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COMMONWEALTH OF PENNSYLVANIA Office of Developmental Programs

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Title: COMMONWEALTH OF PENNSYLVANIA Office of Developmental Programs


1
COMMONWEALTH OF PENNSYLVANIAOffice of
Developmental Programs
  • BUREAU OF AUTISM SERVICES
  • Nina Wall-Côté, MSS, LSW
  • Director

2
OUR VALUES
  • Support for those living with ASD throughout the
    life span.
  • Support those living with ASD across the
    spectrum.
  • Families need our support.
  • Every person living with ASD can have an improved
    quality of life given the right supports
    delivered by trained staff.
  • Our goal is to increase independence and
    self-sufficiency.
  • Need to explore innovative models.

3
OUR BEGINNING
  • THE PENNSYLVANIA AUTISM TASK FORCE
  • Created by Secretary Richman in 2003
  • Comprised of families, professionals and
    educators
  • Submitted 1,000 page final report in December
    2004
  • The key recommendations from this report drive
    the work of the Bureau of Autism Services

4
BUREAU OF AUTISM SERVICESCentral and Regional
OfficesClinical Operational Staff Located in
all Three Regions
5
Autism in Pennsylvania 19,951
  • 1,400 Adults, 21 years of age and older -
    Served by DPW
  • BAS will be looking further at other state
    agencies and facilities to identify adults living
    with ASD.
  • 4,377 - Under 21 served by DPW
  • 3,940 Under 21 served in the autism category of
  • special education
  • 128 Under 21 - served in another category of
  • special education
  • 5,895 Under 21 - served through DPW and the
  • autism category of special education
  • 4,211 Under 21 - served through DPW and another
  • special education exceptionality

6
Autism in Pennsylvania
7
What the Numbers Tell us
  • The numbers in Pennsylvania are consistent with
    the national data.
  • Rapidly increasing numbers and we do not
    completely understand WHY.
  • Given the low number of adults, we know many
    adults living with ASD were not captured in our
    data.

8
People Living with ASD Are In Virtually Every
System
  • Education
  • Mental Retardation
  • Child Development and
  • Early Learning
  • Early Intervention
  • Children, Youth and Families
  • Mental Health
  • Juvenile/Criminal Justice
  • COLLABORATION IS NEEDED BETWEEN ALL SYSTEMS

9
Challenges
  • Increasing population
  • Lack of trained professionals
  • Limited resources
  • Families stressed
  • Need to
  • Share responsibility and collaborate
  • Address needs across the lifespan
  • Look at the entire spectrum, not just those with
    cognitive deficits
  • Support families

10
SERVICES FOR ADULTS AND THEIR FAMILIES LIVING
WITH ASD
  • AUTISM WAIVER - Began taking requests for
    applications
  • July 1, 2008 toll free phone number to
    request applications
  • is 1-866-539-7689, Option 1.
  • ADULT COMMUNITY AUTISM PROGRAM
  • (ACAP)
  • Written approval received from the Center
    for Medicare and
  • Medicaid Services (CMS) in January 2009.
    Program to start
  • Spring 2009. Additional information can be
    obtained by
  • calling 1-866-539-7689, option 5, then
    option 2, if in
  • Pennsylvania, or 717-265-7760, if outside of
    Pennsylvania.

11
PA ADULT AUTISM WAIVER AND THE ADULT COMMUNITY
AUTISM PROGRAM (ACAP)
  • Both delivery systems will serve adults, 21 years
    and older, living with ASD and their families.
  • Both the Autism Waiver and ACAP are assessment
    and outcome driven.
  • Assessments inform delivery of services
  • Outcome determine measure of success
  • Increased hours of employment (paid or volunteer)
  • Decreased psychiatric hospitalizations and
    medication
  • Decreased involvement with law enforcement
  • Improved capacity to perform independently
  • Decreased frequency and length of crises
  • Decreased family stress
  • Both require providers to complete ASD-specific
    training and demonstrate competence.
  • Behavioral and crisis support are key services in
    both programs.

12
PENNSYLVANIA AUTISM WAIVERFirst Waiver Targeting
Adults with ASD in the Nation!
  • Response to key findings of the Autism Task
    Force.
  • Specifically designed to meet the needs of people
    living with Autism Spectrum Disorder (ASD).
    Assessment and outcome driven.
  • Initial capacity will serve 200 individuals
    statewide.
  • Providers are required to complete ASD-specific
    training and demonstrate competence.

13
AUTISM WAIVER
  • To be eligible
  • Live in Pennsylvania
  • Have a diagnosis of ASD.
  • Age 21 or older by the time of enrollment
  • Meet Medical Assistance financial eligibility.
  • Meet Intermediate Care Facility level of care.
  • Intelligence (IQ) is not considered for
    eligibility.
  • Waiver Services may include
  • Respite - Family counseling
  • Community inclusion - Day
    habilitation
  • Supported employment - Family Training
  • Job Assessment and Finding - Occupational
    Therapy
  • Transitional Work Services - Supports
    Coordination
  • Behavior supports - Speech/Language Therapy
  • Crisis intervention - Residential habilitation
  • Environmental modifications - Nutritional
    consultation
  • Counseling - Assistive Technology

14
Adult Community Autism Program (ACAP)
  • Uses the federal PIHP (Prepaid Inpatient Health
    Plan) funding model used currently by Long Term
    Living one rate paid to one provider for an
    array of services.
  • Pilot Program Will serve 200 individuals -
    initially available in Cumberland, Dauphin, and
    Lancaster counties only.
  • Additional ACAP programs will be rolled out in
    the future as resources are available.
  • Assessment and outcome driven.
  • Keystone Autism Services - ACAP provider
    developing provider network to support an
    individuals needs.
  • Flexible Offers a team approach, including the
    individual, family, the ACAP Provider and health
    professionals. ACAP Provider and their network
    will offer an established list of services,
    including physician/physical health services and
    services to support the individual in the
    community. Additional services can be provided
    if cost effective and necessary to keep
    individuals living in their communities.

15
Adult Community Autism Program (ACAP)
  • Designed for individuals
  • Age 21 and older
  • Diagnosis of Autism Spectrum Disorder
  • Be eligible for Medical Assistance
  • Be certified as meeting Medical Assistance
    Program clinical eligibility for Intermediate
    Care Facility (ICF) services in the Commonwealth
    of Pennsylvania
  • Not enrolled in a Medical Assistance home and
    community based waiver program at the time of
    application

16
Adult Community Autism Program (ACAP)
  • At the time of enrollment be able to live in a
    community setting without sixteen (16) or more
    awake paid and unpaid staff and supervision hours
    per day without presenting extreme danger to self
    or others or a threat to property
  • Does not exhibit levels of extremely problematic
    behaviors that would present a danger to self or
    others or threat to property
  • Reside in the service area at the time of
    enrollment
  • Not enrolled in a Medical Assistance Managed Care
    Organization (MCO) at the time of enrollment in
    the Plan

17
Adult Community Autism Program (ACAP)
  • Supports May Include
  • Coordination of Supports
  • Medical/Physician Services
  • Behavioral Health Services
  • Respite
  • Community Integration
  • Support Employment
  • Behavior Specialist Services
  • Crisis Intervention
  • Assistive Technology
  • Family Counseling

18
Autism Services, Education, Research, and
Training (ASERT) Regional Centers
  • Recommendation of the Autism Task Force
  • Priority for Families
  • Focus on training, applied research, service
    delivery and information dissemination
  • Collaborative partnerships
  • Needs assessment
  • Support to BAS in efforts to build statewide
    capacity

19
Autism Services, Education, Research, and
Training (ASERT) Regional Centers
  • Autism Services - Ensure that people living with
    autism and their families, in every part of the
    Commonwealth, can access quality supports and
    interventions that are based on best practices
    and provided by trained professionals
  • Education Develop educational materials
    relative to ASD and disseminate to families,
    providers and all other stakeholders.
  • Research - Research yielding practical and
    measurable results that contributes to the
    enhancement of quality of life for people with
    autism and provide evidence-based information for
    use by families and service providers.
  • Training Partners in the development of
    standards and the professional capacity to
    support the needs of individuals with ASD across
    the lifespan.

20
PA ASERT Regional Centers
  • Bureau of Autism Services
  • Nina Wall-Cote, MSS, LSW Director
  • (717) 265-7760
  • Carol Lynch, MBA
  • ASERT Project Officer
  • (717) 265-7760
  • Claire Choutka, M.Ed., BCBA
  • Clinical Director
  • (717) 265-8963
  • Erica Wexler, Project and Training Coordinator
  • BAS Staff Support
  • (215) 965-0547
  • ASERT Contact Information
  • Lindsay Lawer, MS
  • Director PA Regional ASERT Center - East
  • 215-746-6099
  • llawer_at_mail.med.upenn.edu
  •  
  • Shiyoko Cothren, M.H.A.
  • Director - PA Regional ASERT Center - Central
  • 717-851-7945
  • scothren_at_psu.edu
  •  
  • John McGonigle, Ph.D.
  • Director PA Regional ASERT Center - West
  • 412-246-6542
  • mcgoniglejj_at_upmc.edu 
  •  
  •  

21
Act 62
  • Significant collaboration of the public and
    private sectors producing the most comprehensive
    insurance legislation of its kind.
  • Act 62 mandates private insurers to begin
    providing coverage, up to 36,000 annually, for
    the diagnosis and treatment of Autism Spectrum
    Disorders (ASD) for children under the age of 21
    as of July 1, 2009.
  • The services and coverage mandated by this bill
    are based on Medical Assistance (MA) definitions
    and standards of care to ensure that essential
    autism services are covered, including those to
    prevent regression.
  • Medical Assistance (MA) remains a safety net.
  • NEW Web site - www.PAAutismInsurance.org
  • EMAIL QUESTIONS TO RA-IN-AUTISM_at_STATE.PA.US

22
TRAINING FOR ADULT SERVICE PROVIDERS
  • Training Needs of Adult Service Providers
  • Few providers are prepared to meet the unique
    needs of adults with ASD across settings.
  • Spectrum Training course
  • Includes nationally recognized subject matter
    experts and content.
  • Consists of nine (9), 45-minute classes.
  • Requirement for providers in ACAP and the Autism
    Waiver.
  • A CD-ROM version of the training is being
    developed.

23
FBA TRAINING
  • We have provided regional Functional Behavioral
    Assessment (FBA) Trainings to over 1400 BHRS
    Behavioral Support Consultants (BSCs) and Adult
    Service Provider Staff free of charge with free
    continuing education credits (CEUs).
  • Fall 2008 classes are complete
  • 2-Day FBA Workshop- 750 more were trained
  • 1-Day Advanced FBA training for staff who have
    completed the 2-day FBA workshop-additional 180
    BSCs trained.
  • Train-the-Trainer sessions with accompanying
    curriculum and DVD set are being conducted with
    each behavioral health managed care company
    (BHMCO), 8 sessions of 45-60 each total of 360
    trainers trained.
  • FBA for TSS Staff Addressing Challenging
    Behaviors
  • Downlinked in August to 800 Therapeutic Staff
    Support (TSS) across the state. Training will be
    up on the BAS training website soon.
  • Information about additional sessions will be
    posted on our website as it becomes available
    www.autisminpa.org

24
SAVE the DATE!
  • 2nd Annual Pennsylvania Autism Training
    Conference
  • May 27-29, 2009
  • Tentative Location
  • Lancaster, PA
  • Watch www.autisminpa.org for details!

25
Continuing Education
  • The Bureau of Autism Services is an approved
    provider of continuing education credits for
  • Educators (Act 48)
  • Social Workers
  • Board Certified Behavioral Analysts (BCBA/BCABA)
  • Psychologists (APA)
  • National Board of Certified Counselors (NBCC)

26
FAMILY ISSUES
  • All families are unique
  • Isolation and overwhelming stress
  • Families have difficulty navigating the system
  • Raising a child with ASD can be lonely, children
    do not have many friends, siblings may feel left
    out
  • Significantly higher divorce rate in marriages
    for parents of children with ASD
  • Parents may have to quit job or reduce hours to
    care for the child or adult with ASD
  • Parent groups are a great source of support,
    information and community

27
SUPPORT FOR FAMILIES
  • Family and Individual Support Grants
  • Families apply for up to 500 to assist with
    respite care, community inclusion, home safety
    modifications, summer programming, etc.
  • Based on feedback received from the autism
    community over the past two years, the mini-grant
    program has had meaningful impact on improving
    the quality of life of individuals and families
    living with ASD.
  • 2007 - Awarded over 1,300 PA families a total of
    650,000 in 500 mini-grants
  • 2008 BAS funded more than one million dollars to
    support over 2,000 families.

28
BUREAU OF AUTISM SERVICES ADVISORY BOARD (BASAB)
  • The BASAB is comprised of family members,
    self-advocates, professionals, and advocates.
  • Members have been appointed by the Secretary for
    Public Welfare and serve three-year terms.
  • Serve a vital role in linking the Bureau to the
    larger Pennsylvania autism community and will
    provide valuable input to BAS on important
    initiatives.
  • Actively engaged with the ASERT regional centers.
  • Provide advice on the initiatives, programs,
    policies, and budget of the Bureau of Autism
    Services offering input regarding the Bureaus
    strategic plan.

29
Biopsycho-Social Unit Western Psychiatric
Institute and Clinic (WPIC)
  • Part of the University of Pittsburgh Medical
    Center
  • Pilot program serving children/adolescents and
    adults with ASD who can not be served by local
    medical/psych resources
  • complex medication assessment issues
  • co-morbid medical assessment needs
  • multiple diagnosis issues
  • program includes added training to support
    careful return to school, home, and community
    providers
  • admission coordinated with BAS clinical office

30
Bureau of Autism ServicesNina Wall-Cote,
Director
  • Email us at
  • DPW-AutismOffice_at_state.pa.us
  • Visit our Website www.autisminpa.org
  • Contact us at 717-265-7760 or
  • Toll Free in Pennsylvania at
  • 866-539-7689
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