Person-Centered Services/Self-Directed Services

Person-Centered/Self-Directed Services

NJ Comprehensive Assessment Tool (NJCAT) online survey results
NJCAT presentation slides 

Issue Description:

1. Person centered planning is a process of continual listening, and learning. It focuses on what is important to and important for someone now, and in the future; and acting upon this in alliance with their family, friends and service providers (http://helensandersonassociates.co.uk/person-centred-practice/). As the system transition to the Fee for Service system, many individuals and families in Self-Directed Services have experienced the erosion of self direction, and the very concept of Person-Centered Services is being actively discouraged by the state. A series of changes has caused a sharp rise in confusion and hardship among families. Families and self-advocates fought very hard for years to achieve self-directed services. Yet recent changes have drastically restricted, rather than expanded, the freedom, choice, and control to address individual needs that families once had.

2. With multiple statewide changes, the role of Support Coordinator has become more important than ever. Individuals and families desire thoughtful planning that actually supports individuals with intellectual and developmental disabilities (I/DD) to achieve their life goals. It is vital for Support Coordinators to be well trained, supervised and empowered to assist individuals and families. The high turnover rate and burnout of Support Coordinators negatively affect the lives of individuals and families.

Issue Action Items: (Include if the Action is at the Federal/State/Local Government/Community or Media Level)

1. Increase focus on the Person-Centered planning in policy making and accountability practice

a. DHS to include individuals, families, Support Coordinators, and service providers at a table from the beginning of discussion, not after the policies/guidelines are drafted (State/Local Government)
b. DHS to schedule regular dialogue sessions with individuals, families, Support Coordinators and service providers for interactive planning and collaboration to ensure the smooth running of the system as a whole.
c. Data and summary of meetings with above-listed groups to be shared with public NJCDD to host a quarterly meeting with DHS, individuals, families, Support Coordination Agencies, and service providers to discuss current Person-Centered practice and future plans.

2. Increase choice of Self-Directed Person-Centered Service System

a. Monitor the implementation of dual models of Fiscal/Employer Agent and Agency with Choice system
b. Allow individuals and families to change their choice without service disruption Offer two Fiscal Intermediary (FI) models for processing payments for services rendered (State)
Developmental Disabilities Advocacy Network

i. FI to simply process payments for those persons in the SDS program that wish to have total control over their needs
ii. Easterseals to be added as an option for FI regardless the number of services individuals use (currently if individuals only receive only self-directed services from a provider and has no self-directed employees, the Fiscal/Employer Agent model is the only option)
iii. DHS to improve its flexibility of Medicaid billing (up to 60 days) in order to prevent service disruption caused by unforeseen circumstances (such as approval delays due to State IT issues)
iv. DHS to use state-only dollars to cover services when service disruption happens due to unforeseen circumstances beyond individual and families’ control

c. Expand the definition of Support Brokerage to include not only management of Self-Directed Employees but also agency-hired staff so that they can assist individuals in federal, state, and local programs such as Supplemental Nutrition Assistance Program (SNAP, formerly called Food Stamp), housing and utilities assistance and Medicaid.

i. Establish a separate funding for Support Brokerage, not out of individuals’ budget

d. Maintain the independence and integrity of New Jersey Comprehensive Assessment Tool (NJCAT) for assessment and reassessment

i. Use independent entity to observe and/or monitor the assessment process

3. Ensure and enhance freedom of choice

a. Include state-only dollars for specialized services and allow time-limited service duplication or extension of approval under special circumstances such as hospitalization and vacation
b. Increase the provider capacity in rural, city and any underserved areas (Local Government/Community)

4. Make robust and comprehensive plan to solve the Direct Support Professional (DSP) workforce crisis (Federal/State/Local Government/Community/Media)

a. Increase the wage for DSP and restore comprehensive benefits for all full-time DSP including medical, dental, life insurance, sick time, paid-time off and paid vacation (Federal/State/Local Government/Community/Media)

i. Closely work with the Coalition for the DSP Living Wage and support advocacy in this area

5. Increase the quality of Support Coordination Services

a. Improve the mechanism to qualify new Support Coordination Agencies and disqualify those that do not meet quality standards.
b. Streamline the documentation so that Support Coordinators can focus and facilitate Person-Centered Planning and Services in collaboration with
Developmental Disabilities Advocacy Network individuals, families, providers and other stakeholders (Federal/State/Local Government/Community) c. Make a robust support and training system to reduce turnover and prevent burnout (Federal/State/Local Government/Community)
d. Utilize innovative international and national recognized leaders in person centered planning to provide evidence-based training (State/Local Government/Community)
e. Offer substitution of relevant experience for required education for Support Coordinators (State)
f. Create a separate code by Department of Labor in order to collect data such as service request, provision and utilization rate (Federal)
g. Increase the rate for Support Coordination Services (State)

Next Steps:
1. Recruit more members, especially younger parents and individuals, to the Committee

a. Committee members will identify potential individual and family member (especially parents who are involved with DCF) for the Committee
b. The list of prospective members will be submitted to DDAN for review

2. Include youth and their families who are involved with DCF and identify main issues

3. Submit recommendations to DDAN including:

a. Host a forum with individuals, families and providers to have a dialogue with DDD and CSOC leadership in October 2019
b. Write a letter to DDD that this committee be invited to the two national projects regarding person-centered/self-directed services

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