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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 August 2008):

Objective 1:

1. Dept. of Health Services (DHS) accepts the Stakeholders report on Self-Directed Supports (SDS).
2. DHS hires a SDS waiver manager.
3. DHS is developing a new SDS waiver (IRIS) to be an option to the current SDS option in the Family Care CMO structure.
4. Board staff continue participation in IRIS advisory, outreach, and budget committees, and Long Term Care Council and Quality Assurance Committee.
5. The Management Group (TMG) has contract to implement IRIS.
6. IRIS waiver is available on July 1, 2008.
7. PR materials sent to ADRCs and others.

Objective 2:

1. DHFS accepts the Stakeholders report on SDS.
2. Staff collaborates with the Self-determination Coalition.
3. PR materials sent to ADRCs and others.

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. Board staff collaborate with Survival Coalition on a series of Family Care training sessions around the state for consumers family and providers in summer of 2008.
4. Board provides grants for 10 people to train consumers, families, and providers about IRIS

Objective 4:

1. SDS Waiver (IRIS) is available as of July 1, 2008.

Objective 5:

1. Staff and Board member participate in Children’s Redesign group.

Objective 6:

1. Marquette Dental School completes a survey (WCDD funded) on increasing dentists’ participation in MA.
2. Council researching dental projects and studies in WI and other states to explore options.
3. Participation in Health Care Access coalition.
4. Support Greg Nycz and Marshfield Clinic proposal to expand community care for low-income people and start a second 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. Collaboration with DHS, FEMA, and DD network partners.
4. Advocating for greater consistency and consumer input into emergency planning.
5. Develop model “Go-Bags” and produce copies for distribution
6. Develop a training program; train trainers.
7. Report with policy recommendations written.

Objective 8:

1. Two-year pilot of the College of Direct Support is underway in Dane, LaCrosse, and Milwaukee counties. At least 10 agencies are involved.
2. UW-Oshkosh is the administrator for the program. They will provide training, collect data and evaluate the program.
3. MA Infrastructure Grant (MIG) provides funding to improve training for vocational staff.
4. Promote “Rewarding Work” model.

6. Resources:

1. Self -Directed Support Grants

7. Events:

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