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DMR Facts and Figures that all CABs Should Have

DMR Facts and Figures that all CABs Should Have. SAC reTREAT January 12, 2008. Governor and Lt. Governor. Deval Patrick Timothy P. Murray. EOHHS Organization The Secretariat. Undersecretary EOHHS Vacant. EOHHS. Assistant Secretary CYF Marilyn Chase. Assistant secretary

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DMR Facts and Figures that all CABs Should Have

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  1. DMR Facts and Figures that all CABs Should Have SAC reTREAT January 12, 2008

  2. Governor and Lt. Governor • Deval Patrick • Timothy P. Murray

  3. EOHHS OrganizationThe Secretariat

  4. Undersecretary EOHHS Vacant EOHHS Assistant Secretary CYF Marilyn Chase Assistant secretary Disabilities Jean McGuire Assistant secretary Health Services Vacant Deputy Assistant Secretary, Health Vacant Deputy Assistant Secretary, CYF Kathleen Betts Deputy Assistant Secretary, DCS Laurie Burgess Commissioner DMR Elin Howe

  5. The Department of Mental RetardationStructure, Services, Programs

  6. DMR Organizational Chart – More Detail

  7. Demographics • Who receive services?

  8. Demographics Continued

  9. DMR Class Members • Ricci Class: 3,834 class members • 2995 reside in the Community • 779 reside in ICF/MR Facilities (22 in Marquardt SNF) • 60 reside outside of Massachusetts • Brewster Class: 36 class members • Rolland Class Members 2,951 • 836 reside in Nursing Facilities • There are approximately 400 nursing facilities in Massachusetts, 250 of these facilities have Rolland Class Members • Boulet Class Members original class 2,439

  10. How are individuals supported? • Families and Informal Caregivers • State supported services • DMR statewide employs 7523 • Contracted Services • 220 providers • 18,182 employees

  11. What are the DMR funded services? • Service Coordination • Family Supports • Individual Supports • Residential Supports • Facility Supports • Day Supports • Employment Supports • Transportation

  12. Service Coordination • What is it? Service Coordinators arrange, coordinate, and monitor the supports that DMR provides, purchases or arranges for an individual. • Who provides it? DMR staff • How many receive it? 32,445 individuals (23,459 Adults & 8,986 children) • Caseload Ratio: Adults: 1 to 53 Children: 1 to 279

  13. Family Supports • What it is? Family Supports is a flexible array of services that enable children and adults to live with their immediate family and be welcomed, contributing members of their communities. • Who provides? A network of 72 Family Support Provider Agencies under contract with DMR. • How many receive? Approximately 4600adults and 8,650children and families in 2007.

  14. Individual Supports • What it is? Individual Supports consist of assistance with a variety of community activities, such as, help with money management, food preparation, food shopping, cooking, banking, and housekeeping. • Who provides?Provider Agencies under contract with DMR • How many receive? Approximately 3,000 individuals

  15. Employment Supports • What it is? Employment Supports provide supervision, training, and/or transportation that enable individuals to get paid jobs. It includes help with career planning and job development as well. • Who provides? Providers Agencies under contract with DMR. • How many receive? Approximately 4,400 individuals

  16. Community Day Supports • What it is? Day supports help individuals to build and maintain their ability to participate in community activities by focusing on important skill areas that include communication, self-care, relationship building and community involvement. • Who provides? State and Provider Agencies under contract with DMR • How many receive? Approximately 1,700individuals

  17. Residential Supports • What it is? Residential Supports provide care, supervision and basic life skills and community living skills training in various residential setting for up to 24 hours a day, 7 days a week. • Who provides? State and Provider Agencies under contract with DMR • How many receive? Approximately 9,200 adults

  18. Facility Supports • What it is? Facility Supports is provided in 6 large state owned and operated facilities that are certified by the federal government as intermediate care facilities for the mentally retarded (ICFs/MR). They are: • Monson Developmental Center, • Glavin Regional Center, • Templeton Developmental Center, • Hogan Regional Center, • Wrentham Developmental Center • Fernald Developmental Center • Who provides? The Department of Mental Retardation • How many receive? 946 individuals

  19. DMR Consumer Service Types • Supports include family supports, individual supports, transportation, respite, clinical services, etc. • Day includes DMR Community Based Day Services and MassHealth Day Habilitation • Community Residential Services includes DMR Community Based Residential Services and MassHealth Adult Foster Care • Facilities include ICF/MRs (Monson, Glavin, Templeton, Hogan, Fernald, Wrentham) and and Marquardt Skilled Nursing Facility.

  20. MassHealth Funded Services • Day Habilitation: provides individualized assistance to 6338 DMR consumers to acquire and maintain life skills, such mobility training, social behaviors, communications, basic safety skills, health skills and personal care skills. • Adult Day Health: community based program providing a variety of health, social and related services that is serving 851 DMR consumers. • Adult Foster Care: provides residential placement, health and social supports for 791 DMR consumers with various needs, such as, help with medication, ADLs, and ambulation.

  21. DMR Programs

  22. Waiver Programs • DMR program that provides home and community-based services through the federal Medicaid Home and Community-Based Services (HCBS) waiver program. • The Waiver Program helps fund community services with federal dollars. • DMR operates 2 Waiver Programs: • Comprehensive Waiver serving 12,500 adults • Autism Waiver serving 80 children (ages 0 through 8)

  23. Waiver Services • Adult Waiver Services: Family Supports, Individual Supports, Residential Supports, Supported Employment, Community Based Day Supports, Respite, Transportation, Personal Agents, Transitional Services, Assistive Technology • Autism Waiver Services: Habilitation-Community Integration, Habilitation – ADL/ Independent Living Skills, Expanded Habilitation Service-Education, Respite, Family Training, Adaptive Aids, Vehicle Adaptations, Homemaker

  24. ISO (Intermediary Service Organization) • Consumer driven program that allows individuals and families to actively participate in the design and manage their services • ISO helps support self determination goals by enabling participants to have individualized budgets and control their services. • The ISO helps individuals and families directly select and arrange for supports and services with community providers. • In FY 2008, there are 281 ISO participants

  25. DOE/DMR Program • Provides specialized intensive home, community and education supports. • Serves children: • Ages 6 through 21 • Enrolled in Department of Education (DOE) approved special education residential school OR school district determines child is at risk of needing a more restrictive out of home placement • eligible for DMR services • In FY 2007, 366 special education students were served in the DOE/DMR Program

  26. Turning 22 Program • The Ch. 688 law establishes a transitional planning process for students with severe disabilities during the final two years of special education (before high school graduation or turning 22 years of age, whichever happens first) • The goal for the student is to: 1) Plan for appropriate adult service delivery 2) To gain a level of independence • The Ch. 688 law does not require thecontinuation of the special educational entitlement nor does it automatically secure funding for adult services • The FY 2008 Turning 22 class for DMR is 608 individuals.

  27. Quality Assurance

  28. How does DMR assure Quality? • A strong quality management and improvement system (QMIS) that looks at quality at 3 levels: • the individual, • the provider • the system • QMIS measures quality outcomes important to stakeholders • QMIS consists of 22 different processes involving DMR staff, consumers and families on all levels of service delivery

  29. What are the Quality Outcome Measures? • Health • Protection from Harm • Safe Environments • Human & Civil Rights • Decision-making & Choice • Community Integration & Membership • Relationships • Achievement of Goals • Work • Qualified Providers

  30. Licensure and Certification Processes • Public and private providers are evaluated on the level of quality of supports provided • Certification process assures that the quality outcomes and health and safety are present in people’s lives. • Licensure process assures that essential safeguards regarding health, safety, and rights are in place. • The evaluation uses observation, interviews and review of documentation for a sample of individuals served by a provider. • Residential, day, employment & respite providers are subject to licensure and certification.  Individual supports are subject to certification.

  31. Investigations – Fiscal Year 2007

  32. Complaint Resolution Team (CRT) • Each Area Office and Facility has a CRT • Brings citizen perspective regarding prevention of abuse and mistreatment • Reviews all investigated cases and cases subject to administrative review and develops Action Plan for all those cases

  33. Investigations and CRT Action PlansFiscal Year 2007

  34. Family Citizen Monitoring • A CAB managed quality assurance activity • 20 of 23 CABs conduct monitoring • 2 to 6 residences are visited monthly per CAB • Focus varies by CAB: safety, nutrition, relationships, etc. • Area Director follows up on problems and concerns identified.

  35. Human Rights Committees • Every Provider and DMR program have a Human Rights Committee (HRC). • HRC educates consumers and staff regarding human rights (e.g. privacy, self-determination and freedom of choice, free from exploitation, enjoyment of basic goods & services) • HRC monitors compliance through visits, reviews of mistreatment and abuse complaints, restraints and other reports. • Oversight provided by DMR Human Rights Advisory Committee

  36. Quality Councils • 4 regional and 1 statewide Quality Council that meet quarterly • Comprised of self-advocates, family members, providers and DMR staff • Charged with reviewing data from all sources regarding the quality of DMR services and supports • Identifies service improvement targets and monitors progress towards achieving targets

  37. The Budget Process DMR to EOHHS September Governor’s House 1 Budget: January House Ways & Means: April Senate Ways & Means: April – May Conference Budget: June - July Governor Signs Budget: June - July

  38. DMR Budget – FY 2008 • 5911-1003 DMR Administration & Operations $77,144,454 • 5911-2000 Transportation $14,137,324 • 5920-2000 Community Residential $547,716,905 • 5920-2006 Residential Rate $2,000,000 • 5920-2010 State Ops $135,018,927 • 5920-2020 Boulet/Waiting List $87,870,762 • 5920-2025 Day/Employment $122,669,711 • 5920-3000 Family Supports $55,044,228 • 5920-3010 Autism $3,277,672 • 5920-5000 Turning 22 $7,700,000 • 5930-1000 State Schools $184,933,044 • 5982-1000 Templeton Retained Revenue $150,000 • 1599-6901 EOHHS Salary Reserve $10,826,454 • 5948-0012 DOE/DMR $8,000,000 TOTAL $1,256,489,481

  39. SAC & CAB on DMR Web Site: www.mass.gov/dmr“Role of Individuals, Families & Volunteers”

  40. SAC & CAB Section on DMR Web Site

  41. SAC & CABs can post and publicize on the DMR Web Site!

  42. SAC & CABs can Collaborate Using PACE’s Team Room • The PACE Team Room is an internet based tool that the SAC & CABs can use to: • Share information • E-mail each other • Have on-line • discussions

  43. Getting into Team Rooms I'm happy to report that PACE is now accessible via a link on the home page on the Internet – see lower left hand side under the heading of “Key Resources" which looks like this: • KEY RESOURCES • ·                               Find a DMR Office • ·                               DMR Offices and Facilities • ·                               After Hours Emergency Phone Number (781) 894-3600 • ·                               PACE Training Login • Once you click the link above "PACE Training Login" you will automatically link to this page (see below) next scroll down to the Department of Mental Retardation and click on that link: • PACE Login • Please find your agency and login properly. Thanks. • Human Resources Division  - Municipality/Non-State Government • Department of Conservation and Recreation  -Municipality/Non-State Government • Department of Revenue  - Municipality/Non-State Government • Office of Health and Human Services  - Center Staff Development  - Virtual Gateway • Department of Mental Health  - Municipality/Non-State Government • Department of Mental Retardation  - Municipality/Non-State Government

  44. PACE questions? For further questions about PACE please contact: Valarie Oresto Staff Development and Training Director 500 Harrison Avenue Boston, MA 02118 617- 624-7755 valarie.oresto@massmail.state.ma.us

  45. DMR Resource for SAC and CABs Ralph Edwards, Director Office of Citizens Leadership 500 Harrison Avenue Boston, MA 02118 617- 624-7755 Email: Ralph.Edwards@massmail.state.ma.us

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