Transcript Adult Services for People with Disabilities

Adult Services
for People with Disabilities
in Vermont
VERMONT FAMILY NETWORK
MAY 24, 2012
PRESENTED BY
CLAUDIA PRINGLES, HELEN JOHNKE & CINDY MARSHALL
Topics
 Developmental Services- Claudia Pringles
(VFN)
 SSI- Claudia Pringles
 Choices for Care- Helen Johnke (VCIL)
 Vocational Rehabilitation- Helen Johnke
 Benefits to Work Program- Helen Johnke
 Mental Health Services- Cindy Marshall
(VFFCMH)
Developmental Services
CLAUDIA INÉS PRINGLES
VERMONT FAMILY NETWORK
About the Presenter
 Claudia Inés Pringles is a Developmental
Disabilities Specialist at VFN and assists families
with questions regarding developmental disabilities
and navigating state systems. Claudia is a parent of
two children, including a daughter on the autism
spectrum. Claudia is also an attorney in private
practice with a focus area of special needs planning.
She enjoys systems advocacy in her spare time.
Information, Referral & Assistance
 Questions about Developmental Disabilities, across
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the lifespan
Information about healthcare, access to services,
guardianship, SSI, housing and more
Resources
Sponsored by a grant from the Vermont
Developmental Disabilities Council
http://www.vermontfamilynetwork.org/i-need-helpwith/developmental-disabilities/
Developmental Services for Adults
 Agency of Human Services/DAIL/DDAS
 Services for individuals with developmental
disabilities or autism

Community supports, service planning, employment supports,
home supports, respite, etc.
 Not all individuals with developmental disabilities or
autism will actually qualify for services
Developmental Services for Adults
 Make Contact with your Designated Agency (DA)
 The DA should be involved at least a year before your
child is scheduled to graduate in order to plan for
funding.
 When your child is of transition age (16 and older),
the school transition team should include a
representative from adult services.
 You can request an intake appointment with your
local Designated Agency.
Developmental Services for Adults
 The intake coordinator will gather information to
determine whether your child is eligible for
developmental services.
 This process may include an interview, examining
school, medical and treatment records, and a review
of your child’s adaptive functioning level, such as
self-care skills, safety awareness, etc.
 Important to keep records
Developmental Services for Adults
 In order to qualify for developmental services, a
young adult will need to be
 (1)
eligible by meeting the criteria for
developmental disability, and
 (2) meet a ‘funding priority’.
Developmental Services for Adults
 “Developmental Disability”
 Defined by Vermont Statute
 According to the Vermont Developmental Disabilities Act, a
developmentally disabled individual is someone who (1) has an
IQ of 70 or below OR is on the autism spectrum, and (2) has
adaptive functioning deficits.
 Your documentation must show that your child’s disability
existed by the time he or she turned 18.
Developmental Services for Adults
 Adaptive Functioning is measured by a questionnaire
that is typically filled in by the parent or other
caregiver.
 Similar to types of questions used to determine
Personal Care Attendant needs.
 Score of 70 or below
Developmental Services for Adults
 Individuals who are eligible for developmental
services must also meet what is called a “funding
priority”.
 The funding priorities are found in the System of
Care plan, which runs on a three year cycle.
 The funding priorities can and have changed from
cycle to cycle, thereby widening or restricting entry
into developmental services.
Developmental Services for Adults
 How are adult services paid for?
 In most cases, Medicaid will pay for adult services. If
your child is found eligible and meets a funding
priority, he or she must be eligible for Medicaid.
 Some of the programs which provide Medicaid to
your child will end by age 18 (Dr. Dynasaur) or age
19 (Katie Beckett).
 Otherwise, he or she will be expected to pay for
services based on a sliding scale.
Developmental Services for Adults
Tips
 Remember that disability does not necessarily mean
eligibility. Eligibility criteria differ between special
education and developmental services.
 An individual with a DD who was on an IEP while in
school is not necessarily eligible for developmental
services as an adult.
Developmental Services for Adults
More Tips
 Contact the Designated Agency by your child’s junior
year in high school, even if you expect your son or
daughter to stay in school until age 22.
 Be aware that there is a gap between the ages of 18
and 19 where it is very difficult for an individual to
get adult services, even if the person finishes high
school.
Developmental Services for Adults
More Tips
 Recognize that, unlike special education, adult
services are not a federal entitlement.
 Developmental services are frequently targeted for
budget cuts. You can help by getting involved with
systems advocacy and attending the public hearings
regarding the System of Care Plan and being vigilant
of proposed budget cuts at the State House.
 Advocate, Advocate & Advocate some more…
Developmental Services for Adults
More Tips
 If your child is on a multi-year IEP, encourage him
or her to stay in a school program until age 22.
 Staying in school as long as possible is an extremely
important opportunity for your child to continue to
learn job skills, academics and independent living
skills while under an entitlement program.
Developmental Services for Adults
More Tips
 Determine if your child is eligible for Medicaid. Even
if your child is otherwise able to get services, the
implementation will be delayed until he or she
begins receiving Medicaid benefits.
 See VFN publication 6 Ways to Medicaid
http://www.vermontfamilynetwork.org/resources/vf
n-publications/
Developmental Services for Adults
More Tips
 Be honest about your child’s abilities when asked to
complete the functional capacity assessment. The
assessment is seeking information on what your
child can and cannot do on his or her own.
 Your responses will be compared to records and
responses from other sources.
Supplemental Security Income
(SSI)
CLAUDIA INÉS PRINGLES
VERMONT FAMILY NETWORK
SSI
 Supplemental Security Income (SSI) is a monthly cash benefit
for people with disabilities who have little to no income or
resources.
 SSI (Supplemental Security Income) should not be confused
with SSDI (Social Security Disability Insurance).
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SSI is a means-tested government program: it provides benefits to
those whose income and financial resources meet certain requirements.
 SSDI is an entitlement: the benefit is based on whether
funds were paid into the system.
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Own work record
Parent’s work record
 Both SSI and SSDI programs require a finding that the
individual has a disability under Social Security Rules.
SSI
 What happens at age 18
 Children who were receiving SSI must reapply as
adults
 Children who were not eligible to receive SSI due to
family income and resources can now apply.
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Once an individual with a disability turns 18, the income and
resources of parents are no longer counted, even if the
individual is living at home.
SSI
 At all times, however, the individual’s own income
and resources are taken into consideration and must
be at poverty level to qualify.
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To lower resource amount to qualify, learn about
spending down
 Non-countable resources
 Special needs trusts
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SSI
 Disability Determination
 Both SSI and SSDI programs require a finding that the
individual has a disability under Social Security Rules.
 Decisions are based on evidence
 School evaluations and questionnaires
 Medical records
 Parent questionnaire
 KEEP GOOD RECORDS!
SSI
 Why is SSI important?
 The cash benefit that your son or daughter could
receive per month, the purpose of which is to provide
cash to meet basic needs for food, clothing, and shelter.
The maximum cash benefit actually paid could be less for
several reasons, including income, gifts or free room and
board.
 SSI is also important because it is an automatic
gateway to Medicaid. It is important to note that other
Vermont Medicaid programs that your child may
currently be on, including Dr. Dynasaur and Katie
Beckett Waiver, end by the time the individual is 18 or
19, respectively.
SSI
TIP
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Cooperate with Disability Adjudicator to help them get the
evidence they need for a positive finding.
If asked to do a consultative exam, keep appointment and avoid
rescheduling
 Follow up with school to make sure school sends requested
information and completes questionnaire.
 Complete paperwork on your end promptly
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Consider hiring an attorney
By law, they will only get paid if a claim is successful.
 Less expensive to hire an attorney at the beginning of the process
than later as their payment will be retroactive.
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Questions
Contact Information
Claudia Inés Pringles
Family Consultant -Developmental Disabilities Specialist
Vermont Family Network
600 Blair Park Road, Suite #240
Williston, VT 05495-7549
(802) 764-5290 (Williston office)
(802) 917-2475 (cell)
[email protected]
http://www.vermontfamilynetwork.org
Choices for Care
HELEN JOHNKE
VERMONT CENTER FOR INDEPENDENT LIVING
About the Presenter
 Helen Johnke has been a benefits to work specialist in
the Vermont Center for Independent Living ‘s (VCIL)
Benefits to Work Program for seven years. She provides
information to people who receive Social Security
Disability Benefits about the impact of work earnings on
their federal and state benefits. She helps beneficiaries
understand how to use Social Security’s Work Incentives
as a way to transition from dependence on public
benefits to independence through employment. She also
acts as liaison between beneficiaries and SSA or other
benefit programs when they have work earnings. Before
she became a Benefits to Work Counselor she worked as
a Peer Advocate Counselor assisting people with
disabilities meet their goals.
Vermont Center for Independent Living
 VCIL supports the rights of individuals to live with dignity in
their own homes, fully participate in their own communities
and to make decisions about their own lives.
 VCIL has four Core Services:
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Information and Referral Services
Peer Advocacy
Systems Advocacy
Independent Living Skills Training
 VCIL has a variety of programs that assist Vermonters with
disabilities to live as independently as possible within their
Communities.
 VCIL has offices in:
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Montpelier, Burlington, Newport, Brattleboro, Bennington and Rutland
Choices for Care
 Choices for Care is a Medicaid-funded, long-term
care program that pays for care and support for
Older Vermonters and people with disabilities of
at least 18 yrs. of age.
 The program is open to people that have physical
disabilities.
 Services may be self-directed or provided through
case management.
Choices for Care
 The application is a two part process. The first part is
an assessment by a clinical coordinator that will assess
whether the student meets the needs criteria:
 The person must need hands on assistance with:
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toileting
turning over in bed
transferring from bed to chair
eating
dressing
 and assistance with:
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meal planning
household chores
medication management
Choices for Care
 The second part is a financial eligibility application.
 Since this is a program for adults, it is important for
the student to connect with the Social
Administration (SSA) and apply at the age of 18 for
Supplemental Security Income or SSI, as an adult.
 There may be a patient cost-share.
Choices for Care
Tips and Suggestions
 Start planning for the transition from school into the
community early!
 Contact SSA before the student is 18 and let them
know that the student will be applying for SSI as an
adult at the age of 18.
 When dealing with the student’s school, be involved
in the IEP process.
Choices for Care
Tips and Suggestions (continued)
 When you attend IEP meetings, it is helpful for you
to have goals for your child. You know your child the
best.
 Make a list of questions/concerns and take it with
you when you go to the IEP meetings.
 Do not be afraid to ask for what your child needs.
Choices for Care
 For more information about Choices for Care:
 On the Internet, see:
http://www.ddas.vermont.gov/ddasprograms/programs-cfc/programs-cfc-default-page
 Questions?
Benefits to Work Program
HELEN JOHNKE
VERMONT CENTER FOR INDEPENDENT LIVING
Benefits to Work Program
 Benefits to Work Program
 Our Benefits to Work Program helps people transition from
total dependence on benefits to employment.
 Our Community Work Incentives Coordinator (CWIC)
explains the impact of work earnings on Social Security
Disability Benefits: Social Security Disability Insurance or
SSDI and Supplemental Security Income or SSI and state
benefits.
 Provides a written summary and analysis of the impact of
work earnings on benefits.
 Helps with reporting earnings accurately to SSA.
Benefits to Work Program
 Provides updates on the impact of earnings on benefits as employment
progresses.
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Help to develop a system for anticipating and addressing changes in
benefits and work earnings. This could include a written plan with
important dates, action steps and recommendations.
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For more information and support on going to work, contact:
VCIL
1 800 639-1522
Benefits to Work
Vocational Rehabilitation
HELEN JOHNKE
VERMONT CENTER FOR INDEPENDENT LIVING
Vocational Rehabilitation
Division of Vocational Rehabilitation
Vermont Agency of Human Resources
VocRehab Vermont provides a wide range of services and supports to help people affected by disability get
to work and help the employer keep them in the job. Adapted from their website:
Youth
Are you getting ready to graduate from high school? Excited? Nervous? Feeling pressured?
Overwhelmed?
or
Are you out of school? Wondering what to do next? In need of a job?
Or having difficulty getting or keeping a job?
Are you the parent or guardian of a youth who might answer yes to the above questions?
....VocRehab Youth Transition Counselors are there to help you. They can help you think about possible
careers and further training after high school or help you find a job.
Vocational Rehabilitation
There is a youth transition counselor in each VocRehab office so that you can meet with
someone in your own community, at school or in a VocRehab office. Contact us today!
Vermont Vocational Rehabilitation
103 South Main St., Weeks 1A
Waterbury, VT 05671-2303
1-866-VRWORKS
1-879-6757 (voice/TTY)
802-241-1455 (TTY Next Talk)
Barre Area
Bennington Area
Brattleboro Area
Burlington Area
Middlebury Area
Morrisville Area
Newport Area
Rutland Area
Springfield Area
St. Albans Area
St. Johnsbury Area
White River Area
Questions
Contact Information
Helen L. Johnke, CWIC
Benefits to Work Program
Vermont Center for Independent Living
11 East State St.
Montpelier, VT 05602
[email protected]
802 224-1814
Mental Health Services
CINDY MARSHALL
VERMONT FEDERATION OF FAMILIES FOR
CHILDREN'S MENTAL HEALTH
About Cindy
 Cindy Marshall is a mother of two young
adults. Her youngest son Joel has
Autism. Cindy has enjoyed working for three
Vermont family support organizations over the
last 12 years, providing non-profit leadership. She
is currently the Assistant Director of the
Vermont Federation of Families for Children's
Mental Health. She has facilitated
and presented numerous trainings bringing a well
balanced, respectful, and sometimes humorous look
at the unique needs of families raising children with
special needs.
3 Projects that try to Fill the GAP
 Vermont Youth In Transition Grant- The goal in the
grant is to develop of system of care and empower
young adults!
 Vermont Transformation Grant – To create a peer
network and peer supports in two regions
Montpelier & Burlington
 IFS / EFS Integrated Family Services and Enhanced
Family Services – this is systems transformation that
will increase flexible and individualized services
while decreasing the silo’s
TIPS – for you to know
 Most services provided by your Designated Agency are
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Medicaid Services and must have Medicaid (Katie
Beckett waiver with disability not income eligible with
private insurance)
CSP Coordinated Services- Act 264 available which
includes the LIT / SIT Process
A child who receives Special Education for Emotional
Disturbance – by law a parent should be told every year
they are entitled to a CSP.
Need a CSP if considering a need for an out of home
placement
If your child was hospitalized for mental health reasons,
after discharge a CSP is recommended
TIPS- cont.
 The age of consent is really critical in Vermont
 Make sure you have proper evaluations and
diagnosis’s on record prior to 18. If child was
hospitalized, make sure you receive the discharge
plan. More importantly make sure you have a copy
of the Discharge Summary Report which is usually
received 2-3 weeks later.

Changes in Adult Services – Since Irene
 Adult Services are purely voluntary
 Today Vermont State Hospital VSH is closed due to
Tropical Storm Irene- there are several locations
where 51 patients were displaced across Vermont
 Today we have 5 sites where the DMH Commissioner
has designated hospitals for Psychiatric Care:
Fletcher Allen, Rutland Regional, Central Vermont
Medical, Brattleboro Retreat and the Windham
Center
Adult TIPS cont.
 The future if the VSH not one site, is in three
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locations, as per Act 79
Brattleboro Retreat 14 beds
Rutland Regional 6 beds
To be built 25 beds in Berlin
Interim plan is 8 beds at Lamoille Community
Connections ready in September
Questions
Contact Information
Cindy Marshall
Assistant Director, VFFCMH
Our *NEW post flood address is:
VFFCMH
PO Box 1577
Williston, VT 05495
1-800-639-6071
www.vffcmh.org
Thank you
Claudia Pringles, Vermont Family Network
[email protected] * www.vtfn.org * 800-800-4005
Helen Johnke, Vermont Center for Independent Living
[email protected] * www.vcil.org *800-639-1522
Cindy Marshall, Vermont Federation of Families for
Children’s Mental Health
[email protected] * www.vffcmh.org* 1-800-639-6071