2006 Annual Meeting
Hyatt Regency Crystal City
Arlington, Virginia

November 8-10, 2006

Balancing Autonomy and Accountability
in a System of Individual and Family Supports

Meeting Presentations

To view a presentation file, click on the appropriate file name (e.g., SAPD-Petty.ppt). The presentations are in the format submitted by the each panel and/or session presenter.

= Word Document
= PDF File
= PowerPoint Presentation
= Excel File

Self-Advocate Panel Discussion

PANELISTS:

Julie Petty
Chairperson
Self-Advocates Becoming Empowered (SABE)
SAPD-Petty.ppt (6038 KB)

Betty Williams
President,
Self-Advocates of Indiana; Vice President, SABE

Carol Grabbe
Self Advocate Coordinator,
Connecticut Department of Mental Retardation

PANELISTS:

Cathy Ficker Terrill
President and CEO
Ray Graham Association for People with Disabilities
FAP-Terrill.doc (39 KB)

Rud Turnbull, JD, LI.M.
Professor, Department of Special Education and
Director, Beach Center on Disability,
University of Kansas
FAP-Turnbull.doc (77 KB)

John Agosta, PhD
Vice President,
Human Services Research Institute

Systemic Challenges in Creating A Service Delivery System Grounded in Individual and Family-Centered Values - Can We Get There From Here?

What slows the replication and evolution of individualized and family-centered supports? What keeps us from doing what we now know? We all have our version of the usual and customary subjects. But what if it is us, Pogo? What might we learn from Tiger Woods, Robert Greenleaf, and Suzuki Roshi that will help us get there from here?

Dennis Harkins
Consultant, A Simpler Way
Harkins.ppt (898 KB)
Harkins.doc ( 67 KB)

BREAKOUT SESSIONS I:

SESSION I-A Financing

COLORADO
Overcoming Challenges in Redesigning System-Wide Financing

PRESENTER:
Fred DeCrescentis
Director,
Division for Developmental Disabilities,
Office of Adult, Disability, and Rehabilitation Services,
Colorado Department of Human Services
(I-A)DeCrescentis.doc (38 KB)

Mr. DeCrescentis provided an overview of Colorado's journey to date in its pursuit of developing a more transparent financial system to promote informed choices for self-advocates and families to direct services within a system of accountability.

CONNECTICUT
Resource Allocation and Individual Budgeting Based on Support Needs

PRESENTERS:
Kathryn duPree
Deputy Commissioner,
Connecticut Department of Mental Retardation

Laura Nuss
Director,
Strategic Operations Division,
Connecticut Department of Mental Retardation

Ms. duPree and Ms. Nuss shared how DMR has implemented their new Level of Need (LON) tool and individual budgeting process. The LON is used to assess individual support needs and to allocate resources based on identified needs. The assessment also generates a level of need summary and a health and safety risk profile. DMR staff also discussed the department's shift from master contracts for services to individual budgets and a rate-based system of payment for supports.

SESSION I-B Infrastructure Development

GEORGIA
The Real "Paradigm Shift" Boat is Now Docked in Your Port

PRESENTER:
Stephen Hall, PhD
Director,
Office of Developmental Disabilities,
Georgia Department of Human Resources

What we need are competent good providers who can deliver services that make a positive impact on the lives of citizens with developmental disabilities. This presentation described how Georgia is switching from funding providers through contracts to funding individual budgets in order to create a new infrastructure of habilitation, employment, transportation, and other useful community services. It also focused on "A Service is not a Place" program being used in Georgia to transform state-funded services for everyone.

MINNESOTA
Minnesota's Consumer-Directed Community Supports System:
Its Evolution and Lessons Learned

PRESENTERS:
Shirley York
Director, Disability Services Division,
Minnesota Department of Human Services

Shantel Jaszcak
CFO,
Consumer Directions, Inc.

Ed Sootsman
Principal Planning Analyst,
Hennepin County
Human Services and Public Health Department

Representatives talked about the evolution of consumer-directed services including "lessons learned" in building the approach and infrastructure for Minnesota's Consumer-Directed Community Supports system. Representatives included state officials, a county administrator, and a fiscal support entity representative. The presenters highlighted key decision points and actions that either helped or hindered the development of consumer-directed options.

SESSION I-C Managing a Decentralized Service Network

INDIANA
Taking "Dignified Risks" for Self-Determination

PRESENTERS:
Betty Williams
President, Self-Advocates of Indiana
Vice President, Self-Advocates Becoming Empowered

Peter A. Bisbecos
Director,
Division of Disability and Rehabilitative Services,
Indiana Family and Social Services Administration
(IC)Bisbecos.ppt (51 KB)

As people with developmental disabilities increasingly realize opportunities for self-determination, the managerial and regulatory challenges necessary to ensure continued growth of self-determination multiply dramatically. The presenters discussed the importance of ensuring that consumers can take "dignified risks," and how they intend to reform our regulatory structure to accomplish that. Ms. Williams and Mr. Bisbecos concluded by discussing how these changes will lead to greater self-determination.

BREAKOUT SESSIONS II:

SESSION II-A Managing a Decentralized Service Network

COLORADO
Enhancing Colorado's Decentralized Service Delivery System

PRESENTER:
Fred DeCrescentis
Director,
Division for Developmental Disabilities,
Office of Adult, Disability, and Rehabilitation Services,
Colorado Department of Human Services
(II-A)DeCrescentis.doc (36 KB)

Mr. DeCrescentis provided an overview of Colorado's journey to date in its work of developing a more transparent system to promote informed choice for self-advocates and families to direct services within a system of accountability.

CONNECTICUT
Quality Reviews and Quality Councils

PRESENTERS:
Mary McKay
Connecticut Department of Mental Retardation

Sheila Mulvey
Connecticut Department of Mental Retardation
(II-A)McKay&Mulvey.ppt (1107 KB)

Ms. McKay and Ms. Mulvey discussed the Connecticut Department of Mental Retardation's new Quality System Review (QSR), and relevant policies and procedures needed to implement and operate a system of individual and family supports. They also discussed the role of families and consumers in quality management and improvement.

SESSION II-B Financing

GEORGIA
The Real "Paradigm Shift" Boat is Now Docked in Your Port

PRESENTER:
Stephen Hall, PhD
Director,
Office of Developmental Disabilities,
Georgia Department of Human Resources

Today, community services funding for citizens with developmental disabilities is, for the most part, locked in state-to-provider contracts. This presentation detailed how Georgia is moving to an entire system of customer-driven budgets based on the person's needs and how provider reimbursement rates are now being established based on costs. Dr. Hall also provided insight on solving the problem of inequitable funding, ensuring good utilization management, and funding services that make a positive impact on a person's life while reducing future costs.

MINNESOTA
Methodology for Consumer-Directed Budgets

PRESENTERS:
Shirley York
Director, Disability Services Division,
Minnesota Department of Human Services

Kathleen Kelly
Supervisor, Disability Services Division,
Minnesota Department of Human Services

Ed Sootsman
Principal Planning Analyst,
Hennepin County
Human Services and Public Health Department

State officials discussed the development of and the current experience with their consumer-directed budget methodology, including how various state-level budget issues have impacted its use over time. Included in the discussion was the basis upon which the budget is assigned to individuals.

SESSION II-C Infrastructure Development

INDIANA
Working Relationships Make Change Possible

PRESENTERS:
David Mank, PhD
Director, Indiana Institute on Disability and Community Professor,
School of Education, Indiana University

Andrew Ranck
Director, Initiatives
Division of Disability and Rehabilitative Services,
Indiana Family and Social Services Administration
(II-C)Mank&Rank.ppt (63 KB)

Indiana is implementing dramatic changes to its waiver system. These kinds of changes present significant challenges both politically and in the massive details that are required to make a new system function properly. We would not be able to implement so much, nor could we do it as quickly as we are, without a broad base of support from consumers, families, and advocates. This session discussed the change process and the various working relationships that are making it possible. The presenters concluded by discussing how these changes will lead to greater self-determination.

BREAKOUT SESSIONS III:

SESSION III-A Infrastructure Development

COLORADO
Challenges to Developing Infrastructure

PRESENTER:
Fred DeCrescentis
Director,
Division for Developmental Disabilities,
Office of Adult, Disability, and Rehabilitation Services,
Colorado Department of Human Services
(III-A)DeCrescentis.doc (39 KB)

Mr. DeCrescentis provided an overview of Colorado's journey to date in its development of infrastructure needed to provide self-directed services to individuals and their families.

CONNECTICUT
Real Time, Real World Supports: Developing Fast, Efficient, and Flexible Infrastructure Supports for People Who Self-Direct Their Services

PRESENTERS:
Carol Grabbe
Self Advocate Coordinator-North Region
Connecticut Department of Mental Retardation

Mickey Verno
Operations Manager,
Operations Center,
Connecticut Department of Mental Retardation

Ms. Grabbe and Mr. Verno discussed the Department of Mental Retardation's new infrastructure supports for self-directed services and supports: private support brokerage option, Family and Individual Consultative Services (FISC), employer materials and resources, involvement with the Connecticut C-PASS grant, and rewardingwork.org. Also discussed was the work of the department's Self Advocate Coordinators to promote self-determination, self-directed supports, and choice of providers.

SESSION III-B Managing a Decentralized Service Network

GEORGIA
The Real "Paradigm Shift" Boat is Now Docked in Your Port

PRESENTER:
Stephen Hall, PhD
Director,
Office of Developmental Disabilities,
Georgia Department of Human Resources

Tools to manage a contract/provider/deliverables/standards system are different than the tools needed to manage the emerging paradigm of an individual budgets/customer/impacts/outcomes system. This presentation explained how to safely reconfigure old tools and incorporate new ones needed to give people with developmental disabilities an opportunity to enjoy a safe and fulfilling life in the community.

MINNESOTA
Consumer-Directed Community Supports

PRESENTERS:
Shirley York
Director, Disability Services Division,
Minnesota Department of Human Services

Shantel Jaszcak
CFO,
Consumer Directions, Inc.

Kathleen Kelly
Supervisor, Disability Services Division,
Minnesota Department of Human Services

Ed Sootsman
Principal Planning Analyst,
Hennepin County
Human Services and Public Health Department

Representatives talked about the standards and practices relating to Consumer-Directed Community Supports in Minnesota. State officials discussed the general parameters for operating this option. Local officials will discuss the processes used to authorize and monitor the use of consumer-directed options, including the steps being taken to insure that people are adequately informed about how to use the option. A representative of a fiscal support entity described the manner in which her agency works with consumers in managing the budgets approved.

SESSION III-C Financing

INDIANA
Changing Financial Systems to Facilitate Greater Self-Determination

PRESENTERS:
Kim Opsahl
Vice President, External Affairs,
Indiana Association of Rehabilitation Facilities

Lilia Teninty
Chief of Staff,
Division of Disability and Rehabilitative Services,
Indiana Family and Social Services Administration

Nanette Whightsel
Director,
Family Education and Community Resources,
The Arc of Indiana

Indiana is moving towards a financial system that will objectively assess waiver consumers' needs so that budgets reflecting those needs may be provided. Today, many budgets are more a reflection of the persuasive ability of the consumer's advocates than of his/her needs. This process was in the conceptual phases when this administration took office. It survived a change of administration and political party due to widespread consensus of consumers, advocates, and providers. The presenters concluded by discussing how this change will lead to greater self-determination.

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