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St of ca-rehabilitation-cal2 Moderator: Thomas Dempsey February 12, 2015 2: 45 pm ct


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Any amendments to the SPIL, including an amendment changing the designated state entity, must be developed in accordance with the Rehab Act, which means it also needs to be signed by more than half the directors of the centers in California. Amendments will continue to be signed by the chairperson of the SILC. They need to be signed by 51% of the directors. The director of the designated state entity is required to sign it but more to be a part of the implementation. It’s not a role of approval.
WIOA emphasizes that the provision of Independent Living services to individuals with significant disabilities needs to increase in unserved areas, and that that should be reflected in the SPIL.
The next SPIL development will include the directors and we want to get engagement early in the process so that it’s very easy to move through to the end. We’ve already started. We’ve put out inquiries for our needs assessment and we continue to get feedback from the community at our quarterly meetings. Our next quarterly meeting is March 5 and 6 here in Sacramento.
The SILC will proactively communicate with the leadership of the Independent Living Network to make sure we have consensus of at least 51%. I think we’d like 100%, but we want to get as much consensus and cooperation as we can in order to avoid disruption of 7C funded programs. Because when the SPIL isn’t approved, then the 7C monies get held up.
The Department of Rehabilitation and the SILC will work together on the issue of twenty-eight centers and forty-nine 7C grants. The SILC has voted already to create a resolution that they want to send out, definitely to RSA and to ACL, that - the SILC believes and recognizes California to have twenty-eight independent living centers. This is something, also, that the funding formula - the ad hoc funding formula workgroups that is convening has acknowledged and approved.
You know that in the past, because California receives forty-nine 7C grants, sometimes we get into this tug of war with RSA about how many centers there are in California; but we feel like we have really strong footing in asserting that there are twenty-eight centers and the Department of Rehab supports us in that. All of California independent living centers have at least one 7C grant. So everybody counts as a center in that regard.
Irene?
Irene Walela: Sure. Thank you, Liz. WIOA will also change performance indicators for the ILC’s and develop performance indicators for the SILC’s, which is a change. WIOA charges the administrator for the independent living program with developing and publishing these performance indicators for the ILC’s and the SILC no later than one year after the enactment of the WIOA, which would be July 2015.
The law has not changed regarding compliance reviews or monitoring of the ILC’s. the IL staff at RSA -- which is now going back and forth with Health and Human Services, it’s the same staff -- will continue to conduct those on-site compliance reviews during the transition process. APL will be making the final decisions if there are proposed corrective actions or technical assistance needed related to those reviews.
WIOA also transfers the federal oversight for independent living services and programs under the Assistive Technology Act of 1998 from the RSA to the Administration for Community Living and Health and Human Services at the federal level.
The Independent Living Administration within ACL is headed by a director who is appointed by the Health and Human Services secretary. A minor point is that the Senate confirmation that’s required for the commissioner of the RSA is not going to be required for the director of the Independent Living Administration. The director of the Independent Living Administration will be directly responsible to the administrator of ACL.
In December, ACL announced the beginning of its reorganization, which included the process that we’re undergoing right now which is the transition of grant monies and transition of staff. Over this past weekend, staff started the moving process from RSA to ACL and will continue to keep getting those updates and staying in touch so that we’re providing the proper services.
And I’m going to turn it back over to Liz.
Liz Pazdral: Thanks, Irene. We recently learned that (Jamie Kendall) is serving as the Acting Director of Independent Living for the Administration on Community Living. WIOA changes the language. You all have noticed this. It’s no longer called a DSU -- designated state unit. It’s now going to be called a designated state entity. The independent living and assisted technology programs continue to be administered within the Department of Rehabilitation in California consistent with California law. We are looking forward to regulations that clarify whether there is a change from how a designated state unit was made and from how a designated state entity is made.
Department of Rehab and SILC continue to actively engage with the Administration on Community Living and RSA regarding the independent living and assisted technology federal level transition activities such as staffing, State Plan for Independent Living development, monitoring, reporting, and the most important funding.
Irene Walela: Thank you, Liz. This concludes our presentation, which we put together to present a high level overview of the important issues, some of which are currently in effect and some which we will expect to be planning for. Thank you for listening. Again, you’re invited to email comments to WIOA@dor.ca.gov. And also, watch for the transcript of this call on the DoR WIOA Web site.
Liz Pazdral: Information about all of SILC’s work can be found on our Web site at www.calsilc.org. Now is your opportunity to respond to questions on the invitation that will help the Department of Rehabilitation and SILC in moving forward. WE will repeat the questions that we asked earlier.
Irene Walela: This is Irene. The first question we asked was -- what more can the DoR do to provide useful guidance and technical assistance on WIOA-related topics with no new resources?
Liz Pazdral: This is Liz. How can the DoR be a better partner with the SILC and with all the twenty-eight independent living centers? Another question -- what successful strategies have you developed for offering transition services?
Irene Walela: Now I’ll turn it back to Tom.
Thomas Dempsey: Thank you Liz and Irene. Operator, at this time we’re going to turn it over to our question and answer portion of the conference call. Would you please remind the participants how they might get into the queue to ask a question or make a comment?
Coordinator: If you would like to ask a question or present a comment, please press star one. You will be prompted to unmute your phone and record your name. Again, that’s star one. One moment, please, for the first participant.
Irene Walela: This is Irene. I know that we offered the three questions as possible discussion prompts, but I wanted to be clear to everyone that’s listening that we welcome your comments and ideas on subjects that are of interest of you, and particularly about WIOA. We consider this a time to hear from you.
Coordinator: (Robert Hand), your line is open.
(Robert Hand): Hi, this is (Bob). I just wanted to mention dealing with transition services, we do have the CCT program and we do that, but I think we have a very strong program for transitioning people out of high school called our Bridges Program and we have a 7B grant to develop them in training components and documents and things that could then be accessed by other ILC’s and others just for the small price on it. It would be like the little business for us. So we’re going to be having those available starting within the next month or two. I mention that for transitions.
Irene Walela: Thank you, Bob. That’s very helpful to share that and I hope that we can have a more in-depth conversation on the Bridges program and the other resources that you’re developing when we get to have a call that we can develop to brainstorming.
Liz, did you want to add?
Liz Pazdral: No. I appreciate (Bob) speaking up.
Coordinator: (Amy), Access to Independence, your line is open.
(Amy): Hi, good afternoon. This is (Amy Cuivas) from Access to Independence in San Diego. I just had some suggestions regarding how DoR can partner more formally with ILC’s related to youth transition. We’ve been involved for a few years now with a local entity at the San Diego unified school district called the Trace program. And they’re actually a TPP provider with our local voc rehab, so we’ve been working with their students on providing independent living skills training, peer support groups, and that type of thing from our core services.
And while Trace has a TPP contract with the Department of Rehab, Access to Independence does not and we’ve never been able to get any type of formal contract like that. So I think that that may be an area if ILC’s have the ability to become a TPP provider where we could have that more formal partnership and contract relationship with the Department of Rehab to do the new transition services.
And then my other thing was a question -- I may have missed it -- related to Cal Promise. I wasn’t sure what that was. You mentioned career service coordinators. So if you could email that after the call or give that information to us now, I’d love to be able to follow up on that. Thank you.
Irene Walela: Thank you, (Amy). This is Irene. I’m turning it over to Juney to talk about Cal Promise.
Juney Lee: Hi (Amy). I’d like to provide you and the rest of the listeners just a very brief overview of Cal Promise. Cal Promise is a federal grant that the state actually received last year. It’s $50 million over five years -- so $10 million a year -- and the grant funds a study.
The study is to provide services to a treatment group between the ages of fourteen to sixteen who are on SSI. And the services would be intervention to the youth and their families which would make a difference in future self-sufficiency. So it would be information around careers, more focused work experience, more counseling about benefits and how you can get off of benefits through a successful career.
And also, it is a bridge from that service to vocational rehabilitation services or other post-secondary opportunities such as college or vocational training. So that’s the program and to actually implement the services of that program, we have hired - not the Department, but the schools have hired sixty-five career service coordinators and they are the individuals that actually work with the students and the families.
Irene Walela: Thank you for that Juney. I’m available to answer more questions too after the call. I’d be happy to email you, (Amy).
I also wanted to respond to the good news that you have been working with the San Diego unified school district and the TPP program there. The TPP program is one that is set up between public entities and includes match requirement, and so there has not been opportunity in that particular method to link a non-profit and a public entity.
That does not mean that there isn’t room to explore new ideas on these kind of partnerships going forward. And as I mentioned briefly, Deputy (Jeff Real) who manages the youth services portion and the co-op program will be conducting a meeting with the ILC’s to talk about potential partnerships that we can explore.
So thank you for that suggestion and we’ll follow up with you.
Coordinator: (Paula) with Dale McIntosh Center, your line is open.
(Paula): Hi. I’m thinking that you may have answered by question, but I’m going to go ahead and restate it. If a SIL is currently implementing a youth transition program and it meets some of the criteria that DoR has for extension into youth service areas, is there a possibility that you would (unintelligible) with us, the partner, in that regard as you do in some other types of programs?
Irene Walela: Thank you (Paula). That is one of the areas that we need to explore because each of the centers has their own approach and their own program. What I plan to do is gather this information as you brought up from each center as to what exists now and look at what we can do to build on that with the DoR vendorization process, if that’s the divest model. So I look forward to talking with you about that and learning more about your program.
(Paula): Thank you.
Coordinator: (Susan Miller), your line is open.
(Susan Miller): Hi. This is (Tink Miller) at (Peers) up in the Sierra Foothills. Being small and being rural, I always have a concern that one size does not fit all and we don’t have the resources to do a lot of the services that urban centers are able to do. And we also have a great deal of difficulty with transition out of skilled nursing facilities because of the difficulties of affordable housing and getting a personal assistance provision, whether it’s IHSS or private providers because of the geography and the weather as much as anything. Nobody’s going to drive an hour up into the mountains to do a couple hours of care once or twice a week. They spend more in gas than they would - in the winter time, they probably can’t get their anyway.
So those kinds of issues play into how we’ve approached transition. We’ve only done a very few transitions out of skilled nursing facilities, but we look a lot at diversion and prevention. We do a great deal of outreach to discharge planners in hospitals as well as the nursing facilities and group homes, whatever.
So we do get a lot of referrals from them to our minor home modification program, which for us is funded primarily by our area Agency on Aging and for our AT services. So we consider that to be a transition in the sense of diversion and prevention. If we’re going directly into the home and doing the aids here - the home modification, we’re preventing them from going into the skilled nursing facility.
So one of the issues for us around the home mod program - because the funding comes from the area Agency on Aging, it has age restrictions. It’s Older Americans Act money. So we’re always looking for money from other sources that allow us to serve younger people with disabilities that don’t qualify for being served by Older Americans Act money.
So I would love to see some kind of - weather it would be Title B money or other funds that the SILC might be able to help identify and secure so that centers could access to help by assisted technology leveraged with whatever resources, locally, were available. That would be really helpful for us.
Liz Pazdral: Great, (Tink). This is Liz - and give us a fundraising goal. That’s fabulous. Thank you.
(Susan Miller): And I will -- just as an afterthought, I’m thinking it’d be great to have, at some point -- I don’t know whether it would be on a Web site or how it would work -- but a database of resources and model programs. How are those different kinds of services getting delivered in different jurisdictions? Because we always look at what else exists in the community because we have limited resources an di don’t want to waste ours to do something that somebody else is doing and doing well.
So for us, TPP is in the schools but we work very closely with the one-stop career centers. I’ve said many times before I’ve been on the board for about fifteen years and chair for the last five or six years. So we’ve really pushed accessibility and making the services and facilities fully accessible, and for them to become an employer network under Ticket to Work and to build a very close relationship with our local Department of Rehab offices.
So I’m very proud of what we’ve accomplished in that and it hasn’t been painless, exactly, to get there. but we’ve done it and so we’re meeting the need in a different way, including youth. So that’s one way that we’re able to help see that youth are getting the transition services they need through these other services.
Irene Walela: Thank you (Tink). This is Irene. I’m so glad to hear about the diversion work that you’re able to do in helping people stay out of institutions and stay (unintelligible), and also about your work with the one-stop. Definitely I’ll talk more with you about that.
(Susan Miller): Oh, I’d be happy to.
Irene Walela: Okay.
Coordinator: And once again as a reminder, to ask a question or present a comment form the phone lines, please press star one.
(Evan Levang) your line is open.
(Evan Levang): Good afternoon. This is (Evan Levang) with Independent Living up in Chico and Redding, and I share a lot of (Tink)’s concerns. We’re also a rural center, small center with - rural with offices in Chico -- which is (Buke) County, (Shasta) County. We have an office in Redding and we have jurisdiction, I guess you could say, over six more rural counties.
So we have a tremendous on-demand need particularly around transitioning youth. People have been talking to me in the community and other agencies about putting together a transition program, and I’ve been meeting with other folks in our region and putting together - working out a plan; and then with the idea of perfecting and sharpening it around for funding. So, imagine my surprise to find out that we’re going to have to do it anyway and we’re not going to get any money to do it.
So it’s - this whole thing is - I’m trying not to be demoralized and trying not to be frustrated, but I’ve been on the job here for eleven years and it’s been eleven years of trying to do more with less. This just seems like more and more with less. I’m very frustrated and I’m wondering what are we not - what can we not do if we’re going to do the new stuff?
We got just last week a large contingent of long community members came to us and laid out a whole list of requests for services. And it’s, again, another situation of tremendous unmet need, great opportunity; and that’s exciting. We really - there’s so much opportunity there, but my service providers are maxed. We’re just about at capacity. We have a hard enough time with our folks meeting the demand, and then getting everything accurately into the database so we can report. We’ve got eight hour days. I’ve got two direct service providers serving eight counties. Our business expenses go up every year. Our healthcare goes up; our grants don’t.
So that’s - there’s probably other directors on this call that are feeling - I feel it makes me apprehensive. It makes me, like I said, a little demoralized. I know there’s a lot of opportunity here and that’s the thing -- if we could - I just feel like that we could identify some resources. If Congress could free up - I mean, maybe what the twenty-eight ILC’s in California need to do is declare war on someone because Congress seems very keen on unlimited funding for activities of violence. I know I’m being facetious, but man, we could do a lot with just a little bit more support.
So I find it a little ironic - I’m actually going to have to go out and find private foundation money to do services that are federally mandated without any funding to go with it. I don’t really - then there’s fundraising as well, but we’re not big enough to have the development and all (unintelligible) fundraising falls on my shoulders. If anyone has any ideas -- bake sale -- I’m not sure what we’re going to do but we need to - we need some support. I think we can do great stuff if we just get a little bit of love - Congress, or someone. That’s all I have to say. Thanks.
Irene Walela: Thank you (Evan). This is Irene. We certainly feel your pain with the “no new funding” mantra that we’re all dealing with, and that question you asked is the very one that - one of the questions we have to focus on is - how can we keep doing this critical work and what can we stop doing so that we can do what’s mandated and expected, and meet these needs that are tremendously surfacing every day? Liz, did you want...
Liz Pazdral: Yes. (Evan), this is Liz and I’ve been bringing this up with people that I’ve been talking to and I don’t know quite how to do it; but I’d love some advice. I’ve seen other states where they’re redirecting some of the Medicaid dollars that they’re saving by moving to managed care and by emphasizing home- and community-based services - how some of those Medicaid dollars are diverted back to the independent living programs.
And I know that Department of Health - DHCS -- Department of Health and Community Services or healthcare services here in California -- is using some money that it has for administration and training and everything on the Money Follows the Person, giving it to Department of Aging, inviting Department of Aging to provide options counseling trainings. It’s seems to me there’s opportunity there for independent living to participate.
(Evan Levang): Yes, thanks Liz. I’m sure it’s not as bad as I’m thinking it is right now. Pardon my sky falling attitude, but I know we can work together. We really need to pull together. The work that we’re doing - I just think we could - we’re doing good work and we could do a lot more, but we can’t do it for free, unfortunately.
Coordinator: (Delores), Disabled Resource Center, your line is open.
(Delores): Hi. This is (Delores) at the Disabled Resource Center in Long Beach and one of the questions you gave us is - you said without any new funds, how can DoR support the ILC’s? And there’s some wonderful webinars such as the ones ILRU presents -- the Fee-for-Service and so on and so forth -- and these cost like $100. And a lot of the centers including myself can’t afford these fees; but yet we should have this important training if we’re going to be successful in presenting these innovative programs. So I was just wondering if possibly DoR could find some way to have these webinars free of cost for us.
Irene Walela: This is Irene, (Delores). Thanks for your question. I will look into that. I don’t know the answer right now and I will get back to you.
(Delores): Great, thanks.
Irene Walela: Okay.
Coordinator: (Anna Actin) with (Freed), your line is open.
(Anna Actin): Thank you. This is (Anna) and I don’t even know where to start. So I wanted to talk a little bit about - very clear on the understanding that there’s a new federal mandate and no additional dollars. But I don’t think - I think independent living centers are kind of not - we’ve always kind of been willing to do what we have to do and not really ask for much more.
And I think there are a lot of initiatives that we can really look to to help build the capacity of independent living centers to do this important work. Those of you who (unintelligible) Medicaid dollars (unintelligible) that we need around expansion of our services; and especially with managed care, with new transition or transition (unintelligible) diversion.
There’s really this need and the SILC has taken a lead, really, around this on the ADRC’s and I think that regardless of whether you are an ADRC or believe in that, that the concept - I think many of us would not disagree with because we’re at a point where we have to coordinate on the local level, the state level, and the federal level with all these different funding sources to leverage our strengths and to make us more effective at what we do to produce better outcomes and serve the community.
And so I think the idea of really looking on the state level with the Department of Rehab of what’s going on with the Department of Healthcare Services, Medicaid, CCT, and look at where we can leverage these kind of relationships and opportunities. We are a CCT lead organization at (Freed) and we’re really ramping up our particular program, and have done it smart and been strategic about it, and are getting some really good results.
But I’m always taken aback at the criticism, really, from Department of Healthcare Services that they don’t believe that we have the capacity or the strength to be able to really do this effectively. And then they refer to the Department of Developmental Services and how well they’re doing in transitioning individuals; yet we know that they have always funded the DD system to transition people out of institutions through administrative dollars that maybe wasn’t - maybe they weren’t supposed to use it in that way and that stuck.
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