SW 644: ISSUES IN DEVELOPMENTAL DISABILITIES

FAMILY SUPPORT PROGRAM (CONTINUED)

Beverly Doherty, M.S.S.W.

Unit 6

(Slide 21) SW 644: Issues in Developmental Disabilities

(Slide 22) Video of Bev Doherty

The Wisconsin Family Support Program was first put into state statute in 1985, that was the year after the first demonstration year. At that time, the program was operating in only eleven counties. Today this program is working in all 72 counties, with state funds totaling $4.3 million.

(Slide 23) Wisconsin Family Support Program

Now these funds are distributed to counties on a formula basis, based on the population of children and on other factors. The county human services or community board services agency, either administers the program themselves within that agency, or they contract with another agency to administer the program. What is required is a Family Support Program Coordinator to be designated in each service area. The administering agency designates that person.

(Slide 24) The Application Process

Families who are interested in applying for Family Support need to apply to the program. The application process includes a determination of eligibility, and a needs assessment. Families who have a child with a severe disability under the age of 21, and are living at home, are eligible for services. I won't go into the description of all the eligibility criteria, but that is basically it. The Family Support program definition of eligibility is put in law. It is its own definition, the definition is based on the Federal definition of developmental disability, and includes severe physical disability, mental or emotional impairments which seriously limit a child's ability to carry out basic daily living activities, such as self care, learning, communication, mobility and self direction. Income is not a basis for eligibility for this program. However, cost sharing may be required on a sliding fee scale.

Once eligibility has been determined, a service coordinator will arrange for a visit to the home, where they will help the family identify needs and set priorities for meeting those needs. Together, the parents and the service coordinator develop a strategy to meet family needs.

(Slide 25) Resources for Support to Children with Disabilities

Service planning often includes the use of several funding sources, starting with the family's own insurance or the Medical Assistance program. The service provider should have in their backpack, a knowledge of all of these services that are shown on this graphic, beginning with private insurance, you are going to ask the family about what does their insurance currently cover, and you want to make sure, that the family, if the child is eligible for Medical Assistance, does take advantage of eligibility for that program.

(Slide 26) Medical Assistance

Medical Assistance can pay for many of the medical needs of children, including diapers for children over the age of 3, special medical needs, home nursing services, a whole range of medically necessary services can be paid for through the Medical Assistance program.

(Slide 27) Public Schools

Beyond the Medical Assistance program, public schools also provide services, including occupational, physical and speech therapies. Ordinarily you want to know what the child's school program is like. You want to know what the child is getting through their school program. You also want to inform the family of any special projects, such as the parent education project, if the family feels the need to know more about their rights and how they can advocate on behalf of their child in the schools. So you want to be aware and knowledgeable of those resources that are available to help families as they negotiate the school service system.

(Slide 28) Program for Children with Special Health Care Needs

Another program that a family might need and might be useful to them, is the program for Children with Special Health Care Needs. This program can offer an assessment of the child's medical needs. They do offer specialists, audio specialists for children with hearing impairments, and other types of specialists. They do offer some direct assistance, direct cash payments for services or for particular medical items if the child needs and the family meets certain income guidelines. So that is another program that you want to be familiar with, and you want to know when would be the right time to refer a family to this program. Sometimes you may have a child who is not eligible for the Family Support Program, but who may be eligible for this program if they have certain medical needs, but they don't have the extent of disability that the Family Support program requires.

(Slide 29) County Community Service Agencies

The next is the county community service agencies. The county community service agencies will provide the Family Support Program as one of a list of other programs that they do provide. The Birth to 3 Early Intervention program is another important service for children under the age of 3. That program can offer services, therapies, and individual help to families. And when your child is in this age group, often times the Family Support program takes sort of a second, or supportive role to the Birth to 3 program. The Birth to 3 coordinator may be the lead person who is coordinating the services for this child. They work with the Family Support Coordinator for children who are eligible for both programs.

The Community Options Program is another program that is administered by the county agency. That program was created to divert people from nursing home services. It generally deals with adults who are either who are elderly or disabled. However, the Community Options Program has been a tremendous additional support for children and families in this state. About 400 children in Wisconsin are on the Community Options program. Generally they are children whose needs extend beyond what the Family Support Program is able to pay with its limited dollar amount, its limited gas filling funds. The Community Options Program can pay additional funds for higher cost situations. Now beyond that, other programs which have helped similarly to the Community Options Program are the Medicaid Home and community based waiver programs. The Community Integration Program, the Community Options Program, which is the waiver part of that program, and there are a couple of community integration programs. The detail on this, the Family Support Coordinator will have to know and understand. But this is not something I would go into detail here.

The next thing that a community county agency might provide would be respite services. As I said, many respite services were developed in the state prior to the time that the Family Support Program came into place. Those respite services are still in place, and many counties have respite programs. Some counties don't have respite programs, but many counties do. They often serve adults and children, they serve a large group of people, but those programs can offer services and can be part of the full complement of services you might offer a family. And then, I just wanted to point to the adult services. That a young person might be looking to go into as they get in their adolescence, and as they begin to plan as families and service coordinators begin to plan for adult services for a young person.

(Slide 30) Voluntary Groups

Voluntary resources should be looked at. Those include Easter Seals, the Arc, the local telethons, United Way, civic groups and so forth. These are things that people need to search out themselves. Some folks are very good at this, going out and speaking to different voluntary groups and seeking their help and also seeking their partnership and including children with disabilities in some of their activities and in many of the things that they are doing.

Finally, but certainly not least, are the family, friends and neighbors of the child. We talked a lot about that, so I won't go on with that. All of these resources, are again, this is a list of services and a list of resources, but the family support coordinator is responsible for negotiating this list, for thinking about what can be helpful, and for telling the family, informing the family about what is available, what are they eligible for, what can they get, what are the kinds of things that they should be doing and should be looking out for that they may not know about in their experiences.

(Slide 31) Service Implementation

Once the family support coordinator has worked with the family and developed a service plan, then the services are put into place. The family doesn't really see the coordinator, may not see the coordinator for another six months. At this time, they would reassess how the service plan is going. Of course, at any time in between, the service coordinator and the family can get together, they can talk on the phone, they can modify the service plan, they can change what is in there to fit what are the individual needs of that particular family, should those needs change over that time.

Now, will all of the people who meet eligibility for family support services actually get them? This is a hard question, because it has a difficult answer. The fact is that this is a state funded program with a limited budget. Eligibility is not a guarantee that all families will be served. Agencies may have waiting lists for services and assessments. Agencies do make the final decision on who is served and must approve each family service plan. Priority for services may be given to families in a crisis situation, or families who are bringing their child home from an out of home placement. The agency makes those decisions.

(Slide 32) Oversight and Monitoring

Oversight and monitoring of the Family Support program is done at both the local and state level. At the local level, the administering agency is required to set up a local Family Support advisory committee. This committee, made up of more than 50% parents and also people from the schools, public health and social services, is charged with responsibility of reviewing and advising on the annual family support program plan. They look at how the program is going and they help the agency and advise the agency in planning the next year of services, and in how the services will work that year. The primary purpose of this advisory group and of the service plan is to help assure that parents are involved in all levels of service development, including the oversight and policy development for the program.

Now this is the basic framework of the Family Support Program. Through this foundation, the program attempts to provide individualized, family centered supports for families who have a child with severe handicaps. There aren't many guarantees in life, but families are one guarantee that you can count on. And that is what we like to do.