Montana Developmental Disabilities Program

What You Need to Know for Students

March 19, 2007

d bPresented by:

• Bobbi Dyrud• Bobbi Dyrud– Intensive and FES Program Director

Child Development Center Missoula– Child Development Center, Missoula• Bonnie Chambers

– Case Manager– Region V DDP, Missoula office

http://www.dphhs.mt.gov/dsd/ddp/index.shtml

Developmental Disability MontanaDevelopmental Disability – Montana Definition

• Attributed to mental retardation, cerebral palsy, epilepsy, autism or any other neurological handicapping condition closely related to mentalhandicapping condition closely related to mental retardation and requiring treatment similar to that required by individuals with mental retardation q y

• Originated before age 18• Has continued or can be expected to continue

indefinitely• Constitutes a substantial handicap to the person

Child and Family ServicesChild and Family Services

Who is eligible forWho is eligible for Child and Family DD Services?

• Under age 6, a child who has a developmental disability or is “at risk” of developing a developmental disability

• Over age 6, a child who has a diagnosed d l t l di bilitdevelopmental disability

• There are no income qualificationsh f h h l l f h• Each of the three levels of services has

individualized eligibility requirements

What are the levels of service?

• Part C Infant and Toddler Program (Part C)

• Family Education and Support (FES)y pp ( )

• Intensive Family Education and Support• Intensive Family Education and Support (IFES)

Part C Infant and Toddler Program (Part C)

• Family Education and Support services • Children 0-3Children 0 3• Diagnosed physical or medical condition

that has high probability for developmental g p y pdelay or

• Significant delays in cognition, gross and f k ll lfine motor skills, communication, social-emotional development, or self-help areas

Part C Infant and ToddlerPart C Infant and Toddler Program (Part C)

• Counseling

• Therapies

R it• Respite

• Other services based on child’s• Other services based on child s area of need and family’s concerns and priorities

Family Education and Support (FES)

• Children 0-6

• Risk factors that have a high probability of resulting in developmental delayg p y

• Also includes children and young adults 6-y g21 who have a diagnosed developmental disability

I i F il Ed iIntensive Family Education and Support (IFES)

• Intended to expand range of services available to families

• Children 0-21

• Have extraordinary medical or behavioral needs and a developmental disabilityp y

• Medicaid Waiver program

IFES F ll Child iIFES Follows Child into Adult Status

• When child turns 18 and is graduated from high school:– Can take funding allotted to provide support

services and use it to purchase…– Adult services from adult provider of their choiceAdult services from adult provider of their choice

• Individuals served in regular Family Education and Support must be placed on adult services pp pwaiting lists and wait to be chosen to fill an available opening

I i F il Ed iIntensive Family Education and Support (IFES)

• Families have a great deal of choice determining where when and how childdetermining where, when and how child will be served by adult providers

• Can negotiate with adult providers to best• Can negotiate with adult providers to best meet child’s needs (work services, Respite, Foster Care supports etc )Foster Care supports, etc.)

• Create individualized support plan

I t i F il Ed tiIntensive Family Education and Support Services

• Strong case managementP t hi• Parent coaching

• Respite• Specialized instruction• Access to a variety of other applicable y pp

resources and supports

Oth Child d F ilOther Child and Family DD Services

• Limited Respite– Respite funding and limited support– Individuals of any age who have a

developmental disability– Families must have one annual visit to

develop IFSP– Families eligible for three additional contacts

Oth Child d F ilOther Child and Family DD Services

• Follow-Along– Individuals 0-21Individuals 0 21– At risk for delays in development or have

diagnosed developmental disabilitydiagnosed developmental disability– Up to four home visits per year– Limited support coordinationLimited support coordination

How can the Family SupportHow can the Family Support Specialist assist with transition?

• Attend IEPs at parent’s request • Help family develop a plan for child’s futurep y p p• Initiate application for adult services and

complete all required paperworkp q p p• Inform parents of adult service options,

arrange for tours, assist with planning g , p gprocess and financial arrangements for adult services

A li i f Ad lApplication for Adult DD Services

• FSS is responsible if child is in Family Education and Support Program or IFESEducation and Support Program or IFES

• Otherwise application is usually completed• Otherwise, application is usually completed by an Adult Case Manager through DDP with assistance from parents and schoolwith assistance from parents and school staff

Wh h ld h b f dWhen should youth be referred to adult services?

• Adult eligibility determined at age 16

• Rest of referral information usually completed in youth’s junior or senior year of high school, or within a year of transitioning

d lto adult services

H d f ili l f ChildHow do families apply for Child and Family DD Services?

• Anyone can call a Child and Family provider directly to refer a childy

• Referrals usually come from a parent, familyReferrals usually come from a parent, family member, therapist, physician, etc.

• See map or DDP Web site for provider nearest you

Adult ServicesAdult Services

Wh i li ibl fWho is eligible for adult DD services?

• At least 16 years oldy

• Meets Montana definition of having a• Meets Montana definition of having a developmental disability (see slide #3)

Wh tWhat are some of the DD services?

• DDP contracts with DDP-qualified provider agencies…support services tailored to individual’s preferences and needsindividual s preferences and needs

• Case management for individuals over 16Residential supports• Residential supports

• Employment supportsS t t ti i t i ’ it• Support to participate in one’s community

• Support to maximize one’s health and safety

Examples of Specific Service Titles

• Adult Companion Services

• Residential Habilitation• Residential TrainingServices

• Adult Foster Support• Assisted Living

• Residential Training Supports

• Respite ServicesAssisted Living• Day Habilitation• Personal Care

Respite Services• Supported Employment• Transportation

Servicesp

• Private Duty Nursing

What are “caseWhat are case management” services?

• Assistance gaining and coordinating access to necessary care and services appropriate to needs of individuals

• Montana Medicaid funds Targeted Case M t (TCM) ”i di id l ithManagement (TCM)…”individuals with Developmental Disability age 16 and over” is one of seven “targeted” groupsone of seven targeted groups

• Over 60 case managers in Montana

H h lHow can a case manager help with transition planning?

• Attend IEPs (by invitation)• Provide information about adult services available

locally• Present at local Transition Fair or Forum• Provide waiting list information and suggest

alternatives S t kill d i t d t h ld• Suggest skills and experiences students should have in school to promote adult independence

One more thing about case management…

• In some areas of Montana, case managers are State of Montana employeesare State of Montana employees

• In other areas, case managers are employed by agencies that contract with the State ofby agencies that contract with the State of Montana to deliver services

BUTBUT• The services provided are the same

What is “CommunityWhat is Community Supports”?

• DDP gained Medicaid funding for Community Supports in 2001C t 320 l t t id• Can serve up to 320 people statewide

• Emphasizes flexibility, portability, client-centered choicecentered choice

• 15 service categoriesM t b li ibl f d lt DD i d• Must be eligible for adult DD services and

• Need very little support

Community SupportsCommunity Supports(continued)

• Health and safety needs must be able to be met by this limited dollar program

• $7800 cap per individual per year (prorated if services start after July1st)

• Name can be added to waiting list at 17½ by completing DD referral packet (regional offices maintain waiting lists)

• Must be 18 to enter services

l b l lEligibility Vs. Entitlement

• Eligibility for DDP-funded services: person has provided documentation that verifieshas provided documentation that verifies he/she has a developmental disability

• Entitlement: services must beEntitlement: services must be funded/provided immediately if eligible

• In Montana Adult DD services are not anIn Montana, Adult DD services are not an entitlement

l b l lEligibility Vs. Entitlement

• Free, appropriate public education is an entitlement…

• Often a shock to learn adult services don’t automatically start when high school ends

• Waiting lists for almost all DDP-funded adult services (more people than money)

• No waiting list for DD case management

A li ti fApplication for Adult DD Services

• May request adult services any time after age 16

• Participation is voluntary• Typically, IEP teams discuss need for yp y,

services during transition planning• Initial referral might come from school g

personnel, parents or guardians, children’s case managers, or other agenciesg g

d h lHow and Where to Apply

• If youth already has DDP-funded children’s services, assigned staff from provider agency should be invited to IEPs and they will coordinate Adult DDP eligibility d t i ti d i tdetermination and service requests

• Otherwise, contact DDP Regional office to l iapply – case manager can answer questions

and assist with process and referrals

What about theWhat about the waiting list?

• Statewide, currently a few hundred adults waiting for DDP-funded adult servicesS h i d• Some have no services, some need additional servicesWhen opening occurs anywhere every• When opening occurs anywhere, every person referred for that service in that location is considered and one will belocation is considered and one will be selected to fill the opening…others stay on list

Wh t b t thWhat about the waiting list?

• Impossible to predict when and where opening might occur

• Impossible to predict how long an individual will wait for serviceswait for services

• Develop support plans that do not depend on DDP• Develop support plans that do not depend on DDP funding for 3-5 years after graduation

lProactive Planning

• Identify the youth’s post-school goals:“Where will I live?”– Where will I live?

– “What will I do during the day?”What will I do for fun?”– What will I do for fun?”

– “How will I get from place to place?”“H ill I fi li i ?”– “How will I finance my living expenses?”

lProactive Planning

• Always envision individuality and quality of life

• Seek to understand how individual’s disability might impact capacity to manage tasks, activities, relationships of adulthood

• Teach and practice skills adults need• Seek information

lProactive Planning

• Develop community connections – build a network

• Talk with families of previous graduates…their support, knowledge, ideas might be invaluable

• Establish eligibility for DDP adult services as soon after age 16 as possible

lProactive Planning

• Work with targeted case manager to identify supports the individual will need after high school to ensure health, safety, smooth transition to adulthood

• Meet local DDP provider staff and discuss service options

• Identify sources of “unpaid” support

lProactive Planning

• Identify community services/resources and apply as early as allowed if there are waiting listswaiting lists

• If appropriate, help youth apply for benefits through SSA at age 18 (wait forbenefits through SSA at age 18 (wait for DDP services is usually much longer if person isn’t eligible for Medicaid)p g )

• Attend conferences

lProactive Planning

• Establish savings accounts or Medicaid qualifying trust accounts to help pay privately for needed services while on waiting lists

• Be an informed voter – DD services are driven by the budgets and laws approved b d f d l l d ffi i lby state and federal elected officials

Questions and Answers?Questions and Answers?