DMR Facts and Figures that all CABs Should Have

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DMR Facts and Figures that all CABs Should Have

• SAC reTREAT
• January 12, 2008

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Governor and Lt. Governor

• Deval Patrick
• Timothy P. Murray

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EOHHS OrganizationThe Secretariat
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Undersecretary EOHHS Vacant
EOHHS
Assistant Secretary CYF Marilyn Chase
Assistant secretary Disabilities Jean McGuire
Assistant secretary Health Services Vacant
Deputy Assistant Secretary, Health Vacant
Deputy Assistant Secretary, CYF Kathleen Betts
Deputy Assistant Secretary, DCS Laurie Burgess
Commissioner DMR Elin Howe
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The Department of Mental RetardationStructure,
Services, Programs
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DMR Organizational Chart More Detail
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Demographics

• Who receive services?

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Demographics Continued
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DMR Class Members

• Ricci Class 3,834 class members
• 2995 reside in the Community
• 779 reside in ICF/MR Facilities (22 in Marquardt
  SNF)
• 60 reside outside of Massachusetts
• Brewster Class 36 class members
• Rolland Class Members 2,951
• 836 reside in Nursing Facilities
• There are approximately 400 nursing facilities in
  Massachusetts, 250 of these facilities have
  Rolland Class Members
• Boulet Class Members original class 2,439

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How are individuals supported?

• Families and Informal Caregivers
• State supported services
• DMR statewide employs 7523
• Contracted Services
• 220 providers
• 18,182 employees

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What are the DMR funded services?

• Service Coordination
• Family Supports
• Individual Supports
• Residential Supports
• Facility Supports
• Day Supports
• Employment Supports
• Transportation

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Service Coordination

• What is it? Service Coordinators arrange,
  coordinate, and monitor the supports that DMR
  provides, purchases or arranges for an
  individual.
• Who provides it? DMR staff
• How many receive it? 32,445 individuals
• (23,459 Adults 8,986 children)
• Caseload Ratio Adults 1 to 53
• Children 1 to
  279

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Family Supports

• What it is? Family Supports is a flexible array
  of services that enable children and adults to
  live with their immediate family and be welcomed,
  contributing members of their communities.
• Who provides? A network of 72 Family Support
  Provider Agencies under contract with DMR.
• How many receive? Approximately 4600 adults and
  8,650 children and families in 2007.

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Individual Supports

• What it is? Individual Supports consist of
  assistance with a variety of community
  activities, such as, help with money management,
  food preparation, food shopping, cooking,
  banking, and housekeeping.
• Who provides? Provider Agencies under contract
  with DMR
• How many receive? Approximately 3,000 individuals

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Employment Supports

• What it is? Employment Supports provide
  supervision, training, and/or transportation that
  enable individuals to get paid jobs. It includes
  help with career planning and job development as
  well.
• Who provides? Providers Agencies under contract
  with DMR.
• How many receive? Approximately 4,400 individuals
  

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Community Day Supports

• What it is? Day supports help
• individuals to build and maintain their
  ability to participate in community activities by
  focusing on important skill areas that include
  communication, self-care, relationship building
  and community involvement.
• Who provides? State and Provider Agencies under
  contract with DMR
• How many receive? Approximately 1,700
  individuals

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Residential Supports

• What it is? Residential Supports
• provide care, supervision and basic
• life skills and community living skills
• training in various residential setting
• for up to 24 hours a day, 7 days
• a week.
• Who provides? State and Provider Agencies under
  contract with DMR
• How many receive? Approximately 9,200 adults

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Facility Supports

• What it is? Facility Supports is provided in 6
  large state owned and operated facilities that
  are certified by the federal government as
  intermediate care facilities for the mentally
  retarded (ICFs/MR). They are
• Monson Developmental Center,
• Glavin Regional Center,
• Templeton Developmental Center,
• Hogan Regional Center,
• Wrentham Developmental Center
• Fernald Developmental Center
• Who provides? The Department of
• Mental Retardation
• How many receive? 946 individuals

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DMR Consumer Service Types

• Supports include family supports, individual
  supports, transportation, respite, clinical
  services, etc.
• Day includes DMR Community Based Day Services and
  MassHealth Day Habilitation
• Community Residential Services includes DMR
  Community Based Residential Services and
  MassHealth Adult Foster Care
• Facilities include ICF/MRs (Monson, Glavin,
  Templeton, Hogan, Fernald, Wrentham) and and
  Marquardt Skilled Nursing Facility.

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MassHealth Funded Services

• Day Habilitation provides individualized
  assistance to 6338 DMR consumers to acquire and
  maintain life skills, such mobility training,
  social behaviors, communications, basic safety
  skills, health skills and personal care skills.
• Adult Day Health community based program
  providing a variety of health, social and related
  services that is serving 851 DMR consumers.
• Adult Foster Care provides residential
  placement, health and social supports for 791 DMR
  consumers with various needs, such as, help with
  medication, ADLs, and ambulation.

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DMR Programs
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Waiver Programs

• DMR program that provides home and
  community-based services through the federal
  Medicaid Home and Community-Based Services (HCBS)
  waiver program.
• The Waiver Program helps fund community services
  with federal dollars.
• DMR operates 2 Waiver Programs
• Comprehensive Waiver serving 12,500 adults
• Autism Waiver serving 80 children (ages 0 through
  8)

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Waiver Services

• Adult Waiver Services Family Supports,
  Individual Supports, Residential Supports,
  Supported Employment, Community Based Day
  Supports, Respite, Transportation, Personal
  Agents, Transitional Services, Assistive
  Technology
• Autism Waiver Services Habilitation-Community
  Integration, Habilitation ADL/ Independent
• Living Skills, Expanded Habilitation
  Service-Education, Respite, Family Training,
  Adaptive
• Aids, Vehicle Adaptations, Homemaker

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ISO (Intermediary Service Organization)

• Consumer driven program that allows individuals
  and families to actively participate in the
  design and manage their services
• ISO helps support self determination goals by
  enabling participants to have individualized
  budgets and control their services.
• The ISO helps individuals and families directly
  select and arrange for supports and services with
  community providers.
• In FY 2008, there are 281 ISO participants

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DOE/DMR Program

• Provides specialized intensive home, community
  and education supports.
• Serves children
• Ages 6 through 21
• Enrolled in Department of Education (DOE)
  approved special education residential school OR
  school district determines child is at risk of
  needing a more restrictive out of home placement
• eligible for DMR services
• In FY 2007, 366 special education students were
  served in the DOE/DMR Program

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Turning 22 Program

• The Ch. 688 law establishes a transitional
  planning process for students with severe
  disabilities during the final two years of
  special education (before high school graduation
  or turning 22 years of age, whichever happens
  first)
• The goal for the student is to
• 1) Plan for appropriate adult service
  delivery
• 2) To gain a level of independence
• The Ch. 688 law does not require the continuation
  of the special educational entitlement nor does
  it automatically secure funding for adult
  services
• The FY 2008 Turning 22 class for DMR is 608
  individuals.

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Quality Assurance
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How does DMR assure Quality?

• A strong quality management and improvement
  system (QMIS) that looks at quality at 3 levels
• the individual,
• the provider
• the system
• QMIS measures quality outcomes important to
  stakeholders
• QMIS consists of 22 different processes involving
  DMR staff, consumers and families on all levels
  of service delivery

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What are the Quality Outcome Measures?

• Health
• Protection from Harm
• Safe Environments
• Human Civil Rights
• Decision-making Choice
• Community Integration Membership
• Relationships
• Achievement of Goals
• Work
• Qualified Providers

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Licensure and Certification Processes

• Public and private providers are evaluated on the
  level of quality of supports provided
• Certification process assures that the quality
  outcomes and health and safety are present in
  peoples lives.
• Licensure process assures that essential
  safeguards regarding health, safety, and rights
  are in place.
• The evaluation uses observation, interviews and
  review of documentation for a sample of
  individuals served by a provider.
• Residential, day, employment respite providers
  are subject to licensure and certification. 
  Individual supports are subject to certification.

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Investigations Fiscal Year 2007
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Complaint Resolution Team (CRT)

• Each Area Office and Facility has a CRT
• Brings citizen perspective regarding prevention
  of abuse and mistreatment
• Reviews all investigated cases and cases subject
  to administrative review and develops Action Plan
  for all those cases

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Investigations and CRT Action PlansFiscal Year
2007
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Family Citizen Monitoring

• A CAB managed quality assurance activity
• 20 of 23 CABs conduct monitoring
• 2 to 6 residences are visited monthly per CAB
• Focus varies by CAB safety, nutrition,
  relationships, etc.
• Area Director follows up on problems and concerns
  identified.

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Human Rights Committees

• Every Provider and DMR program have a Human
  Rights Committee (HRC).
• HRC educates consumers and staff regarding human
  rights (e.g. privacy, self-determination and
  freedom of choice, free from exploitation,
  enjoyment of basic goods services)
• HRC monitors compliance through visits, reviews
  of mistreatment and abuse complaints, restraints
  and other reports.
• Oversight provided by DMR Human Rights Advisory
  Committee

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Quality Councils

• 4 regional and 1 statewide Quality Council that
  meet quarterly
• Comprised of self-advocates, family members,
  providers and DMR staff
• Charged with reviewing data from all sources
  regarding the quality of DMR services and
  supports
• Identifies service improvement targets and
  monitors progress towards achieving targets

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The Budget Process
DMR to EOHHS September Governors House 1
Budget January House Ways Means April Senat
e Ways Means April May Conference
Budget June - July Governor Signs
Budget June - July
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DMR Budget FY 2008

• 5911-1003 DMR Administration Operations
  77,144,454
• 5911-2000 Transportation 14,137,324
• 5920-2000 Community Residential
  547,716,905
• 5920-2006 Residential Rate 2,000,000
• 5920-2010 State Ops
  135,018,927
• 5920-2020 Boulet/Waiting List
  87,870,762
• 5920-2025 Day/Employment
  122,669,711
• 5920-3000 Family Supports 55,044,228
• 5920-3010 Autism 3,277,672
• 5920-5000 Turning 22 7,700,000
• 5930-1000 State Schools 184,933,044
• 5982-1000 Templeton Retained Revenue
  150,000
• 1599-6901 EOHHS Salary Reserve 10,826,454
• 5948-0012 DOE/DMR
  8,000,000
• TOTAL
  1,256,489,481

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SAC CAB on DMR Web Site www.mass.gov/dmr
Role of Individuals, Families Volunteers
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SAC CAB Section on DMR Web Site
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SAC CABs can post and publicize on the DMR Web
Site!
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SAC CABs can Collaborate Using PACEs Team
Room

• The PACE Team Room is an internet based tool
  that the SAC CABs can use to
• Share information
• E-mail each other
• Have on-line
• discussions

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Getting into Team Rooms

•  I'm happy to report that PACE is now accessible
  via a link on the home page on the Internet see
  lower left hand side under the heading of Key
  Resources" which looks like this
•  
• KEY RESOURCES
•                                Find a DMR Office
  
•                                DMR Offices and
  Facilities
•                                After Hours
  Emergency Phone Number [phone]
•                                PACE Training
  Login
•        
•  Once you click the link above "PACE Training
  Login" you will automatically link to this page
  (see below) next scroll down to the Department of
  Mental Retardation and click on that link
• PACE Login
• Please find your agency and login properly.
  Thanks.
• Human Resources Division  - Municipality/Non-Stat
  e Government
• Department of Conservation and Recreation   -
  Municipality/Non-State Government
• Department of Revenue  - Municipality/Non-State
  Government
• Office of Health and Human Services  - Center
  Staff Development  - Virtual Gateway
• Department of Mental Health  -
  Municipality/Non-State Government
• Department of Mental Retardation  -
  Municipality/Non-State Government

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PACE questions?

• For further questions about PACE please contact
• Valarie Oresto
• Staff Development and Training Director
• 500 Harrison Avenue
• Boston, MA 02118
• 617- 624-7755
• valarie.oresto_at_massmail.state.ma.us

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DMR Resource for SAC and CABs

• Ralph Edwards, Director
• Office of Citizens Leadership
• 500 Harrison Avenue
• Boston, MA 02118
• 617- 624-7755
• Email Ralph.Edwards_at_massmail.state.ma.us