An Update on the Oregon Needs Assessment (ONA) by ODDS Director Lilia Teninty

On October 30th, 2017, Oregon Developmental Disabilities Director Lilia Teninty released the following statement regarding the Oregon Needs Assessment:

“We’ve reached some important milestones I want to share with you. The summary below reflects a great deal of work done by everyone in our service system – ODDS staff, CDDP and Brokerage staff, providers, people with I/DD and their families. Thank you for your thoughtful feedback and your efforts to help us get to this point.

The journey to create the ONA started in 2013. The Legislature told ODDS to implement a single, uniform assessment tool. It would be used for everyone we support, regardless of setting.

We engaged a stakeholder group for the project. We also hired Mission Analytics Group. Mission Analytics’ role was to ensure the ONA is a validated tool for all service settings.

The project team members have been diligent. They worked through technical challenges, revisions to the questions, and more. They conducted hundreds of assessments that were used to test the validity and reliability of the ONA. They managed two rounds of pilot testing.

We are close to rolling out the ONA. All individuals receiving I/DD services will be assessed using the ONA in 2018. We need to start the ONA assessments in January to be able to collect data needed for the Compass Project.

Based on input from advocates and partners, we asked CDDPs and Brokerages to work with us to identify staff to administer the ONA. CDDPs and Brokerages are identifying staff in their entities to perform the assessments. The ODDS assessment team will also assist with administering ONAs in rural areas of the state.

From January through June, staff will use both the ONA and the current assessment tool. In July, the ONA will be the official assessment. The ODDS assessment team will train the CDDP and Brokerage staff who will use the tool. The team will also provide technical assistance and quality assurance. They will do this to ensure the tool is administered consistently across the state.

The ONA will be administered by a staff person who is not the person’s case manager.

Benefits of separating case management from the assessment include:

  • Removes real or perceived conflicts of interest.
  • Improves objectivity and consistency.
  • The case manager may still take part in the assessment. The case manager will not be responsible for the results of the assessment itself. Instead, the case manager can support the person and provide information to inform responses.

Our journey to create the ONA is reaching its destination. Thank you to the many people who are making it possible.”

 

Brokerage Services are Medicaid Services and Funding is at Risk

You may have heard that Brokerages and CDDPs/counties are facing serious cuts.

Locally, we expect a pretty significant hit to disability services, primarily in the case management and crisis arenas. At the federal level, not only is case management in the cross hairs, but so are your in-home brokerage supports. When you hear politicians talking about healthcare reform, it’s not only about medical care with your doctor or at a hospital. It’s important to understand that Brokerage services are Medicaid services. Most county/CDDP services are Medicaid services. The K Plan is a Medicaid service. For the past four-plus years, the vast majority of services for thousands of children and adults with disabilities in Oregon has been funded through the Affordable Care Act (Obamacare) – a Medicaid program. And the Senate proposal (now called the Better Care Reconciliation Act of 2017) led by Mitch McConnell directly targets the reduction of home and community based services for people with disabilities (including brokerage services.)

This message is a simple ask: please contact your legislators and tell them your story as soon as possible. You can send an email or make a call. A vote is possible following Independence Day.

The great folks at the Oregon Developmental Disabilities Coalition have created easy-to-use advocacy instructions to help you get started. This is a key moment in the history of services for people with disabilities. Please take a moment to share your story and let your voice be heard.

WHAT CAN YOU DO?
Everyone has a story, and there is power in sharing it. If Medicaid matters in your life, NOW is the time to share your Medicaid story with members of the United States Senate. They need to understand the positive impact Medicaid has in lives of millions of Americans with disabilities each and every day.

WHAT DO YOU SAY?

  • I am your constituent.
  • I am a person with a disability [or I am a family member of someone with a disability or I am a professional in the disability field].
  • “Please do NOT allow cuts or caps to Medicaid.”
  • “Because of Medicaid, I have healthcare and supports to live in my community. For example, I use my services to _____________________________________.”
  • “If I don’t have these Medicaid-funded supports, my life will be harder because _____________.”

HOW TO CONTACT UNITED STATES SENATORS
Oregon’s Senators, Senator Ron Wyden and Senator Jeff Merkley, are both very supportive of the disability community and will not be voting for this bill. However, they still need to hear your story because they can share it with their Senate colleagues and they are keeping tallies of the contacts they have with their constituents so each contact you make is extremely important. Even if you have reached out to them already, please share your story again and ask for their support in stopping this legislation that would have a devastating impact on the disability community. Reach out to them by phone or email or via their website or on social media – whatever modes work best for you. Make calls to their offices in Washington DC at 202-224-3121

Send them an email at:

Share your personal story about Medicaid in their story banks: www.merkley.senate.gov/share-your-aca-story and www.wyden.senate.gov/trumpcare-story

Reach out to your family and friends across the nation to support your advocacy efforts to save Medicaid by contacting their United States Senators and urge them to vote NO on the BCRA! Please encourage your family and friends to call their United Senators via the Congressional Switchboard at 202-224-3121 to reject the current draft of the BCRA.

We want all U.S. Senators to be urged to reject Medicaid Cuts & Caps, including:

  • Alabama:  Shelby
  • Alaska:  Murkowski & Sullivan
  • Arizona:  Flake
  • Colorado:  Gardner
  • Florida:  Rubio
  • Georgia:  Isakson
  • Indiana:  Young
  • Louisiana:  Cassidy
  • Maine:  Collins
  • Missouri: Blunt
  • Montana:  Daines
  • Nebraska:  Fischer & Sasse
  • Nevada:  Heller
  • North Dakota: Hoeven
  • Ohio:  Portman
  • Pennsylvania:  Toomey
  • South Carolina: Graham
  • South Dakota: Rounds & Thune
  • West Virginia:  Capito
  • Wisconsin: Johnson

Thank you for your continued support and advocacy for essential services for Americans with intellectual and developmental disabilities! And thank you to the I/DD Coalition for the materials to share.

 

 

Oregon Disability Services Face Cuts – Your Voice is Needed this Saturday in Portland

Oregon is currently facing at a significant budget deficit and in order to deal with the issue, our state legislature is looking at places to reduce, discontinue, or rearrange funding. There are several areas the legislature is considering cuts in the coming months, many of which were outlined in the Governor’s Proposed Budget:

  • A reduction in brokerage and county/CDDP case management funding
  • Elimination of the Family Network program
  • Elimination of Regional crisis services
  • Elimination of the Fairview Housing Trust Fund
  • Partial rate increase to Direct Support Provider wages

You can learn all about the proposed budget cuts and adjustments in this great article by brokerage association director Katie Rose. Remember, these are cuts mentioned only in the Governor’s budget – legislators may be looking at other ways to adjust funding to balance the budget.

How You Can Help

This Saturday, attend the Town Hall at PCC Sylvania in Portland! The Joint Committee on Ways and Means has scheduled a series of Town Hall meetings across the state. Having advocates from the I/DD community show up and give testimony at these public budget hearings is very important.  This is a unique opportunity to tell legislators what your services mean to you and why keeping service networks strong is important for you and your family. We have heard that legislators aren’t getting a lot of feedback from the community on services – please take this chance to make your voice heard.

What to expect if you go? Be prepared for large crowds, and plan to arrive early, especially if you want to sign up to give testimony (at least 1 to 1 ½ hours early). The sign-up sheet for testimony fills up quickly. Even if you don’t plan to give testimony, your presence at these events, wearing or waving something yellow in support of the DD Community, will send the message to legislators that the DD Community is unified in its support of DD programs and services.

RSVP and connect on the event Facebook page here.

When: Saturday February 11th 12 – 2pm (Be there as early as 10:30 or 11:00 if you want to speak!)
Where: Main Mall, Amo DeBernardis CC Building
PCC, Sylvania campus 12000 SW 49th Ave, Portland

To support your participation in these statewide budget town halls, the I/DD Coalition will ensure a host will be on site at the event to provide you with fact sheets, advocacy stickers and more. Please register for this event via Facebook to stay informed and receive the latest information.

Thanks to our friends at the I/DD Coalition and GO! Project for their great work organizing the community and providing the content for this post.

 

Oregon I/DD Services Director Releases Statement on Proposed 2017 Budget Cuts and Investments

Lilia TenintyOregon Office of Developmental Disabilities Services Director Lilia Teninty released a statement today regarding budget cuts and investments in Governor Brown’s recently-released state budget for 2017 – 2019 related to the intellectual and developmental disabilities community:

Dec. 5, 2016

To: All ODDS Staff and Stakeholders

On December 1, Governor Kate Brown published her proposed budget for the 2017-2019 biennium. The governor noted she had tough decisions to make under difficult circumstances, including a $1.7 billion budget gap. Her budget fills the shortfall with a combination of new revenue, program cuts and efficiencies.

The governor’s budget for DHS is nearly $11.3 billion total funds, a 6 percent increase over the current biennium. It includes investments to balance the DHS budget in a long-term sustainable manner to meet the needs of Oregon’s most vulnerable residents. It also includes reductions that impact DHS.

The Intellectual/Developmental Disabilities system

The Oregon Intellectual/Developmental Disabilities (I/DD) program strives to support choices of individuals with disabilities and their families within communities by promoting and providing services that are person-centered, self-directed, flexible, community-inclusive, and culturally appropriate.

The I/DD system has many critical partners including Community Developmental Disabilities Programs (CDDPs), Brokerages, providers, families, and self-advocates, which support individuals with I/DD to live full lives in their communities. Oregon no longer has institutional settings for persons with developmental disabilities, so all individuals are served in the community. Most of these services are administered under Medicaid waivers and the Community First Choice Option (the K-Plan). The Stabilization and Crisis Unit (SACU) is also part of this program.

With the implementation of the K-Plan, the I/DD program has experienced and continues to experience increases in caseload and cost per case for individuals served. The 2017-19 Governor’s budget for Office of Developmental Disabilities Services (ODDS) is $2.7 billion total funds ($893.9 million General Fund).

Governor’s proposed 2017-2019 budget

In order to fully fund increased caseloads and costs, certain tradeoffs had to occur. While continuing to protect eligibility requirements for children and adults to qualify for services, the budget makes some reductions.

  • Community Developmental Disability Programs and Brokerages. Thirty-four CDDPs and 14 Support Services Brokerages provide case management services to approximately 26,000 individuals with I/DD. CDDPs serve as a front door to the I/DD System, responsible for eligibility determinations and re-determinations, protective service investigations, and on-site reviews of foster homes for children and adults. Since implementation of the K-Plan, case management entities have been serving rapidly growing number of individuals with I/DD enrolling into the system and have experienced increasing workloads. This budget reduces equity funding from 95 to 91 percent.
  • Family-to-Family Network program. With the K-Plan, services are available to all eligible children and adults in Oregon. Families take advantage of the Family-to-Family Network to learn about and access other local resources and unpaid supports. This program would be eliminated in this budget.
  • Regional programs. Funding provided to regional programs has been eliminated. These programs are funded by the state but the functions were determined by local CDDPs, ranging from provider training and capacity building to crisis placement, depending on the needs of the area.

The budget also makes significant investments in DD programs.

  • Rate increase to support Direct Support Professionals. To address the need to develop a stable and well-trained workforce, the budget funds increasing the rate structure for non-bargained, agency services with a $22.3 million General Fund increase. This can help reduce the staff turnover rate and help attract and retain qualified workers, increasing safety for individuals with intellectual and developmental disabilities.
  • Fairview Trust Fund. The budget expends the $6 million Fairview Housing Trust Fund on services dedicated to individuals with intellectual or developmental disabilities.

Related investments.

  • Background Check Unit. Additional staff will help eliminate a backlog of background checks for I/DD Personal Support Workers, agency DSPs and other DHS programs, helping meet required staffing levels while maintaining health, safety and financial wellness of Oregonians.
  • Technology improvements. The budget adds $14 million General Fund for two important technology programs. One of those, the Centralized Abuse Management System, will replace a patchwork of solutions for records related to abuse reporting for our programs and others within DHS.

Whenever we are faced with budget cuts — even as we have increases in other areas — it causes a lot of uncertainty and worry. Governor Brown says that state government will tighten its belt and live within its means, but not without painful cuts to critical programs at a level she finds unavoidable and unacceptable. She has presented this budget “ … as the starting place for a broader conversation with Oregonians and legislators about how best to align our resources with our shared values and vision for moving Oregon forward.”

In January, the Legislature will take up the state budget. There will be many opportunities to provide input to Legislators throughout the session. I look forward to working with advocates for the DD system throughout this process and I will provide you with information as the process unfolds.

Lilia Teninty, Director
Office of Developmental Disabilities Services

 

INW Hosting Day and Evening Info Sessions on Adult In-Home Services this October

What’s Changing?

In the last few weeks, Personal Support Workers and brokerage customers should have received information directly from the State of Oregon and/or SEIU regarding an important change just around the corner. For a good many years, TNT Fiscal Intermediary Services has issued paychecks for PSWs serving our customers. TNT’s contract with the state ends at the end of 2016 and a new agency, PCG Public Partnerships LLC (known as PPL) will be taking over this responsibility. So in the very near future, Personal Support Workers will stop getting payment from TNT and start getting payment from PPL.

 

What does this mean to Personal Support Workers and Customer-Employers?

Generally speaking, it means that Personal Support Workers and employers (be they a brokerage customer or a legal designee) have some paperwork to fill out. Right now, PPL is sending out mailers to three groups of folks:

  • Employers (customers or their designees) who employ PSWs (You’ll get a packet by mail on or around November 4th, 2016)
  • Personal Support Workers who work for one Employer (customer or their designee) (You’ll get a packet by mail on or around November 7th, 2016)
  • Personal Support Workers who work for two or more Employers (customers or their designees)  (You’ll get a packet by mail on or around November 8th, 2016)

Customer-Employers and Personal Support Workers can return their packets in a variety of ways: by mail, fax, or secure email.

 

What Help Is Available?

If you’d like some hands-on help, consider attending one of the optional Enrollment Information and Help Sessions for Employers and PSWs. Multiple sessions will be held here at Independence Northwest and there are sessions in all three metro area counties. RSVP for a session by clicking here. If you have received your packet, you can bring it to the session in your area to receive hands-on help. If you haven’t received it by the time the session you want to attend happens, they’ll print a packet for you there and assist you in person.

You can also call PPL Customer Services for help. Their number is listed on this flyer or you can visit this website.The state’s eXPRS Facebook page has a ton of resources related to the change as well.

 

Transition time is very tight on this, so be sure you’re responsive and get the help you need! If packets are not completed and processed by the end of the year, payment for services may be affected. If you have questions, don’t hesitate to reach out to PPL for help.

We Need Your Help: Brokerage Case Management Funding Faces Reduction Next Week

Dear Customers, Family Members, and Providers,

I’m writing you to ask for your help.

On Monday, Legislators meet to make final budget decisions and Brokerages statewide may receive cuts to our administrative and case management funding. Your support can make all the difference in making sure that doesn’t happen.

If you have a spare couple of minutes between now and Friday, we would greatly appreciate your support. A quick email to the legislators listed below or just a call to their offices will go a long way. Ask them to support “funding of the Workload Model at 95% and no less!”

I have come to know many of you over the past couple of years as INW has done outreach to the community, educating hundreds and hundreds of community members on the systemic changes, specifically the K Plan (Community First Choice Option). While the K Plan has brought a lot of funding into the system to pay for direct services, it has not added a penny to our administrative budgets. Personal Agents who were supporting 45 people historically managed about a half million dollars in Medicaid funds on behalf of customers and providers. Today, many manage double, triple, and quadruple that. Think about the way you’ve seen your plan or the plans of others change over the past two years and multiply that by 7,800, the number of people brokerages serve statewide. The change has been huge. Add to that the Adult Needs Assessment requirement, the unfunded burden of the eXPRS payment system implementation, our Personal Agents now entering timesheets on behalf of many providers, the state’s change to a much longer and more complicated ISP, and enormous systemic shifts, and we are in no place to take a statewide reduction in funding. I believe that some lawmakers may be confusing the K increase with an overall funding increase and it’s just not the case.

I have included a couple of example letters you might use as a template for your email or as a script for your phone call. If you could contact the legislators listed below (whether you live in their district or not) it would be great! If you’re interested in additional details about the Workload Model issue, check out this in-depth explanation: Brokerage Reductions at 90%.

The importance of your support is immeasurable to us right now. I wouldn’t ask for last-minute action if I didn’t believe it could change the future. Your voice will make all the difference between a continued move toward better and more person-centered services versus a world where we may be looking at increased caseloads and a reduction in overall quality for a system known for its innovation, responsiveness, and vision. Our system has taken enough hits this past biennium.

Best to you and yours and thank you again for your support and the opportunity to serve this community.

Larry Deal
Executive Director

 

Legislators to Contact

Representative Deborah Boone Rep.DeborahBoone@state.or.us 503-986-1432
Representative Alissa Keny-Guyer Rep.AlissaKenyGuyer@state.or.us 503-986-1446
Representative Nancy Nathanson Rep.NancyNathanson@state.or.us 503-986-1413
Representative Andy Olson Rep.AndyOlson@state.or.us 503-986-1415
Representative Duane Stark Rep.duanestark@state.or.us 503-986-1404
Senator Alan Bates Sen.AlanBates@state.or.us 503-986-1703
Senator Elizabeth Steiner Hayward Sen.ElizabethSteinerHayward@state.or.us 503-986-1717
Senator Jackie Winters Sen.JackieWinters@state.or.us 503-986-1710


SAMPLE LETTER FROM CUSTOMER/FAMILY MEMBERS

Dear LEGISLATOR,

I am a customer of OR a family member of a person who receives brokerage services for people with IDD (intellectual and developmental disabilities) here in Oregon. I understand that you are making budgetary decisions next week regarding funding for case management. PLEASE FUND BROKERAGES AT THE 95% WORKLOAD MODEL LEVEL – AND NO LESS.

While the Community First Choice Option (K Plan) brought more services to me/my family, it did not add any additional funding for brokerages to administer double and triple the services they have administered historically. We need to know that our brokerage Personal Agent will be responsive when we need him/her. If you reduce funding, we know that increased caseloads are likely. That means we won’t have access to the services we need as quickly. Some of the services I receive right now are: __________________________________. The time I need my brokerage support the most is to help me ______________________________.

Statewide, brokerages have experienced huge increases in workload related to the K Plan, the state’s much more complicated ISP, the eXPRS payment system, and all the paperwork changes. I rely on these services to live an independent life in the community. Please fund brokerages fairly in the next biennium – 95% and no less.

Thank you for your consideration and your service.

YOUR NAME

_________

SAMPLE LETTER FROM PROVIDER/PERSONAL SUPPORT WORKER

Dear LEGISLATOR,

I am a Personal Support Worker/Employee/Provider of services for a person who receives brokerage services for adults with IDD (intellectual and developmental disabilities) here in Oregon. I understand that you are making budgetary decisions next week regarding funding for IDD case management. PLEASE FUND BROKERAGES AT THE 95% WORKLOAD MODEL LEVEL – AND NO LESS.

While the Community First Choice Option (K Plan) brought more services to the people I serve, it did not add any additional funding for brokerages to administer double and triple the services they have administered historically. We need to know that the brokerage Personal Agents we work with will be responsive when customer needs arise – including processing payment to providers like me. If you reduce funding, we know that increased caseloads are likely, meaning slower response time for getting essential needs met. As a provider, I rely on the brokerage for ___________________________________________.

Statewide, brokerages have experienced huge increasing in workload related to the K Plan, the state’s much more complicated ISP, the eXPRS payment system, and all the paperwork changes. The people I support rely on these services to live an independent life in the community and my livelihood is reliant on this program. Please fund brokerages fairly in the next biennium – 95% and no less.

Thank you for your consideration and your services.

YOUR NAME

 

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