Department of Developmental Services
Annual Family Support Plan
FY ’12(July 2011 – June 2012)
Human Service Agency Overview of Family Support
A. Background
The Department of Developmental Services (DDS) has been providing flexible family support services since 1995. These services are provided to children and adults living at home with their families who are eligible for services from DDS. In July 2002, Chapter 171 of the Acts of 2002, “An Act Providing Support to Individuals with Disabilities and Their Families,” was signed into law. This legislation specifies that all named state agencies, with substantial consultation from families and individuals with disabilities, need to prepare and submit on an annual basis an individual and family support plan that explains how the department intends to provide flexible supports to families and individuals. This is the ninth Annual Plan for Family Support to be submitted by the Department.
The Department is organized into four regions with Regional Directors and 23 Area Offices with Area Directors, all under the umbrella of Central Office. Each DDS region has a Director of Family Support, who works with the Assistant Commissioner for Policy, Planning and Children’s Services, the Central Office Director of Family Supports, and the Project Manager for the Autism Division. Assistance and supports to individuals/families is provided by the Department’s Service Coordinators. Each Area Office has a Children’s Coordinator position who generally works with children under the age of 18 years and their families, and a Transition Coordinator who works with individuals generally between the ages of 18 and 22. Individuals over the age of 22 who have met the adult eligibility criteria for DDS services are assigned a Service Coordinator and participate in an Individual Service Planning process.
B. Overview of Family Support
The primary goal of family support is to provide a variety of options to families of individuals with disabilities that enable them to stay together and to be welcomed, contributing members in their home communities. The Department’s Family Support system is based on the principle that individuals and families know their own needs. For this reason, and because of the individuality of each family, the range of services available under the program is broad. This approach allows families the flexibility to identify the resources that will be helpful to support their family member in her/his home. Families are always encouraged and supported to identify resources within their community that can offer assistance. FamilySupportCenters and other family support program services are designed to be responsive to the dynamic and changing needs of the individual with a disability and his/her respective stages in life within the family context.
The Department has establishedGuiding Principles for Family Support which serves as the foundation for the delivery of services through the FamilySupportCenters and all of the other family support program services funded by the Department.
Family support strives to achieve the goal of helping families stay together through:
developing families’ natural capacity to meet the needs of family members;
offering additional supports such as staff resources, goods and services, and financial assistance; and
enhancing the capacity of communities to value and support people with disabilities and their families.
Operating principles that guide family support activities are:
Individuals with disabilities and their families are recognized as primary decision makers about their lives and supports.
Family support focuses on the whole family and recognizes that benefits to the whole family also benefit the person with a disability.
Family support requires flexible options that are responsive to families’ unique needs, strengths, and cultural values.
Families are afforded opportunities for increasing control in the planning, implementation, management, and evaluation of satisfaction of family support services.
Families are encouraged and supported to develop their natural capacities for innovation, initiative, and leadership.
Family support operates in ways that respects individuals with disabilities and their families as valued members of their communities.
Family support should be equitably and fairly available throughout the state.
Family support is pro-active and encourages family independence and capacity-building.
Family support builds on existing natural and community supports and maximizes the use of generic resources.
This past year saw many changes in the delivery of family support services related to several major re-design and re-structuring initiatives that were planned during the previous year. One was the re-design of services through the competitive procurement of family support services that was required in FY ’11, and was influenced by the significant budget reductions that had occurred in FY’10. The second was the approval of three new Home and Community Based Waiver Programs for adults. These Waiver programs requiredthe “unbundling of services” which many families had historically purchased through stipends or ‘flexible funding’ allocations, such as respite, adult companion, and individualized home supports, as examples. The Department has established master lists of qualified providers to deliver these services which offer individuals and families increased choice in selecting a provider and in the method of service delivery they prefer. This is consistent with the Department’s overall commitment to enhance self-determination. In addition, these new Waiver programs provide individuals and families increased options for self-direction of services through a new model called Agency With Choice or through use of the Fiscal Management Service, Public Partnership Limited (PPL). The creation of these services through the Waiver programs will enable the Department to increase its Federal Financial Participation (FFP), a requirement of the legislature.
The Department has specific funding designated for the delivery of family support services through the Family Support Appropriation Account in the state budget. This funding has been vulnerable during the past several fiscal years due to the fiscal challenges facing the nation and state. In FY 2010 this account was funded at $46.5 million, a reduction of almost 10 million dollars from the previous year. The budget appropriation for FY 2011 was $45,004,298dollars, and for the upcoming fiscal year, FY 12, the amount is $41, 004, 298. Of this total appropriation, approximately $35-36 million is for specific family support services and the remainder for other community support services. The Department will be looking at ways to address the reduction in funding this fiscal year of about 4 million dollars to minimize impact on direct services to families. The array of family support services provided with this funding is described in more detail in Section III, Family Support Resources and Funding.
C. Process for obtaining substantial input from families on current family support services:
The Department uses both formal and informal approaches to seek input from families and individuals with intellectual disabilities in order to help assess the Department’s current system of family support services, and to get input on policy development and future directions. This information is helpful in the development of this Annual Plan for Family Support. Department leadership is committed to continuing to expand and strengthen avenues to obtain input and engage individuals and families in discussions about Department’s services and priorities, especially during difficult budgetary periods.
Identified below are some of the key ways the Department has obtained feedback and input this past year. There have been several specific overarching planning activities in which family member consultation and participation was important.
Family Support Implementation Work Group:To support implementation of the newly funded Family Support Centers a work group was established which included several family members from the Statewide Family Support Council, FamilySupportCenter directors, some of whom are family members as well, and DDS regional and area office staff. This group collaborated to develop operational guidance for the Centers, jointly developed plans and forms for use by the Centers, and assisted in the dissemination of this information. This group continues to meet on a less frequent basis to review the delivery of program services to suggest ways for enhancement, as well as discuss ways to provide clarification and support to the Centers. Having the perspective of families as part of this work group has been invaluable.
Autism Commission: DDSleadership staff have been active members of the Autism Commission authorized by the Legislature to develop a plan and recommendations to address the growing needs of children and adults with an Autism Spectrum Disorder. DDS staff participate both in the large Commission meetings as well as on the established sub-committees. Numerous family members, as well as staff from the DDS funded Autism Support Centers, many of whom are parents of children with ASD, have been actively participating on the Commission and sub-committees where their input has helped to shapethe plansand recommendations being proposed.
Proposed Reorganization of Children’s Services by the Executive Office of Health and Human Services (EOHHS):Leadership staff at DDS are actively involved in this planning activity initiated by EOHHS with the other human service agencies who provide services to children and their families. This includes the Department of Children and Families, Department of Youth Services, Department of Mental Health and some services through the Department of Public Health. The overall goal of this proposed reorganization is to provide a more coordinated and integrated approach to the delivery of services to children from birth to age 18 and their families. Feedback and input on some of the initial ideas was sought from families, including members of the Council and MFOFC, (Massachusetts Families Organizing for Change) and the Arc of Massachusetts. Family input will be integral as this planning process proceeds in the upcoming year through involvement on both a core planning team and advisory group. It will be important that any proposed reorganization will be responsive to the specialized needs of children with intellectual and developmental disabilities and their families.
The Department’s Statewide Family Support Council is an important and ongoing vehicle to obtaininput and consultation on family support services, practices, policies, and needs. This Council, established in 2004,is comprised of parents from across the state who have children and adult family members with disabilities. The Council meets four times a year with the Commissioner and other leadership staff, with conference calls scheduled at other times to discuss emerging topics and issues. This past year the Council provided important consultation related to priorities and decisions about how to best utilize family support budget resources in response to proposed potential reductions.
Council input has stressed the importance of having an infra-structure of Information and Referral and other supportive services provided through the Family Support Centers, as well as continued funding for specific specialty family support programs, and making flexible funding available to families to help them purchase services and goods that are beneficial in supporting their family member at home. Council members also offer input and guidance on communication approaches with families and review relevant information materials as they are developed. The Council will continue to play an important role in guiding and providing feedback about the delivery of family support programs and services. During the past seven years the Council has evolved into an important vehicle for communicating the perspectives of families as policy and service decisions are being made.
The Commissioner and other Central Office leadership staff meet regularly with representatives of family and individual advocacy organizations to seek input and obtain feedback on services and future directions. This includes representation from the Arc of Massachusetts, Massachusetts Families Organizing for Change (MFOFC), Advocates for Autism in Massachusetts (AFAM), the statewide self-advocacy organization, Massachusetts Advocates Standing Strong (MASS), and the Developmental Disabilities Council. Monthly meetings are also held with the leadership of ADDP, the Association of Developmental Disability Providers.
There is regular information-sharing, discussion, and solicitation of input from the Department’s Statewide Advisory Council (SAC) and the regional and area offices’ Citizen Advisory Boards (CABs). These advisory groups play an important role in helping to inform and educate the public and other decision-makers about the needs of individuals and families and the importance of and benefits of the flexible services and supports that are provided.
Strategies and efforts will continue to evolve, through both organized and informal mechanisms, to gather ongoing feedback about the Department’s array of family support services and the implementation and effectiveness of this Plan.
D. Focus Areas: Review of Activities and Accomplishments in FY 2011 and Proposed Initiatives for FY 2012.
The following section provides a brief description of ongoing efforts as well as new activities the Department has undertaken this past year, and includes where relevant, initiatives fordevelopment in the upcoming fiscal year.
- Family Empowerment
What is the agency currently doing to promote or enhance family input or direction in the development of agency policies and procedures, program development, and evaluation of services?
The Department seeks input from individuals and families about agency services and new directions both formally and informally through a variety of organized groups and mechanism. This includes regular communication with the Family Support Council, the Statewide Advisory Council, the regional and area Citizen Advisory Boards, Massachusetts Advocates Standing Strong, and the Arc of Massachusetts, and periodic consultation with other family advocacy groups, such as AFAM and the Massachusetts Down Syndrome Congress. This past year family members were integral participants in a Family Support Implementation Work Group by providing input on the services, processes, and reporting mechanisms to support implementation of the newly funded Family Support Centers.
When the Department was engaged in several major policy development and program development planning activities related to the development of the Home and Community-Based Waiver programs and the re-design of family support services, input and directions was sought from representative family members and individuals with disabilities. Family member participation on a planning team focused onthe implementation ofthe FamilySupportCenterservices has been instrumental in helping to ensure they are family-friendly and responsive to the needs of families. Additionally, the Department’s Family Support Council members have the opportunity to review materials as they are developed as a way to seek broader input and feedback
How will agencies change how they are currently doing business to make their agency and services more family-friendly and provide opportunities for families and individuals to have greater input and influence?
Beginning in the fall of 2011, the Department will initiate a comprehensive planning process to set the course for the future of Family Support Services as we move toward the next decade. This will result in the development of a Strategic Plan that is responsive to the needs of families and individuals who benefit from this vital service. An organized approach will be developed and implemented across the regions of the State to obtain input and ideas from families using a variety of approaches including: focus groups, larger forums, written surveys, etc. This information will help identify essential services for family caregivers across the lifespan, different models for providing supports, and help document the needs and cost-benefits of providing these services. This information will be used to guide agency planning and budget development to expand resources over the next decade to support families caring for their family member at home.
The Department’s Home and Community Based Waiver Programs provide increased and enhanced opportunities for individual and family empowerment, through increased choice in service providers, choice of service delivery method, and portability of services, which allows individualsunder most circumstances, to choose to have their services moved to another service provider. The Department will continue to provide education to individuals and families so they are aware of the options available and support them to exercise their rights and choices.
The Waiver programsalso expand opportunities for individuals and families to engage in self-direction of services. There are two forms of self-direction available based on the amount of control preferred. One option is the Agency With Choice, a newer provider model that allows individuals/families to have an increased level of self-determination when they share responsibility for the hiring and management of employees who provide services to them. Individuals/families who want to completely direct their own services can do this through use of the Fiscal Management Service the Department contracts with, Public Partnerships Limited (PPL). Information and education on these self-directed service options needs to be provided on an ongoing basis so individuals and families are aware of the opportunities available to them.