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