TO: The DMR Community
FROM: Elin M. Howe
DATE: February 19, 2010
RE: Update 168

As we begin the new year and the start of a new decade, I want to take this opportunity to share with you the accomplishments we achieved in 2009 and to highlight a few of the initiatives that are currently underway.

Name Change: A major milestone was the change of our agency's name to the Department of Developmental Services. Thanks to the perseverance and committed efforts of many self advocates, families, citizen advisory board members, legislators, public officials, state staff, provider staff, and other supporters, the agency name change became effective on June 29, 2009.

Facilities Restructuring Plan: In December 2008, the Executive Office of Health and Human Services released the Community Services Expansion and Facilities Restructuring Plan with the announcement that four facilities including the Fernald Developmental Center, Monson Developmental Center, Templeton Developmental Center and the Glavin Regional Center would be closed. The current facilities' census is 806. The Department anticipates closing Fernald this fiscal year, pending completion of renovations at Heffron Hall A & B at the Wrentham Developmental Center. Facility staff at all Centers continues to provide quality support to the residents as evidenced by the Centers continued re-certifications to operate as ICFs-MR.

Rolland: Through the tremendous efforts of our field operations staff and our providers, we were successful in meeting our obligations under the Rolland Settlement Agreement. By the close of December 2009, the Department had successfully placed 300 individuals through both the use of Rolland expansion funds and through facilitating the return of individuals to their homes.

Self Determination: We have also made significant progress in promoting self-determination within our programs and services. In the Spring and Summer of 2009, the Department committed to making Self Determination our agency's priority with the issuance of our Policy on Self Determination and the Report to the Governor and Legislature on how DDS would implement a self determination service model. You can find the Policy on Self Determination and the Report with recommendations, on the Department's website, www.mass.gov/dds.

Autism Waiver: October 1, 2009 marked the start of the third and final year of the Model Autism Waiver Program where the families of all participants are self-directing their supports. This program currently serves 107 children under the age of nine. Since it began, the program has served a total of 144 children. This past June, the Autism Waiver Program was reviewed by the federal Centers for Medicare and Medicaid Services and received positive feedback on the robust and integrated nature of the quality management system. DDS staff will be working on the renewal to extend the Autism Waiver Program for five additional years.

Three New Federal Waivers: In the next several weeks, the Department will be formally submitting to CMS for federal approval of three new adult waivers that will offer more self-directed options for individuals and families. The three waivers are the Residential Supports Waiver, the Community Living Supports Waiver and the Adult Supports Waiver.

Each of these waivers offers a range of self-direction opportunities. Each identifies the specific services that can be self-directed and will include tools and processes that can help those individuals who wish to self-direct. Among the many waiver services that individuals can self-direct are in-home supports, individualized day services, homemaker, chore services, home modification and assistive technology services. Support brokers, agency with choice, a more person centered planning process are amongst the tools and processes to help individuals and families who choose to self direct. Currently, staff is working on finalizing the service definitions, tools, processes and supports to make self direction successful. The plan is to implement these new waivers on July 1, 2010.

Family Supports: Family Support is a service that is due to be put out to bid this Spring under state procurement law. Family Support is really is a mix of many different services (such as, respite, family leadership and training, home modifications, family support coordination and specialized equipment and supplies). Under the rules governing the waivers, services cannot be bundled. For Family Support, this means that the Department will need to separate family support, as we know it now, into new discrete activities and services. The Department has been seeking advice and feedback from members of the Statewide Family Support Council, providers and other stakeholders on how family support should be re-designed to satisfy the federal requirements and to provide new ways to improve supports to individuals and families and promote self-determination. The contracts for the new Family Support programs and services will take effect on July 1, 2010.

Survey and Certification: Since the Spring of 2009, the Department has been working closely with providers and getting feedback from individuals and families to revise the survey and certification process that has been in place for over 15 years. The new process will result in more efficient and thorough review of programs and services by taking an "audit" approach to capturing information from a cross section of individuals, records and interviews which would be more representative of the breadth and depth of a provider's supports. Emphasis will be on continuous quality improvement cycle that focuses on areas needing improvement, and greater use of the provider's internal systems for supporting quality. This new process will be implemented in Fiscal Year 2011.

Changes in Law and Regulations: There were changes to the DDS regulations that went into effect this past September in 3 main areas, 1) the agency name was changed to the Department of Developmental Services and language consistent with contemporary usage, such as individual with intellectual disability was added; 2) the procedures for conducting eligibility re-determinations was amended; and 3) the Department's CORI regulations were replaced by EOHHS CORI regulations.

The revisions to the Uniform Probate Code also changed how guardianship cases and other probate matters are handled.

Investigations: Over the past 18 months, the Investigations Division reduced by almost 40 percent, the number of outstanding investigations. This was achieved through improvements and efficiencies in business processes and practices, staff training and greater use of information and data collected through the Department's information systems. The Department's investigations regulations that have been in effect since the mid-90's are being revised to bring them in line with business practices and protocols that have been developed over the past 15 years. Many of the changes proposed in the new regulations will lead to better and more efficient work by investigators and the Department's staff.

Human Rights: Our Statewide Human Rights Advisory Committee is reviewing the Department's restraint regulations and current practices as measured against the generally accepted practice standards. This review covers the use of prone restraints which many states have banned because the technique poses a significant risk of serious harm.

Health and Wellness: H1N1 - Over the past several months, the Department has been taking steps to minimize the disruptive effects of the H1N1 (swine) flu and to reduce the spread and seriousness of illness during this flu season. Through our coordinated efforts with the Department of Public Health, we have provided guidance to individuals, families, providers and DDS staff, on how they can prevent getting or spreading the flu and taking care of someone who becomes sick with the flu. In addition, we established flu clinics at DDS facilities and provider sites where individuals and employees can get the H1N1 flu vaccinations.

Falls Prevention Campaign - The Falls Prevention Campaign is a direct result of our Quality Council's review of HCSIS data showing a high number of unplanned hospitalizations due to injuries from falls. The goal of this project, known as "Screen, Train, Observe, Prevent, F alls ( S.T.O.P. Falls )" is to decrease the number of preventable falls for people with intellectual disabilities. As part of the campaign, we provided all 200 of our providers with a training CD and curriculum designed to decrease fall and trained over 300 provider staff across the state on how to use the new materials to train additional staff. Our current tracking of the rate of all falls in residential and day programs will tell us whether the initiative made a positive impact.

Employment Initiative: In spite of the tough economy last year, 1,726 individuals supported by the Department were working in individuals jobs. This represents an increase of about 130 people from the previous year. The Department has used various approaches to promote employment. Through the re-bidding of our employment and day services, we directed these services to focus on increasing employment in jobs in the community. All of the area offices developed local employment plans that set goals to increase the number of individuals employed at jobs in the community. These local planning efforts also strengthened partnerships and collaboration with providers, other state agencies such as MRC, schools, the career centers and businesses in promoting employment for people with disabilities. One concrete example is our work with the Institute for Community Inclusion and the Work Without Limits federal grant that included comprehensive training for more than 200 front-line employment specialist staff on job development; training for young adults and their families on transition to employment; work with self-advocates in developing training and resource materials on employment for them to share with their peers; and a new publication, "School Days to Pay Days: An Employment Planning Guide for Families of Young Adults with Intellectual Disabilities" that will be available shortly.

In the upcoming year the Department will continue to work collaboratively with all of our partners to promote employment in a variety of ways including offering training opportunities and the development of other resources and publications.

Residential Initiative: A team of DDS staff and residential providers are working on evaluating our current residential system. The team is exploring other options to the standard community residential models, which may open a variety of living opportunities for individuals who need residential supports. The team has begun to compile a list of short-term and long-term recommendations for Departmental review.

SAC-CAB-Advocacy Collaborations: Our Statewide Advisory Council (SAC) and each of our Citizen Advisory Boards (CAB) and Boards of Trustees had another very busy year. Their valuable contribution in time and effort in communicating and educating legislators and state officials about individuals with intellectual disability and their families and their real life stories of what DDS services and supports mean to them had a great impact on the various budget deliberations that took place throughout the Spring and Summer. In addition, the SAC worked on disseminating emergency preparedness information, recommendations for promoting self advocacy/self-determination, recommendations to address diversity issues, and advice on the new waivers and on a grant to evaluate the autism waiver. The CABs were also very active. Among the activities reported were the recruitment of new board members, including self-advocates; family citizen monitoring visits of residential and day programs; hosting of legislative breakfasts and forums; and testifying at public hearings and town meetings. Go to the Department's website, www.mass.gov/dds, where you can learn more about the CABs work in the booklet, "In Their Own Words," Citizen Advisory Board Accomplishments 2009.

Last year was a very challenging year. It looks like 2010 will be equally challenging. We have much to be proud of in terms of what we, in partnership with our DDS Community, have accomplished. For 2010, we will need to continue work on our initiatives and stay focused on our mission to create innovative and genuine opportunities for individuals with intellectual disabilities to participate meaningfully in and contribute to, their communities as valued members.

SAC/CAB Annual reTreat held on January 23
On Saturday, January 23, 2010, there were about 50 individuals from the Statewide Advisory Council, the Citizen Advisory Boards, Boards of Trustees and the Department who attend the annual SAC/CAB retreat in Palmer Massachusetts. The focus this year was on strengthening advocacy and collaboration amongst the boards and with our disability partners. During the morning session, there was a panel discussion by representatives of the disability partners on legislative priorities and strategies for building stronger advocacy networks and coalitions. On the panel were Leo Sarkissian from ARC MASS, Gary Blumenthal from the Association of Developmental Disability Providers, Craig Smith and Ed Bielecki from Massachusetts Advocates Standing Strong, Richard Krant, Jr. from the Coalition of Families and Advocates of the Retarded, Maureen Gallagher from the Massachusetts Down Syndrome Congress, Dan Shannon from the Massachusetts Developmental Disabilities Council, Mike Borr from the Advocates for Autism of Massachusetts and Christine Shane from the Statewide Advisory Council,.

SAVE THE DATE - DDS State House Event Set for March 22 nd at 10 AM
On Monday, March 22, 2010, the Department of Developmental Services and the Statewide Advisory Council will celebrate "March is Intellectual Disability/ Developmental Disability Month" in the Great Hall at the State House. The theme, "Take Action, Take Charge." acknowledges the increased and effective civic involvement of individuals with intellectual disability and their families to educate the public, policy-makers and legislators on their issues. For more information, contact Ralph Edwards at 617-624-7755 or email him at: Ralph.Edwards@state.ma.us.

SAVE THE DATE - Wednesday, March 2 nd is MDDC/Arc Legislative Reception
The 32 nd MDDC/Arc Legislative Reception is set for March 2 nd at 10:30 am at the Grand Staircase of the State House. This theme for this year's event is "Shaping 21 st Century Disability Policy- the Americans with Disabilities Act: 20 years and counting."

Translation Feature Added to MADIL
The Massachusetts Aging and Disabilities Information Locator (MADIL) has added a language translation feature. MADIL is a one-stop search engine that will search both disabilities and elder service resource Websites.

You can now enter information and see results in your choice of over 50 languages. The translation feature will allow you to enter in MADIL your search term in English and then to print out the results in Spanish, for instance. It will also allow you to enter the search term in their native language.

To use the translation feature, you would click the Translation link that appears under the search box at http://www.mass.gov/madil. Enter the search term(s) in the language of your choice, then select the language you used in the search box and the language you'd like to have for the results. Clicking links on the results pages will bring you to more detailed information that is also translated. The translation feature on MADIL is solely for the purpose of performing searches. If you are looking for a place to translate text you can try the Google Language tools at http://translate.google.com/# or http://www.google.com/language_tools?hl=en.


This information is provided by the Department of Developmental Services.