transition, publicly funded long term care and integrated employment in wisconsin counties with...
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Transition, Publicly Funded Long Term Care
and Integrated Employment in
Wisconsin Counties with
Waiver Programs1
State of WisconsinDepartment of Health Services
Division of Long Term CareOffice of Resource Center Development
(10/2012)
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Our Goal
Publicly Funded
Long Term C
areTr
ansi
tion
Integrated Employment
Helping Students with Disabilities Get Ready for
Life After High School
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Learning Objectives?
Introduce ManualTransition Planning
Publicly Funded LTC
Integrated Employment
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Quality of Life OutcomesI decide where and with
whom I live.I make decisions
regarding my supports and services.
I decide how I spend my day.
I have relationships with family and friends.
I do things that are important to me.
I am involved in my community.
My life is stable. I am respected and
treated fairly. I have privacy. I have the best possible
health. I feel safe. I am free from abuse and
neglect.
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Interesting Facts
Approximately 45K students in special education Wisconsin (ages 14-21).
Approximately 8K leave school districts across the state annually.
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Key Players in TransitionStudentParentsTeachersCommunityDVRGuidanceSocial WorkerPsychologistTransition CoordinatorAides
ADRC StaffSupport StaffUniversities, Technical
/Community CollegesEmployersIndependent Living
ServicesSocial Security
AdministrationParaprofessionalsSchool Administrators
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I know my dreams and goals
Parents or guardian help me with my goals
Teachers help me with my goals
Division of Vocational Rehabilitation (DVR) can help me reach my employment goals
Social Security can help with benefits like Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), Medical Assistance (MA) or Ticket to Work
Student
Aging and Disability Resource Center (ADRC)
Provides information about services, resources and programs.
Education
Employment
Independent Living Options18 Yrs Old
At 17 yrs & 6 months call Aging and Disability
Resource Center & at 18 Call Social Security
Living My Dream: Transitioning to Life After High School
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Student RoleIdentify my interests, talents, and passions to
pursue after leaving high school.Actively participate in the IEP process and
identify my employment and independent living goals.
Work toward achieving my goals.Identify supports (people and resources) that can
help me achieve my goals.Stay in School.Develop Self-determination & Self-advocacy
skills.
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Parent RoleHelp my son/daughter identify interests, talents,
& passions.Work with IEP team.Work with son/daughter to achieve post school
goals.Collaborate with identified support systems.Support my son/daughter in advocating for
him/herself.
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Teacher RoleDevelop understanding of student’s abilities,
interests, passions.Develop & implement transition plan with student
& family.Work with student & family to achieve post school
goals.Collaborate with identified support systems.Support student in advocating for him/herself.
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Why Self-Determination?To live life as you choose in accordance with
your interests, needs, and abilities.
Self-DeterminationExercising the right to make choices & direct
your life.Self-AdvocacyKnowing and standing up for your rights.
How?Provide opportunities to make decisions and
choices at home.12
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Transition PlanningStart planning no later than 9th grade;
Several questions are provided to assist with planning; and
Students can express their goals and desires several ways.
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What have I learned? Pg. 9
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Important Things that Happen At 18Resolve the issue of guardianship and/or related
alternatives.
Understand Adult Rights & Responsibilities.
Disability Determination through SSA and apply for SSI and Medical Assistance if appropriate.
May get personalized information directly from Aging and Disability Resource Center (ADRC).
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GuardianshipParents need to resolve the issue of
guardianship and/or related alternatives
• Guardianship is the legal power to care for another person and manage his/her affairs: Guardian of the estate -finances Guardian of the person –personal needs Person may be appointed as both
• Some alternatives may include: Health care power of attorney Conservatorship Representative Payee Dual Signature Accounts
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Entitlement vs. Eligibility High School Adult Services
Special education services are free
Services based on IEP initiated by school district
Progress toward IEP goal is monitored and communicated to parents & students
Individuals with Disabilities Education Act (IDEA)
Adult services based on eligibility & vary by agency
Services based on ISP initiated by adult
Progress toward goals are monitored by consumer & require self-advocacy
Section 504 of the Rehabilitation Act & the Americans with Disabilities Act (ADA)
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What have I learned? Pg. 14
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Provides Information about services, resources, and programs
Functional ScreenFinancial Eligibility
Counsel individuals about eligibility for various programs and benefits
Aging and Disability
Resource Center
Eligibility Determination
Options/Enrollment Counseling
Path to Publicly Funded Long Term Care Services
CallADRC
At least17 yrs and 6
months old
Medicaid (Title 19)"Forward" Card
Community Options Program-Waiver (COP-W)Community Integration Program (CIP-IA , IB, II)
Provide long term care assistance that help eligible persons with physical or developmental disabilities live in their own homes or communities
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Connecting with the ADRCCall the ADRC for answers to disability
related questions
Ph.
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Aging and Disability Resource Center (ADRC)
Offers the general public a single entry point for information and assistance on issues affecting people with disabilities regardless of income.
A place to call for Students/Parents/Teachers with disability questions related to adulthood (18+).
Accurate unbiased information related to living and working with a disability.
Services can be provided at the center, via telephone, and/or through a home visit.
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Definitions “Physical Disability” means a physical
condition, including an anatomical loss or musculoskeletal, neurological, respiratory or cardiovascular impairment, which results from injury, disease or congenital disorder and which significantly interferes with or significantly limits at least one major life activity of a person” (WI Statutes 15.197(4)(a) 2).
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Definitions “Major life activity” means any of the following:
A. Self-care B. Performance of manual tasks unrelated to gainful
employment C. Walking D. Receptive and expressive language E. Breathing F. Working G. Participating in educational programs H. Mobility, other than walking I. Capacity for independent living (WI Statutes
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Definitions “Developmental disability" means a disability
attributable to brain injury, cerebral palsy, epilepsy, autism, Prader-Willi syndrome, intellectual disability, or another neurological condition closely related to an intellectual disability or requiring treatment similar to that required for individuals with an intellectual disability, which has continued or can be expected to continue indefinitely and constitutes a substantial handicap to the afflicted individual. "Developmental disability" does not include dementia that is primarily caused by degenerative brain disorder. (WI Statutes 51.01(5)(a)).
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Long Term Care (LTC) LTC is any service or support that a person
may need as a result of a disability that limits the ability to do the things that people need to do throughout the course of the day. This includes bathing, getting dressed, making meals, going to work and paying bills.
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Long Term Care (LTC) Target GroupsAdults with primary physical disabilities; or
Adults with primary developmental disabilities;
or
Adults with mental health or substance abuse
problems if they are also in the above target
groups; and
Adults who meet Functional Screen and
Financial Eligibility for Medicaid Assistance. 26
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Eligibility DeterminationFinancial EligibilityFunctional Screen
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Financial EligibilityBased on income
Generally individuals eligible for Medicaid will be
financially eligible for publicly funded LTC services.
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Functional Screeninventory of needs or list of activities that
people need to perform, or have performed for them, in the course of every-day life;
gathers information about whether a person needs help, and how much help they need, in performing the activities;
only experienced professionals who have taken a training course and have passed a certification exam can administer the screen.
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Publicly Funded LTC ServicesAdaptive aidsAdult day careAdult family homeDisposable Medical SuppliesCommunication aids/interpreter servicesCommunity-Based Residential Facility (CBRF)Consumer education and trainingCounseling and therapeutic resources
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Publicly Funded LTC Services Daily living skills training Day services Financial management services Home delivered meals Home modifications Housing counseling Personal emergency response system services Prevocational services
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Publicly Funded LTC ServicesRespite careNursing servicesSpecialized medical equipment and suppliesSupported employmentSupportive home careSpecialized transportationVocational futures planning
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The Publicly Funded Long Term Care Options Umbrella
Community Options Program-Waiver (COP-W)
Community Integration Program (CIP-IA, IB, II)
Medicaid (Title 19)"Forward" Card
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Quality of Life OutcomesI decide where and with
whom I live.I make decisions
regarding my supports and services.
I decide how I spend my day.
I have relationships with family and friends.
I do things that are important to me.
I am involved in my community.
My life is stable. I am respected and
treated fairly. I have privacy. I have the best possible
health. I feel safe. I am free from abuse and
neglect.
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Not Eligible for LTC ServicesReferral to DVR;
Consult Disability Benefits Specialist;
Post Secondary Education and Training;
Ticket to Work: Voluntary employment program through SSA.
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Appeals & GrievancesEligibility decision;
Any care plan changes;
Additional information on appeals and grievances is available from the ADRC.
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Independent Living & Housing OptionsSupport Services in the HomeSupervised/Supported ApartmentsCommunity Based Residential FacilitiesAdult Family Care Homes
There Are Varying Degrees of
Independence
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Independent Living CentersEight Independent Living Centers in
WisconsinAssist people with disabilities
Live independent livesBe active participants in community life
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What have I learned? Pg. 21
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I want to work!
Student
What Can I Do if I Want to Work?
High School Work
Experience
DVR
Learn About My Interests
& Abilities
Paid Part/Full Time Integrated Employment
Job Shadow
Social Security
Work Incentives
Paid Internship
s
2-4yr College or
Tech School
Adult Service
Agencies
LTC Employment Support
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Working with a disability?
Plan for the FutureLearn your interests and
abilities.Set employment goals.Share your dreams and
visions.Ask what do I want to do
right after high school and five years after.
Plan for the future, don’t wait for it to happen!
Prepare for WorkParticipate in work
experience through the high school.
Develop self-advocacy skills.Complete a career inventory.Know what you can do with
and without assistance.Apply to DVR four semesters
prior to completing high school.
Everyone can work!
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Employment FirstStrategies that identify employment in integrated,
community-based businesses earning at or above minimum wage .
Integrated, community-based employment as thepreferred outcome for individuals with disabilities.
Individuals with disabilities are held to same standards, responsibilities, and expectations as any working age adult.
Employment First is about raising expectations!
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Key Employment DefinitionsEmployment- Regular employment in the
workforce on the payroll of a company (unless self employed) at minimum or prevailing wages with commensurate benefits.
Integration - Interaction with co-workers without disabilities and customers is assured.
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Employment StrategiesCompetitive EmploymentSupported or Customized EmploymentSelf-Employment/Micro-EnterpriseCommunity Rehabilitation ProgramsSegregated Work Activities (previously
known as sheltered employment)Real Jobs, Real Wages, Real Business
Settings: no sub-minimum wage
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Educational Options at 18Stay in High School until 21.Some students will choose to attend
college or receive technical training, certification, etc.
Coordinate with DVR as appropriate.
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Why stay in school?Complete educational objectives
Graduate
Complete Transition GoalsVocational Assessment Job ShadowingSupervised & Supported Employment
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What have I learned? Pg. 28
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Social SecurityDisability Benefits
Disability Determination
Supplemental Security Income (SSI)
Social Security Disability Insurance (SSDI)
Employment Supports
Ticket to WorkPlan to Achieve Self-
Support (PASS)SSDI Employment
SupportsSSI Employment
SupportsStudent Earned
Income Exclusion51
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SSI + Work
Larger Total Income
SSI and WorkSSI
+ =
SSI
SSI Work Income
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Medical AssistanceAlso known as Medicaid, Title XIX (19)
Forward CardProvides Coverage for services such as:
Students receiving Medicaid, need to contact Social Security and reapply as an adult at age 18.
Doctor Services Hospital StaysPrescriptions Other Medical NeedsTransportation Personal Care
Assistants
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Medical Assistance and Work
It is possible to continue receiving Medical Assistance while working.
In Wisconsin, Medicaid will continue up to the yearly wage maximum of $32,044 (2012).
Contact Social Security for details.
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Division of Vocational Rehabilitation (DVR)
• Provides employment services and counseling to individuals with disabilities.
• Provide or arrange for services to enable an individual to go to work.
• Provide training and technical assistance to employers regarding disability employment issues.
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Vocational Rehabilitation Services Two separate determinations must be made
before an individual receives DVR services:
Eligibility determination; andPlacement on the order of selection waiting
list.The Rehabilitation Act requires that people
with the most significant disabilities be served first.
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What have I learned? Pg. 33
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Transition Checklist Pg. 34
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Resourceshttp://dhs.wisconsin.gov/LTCare/Generalinfo/
RCs.htmhttp://www.wsti.org/http://dpi.wi.gov/sped/transition.htmlhttp://dwd.wisconsin.gov/dvr/pdf_files/tag.pdfhttp://dwd.wisconsin.gov/dvr/http://www.ssa.gov/pgm/links_disability.htmhttp://dwd.wisconsin.gov/dvr/tran.htmhttp://apse.org/
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Contact InformationPresenterCell Ph. Email:
PresenterCell Ph. Email:
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State of WisconsinDepartment of Health Services
Division of Long Term CareOffice of Resource Center Development
(10/2012)