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How do Support Brokers fit in Wisconsin?. Self Directed Supports in Dane County.

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Presentation on theme: "How do Support Brokers fit in Wisconsin?. Self Directed Supports in Dane County."— Presentation transcript:

1 How do Support Brokers fit in Wisconsin?

2 Self Directed Supports in Dane County

3 Robert Wood Johnson Foundation Based on a the Robert Wood Johnson Foundation (RWJF) Grant in New Hampshire: In November 1995, the RWJF authorized up to $5 million to establish the Self-Determination for People with Developmental Disabilities Program. The program's goal was to help states implement a more cost-effective system for serving persons with developmental disabilities while simultaneously giving those persons and their families more choice in determining the services they receive. The national program office was set up in January 1996. Wisconsin one of the first states awarded & Dane County began it’s pilot in January 1997

4 Consumer Directed Supports Medicaid Waivers Manual Chapter IV Allowable Services and Provider Requirements Page IV-59 CONSUMER-DIRECTED SUPPORTS SPC 609.10 Applies to CIP1A, 1B, BIW (See 609.20 for similar service) DEFINITION The provision of a flexible array of services provided to participants that include a specified portion of the services covered by the waiver. Services are planned and implemented through processes characterized by: 1. Support for the consumer and those close to the consumer to assist in identifying the consumer’s goals and means of reaching those goals, in a manner that reflects consumer preferences as closely as possible; 2. Planning that occurs within the limits of an individualized budget that is based on typical service costs for Waiver participants with similar needs in similar situations; and 3. An emphasis on identifying and strengthening networks of informal supports and on making use of generic community resources to the maximum extent possible. 4. Processes and supports for person-centered service planning, implementation, operation and monitoring that are established through a locally developed county Consumer-directed Services (CDS) implementation plan that is subject to approval by the department. Based on this plan, a Memorandum of Understanding (MOU) is executed between the county and department. This MOU governs county operation of this service.

5 Case Management CARE MANAGEMENT/SUPPORT AND SERVICE COORDINATION (Also known as Case Management) SPC 604 Applies to CIP 1A/1B, BIW, CIP II, COP-W, CLTS & COR DEFINITION Care management/support and service coordination is the provision of service to locate, manage, coordinate and monitor all waiver program services, additional services, (regardless of funding source) and informal community supports provided to eligible applicants/participants and to assure that services are provided in accordance with program requirements. This service is intended to insure the waiver program participant’s health and safety by enabling the participant to receive a full range of appropriate services and supports consistent with his/her assessed needs in a planned, coordinated, efficient and cost effective manner. While these general guidelines apply to all care management/support and service coordination provided, the service activities may be target group or age-specific. This service includes assistance with establishing financial, functional and all other aspects of Medicaid waiver eligibility. Service may also include assisting the participant to access waiver, Medicaid state plan, medical, social and natural supports and services. Beyond plan development and service coordination activities, the CM/SSC role includes the primary responsibility to assure participant health and safety.

6 Becoming a Support Broker All support brokers are hired and trained by one of the seven support broker agencies listed in the previous section. Once hired and trained by a support broker agency, brokers then interview with and get selected by people with disabilities. While each support broker agency develops its own job descriptions, all have agreed to the universal elements listed in this section’s “Job Description”. Additionally, broker job descriptions get individualized by the people with disabilities who select them.

7 Support Broker Role Support Brokers will be selected by and work under the direction of the person receiving support. People selecting Support Brokers will be urged to select a Support Broker that is independent of a service provider to minimize the inherent conflict of these roles. People can change Support Brokers and will be asked to renew and sign a contract each year outlining their expectations Will meet the minimum qualifications according to the guidelines of the Medicaid Waiver program. Will successfully pass a criminal background check. A Support Broker cannot be a legal representative of the person receiving support. Support Brokers must be readily accessible to the individual.

8 Support Broker Job Description Purpose: To advocate for adults with developmental and other disabilities to lead a self-directed life. We believe people with disabilities deserve the opportunity to direct their own supports while maintaining or improving their quality of life in their homes and in their community. Duties and Responsibilities  Planning  Training  Fiscal Responsibility – public funding and personal funds (e.g. benefits)  Communication  Mandatory Reporting  Paperwork Documentation  Knowledge of Community Resources  Team Building and Conflict Resolution

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10 Common Themes In Self-Determination Expand people’s choices Enable people to control the money spent on their support and services

11 Conceptual Shift

12 Mobility Training & Independent Living Activities of Daily Living Skills Training Mobility Training & Independent Living Activities of Daily Living Skills Training Waisman Center Community TIES Crisis/Behavioral Intervention Waisman Center Community TIES Crisis/Behavioral Intervention Mental Health Center Counseling, Groups, Psychiatric Consultation Mental Health Center Counseling, Groups, Psychiatric Consultation Dane County Adult Community Services Intake & Eligibility Dane County Adult Community Services Intake & Eligibility United Cerebral Palsy Assessment & Planning One time funding United Cerebral Palsy Assessment & Planning One time funding Person/Family with Presenting Need Responsive Solutions, Inc. On-call Crisis Staff Environmental Modifications/Adaptations Responsive Solutions, Inc. On-call Crisis Staff Environmental Modifications/Adaptations

13 How Adults are Supported

14 Independent Consulting Agency (ICA)- TMG Develop Individual Support Plan The person directs their funding based on this plan Individual Service plan developed. Funding is approved based on RAD ADRC Independent Consultant – Assigned by ICA MCO(s ) Care Manager Current terrain in Wisconsin

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16 Group Project

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18 Jim IRIS Cri du Chat, MR, poor coordination, behavioral issues Jim lives at home with his parents (guardians) who provide all of his supports: personal cares, house cleaning, transportation, medical appointments and keeping Jim safe.

19 Supports Mom and Dad Summer Camp staff Church friends Respite Staff Therapist

20 Concerns Paperwork  questions about benefits  Time to research questions and resolve issues Finding resources and following up with potential providers Ongoing planning

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22 Craig IRIS Muscular Dystrophy, sleep disorder, back pain, cataracts Staff and Craig’s wife help with: personal cares, house cleaning, transportation, help set up my medical appointments, and always attend these appointments with me.

23 Supports Wife Father Staff he knows and trusts Muscular Dystrophy Association

24 Concerns Gets anxious about paperwork:  Timesheets  letters from Medicare and Medicaid Keeping track of recommendations from his many doctors.

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26 Dawn IRIS TBI with some physical impairments Father is guardian and lives out of county. Lives alone with residential “come-in” support for house cleaning and organizing finances. Employed with support from a vocational provider.

27 Supports Dad and Step-Mom Siblings Residential Staff Vocational Staff

28 Concerns Liaison discussions between providers, family (guardian) and Dawn. Financial negotiations with providers. Paperwork questions especially benefits. No proximity of guardian.

29 Presenter Information Alexa Butzbaugh – Progressive Community Services alexab@pcsdane.org (608) 848-8305 Kevin Keisling – Avenues to Community Inc. kevink@avenuestocommunity.org (608) 663-8390 Ext. 436


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