OMB Approval No.: 0980-0162
Expiration Date: pending
Missouri Developmental
Disabilities Council
State Plan
For Federal Fiscal Year 2015
Submitted on: 2014-12-29 20:52:26
Printed on: 2015-04-29 11:16:57
Vicky Davidson, Executive Director
Missouri Developmental Disabilities Council
P.O. Box 687
1706 E. Elm Street
Jefferson City, MO
65102
Section I : Council Identification
PART A:
State Plan Period:
October 1, 2011 through September 30, 2016
PART B:
Contact Person:
Vicky Davidson
Phone Number:
(573) 751-8206
E-Mail:
vdavidson@moddcouncil.org
PART C:
PART D:
Council Establishment:
(i) Date of Establishment:
1979-10-26
(ii) Authorization:
Executive Order
(iii) Authorization Citation:
Executive Order 79-23
Council Membership [Section 125(b)(1)-(6)].
(i) Council Membership rotation plan:
A number of boards and commissions find it difficult to keep their membership up-to-date and this is also true of
the MODDC’s membership despite numerous contacts with the Governor’s office to request that terms of
MODDC members be addressed either through re-appointments of terms or replacement of vacant or expired
terms of members.
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(ii) Council Members:
#
1
Name
Harper, John
Code
A1
2
3
Gilpin, Barb
Brewer, Michael
A2
A3
4
Kremer, Glenda A
A4
5
6
Eckles, Susan
McVeigh, Thomas
A5
A6
7
8
Blackwell, Brent
Crandall, Lisa
A7
A8
9
Davis, Wendy
A9
10
11
12
13
14
15
16
17
18
19
20
21
Enfield, Cathy
Ohrenberg, Mark
Stahberg, Kit
Willard, Diana
Briscoe, Stephanie
Dowell, Dale
Hoffmesiter, Michelle
Niemeyer, Brenda
Riggs, Douglas
Swinnie, Jackie
Williams, Sharon
Nelson, Allen
B1
B1
B1
B1
B2
B2
B2
B2
B2
B2
B2
C1
PART E:
Organization
DESE, Division of Vocational
Rehabilitation
DESE, Effective Practices
Department of Health & Senior
Services
Dept. of Social Services,
MOHealthNet
MO P&A Services, Inc.
UMKC University Center for
Excellence in DD, IHD
Carroll County SB 40 Board
Dept of Health & Senior Services,
Special Health Care Needs
Dept. of Mental Health, Division of
Developmental Disabilities
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Appointed
2009-11-02
Term Date
2012-06-30
2009-11-02
2012-06-30
2009-01-15
2011-04-01
2011-06-30
2012-06-30
2013-06-03
2014-06-30
2013-06-03
2015-06-30
2006-09-13
2009-02-09
2006-09-13
2009-03-04
2008-03-06
2010-03-25
2009-02-17
2009-02-17
2010-03-25
2010-04-08
2009-02-17
2010-04-08
2010-06-30
2011-06-30
2011-06-30
2011-06-30
2010-06-30
2012-06-30
2010-06-30
2010-06-30
2011-06-30
2011-06-30
2009-06-30
2011-06-30
Alt/Proxy State Rep Name
Council Staff [Section 125(c)(8)(B)].
#
Name
Position or Working Title
1
Dickey, Becky
Receptionist/Clerical Aide
2
German, Charolotte
SOSA
3
Gjesvold, Darla
Program Assistant
50.00
4
Holterman, Christie
Administrative Assistant
100.00
5
Lackey, Andrew
Program Specialist II
100.00
6
Nickolaus, Charles
Program Specialist II
100.00
7
Sanderfer, Carrie
Program Specialist II
100.00
8
Sparks, Dolores
Program Specialist II
100.00
9
Vicky Davidson
Executive Director
100.00
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FT/PT %
0.10
100.00
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Section II : Designated State Agency
PART A:
The designated state agency is:
Division of Developmental Disabilities, DMH
P.O. Box 687, 1706 E. Elm Street
Jefferson City, MO 65102
phone: (573) 751-4054, fax: (573) 751-9207
email: Valerie.Huhn@dmh.mo.gov
PART B:
Direct Services. [Section 125(d)(2)(A)-(B)].
The DSA provides direct services to persons with developmental disabilities. (The Division
of Developmental Disabilities is our designated state agency and is the state\'s agency for
residential, habilitation and family support services for people with developmetanl
disabilities.)
PART C:
Memorandum of Understanding/Agreement: [Section 125(d)(3)(G)].
The DSA has a Memorandum of Understanding/Agreement with the Council.
PART D:
DSA Roles and Responsibilities related to Council. [Section 125(d)(3)(A)-(G)]
The DSA houses the council and provides administrative support such as accounting,
personnel (HR), contracting, limited supplies, etc.
PART E:
Calendar Year DSA was Designated. [Section 125(d)(2)(B)]
1979
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Section III : Comprehensive Review and Analysis [Section 124(c)(3)]
INTRODUCTION: A broad overview of the Comprehensive Review and Analysis conducted by the Council.
MO began discussion of the 2012-16 Plan in the fall of 2009 with a presentation to members about the process,
timeline and their role. A small group met to provide more input regarding relevant data, resources, survey
questions, focus group tools, and an analysis of available information and data. Council committees participated
by identifying data and systems that should be included in the process from the perspective of their work in
education, employment, housing, guardianship, community living, and public policy. A statewide survey was
prepared and distributed using the Council's website, multiple listserves and extensive mailing lists, as well as
visits with organizations and stakeholder groups. Staff and members also collected input from existing groups
with which they participate. Letters of concern, emails and public testimony during Council meetings were also
considered as public input for purposes of this plan. The Council reviewed its mission and values and set
priorities to be addressed in surveys and focus groups. They received regular reports about the tools and
process being used and provided input for each step. In the fall of 2010, staff presented briefs regarding various
issues and data collected so that all members had a general understanding of these major areas of concern.
State agency representatives were asked to add information during these discussions. Data from surveys was
provided, reviewed and analyzed during a council meeting.
A retreat allowed members to process this
information more thoroughly and to agree on a first draft of goals and objectives. These were perfected based
on training from ADD and discussed extensively during a second Council meeting before being released for
public comment. The Council's website, extensive listserves and mail lists were used to encourage input.
Members and staff also encouraged input as they participated in meetings with other stakeholders. Input from
the public was addressed during a full council meeting and members agreed that it would not be beneficial to
make additional changes to the plan as the comments supported our findings and intent. In addition to the areas
where members felt our work had not been completed currently (i.e., employment, transportation, education,
housing, and guardianship), several new areas were discussed. The civil rights of individuals who become
entangled in our criminal justice system and court system were new areas considered to be a priority. Members
are also much more concerned with restraints and seclusion in our school systems and the breech of civil rights
presented by sending students to a fully segregated state school system. The Council has also become more
sophisticated about public policy and their ability to impact legislative decisions and policy and practices at the
state agency level. The Council considered the demographics of our state, the current economic status and the
expected challenges to the economy over the next five years. They had detailed discussions about the state's
use of segregated residential settings, the costs of this outdated model and their power to influence ongoing
change. There was also much discussion about the poor outcomes for students with DD as they transition from
MO schools and the lack of community opportunity for students who wish to obtain competitive employment.
The Council has looked carefully at potential partners and the value of working collaboratively to increase our
influence. The evaluation plan was addressed and members understand the importance of this part of the
planning process. There has been ongoing discussion about the Council's funds and how they can be used to
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influence change and identify priorities that will result in the greatest impact.
PART A:
State Information
(i) Racial and Ethnic Diversity of the State Population:
Race/Ethnicity
Percentage of
Population
82.8%
11.6%
0.5%
1.6%
0.1%
1.3%
2.1%
0%
White alone
Black or African American alone
American Indian and Alaska Native alone
Asian alone
Native Hawaiian and Other Pacific Islander alone
Hispanic or Latino of any race
Some other race alone
Two or more races:
(ii) Poverty Rate: 15.50
(iii) State Disability Characteristics:
a) Prevalence of Developmental Disabilities in the State: 94625
Larson S.A., Lakin, K.C., Anderson, L., Kwak, N,, Lee, J., & Anderson, D. (2001) Prevaleance of Mental
Retardation & DD, American Journal on MR
b) Residential Settings:
Year Total Served
2014
2013
2011
2009
2007
2005
275
531
258
109
111
109
A. Number
Served in Setting
of 6 or less (per
100,000)
21.000
20.993
30.980
73.600
70.200
64.600
B. Number
Served in Setting
of 7 or more (per
100,000)
19.000
20.827
32.420
35.100
40.800
44.400
C. Number
Served in Family
Setting (per
100,000)
159.000
151.021
132.210
123.500
136.700
131.800
D. Number
Served in Home
of Their Own (per
100,000)
76.000
71.383
62.490
48.200
46.400
41.200
c) Demographic Information about People with Disabilities:
People in the State with a Disability
Population 5 to 17 years
Population 18 to 64 years
Population 65 years and over
Percentage
6.1%
12.4%
39.3%
Race and Hispanic or Latino Origin of People with a Disability
White alone
Black or African American alone
American Indian and Alaska Native alone
Asian alone
Percentage
14.2%
14.9%
25.4%
4.1%
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Native Hawaiian and Other Pacific Islander alone
Some other race alone
Two or more races
While alone, not Hispanic or Latino
Hispanic or Latino (of any race)
0%
7.6%
14.4%
14.3%
9.1%
Employment Status
Population Age 16 and Over
Employed
Not in Labor Force
Percentage with a
Percentage
Disability
without a Disability
24%
67.8%
70.8%
26%
Education Attainment
Population Age 25 and Over
Less than High School graduate
High School graduate, GED, or alternative
Some college or associate's degree
Bachelor's degree or higher
Percentage with a
Percentage
Disability
without a Disability
26.9%
9.5%
36.9%
30.8%
25.8%
30.6%
10.4%
29.1%
Earnings in the past 12 months
Population Age 16 and Over with Earnings
$ 1 to $4,999 or loss
$ 5,000 to $ 14,999
$ 15,000 to $ 24,999
$ 25,000 to $ 34,999
Percentage with a
Percentage
Disability
without a Disability
33.2%
21.5%
10.8%
8.6%
19.9%
16.7%
12.7%
15.4%
Poverty Status
Population Age 16 and Over
Below 100 percent of the poverty level
100 to 149 percent of the poverty level
At or above 150 percent of the poverty level
Percentage with a
Percentage
Disability
without a Disability
21.9%
11%
14.7%
7.6%
63.4%
81.3%
PART B:
Portrait of the State Services [Section 124(c)(3)(A and B)]:
(i) Health/Healthcare:
Missouri continues to struggle with healthcare. The legislature held numerous hearings for bills that were filed to
either expand Medicaid or reform/transform Medicaid. Many The state continues to struggle with health care as
the legislature has yet to expand Medicaid. The MODDC is a member of large coalition of stakeholders that
support Medicaid expansion or reform. While there is widespread support for the expansion of Medicaid, the
legislature has not supported such expansion. Efforts will continue to reform Medicaid in the 2015 legislative
session.
This year did see the addition of dental services to the Medicaid program. However, these funds were withheld
by the Governor. Persons with DD, like other adults on MO HealthNet (the state’s Medicaid agency), have not
had coverage for preventative dental care since 2005. As a result, adults with DD with dental problems have had
to utilize emergency room care to deal with excruciating pain, and other health complications that occur when
dental issues are left untreated. The MODDC is advocating for the release of those funds as it would be
considerably less expensive to the state, and would increase the quality of life of the individuals with DD with
untreated dental issues, to provide preventative dental care, instead of paying for the high cost of emergency
room visits and chronic conditions later in life.
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(ii) Employment:
The current emp rate of inds w/DD in competitive, comm-based jobs is 7% using 09 ICI’s State Data. MO ranks
48th out of 50 in terms of competitive, comm-based emp for inds w/DD. The Division of DD has direct oversight
of 249 Day Hab Centers providing a variety of svcs & spts, including placing & supporting inds into comm emp.
In 09, the Div spent $39.2 mil on day hab w/only $1.9 mil of funding going to integrated emp. There are 93
state-supported shelt workshops which provide sheltered emp for approximately 7438 ppl w/disabilities &
approximately 900 non-disabled staff. Over 1070 inds are waiting for work in one of these workshops.
Workshops have increased the # of part- time workers over the last 2 yrs to reduce the # of layoffs. Currently
there are 4915 FTE workers.The majority of workers receive subminimum wages (average $2.58/hr) but this
system is well ingrained in MO's social & political values. Inds struggle to obtain adequate job trng & placement
as the bulk of funding is invested in segregated emp. When inds complete the necessary ed & trng, other
barriers become evident.There is much work to be done to ed employers & change public attitude re: potential
contribution of ppl w/DD, the attitudes & expectations of schools, families & even inds w/DD are also a challenge.
Contemporary families & young individuals want competitive emp, but feel that transition offers few choices.To
avoid a transition "to the couch" families accept day programs or shelt work. Moreover, many new graduates are
added to the waitlist leaving families to struggle alone w/limited spts & resources. MO schools often rely on
segregated programs leading to poor academic skills, lower expectations, & inadequate preparation. MO-VR
svcs fall short of the needs of many & others struggle as there are limited funds & resources for follow-along
svcs. Last year, VR returned $5,423,379 in fed funding due to not receiving state match. A return of funds is
anticipated this yr & in future budget cycles due to the state's fiscal challenges & limited GR. Also, MO has
several statues, policies, & practices (such as paying a higher hourly rate for day hab than for supported emp)
that make emp more difficult for inds who want to work. Professionals from various agencies charged with
assisting inds who wish to obtain emp but keep Medicaid struggle w/the complexity of available programs & spts.
MO ranks as one of the lowest states in use of SSI work incentives & successful VR closure for inds who are
self-employed. Public transp is poor in most communities making access to work challenging. The svc system is
too provider-driven & emp opportunities are often limited due to provider convenience & billing issues.
Self-determination in MO is still in its infancy leaving some inds struggling to overcome influences of providers,
families, & limited spts. MO has recognized this challenge & begun looking at ways to increase emp. The Div has
implemented an emp first policy, charged state staff w/increasing emp, & provided leadership by joining ICIs
SELN & developing an AFP team. While the state is encouraging systems change, svc coord is outsourced to a
county brd resulting in diverse emp outcomes. There are some creative pilots that have been supported by the
State, DD Council, local providers or county DD brds, however, the majority of communities continue to struggle
w/nearly insurmountable barriers. The Council is very active in working to improve emp for persons w/DD. While
data regarding the # of youth & adults w/DD that received svcs & spts for each type of emp are not available,
data previously reported for the state's spt of day hab & shelt emp has not changed w/the exception of the #
reported for the # of ppl in shelt emp. The current # of ppl in shelt wrkshps has decreased from 7438 to 7062.
With the decline of the economy, shelt workshops are experiencing a decrease in the # of contracts they secure.
Many are looking at how they do business.
(iii) Informal and informal services and supports:
MO social service systems are available for individuals or families with the greatest need to maintain or improve
quality of life. Each program has its own eligibility criteria but all are based on income, disability, or other specific
circumstances. The menu of possible services is confusing and the application process is generally burdensome
and challenging. Programs are administered through several different state agencies and families or individuals
struggle to find the right entry point. Some services are free while others require a sliding fee adding to the
confusion. Dept of Social Services offers the Healthy Children and Youth (EPSDT) program which serves
140,878 persons with a disability. DSS's Children's Division operates a specialized foster care program for
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children who are behaviorally or emotionally disturbed or in need of extensive medical care. There are 3,245
children in this program with some degree of ID or SED. A range of services are available when the child returns
to their natural home. Subsidies are available for families who adopt children with disabilities.. 1922 children
with disabilities are benefiting from these subsidies. These programs are limited by the number of families
available and 641 children with disabilities are awaiting adoption. DSS also offers the Child Support and
Enforcement program which assists by establishing child and medical support orders and monitoring and
enforcing compliance. The Temporary Assistance Program assists needy families with children so they can be
cared for in their own home but maximum life time benefits are 5 years. Individuals with DD may also benefit
from DSS programs such as Community Services Block Grants, Food Stamps, and Low Income Energy
Assistance. For those who are aging and others who are disabled, a separate state agency, Health and Sr.
Services offers several programs that serve the population as well. However, DHSS services are often
considered too restrictive by people with DD as individuals are not allowed to self-direct if they have a cognitive
impairment and many of the services are required to be delivered in the home. Services delivered in the
community are often provided in such a way that they prevent people from truly participating in the community.
Dept of Mental Health, Div of DD services are friendlier, but there are wait lists that prevent access for many.
DDD offers 5 waivers including the children's, prevention, autism, comprehensive, and community supports
waivers. In combination, these waivers serve around 10,000 individuals. There are wait lists for the children's,
comprehensive, and community supports waivers. MO has 22 Centers for Independent Living staffed by people
who have disabilities so as to provide peer supports. Each center is unique, offering services based upon the
particular needs of its community, but all centers offer core services including: Information and Referral, Peer
Support, Individual and Community Advocacy, and Independent Living Skills Training. DHSS also operates Area
Agencies on Aging and we have a new Resource Center on Aging. Families of children with DD find it very
challenging to obtain funds for respite care. Some families have access to respite through their state system as
well as a county tax levy, while others can access neither. Faith-based programs exist, but not consistently.
They are not coordinated or organized by any system, so individuals have to locate them through other
networks. The Council and others within the DD system partner to support a comprehensive information and
referral network that also serves to establish peer mentoring which includes, families, individuals, and
professionals. This program also supports and coordinates a network for volunteerism within DD systems. This is
a popular project, but it is still greatly underutilized in spite of extensive efforts to increase awareness.
(iv) Interagency Initiatives:
MO continues to improve coordination efforts between state agencies and yet this remains a challenging issue
for our state and its citizens. State leaders recognize the importance of agencies working together to prevent
program gaps and improve and enhance community services, individualized supports and other forms of
assistance for individuals. The Council supports and participates in these efforts and in some cases provides
leadership and financial support to ensure that individuals with DD are well represented. We have also achieved
some success in using interagency initiatives to expand funding for Council projects and to increase public
awareness and usage of other projects. One of the most helpful initiatives for people with DD has been the
Mental Health Transformation Grant. This 5-year federal grant assisted MO in establishing teams focused on
bringing human service agencies together to improve the quality of life for Missourians. The grant increased
cooperation and collaboration of existing efforts and helped MO move toward a public health approach for
mental health service delivery. The Division of DD received a second, smaller federal transformation grant
allowing the work for those with DD to be further expanded and to enhance existing efforts. MO now participates
in the State Employment Leadership Network that brings state DD agencies together for sharing, education, and
providing guidance practices and policies around employment for those with DD. This is in addition to the Mental
Health Employment Team which continues to focus on better data collection and increasing interagency efforts,
the State Rehabilitation Council, and the Work Investment Boards. We hope to see a statewide policy for
Employment First evolve from this collaboration. Employment efforts also expanded through the Alliance for Full
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Participation. An Interagency Transition Team has been formed to promote state- level interagency collaboration
to improve outcomes for young adults with disabilities. The Transformation Grants also enhanced existing
housing efforts and broadened awareness and support to expand housing options. An anti-stigma group was
also formed to increase awareness and identify challenges. MO also has an Aging and Disability Resource
Center that creates a single system of information for all persons seeking long-term support. It provides
awareness and information, assistance and access. MO was fortunate to receive a Money Follows the Person
Grant to increase supports for people who have disabilities or are aged to move from nursing facilities or state
ICF/MRs to quality community settings that meet their needs and desires. This has helped fill the gap created
when the Personal Independence Commission, which was formed to better address Olmstead and individuals'
rights to live and receive services in the community, was disbanded. The Dept of Social Services established a
Children's Division and Dept of Mental Health and Dept of Elementary and Secondary Education (DESE)
partnered to provide a continuum of care for children who require services through multiple programs. MO's
education system has several groups that meet regarding specific programs and practices as required by IDEA.
The Special Education Advisory Panel provides advice regarding programs and services for children with
disabilities and the State Interagency Coordinating Council provides advice and assists DESE in the
performance of responsibilities as stated in Part C of IDEA. MO Head Start looks to a Statewide Advisory
Council to provide guidance on program initiatives and efforts. Much progress has been made in addressing
autism with the establishment of a statewide Autism Commission with representation from an array of state
agencies as well as individuals. MO has a well established and respected Assistive Technology Project that
brings many key players together to promote use of state-of-the-art technology.
(v) Quality Assurance:
MO's QA system has many components. Multiple agencies and systems provide oversight of services and
supports for people with DD. Training and program review are also provided through multiple systems. But,
Missourians often do not have the quality of life that should be guaranteed. The National Core Indicator Project
shows that MO is significantly below average in allowing people to go out for errands and appointments or attend
religious services. Missourians were significantly below average in being allowed to visit multiple homes before
choosing, look at more than one job, or visiting with their families. MO citizens with DD are significantly below
average in reporting satisfaction with where they live and work. Service coordinators do not help them get what
they need, case managers do not ask about their preferences and they do not receive help to do or learn new
things. They do not have transportation to go somewhere when they want. They do not feel safe in their home
and are not allowed privacy in their home. They do not feel they are treated with respect. DMH tracks additional
core indicators for a safety report. This report helps with monitoring trends but its bearing on quality of life can
be unclear since the numbers remain fairly stable. The report indicates that the residents of the state ICFs are
twice as likely as those in the community of being placed on 5 or more psychotropic meds for 60 or more days.
Medication errors are higher in ICFs than in community residential settings. Those in the ICFs are nearly twice as
likely to have a substantiated abuse and neglect investigation. Chemical, physical, or mechanical restraints
occur at rates of 12%, 98% and 16% respectively in ICFs (duplicated) but are not reported for community
residents possibly because restraints are not allowed by many providers. The average age at death in ICFs is
mid- 50s and mid-40s for community residents as compared to a state average of 72.6. The Council is
concerned about individuals with DD who enter the criminal justice system. There is limited data, but we do
know that 4.2% of offenders incarcerated had an IQ below 70, and that convicted offenders with low IQs are
more likely to have been convicted of a violent crime. The top 3 offenses of those with a very low IQ were
robbery, murder, and burglary. The Council has received letters of concern from advocates and families who
report that individuals with cognitive disabilities who are accused of committing a crime often lose all rights, are
assigned a guardian, and are placed in a long-term restrictive environment without ever going to trial. Others
move into the criminal justice system, go to prison and have bad experiences there. Guardianship is another
concern for the Council as we know that there is disproportionate reliance on full guardianship and limited
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guardianship or power of attorney is often overlooked or unavailable. Between FY02 and FY06, 30,860 full
guardianships were awarded and only 349 limited guardianships. Many MO schools use restraints and seclusion
for students with DD leaving parents concerned but powerless. The Division of DD has been creative in
developing a quality review system that brings parents and self-advocates in for home visits in the community.
They have focused efforts on increasing self-determination, and have added employment specialists and
community advocates at each of their regional offices. They have partnered with other stakeholders to increase
community opportunities for those they serve, and they have continued to decrease the number of individuals
living in the state-run ICFs. They have not focused efforts on identifying and assisting those in nursing homes or
RCFs and they do not reach out to those not currently in the service system. They have been creative in
partnering to develop a prevention waiver that allows county boards to blend their funds with state dollars and
serve people who have less significant needs.
(vi) Education/Early Intervention:
57% of MO children w/IEPs ages 6-21 attend reg classes at least 80% of the school day as compared to 53.7%
nationally. 3.7% of children with IEPs are served in separate settings that include private/public separate
facilities, homebound/hospital, private res facilitates & state-operated separate schools as compared to 3%
nationally. MO operates State Schools for the Severely Dis that serve about 1000 children or .95% of the
students w/IEPs /in the state. 46 students are served in MO School for the Blind & 81 students are at the MO
School for the Deaf. MO spends an average of $24,532 per student w/a disability in the pub schools & $30,677
per student w/a disability in the State School for the Severally Disabled. 71% of students in Spec Ed exit with a
diploma compared to 56% nationally & our dropout rate for students w/IEPs is 27% or 2498 children compared to
26% nationally. 80% of students w/IEPs are employed or continuing their ed one yr after graduation. MO
participates in Part C, birth to age 3 through its First Steps Program. Children are assessed & provided svcs
through a web of providers. The program respects that families play an integral role in their child's development
& provides them the tools they need to help their child be successful. As children reach age 3, they are provided
svcs through Part B of IDEA. When a school district's size or resources do not make it feasible to provide svc to
these children, they are allowed to contract w/private agencies or individuals to provide appropr svcs which may
be in group settings for children w/disabilities. This segregation can easily continue as the child progresses
through the system. The Council believes that all children w/DD can attend their neighborhood school in a reg ed
placement w/the necessary modifications & spts as mandated by IDEA. Unfortunately many families are
persuaded that the State Schools are the best solution for their child & others choose this option when the
neighborhood school does not immediately meet their child's needs. While the eligibility criteria for the state
schools has been restricted so that districts must develop justification reflecting why the placement is the least
restrictive ed environment, many Council members believe that DESE should reconsider this option & as
mandated, consider reg ed w/the provision of appropriate modifications & accommodations as the 1st option for
all students. Following several incidents of abuse in the state schools, Council members challenged themselves
to visit the state schools in their area & now continue to express concern that these programs do not sufficiently
address academics & social needs of the students, nor do they prepare youth to participate in their community to
the maximum extent possible. The Council is also concerned with MO's position on restraint & seclusion. New
legislation led to written policies in each school district, but we are unsure of the impact resulting from these new
policies. DESE also operates a system of state funded shelt workshops. These workshops have become
politically challenging as many counties & private entities invest local $ to promote this system. Our needs
assessments & ongoing discussion let us know that many younger families desire change in our state's ed
system. Furthermore, the Council's scientific public opinion survey showed that 84% of Missourians agree that,
when children with and without disabilities are educated together, all children benefit. Council members are
studying the MO system & are anxious to look at ways to partner w/other stakeholders to improve this system.
The council advocated for new legis that passed leading to written policies in each school district. At this writing,
the Council is unsure of the impact of these new policies. Council members will work w/their school dist. Because
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of the passage of the legis, the council has chosen not to include an objective regarding R&S as they monitor the
impact of this legislation.
(vii) Housing:
Lack of housing options is tantamount to a restriction of civil rights of people living with disabilities. The
Olmstead Decision stresses that people with disabilities should be enabled to live in the least restrictive setting,
but this is often not the case for Missourian’s with disabilities. We know that when housing is a low priority,
individuals with disabilities end up living in housing that is not appropriate. This creates a system that is often
burdened and underfunded and leads to decision-makers who are uninformed. Currently, 80,000 Missourians
with disabilities receive SSI and live on $668.00 a month, but a single person with a disability receiving SSI
cannot rent a one bedroom apartment anywhere in the state for less than 50% of their monthly income. State
and local resources are insufficient to meet the growing housing needs. HUD funding has decreased over the
last 10 years and Section 8 lists across the state are closed. In 70 of MO’s 113 counties, two people making
minimum wage do not qualify for affordable housing. On average, Missourians living on SSI use 83% of their
income for housing when renting a one bedroom unit. Thus, many people with disabilities not only live in
poverty, but are also severely cost burdened when it comes to housing affordability. While there are some funds
available to build accessible housing or to modify existing housing, we know that individuals with DD, families
and developers are uninformed and struggle to access these funds. Developers often must be challenged by
legal systems to provide adequate accessible housing when completing new development. The MO Housing
Development Commission recently resorted to using unspent program money intended to increase community
capacity for this population to expand one of the state’s 6 ICF/MRs instead. In late 2011, around 600 people
reside in the 6 ICF/MRs, but there are nearly 500 people waiting for residential services in the community. MO’s
service system is provider-driven and decisions about housing are often guided by provider convenience and
funding issues rather than the desires or best interest of the individuals with disabilities. Self-determination is still
in its infancy in MO, leaving some individuals struggling to overcome the influences of providers, family, or limited
funds and supports. The state has recognized this challenge and has worked to separate housing and services
in their budgeting and increased efforts to support more creative housing options, but they also recently modified
the residential waiver to allow the maximum number of residents to be changed from 3 individuals to 4
individuals as a cost saving measure. Attitude and expectation or acceptance of a diverse community can also
be challenging for housing stock. At least one community has an ordinance that prevents group homes being
developed in their community, and the Public Administrator (public guardian) system questions the “safety” and
feasibility of placing many people who have public guardianship arrangements in community settings. Limited
resources to address barriers and crisis in community settings have further delayed access to community
housing for many. According to Braddock’s State of the State, MO invested $526 million in community services
in 2006 and $218 million on institutional settings, but many leaders have acknowledged the importance of
continuing to focus on rebalancing the service system and associated budgets in order to meet the growing
demand for services.
(viii) Transportation:
The Council has studied issues regarding transportation and recognizes it as a significant challenge for our state.
People with DD often cannot participate in the community because of a lack of transportation; they experience
less social opportunities and cannot use natural supports as easily. They often find transportation as a major
limitation in their ability to obtain a job in the community. Even when there is limited transportation available, it
often does not run during evenings and weekends further limiting work and social opportunities. Our state has
many areas that are rural, which presents additional challenges in building and supporting transportation
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systems. However, many urban areas also struggle with a coordinated, affordable system. We know that public
attitude and habits of using personal transportation are also major barriers. 72% of the respondents of a needs
survey rated opportunities for community-based transportation for persons with disabilities as fair to inadequate.
The MO Department of Transportation's transit section provides financial and technical assistance to public
transit and specialized transit providers across the state. Transportation services for the elderly and disabled are
available in all of MO's 114 counties and the independent city of St. Louis, but most of these services are
provided by systems such as OATS (Older Adults Transit System). This type of system runs by appointment or
sporadically, and does not allow for a person to access the community with affordable, accessible and flexible
transportation. Several cities have special transportation systems to help residents with disabilities access the
community, but they are expensive and use a large portion of the individual's expendable income. Many of the
County DD Service Boards obtain vans or buses to assist individuals with DD through MODOT grants, but,
unfortunately, many of these are used to provide transportation only to the county sheltered workshop. Once the
"workers" are dropped off at the workshop, the van sits in the parking lot until it runs a reversed route to take the
workers home. Most of the existing systems do not provide weekend or evening transportation. Through Council
projects and the creative work of some county DD service boards, we know that a more comprehensive system
can be developed that allows people to get where they want to go, when they want to get there. We know that
these systems can be inclusive, allowing people with DD to build relationships with others and that these
transportation systems can provide affordable and accessible transportation. The Council is anxious to continue
to study this issue and to promote systems change that improves access to needed community services,
individualized supports, and other forms of assistance that promote self-determination, independence,
productivity, and integration in all aspects of community life.
(ix) Child Care:
This area is not considered to be a priority at this time.
(x) Recreation:
This area is not considered to be a priority at this time.
PART C:
Analysis of State Issues and Challenges [Section 124(c)(3)(C)]:
(i) Criteria for eligibility for services:
There are many programs available to individuals who meet basic categorical eligibility criteria. Each program
has its own eligibility criteria making it challenging to ensure all available services are accessed. Medical and
support services for people with DD are accessed through Medicaid eligibility, which is determined by
comparison of income to the Federal Poverty Level. Different programs use different FPL percents. Individuals
in non-spenddown have an income limit of 85% of FPL. Persons above the non-spenddown income limit must
incur medical expenses equal to the amount their income exceeds the limit before they are eligible. Persons
receiving SSI based on disability are automatically qualified for Medicaid. The Dept of Social Services is charged
with administration of the Medicaid program. Adults with low income that are elderly or disabled, & children with
low income, uninsured, or in state custody qualify. Health and Senior Services operates the Senior and Disabled
Program providing state Medicaid plan services to many people with DD. These programs are provided through
a series of waivers and must be cheaper than nursing home services. DDC believes MO's criteria are too strict
and advocates increasing eligibility to a higher FPR level, increasing asset limits, increasing funding for optional
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services and supports, and raising spenddown levels. Many people with DD hope to access services through
MO's Div of DD who determines eligibility based on functional assessment. Eligibility is determined if there is a
limitation in 2 or more of 6 areas of major life activities. This criterion, in place since good economic times, now
contributes to growing wait lists. There has been some discussion of moving toward the federal definition, but a
priority of need scale allows those with greatest need to be served first. Also, County Boards have been creative
in partnering with the state to develop a prevention waiver. This waiver provides services before needs worsen
and has lessened the pressure of eligibility issues. To stretch funds, DDD insists that individuals eligible for
Medicaid apply. Few receive state-only funded services. This prevention waiver known as the Partnership for
Hope, is considered to be successful. During the first year of implementation (October 2010 – September 2011)
37 counties served 1015 individuals. In FY 2013, this program expanded to 100 counties with the capacity to
serve 2870 participants. As of September 2013, 2014 individuals were receiving services through this waiver.
This waiver can prevent an individual reaching crisis. The number of individuals who receive supports through
this waiver flexes as the state is finding that many individuals are able to have their needs met with limited
services and do not need to continue with waiver services. DDC has been active in addressing the wait lists and
has expressed concern regarding the priority of need process, but has not taken a stand on eligibility criteria. MO
Dept of Elementary and Secondary Education provides services to youth with DD through IDEA Part C and B.
DDC is concerned about the K-21 program as some students are determined eligible for services in a
segregated state school system. DDC advocates for inclusion of all students, but is most concerned about those
who are sent to a separate school program entirely based on cognitive deficits, adaptive behavior and least
restrictive environment. When students leave school, the IEP team may recommend Sheltered Work. VR
determines eligibility. DDC would like to see the state adopt an Employment First policy so that every student
leaving school has supports to seek community employment prior to referral to a workshop. (continued on
attachment)
(ii) Analysis of the barriers to full participation of unserved and underserved groups of individuals with
developmental disabilities and their familes:
Much of MOs service system is provided through a series of community or regional offices. Two large provider
organizations formed a DD System Redesign Work Group with DMH/DDD with the plan to design and implement
an efficient, flexible, locally-based system so people with DD receive the supports they need when they need
them. The Council heard from families who expressed concerns that only one individual with DD was at the table
when working on the redesign as it has the appearance of a provider driven system and not a self-determined
individual and family driven system. The Council was not initially included in the workgroup but will participate in
the new FY. Currently, this system operates in a way that people with DD can contact someone in one program
or another and receive information through the mail and may even receive a visit from a service coordinator.
When things work well, this system obviously will support people who might otherwise be in a category of
unserved or underserved. However, we also know that there are some who have great need but struggle to
complete application forms, find transportation, or otherwise access the system. We also know that state the
service system carries stigma that prevents some people from requesting services or following through with a
request. This is especially true of those with fears of the system based on concerns of losing their children,
unpaid child support payments, etc. The Council knows that the growing wait lists have also been a deterrent for
some of our citizens. Service coordinators have discouraged eligible individuals from staying in the system as
they will not be eligible for more than service coordination for many years or until they experience a crisis such
as death of both parents. We also know that there are many families who have kept their adult son or daughter
with DD in their home for many years with no public assistance. The state is concerned that there may be a
sudden influx of this group as parents age and can no longer assist their family members. Braddock estimates
that MO has 15,487 individuals living at home with older caregivers. Many in this group would be considered
unserved, while others who receive limited services because their families are still able to meet their needs
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would be underserved. Unfortunately, we do not have the capacity to drill down to the real numbers of this
population and provide accurate estimates of Missouri’s unserved and underserved. We also know that the
racial and ethnic populations served in the DD system do not match the state's demographic data as identified in
the most recent census. Of individuals with DD receiving services from the Division, only 2 % are identified as
Hispanic, while the state demographics show that 9% of MO's overall population is of Hispanic origin. This
implies that people of Hispanic ethnicity are an unserved population. African Americans make up 15% of the
state’s population, but 18 % of the Division’s census. While there may be valuable information for the council in
this data, we did not determine that African Americans are an unserved population. This methodology is not
strong, but certainly worth further discussion and monitoring.
(iii) The availability of assistive technology:
MO is fortunate to have an Assistive Technology (MAT) project that is strong and provides excellent services to
many citizens with disabilities. In 2010, MAT touched the lives of 22,593 Missourians with disabilities and
provided 5,803 children, adults and older persons with AT through their services and programs. They host an
annual conference that helps providers as well as individuals with disabilities and families stay abreast of the
latest technology. MAT partnered with the Div of DD to host a well attended webinar to increase case manager,
transition coordinators, and provider awareness of technology. They are also collaborating with the Div to
establish better transition supports for students leaving the school system. MAT supports a loaner program and a
library that is very helpful to those who are unsure what equipment will meet their needs. They provide special
assistance for young children and families newer to the DD world through a Technology for Kids program. They
make adaptive computer equipment available for individuals so that they can have access to the Internet. This
technology may also assist individuals in having better access and increased independence in their own home,
but we know that smart home technology is underutilized in MO. This is partly because of a lack of funding and
MO's very low asset limit. Unfortunately, it is also due to limited knowledge and understanding as well as a lack
of experience in this field by MO contractors. Home adaptations often experience similar challenges. As money
becomes available, MAT offers low interest loans for increasing home access. The Council's Inclusive Housing
Cooperative is also finding ways for individuals or families to adapt their home to increase accessibility and
maintain or increase independent living skills. This project is also working MO contractors and developers to
increase awareness of possible adaptations, accessible and affordable home modifications, and available
technology. We are pleased to see an increased awareness recently of adapting homes to save support costs to
allow people to remain in the community. This resulted from several of the DD waivers being expanded to cover
AT, home modifications and home monitoring systems. The new county waiver (Partnership for Hope) allowed
county boards to provide services at a lower cost by using a state and federal match dollars resulted in supports
for many families that will allow them to keep their loved one at home for years to come. However, making sure
that all families and individuals have access to this AT when it is needed will continue to be a challenge. We
know that some families manage for years with outdated equipment or not using any technology because they
do not know what is available and affordable. Others don’t know how to access these services. Some MO
families rely on the schools to provide youth with AT needed but schools may encourage the IEP team to make
recommendations based on the school districts limited funding rather than the child's true need. Also, this
equipment belongs to the school, not the child or family. In some cases, children are not allowed to bring AT
devices home at night, on weekends or for summer vacations limiting the child's learning in natural
environments. MO is continuing to look at how we can increase awareness of AT and usage to increase
community capacity.
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(iv) Waiting Lists:
a. Numbers on Waiting Lists in the State:
Year State Pop. Total Served Number
(100,000)
Served per
100,000 state
pop.
National
Averaged
served per
100,000
2014
2013
2011
2009
2007
2005
151.000
151.200
151.200
143.100
145.100
138.700
60.940
60.210
60.110
59.880
58.780
58.000
12905
31998
15514
6511
6521
6320
214.000
531.449
258.100
108.700
110.900
109.000
Total persons
waiting for
residential
services needed
in the next year
as reported by
the State, per
100,000
1.000
4.998
2.730
8.860
8.620
8.460
Total persons
waiting for other
services as
reported by the
State, per
100,000
35.000
23.883
17.190
66.310
56.290
56.410
b. Description of the State's wait-list definition, including the definitions for other wait lists in the chart above:
The Division of DD has a new wait list. It is a Transition (non-Medicaid) wait list that has 1642 students who are
approaching age 18. The DDD is being proactive and working with DESE to identify students who would qualify
for Medicaid when they reach age 18. The number of people who are receiving either Medicaid services or case
management only which is considered an un-paid service is 31,998. The total number of people who are served
is showing an increase of 16,484 from last year and previous years as the individuals who are receiving case
management only services which is not considered a paid service, were not included in previous years counts.
The total number of people who are receiving only a paid Medicaid service has remained fairly steady and is
15,942. Due to limitations on availability of funding, the Div of DD is unable to immediately provide svcs to all
individuals w/disabilities. (continued on attachment)
c. To the extent possible, provide information about how the State selects individuals to be on the wait list:
People are selected for the wait list through a determination of eligibility for DD services based on the state\'s
definition of DD. Eligible individuals go through a process that assigns a score to the level of need for an
individual, as set forth in state statutes. Scoring is used to determine access to services when funding is limited
and is applied to all individuals prior to participation in programs.
d. Entity who collects and maintains wait-list data in the State:
Case management authorities
Providers
Counties
State Agencies
Other:
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e. A state-wide standardized data collection system is in place:
Yes/No
f. Individuals on the wait list are receiving (select all that apply):
No services
Only case management services
Inadequate services
Comprehensive services but are waiting for preferred options (e.g., persons in nursing facilities,
institutions, or large group homes waiting for HCBS)
Other: Case Management
Other services:
Case Management
Other services description(s):
16,056 individuals receive case management only and many would use other services if possible. MO partners
with county boards who provide supports through local tax levies. There are people in this system who would
benefit from additional services.
g. Individuals on the wait list have gone through an eligibility and needs assessment:
Yes/No
Use space below to provide any information or data related to the response above:
Once eligibility is determined, individuals go through a process that assigns a score to the level of need for an
individual using a Priority of Need instrument and Utilization Review. Scoring is used to determine access to
services when funding is limited and is applied to all individuals prior to participation in programs.
h. There are structured activities for individuals or families waiting for services to help them understand their
options or assistance in planning their use of supports when they become available (e.g. person-centered
planning services):
Yes/No
i. Specify any other data or information related to wait lists:
Currently MO has 3080 people in its In-home and Transition Wait Lists & 151 people on its Residential Wait List.
As reported previously, MO developed 2 new waivers to serve as a prevention approach before the
individuals’ needs reach a crisis point requiring the more costly Community Support or Comprehensive
(residential) Waiver. The Prevention Waiver (PFH) started small in Oct 2010, but quickly expanded in size &
now serves 2014 individuals. PFH is a creative partnership between county boards that receive local tax dollars
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to serve people with DD & the state and has the capacity to serve up to 2870 people.. Previously, these Boards
served people on the state’s wait list and others who had not been identified by the state at 100% of the
costs. Through the partnership,local & state dollars are pooled to bring in federal match, and maximize
resources to serve more people.
j. Summary of waiting list Issues and Challenges:
There are challenges for the Partnership for Hope Waiver in that not all counties have voted to establish a tax
levy, some choose not to participate & others have small levies which have been fully committed to one of
MO’s 93 sheltered workshops. 100 counties have voted to participate in the PFH waiver. The P4H waiver
has been successful in providing very minimal services that have a huge impact on the lives of individuals who
receive these waiver services.
The DMH/DDD was successful working w/the state budget office to propose mandatory funding to address the
increase in ppl needing waiver svcs. These items included supplemental funding to support ind who have
transitioned from nursing homes into DD services under Money Follows the Person.
A recent development – b/c there are no funds available through GR, the DMH/DDD eliminated the waiting list
for those who qualify for services but don’t have, nor are they eligible to receive Medicaid. The MODDC is
reviewing this decision and would advocate for reinstatement of this waitlist that helps to determine the need of
families in MO. If the state expands Medicaid, some of the families may be eligible for Medicaid services.
(v) Analysis of the adequacy of current resources and projected availability of future resources to fund services:
MO's 2009 data shows the state spends $751.3 million on people with DD and ranks 38th in the nation on
spending for support of people with DD. In 2009, 63% of those receiving services were served in community
settings but as the wait lists reached nearly 5000 individuals in 2010, we are fortunate that MO got creative in
rebalancing the system. A CMS disallowance of a proposed waiver change that would have prolonged
segregated services for many individuals contributed significantly to this rebalance. Instead of increasing
services in segregated settings, MO was approved to implement 2 new waivers that allowed them to serve many
of the people from the wait lists and partner with county DD boards to leverage county dollars while increasing
the Medicaid funds brought in as match. MO has continued to reduce the number of residents in its 6 state run
ICF/MRs to less than 600 people. This is a decline of nearly 800 residents and beds since 1999. There is
disagreement about the actual costs of supporting people in the institutions because of the state's method of
taxing and use of CMS funds, but in the aggregate, the cost is double that of community living. The DDC is also
concerned about the 2000 individuals with DD reported to reside in nursing homes and the nearly 200 individuals
who are in private ICF/MRs or 16+ waiver residential facilities. The Money Follows the Person grant has
assisted 131 individuals in transitioning to community settings but unfortunately has done little to assist those
with DD who are in nursing homes or these private settings. MO, like most states does not anticipate a
significant increase in revenue. MO's revenue decline of FYs 2009 and 2010 is the largest sustained decline
since the Great Depression of the 1930s. Revenue estimates for fiscal year FY 2012 remains $709 million below
FY 2008 revenue collections. Advocates fear that the economic challenges and our conservative leadership will
actually reduce spending on long-term care and supports and therefore, it is very important that we continue to
transition away from costly segregated settings to community supports and to waivers that allow families to
support their loved one at home. MO's poverty rate continues to rise and our unemployment rate has stayed
high (8.9% in May of 2011) which will continue to lead to a slow recovery. We have also experienced a series of
natural disasters that will challenge our state's budget for years to come. Our educational system continues to
be underfunded and leaves many local schools struggling to meet the needs of all students. While we expect
the economic challenges of our state to continue to make funding for services challenging, we are pleased that
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the new county waiver system has brought additional dollars to the table and that additional counties are
pursuing putting tax levies into place in order to participate in this option.
(vi) Analysis of the adequacy of health care and other services, supports, and assistance that individuals with
developmental disabilities who are in facilities receive:
MO has continued to fall in the national ranks of health care & is now at 39th in the nation. The United Health
Foundation reports that we continue to decline in such health related issues as health behaviors, public and
health policies, and community and environmental conditions. We have high rates of smoking and obesity. Our
spending on public health is $9.26 a person as compared to a national average of $28.92. We spent 16.3 % less
for public health in 2010 than in 2000. 41% of those under 100% of the FPL are uninsured. A Kaiser Family
study reported in 2009 that MO has an uninsured population of 826,600 and this number has most likely
continued to increase with the recession. MO is designated as a primary care and dental health professional
shortage area. Many individuals with disabilities will experience these same general trends. If they have been
determined to be Medicaid eligible, they may receive some services, but there are many challenges still reported.
People with Medicaid must drive many miles for dental care and in some areas of the state, there is a shortage
of physicians who will provide care for those who use Medicaid. Those in the 6 state run ICF/MRs are generally
eligible for Medicaid and the state has contracted or hired physicians and dentists to provide needed services.
However, advocates have observed that dental care still seems inadequate as many of the long-term residents
are missing teeth or have dental problems. This is especially a concern for the DDC as some families and
guardians of those who reside in the institutions say that they want their ward to remain in the institution as they
are concerned that medical and dental care will not be available in the community. The Independent Reviews of
the ICF/MRs have few medical issues identified, but the Dept of MH's Annual Safety Report describes several
statistics that indicate the status of healthcare for Missourians with DD. There has been a fairly steady rate of
injuries to individuals in the state ICF/MRs reported since April of 2008. The quarterly number varies from a low
of 67 to a high of 106, but as the census went from 880 to 704, one would expect a gentle decline. The majority
of these injuries required medical intervention or emergency room visits. Community Injuries during this same
period have demonstrated a slight decline with some bumps in the 2nd quarter of 2009 and 1st quarter of 2010.
The highest incidents of injury in community placement were 398 in April-June of 2008 and the lowest was 315 in
July-Septembers of 2009. The number of residents in community placement has increased from 5954 to 6738.
Medication errors are also tracked for the state ICF/MRs. Med errors where minimal adverse consequences and
no treatment are needed have increased since the state began tracking this data in April of 2008 from 4.36 to
7.05 per 100 consumers per month. Medication errors in the community have decreased per 100 consumers per
month from 9.74 in April-June 2008 to 5.63 in January –March 2010. Another finding in this report is that 34 or
6.49 % of the adults use 5 or more psychotropic meds for 60 or more days. Another 4 or .76% use 3 or more
antipsychotic meds for 45 or more days. The division is concerned about this and has been communicating with
physicians and offering training, but has had limited success in lowering these numbers. Community numbers
are tracked as well but demonstrate less usage of psychotropic medications. Chemical, physical, and
mechanical restraints have all been shown to decrease from higher usage reported in early 2009. Almost all
individuals in the state ICFs have behavioral support programs; generally around 80-87%. The average age of
death in our state run ICFs is 54.50, while it is 45.18 in the community and 72.6 for the general population. The
state has sponsored a nationally recognized study about these early deaths but has not been able to find
comparable data or resolve this cause.
(vii) To the extent that information is available, the adequacy of home and community-based waivers services
(authorized under section 1915(c) of the Social Security Act (42 U.S.C. 1396n(c))):
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People w/DD & families often state that they are fortunate to be able to access one of the Div of DD's 5 waivers.
There are some individuals who receive services under other programs & waivers which may or may not
adequately meet their needs. DDD's Comprehensive Waiver serves 7698 individuals at an average cost of
$53743. 76% of the individuals served live in ISLs or group homes in the community but the remainder live w/
their families. 1250 individuals receive services through the Community Spt Waiver which has an approximate
average cost of $8800. This waiver has allowed many families to support their family member at home rather
than look to the state to provide residential supports. The Children's waiver serves 191 individuals, the Autism
Waiver serves 146 individuals and the newest waiver, Partnership for Hope is a county-based waiver that serves
888 individuals who live in the community, usually with their families. This series of waivers has allowed MO to
rebalance their services toward a robust community system. Less than 600 people receive services in the state
ICF/MRs & this number continues to decline. There are nearly 200 individuals in private ICFs or 16+ bed waiver
facilities, but current leadership shares our concern that people w/DD belong in the community. There are 4101
people waiting for in-home services & 360 people waiting for residential services so we know that our service
system is not adequate. However, we are pleased to report that the state anticipates case load growth funding in
the near future that will allow them to serve 275 of the individuals waiting for in-home services & 105 of the
individuals waiting for residential services. The Div also anticipates that many of those on the residential list
would not accept placement if it were offered but have held their position reasoning that years on the list rather
than priority of need will allow them services sooner. DDC is concerned that there are individuals needing
services but who are not on the list because they feel the wait is hopeless. We know that by partnering with
County Boards to implement the PFH Waiver, 318 individuals were identified that were not currently on the wait
lists and likewise, the new Autism Waiver brought 60 individuals forward who were not listed with those waiting.
The DDC feels strongly that the state should continue & expand efforts to carefully close the 6 ICFs & especially
some of the multiple campuses for the ICFs. While some state leaders tell us that there would be no savings, it is
clear that in the aggregate it is much more costly to support people in institutions. The council also believes we
need to increase inclusion in school, improve transition practices & increase employment opportunities to assist
people w/DD to develop skills that allow them to live in the community & access natural supports when possible
rather than expensive specialized services. The Council also believes & is trying to assist the Div to increase
opportunities for people w/DD to live in their own homes. We know that individuals’ families or other support
systems can assist in maintaining less costly & more independence in home ownership. The Div is investigating
& looking to expand shared living options as a reasonable cost option that supports community life. We have
worked together to increase self-determination options & self-direction to not only allow individuals to have more
control over their lives but to also have better access to natural supports. For those who receive services through
other programs, we are less sure about the adequacy of services. They do have services as outlined in the state
plan, but in many cases they do not have the options provided by the waivers that allow for community
opportunities. For people with DD, it is often impossible for them to self-direct their services because of tough
rules on functional level.
PART D:
Rationale for Goal Selection [Section 124(c)(3)(E)]:
The MODDC conducted a review of the current goals in the State Plan and determined that the goals and
objectives outlined continue to be relevant. The MODDC had two obj. each for guardianship and victimization.
The two obj. for guardianship were very similar as were the activities. This was true of the objectives for
victimization. Therefore, to ensure clarity, the MODDC consolidated the 2 guardianship obj. into one and it now
reads: By 9/30/16, the number of full guardianships in Missouri will decrease by 15%. The victimization obj. is: By
9/30/16 Support the work of the Missouri Victimization Task Force to decrease the number of adults with
developmental disabilities who are sexually, physically, verbally, or fiscally victimized by addressing change in
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policies and practices in all aspects of victimization such as prevention, identification, intervention, reporting,
investigation, prosecution and supports and services. The intent, impact, activities and outcomes expected
remain unchanged.
(i) Council membeship rotation plan: A number of boards and commissions find it difficult to keep their
membership up-to-date and this is also true of the MODDC’s membership despite numerous contacts with the
Governor’s Office to request that terms of MODDC members be addressed either through re-appointments of
terms or replacement of vacant or expired terms of members.
PART E:
Collaboration [Section 124(c)(3)(D)]
(i) As a Network:
The MODDC and its network partners have regular, ongoing conversations regarding the goals and focus of ea
entity and how we can collaborate to achieve our desired outcomes. While the broader group's concerns and
goals are always considered in these conversations, the Division of DD, self-advocates and other stakeholders
are frequently invited to participate in collaborative efforts. The MODDC partnered with both entities to
implement the guardianship training curriculum developed by the partnership and tracking outcomes for the
training. A manual was prepared for families and individuals who will struggle with this issue in the future and the
three entities are working together on the legal policies and practices that influence MO's guardianship usage.
Additional stakeholders are engaged in this project as well which we anticipate will lead to much support in our
upcoming efforts to change the state statutes and re-train MO's legal system to better protect the rights of
individuals with DD. All network partners are also working together to strengthen MO's community capacity and
rebalance its service system from one of segregation to one of inclusive opportunities for all citizens. The DD
network partners are also collaborating regarding the DD service system redesign as well as address
victimization of individuals with disabilities in MO. Sometimes this involves conferring is a "behind the scenes"
because of MO's political challenges and in others each entity assumes agreed on roles and responsibilities.
(ii) With each other: (e.g. Describe the plans the Council has to collaborate with the UCEDD(s). Describe the
plans the Council has to collaborate with the P&A.)
The DD network collaborate extensively on issues that impact people with DD. The MODDC and P&A recently
completed a demonstration project to help people w/DD who recently moved into the community from a state
institution. This citizen advocacy project assisted these individuals in building relationships & becoming more
engaged in the community as well as developing a stronger system to ensure their health & safety in the
community. This project evolved out of our shared concerns that families & guardians complained that their loved
one would not be safe in the community & that once in the community individuals w/DD were often relegated to a
system as restrictive as the institution from which they moved. In addition to the guardianship project that
incorporated People FIrst and ensures individuals who move to the community are able to lead quality lives, the
network collaborates on a number of initiatives. The P&A coordinates the network display for conferences.
Folders were developed that are used to provide information about each organization to families and individuals
with DD so that they are aware of the network and other resources. All DD network partners are working together
to address the DD system redesign. The MODDC recently established a victimization task force that includes
the DD network in addition to other key stakeholders.
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(iii) With other entities: (e.g. network collaboration with other entities in the State, including both disability and
non-disability organizations, as well as the State agency responsible for developmental disabilities services)
The Network partners look for ways to strengthen and broaden their projects and outcomes by working in
collaboration with other stakeholders. We have included People First and our County Board Association in
public awareness efforts. We worked with People First, providers, and the Division of DD as we addressed
self-determination and self-direction. We are partnering with People First to strengthen the network of
self-advocacy across the state and prepared this organization to reach out and support those who are newer to
the community, especially people with DD who are transitioning to the community from one of the state's
institutions. We have included the Public Administrator, Bar Association, and County Court system in our
guardianship efforts. We have reached out to the MO Housing Development Corporation, Mental Health
Housing Team and others as we developed a system to increase community housing opportunities for people
with DD. We are working with key legal systems, law enforcement to include the FBI, Sheriff’s Association,
Highway Patrol, hospitals, hotline services and others to address victimization. The MODDC has a strong
relationship with the County Board Association and the Provider Associations as these organizations provide us
with better understanding of the systemic issues and challenges faced by those individuals who provide
community services and supports to people with DD and their families. As we have continued to strengthen our
legislative advocacy and public policy advocacy, we have broadened our collaborative efforts to include the
Independent Living Centers, Brain Injury Association, AAIDD, APSE, and Mental Health groups in order to better
coordinate our message to MO policymakers thus strengthening our message and achieving better outcomes.
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Section IV : 5-Year Goals [Section 124(4); Section 125(c)(5) and (c)(7)]
GOAL # 1: Education
In partnership with others, the Missouri Developmental Disabilities Council will engage in advocacy, capacity
building, and systemic change to increase the number of youth with developmental disabilities who will receive
inclusive educational and socialization opportunities that prepare them to transition and function as
self-determined adults in their community.
Area(s) of Emphasis:
Strategies to be used in achieving this goal:
Quality Assurance
Outreach
Education and Early Intervention
Training
Child Care
Technical Assistance
Health
Supporting and Educating Communities
Employment
Interagency Collaboration and Coordination
Housing
Coordination with related Councils, Committees and
Transportation
Programs
Recreation
Barrier Elimination
Formal and Informal Community Supports
Systems Design and Redesign
Coalition Development and Citizen Participation
Informing Policymakers
Demonstration of New Approaches to Services and
Supports
Other Activities
Objective: 1.1
By 9/30/16 increase by 20 percent the number of youth with developmental disabilities receiving
general education services more than 80 percent of their day in at least three targeted public school
districts.
Activities
1. Finalize competitive CFI parameters and expected outcomes for development and implementation
of a combination peer mentoring/tutoring model in at least 3 highschools
2. Release CFI
3. Select grantee and execute contract
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4. Assist grantee in hosting summit on value and anticipated outcomes of a mentoring model
5. Assist grantee in selecting 3 highschools that will provide us with a broader understanding of
potential outcomes of peer mentoring
6. Maintain ongoing involvement in implementation to allow for close monitoring of outcomes and
course corrections for this project
7. Monitoring of progress toward outcomes and reporting of data that can be used to market and
encourage replication of this project
Timeline
1. Summer 2011
2. Fall 2011
3. Fall 2011
4. Spring 2012
5. Spring 2012
6. Fall 2012-Fall 2014
7. Fall 2012-Fall 2014
Objective: 1.2
By 9/30/16 increase by 20 percent the number of youth with developmental disabilities who transition
to employment or post-secondary education in at least two targeted communities.
Activities
1. Explore & research ways to increase students' likelihood of transition to work or higher levels of ed
2. Identify outcomes that meet the expectations of indivdiuals with DD & their families
3. Develop evaluation plan that assesses transition of students to competitive employment & supports
schools through this process
4. Research & explore practices that support students w/DD to enroll & remain in neighborhood
schools rather than starting school or transitioning to MO's State Schools for Severely Disabled
5. Research & explore barriers & opportunites for studetns enrolled in the state school system
returning to their neighborhood schools
6. Assess feasibility of developing & evaluating a project that will demonstrate schools can be
supported to bring these students back to neighborhood schools
7. Publicize positive findings & outcomes & provide training & guidelines to asist all schools to support
students with the most significant disabilities in neighborhood schools
Timeline
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1. Fall 2012
2. Fall 2012
3. Fall 2012
4. Fall 2012
5. Fall 2012
6. Fall 2012
7. 2012-2016
Objective: 1.3
By 9/30/16 influence at least two policies that will afford youth with developmental disabilities more
access to inclusive education or socialization opportunities leading to increased opportunities following
graduation.
Activities
1. Research barriers & opportunities regarding students w/DD participating in inclusive education
settings, accessing social opportunities and transitioning to employment or higher educational
opportunities
2. Build collaborative relationships with stakeholders that will generate support for policy change
3. Develop and implement a strategic plan to educate policy makers and legislators on the
expectations of indivdiuals w/DD and their families
4. Share findings from projects and studies with diverse audiences through material distribution and
public awareness efforts to promote systems change and policy changes
Timeline
1. Fall 2011-2016
2. 2012-2016
3. 2012-2016
4. 2012-2016
Objective: 1.4
By 9/30/16 increase by 20 percent the number of youth with developmental disabilities to be included
in socialization activities with their non-disabled peers in two targeted communities.
Activities
1.Integrate socialization activities into Peer Mentoring project and assist grantee in implementing this
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component and tracking outcomes
Timeline
Summer 2013 - Fall 2014
Objective: 1.5
Activities
Timeline
Intermediaries/Collaborators Planned for this goal (if known):
State and P&A
University Center(s) for Excellence
State DD Agency
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GOAL # 2: Access, Self-Determination & Civil Rights
In partnership with others, the Missouri Developmental Disabilities Council will enhance awareness,
understanding and access to evidence-based best practice and services that support individuals to be
self-determined, enjoy the same human and civil rights as others to allow them to live and work in communities,
and be a valued member of that community.
Area(s) of Emphasis:
Strategies to be used in achieving this goal:
Quality Assurance
Outreach
Education and Early Intervention
Training
Child Care
Technical Assistance
Health
Supporting and Educating Communities
Employment
Interagency Collaboration and Coordination
Housing
Coordination with related Councils, Committees and
Transportation
Programs
Recreation
Barrier Elimination
Formal and Informal Community Supports
Systems Design and Redesign
Coalition Development and Citizen Participation
Informing Policymakers
Demonstration of New Approaches to Services and
Supports
Other Activities
Objective: 2.1
By 9/30/16 increase to 15 percent the number of people with developmental disabilities who are
employed in competitive community-based employment.
Activities
1. Support staff & members to take leadership roles in various statewide organizations, i.e., APSE,
AFP, SELN, DDD Employ Team, BLNs & other business partnerships addressing employment
2. Provide leadership for October Disability Employment Awareness Month activities
3. Encourage utilization of council resources that increase understanding of employment opportunities,
i.e., Empower MO, Success Stories, Career Discovery Guide, etc.
4. Contract w/WID to develop a MO application of the Disabilities Benefits Calculator for adults &
youth & expand collaborative relationships to encourage usage
5. Partner with UCEDD to develop a curriculum and implement entrepreneurialship project
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6. Engage in public awareness efforts promoting models that increase non-facility based employment
for people w/DD, encourage employer involvement and suport, and increase expectations of youth
w/DD, families and stakeholders regarding competitive employment
Timeline
1. 2012-1016
2. 2012-2016
3. 2012-2016
4. 2012-2016
5. Spring 2012
6. 2012-2016
Objective: 2.2
By 9/30/16 200 adults will develop meaningful relationships in their community.
Activities
1. Implement and sustain Citizen Advocacy projects in two MO comunities wher many individuals are
transitioning from segregated settings to homes in the community
2. Assess the feasibility of expanding this project to a larger MO community and to areas where
residents are transitioning to the community from their parent's home rather than institutions
Timeline
1. 2012-2016
2. Fall 2013
Objective: 2.3
By 9/30/16 increase by 200 individuals the number of people with developmental disabilities who have
access to and are supported in community homes of their own.
Activities
1. Continue to support and partner with the MO Inclusive Housing Corporation
Timeline
1. 2012-2016
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Objective: 2.4
By 9/30/16 8,000 self advocates and/or family members will readily have access to information and
other supports that assist them in using advocacy, capacity building and systems change to better
direct services and supports that meet their individual needs and that influence public policy and
practices.
Activities
1. Continue to spt DDRC F2F Res Ctr but with decreasing funding & increasing efforts to promote this
as a collaboratrive effort of stakeholders
2. Continue to ssptleadership trng through Partners
Partners Post-Grad trng & other internal
conferences & trng
info purposes
4. Continue to track info obtained from website
5. Continue to participate in other activities that increase awareness among ppl w/DD, families &
stakeholdes and the public through displays, folders, etc.
6. Continue to spt the dev of a statewide fam adv networ kthru support of the Arc grant addressing
waitlists
7.Particpte in efforts to redesign DMH/DDD Service system, iInform
families of systems change
efforts for the DD System Redesign and new HCBS rul
Timeline
1. 2012-2016
2. 2012-2016
3. 2012-2056
4. 2012-2016
5 2012-2016
6. 2012-2016
7. 2015-2016
Objective: 2.5
by 9/30/16 increase access to quality health care services for all people with developmental disabilities
through advocacy, capacity building and systems change that leads to improved policies, practices
and funding for Missouri's citizens with developmental disabilities.
Activities
1. Council staff and members will continue to participate in healthcare efforts such as the Disability
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Coalition for Healthcare Reform to guide our advocacy regarding healthcare and to support statewide
efforts to improve healthcare for people w/DD
2. Council will continue to look for ways to use advocacy efforts to promote better health care for MO
citizens w/DD
Timeline
1. 2012-2016
2. 2012-2015
Objective: 2.6
By 9/30/16 three communities will have developed a community-wide, accessible, affordable
transportation system.
Activities
1. Analyze outcomes and methodology of earlier successful transportation projects and explore
coordination of existing resources that will support additional communities to develop and sustain
accessible, affordable, inclusive public transportation systems that allow people w/DD to have
increased access to their community
Timeline
1. 2012-2016
Objective: 2.7
By 9/30/16 at least three of the six state-run habilitation centers will close.
Activities
1. Continue to support current and additional public awareness projects, legislative adovacacy and
coalitions that focus on transitioning individuals to community settings and increasing community
capacity
Timeline
1. 2012-2016
Objective: 2.8
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By 9/30/16 improve five public policies that limit the rights or opportunities of individuals with
developmental disabilities.
Activities
1. Work with individuals w/DD, families & other stakeholders to research barriers & identify
opportunities regarding policies & practices that limit the rights or opportunities of people w/DD
2. Build collaborative relationships with stakeholders that will generate support for policy change
3. Develop & implement a strategic plan to educate policymakers & legislators on the expectations of
individuals w/DD & their families
4. Share DD specific informatio &, findings from projects & studies with diverse audiences through
material distribution & public awareness efforts to promote systems change, improve policies &
publicize the work of the Council
5. Continue to support the Arc Waitlist Grant project focusing on increasing funding and services and
decreasing waitlist for people w/DD
Timeline
1. Fall 2011-2016
2. 2012-2016
3. 2012-2016
4. 2012-2016
5. 2012-2016
Objective: 2.9
By 9/30/16, the number of full guardianships in Missouri will decrease by 15%.
Activities
1. Continue to lead and support the work of the guardianship taskforce to develop recommendations
for updated statutes on guardianship
2. Continue to monitor numbers of full guardianships, any change in less restrictive alternatives to full
guardianship and resources available to assist individuals who wish to change their guardianship
Timeline
1. 2012-2016
2. 2012-2016
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Objective: 2.10
By 9/30/16 Support the work of the Missouri Victimization Task Force to decrease the number of
adults with developmental disabilities who are sexually, physically, verbally, or fiscally victimized by
addressing change in policies and practices in all aspects of victimization such as prevention,
identification, intervention, reporting, investigation, prosecution and supports and services.
Activities
1.
Increase council understanding of victimization issues by exploring and researching existing
information regarding sexual, physical, verbal and fiscal victimziatin to increase understanding and
awareness of the issues.
2. Monitor health, safety, and prevention of individuals who have transitioned from ICFs/MR to the
community through Citizen Advocacy Projects.
Timeline
1. 2012-2016
2. 2012-2016
Objective: 2.11
By 9/30/16, 1,000 self-advocates and families will have information to develop personal preparedness
plans in the event of an emergency.
Activities
1 Participate in activities that increase the awareness of persons with I/DD and their families regarding
implementation of personal preparedness plans.
2 Film preparedness webinar specific to persons with disabilities in collaboration with the MO
Family-to-Family Network.
3 Develop preparedness campaigns and tools.
4 Provide preparedness training opportunities.
Timeline
1. 2013 – 2016.
2. Fall 2013.
3. 2013 – 2016.
4. 2013 – 2016.
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Objective: 2.12
By 9/30/16 at least 50 local and statewide policies, operations plans and resources will be improved to
incorporate model practices in inclusive emergency management.
Activities
1 Participate on Governor’s Faith-based and Community Service Partnership for Disaster Recovery
Committee.
2 Participate in the work of the statewide Access and Functional Needs Committee that is in the
process of developing policies, operation plan templates, tools, training and practices in the
emergency management field.
3 Participate in the development, launch and implementation of Functional Assessment Support Team
(FAST) training as well as development of statewide and regional FASTs.
4 Release CFI.
5 Lead the development of a smartphone app specific to MO, “TIPS for First Responders,” in
collaboration with Texas A&M, SEMA and DHSS.
6 Work with the MO Inclusive Housing Corporation, SEMA and the Housing Corporation to affect
policies for temporary housing, permanent housing and building codes for homes built following a
disaster.
Timeline
1. 2013 – 2016.
2. 2013 – 2016.
3. 2013 – 2016.
4. 2015.
5. 2013 – 2014.
6. 2013 – 2016.
Objective: 2.13
Activities
Timeline
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Intermediaries/Collaborators Planned for this goal (if known):
State and P&A
University Center(s) for Excellence
State DD Agency
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GOAL # 3: Self-Advocacy
The Missouri DD Council will collaborate with self-advocates to provide competency-based and experiential
leadership training opportunities that will lead to increased self-direction. Self-advocates will increase active
participation in statewide and/or community cross-disability coalitions where they will also serve in leadership
positions thus, growing and strengthening the self-advocacy movement.
Area(s) of Emphasis:
Strategies to be used in achieving this goal:
Quality Assurance
Outreach
Education and Early Intervention
Training
Child Care
Technical Assistance
Health
Supporting and Educating Communities
Employment
Interagency Collaboration and Coordination
Housing
Coordination with related Councils, Committees and
Transportation
Programs
Recreation
Barrier Elimination
Formal and Informal Community Supports
Systems Design and Redesign
Coalition Development and Citizen Participation
Informing Policymakers
Demonstration of New Approaches to Services and
Supports
Other Activities
Objective: 3.1
1. By 9/30/16 support at least 1,000 self advocates in leadership training programs that will increase
the leadership skills and numbers of self-advocates who become better organized as they exercise
self-determination via participation in statewide and community coalitions.
Activities
1.
Continue to provide support for MO's People First Organization to host a statewide biannual
conference, to attend the biannual national conference, and self-advocacy training camp.
2. Cointinue tu suport MO self-advocates to participate in leadership training oppotunities such as
Partners in Policymaking, Partners Post-Grad Training and other internal conferences and trainings.
Timeline
2012-2016
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Objective: 3.2
2. By 9/30/16 support a statewide self advocacy organization to assist them in strengthening and
meeting their defined organizational goals.
Activities
1. Contiue to support the statewide People First Steering Committee.
Timeline
2012-2016
Objective: 3.3
By 9/30/16 support the active participation of people with developmental disabilities on at least five
cross-disability and diverse coalitions.
Activities
1. Explore the development of a project that demonstrates best practice regarding the leadeship,
participation and involvement of self-advocates on various boards and commissions.
Timeline
2012-2016
Intermediaries/Collaborators Planned for this goal (if known):
State and P&A
University Center(s) for Excellence
State DD Agency
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Section V : Evaluation Plan [Section 125(c)(3) and (7)]
• Outline how the Council will examine the progress made in achieving the goals of the State Plan.
• Explain the methodology, which may be qualitative or quantitative, thatwill be used to determine if the needs
identified and discussed are being met and if the Council results are being achieved.
• Describe the Council's role in reviewing and commenting on progress towards reaching the goals of the Plan.
• Describe how the annual review will identify emerging trends and needs as a means for updating the
Comprehensive Review and Analysis.
The Council will continually evaluate the state plan progress through both qualitative and quantitative methods.
Using the logic model, each project will be monitored to ensure that we are bringing the right resources (inputs)
to the table, tracking outputs and achieving outcomes that are immediate, intermediate and systems change,
long-term outcomes. As projects and activities are developed, we will continue to rely on this model of
outcome-driven thinking to assist us in planning and designing an evaluation process that measures progress
toward our intended plan goals. The working committees or assigned groups will track the formative processes to
ensure that each project or activity is achieving its objectives, carrying out the strategies and implementation
activities as required by the contract or grant, and keeping the Council informed about their progress and
challenges that need to be addressed. The committee members will provide leadership as the Council appraises
the summative evaluation process by monitoring progress toward the immediate, intermediate and long-term
outcomes. Each project or activity is required to have a clear plan in place to track outcomes and measure
impact prior to receiving funding or staff time and commitment. Council members as well as staff are required to
think about the evaluation plan, not just the intent. We are putting better research efforts into place prior to
picking a project to ensure that it will truly influence the plan goals and objectives. Advocacy, training or other
work that challenges our ability to track outcomes will not be exempt from this way of thinking.
By using the logic model, the Council will have a meaningful & measurable method in place to track outcomes of
projects, activities & advocacy. Diverse & multifaceted methods of measurement will be used for projects to
guide in understanding progress & outcomes. Many projects will rely on both qualitative & quantitative
measures. We are committed to tracking impacts of our work & recognize in some cases this will require
qualitative measures such as pretests & posttests, focus groups & follow up calls. We are looking into methods
of rewarding activity participants for staying engaged & reporting their work. We intend to measures impact of
any trainings on participant actions & behaviors over a period of time. We are looking carefully at the impact &
communication power of the quantitative data we track in demonstrating clear progress toward the intended
goal. MDDC will continue to use staff time & monitoring work to influence projects & activities. We know that
keeping a staff person & in some cases Council members involved in a project yields higher results. We have
increased the criteria for selecting potential grantees/contractors to ensure outcomes that move MO toward the
Council's plan & goals. Each project is required to develop benchmarks in conjunction with staff & committees &
ongoing funding is generally tied to their ability to make progress on these benchmarks. We also require that all
projects address sustainability from the beginning. We know that when project leaders are required to report
progress & work toward sustainability from the onset, they take this responsibility more seriously. We charge
each grantee w/assisting us in tracking & reporting data that truly impacts Missourians w/ DD or the target
population. The MDDC will continue to request that each grantee assist us w/efforts to take successful projects
statewide. We require whitepapers, presentations at conferences, how-to manuals, & other means of sharing info
w/additional communities, schools or providers. We frequently request that grantees volunteer to remain
available for 2 or more years after project end so we can use their expertise to assist us or others in replication.
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We often begin and/or end our grants with a focused trng that develops & supports a learning community to
discuss & work together to expand the potential outcomes & address challenges. MDDC partners w/key
stakeholders so they too can monitor the progress of Council projects & activities. This can bring additional
opportunities to bear for the grantees/contractors. Recently, we found that the Div of DD & VR were engaged to
pilot using state dollars to support efforts of one project because of this type collaboration. We have assisted
grantees w/similar projects & share trng or work together to resolve challenges. We are committed to using the
eval process to demonstrate outcomes & will not move forward until a clear plan to assess short/long-term
outcomes is in place.
The Council and each of the working committees meet face to face on a bimonthly basis and the committees
frequently have conference calls in-between. At a minimum, the committees will review and thoroughly discuss
progress of each project assigned to them as well as the implementation activities identified by the group during
the face-to-face meetings. They will report out to the larger membership at each meeting on the progress of their
assigned projects and seek input from the broader group. Committee members receive copies of quarterly,
six-month, and annual project reports. Grantees or contractors for the Council's larger projects are often asked
to present their project outcomes and progress to the Council or to present at a conference or training where at
least some of the committee members will be available to hear the presentation. Council members have been
encouraged to assess advancement on both the process and the progress toward the long-term goal established
by the state plan. In some cases, committee members may be asked to help interview or track outcomes from a
particular project. Members actually participate in a few projects to assist them in personal or professional
growth as well as to assess the impact of the project.
The working committees' receive and seek information about trends of key issues at both the state and national
level. They are supported in tracking changes to our state's needs and challenges as well as the
accomplishments. Representatives from relevant state agencies are included in the committee membership
which allows the group to receive continuous feedback and input from the agency's perspective. Guests are
invited to these committees as well to assist members in better understanding their charge, responsibilities and
state trends. Committees often take the lead in challenging the council's advocacy efforts regarding their focus
areas. Their ongoing discussion and analysis guides future projects and leads to any necessary course
corrections on current projects. Members are supported and encouraged to participate in state level meetings
where policy decision are being made. This allows them to continue to gain knowledge and understanding of
state and federal issues as well as to provide input from the perspective of individuals with DD and their families.
Their work also assists them in identifying information that they want the entire Council to have and understand.
Each committee provides an update on their work during the council meetings. The Council has an annual
meeting or retreat in which a more in-depth discussion on key areas of concern are discussed and the details of
the comprehensive review and analysis are reviewed so that the plan can be updated or adjusted as needed.
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Section VI : Projected Council Budget [Section 124(c)(5)(B) and 125(c)(8)]
Goal
Subtitle B
1. Education
2. Access, Self-Determination & Civil Rights
3. Self-Advocacy
4. Functions of the DSA
5. General Management
Totals
185,049
733,564
250,049
0
128,100
1,296,762
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Non-Federal
Share
12,778
165,782
34,444
0
42,700
255,704
Total
197,827
899,346
284,493
0
170,800
1,552,466
Page 39 of 41
Section VII : Assurances [Section 124(c)(5)(A)-(N)]
Written and signed assurances have been submitted to the Administration on Intellectual and Developmental
Disabilities, Administration for Community Living, United States Department of Health and Human Services,
regarding compliance with all requirements specified in Section 124(c)(5)(A-N) in the Developmental Disabilities
Assistance and Bill of Rights Act of 2000:
Assurances submitted
Approving Officials for Assurances
For the Council (Chairperson)
For DSA, when not Council
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Section VIII : Public Input and Review [Section 124(d)(1)]
PART A:
How the Council made the plan available for public review and comment and how the Council
provided appropriate and sufficient notice in accessible formats of the opportunity for review and comment.
The revisions made to the Plan was re-wording and consolidation of the victimization and guardianship
objectives to make them more clear. The Community Living Goal, activities, intent, expected outcomes
and timelines did not change.
Therefore it was not necessary to seek public comment.
PART B:
Revisions made to the Plan after taking into account and responding to significant comments.
The revisions made to the Plan was re-wording and consolidation of the victimization and guardianship
objectives to make them more clear. The Community Living Goal, activities, intent, expected outcomes
and timelines did not change.
Therefore it was not necessary to seek public comment.
OMB 0980-0162
2015 DD Suite State Plan : Missouri Developmental Disabilities Council
Page 41 of 41