Overview of Developmental Disabilities Services Community Developmental Disabilities

Overview of Developmental Disabilities Services ~ Community Developmental Disabilities Programs (CDDP) Presenters: Alexis Alberti, Multnomah County Program Supervisor H. S. Transition Team Stacie Mullins, Clackamas County Lead Eligibility Specialist

Who We Are: A Community Developmental Disability Program (CDDP) Community Developmental Disabilities Programs (CDDPs) employ Service Coordinators to provide individually focused care coordination and planning to children and adults with Intellectual and/or Developmental Disabilities. Our goal is to increase overall quality of life, promote independence, and integration into the community by providing resource linkage and in home and community supports for individuals we serve.

Community Developmental Disabilities Program (CDDP n Our program is voluntary. n Families can decline services at any time if they do not find our services to be relevant or helpful. n We work in teams/collaboration with parents, legal guardians, the courts, CASA’s, the schools, vocational rehabilitation counselors, therapists, psychiatrists, and other members of the child’s/client’s natural network of support. n Each client is assigned a Service Coordinator to work with.

What does a Service Coordinator do? n They work in collaboration with the client and their support team to identify ways to support the client throughout the year. n They help develop Annual Support Plans/ISP’s. n They help individuals and families obtain resources. n Examples of resources: n n n n n Help in the home with activities of daily living Respite Family training Behavior consultation Community inclusion opportunities, vocational support, career development planning Adaptive equipment If necessary, help in locating out of home placement Transportation Any other services needed to reach the supports identified in the Annual plan/ISP.

Service Coordinators cont’d n They Assist in coordinating emergency interventions. n Participate as a liaison between the child and school. n Guide and support the individual and family to plan for the future n Assist in creating a transition plan that is meaningful to the individual and family. n Monitors health, safety, financial record keeping, medication/MARS, and other supports for clients in foster care.

Service Coordinator cont’d: n The Service Coordinator emphasizes the importance of person centered planning when working with agencies and the individual’s support team. n Person Centered Principles include: n n Looking at what areas are meaningful and relevant to the individual and their family. Emphasizing the strengths of the family and individual. Exploring how to increase the individual’s own ability to manage challenges by focusing on their areas of strength. Focusing on how to keep individual’s in their natural environment / family home and facilitate increased community inclusion and supports.

Service Coordinator cont’d: n At a minimum, the Service Coordinator meets yearly with families/teams to create a family support plan/ISP for the individual. n The Service Coordinator has specialized training and experience working with individuals impacted by developmental and intellectual disabilities. n They are a great resource of knowledge and expertise in the field of ID/DD. n They Conduct monitoring visits monthly, quarterly, semi-annually, and/or annually as outlined in the OAR’s.

How we monitor and support Individuals and Families in Oregon: n Family Support/Annual Plan development and review n Help develop Kplan funded In-home supports for n n n people MEDICAID eligible Children’s Intensive In-home Support referrals Personal Care Support (funded by Medicaid’s State Plan PC program) Locating, certifying, and funding DD Foster Homes and other out of home placements (when needed) Monitoring services to individual’s in foster care, (permanently or temporarily) to ensure continuity of services, health and safety, and provision of needed supports High-School Transition and Brokerage Support Planning, and quality of life planning for adults. Career development planning

Our Demographics: Multnomah County CDDP is responsible for 3, 751 adults and children impacted by Intellectual and Developmental Disabilities. Clackamas County CDDP is responsible for 2, 395 adults and children impacted by Intellectual and Developmental Disabilities; In Multnomah County we have approximately 76 Service Coordinators with individual caseloads ranging between 55 -60 individuals per caseload. In Clackamas County there approximately 30 Service Coordinators with individual caseloads ranging between 65 -75 individuals per caseload. Approximately 85% of children and 50% of adults currently being served in the metro area live at home. Adults are able to choose between CDDP and Brokerage Case Management services.

Intake, Eligibility and Administrative Hearings OAR 411 -320 -0080

Intake process… n Before a service coordinator can be assigned, and before an individual can access services through a CDDP, they must first complete and intake process and be determined eligible. n CDDPs have Eligibility Specialists who are responsible for making the eligibility determinations. n We all follow the same OAR requirements, but each CDDP will have their own intake process. n To begin the intake process or to make a referral contact: n Multnomah County – Mary Putnam @ 503 -988 -6258 n Clackamas County Intake Line (503) 557 -2824

Application - Criteria n Oregon resident n Apply in county of origin. Kids (<18) apply in the county where the guardian resides, and adults apply in the county where they reside. n Must have an application signed and dated by the individual or their legal guardian. n Applicants are required to provide documentation of US citizenship or permanent residency

How the process works: n Once a signed and completed application is obtained, we have 90 days to make an eligibility determination. n During this time we are required to gather all current and historical eligibility documentation, and determine if we have sufficient information to make an eligibility decision. n This timeline can be extended upon mutual agreement between the individual/guardian and the CDDP.

Eligibility Criteria: Intellectual Disability • • History of ID must be prior to age 18 Eligibility is based on IQ and adaptive scores IQ scores are always looked at first, and we can consider IQ scores up to 75 If IQ is 66 -75, an adaptive assessment is required Adaptive assessment must indicate “significant impairment” Significant impairment must be directly related to Intellectual Disability

Eligibility Criteria: Other Developmental Disability • Other Developmental Disability • • • History of DD must be evident prior to age 22 IQ scores are not used Must have a medical/clinical diagnosis of a QUALIFYING developmental disability An adaptive assessment is required Adaptive assessment must indicate “significant impairment” directly related to the developmental disability. Individual must also require “training and support” similar to someone with an Intellectual Disability

Eligibility Notices – Not Eligible n Notification of Planned Action (NOPA) – Not Eligible n n Informs the individual that they are not eligible and the reason for the denial. Provides a list of documents used in making the eligibility decision. Hearing rights are included and inform the individual that they have 90 days to request a hearing (verbal or in writing) Individuals can always reapply.

Hearing process n n n Hearing requests must be on specific state form This form can be completed by the individual/guardian or a designated representative. It can also be completed by the eligibility specialist at the CDDP. This form must be received in Salem within 90 days from the date of the NOPA Contact eligibility specialisted on NOPA for assistance In the event that an individual who is already receiving DD services is determined ineligible, they can request continued services during the hearing process. If the outcome of the hearing is not in their favor, they may be asked to pay for services received during the hearing process.

Eligibility Notices – Eligible n Notice of Eligibility Determination – Eligible n n Informs the individual that they are determined eligible Lets them know if their eligibility is considered “provisional. ” If so it will let them know when they can expect the next review of eligibility to occur. Notifies the individual of the service coordinator (or Brokerage) being assigned to them. Provides a list of documents used in making the determination.

Eligibility Redeterminations n Eligibility for children is always provisional n Eligibility for young children must be re-determined by age 7 or 9 for school-age eligibility. n Eligibility for school-age individuals must be redetermined by age 18 for Intellectual Disability and between ages 20 -22 for Other Developmental Disability. n Redetermination process is typically initiated 1 year prior to the redetermination date n Redetermination must be issued any time evidence is obtained that contradicts and eligibility determination.

Aligning Eligibility at age 18 n Between the ages of 18 and 21(usually at age 18) a young adult goes through a re-determination for both DD services and a re-determination at Social Security regarding eligibility for SSI. These determinations effect the funding and thus the living arrangements that are available to various individuals. This needs to be discussed and planned for accordingly. Every person’s situation may have a slightly different twist. n This is also a very standard transition age timeframe for things like: n n n School (i. e. OAR mandates to attend IEP meeting, start voc planning, help with community transition supports for those in a modified program) Guardianship Access to employment resources and support Ability to direct their own plan of care Access to independent living resources. . Etc Case managers provide transitional services support to assist individuals and their families through this transition.

Types of Program Services are categorized in 5 main groups n In-home services – funded services provided in the home to client’s paid for through General Fund or MEDICAID dollars n 24 hour supported services – Residential or Foster Care services paid for through MEDICAID dollars n Vocational Services – career development and Day Support Activities paid for by MEDICAID dollars n Supported Living services – In-home and integrated community support provided to adult client’s living independently, and provided by agency providers (vs. PSW’s) n Transportation services – provided to support adult client’s in getting to their vocational/community integrated placement.

Funding for program services n Family Support - non MEDICAID, has a $1200 annual plan year cap, and is specific to individuals under the age of 18. n State Plan Personal Care – MEDICAID resource that pays for up to 20 hours per month (more with an exception) of in-home support specific to ADL and IADL needs n Kplan – MEDICAID resource that pays for supports without an hourly cap, but based on the needs assessment’s assessed hours of need for in-home support specific to ADL and IADL needs. Additional services include: Communication Technology, Emergency Response Resources, Nursing Delegation, Adaptive Equipment, Home Modification, Chore Services, Relief Care, Skills Training, Supported Living, Day Support Activities, and Transportation n Waiver – MEDICAID resource that pays for Family Training

Other n Services are transferrable across the state of Oregon n Adults have the ability to choose between getting n n their case management from CDDP’s or Brokerages All MEDICAID funded resource programs have an assessment as part of their criteria All plans are person centered and self-directed All MEDICAID funded resource programs have a Monitoring for Health/Safety/Resource component At age 65 a person can decide if they want services through ADS or our program (CDDP)

The goal of our program? ~ Full Inclusion and Enhanced Quality of Life