TO ASSURE CONTINUED COMMUNITY INTEGRATION
OF VIRGINIANS WITH DISABILITIES
2009 Progress Report
Adopted June 23, 2009 Pursuant to Executive Directive 6 (2007)
By the Community Integration Implementation Team
Submitted to The Honorable Timothy Kaine, Governor of Virginia
August 10, 2009
Table of Contents
I. INTRODUCTION 2
II. EXECUTIVE SUMMARY:
2008-2009 COMMUNITY INTEGRATION HIGHLIGHTS 2
III. 2009 PROGRESS REPORT BY CRITICAL SUCCESS FACTOR 5
Critical Success Factor #1: Plan, Understand, Choose and Self-Direct
Services and Supports 5
Critical Success Factor #2: Choose Among Quality Community
Providers and Direct Support Professionals 10
Critical Success Factor #3: Obtain Housing 13
Critical Success Factor #4: Locate and Obtain a Job 20
Critical Success Factor #5: Access Transportation 22
Critical Success Factor #6: Surrogate Decision-Making 25
Critical Success Factor #7: Access Ongoing Supports: Community 25
Critical Success Factor #7: Access Ongoing Supports: Facilities 29
Appendix I A Guide to Acronyms Used in This Progress Report Appendix II Executive Directive 6 (2007)
2009 Progress Report: Community Integration for Virginians with Disabilities 1
VIRGINIA’S COMPREHENSIVE, CROSS-GOVERNMENTAL
STRATEGIC PLAN TO ASSURE CONTINUED COMMUNITY INTEGRATION
OF VIRGINIANS WITH DISABILITIES
2009 Progress Report
On August 2, 2007 the four Secretariats, two Councils, 21 Executive Branch entities, and six local government and agency representatives comprising the Community Integration Implementation Team (Team), and the 21-member stakeholder Community Integration 1Advisory Commission (Commission) jointly adopted Virginia’s first Comprehensive, Cross-
Governmental Strategic Plan to Assure Continued Community Integration of Virginians with Disabilities (the Plan) pursuant to Executive Directive 6 (2007). The original Plan was submitted to the Honorable Timothy Kaine, Governor, on August 31, 2007.
Executive Directive 6 charges the Team to annually update the Plan and report on implementation progress by August 31 of each year. The original 2007 Plan was updated and submitted to Governor Kaine in August 2008. The Team respectfully submits this 2009 2Progress Report, which measures progress in implementing the 2008 updated plan.
How the 2009 Progress Report Was Prepared
Each of the 21 state entities having a role in implementing various components of the Plan was asked to provide an update on progress covering the July 2008 to May 2009 period. This Report represents a compilation of the agencies’ reports, additional publicly available
information, and progress reports made by four Team Task Groups that developed recommendations on portability of the auxiliary grant, family members as providers, housing barriers, and proposed amendments to the nurse and medical practices and drug control acts. This Report was presented to the Commission and approved by the Team on June 23, 2009. Acronyms used in this Progress Report appear at Appendix I. Executive Directive 6 (2007) appears at Appendix II.
II. EXECUTIVE SUMMARY: 2008-2009 COMMUNITY INTEGRATION HIGHLIGHTS
This section highlights major initiatives of the past year that move Virginia closer to attaining the Plan’s two goals:
1) Virginians with disabilities who currently reside in a mental health, mental retardation (now intellectual disability), nursing or assisted living facility will have the opportunity to choose to move from these facilities to an appropriate, more integrated setting and stay there; and 2) Virginians with disabilities who are at risk of unwanted admission to a mental health, mental retardation (now intellectual disability), nursing or assisted living facility, will have the opportunity to receive services and supports that prevent admission.
1 SB 1062 (2009) extended the Commission’s original July 1, 2009 sunset provision to July 1, 2010. 2 At the request of the Commission, this 2009 Progress Report was developed as a stand-alone document. It should be read in conjunction
with the 2008 Updated Plan, which is available at http://www.olmsteadva.com/downloads/2008PlanUpdatesProgressReports.doc.
2009 Progress Report: Community Integration for Virginians with Disabilities 2
Money Follows the Person (MFP) Demonstration:
As of July 27, 2009, 74 individuals had enrolled in this project, and 46 had successfully transitioned to the community from nursing facilities, long-stay hospitals and Intermediate Care Facilities for Individuals with Mental Retardation /Intellectual Disability (ICFs/MR). Of these, 36 were enrolling in the Elderly or Disabled with Consumer Direction (EDCD) waiver; 37 the Mental Retardation/Intellectual Disability (MR/ID) Waiver, and one the Developmental Disabilities (DD) Waiver. To assure appropriate Medicaid-reimbursed community services and supports for these individuals, the following services were added to the indicated Medicaid Home and Community Based waivers:
; Transition services (up-front household expenses) were added to EDCD, MR/ID, DD,
HIV/AIDs and Technology Assisted (Tech) Waivers.
; Transition coordination services (transition assistance both before and after transition)
were added to the EDCD Waiver.
; Personal Emergency Response Systems were added to the Tech Waiver.
; Assistive Technology and Environmental Modifications were added to the EDCD and 3 HIV/AIDs Waivers (but now are available only for individuals participating in MFP).Additionally, the Department of Housing and Community Development (DHCD) is providing supplemental funding for home modifications that exceed $5,000 and temporary rental payments while home modifications are being completed for individuals participating in MFP. Planning is underway for Consumer-Directed Supported Employment, which provides a consumer-directed option for individual supported employment services, to be added to the MR/ID, DD, and Day Support Waivers in the future.
Systems Transformation Grant:
This grant supports the disability and aging services systems in Virginia in working together to improve services and supports for all individuals and includes:
; Expansion of Virginia’s No Wrong Door system to add sites and all disability populations;
; Launch in 2008 of Virginia Easy Access, a public-private partnership involving the
Commonwealth of Virginia, SeniorNavigator, and 2-1-1 Virginia, which provides
comprehensive information on a variety of topics of interest to seniors and people with
disabilities. Under this project, disability services and supports information is being added
to the SeniorNavigator database to create VirginiaNavigator;
; Streamlining of Medicaid eligibility determinations through creation in July 2009 of an on-
line Medicaid application on Virginia Easy Access;
; Infusion of person-centered practices throughout all services systems with development of
an Individual Support Plan; training; technical assistance; revision of Code, regulatory and
policy terminology; and examination of practices within many of the Medicaid waivers; ; Creation by individuals who use Medicaid waiver services of guides to various topics of
interest to individuals who direct their own services;
; Planning for individual budgeting to be added to certain Medicaid waivers; ; Creation of a statewide critical incident database; and
; Modernizing the application and preauthorization processes for some Medicaid waivers.
3 These services were also added on July 1, 2008 to these waivers for individuals currently residing in the community; however, according to DMAS, “the extension of these services to all EDCD and AIDS waiver participants has led to costs in excess of the cost-savings generated through the MFP Demonstration program.” Thus, these services were no longer available as of July 1, 2009.
2009 Progress Report: Community Integration for Virginians with Disabilities 3