New Directions for Missourians with Developmental Disabilities

1
New Directions for Missourians with Developmental
Disabilities

• Presentation to
• Recommendation 24 Stakeholder Committee
• Wednesday, January 24, 2007

2
New Directions Values

• All Missourians with developmental disabilities
  should receive the services and supports they
  need, when they need them.
• They should have the opportunity to choose where
  they live and work.
• They should be able to participate and receive an
  education in the community.
• They should have opportunities to build
  relationships with friends and family.
• They should be provided environments that are
  safe, dignified, and inclusive.

3
New Directions Vision

• The State of Missouri DMRDD shall reform the
  regional center system through public/private
  partnerships that will
• improve accountability to ensure safety
• improve quality of service
• maximize stakeholder input
• increase local control through collaboration
  among providers, funding agencies, schools, and
  others
• build capacity of services based on need

4
New Directions ProposalResponsibilities of DMRDD

• Contract with private not-for-profit agengies or
  SB 40 Boards (Administrative Agents)
• Establish statewide, measurable outcomes to
  assure safety and quality of programs and
  services
• Maintain statewide wait list
• Identify, obtain, and manage Medicaid waivers
• Provide quality assurance and oversight to the AA
• Investigate incidents of abuse and neglect
• Operate Habilitation Centers

5
New Directions ProposalResponsibilities of
Administrative Agents

• Assure consumer needs are met
• Develop a system of programs and services to meet
  needs
• Act as the single point of application,
  eligibility determination, and referral
• Assure informed choice and increased
  opportunities for inclusion
• Provide ombudsman office to resolve consumer
  concerns and conflicts

6
New Directions ProposalMinimum Requirements of
an AA

• Private not-for-profit agency or SB 40 Board
• Experience serving needs of people with
  developmental disabilities
• Nationally accredited
• Separate and distinct board of directors

7
New Directions ProposalCase Management

• AA assures that each eligible person has a
  qualified case manager of their choice.
• Case management may be provided by AA or
  affiliated provider.
• Case managers may not provide any services other
  than case management.
• Caseloads may not exceed 30 persons.
• Case managers must act impartially, assuring that
  informed choice is respected.

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New Directions ProposalExpected Outcomes

• Reduce abuse, neglect, and exploitation
• comprehensive training for staff, consumers, and
  families
• lower case loads for case managers
• improve oversight and accountability of service
  providers
• provide civil immunity for employers in relation
  to background screenings

These outcomes address MMHTF Recommendations 3,
4, 6 and 14
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New Directions ProposalExpected Outcomes

• Adhere to rigorous standards of quality
• national accreditation of all DD service
  providers
• meaningful person centered planning with
  stakeholder input
• establishment of meaningful peer review process
• enforce contract compliance, including penalties
  for failure to implement plans of correction

These outcomes address MMHTF Recommendations 1, 5
and 6
10
New Directions ProposalExpected Outcomes

• Reformed system will provide local control of
  programs and services
• increased capacity to meet needs of people
  currently living in habilitation centers who
  choose to move into the community
• consumers and families choose where they live,
  recreate, and work
• manage wait list at local level

These outcomes address MMHTF Recommendation 11
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New Directions Proposal

• This proposal is a starting point of discussion
  for system redesign.
• Concept design and specifics require stakeholder
  input, including
• consumers and families
• providers
• funders

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New Directions Proposal

• Any system redesign must accomplish the
  following
• Keep consumers safe from harm
• Assure consumer choice
• Improve accountability and outcomes
• Reduce governments role as a provider of
  services
• Maximize stakeholder input
• Enhance quality and availability of services
• Reduce staff turnover