Department of Mental Retardation
Annual Plan for Family Support
State Fiscal Year 2005 (July 2004 – June 2005)

Background
Since 1995 the Department of Mental Retardation (DMR) has been providing flexible family support services.  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 individuals with disabilities and their families, 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 Department of Mental Retardation’s second Annual Family Support Plan.	

Overview of Family Support 
Definition of family support:
Family support strives to achieve the goal of helping families stay together through:
•	Developing the family’s 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.

Array of family support services and how funding will be used to deliver these services through network of family support providers:  
In the State budget for fiscal year ’05, (July 1, 2004 through June 30th, 2005), the Family Support account has been funded at $48,800,000.00. This is a $620,000.00 increase to the fiscal year 2004 budget.  The Department is currently analyzing various options to determine how to best serve individuals and families with this additional funding.  

Approximately 45 million dollars will be spent on a range of contracted family support services. Approximately 80% of this total amount provides funding for general family support services though Family Support Provider Agencies, which includes the delivery of core services that are contractually required, and flexible funding allocations.  The rest of these resources is used to fund a variety of enhanced and specialty family support services. Every DMR region funds Enhanced Family Support services including Intensive Family Support and Medically Fragile Projects.  In addition, each DMR region has funding for an Autism Support Center.  Also, there is funding for a variety of specialty family support projects that vary from region to region, such as after-school programs, social/recreational activities, camps, and planned facility-based respite services.  Some of these services are designed to only provide services for children. 

The Department of Education & Department of Mental Retardation Community Residential Education Project is a successful collaborative initiative that had an allocation of $7.5 million dollars in fiscal year 2004.   It has been funded at that level again for fiscal year 2005.  During fiscal year 2004, 308 children participated in this project.  This included 25 students who were assisted to return from residential school placements to their home communities.  In addition, 283 students utilized project resources to obtain a diversity of supports as an alternative to an initial residential special education school placement. 

It is estimated that approximately 10,000 to 13,000 families of both children and adults are receiving some type of family support service at any given time.  These services are delivered through contracts developed with about 74 family support provider agencies across the state.  All Family Support Provider Agencies are required to complete and are evaluated on Performance Outcome Measures designed around the key family support principles and core service elements.

In July 2002, the Department issued the New Family Support Guidelines and Procedures. This is a document that describes the goals and principles of family support, the types of family support services available, and all of the operational requirements.  This document was first published in 1995 and most recently revised in July 2002.	

DMR internal family support network: 
Presently DMR is organized into four regions with Regional Directors, and 23 Area Offices with Area Directors, all under the umbrella of Central Office.  Each DMR 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 DOE/DMR project.  In each Area Office there is a Children’s Coordinator 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.  Adults over the age of 22 who have met the eligibility criteria for DMR services are assigned a Service Coordinator and participate in an Individual Service Planning process.

Process for obtaining “substantial” input from families regarding current family support services:
The Department has used and continues to develop different approaches to get input from family members, in order to help assess the Department’s current system of family support and assist in revising and crafting this Annual Plan for Family Support.  The Department, in partnership with Massachusetts Families Organizing for Change (MFOFC), hosted regional forums for family members in the fall of 2003 to get input and consultation on DMR’s Annual Plan for Family Support. In addition, feedback was solicited from the Board of MFOFC, the Statewide Advisory Council (SAC) for DMR, and the newly established Statewide Family Support Council.   Efforts will continue to evolve, through both organized and informal mechanisms, to gather ongoing feedback about our family support services and the implementation and effectiveness of our Plan. 

Another approach for getting information from families and individuals occurs through DMR’s involvement in the “National Core Indicators Project,” a multi-state collaborative effort to improve performance in state services for people with mental retardation and developmental disabilities.  This national project is overseen by the National Association of State Directors of Developmental Disabilities Services, (NASDDDS), and the Human Services Research Institute.  During the past two years mail surveys were sent to: 1) families who have an adult family member living at home who is receiving some funded DMR services (2000 total with a 25% response rate); 2) families of children who are DMR eligible (1500 with a response rate of 25%); and 3) personal interviews of adult individuals receiving DMR services (total 766).   One of the purposes of these surveys and interviews was to learn more about satisfaction with services provided and with the assistance and support received from Service Coordinators.   One of the surveys findings with adult family members indicated that overall families felt that their service coordinators are listening to them attentively and sincerely; however, at the same time, families indicate there is a need for improvement on the part of the service coordinator to respond to the changing needs of the individual and family, and to help families link with other local (non-DMR) community resources.  The results of the information gathered through the National Core Indicator Project will also be used to help guide priorities for DMR’s family support services and the annual family support plan.

Focus Areas

I.  Family Empowerment:  Opportunities for families and individuals to be involved in the development of agency policies and procedures, program development, and evaluation of services.
Current Activities:
1.	The Department provides funding for family-governed and family-directed projects across the state to enable families to exercise increasing control and influence over the direction and operation of these family support services.  Information about these initiatives is included in the Department’s “Family Support Guidelines and Procedures.”
2.	Department staff will work with Family Support Provider Agencies to improve their performance in meeting contractual requirements and Performance Outcome Measures, through goal setting and monitoring.  A particular emphasis will be placed on the following expectations:  to provide opportunities for the establishment of family councils; to get family member input on policies and program development; and to at least annually conduct satisfaction surveys with families to get information about supports provided and ways to enhance services for families.
New & Ongoing Initiatives:
1.	In April 2004 the Commissioner appointed 15 members to a newly established Statewide Family Support Council.  The leadership of the Department will meet regularly with this Council to obtain their advice on issues that affect the well-being of families with family members who are either living at home or have recently transitioned from their home.  This Council will be an important vehicle to receive “substantial consultation” from families in evaluating, developing and assisting in implementing the Department’s Annual Family Support Plan.  
2.	The Department, with support and guidance from the Statewide Family Support Council will continue to work on developing multiple ways of reaching families and communicating with them about developments in our services, to obtain feedback on service delivery and program development, and to get input on satisfaction with the outcomes of activities outlined in this Plan as well as to inform new initiatives.  In addition, strategies will be explored and pursued to share more publicly the focus and work of the Statewide Family Support Council, such as posting information on our web-site, and possibly creating linkages with DMR’s Regional and Area Advisory Boards and the Regional Family Support Directors.

II.	Family Leadership
Current Activities:
1.	The Department provides support for family-directed groups to provide educational and leadership opportunities for families, such as the Family Leadership Series sponsored by MFOFC.
2.	As part of the required Core Service Elements, Family Support Provider Agencies are expected to provide and offer varied educational and learning opportunities for families and individuals that are responsive to their specific interests and needs.
3.	In partnership between the Department and the Arc, fifteen Family-to Family Support Centers provide an array of educational and training opportunities on a range of topics.  In addition, they offer mentoring and clinical support services to families covered under the Boulet Settlement Agreement to help them develop more independent living options for their family member. These services also help develop a network among families for ongoing support and assistance. 
New & Ongoing Initiatives:
1.	The Department will provide funding for leadership development opportunities for families in all of the DMR regions.  It will be important that a variety of leadership opportunities are developed that are responsive to the different needs of families across the state, particularly those from diverse cultural and linguistic backgrounds.  
2.	Department staff, with the assistance of some family members, will develop different ways to provide family members culturally relevant information and assistance that may be helpful as they plan for and encourage more independent lifestyles with their adult son or daughter.  Possible ideas include: sending information/articles in a packet to individuals and families at the time they are found DMR eligible for adult services, hosting meetings in Area Offices for families going through the transition planning process from school to adult services, and exploring the availability of resources of the existing Family to Family Centers that have been established across the state.

III.	 Family Support Resources and Funding
Current Activities:
1.	The Department will continue flexibility in funding options to support   individuals and families.
  2.  The Department will continue funding for enhanced and specialized services in order to respond to the specific needs of individuals and families, e.g. the Medically Fragile Projects, the Intensive Flexible Family Support Services.
New & Ongoing Initiatives:
1.	Completion of revisions to the “Family Support Guidelines and Procedures” will be made to update them with all current policies and practices and to ensure that departmental funding mechanisms and policies and procedures support flexibility in services to eligible individuals and their families.  When finalized, Department staff will implement a variety of ways to disseminate these and offer training on the key changes to both DMR staff and provider agencies, creating an opportunity to also address improved consistency in how services are provided across the state.
2.	The Department will continue working on a Home and Community Based Waiver for Children to pursue federal reimbursement for family support services.
3.	 The Department will continue to develop a variety of approaches to share information and support families and their adult family member in exploring and pursuing more flexible, consumer and family driven approaches in the design and purchasing of support services.  Some of these approaches include, but are not limited to, funding partnerships between families and DMR, self-determination initiatives, and expanded utilization of the Intermediary Service Organization (ISO). This information may be most applicable to individuals in the process of transitioning from school to adult life and their families, and outreach efforts will initially be focused on reaching this group. 

IV.  Accessing Services and Supports
Current Activities:
1.	The Department’s website, in concert with EOHHS,  will continually be reviewed and modified to ensure it includes all relevant family support information and that all information is presented in a family friendly way.
2.	The Department, in partnership with EOHHS and other groups, offers a variety of ways for families to access information about services and resources, such as, the Virtual Gateway, New England Index, First Call (United Way), etc.  The Department will work to improve publicity and information about these resources to help make sure families are aware of and can access them.
3.	The Department provides training for all new Service Coordinators on family support principles and services, as well as effective strategies for working in partnership with families. 
New & Ongoing Initiatives:
1.	Each DMR region will develop and make available Family Support resource information that provides both a comprehensive listing of the Family Support Provider Agencies in their region, and contact information for other family support organizations and resources, both regionally and statewide.  This information will be developed to be responsive to the primary cultural, ethnic and linguistic backgrounds of families in each region.
2.	The Department will complete a “Family Support Handbook” that will be an abridged version of key sections of the Family Support Guidelines and Procedures that is of greatest importance and relevance to families who are using family support services.
3.	The Department will offer training for Service Coordinators to improve their awareness and knowledge of generic community resources and other entitlement and benefit programs so they can provide more assistance to families in accessing other services and entitlements.  In addition, professional development opportunities will be made available to Service Coordinators to further promote their understanding of ways to develop effective and supportive partnerships with families.

V.  Culturally Competent Outreach and Support
Current Activities:
1.	The Department will continue to support a number of existing cultural initiatives in western Massachusetts and with the Family Governing Boards in Boston representing different cultural and linguistic communities, as well as focused outreach and family support initiatives in many other areas and regions.
2.	The Department has established a Diversity Council and has a Diversity Plan that includes a focus on staff training on diversity and more culturally competent service delivery. 
3.	The Department will complete work on a one year planning grant from the Administration on Developmental Disabilities to develop a design and model for a One Stop Family Center in the Enterprise Community in the city of Springfield. This planning process was primarily guided by family members and representatives of diverse and grassroots community organizations in Springfield.

New & Ongoing Initiatives:
1.	The Department will continue to develop a comprehensive and streamlined system for the translation of DMR information and materials and the provision of interpretation services, in order to promote the delivery of culturally competent family support services.
2.	Department staff will utilize the performance outcome monitoring process to evaluate the progress of Family Support Provider Agencies in improving their responsiveness to the specific ethnic, cultural and linguistic needs of families in the geographic areas that they serve, a requirement of all contracted providers.
3.	The Department will apply for a five year implementation grant from the Administration on Developmental Disabilities for the development of One Stop Family Center Network in Springfield, MA that will enhance access and coordination of services to families who are economically disadvantaged and from diverse cultural, ethnic and linguistic communities in the city.
4.	The Department will sponsor training and professional development opportunities for Department and/or provider agency staff to improve understanding of the needs of families from culturally diverse backgrounds and enhance the delivery of culturally relevant family support services.
5.	The Department will provide diversity training for up to 1,000 agency staff in the upcoming year.

VI.	Interagency Collaboration
Current Activities:
1.	The Department will continue managing the very successful Department of Education and Department of Mental Retardation Community Residential/Education Project.
2.	The Department is involved in a number of inter-agency activities with other EOHHS agencies as well as other state agencies to enhance service delivery to families and individuals served by both agencies.  Examples include the Family Caregiver Support Program, the Children’s Mental Health Commission, the Interim Policy with the Department of Social Services, etc.
New & Ongoing Initiatives:
1.	The Department will maintain an ongoing coordinating role with the other designated human service agencies named in the Chapter 171 legislation to discuss and monitor progress on family support initiatives, and to work collaboratively on improving and expanding family support services.  In addition, the Department will work with Massachusetts Families Organizing for Change in support of a new project they received funding for from the Developmental Disabilities Council to support education and awareness about Chapter 171, and to support activities related to the implementation of this legislation.
2.	Department staff will continue to work on the Transition Team, an inter-agency group in the Executive Office of Health and Human Services, which has been developed to establish a more streamlined approach for assigning state agency responsibility for service planning for individuals in the “Turning 22” process who “fall between the eligibility cracks.”  The Transition Team includes representatives of the Departments of Mental Health, Mental Retardation and Social Services, and the Massachusetts Rehabilitation Commission, Massachusetts Commission for the Deaf and Hard of Hearing, and the Massachusetts Commission for the Blind.
3.	Department staff will work in cooperation with the Department of Public Health and other EOHHS agencies to include consumers/families utilizing their services and who also have special health needs in regional emergency planning initiatives. Service providers will receive training and information about emergency personnel and resources.  Families will be assisted to develop emergency health plans.
4.	Department staff will assist the Office on Health and Disability  (OHD) with the Division for Special Health Needs to conduct outreach to organizations serving adults with disabilities.  Efforts to initiate collaborative information sharing and planning to facilitate emergency preparedness will take place with among others, the area Councils on Aging, the MS Society and the ALS Association.
5.	Department staff will continue to participate in the development and implementation of the newly created ‘Planning & Review Team,’ an EOHHS inter-agency project.  This initiative is designed to develop a coordinated effort to better serve youth and children who require services from multiple EOHHS agencies.