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Self-Determination

1. Explanation of the Goal:

Self-Determination is the right of people to have power over their own lives.

In the broadest sense, it's a combination of attitudes, beliefs and skills that enable people to gain control over their lives and work toward personal goals. For children and others who need assistance in exercising self-determination, families or allies must represent the person's preferences and interests.

In the long-term care system, Self-Determination refers to specific rights: the right to live and work where you want, to control your individual service budget, to find supports outside the traditional service system, and to choose someone to help you find resources and manage funds.

2. The change we want to see:

People with DD who receive long-term care services through a managed care system will use Self-Determination concepts to be more included in the community.

3. How we will know the change happened:

The Council will work with care management organizations and DHFS to obtain information about how many people with DD are using Self-Determination concepts in their plans.

4. What we’ll do to get there:

This part of the Plan has eight objectives or activities aimed toward meeting this goal:

1. By September 2008, staff of managed care organizations will promote the Self-Determination option to all participants with DD.
2. By September 2009, all people who choose Self-Determination will have qualified people, independent of the service system, to help them manage their budget and contract for services.
3. By September 2011, 30% of adults with DD who receive long-term care services through managed care will direct their public resources to supports of their choice.
4. By September 2011, 10% of participants will be more included in the community as a result of their Self-Determination plan.
5. By September 2009, 10 families in the Children’s Redesign pilot counties will use a Self-Determination model.
6. By September 2011, 20% of Self-Determination participants will report greater access to medical and dental services.
7. By September 2011, 500 people w/DD/families will be prepared for emergencies.
8. By September 2011, 20% of Self-Determination participants will report more satisfaction with support received from direct service professionals.

5. Progress to date (as of April 2008):

Objective 1:

1. Dept. of Health and Family Services (DHFS) forms Waiver Stakeholder Committee, Committee completes report on Self-Directed Supports (SDS), and DHFS accepts the report.
2. DHFS is developing a new SDS waiver to be an option to the current SDS option in the Family Care CMO structure.
3. DHFS hires a SDS Waiver Manager.
4. Board staff continue work on Committee in preparation of the start of SDS Waiver in Family Care counties on 7/1/08.

Objective 2:

1. DHFS accepts the Stakeholders report on SDS.

Objective 3:

1. 50 different groups including over 1200 people have received training on Self- Determination (SD).
2. Seven regional SD training events were held statewide where over 425 people were trained on the principles of SD.
3. SDS support and assistance has been provided to 90 individuals locally from 10/07 to 3/08.

Objective 4:

• No Progress to Date

Objective 5:

1. Staff participate in Children’s Redesign group.

Objective 6:

1. Marquette Dental School completes a survey (Board funded) on increasing dentists’ participation in MA.
2. Board researches dental projects and studies in WI and other states to explore options.
   • Dental Access Report
3. Board supports Marshfield Community Clinic model including the start of a 2nd dental school with a rural focus.

Objective 7:

1. Researched available emergency preparedness materials.
2. Emergency preparedness work group formed and meets with Rep. Ballweg.
3. Board contracts to develop policy recommendations to ensure planning systems include people from the disability community.
4. Training programs and materials along with “Go Bags” are being developed for consumers and families.

Objective 8:

1. Council, Waisman Center, and DHFS will collaborate on 2-year pilot of the College of Direct Support (CDS) in Dane, LaCrosse, and Milwaukee counties.
2. 2-year pilot is underway. At least 10 agencies are involved. Tech colleges are interested in offering CDS.
3. Board contracts with UW-Oshkosh to administer the pilot program. They will train groups, provide technical assistance, collect data, and evaluate the pilot.
4. The MA Infrastructure Grant (MIG) contributes $70,000 to the pilot to improve training for vocational staff.

6. Resources:

7. Events:

1. Self-Directed Support and Managed Long-Term Care: Coming to a Neighborhood Near You?
   September 19, 2007 Best Western Claridge, Rhinelander
2. 1st Annual Wisconsin Self-Determination Conference "Organizing for Self-Directed Supports"
   November 5-7 – Wisconsin Dells – Kalahari Resort