Guest Blog: Proposed Rate Cuts to Provider Organizations Threaten Innovation

Our first blog post of 2014 is an important one. Late in 2013, word came from the Oregon Office of Developmental Disabilities Services that they were planning to significantly reduce Small Group Inclusion and Skills Training rates paid to provider organizations. Upon review, brokerages immediately responded explaining such a decision would put many small business completely out of business, reducing key resources for our customers statewide. In the weeks since that exchange, small provider agencies in the Portland metro area (led by On The Move Community Integration, Creative Goal Solutions and Trellis) have come together to form a grassroots coalition (known as The Coalition of Provider Organizations.) Their aim is to educate the state, legislators and the general public on their services and fight the potential reductions in rates. The group developed a comprehensive white paper on their concerns (read it here: Provider Organization Coalition Paper) and, in December of 2013, presented to and gained the support of the I/DD Coalition. As a result of their efforts, state leadership has agreed to meet with some small agencies this week as they reconsider the rates. Our understanding is that the state will need to publicly share their methodology and reasoning and has committed to entertaining stakeholder input and education throughout the process. Given the stakes, full engagement is key.

Sasha Vidales, Owner and Director of Creative Goal Solutions, one of the most sought-after agencies in the Portland area is today's guest blogger for the Independence Northwest blog. Below, she shares what this all means from a provider organization, small-business owner and concerned community member perspective.

Sasha Vidales, Director of Creative Goal Solutions

Sasha Vidales, Director of Creative Goal Solutions, one of the most sought-after agencies in the Portland area is today’s guest blogger for the Independence Northwest blog. Below, she shares what this all means from a provider organization, small-business owner and concerned community member perspective.

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“Proposed Rate Cuts to Provider Organizations Threaten Innovation”

By Sasha Vidales, Director of Creative Goal Solutions

While Oregon is moving to the K-Plan, many customers are seeing increased access to funding for their services. But simultaneously, provider organizations’ hourly rates are slated to be cut by almost 18%. Perhaps most affected by these cuts are smaller, local, grass-roots organizations who have sprung up in response to the diverse needs of brokerage customers; programs like Creative Goal Solutions, which I started in 2011 to offer fully-integrating community-based services to adults with developmental disabilities. Already operating on a shoe string budget and my personal investment, the proposed rate would unquestionably force Creative Goal Solutions to close its doors within just a couple of months.

The greatest detriment would be to the individual customers served by Creative Goal Solutions, customers like Annie Rose. When Annie Rose started working with Creative Goal Solutions, she had the same goals as most twenty-somethings—to move out on her own, get a job, have new life experiences, and exert her independence. Through working with CGS, she had the opportunity to explore her greater community in a group setting. “I like Creative Goal Solutions because it gets me out of the house. I like meeting new people. I discovered new foods…I enjoy going to the park… camping was lots of fun. I like going to the library and art showings.” Soon after her start, Annie decided to move into her own apartment. CGS staff helped her establish a routine around cooking and cleaning that would increase her success as she transitioned. Knowing the importance of community connectedness, staff also helped Annie explore her immediate community on foot and on bus to find new hang-outs. She now independently works out at her local community center and has some favorite local shops and cafes, all the while staying involved in CGS’ group community inclusion. A while later, Annie also took on various volunteer jobs. With staff support, Annie Rose works alongside community members and other customers to gain job skills and give back to her community.

“I like doing Zenger Farms,” says Annie Rose, “I really like gardening and don’t do enough. Now I get to go out once a week and it’s a relief. I’m suddenly happy! I’ve noticed the weeds have gotten enormous and tough to pull out. I’m proud that I can pull them out.”Annie is just one of the over 40 customers flourishing with the support of Creative Goal Solutions’ unique service model. When I started Creative Goal Solutions, I was excited to use innovative strategies to develop meaningful, community-integrating experiences for our customers. I envisioned services that would empower each customer to become involved citizens and create meaningful visibility for themselves. Over the past two and a half years, I’ve assembled a team of highly creative, motivated and skilled employees to put this vision into action. Now, we boast a diverse array of programs to accomplish that vision.What I didn’t realize upon CGS’ inception, was the tremendous value of the group-model. Customers learn so much from each other and there is often a lot of camaraderie, connectedness and natural support developed. At the same time, the model differs drastically from facility-based models in that customers are making daily, “real-life” contact with their communities through recreation and volunteering. Many customers and parents, including Laurie Burk, have noticed the difference.

“[The facility-based program he attended prior to CGS]… provided little or no outside community activities. There was nothing special about the program. I likened it to a daycare center. Since attending CGS, he has shown much improvement. We believe this to be directly related to attending outings to places that “regular” people go. I don’t think many people who are not affected by developmental disabilities understand the secluded life of a young person with disabilities and what they face day in and day out… Just because he has a disability doesn’t mean he doesn’t have worth.”Our Volunteer Program connects and teaches customers at six different community organizations, including The Rebuilding Center, SCRAP, Hoyt Arboretum, Impact NW, the Bike Farm, and Zenger Farms. All of these sites give our customers job-like experience where they can gain skills and confidence working right alongside community volunteers. The program has been tremendously impactful in our customers’ social well-being and sense of worth and individual contribution.

Nightlife Group at local pub

We also provide fully-integrating recreation experiences. The programming is diverse, offering many activities not commonly accessible to people with developmental disabilities. We fill the monthly calendar with customer-preferred activities, such as bowling and libraries and unique experiences, such as attending the Feast of Guadalupe concert, Leech Botanical Gardens, and a tour of the Human Society. We also offer a Nightlife Group. Through this, many customers have their first experiences going to activities like stand-up comedy, salsa dancing and pub trivia. Additionally, our camping trips afford customers the opportunity to be away from home with a group of friends and foster budding friendships through exploring nature.

At Creative Goal Solutions, we continually challenge what others think possible. Those with seemingly significant barriers are equally engaged through our program. Oxana Betska, a mother of one such customer wrote, “[Though he is] nonverbal, he is very social. He wants to be around people, go places, learn new things… [at CGS] he is taught how to behave around other people, how to treat them properly. We can definitely see the progress he has made paying attention to the instructions he was given, evaluating the situation which can be new for him, becoming more independent and mature. The program has helped my son gain self-esteem. Through the program our son volunteers at the retirement center. He has a wonderful time there!”

Volunteering at Bike Farm

Writes Matthew Burk, customer and self-advocate, “I like the format where we meet at the office and board mass transit and go to different places like Fazio Farm, The Old Church for a lunch time concert, the Rose Garden up near the zoo, the zoo, and the game room down at PSU among other cool places. My favorite part of the program is that being a boy from SE Portland I get to see the other parts of the city that I never knew existed. If cuts were to be made I’m not sure what I would do. Without CGS I would go back to being a couch potato and having no routine.”

Despite our customer’s successes, we’ve experienced significant barriers when it comes to a functional and sustainable business model, having to fit a square peg in the proverbial round hole. Our program model of fully-integrating group experiences does not fit well in the current provider rate structure. Most traditional services are provided with one staff per one customer or take place in a facility. Our services don’t fit either of those models and our way of providing services comes with substantial added costs as well as barriers to be able to bill for the full rate. Despite these barriers, we’ve persevered. We’re proud to be one of the handful of truly unique, local, grass-roots organizations with truly unique services to offer.

Rock wall climbing

It’s hard to imagine the local impact of all of these customers losing the visibility and community presence that we’ve worked so hard to promote. Observing our customers’ growth in confidence and self-efficacy over the past two years has been one of the most impactful experiences of my life. Equally important, I’ve seen our community’s response to our customers. I believe that through our work, we’ve begun to shift how people understand disability. They are witnessing all that people with developmental disabilities are capable of contributing, and, with time, learning how essential they are to the fabric of our community.

We’ve accomplished a lot in just over two years. I have many more ideas that I’m actively implementing: a self-employment program, a healthy lifestyles group, and leveraging our culturally-competent, 50% Spanish-speaking staff to better engage Latino customers. Yet, my intense passion and enthusiasm is met with a very real possibility of closure. I’m working hard to push back against the proposed cuts. I’ve co-formed a coalition of small provider organizations, including On-the-Move Community Integration and Trellis to express our alarm and the potential impact of cuts. We’re meeting with decision-makers at the State level as well as other affected provider organizations. I am also counting on the support of families, professionals, self-advocates, community members and the decision-makers at DHS to halt rate cuts and make the growth and development of our innovative program, and others like it, to flourish… for the betterment of our customers and the betterment of our communities.

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ABOUT

Sasha Vidales has worked in community services for 14 years in mental health, policy research, training development, case management, quality assurance and other capacities. She has a BA in Psychology and an MBA in Organizational Behavior and is trained as an Autism Specialist and Social Sexual Consultant. Sasha founded Creative Goal Solutions in 2011 because of her belief in and commitment to strong communities. She knows that strengthening communities requires meaningful and full integration for all people. If you are interested in learning more or joining the coalition, contact Sasha at sasha.vidales@creativegoalsolutions.org.