Self Determination in Long Term Care

1
Self Determination in Long Term Care

• Self-determination is a set of concepts and
  values that people with disabilities should have
  the freedom and support to decide how they live
  and participate in the community.

2
Self Determination Principles

• Freedom The opportunity for the individual to
  plan a life with necessary supports
• Authority The ability of individuals to control
  budgeted funds for purchasing supports
• Support The arranging of resources and personnel
  both formal and informal- that will assist and
  individual to achieve meaningful community
  participation
• Responsibility Acceptance of valued community
  role and accountability for public dollars

3
Individual Plan of Services Supports

• Participants, with their allies, develop an
  individual plan of services and supports through
  the person-centered planning process
• A participants allies are chosen by the
  participants and may include family members,
  friends,paid staff,other professionals, and
  community members, etc

4
Individual Budget

• An individual budget is the cost of implementing
  a persons individual plan of services supports
• The individual budget is authorized by the Waiver
  Agent to provide a defined amount of money to
  implement the plan

5
Fiscal Intermediary

• A Fiscal Intermediary is an independent legal
  entity that acts as a fiscal agent of the Waiver
  Agent for the purpose of assuring financial
  accountability for the funds in a participants
  individual budget
• The Fiscal Intermediary performs essential tasks
  that support self-determined arrangements for
  participants

6
Fiscal Intermediary Functions

• Functions as the employer agent for participants
  directly employing workers
• Ensures public funds are properly managed and
  provider requirements for workers are met

7
Fiscal Intermediary Functions

• Offers supportive services to enable participants
  to self-determine and direct the services and
  supports they need
• Provide monthly budget status reports to
  participant and Waiver Agent and monitor the use
  of the budget

8
Cash Counseling

• Robert Wood Johnson Foundation sponsors three
  states to implement consumer-directed personal
  care services
• Arkansas
• Florida
• New Jersey

9
Cash Counseling Outcomes

• Cost neutrality
• Increase in services
• Improved quality of life
• Reduced stress on caregivers

10
Cash Counseling in Michigan

• Part of 11 states to receive funding from RJWF to
  implement project
• In the second year of a three-year grant
• Supported by the Boston College Graduate School
  of Social Work as the National Program Office

11
Self Determination in Long Term Care

• Michigans Cash and Counseling
• 4 Pioneer Sites are initiating project
• Detroit Area of Aging
• Burnham Brook
• Tri-County Office on Aging
• UPCAP Services

12
Systems Changes to implement

• Amend the current MI Choice Waiver
• Reduce the assessment
• Provide training and support to Pioneer Sites

13
Project Goals

• MI Choice Waiver participants will be able to
  choose self-determination as a method for
  receiving supports and services on a state-wide
  basis

14
For More Information

• Tari Muñiz, Project Coordinator
• 517.335.5671
• munizt_at_michigan.gov
• www.cashandcounseling.org