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Hi, I'm David Mank, Director of the Indiana Institute
on Disability and Community
at Indiana University in Bloomington.
I hope you are doing well today where ever you are in Indiana.
I wanted to extend an invitation to you to participate
in a very important conversation - a conversation important
to individuals with developmental disabilities
and their families in Indiana.
For more than twenty years now,
the Federal Government has made it possible for States
to provide services to people with disabilities in their homes
and communities rather than segregated centers,
groups homes, and the like.
This has been done under the Medicaid Home
and Community Based Services Waivers.
Indiana has made progress in supporting people
in community-integrated settings.
We have brought more than 2000 people
onto waivers in recent months.
Supported living and employment are becoming priorities.
New approaches are emphasizing community, employment,
and quality of life outcomes.
Yet we know despite this progress,
there is much more to be done.
Waiting lists are still long, and continue to grow.
We need more and improved community and family supports.
It is difficult to find and keep qualified staff
and personal assistants.
Staff turnover is an ongoing problem.
And we have a grim economic condition in Indiana
and across the country.
It is important however that we still move forward.
We have an opportunity, Peter Bisbecos and the Division
of Disability and Rehabilitative Services
in FSSA have asked us here at the Institute
to start a conversation about the future of waivers
in Indiana - especially those waivers handled by DDRS -
the Developmental Disabilities Waiver, the Autism Waiver,
and the Support Services Waiver.
FSSA wants to hear from stakeholders - providers,
case managers, people with disabilities, family members,
advocates, and others - anyone with ideas about how
to make Indiana's waivers the best that they can be.
We hope this conversation includes YOU -
whether you are a person with a disability, a family member,
whether you have a waiver or not.
Whether you are a provider, an agency director
or have some other stake in the waivers and in supports
for people with disabilities in our state.
We at the Institute are pleased to have been asked
to gather this information.
We will not actually be writing the waiver ourselves
but we will work to be sure that decisions
about Indiana's waivers are as informed as possible.
We need some guiding principles to move forward,
no matter what the new waivers might look like.
It will be important to ground them in ideas and principles
that we can agree on and then apply those ideas
to all of our waivers.
Whether it is the DD waiver, Autism waiver,
or the Support Services waiver
or whatever waivers may be called in the future.
We have a start on this.
In 2006, DDRS established a Vision 20/10 on direction
and principles - Vision 20/10 included four particular goals
to create a more equitable, person-centered support system
for people and their families in Indiana.
These principles can form an early foundation for decisions
about waivers in the future.
Let's look at those four first: One, A commitment
to Self-Advocacy and Self-Direction Second,
A commitment to Quality Integration
and Quality Outcomes Third, A commitment to Work First
and Meaningful Days Fourth, A commitment to Dignified Risk
and Risk Management Based on these "guiding principles"
from Vision 20/10 we also need to know what other kinds
of principles and ideas to base the conversations
about waivers what should we base this on.
We have additional notions that have come from conversations
around Indiana in recent months
and perhaps we can gain some measure of consensus
that these are good guiding principles going forward.
So, for starters, let's begin with the Vision 20/10 principles
and move on from there.
o A foundation of self-advocacy, self direction,
and person-centered planning o An emphasis
on employment outcomes o An emphasis on "community" outcomes
such as having a meaningful day, getting out of the house,
having a circle of friends, seeing family regularly.
o A focus on quality outcomes o And promoting dignified risk
and risk management We can add to that list based
on conversations around Indiana right now:
o We can add Individualizing supports rather
than providing group programs o Supporting the use
of technology solutions o Including a range of supports
for families, for family-centered planning,
and for support for aging parents o We can include support
for future planning, for permanency planning -
such as finances, trusts and wills,
future living arrangements, and so on.
When parents are no longer able to care for their adult child.
o Allow for flexibility over time in services and supports -
adjusting for needs over the lifespan o Allowing
for flexibility over time in cost that cost can increase,
cost can decrease based on circumstances
and how situations change We want to hear what you think
about these ideas and how we can improve the waivers
that we have in Indiana.
We need your ideas about SOLUTIONS -
about ways that Indiana can improve the waivers that we have
or create new waivers and how best to put them into practice.
We have established a website for your ideas and thoughts.
You will find a link to a survey where you can write us
with your ideas and your answers to a few questions.
If you prefer you can fax or send
by mail your ideas to these questions.
So, here are the questions: First, what is working now
with the waivers in Indiana?
How well do the current services and supports promote the kinds
of principles and ideas I described a few moments ago?
We also want to know what is NOT working with Indiana's waivers.
What other supports are needed?
If supports are being provided
but not working very well how can it be changed
so that the services are better.
Are there supports that are missing that we need to add
to a waiver system in Indiana?
How can we make these best work?
And third, We'd like to have you think in terms of SOLUTIONS -- -
what can we change, what can we create to make supports
and waivers work for individuals and their families in Indiana?
Thanks for your time.
Thanks for being part of the conversation.
There are links on the screen to lead you to the survey
where you can make your ideas known.