Community Living Committee
Thursday, August 9, 2018
10:30 a.m. to 12:30 p.m.
Hilton Garden Inn, Asheville, NC
Members Present: Kerri Eaker, Katherine Boeck, Allison Dodson, Joshua Gettinger, Brendon Hildreth, Aldea LaParr, Vicki Smith, Mya Lewis, Andrea Misenheimer, Christina Dupuch
Members Absent: Peggy Terhune, Sandra Terrell, James Stephenson, Kristy Locklear
Staff in Attendance: Philip Woodward, JoAnn Toomey, Yadira Vasquez, Letha Young, Shar’ron Williams, David Ingram
Guests: Michael Groves, Darcy Hildreth, Linda Kendall Fields, Janet Price-Ferrell, Jesse Smathers, Steve Strom, Jill Hinton, Erika Hagensen, Sheri Badger, Jim Laughman, Krista Brinkerhoff, Brittany Matney
Kerri Eaker opened the meeting welcoming the members and doing an icebreaker activity by asking them to name a song that’s on their mind. Kerri recognized Michael Groves and Vicki Smith to thank them for their contributions to the committee and to NCCDD.
MOTION: Joshua Gettinger made the motion to approve the amended February minutes and the May minutes. Katherine Boeck seconded the motion. The motion was approved by unanimous vote.
Yadira provided the fiscal report. The fiscal report was added to the mail-out booklet to help members see the reports before they come to the meetings. She encouraged members to review it and ask questions. Katherine asked her to go over each initiative’s current budget.
Rethinking Guardianship: A Person-Centered Approach
Linda Kendall Fields provided an update and said the Division of Aging and Adult Services (DAAS) printed the Rethinking Guardianship: Building a Case for Less Restrictive Alternatives final report this year. She mentioned the initiative’s continuing work with the Division of Social Services (DSS) and children who lose some protections when they age out of the foster care system. The new initiative that started on July 1, 2018 with funds from Money Follows the Person (MFP) and the Transitions to Community Living Initiative (TCLI) will work with people with disabilities who live in facilities to transition to community living. There will be listening sessions to examine the support needs of these individuals.
Linda reported that she had a positive conversation with the Executive Committee of the Conference of Clerks, and they agreed to work on reforming North Carolina’s guardianship statute. She said Judge Marion Warren of the Administrative Office of the Courts supports this effort, and she will report to the Rethinking Guardianship Steering Committee when it meets on August 21st.
Joshua Gettinger said he can see the value of this initiative at the end of the 18 months, and he asked about long-term sustainability. Linda mentioned that North Carolina will stay involved as one of the Working Interdisciplinary Network of Guardianship Stakeholders (WINGS) states in the network with American Bar Association oversight.
Katherine Boeck, Brendon Hildreth, and Kerri Eaker discussed specific situations or questions about various types of guardianship situations. Linda responded that clerks are supposed to appoint a trusted individual who knows the person with a disability before appointing a guardian, but this is not equally applied across North Carolina’s 100 counties.
Natural Support Network Development
Janet Price-Ferrell gave an update, saying the initiative will host two training meetings called Community Conversations in September in Black Mountain and Goldsboro. She distributed a flyer for these events. This initiative will train at least 25 professionals/family members and at least 25 individuals with I/DD on how natural supports develop. Katherine Boeck asked what “professionals” means. Janet said this term includes case managers and people who work in the I/DD field. Joshua Gettinger asked if we envision a professional being with that same person with I/DD over the course of two years? Janet said Community Navigators can participate, and Kerri Eaker agreed that Community Navigators will benefit from this initiative. Katherine asked about Care Coordinators participating. Mya Lewis said individuals with I/DD will also have other people investing in that person, and a specific professional is not expected to be the lead person all the time. Janet said friends of people with I/DD or other people providing non-paid support to people with I/DD will benefit. Kerri suggested that anybody from a group at church or in the community who wants to provide support can participate, not just Care Coordinators.
Supported Living: Making the Difference
Jesse Smathers gave an update. The initiative has hosted two webinars in Year Two and stakeholder meetings in April to focus on supporting individuals who have the highest level (Level 3) of needs. The feedback is pushing next steps that involve changing the living environment and being flexible. Partners are coordinating all of the different efforts together; for example, national speaker David Pitonyak came to Durham in July because of support from Monarch and Cardinal Innovations.
Jesse said the initiative presented at The Arc of North Carolina Conference in March and at the National Association of Councils on Developmental Disabilities (NACDD) Conference in July. More than 27 people have transitioned to Supported Living, and, according to the survey from Trish Farnham, 160 people in North Carolina are using Supported Living services. He also pointed out that North Carolina has 13,000 Innovations Waiver slots. Jesse also provided an update on how the national consultants have been involved. He said there is a goal to close three group homes; one has closed so far.
Kerri Eaker mentioned connecting people to natural supports as people move out of group homes. Jesse responded that social opportunities, sports opportunities, and engaging friends (having connections and not being isolated) all help individuals transition successfully.
MOTION: Joshua Gettinger made a motion for continuation funding to Vaya Health for the Supported Living: Making the Difference initiative. Funding is approved for up to $100,000 ($25,000 DD Funds, $75,000 MFP/DMA Funds), with a required minimum of 25% non-federal matching funds ($33,334), for Year 3 (of 3) from January 1, 2019 to December 31, 2019. Katherine Boeck seconded the motion. The motion was approved by unanimous vote.
From Planning to Action: Integrated Collaborative Care for People with Intellectual and Developmental Disabilities (I/DD)
Jill Hinton and Erika Hagensen gave an update for contractor Karen Luken who is in Florida taking care of a family medical emergency. Jill said many children with I/DD have been identified who were not previously diagnosed with I/DD. Erika expressed surprise at how many doctors work with kids without asking if they are on the waiver or the waiting list and discussed the Modified Checklist for Autism in Toddlers (MCAT). Jill said the pediatric access phone line is open now, and the initiative can track its use.
Mya Lewis talked about the Consultation Summit that occurred in Raleigh on May 21st with updates on the initiative’s two pilots and presentations from Michigan and Wyoming experts. Jill feels as if everyone left the Summit with shared knowledge rather than feeling as if one state is better than another state. Erika said studying other consultation models will assist with Medicaid Transformation, and she commended NCCDD’s focus in launching something that will work.
Jill mentioned the Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMH/DD/SAS) providing funding for this initiative. There will be three pilot expansion sites – one with the Mission Health Family Support Network in Asheville, one in Wilmington, and one in Greenville. Joshua Gettinger said he knows how Duke and UNC collaborate, but he asked, how does this third part get in? Mya explained that the funding from DMH/DD/SAS came to ensure that this consultation work spreads through all areas, not just Raleigh. Erika talked about how to address data points to provide a more full picture, and Jill said the DMH/DD/SAS project shows the ripple effect of this initiative. Vicki Smith mentioned children with complex health needs and how they fit into this work. Erika commended everyone’s participation and partnership to help this initiative achieve successful outcomes.
Brendon Hildreth asked a question about advocating and spreading this information around New Bern. Jill said we are trying to achieve systems change all over our state, not only in our pilot areas.
MOTION: Katherine Boeck made a motion for continuation funding to The Arc of North Carolina for the From Planning to Action: Integrated, Collaborative Care for People with Intellectual and Developmental Disabilities (I/DD) initiative. Funding is approved for up to $125,000 with a required minimum of 25% non-federal matching funds ($41,667), for Year 3 (of 3) from January 1, 2019 to December 31, 2019. Allison Dodson seconded the motion. The motion was approved by unanimous vote.
Transportation (RFA Update)
Andrea Misenheimer asked about the article, “The State of Transportation for People with Intellectual and Developmental Disabilities in Medicaid Home and Community-Based Services 1915(c) Waivers”, that Philip Woodward mentioned during the morning meeting. Philip will send the article to the Community Living Committee members. Kerri Eaker wondered if this type of transportation is only for medical purposes, but she said access to the community is important. Joshua Gettinger said transportation will be an expensive issue to resolve, and a demonstration with 50 people must happen in a specific way. He added that we cannot resolve this issue without major changes to the transportation system. Vicki Smith suggested looking at what the specific barriers are, including a city that has resources and a city that does not have enough transportation. Kerri agreed that it is important to address the barrier instead of just looking at how to improve access for people with I/DD.
The committee then discussed the idea of accessible vans that people can share, but liability and having liability insurance are concerns. Kerri said some type of financial stability is necessary to be able to own a vehicle.
Philip said the North Carolina Department of Transportation (NCDOT) recognizes the importance of removing transportation barriers for people with I/DD and other disabilities, including senior citizens. He will analyze the data that NCDOT recently sent to him, do more research, and provide an update at the November meeting.
Wrap Up and Reminders
Kerri Eaker motioned to adjourn. The meeting was adjourned at 12:27 p.m.