D.C. Statehood Hearing Delayed

This weekend the Washington Post reported that the planned July 24 hearing in the House of Representatives on D.C. statehood has been postponed:  https://tinyurl.com/yy8dqves.  The hearing was delayed at the request of D.C. Representative Eleanor Holmes Norton, due to the postponement of former special counsel Robert Mueller’s hearing in the House from this coming Wednesday, July 17, by one week, to July 24.  Alas, no schedule yet for the D.C. hearing, but I promise to keep on top of it and to let you know!

Staying Informed on the Georgetown Health Contract

In addition to the comment that Andy Reese, director of D.C.’s Department on Disability Services (DDS) posted at the end of my blog post on July 5, “Andy, You Need a Plan” (https://www.DDinWDC.com/2019/07/andy-you-need-plan.html), he issued a formal statement via email on July 12 which I quote in full below:

Several people have reached out recently expressing concern that the Department on Disability Services’ (DDS’s) contract with Georgetown’s University Center for Excellence in Developmental Disabilities (UCEDD) will conclude at the end of August 2019.  Although this contract is ending, and the mechanism for providing these services may change, as DDS Director I want to clarify for you that no services currently available under this contract to people supported by DDS’s Developmental Disabilities Administration are being terminated.  DDS will continue to ensure that people receive high quality, innovative services from DDS and our provider network.

The UCEDD has been a vital partner with DDS for the past thirteen years, and its Developmental Disabilities Administration Quality Assurance Health Initiative (DDA Health Initiative) was a critical component over many years. Together, we strengthened our system’s ability to support people with intellectual disabilities living with complex clinical and medical needs within our community. Today, our service delivery system has matured to the point that the services not already provided under the Medicaid Home and Community-Based Services (HCBS) Waiver for Persons with Intellectual Disabilities can be successfully transitioned to agency staff and other providers.  

With the expiration of Georgetown’s latest contract on August 31, 2019, which included a base year and four, one-year options, DDS revisited each of the elements of the contractual requirements to determine how best to deliver those services. Two of the services included in the current contract (i.e. Parenting Support and Sexuality Education) are now HCBS waiver services for which DDS has adequate providers. For the remaining services, DDS will be continuing services through in-house staff or external contracts. The development and provision of training, technical assistance and onboarding of new nurses will continue and be provided by the DDS’s State Office of Policy, Planning and Innovation (SOPPI). Already SOPPI has hired a registered nurse trained as a nurse educator who has experience providing this type of support. Having this position within DDS’s office on innovation ensures a focus on best practices in the field of ID. Coordination of care will continue to be supported during hospitalizations, sub-acute, and long-term acute care placements by a transition specialist under a contract, with the flexibility in hours and scheduling to enable the specialist to successfully support people in their evening, night and weekend work. DDS plans to contract with a physician who will continue the work of serving as a liaison between physicians, specialists, surgeons, providers and DDS. This contractor will have the same flexibility in both hours and scheduling. 

We are actively working with Georgetown University to transition all of these activities. This transition has been thoughtfully planned. I am confident that all necessary services will continue, without interruption. DDS will continue to move forward in ensuring the health and safety of people with intellectual disabilities and providing innovative high quality services that enable people with disabilities to lead meaningful and productive lives as vital members of their families, schools, workplaces and communities in every neighborhood in the District of Columbia.

(signature)

Andrew Reese, Director

DC Department on Disability Services

At the same time, today’s Washington Post contains this follow-up article by Theresa Vargas: https://tinyurl.com/y2kj7sjq, which quotes former DDS director Laura Nuss on the subject.  Andy’s comment on my blog, and his follow-up statement above, tells such a different story from that told in the Post that it can be quite hard to disentangle.  Hopefully, the human services committee’s roundtable on July 23 (https://dccouncil.us/event/committee-of-the-whole-human-services-public-roundtable/) will give everyone the full picture.  What I will say for now is this, though:

This is yet another example of DDS’ not engaging its stakeholders adequately at the front end – having not adequately explained and discussed ahead of time with stakeholders where it’s proposing to take health services in the future, it has laid itself open to a media furor.  Much of this could have been avoided.  More broadly, I do not personally feel satisfied by the invitation Andy extended in his July 9 comment contained below, for people to join established DDS working groups in order to shape the future of disability services:  DDS needs to reach out to people in a more open-ended, receptive way about the strategic direction of the Department.  Otherwise I’m afraid we will all be seeing too many disagreements playing out in the pages of the Post, and that is in no one’s best interests.

More on DDS Cancellation of the Georgetown Contract

Quick update:

·       In my last blog post (“Andy, You Need a Plan”) I wrote about cancellation of the DDS contract with Georgetown for health services.  In response to that blog post I received a response from Andy Reese, DDS director, which you’ll find in the Comments section underneath that post.  Andy’s views as expressed in that comment are his own – like you, I’ll be examining it to determine my further thoughts on the subject.

·       Also relevant is the fact that Brianne Nadeau’s committee of the DC council is planning a roundtable on this matter on July 23:  https://dccouncil.us/event/committee-of-the-whole-human-services-public-roundtable/.

This issue is clearly creating  some serious buzz.  I happen to find myself in New Orleans at the moment so the weather is a bit on my mind.  You’ll hear more from me on this, I promise!

Andy, You Need a Plan

If you took the time to read through the Post yesterday you saw this article:  https://wapo.st/328YVLp concerning DDS’ cancellation of the contract with the Georgetown University Center (https://ucedd.georgetown.edu/index.php) for medical services.  My son has not had a need for these services as yet, but I can well understand the concerns of people for whom such supports can smooth the path from hospital to home.   At a more fundamental level, what I see here is another example of DDS springing a surprise on the disability community rather than engaging with its partners and stakeholders about the directions it is taking and its forward planning to meet future challenges.  I wrote about this early last month, and invited my readers to contact Andy and others in the senior DDS management – have you done that?  DO IT TODAY!  Here are those addresses again:

Andrew Reese, DDS director andrew.reese@dc.gov

Jared Morris, DDS chief of staff thomas.morris@dc.gov

Winslow Woodland, DDS/DDA deputy winslow.woodland@dc.gov

Erin Leveton, DDS deputy, quality and performance   erin.leveton@dc.gov

(she’s not gone until July 19!)

Darryl Evans, DDS/RSA deputy darryl.evans@dc.gov

It’s well past time for Andy and other senior managers to take some time to get real with stakeholders on DDS strategy, and to invite a dialogue (no, a series of dialogues) on how best to address core challenges.  Continuing to launch surprises is not the way to sustain support in the community. 

And before closing – I promised the information on the time and place of the hearing in the House of Representatives on DC statehood on July 24.  The time is 10:00 a.m. at the Rayburn House Office Building (Room 2154).  Mayor Bowser has declared this month DC Statehood Month in honor of this historic event:  https://content.govdelivery.com/accounts/DCWASH/bulletins/24ec935.  PLAN TO BE THERE!

NOW HEAR THIS

I hope that you, your families and friends are looking forward to a happy and healthy 4^th tomorrow.  In the holiday spirit, I’m keeping this new blog post brief, with just a few important announcements:

·       First, the sad news that Erin Leveton will be leaving DDS on July 19.  She will become a consultant on systems change to the state of Maryland’s disability services.  D.C.’s loss will be Maryland’s gain.  I hope that Andy Reese will select someone who is equally focused on innovative systems change in D.C. and outreach to the full D.C. community.

·       Congratulations to Molly Whalen, co-chair of the DDS Family Support Council, for this opinion piece in the new online newspaper DC Line (https://thedcline.org/) on dwindling education options for D.C. students with disabilities:  https://tinyurl.com/y5hyqpc3

AND

·       MARK YOUR CALENDARS FOR THREE IMPORTANT EVENTS DURING THE WEEK OF JULY 22!

o   On July 24 there will be a hearing on D.C. statehood in the U.S. House of Representatives. It will take place in the Rayburn House Office Building, and as soon as I have the exact time and room number I will share those.  (If you know, please leave a comment on this post!)  I am hoping to gather a dedicated band of D.C. folks from the disability community to show up in force – WE NEED TO MAKE OUR NATIONAL REPRESENTATIVES SEE REAL PEOPLE WHO LIVE IN D.C. AND WANT OUR RIGHTS! (note the 51 stars!)

o   On July 25, 12:30-2:30 (location TBD), the Family Support Council will hold a public meeting focused on recent developments with HSCSN (https://hschealth.org/health-plan) that affect Medicaid services for those 26 and under.  This is a great opportunity to get up to speed on what the recent changes mean, and the Department of Health Care Finance (DHCF), which oversees all Medicaid waiver programming, will also be present.

o   On Saturday, July 27, 5:30 onward, Quality Trust for Individuals with Disabilities will hold its annual Summer Breeze gala (https://tinyurl.com/yydzdxdv), at the Ronald Reagan Building, 1300 Pennsylvania Avenue NW.  Please come and support QT – I serve on its board and know better than most all the essential contributions it makes behind the scenes on behalf of people with developmental disabilities in D.C. as well as on the national scene.  Buy your tickets and be there!

A Fair Deal for Direct Support Professionals

(The supporter above asked that I not show her face in the photo)

The D.C. council’s committee on human services and committee on health co-chaired a joint hearing on June 13 to consider Bill 23-214, “Direct Support Professional Payment Rate Act of 2019.”  This bill arose from the conclusions of a working group that has been looking at DSP pay and retention issues over the past year.  At this time DSPs must be paid the D.C. living wage, which any organizations receiving $100,000 or more in contracts or assistance from the D.C. government must pay their employees.  However, by July 2020, D.C.’s minimum wage will reach $15.00 and catch up with the living wage.  With little (now) or no (by next year) differential between the two wage rates, there will be little incentive for people to assume the arduous work of being a DSP rather than taking a far less demanding minimum-wage job.  In order to address this, the bill - co-sponsored by councilmembers Nadeau (human services committee chair), Gray (health committee chair), Silverman and Grosso - recommends adoption of a tiered wage system for DSPs ranging from 110% to 125% of the D.C. living wage.  Here is a summary of the bill - https://tinyurl.com/y33t88yl.  (I have not yet located a copy of the actual bill.)

The D.C. Coalition of Disability Service Providers (http://dc-coalition.org/), as well as many individual service provider agencies, DSPs, people receiving support, family members and others turned out in support of the bill, with more than 40 people testifying in favor.  Supporters pointed to the fact that neighboring jurisdictions in Maryland have established DSP wage floors above the Maryland minimum wage.  (The Maryland state minimum wage is currently lower than D.C.’s, but Montgomery County already is supporting a DSP pay rate of $15.00, above the current D.C. minimum wage which will go to $14.00 on July 1.)  They also discussed the difficulty facing DSPs who want to live in D.C. as opposed to the far suburbs – according to a 2018 report by the budget director of the D.C. council (https://tinyurl.com/y5hvbkot), the actual cost of living for a single adult living in D.C. would require an hourly wage of $17.78 per hour, and many DSPs must hold at least one other job in order to make ends meet.  A key argument made was that vacancy and turnover rates in D.C. are higher for DSPs than in neighboring jurisdictions.

Speaking for the D.C. government, deputy mayor and director of the Department of Health Care Finance Wayne Turnage and DDS director Andy Reese argued that  the National Core Indicators (https://www.nationalcoreindicators.org/) do not show the same numbers for DSP vacancy and turnover rates as those cited by the Coalition and other supporters.  They went on to say that singling out DSPs as worthy of a higher pay rate than similar care providers such as home health aides and personal care assistants would not be defensible and that the pay raise, if enacted, would need to be extended to others, meaning higher costs.  They said providers are able to pay DSPs at a higher rate now if they want to and can justify the costs.  They further said that self-direction, which DDS plans to introduce next year, will provide more flexibility in this regard.

Government representatives are always going to argue for budget restraint.  It’s what they have to do.  For me, though, what’s true without a doubt is that DSPs can’t support themselves, much less a family, living within the boundaries of D.C.  Do we want D.C. providers to keep having to reach further and further out into the suburbs for DSPs who have to drive 10 or 15 miles to get to the people they support?  In the end, what the deputy mayor testified may also be true – these same benefits may need to be extended to other groups of care providers.  But doesn’t that just show that we don’t yet have a living wage in D.C.?

This was an amazing event at a great many levels, including the fact that this is the first time in the past decade that I recall sitting in a hearing on legislation about which local advocates and DDS were on opposite sides of the issue.  This is a sign of maturity in the D.C. disability community, and it was exciting to see how many folks turned out to testify.  I hope that people will stay just as motivated as we move ahead to create a system of disability supports in the District that is equitable and rights-based for everyone.

And there’s still time on this bill – written testimony can be provided through June 26 at humanservices@dccouncil.us.  Let your voice be heard!

And So Many Aren't Even Eligible for Disability Supports in D.C.

As I wrote in my last blog post, all signs are pointing toward cutbacks in waiver services through the Department on Disability Services. This is happening while many folks still aren’t even eligible for any waiver supports at all because they can’t qualify for the restrictive IQ cutoff that determines eligibility.  Foremost among these in terms of numbers are D.C.’s autistic citizens.  I’ve written about this before, but I’m glad to see that the D.C. council is beginning to pay more attention to this issue, as shown in the FY 2020 budget report issued by Brianne Nadeau’s committee on human services:  https://tinyurl.com/y47p8qu5.  The discussion of the DDS budget starts on page 44 of this report, and on page 49 is a section entitled “Identifying Autism Spectrum Disorder [sic] needs and providing supports.”    In this section and in the committee’s “Policy Recommendations” on page 52 of the report, the committee commits itself to work with the Office of the State Superintendent of Education (OSSE) “and any other relevant parties” to identify needs of those on the spectrum.  The committee also states that it will “urge DDS to make changes in their referral system…[and] continue meeting with stakeholders to determine whether legislative action might be appropriate moving forward.”

This is an immense breakthrough, which we should all hail wholeheartedly.  Having the ear of the council on this matter is essential, and the wording as it stands has only one crucial drawback:  there are people with other developmental disabilities who also are being excluded by the IQ requirement, and the council needs to ensure its further discussions and planning remain inclusive of these other less numerous groups of people who also may need targeted supports.

It may seem counterintuitive to be discussing budget constraints and eligibility expansion in the same blog post, but the important thing to note here is that this is a time of ferment in the city’s thinking about disability supports.  With the closing two years ago of the Evans case that for so long defined the city’s disability services, now is the time to shape a new future.  At this moment the mayor may be seeing this only through the optic of budget strictures, but that can change if she hears from folks who care about disability rights in the District.  And as the committee report I quoted above demonstrates, human services chair Brianne Nadeau (Ward 1) is just waiting to hear more from us on this subject.

D.C. has made remarkable strides over the past dozen years in the planning and delivery of supports for people with disabilities.  It’s gotten loads of credit for the progress that’s been made.  Now is the time to set the stage for D.C.’s next big breakthrough and keep us at the cutting edge of disability rights. 

DDS: Let's Talk About Where You're Headed

During consideration of the mayor’s proposed FY 2020 budget there were significant disagreements between the Bowser administration and the D.C. council with respect to public housing, and according to WAMU these continue to create hurdles for the District’s budget next year:  https://tinyurl.com/y68xxhse.  It becomes more obvious each and every day that housing also is undermining prospects for the future of D.C. disability services and supports.  This is true even though DDS fundamentally got the budget for FY 2020 that it requested.  (See page 3 of the report of the D.C. council’s committee on human services at https://tinyurl.com/y47p8qu5.)

Advocates and provider agencies spent much of this past spring reviewing policies and regulations that will change how people receiving residential supports from DDS will be able to obtain and pay for housing and other costs.  Now, having gotten the funding it requested for FY 2020, DDS has quietly begun rolling out a far more significant and fundamental change: a proposed regulation that would restrict intakes for residential supports to those in an emergency situation who have limited informal supports.  Many are seeing a direct line from the housing policies discussions earlier this spring to this new development – with DDS now proposing to cut not only the costs of residential services for individuals (a separate regulation would limit day services for people receiving residential supports to 30 hours per week), but also seeking to throttle back on the number of people for whom it provides housing supports – with foreseeable results for those left out in the cold.

These new draft regulations were distributed in a routine way week before last and input was sought from whoever was able to attend the standing Monday afternoon I/DD waiver meeting on June 3. This was a remarkably low-key rollout for regulations that will have such a momentous effect on anyone hoping to live on their own with support rather than continuing to live with their parents until they die or abandon their son or daughter.  It’s nothing short of amazing that DDS never breathed a word of it in the budget hearings and briefings that were just completed two months ago.  Obviously this already was in the works, but DDS waited to drop the other shoe until its budget was safely through the council.  How the process will play out from here on these regulations is unclear.

Budget season would have been the logical time to present such a fundamental shift - one so clearly driven by cost-cutting considerations.  With the DDS director and deputies in the room, there would have been the opportunity for a dialogue with senior managers about this electrifying new departure, why it was being proposed and whether there were alternatives.  There might have been room to pursue in greater depth the ways in which DDS is collaborating with other parts of the D.C. government to open more housing to people with disabilities across the board within District boundaries and perhaps to find more creative approaches to future housing needs of those receiving residential supports.

Instead of such an open discussion, DDS is continuing the drip-drip of new policies and regulations, holding low-key “y’all come” listening sessions, with no sense for the broader context of strategic directions and choices. People also are facing new roadblocks as they seek services for themselves or family members, not just with respect to housing and residential supports. This leaves everyone – families, providers, self-advocates and other advocates – feeling insecure about the direction things are taking. 

I believe the time is overdue for a real dialogue between the senior management of DDS and the entire stakeholder community, to understand the vision DDS is pursuing for its future and the trajectory it plans in order to get there.   This is even truer in light of the discussion of broader unmet needs in the community which were raised in the DDS performance review and budget hearings (see discussion of the DDS budget in the committee report above beginning on page 44).  (I’ll talk more about this in a future blog post.)  For now, though, I urge you to reach out to Andy Reese and his senior team at DDS:

Andrew Reese, DDS director
andrew.reese@dc.gov

Jared Morris, DDS chief of staff

thomas.morris@dc.gov

Winslow Woodland, DDS/DDA deputy winslow.woodland@dc.gov

Erin Leveton, DDS deputy, quality and performance        erin.leveton@dc.gov

Darryl Evans, DDS/RSA deputy
darryl.evans@dc.gov

Ask for a series of public dialogue sessions (with a variety of participation modes to take account of accessibility and availability issues) specifically on the agency’s vision and strategic direction for FY 2020 and beyond.  There has to be more driving the future than clamping down on residential costs. and while looking back on FY 2018 is fine and important (https://dds.dc.gov/page/respect-dignity-inclusion-report-community), people need to understand clearly where things are headed as well.   DO THIS TODAY! 

A Week Worthy of Note

Two events this week should get your attention:

-          DD Council meeting.  As I’ve mentioned here before, I am the new chair of D.C.’s Developmental Disabilities Council, and this week – Thursday, May 16, 3:00 to 5:00 – is our first public meeting of the year.  (Others will be in August and November.)  This month we’ll be holding our meeting on the first floor of the Department on Disability Services, 250 E Street SW.  (Closest metro stop Federal Center SW).  Please join us to hear what your DD Council has been up to and what we have planned!

-          On Saturday, May 18, 10 to 12, Quality Trust (https://www.dcqualitytrust.org/) will hold a special event at their offices (4301 Connecticut Avenue, NW, Suite 310 – next to Van Ness metro station, across from UDC) entitled “Choosing a Service Provider:  What You Should Consider.”  If you’re just getting involved with adult services in DC or Maryland, or if you’re considering a change, this is the event for you.

Besides those specific events, I want to call your attention to two other important developments:

-          DDS has issued its first “Report to the Community,” found at https://dds.dc.gov/node/1400986.  Primarily covering accomplishments during the 2018 fiscal year (October 2017 through September 2018), it also provides a solid overview of DDS priorities.  Yes, it’s a promotional publication and so it paints a rosy view, but that’s not a bad thing when you’re trying to motivate the community to take a more forward-learning approach toward people with disabilities in our city.  So bravo, and definitely worth a read.

-          Second, I want you to know about this:  https://www.aapd.com/advocacy/voting/.  The disability vote is getting greater and greater attention, and it deserves your attention, too.  This is one of the reasons I’ve been so concerned about DDS moving people to Prince George’s County due to the cost of housing in D.C. – the right to vote is an integral part of community integration!  And just in case you think that D.C.’s voice doesn’t matter – do you realize that the House of Representatives recently voted to support D.C. statehood and that there are plans to schedule a hearing on D.C. statehood later this year (https://www.popville.com/2019/03/house-of-representatives-endorses-d-c-statehood-for-first-time-in-american-history/)?  Wouldn’t it be awesome if D.C.’s disabled citizens turned out in force at that hearing?  Think of the statement we could make! 

Any special issues or concerns you’d like me to consider in my blog?  Add a comment to let me know!

My name is Carol Grigsby.  I share information and advocacy opportunities on issues affecting citizens with developmental disabilities in Washington, D.C., including my own son.  I currently chair D.C.'s State Council on Developmental Disabilities, as well as serving on the board of the Quality Trust for Individuals with Disabilities and the Family Support Council of D.C.'s Department on Disability Services.  Previously a member of the federal government’s senior executive service, I have lived in D.C. since 1978. Follow me on Twitter @DDinWDC!

The Road Behind, the Road Ahead

Two articles appearing in the Washington Post over the past week provided much food for thought for people concerned with disability rights. I’m usually very practically minded in my blog, but these have me thinking more philosophically, and I hope to inspire you to do likewise.

First, this obituary: https://tinyurl.com/y2w8h4f3.  If you don’t know who Jean Vanier was, then you should read this concise story of his life end to end.  Vanier was a trailblazer in altering attitudes toward people with intellectual disabilities, and he left behind a model that lives on in L’Arche (https://larche.org/en/web/guest/welcome) communities worldwide.

Second, this article from Sunday’s Outlook section:  https://tinyurl.com/yynbrs7g.  This is harder to read, and introduces issues which risk dividing rather than uniting us.  I’m putting it before you in the belief that the article does a good job with a complex subject.  It’s only by grappling with such fundamentals that we can make progress together toward a world of greater acceptance and mutual support – such as Jean Vanier envisioned.

Read these, examine your heart, and move forward with courage.  Happy Mother’s Day.

My name is Carol Grigsby.  I share information and advocacy opportunities on issues affecting citizens with developmental disabilities in Washington, D.C., including my own son.  I currently chair D.C.'s State Council on Developmental Disabilities, as well as serving on the board of the Quality Trust for Individuals with Disabilities and the Family Support Council of D.C.'s Department on Disability Services.  Previously a member of the federal government’s senior executive service, I have lived in D.C. since 1978. 

Follow me on Twitter @DDinWDC.