership for children's behavioral health; however, there is no structured or systematic approach to family psycho-education, and families/consumers report that this is a critical service gap.

DCMHS (the lead agency) is the single statewide payor for Medicaid children's behavioral health extended services with a statewide provider network and a commitment to effective treatment in the least restrictive environment and the use of evidence-based practices. Family psycho-education is already a Medicaid-coverable service in Delaware. DCMHS will partner with Delaware Federation for Families for Children's Mental Health, a statewide family organization and the family voice driving development of this project. In addition, the University of Delaware Center for Disabilities Studies is a strong academic partner with relevant expertise and evaluation capability and has already partnered effectively with DCMHS to produce curriculum for functional behavior analysis. These three partners will collaborate with Delaware Medicaid and behavioral health treatment providers to create Family Psycho-Education to directly benefit Medicaid children and their families. Outcomes to be achieved include

Note: This Compendium form was not reviewed by the Grantee prior to publication.

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Mental Health: Systems Transformation

MAINE

Grant Information

Name of Grantee
Maine Department of Health and Human Services, Adult Mental Health Services
Title of Grant
Maine Recovery Specialist Program for Consumer-Driven Mental Health Systems Change
Type of Grant
Mental Health: Systems Transformation
Amount of Grant
$262,318
Year Original Funding Received
2004

Contact Information

Ms. Leticia Huttman, Project Officer
Department of Health and Human Services
#11 State House Station
Marquadt Building, 2nd Floor
Augusta, ME 04333
207-287-4253
leticia.huttman@maine.gov

Subcontractor(s)

Nadine Edris
Center for Learning
Edmund Muskie School of Public Service
University of Southern Maine
207-626-5220
nadine.edris@maine.gov

Shery Mead
302 Bean Road
Plainfield, NH 03781
603-469-3577
shery466@adelphia.net

Target Population(s)

Adults with mental illness who are Medicaid eligible.

Goals

Activities

Abstract

The Maine Recovery Specialist Program for Consumer-Driven Mental Health Systems Change project is guided by the view that effective implementation of recovery-oriented principles in a state mental health system requires a strategic catalyst, a top-down and bottom-up approach, and a collaborative approach with strategic partners. Maine Department of Health and Human Services (DHHS), Adult Mental Health Services, in cooperation with DHHS Bureau of Medical Services, will collaborate with the Maine Peer Support Workgroup and the Center for Learning, Institute for Public Sector Innovation of the Edmund S. Muskie School of Public Service, University of Southern Maine, to implement this grant project.

A Consumer Project Advisory Committee representing consumers, survivors, and former patients from across the State will advise the project and provide a communications link to consumer organizations statewide. This Advisory Committee will be an expanded form of the Peer Support Workgroup, which designed the premise for this project with the Office of Consumer Affairs to further mobilize consumers and families to move a recovery-based agenda forward.

The project focus on training consumers as Recovery Specialists will serve as a catalyst for promoting a recovery-based approach for increasing community integration and inclusion of consumers and transforming the overall level of recovery-orientation of Maine's mental health system. Adult Mental Health Services will strengthen its strategic alliance with MaineCare, the State Medicaid program, collaborating to assure utilization of newly trained and certified peer support Recovery Specialists and WRAP and RWG facilitators and thereby enhance the recovery-orientation of Maine's mental health system. Concurrently, the Deputy Commissioner, Programs, Director of Adult Mental Health Services, and grant project staff in the Office of Consumer Affairs will work to permeate a recovery-oriented philosophy in policy and decision making and planning and evaluation processes of the state mental health agency.

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Mental Health: Systems Transformation

MASSACHUSETTS

Grant Information

Name of Grantee
University of Massachusetts Medical School Center for Health Policy and Research
Title of Grant
Massachusetts Mental Health Systems Transformation Grant
Type of Grant
Mental Health: Systems Transformation
Amount of Grant
$300,000
Year Original Funding Received
2004

Contact Information

Debra Hurwitz, Co-Principal Investigator
55 Lake Avenue North
Worcester, MA 01655
508-856-4270
Debra.Hurwitz@umassmed.edu

Subcontractor(s)

Deborah Delman, Executive Coordinator
M-Power
617-929-4111
drdelman@comcast.net

Jonathan Delman, Executive Director
Consumer Quality Initiatives
197 Ashmont Street
Dorchester, MA 02124
617-929-4400
jdelman@cqi-mass.org

Target Population(s)

Mental health consumers, adults, adolescents, and children who are Medicaid-eligible, including mental health consumers with substance abuse problems and young adults transitioning out of the children's mental health system.

Goals

Activities

Abstract

Consumer-directed services have taken root in Massachusetts and are providing much-needed support and assistance to mental health consumers, especially those who tend to avoid traditional service providers. However, several barriers currently stand in the way of consumer-directed programs, fully impacting services and policy, including the lack of systematic quality measurement tools and program evaluations, limited training and technical assistance, limited funding streams, and systemwide cultural inertia.

The ultimate aim of this grant is to address these barriers, developing the infrastructure needed to support and sustain effective ROCD mental health services in Massachusetts. This will be accomplished through the establishment of a state-level, consumer-directed RCOE that will address each of these barriers by focusing on training, education and advocacy, planning and program development, and policy development. The RCOE will integrate consumer leaders and organizations to develop a consumer center of gravity that will influence the Massachusetts Department of Mental Health and Office of Medicaid policy and practice, and will ultimately promote systems transformation throughout the State.

Although the RCOE will ultimately impact the overall mental health system, its primary focus will be on Medicaid-eligible mental health consumers of all ages. This will be accomplished by targeting training, technical assistance, and education efforts to consumer-directed programs and traditional mental health providers that serve MassHealth members. Additionally, the RCOE will aim its efforts at two specific populations that have struggled greatly with the traditional mental health system—mental health consumers with substance abuse problems and young adults transitioning out of the children's mental health system.

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Mental Health: Systems Transformation

MICHIGAN

Grant Information

Name of Grantee
Michigan Department of Community Health
Title of Grant
Mental Health Systems Transformation
Type of Grant
Mental Health: Systems Transformation
Amount of Grant
$300,000
Year Original Funding Received
2004

Contact Information

Irene Kazieczko, Grant Administrator
Director, Bureau of Community Mental Health Services
Lewis Cass Building, 5th floor
320 S. Walnut
Lansing, MI 48913
517-335-0252
Kazieczko@michigan.gov

Subcontractor(s)

To be decided.

Target Population(s)

Adults with serious and persistent mental illness.

Goals

Activities

Abstract

Michigan has a strong history of promoting and supporting consumer choice and control in the delivery of mental health services and supports. The State has partnered with consumers and families in work groups to develop practice guidelines, technical advisories, and other communications to the field. Person-centered planning is included in the State's Mental Health Code and a Self-Determination Policy and Practice guideline became effective in October 2004. While these innovations have moved professionals and systems into a services delivery model of consumer choice and control, there have been pockets of success without significant systems change.

In recent years, the State has sought to bring the theme of recovery into the forefront of thinking among professionals, service system mangers, families, and consumers. However, infrastructure is needed to address systems barriers and accountability of recovery-oriented services. Recovery education, training, and support are needed to continue the evolution of supporting positive practices that are evidenced-based.

The grant project seeks to transform Michigan's public mental health system so that recovery is the foundation of the service delivery system. The Department of Community Health will lead a focused and intensive effort to instill the principles of recovery, to enhance the understanding of pathways to achieve recovery, and to support models that can be built upon to demonstrate these pathways. The infrastructure development will include peer supports, self-direction, and consumer-owned and -operated services. In Year 2, the project will focus on developing and supporting at least three Recovery Centers of Excellence to move recovery from a statewide leadership focus to a regional and local level.

Outcomes and products will minimally include a Recovery Council of experts, a recovery brochure and handbook, a Web site with links to national resources, a speakers bureau of recovery experts, contract requirements for managed care, and infrastructure development to support recovery-oriented, evidenced-based mental health services.

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Mental Health: Systems Transformation

MINNESOTA

Grant Information

Name of Grantee
Minnesota Department of Human Services
Title of Grant
Using Evidence to Transform Systems: Science in Service of Children's Mental Health
Type of Grant
Mental Health: Systems Transformation
Amount of Grant
$300,000
Year Original Funding Received
2004

Contact Information

Dr. Patricia Nygaard, Project Lead
Children's Mental Health Division
Minnesota Department of Human Services
PO Box 64985
St. Paul, MN 55164-0985
651-431-2332
pat.nygaard@state.mn.us

Subcontractor(s)

Dr. Eric Daleiden, Consultant
Hawaii Department of Health
808-733-8354
eldaleid@camhmis.health.state.hi.us

Dr. Bruce Chorpita, Consultant
University of Hawaii
808-956-3607
chorpita@hawaii.edu

Sue Abderholden, Supervisor
National Alliance for the Mentally Ill, Minnesota (NAMI-MN)
651-645-2948
sabderholden@nami.org

Target Population(s)

Medicaid-eligible children with serious emotional disturbance (SED).

Goals

Activities

Abstract

The Minnesota Department of Human Services will develop and implement an evidence-based practices database to function as a clinical decision-making tool for parents and providers. The project is designed to make the best possible use of structures and processes used by Hawaii to implement evidence-based interventions throughout its system of care, to determine modifications in those structures and processes needed to match Minnesota's unique assets and constraints, and to evaluate the effectiveness and cost-efficiency of these changes to Minnesota's children's mental health service system.

Based on Hawaii's approach, the project will join families and providers in a learning collaborative to build and implement a systematic approach to evidence-based services from published research and evaluation data. By the end of the project's first year, there will be a plan in place for technical systems changes that need to be made; evidence-based concepts will be familiar to a wide range of families, providers, and administrators; and Minnesota will be prepared to acquire and install the Hawaii-developed core practice elements database. In the second phase of the project, spanning most of Year 2, pilot projects will be developed, implemented, and evaluated. Pilot sites will be chosen regionally in order to ensure the applicability of the project to urban, rural, and frontier areas. At the end of Year 3, the State will have a fully operational EBP database accompanied by strengthened collaborative consumer/provider relationships, customized training materials, enhanced claims and authorization systems, a continuous quality monitoring system, and evaluation reports.

Ultimately, the outcome will be a statewide system that improves clinical and functional outcomes for children, and parents and providers will have more choices in treating children. These system changes will also result in less institutional treatment of children and greater efficiencies in the State's Medicaid system.

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Mental Health: Systems Transformation

NEW HAMPSHIRE

Grant Information

Name of Grantee
State of New Hampshire, Bureau of Behavioral Health (BBH)
Title of Grant
Statewide Implementation of Illness Management and Recovery (IMR) for Consumers with Severe Mental Illness (SMI)
Type of Grant
Mental Health: Systems Transformation
Amount of Grant
$300,000
Year Original Funding Received
2004

Contact Information

Erik Riera, Project Director
Bureau of Behavioral Health (BBH)
105 Pleasant Street, Main Building
Concord, NH 03301
603-271-5000
eriera@dhhs.state.nh.us

Richard Kellogg, Project Co-Director
Office of Medicaid Business and Policy
603-271-4321
rkellogg@dhhs.state.nh.us

Subcontractor(s)

Kim Mueser, Consultant/Training Director
NH-Dartmouth Psychiatric Research Center (PRC)
603-271-5226
Kim.T.Mueser@dartmouth.edu

Target Population(s)

Individuals with severe mental illness (SMI).

Goals

Activities

Abstract

The New Hampshire Bureau of Behavioral Health will implement the EBP Illness Management and Recovery (IMR) program statewide to empower consumers to better manage their mental illness and reclaim their lives by supporting their pursuit of personal recovery goals. The critical ingredients of IMR are supported by multiple controlled studies and include psycho-education, strategies for improving medication adherence, developing a relapse prevention plan, and enhancing skills for coping with persistent symptoms.

Implementation analyses of the IMR program and other EBPs conducted in New Hampshire and across the country have identified barriers to accessing IMR, including lack of a coherent service structure for IMR, a mismatch between Medicaid-reimbursable procedures and some key components of evidence-based IMR interventions, lack of involvement of consumer providers, and the need for ongoing mechanisms to ensure access to training and to sustain high-quality services. The grant will be used to address these barriers to IMR in New Hampshire as follows: (1) establish a coherent service structure for delivering and monitoring IMR in every community mental health center/peer-support program region (and the two state-operated inpatient facilities) involving trained clinician IMR service providers at each site, a supervisor, and a state IMR coordinator; (2) provide training for IMR in each community mental health center/peer-support program region and state-run inpatient facilities, and consultation to center administrations; (3) develop recommendations for modifying Medicaid reimbursement guidelines to support provision of IMR services; (4) develop an IMR state team at the BBH level to lead, monitor, and continuously improve the system transformation; (5) develop credentialing procedures and standards to facilitate long-term Medicaid reimbursement capability; and (6) establish a Center of Excellence for IMR services that will provide training and consultation to both centers and the State to ensure sustainability of collaborative high-quality IMR services throughout New Hampshire.

BBH has already convened a multi-stakeholder EBP team comprising consumers, family members, community mental health providers, BBH, and NH-Dartmouth Psychiatric Research Center (PRC). This team has been meeting on a regular basis and has unanimously endorsed this IMR project.

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Mental Health: Systems Transformation

NORTH CAROLINA

Grant Information

Name of Grantee
NC Division of Mental Health, Development Disabilities, and Substance Abuse Services
Title of Grant
Real Choice Systems Change Grant—Mental Health Systems Transformation
Type of Grant
Mental Health: Systems Transformation
Amount of Grant
$881,307
Year Original Funding Received
2004

Contact Information

Flo Stein, Chief
Community Policy and Management
DMHDDSAS
3007 Mail Service Center
Raleigh, NC 27699-3007
919-733-4670
Flo.Stein@ncmail.net

Wei Li Fang, Ph.D., Project Director
Director for Research and Development
Governor's Institute on Alcohol and Substance Abuse, Inc.
PO Box 13374
Research Triangle Park, NC 27709
919-990-9559
weilifang1@cox.net

Subcontractor(s)

Governor's Institute on Alcohol and Substance Abuse, Inc.

Target Population(s)

Adults with mental illness.

Goals

Activities

Abstract

The goal of the grant project is to achieve greater incorporation of evidence-based practices into the mental health system by assisting LMEs to develop infrastructure necessary to support and sustain the implementation of evidence-based practices within their local communities. To accomplish this goal, a project work group (maximum of 10 persons) will be established at each LME and will consist of administrators, managers, clinicians, providers, and Consumer and Family Advisory Committee (CFAC) members. During planning and development, the local work groups will meet once or twice a month until consensus is reached on the strategic action plan. Once implementation begins on the strategic action plan, the work group will meet monthly. Over time, meetings will be held on an as-needed basis.

Representatives (i.e., LME coordinator, LME staff member, and CFAC member) of the four Project work groups will meet as a group quarterly to discuss implementation issues such as essential infrastructure elements for successful planning, purchasing of services, training, instrument development, barriers to implementation, monitoring of implementation fidelity, clinical supervision, and reporting. Two of the four meetings will be held in tandem with the Steering Committee meeting so that progress at each site may be reported to the Steering Committee for constructive feedback and future planning.

Representatives of the State Divisions of Medical Assistance and Mental Health, Developmental Disabilities, and Substance Abuse Services, the NC Council of Community Programs, the four LMEs, and the MHST Project staff will meet to discuss the goals, proposed activities, and expectations at each level (i.e., state, Council of Community Programs, Institute, LME, and CFAC). This meeting is critical to ensure that all participants understand what the Project is trying to achieve.

While the first year of the grant will focus on planning and development, the second year will focus on field testing, review, and documentation of the experience and development of an evaluation design for dissemination efforts. The third year will focus on dissemination, training, and technical assistance to implement standardized infrastructure tools across the State. Efforts will include workshops, training materials, and considerable technical assistance provided primarily by individuals from the field sites and the grant work group.


4 The responsibilities of the LME as they relate to system performance are as follows: (1) general administration and governance; (2) access, triage, and referral; (3) service management; (4) provider relations and support; (5) customer services and consumer rights; (6) quality management and outcomes evaluation; (7) business management and accounting; and (8) information management, analysis, and reporting.

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Mental Health: Systems Transformation

OHIO

Grant Information

Name of Grantee
Ohio Department of Mental Health
Title of Grant
Incorporating Peer Support Specialists into Ohio's Assertive Community Treatment (ACT) Teams
Type of Grant
Mental Health: System Transformation
Amount of Grant
$300,000
Year Original Funding Received
2004

Contact Information

Liz Gitter, LISW
Ohio Department of Mental Health
30 East Broad Street, 8th Floor
Columbus, OH 43215
614-466-9963
614-446-3077 (cell)
gitterl@mh.state.oh.us

Subcontractor(s)

Doug DeVoe
Ohio Advocates for Mental Health
614-340-6264
ddevoe@ohioadvocates.org

Jonas Thom
Ohio Coordinating Center for ACT
513-458-6733
jthom@healthfoundation.org

Target Population(s)

Medicaid beneficiaries receiving mental health services from community mental health providers, including Assertive Community Treatment (ACT) services to aid recovery.

Goals

Activities

Abstract

The Ohio Department of Mental Health (ODMH) is partnering with the State Medicaid agency and the Ohio Department of Job and Family Services, to incorporate the evidence-based practice Assertive Community Treatment (ACT) as a distinct Medicaid community mental health service beginning in July 2005. ODMH is working with consumer groups, providers, and county boards to incorporate peer support specialists into Ohio's ACT teams. The grant project will provide funding for training and technical assistance to realize the goal. This will increase Ohio's capacity to deliver evidence-based practices and recovery-oriented services to Medicaid consumers with mental health needs and will have a positive impact on Ohio's mental health system's ability to provide the same services for all mental health consumers.

The measurable outcomes and products of this grant will include a white paper on how to incorporate peer support into ACT, which will be disseminated at national mental health conferences. Eighty people will be trained as peer support specialists, and ACT training will be conducted for providers to support the employment of peer support specialists. In addition, training and/or technical assistance will be provided to 40 providers on how to effectively incorporate peer support specialists into their staff.

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Mental Health: Systems Transformation

OKLAHOMA

Grant Information

Name of Grantee
Oklahoma Department of Mental Health and Substance Abuse Services
Title of Grant
Oklahoma Evidence-Based Practices Implementation Project
Type of Grant
Mental Health: Systems Transformation
Amount of Grant
$299,820
Year Original Funding Received
2004

Contact Information

Terri White, Management Analyst
1200 NE 13th
PO Box 53277
Oklahoma City, OK 73152-3277
405-522-3841
tlwhite@odmhsas.org

Subcontractor(s)

None.

Target Population(s)

Adults with mental illness or substance abuse who are eligible to receive Medicaid or state-purchased services.

Goals

Activities

Abstract

The Oklahoma Evidence-Based Practices Implementation Project is an extension of the Recovery Collaborative of Oklahoma. The Collaborative is sponsored by the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS), which is the State Mental Health Authority, and the Oklahoma Health Care Authority (OHCA), the State Medicaid Agency. The Oklahoma Department of Human Services and the Oklahoma Department of Rehabilitative Services also participate in activities of the Collaborative as needed.

The mission of the Collaborative is to implement modifications to the Oklahoma adult outpatient behavioral health delivery system that will enhance the quality of services provided, focus those services upon recovery and the needs of the consumer, and ensure that state- and federally-funded health care is purchased in the most efficient and comprehensive manner.

The Collaborative will implement two evidence-based practices: the Family Psycho-education Program and the Illness Management and Recovery Program. These initiatives fall within the purview of the Collaborative to implement the six evidence-based practices suggested by the Substance Abuse and Mental Health Services Administration (SAMHSA).

The Collaborative will use grant funding to add one full-time staff member at ODMHSAS and one full-time staff member at OHCA. These individuals will develop a statewide network of Recovery Support Specialists who will collaborate with the current network of behavioral health practitioners to form a multidisciplinary team that will serve as providers of Illness Management and Recovery Services and Family Psycho-education. The new staff members will develop policies, procedures, reimbursement strategies, credentialing standards, outcome measures, and provider contracts that will serve as the foundation for these two programs.

Network development and provider training activities will begin in late 2005 and will continue throughout 2006. It is anticipated that the practitioner training sessions conducted through the funding of this grant will continue developing a collaborative relationship with the behavioral health provider community that will serve as the foundation for this effort and the continued implementation of evidence-based practices in the future.

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Mental Health: Systems Transformation

OREGON

Grant Information

Name of Grantee
Portland State University
Title of Grant
The Peer Expertise Network: Building Peer Operated Supports for Recovery
Type of Grant
Mental Health: Systems Transformation
Amount of Grant
$300,000
Year Original Funding Received
2004

Contact Information

Laurie Powers, Project Director
503-725-4040
powersl@pdx.edu

Rollin Shelton, Project Manager
Regional Research Institute for Human Services
PO Box 751
Portland, OR 97207
503-725-8097
sheltonr@pdx.edu

Subcontractor(s)

None.

Target Population(s)

Individuals with psychiatric disabilities.

Goals

Activities

Abstract

The Peer Expertise Network (PEN) project will undertake a series of interrelated activities designed to increase the utilization, validation, and sustainability of peer-operated services. Consumer leaders will be involved at all levels of the project, leading design, outreach, policy, evaluation, and dissemination teams. Peer-operated services will be outreached through the development of a network that brings together groups and leaders already skilled in the delivery of peer-based services with groups committed to move toward increasing peer operation. Train-the-trainer tools and approaches for peer support, education, and advocacy will be infused as well as peer-guided methods for providing supports, such as person-directed planning and self-directed employment. A PEN Leadership Conference will be conducted to promote knowledge exchange, facilitate organizational planning for peer-operated services, and establish network linkages that bring together consumer/survivor leaders to support one another's efforts. An ongoing collaborative planning effort by consumers, state, and local agencies, and other leaders will identify policy improvements, collaboration strategies, and funding mechanisms for sustaining peer-operated programs and services.

Key outcomes will include an increase in (1) the number of peer-operated programs, (2) the level of evidence-based peer services delivered within those programs, and (3) consumer/ survivor involvement in the implementation and evaluation of other evidence-based practices. Products will include evidence-based practice guidelines, benchmarks, and tools for structuring and delivering peer-operated services, and a policy and funding framework for incorporating peer-operated services as a standard practice.

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Mental Health: Systems Transformation

PENNSYLVANIA

Grant Information

Name of Grantee
Pennsylvania Department of Public Welfare, Office of Mental Health and Substance Abuse Services (OMHSAS)
Title of Grant
Real Choice Systems Transformation Grant
Type of Grant
Mental Health: Systems Transformation
Amount of Grant
$300,000
Year Original Funding Received
2004

Contact Information

Carol J. Ward-Colasante
Project Director
717-772-7913
ccolasante@state.pa.us

Bill Boyer
OMHSAS
PO Box 2675
Beechmont Building, 2nd Floor
Harrisburg, PA 17105
717-705-8181
wboyer@state.pa.us

Subcontractor(s)

Jeanie Whitecraft
Mental Health Association of Southeastern Pennsylvania
1211 Chestnut Street, 11th Floor
Philadelphia, PA 19107
215-751-1800
jwhitecraft@mhasp.org

Target Population(s)

Persons with mental illness.

Goals

Activities

Abstract

Through the Office of Mental Health and Substance Abuse Services (OMHSAS), Pennsylvania develops programs and policies, allocates funds, and develops guidelines for county planning and outcome reporting. County government, through the Mental Health/Mental Retardation Act of 1966 and the Mental Health Procedures Act of 1976, has the responsibility to provide a full array of mandated services to its citizens within each county area. OMHSAS has a long-term commitment to the development of a comprehensive array of mental health and substance abuse services and supports.

The Mental Health Association of Southeastern Pennsylvania (MHASP), in partnership with the Montgomery County Office of Mental Health/Mental Retardation/Drug and Alcohol Services, local providers, consumers, and other stakeholders, has implemented in Montgomery County a CPS Program similar to those developed in other states. Through this program, current or former mental health clients are being trained and certified to function as Peer Specialists. These programs assist consumer trainees to better understand peer support, communication skills, cultural competency, outreach, engagement, conflict management, crisis intervention, setting up and sustaining mutual self-help groups, helping clients build their own self-directed recovery tools, and navigating the work place. In Montgomery County, a protocol has been developed for engaging community stakeholders to support this new recovery workforce, a recovery training curriculum has been produced, training strategies are finalized, and a class of 18 consumers is now certified and functioning as the county and state's first Certified Peer Specialists. Montgomery County is using these Certified Peer Specialists in various service settings, including Targeted Case Management, Community Treatment Teams, and Mobile Psychiatric Rehabilitation programs.

Based on this successful program in the Southeast region of Pennsylvania and the accolades Peer Specialist Certification programs have received in other states (e.g., Georgia, South Carolina, Arizona, Vermont, New Mexico), OMHSAS will use this project to introduce and support a Peer Specialist Certification program in the northeast, central, and western regions of the State. Under the grant, the program will be developed in selected counties and then expanded to the rest of the State. A support network will also be developed for CPS training program graduates. OMHSAS will simultaneously work on a State Plan Amendment to win approval to support a continuing program by Medicaid reimbursement of peer specialist services through the Mental Health Rehabilitation Option.

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Mental Health: Systems Transformation

VIRGINIA

Grant Information

Name of Grantee
Virginia Department of Mental Health, Mental Retardation and Substance Abuse Services
Title of Grant
Transforming Virginia's Mental Health Services System
Type of Grant
Mental Health: Systems Transformation
Amount of Grant
$300,000
Year Original Funding Received
2004

Contact Information

James M. Martinez, Jr., Director
Office of Mental Health
1220 Bank Street, 10th Floor
Richmond, VA 23219
804-371-0767
jim.martinez@co.dmhmrsas.virginia.gov

Subcontractor(s)

Virginia Organization of Consumers Asserting Leadership (VOCAL)
Mental Health Association of Virginia

Target Population(s)

Adults with serious mental illness.

Goals

Activities

Abstract

The Virginia DMHMRSAS will use the grant project to strengthen the capacity of the State's mental health services system to provide integrated community services that embody self-determination, recovery, and empowerment. The project will focus on consensus and partnership building with multiple stakeholders and constituencies to develop (1) state-specific models of illness management and recovery and supported employment; (2) regulatory analysis and agency funding streams that will support programs on assertive community treatment, illness management and recovery, and supported employment services; (3) provider training, consultation, and technical assistance; and (4) process evaluation of project implementation.

Project activities are intended to increase the number of mental health consumers who assume policy, planning, evaluation, and leadership functions and roles at Community Services Boards and in mental health system transformation activities; provide Community Mental Rehabilitative Services (CMHRS) that include relevant components of IMR and SE; and are better able to access recovery-oriented and personalized supports leading to competitive employment and independence. The State estimates that approximately $5 to $10 million of existing CMHRS Medicaid reimbursement will ultimately be redirected to support more effective and efficient recovery-oriented community mental health services and supports.

Grant activities were developed collaboratively with consumers and are responsive to numerous recommendations in the President's New Freedom Commission on Mental Health Report and Virginia's One Community, the Olmstead Task Force Report.

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Quality Assurance and Quality Improvement in Home and Community Based Services

ALASKA

Grant Information

Name of Grantee
Department of Health and Social Services
Title of Grant
Alaska's Comprehensive Quality Management System
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$417,849
Year Original Funding Received
2004

Contact Information

Phillip Jones, Program Coordinator
Division of Senior and Disabilities Services
3601 C Street, Suite 310
Anchorage, AK 99503
907-269-3685
phillip_jones@health.state.ak.us

Subcontractor(s)

Patrick Moran, Ph.D.
University of Alaska Anchorage
Center for Human Development (CHD)
907-264-6223

Target Population(s)

Participants in all the State's Home and Community Based Services (HCBS) waiver programs.

Goals

Activities

Abstract

The processes used by the State to assess needs for services, and to periodically review service plans already incorporates person-centered strategies. The purpose of the grant project is to expand the ability of the Division of Senior and Disabilities Services (DSDS) to provide more comprehensive quality management.

In Year 1, consumer partners (Alaska Commission on Aging, Alaska Mental Health Trust Authority, Governor's Council on Disabilities and Special Education, and State Independent Living Council) will examine instruments and methodologies for assessing quality of life on an ongoing basis and make recommendations to the DSDS Quality Improvement Steering Committee. An assessment will be implemented with a small sample of waiver recipients and, after review by the partner organizations, any problems will be addressed. In Years 2 and 3, this assessment will be implemented with larger samples and expanded to other regions of the State, becoming an ongoing part of Alaska's Quality Management System.

The State's Medicaid system already generates automatic, quarterly satisfaction surveys asking only for complaints. Under this project, the automatic assessments will be modified to solicit general feedback that is person-centered and focused on quality of life.

Simultaneously, in collaboration with the Alaska Mental Health Trust Authority, the project will assist in the implementation of an already existing data management system that can integrate quality of life data with other data, such as eligibility assessments, case management, service delivery, program provider performance, complaints, and incident reports. This will make it possible for Alaska's Quality Management System to become more data-driven in ongoing monitoring and improvement activities. It will allow DSDS to provide data-supported information that will be accessible to consumers and families as a tool for making informed choices, to providers as a tool for making their own QA decisions, and to other stakeholders.

Note: This Compendium form was not reviewed by the Grantee prior to publication.

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Quality Assurance and Quality Improvement in Home and Community Based Services

ARIZONA

Grant Information

Name of Grantee
State of Arizona, Department of Economic Security, Division of Developmental Disabilities
Title of Grant
Empowering AriZona's Individuals with developmental disabilities (EAZI)
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$500,000
Year Original Funding Received
2004

Contact Information

Dr. Ric Zaharia, Principal Investigator
State of Arizona, Department of Economic Security
Division of Developmental Disabilities
1789 West Jefferson
Phoenix, AZ 85007
602-542-6853
rzaharia@azdes.gov

Princess Lucas-Wilson, M.S.W.
Project Manager
Policy, Planning and Special Projects
602-542-6090
plucas-wilson@azdes.gov

Subcontractor(s)

Thomas Uno, Ed.S., Assistant Director
Northern Arizona University/Institute for Human Development

Target Population(s)

People with developmental disabilities and their families.

Goal

Develop and test a consumer-to-consumer strategy for gathering quality assurance (QA) data and identifying quality improvement (QI) needs.

Activities

Abstract

The goal of this project is to develop and evaluate a consumer-to-consumer strategy for gathering QA data and identifying potential QI needs. To ensure the project is consumer/family driven, a consumer steering committee will be created to oversee all aspects of the project. The Grantee will first conduct small pilots and later a larger demonstration to evaluate and refine the model.

The Division of Developmental Disabilities will administer the project and coordinate with the Northern Arizona University, Institute for Human Development, to conduct the initial design and discovery tasks to create the model and engage in evaluation activities. Other partner agencies (Administration on Aging and Department of Health Services) will help review the project, identify ways to assure that the model is sustainable, and implement model components as appropriate in their quality management systems.

Measurable outcomes and products of this project include (a) a consumer-run steering committee with a direct connection to the quality management system, (b) a set of consumer-identified characteristics of quality services, (c) a training curriculum for consumer-to-consumer assessment, (d) a cadre of peer quality reviewers, (e) pilot study and demonstration reports, and (f) a consumer-to-consumer model plan.

Ultimately, the project will help to improve services provided to people with disabilities in Arizona by offering a consumer perspective on the quality of services provided to individuals and families in their own homes. This new source of information will aid continuous quality improvement efforts for the target population.

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Quality Assurance and Quality Improvement in Home and Community Based Services

ARKANSAS

Grant Information

Name of Grantee
Department of Human Services, Division of Aging and Adult Services (DAAS)
Title of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services (HCBS)
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$500,000
Year Original Funding Received
2004

Contact Information

Kris Baldwin
Program Administrator, DAAS
PO Box 1437-S530
Little Rock, AR 72203-1437
501-682-8509
kris.baldwin@arkansas.gov

Subcontractor(s)

Contractor to be determined through RFP in first year of the grant.

Target Population(s)

Persons who participate in Arkansas' 1915(c) Home and Community Based Services (HCBS) waivers.

Goals

Activities

Abstract

The grant project represents a commitment by the Arkansas Department of Human Services (DHS) to (1) assure the quality of the State's HCBS waivers, (2) develop quality management strategies for waiver services, and (3) produce a QM Strategy for home and community based services that addresses quality issues in each of the seven focus areas of the HCBS Quality Framework. At present, the State's HCBS quality assurance initiatives are unevenly developed across waiver programs with varying levels of automated data collection and tracking. The overarching goal of the project is to move HCBS quality assurance and improvement activities from the project or program level to a collaborative, interdepartmental commitment to ensure the health and welfare of all Arkansas waiver participants. DHS, with the Division of Aging and Adult Services as lead agency, will update and standardize quality assurance procedures across programs through the QA/QI grant project.

Successful implementation of this project will result in the following measurable outcomes or products: (1) a sustainable systemwide QM Strategy that meets the requirements of the CMS Quality Framework; (2) a single, automated data collection system for all HCBS waivers that generates reliable and timely reports to allow for informed program decisions; (3) a QA/QI Task Force to provide consumer input on HCBS participant-defined measures of quality (in both services and service delivery) and participant outcomes; and (4) shortening of the response time between identification of quality problems and issues and their remediation.

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Quality Assurance and Quality Improvement in Home and Community Based Services

FLORIDA

Grant Information

Name of Grantee
Agency for Persons with Disabilities (APD)
Title of Grant
A Customer Approach to Quality Management
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$475,000
Year Original Funding Received
2004

Contact Information

Linda Mabile, Project Manager
Agency for Persons with Disabilities
4030 Esplanade Way, Suite 380
Tallahassee, FL 32399
850-414-9132
Linda_Mabile@apd.state.fl.us

Subcontractor(s)

Anne Buechner, Florida Coordinator
Council on Quality and Leadership
443-762-6476
Annetnn@aol.com

Bob Foley
Vice President of Florida Programs
Delmarva Foundation
813-972-8100
Foleyb@dfmc.org

Target Population(s)

Individuals with developmental disabilities (DD) and other stakeholders.

Goals

Activities

Abstract

The grant project involves a partnership effort between the APD (formerly the Department of Children and Families, Developmental Disabilities Program), the Council on Quality and Leadership, Delmarva Foundation, and the Agency for Health Care Administration. All four organizations have been involved in providing direction and resources for project development as well as identifying resources that will be dedicated to its implementation. The grant provides an opportunity for the newly established APD to institute quality management and service delivery structures consistent with the principles of self-determination. The overall goal for this project is to achieve, through improved quality management, a more person-directed service delivery system that will result in increased achievement of desired outcomes for people receiving services.

The focus of Florida's initiative will be to enhance the use of data from existing QA activities and realign district functions to build QI and quality management capacities throughout the service system. This effort will improve abilities at all levels of the system, including local service providers and stakeholders, district operational management, and state-level policy and funding partners. The project will specifically target QI and ongoing quality management for organizational change that supports self-determination and meeting customer expectations through the project's goals, activities, outcomes, and products.

Project funds will be spent at a higher rate early in the grant cycle to establish a strong infrastructure and as capacity is established, a smaller percentage of the grant will be spent each year with an expectation that sustainability is facilitated by a growth and shift in funding through both state and local DD program offices.

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Quality Assurance and Quality Improvement in Home and Community Based Services

MASSACHUSETTS

Grant Information

Name of Grantee
University of Massachusetts Medical School
Title of Grant
New England Quality Improvement Collaborative
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$499,226
Year Original Funding Received
2004

Contact Information

Dr. Steven Staugaitis, PI
University of Massachusetts Medical School
Room 105, Chang Building
222 Maple Avenue
Shrewsbury, MA 01545
508-856-7792
steven.staugaitis@umassmed.edu

Subcontractor(s)

R. Gettings
National Association of State Directors of Developmental Disabilities Systems
rgettings@nasddds.org

Target Population(s)

People with mental retardation and/or developmental disabilities (MR/DD).

Goals

Activities

Abstract

The Commonwealth of Massachusetts, through the University of Massachusetts Medical School, E.K. Shriver Center, Center for Developmental Disabilities Evaluation and Research, will develop a unique QI collaboration between the New England mental retardation/developmental disabilities state systems. The major outcomes for this grant project include the development of a set of common quantitative standards and quality indicators, comparative interstate benchmarks, standard algorithms for trend and pattern analysis of quality data, standardized evidence for use by the CMS Regional Office, National Core Indicators (NCI) enhancement, coordinated resource sharing, multistate training and learning opportunities regarding QI and the use of objective data and analytic methods of performance evaluation, increased partnership between the State Medicaid Directors and the MR/DD system leadership, and improved methods for federal oversight of HCBS supports.

Consumers, families, service providers, and CMS regional personnel will be invited to participate with state personnel in the initial identification of standards and indicators to ensure that the design reflects what is important to HCBS participants, providers, and federal monitors. In addition, grant funds will be utilized to establish methods to facilitate the sharing of resources regarding quality and QI across the participating states and the training of stakeholders in the use of quantitative information and methods for consumer use of objective quality information, including prototype provider profiles.

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Quality Assurance and Quality Improvement in Home and Community Based Services

NEBRASKA

Grant Information

Name of Grantee
Nebraska Department of Health and Human Services
Title of Grant
Quality Assurance and Quality Improvement System in Home and Community Based Services (HCBS)
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$470,000
Year Original Funding Received
2004

Contact Information

Sharon J. Johnson, Grant Coordinator
Nebraska Department of Health and Human Services
Aging and Disabilities Services
301 Centennial Mall South, Fifth Floor
Lincoln, NE 68509
402-471-1764
Sharon.j.johnson@hhss.ne.gov

Subcontractor(s)

Dr. Barbara Jackson, Project Manager
Munroe-Meyer Institute
University of Nebraska Medical Center
985450 Nebraska Medical Center
Omaha, NE 68198-5450
402-559-5765
jjackso@unmc.edu

Charlie Lewis, Project Director
Answers4Families
Center on Children, Families and the Law
University of Nebraska–Lincoln
402-472-3479
clewis@answers4families.org

Dr. Linda Redford
University of Kansas

Target Population(s)

Consumers receiving services through the Aged and Disabled Home and Community Based Waiver, which covers populations across the lifespan.

Goals

Activities

Abstract

The purpose of the grant project is to develop a system of supports and services that builds quality into the design of program operations, including a quality management strategy that involves real-time methods of feedback and information gathering; involves consumers, families and advocates in active roles; and makes effective use of QM processes to guide system improvement. This grant will target consumers receiving services through the Aged and Disabled Home and Community Based Waiver, which covers populations across the lifespan.

This project will integrate and enhance current quality assurance efforts into a coordinated, comprehensive QM system that is aligned with the CMS HCBS Quality Framework. Four key issues will be addressed to improve current processes:

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Quality Assurance and Quality Improvement in Home and Community Based Services

NEW HAMPSHIRE

Grant Information

Name of Grantee
New Hampshire Department of Health and Human Services
Title of Grant
Enhancing New Hampshire's Quality Assurance and Quality Improvement System
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$498,988
Year Original Funding Received
2004

Contact Information

Diane Langley, Project Manager
603-271-7103
DLangley@dhhs.state.nh.us

Maureen Ryan, Grant Manager
NH Department of Health and Human Services
Brown Building, 129 Pleasant Street
Concord, NH 03301
603-271-8761
Maureen.U.Ryan@dhhs.state.nh.us

Subcontractor(s)

To be determined.

Target Population(s)

Individuals with physical or mental disabilities, chronic illness, or older adults.

Goals

Activities

Abstract

The New Hampshire DHHS, through the Bureaus of Continuous Improvement and Integrity (BCII) and Elderly and Adult Services (BEAS) proposes to institutionalize a continuous QI culture and management system at the department level that impacts all HCBS waiver programs as well as other Medicaid and state-funded services for those citizens who have a disability or long-term illness. Additionally, DHHS proposes to initiate selective QA/QI activities that are specific to the HCBC-ECI waiver program that is administered by the BEAS and transfer the knowledge and products to other waiver programs.

These two-tiered goals provide an opportunity to advance the department's new leadership and reorganization efforts that are aimed at generating operational and fiscal efficiencies, increasing program integrity, and building a permanent system of ongoing program monitoring and continuous QI. All of these efforts involve enhanced collaboration with community stakeholders, with the foremost challenge of expanding the role of participants and family representatives in designing, developing, and evaluating the system and its performance.

The project will enable the State to create a fundamental change in the DHHS quality management system and to develop or improve community-based services for the HCBC-ECI waiver program in multiple ways. A participant-centered and participant-directed departmental quality management infrastructure will be secured. This will include a continuous QI culture and department-wide standards for quality management. The HCBC-ECI program will realize operational efficiencies; improved assessment and service planning; an ongoing method for capturing participants' level of satisfaction with services and supports; and the active, meaningful involvement of participants at all levels of system planning and evaluation.

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Quality Assurance and Quality Improvement in Home and Community Based Services

NEW JERSEY

Grant Information

Name of Grantee
New Jersey Department of Human Services, Division of Developmental Disabilities (DDD)
Title of Grant
Building a Quality Management Infrastructure for New Jersey's Division of Developmental Disabilities HCBS Waiver
Type of Grant
Quality Assurance and Quality Improvement Systems in Home and Community Based Services
Amount of Grant
$475,000
Year Original Funding Received
2004

Contact Information

Kelli Rice, Project Director
New Jersey Department of Human Services
Division of Developmental Disabilities
PO Box 726
Trenton, NJ 08625-0726
609-987-1922
kelli.rice@dhs.state.nj.us

Subcontractor(s)

Cindy Kaufman
The Center for Leadership and Quality
301-262-2956
tcbkauff@aol.com

Jeanne H. Wurmser, Ph.D.
Clinical Services Management, P.C.
732-706-7241
jwurmser@comcast.net

Michael Steinbruck
Elizabeth M. Boggs Center for Developmental Disabilities
732-235-9308
michael.steinbruck@umdnj.edu

Diane Conway, Executive Director
New Jersey Association of Community Providers
609-406-1400
njacp.main@verizon.net

Target Population(s)

Persons with developmental disabilities (DD).

Goals

Activities

Abstract

The New Jersey Division of Developmental Disabilities (DDD) has been serving developmentally disabled persons through the Community Care HCBS waiver, relying heavily on group homes and day habilitation programs as its primary service models. Since September 2002, DDD has been pursuing a broad program of system change and planning to expand choices with a community-based, self-directed services option called "Real Life Choices," which uses an objective assessment to allocate an individual budget based on support needs and a person-centered planning model built on Essential Lifestyle Planning to assist participants to purchase supports they choose to achieve desired personal outcomes. DDD has expanded the array of supports for individuals living at home and added resources for participants transitioning from special education.

The current DDD QA/QI program for the division began in 2001 with the creation of an Assistant Director position in the central office to oversee and coordinate quality enhancement activities and the development of a QA/QI staff. The quality program has been involved in planning QM systems for Real Life Choices, helping to develop a new model for the plan of care.

However, the quality program has been hampered by several barriers, including (1) the language and models of facility-based services that dominate the culture of most DDD staff and providers, (2) QA/QI activities that are fragmented and rely on paper systems for data collection and analysis, and (3) a need for broader family and participant involvement in quality management. This grant project aims to upgrade the QA/QI system in a manner consistent with the CMS HCBS Quality Framework by changing the existing culture to support person-centered community-based service models, instituting an integrated QM system supported by browser-based data management and revamping the existing Quality Improvement Steering Committee system to provide more consumer and family input.

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Quality Assurance and Quality Improvement in Home and Community Based Services

VERMONT

Grant Information

Name of Grantee
Agency of Human Services, Department of Disabilities, Aging and Independent Living (DAIL)
Title of Grant
Quality Assurance and Quality Improvement in Home and Community Based Waiver Services
Type of Grant
Quality Assurance and Quality Improvement in Home and Community Based Services
Amount of Grant
$499,709
Year Original Funding Received
2004

Contact Information

Stephen Morabito
Quality Management Development Specialist
802-241-2659
Stephen.Morabito@dail.state.vt.us

Joseph Carlomagno
Quality Management Unit Director
Agency of Human Services, DAIL, DDAS
Weeks Building
103 South Main Street
Waterbury, VT 05671
802-241-2721
joe.carlomagno@dail.state.vt.us

Subcontractor(s)

Susan Yuan
University of Vermont Center on Disability and Community Inclusion
The University Center for Excellence in Developmental Disabilities Education, Research, and Service (UCEDD)
802-656-4031
susan.yuan@uvm.edu

Others to be determined.

Target Population(s)

Persons with disabilities who are eligible for the four Home and Community Based Services (HCBS) waivers within DAIL.

Goals

Activities

Abstract

The grant project will develop a comprehensive quality management system across the four HCBS waivers within DAIL. This system will be based on the expectations contained in the CMS Quality Framework. The four HCBS waivers include the Division of Developmental Services' waiver for individuals with developmental disabilities, the Division of Advocacy and Independent Living's Home-Based waiver and the Enhanced Residential Care waiver for elders and individuals with disabilities, and the Division of Vocational Rehabilitation's Traumatic Brain Injury waiver for individuals with traumatic brain injuries. The goals of the proposal are to effect enduring systems change that fulfils Vermont's commitment to ensure the health and well-being of individuals receiving an HCBS waiver within Vermont's community-based, long-term care system.

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Integrating Long-Term Supports with Affordable Housing

ARKANSAS

Grant Information

Name of Grantee
Department of Human Services, Division of Aging and Adult Services (DAAS)
Title of Grant
Affordable Housing with Long-Term Supports
Type of Grant
Integrating Long-Term Supports with Affordable Housing
Amount of Grant
$900,000
Year Original Funding Received
2004

Contact Information

Kris Baldwin
Program Administrator, DAAS
PO Box 1437-S530
Little Rock, AR 72203-1437
501-682-8509
kris.baldwin@arkansas.gov

Subcontractor(s)

NCB Development Corporation (NCBDC)

University of Arkansas at Fayetteville
School of Architecture

Target Population(s)

All persons who are currently residents of nursing facilities and those at risk of nursing facility placement.

Goals

Activities

Abstract

The overall goals of this project being administered by the Division of Aging and Adult Services (DAAS) under the Arkansas Department of Human Services will be to (1) partner with persons with disabilities of all ages and other stakeholders in a workgroup to identify current and innovative models of AHLTS, create a short-term and a 10-year plan to meet Arkansas' needs, and implement the plan; (2) conduct a county-level needs and resource analysis for community-based care options to direct state activities and provide planning estimates; (3) address the immediate need for affordable AFC and assisted living options by implementing and modifying policy, program, and development infrastructure to facilitate their creation; (4) create universal design standards for State implementation to promote housing accessibility statewide; (5) provide financial and development tools (including universal design standards), technical assistance, and financing to create and help replicate demonstration projects; (6) provide training and dissemination on grant activities to consumers, providers, developers, and state staff to transfer knowledge and create sustainable capacity; and (7) develop and maintain a housing registry to facilitate linkages to community-based sheltering arrangements.

Some of the major outcomes include meaningful consumer involvement in State planning efforts leading to improvement in consumer satisfaction; development of State infrastructure to support innovative settings offering high levels of care that are sustainable, easily integrated into neighborhoods, and viable in small, rural markets; formulation of efficient business models to foster the rapid development of these innovative models; and implementation of development financing, demonstration projects, and an affordable supportive housing registry to promote access to a wide variety of community-based options.

The housing registry will be maintained on the Web site for the Arkansas Department of Human Services. This change was necessitated due to a budget reduction of $100,000.

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Integrating Long-Term Supports with Affordable Housing

DISTRICT OF COLUMBIA

Grant Information

Name of Grantee
District of Columbia Department of Mental Health
Title of Grant
Building Capacity to Integrate Access to Housing Supporting Home Ownership in DC's Medicaid Programs Serving Individuals with Mental Illness, Mental Retardation and Developmental Disabilities
Type of Grant
Integrating Long-Term Supports with Affordable Housing
Amount of Grant
$812,004
Year Original Funding Received
2004

Contact Information

Linda Kaufman, Director
Adult Services Division
64 New York Avenue NE, 4th floor
Washington, DC 20002
202-671-3152
linda.kaufman@dc.gov

Subcontractor(s)

To be determined.

Target Population(s)

Persons dually diagnosed with mental illness and mental retardation/developmental disabilities (MR/DD).

Goals

Activities

Abstract

The Department of Mental Health and the Department of Human Services/Mental Retardation and Developmental Disabilities Administration are seeking to improve access and coordination to long-term supportive services with affordable housing for persons with mental illness and MR/DD. The two agencies share approximately 700 consumers who have been dually diagnosed as persons with both mental illness and MR/DD. Currently, there is no formalized framework, structured process, or conduit for serving this population and for integrating long-term supports and housing in a seamless manner. This grant will assist the two agencies to expand and solidify a comprehensive and extensive partnership base to address needs pertaining to long-term supports integrated with housing.

Under this grant, these two agencies will partner with service provider organizations responsible for housing to remove barriers to accessing housing and increase home ownership for these targeted citizens through an improved infrastructure. A workgroup consisting of consumers from the State Mental Health Planning Council and the Development Disability Council and representatives of the District government, service providers, and other key stakeholders will be formed to support the endeavor.

The grant effort will concentrate on the following tangible results: (1) an integrated and streamlined process for applying for Medicaid-funded long-term supports and housing choice options; (2) a mechanism to pay for the transition needs (i.e., rental deposits, furniture, bedding, etc.) of individuals moving out of an Intermediate Care Facility for Mental Retardation (ICF-MR) to community housing; (3) development of a process that provides individuals with disabilities access to housing of their choice, to include both individual and collaborative relationship housing options; (4) creation of a Section 1115 Research and Demonstration Project Medicaid waiver without the barriers that prevent individuals sharing a home from pooling long-term supports; and (5) development of a new infrastructure among District government agencies that will facilitate implementation of housing options for persons with disabilities who can receive information and support in the process of purchasing their own home.

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Integrating Long-Term Supports with Affordable Housing

MISSISSIPPI

Grant Information

Name of Grantee
The University of Southern Mississippi, Institute for Disability Studies
Title of Grant
Project BRIDGE
Type of Grant
Integrating Long-Term Supports with Affordable Housing
Amount of Grant
$720,000
Year Original Funding Received
2004

Contact Information

Roy