Who Moved My Cheese?

Dear Friends of Full Access:

 

I love this book!  I have been reminded again about the challenges of change when re-reading it.  Here is just a brief statement about the book written by Spencer Johnson:

“Most people are fearful of change because they don’t believe they have any control over how or when it happens to them. Since change happens either to the individual or by the individual, Spencer Johnson shows us that what matters most is the attitude we have about change.”

For me,  I am having to work on my attitude about change and it is not an easy challenge!   I definitely feel that the changes happening are out of my control.  I think there is too much happening at once for everything to go well. As Who Moved My Cheese points out, change can be difficult.  We can deny it, fight it, be smothered by it and even try to ignore it.   Change can also be confusing, frustrating and overwhelming.   Sometimes all three.   What I am hoping for and working for, is to make sure our mission stays first and foremost in the thinking and work of myself and all our staff.   I was reminded of this in a very painful way this week.  One of our long time providers called to ask me about what is going on.  We both expressed deep concerns for our clients, their families, and the movement of self determination that has been our calling.  As two people in this system that experience our work as our own personal missions, we cried a bit, laughed very little and recognized we are in this fight together.  And, it does feel like a fight.

So as all these changes go on around us, and within our agency, and particularly with client services, the “main thing is to keep the main thing the main thing”.  And that is our attention to our clients, their supports and the self determined future they deserve and have been promised.  I have to say truthfully, I think our Personal Agents and the support staff at Full Access have been SUPER AMAZING!  Against the odds, they continue to problem solve and ensure our clients have the supports they need.  We continue to be successful (not perfect!) in this regard, so please let me know if you think differently!

To speak to some of the specific changes upon us, here are reminders for clients and providers both!

 

For our clients there are a couple things to pay particular attention to.

• There are 35 working days left between now and the end of the current fiscal year, June 30, 2014. Over the past year, that date has been a target for many changes in the Oregon’s developmental disabilities brokerage system.  This includes significant changes such as ensuring all 7,500 or so brokerage clients have been assessed with the new Functional Needs Assessment, ensuring that all providers are signed up in the state’s payment system, and preparing for having the state take over direct payment to all brokerage providers.  For Full Access and other brokerages and counties, clients are changing fiscal intermediaries as well.
•  Be sure to respond to your Personal Agent’s (or a state worker’s) call to complete the new Functional Needs Assessment. It’s essential these are completed for everyone by June 30th. This allows the state to draw down increased federal funding via the new K Plan.  Be ready to revise your plan to make some language changes. Your PA or extra staff we temporarily hired will contact you about this.
• If you have a provider, be sure that s/he has filled out a Provider Enrollment Agreement. We want to be sure they can continue to get paid after the state takes over payment (currently planned for July 1st.)

 

If you’re a provider of brokerage services there is quite a list!

• Make sure the customers you serve have scheduled a Functional Needs Assessment with their PA (or a state worker.) If they need some support during the assessment and would like you to assist, offer your help.
• If you have not already, you must apply for and receive a Medicaid provider number. Sign up by filling out the Provider Enrollment Agreement form as soon as possible.  The website for the PSW forms needed is http://www.oregon.gov/dhs/spd/Pages/adv/hcc/tools_psw.aspx
•  If you have already applied for a provider number, but haven’t heard back from the state, please contact them directly at 1-800-241-3013 or email  SPD.ProviderNumber@state.or.us
• If we’ve contacted you about updating your Criminal History Check, be sure you respond quickly. All PSWs must have a CHC completed every two years. You cannot be paid without a current check on file.
• Attend one of the upcoming Personal Support Worker webinars. There are currently three scheduled. The webinars will give you basic details on the state’s payment system (eXPRS) and how the way you’ll be paid is changing. See details below.
  • Thurs, May 15th @ 6:00 pm – To register for this date/time, click here: https://www2.gotomeeting.com/register/268795474
  •  Thurs, May 22nd @ 1:00 pm – To register for this date/time, click here: https://www2.gotomeeting.com/register/73388009
  • Mon, June 2nd @ 10:00 am – To register for this date/time, click here: https://www2.gotomeeting.com/register/522914722

Once registered, participants will receive an email with the training site link, conference phone number and instructions on how to connect to the training on the date you are registered to participate. If you have questions, contact Julie Harrison at JULIE.A.HARRISON@dhsoha.state.or.us

 

I am sure there will be more to come on these changes, so stay tuned!

With thanks to Larry Deal at INW Brokerage for writing much of the detail in this blog!

 

MT, CEO

Blog stealing this week!

Dear Friends of Full Access:

This week we are posting a blog from our Portland area community partners.  This is about concerns that Provider Organization rates are going to be cut.  We did find out, however, in a phone call this week, that this is not happening soon.  Right now we think our communities should be on alert about the issues addressed in this blog.  What we are expecting to hear from our State DHS partner, is that a process involving market research and community input will be underway to address the concerns listed below.

Why is this important to friends of Full Access?  Because we think that the providers of support to our clients are absolutely critical to quality service delivery.  We want to help keep this part of our system strong!

MT, CEO

“Proposed Rate Cuts to Provider Organizations Threaten Innovation”
By Sasha Vidales, Director of Creative Goal Solutions

While Oregon is moving to the K-Plan, many customers are seeing increased access to funding for their services. But simultaneously, provider organizations’ hourly rates are slated to be cut by almost 18%. Perhaps most affected by these cuts are smaller, local, grass-roots organizations who have sprung up in response to the diverse needs of brokerage customers; programs like Creative Goal Solutions, which I started in 2011 to offer fully-integrating community-based services to adults with developmental disabilities. Already operating on a shoe string budget and my personal investment, the proposed rate would unquestionably force Creative Goal Solutions to close its doors within just a couple of months.

The greatest detriment would be to the individual customers served by Creative Goal Solutions, customers like Annie Rose. When Annie Rose started working with Creative Goal Solutions, she had the same goals as most twenty-somethings—to move out on her own, get a job, have new life experiences, and exert her independence. Through working with CGS, she had the opportunity to explore her greater community in a group setting. “I like Creative Goal Solutions because it gets me out of the house. I like meeting new people. I discovered new foods…I enjoy going to the park… camping was lots of fun. I like going to the library and art showings.” Soon after her start, Annie decided to move into her own apartment. CGS staff helped her establish a routine around cooking and cleaning that would increase her success as she transitioned. Knowing the importance of community connectedness, staff also helped Annie explore her immediate community on foot and on bus to find new hang-outs. She now independently works out at her local community center and has some favorite local shops and cafes, all the while staying involved in CGS’ group community inclusion. A while later, Annie also took on various volunteer jobs. With staff support, Annie Rose works alongside community members and other customers to gain job skills and give back to her community.

“I like doing Zenger Farms,” says Annie Rose, “I really like gardening and don’t do enough. Now I get to go out once a week and it’s a relief. I’m suddenly happy! I’ve noticed the weeds have gotten enormous and tough to pull out. I’m proud that I can pull them out.”

Annie is just one of the over 40 customers flourishing with the support of Creative Goal Solutions’ unique service model. When I started Creative Goal Solutions, I was excited to use innovative strategies to develop meaningful, community-integrating experiences for our customers. I envisioned services that would empower each customer to become involved citizens and create meaningful visibility for themselves. Over the past two and a half years, I’ve assembled a team of highly creative, motivated and skilled employees to put this vision into action. Now, we boast a diverse array of programs to accomplish that vision.

What I didn’t realize upon CGS’ inception, was the tremendous value of the group-model. Customers learn so much from each other and there is often a lot of camaraderie, connectedness and natural support developed. At the same time, the model differs drastically from facility-based models in that customers are making daily, “real-life” contact with their communities through recreation and volunteering. Many customers and parents, including Laurie Burk, have noticed the difference.

“[The facility-based program he attended prior to CGS]… provided little or no outside community activities. There was nothing special about the program. I likened it to a daycare center. Since attending CGS, he has shown much improvement. We believe this to be directly related to attending outings to places that “regular” people go. I don’t think many people who are not affected by developmental disabilities understand the secluded life of a young person with disabilities and what they face day in and day out… Just because he has a disability doesn’t mean he doesn’t have worth.”

Our Volunteer Program connects and teaches customers at six different community organizations, including The Rebuilding Center, SCRAP, Hoyt Arboretum, Impact NW, the Bike Farm, and Zenger Farms. All of these sites give our customers job-like experience where they can gain skills and confidence working right alongside community volunteers. The program has been tremendously impactful in our customers’ social well-being and sense of worth and individual contribution.

Nightlife Group at local pub

We also provide fully-integrating recreation experiences. The programming is diverse, offering many activities not commonly accessible to people with developmental disabilities. We fill the monthly calendar with customer-preferred activities, such as bowling and libraries and unique experiences, such as attending the Feast of Guadalupe concert, Leech Botanical Gardens, and a tour of the Human Society. We also offer a Nightlife Group. Through this, many customers have their first experiences going to activities like stand-up comedy, salsa dancing and pub trivia. Additionally, our camping trips afford customers the opportunity to be away from home with a group of friends and foster budding friendships through exploring nature.

At Creative Goal Solutions, we continually challenge what others think possible. Those with seemingly significant barriers are equally engaged through our program. Oxana Betska, a mother of one such customer wrote, “[Though he is] nonverbal, he is very social. He wants to be around people, go places, learn new things… [at CGS] he is taught how to behave around other people, how to treat them properly. We can definitely see the progress he has made paying attention to the instructions he was given, evaluating the situation which can be new for him, becoming more independent and mature. The program has helped my son gain self-esteem. Through the program our son volunteers at the retirement center. He has a wonderful time there!”

Volunteering at Bike Farm

Writes Matthew Burk, customer and self-advocate,“I like the format where we meet at the office and board mass transit and go to different places like Fazio Farm, The Old Church for a lunch time concert, the Rose Garden up near the zoo, the zoo, and the game room down at PSU among other cool places. My favorite part of the program is that being a boy from SE Portland I get to see the other parts of the city that I never knew existed. If cuts were to be made I’m not sure what I would do. Without CGS I would go back to being a couch potato and having no routine.”

Despite our customer’s successes, we’ve experienced significant barriers when it comes to a functional and sustainable business model, having to fit a square peg in the proverbial round hole. Our program model of fully-integrating group experiences does not fit well in the current provider rate structure. Most traditional services are provided with one staff per one customer or take place in a facility. Our services don’t fit either of those models and our way of providing services comes with substantial added costs as well as barriers to be able to bill for the full rate. Despite these barriers, we’ve persevered. We’re proud to be one of the handful of truly unique, local, grass-roots organizations with truly unique services to offer.

Rock wall climbing

It’s hard to imagine the local impact of all of these customers losing the visibility and community presence that we’ve worked so hard to promote. Observing our customers’ growth in confidence and self-efficacy over the past two years has been one of the most impactful experiences of my life. Equally important, I’ve seen our community’s response to our customers. I believe that through our work, we’ve begun to shift how people understand disability. They are witnessing all that people with developmental disabilities are capable of contributing, and, with time, learning how essential they are to the fabric of our community.

We’ve accomplished a lot in just over two years. I have many more ideas that I’m actively implementing: a self-employment program, a healthy lifestyles group, and leveraging our culturally-competent, 50% Spanish-speaking staff to better engage Latino customers. Yet, my intense passion and enthusiasm is met with a very real possibility of closure. I’m working hard to push back against the proposed cuts. I’ve co-formed a coalition of small provider organizations, including On-the-Move Community Integration and Trellis to express our alarm and the potential impact of cuts. We’re meeting with decision-makers at the State level as well as other affected provider organizations. I am also counting on the support of families, professionals, self-advocates, community members and the decision-makers at DHS to halt rate cuts and make the growth and development of our innovative program, and others like it, to flourish… for the betterment of our customers and the betterment of our communities.

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ABOUT

Sasha Vidales has worked in community services for 14 years in mental health, policy research, training development, case management, quality assurance and other capacities. She has a BA in Psychology and an MBA in Organizational Behavior and is trained as an Autism Specialist and Social Sexual Consultant. Sasha founded Creative Goal Solutions in 2011 because of her belief in and commitment to strong communities. She knows that strengthening communities requires meaningful and full integration for all people. If you are interested in learning more or joining the coalition, contact Sasha at sasha.vidales@creativegoalsolutions.org.