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Transportation Committee Present: Greg Montague, Chair, Harvey Rosenthal, Michael Paris, Lisa Kagan, Susan Peerless The mission statement of the committee was read. Mr. Montague then discussed the goals of the MISCC Transportation Committee. The goals were taken from President Bush's Executive Order Human Service Transportation Coordination. The MISCC Transportation Committee should work in concert with what the feds are doing. Mr. Montague pointed out that it was important to keep in mind that DOT is not the only agency involved. The Committee may have to identify other agencies, what services they offer, funding sources, and find out the legislative authorizations and mandates. The first step is to find out what's out there. The Committee needs to have a database from which to work. The Committee is also interested in hearing about Best Practices. There are local initiatives that work. Mr. Montague advised that cooperation cannot be mandated; it can only be encouraged through rules and regulations. Michael Paris suggested that the Committee may also want to ask the agencies to identify why each best practice is successful. Harvey advised that we need to get direct input from consumers and that listening to the agencies is not enough. Harvey suggested that the committee starts with the ILCs. Mr. Montague advised that we first need to start with the state agencies and find out what consumers they serve. Susan Peerless will send a letter to all the state agencies that are represented on the MISCC and request a contact person that deals with transportation issues for that state agency. The letter will also ask for a person that can identify best practices. The contact person for the state agency will be asked to provide the following information: description of the program and purpose, how the program is funded, clients served by number and type, which local agency the state or federal money goes to. Harvey suggested that the Committee also asks for not only the number of people served, but also the number of people in need (the number of people not getting transportation, but need transportation). Lisa from OMRDD said she doesn't know how we'd get this information. Harvey suggested that we ask the providers to give this information. Mr. Montague said that this is the next step. We need to get information from state agencies first; finding out who else needs the services is the next step. The first step is to scan the environment and then you go deeper and get additional data. Harvey talked about a program that is affiliated with NRCIL in the North Country. They use volunteers using their own vehicles to provide transportation. Volunteers are reimbursed for mileage. Funding for the program comes from SOFA, DDPC, private foundations and towns. They actually measure outcomes in terms of miles and funding. For example, they can say we provided this many miles of transportation with "x" amount of funding. Susan Peerless will send out the letter to the state agencies first. The compiled data will then be sent to the Transportation Committee members and Committee members can then develop questions. Issues to consider are liability issues and how do you recruit volunteers for transportation programs. Harvey asked about time frames; he wants to make sure that we have time to get to the second tier of questions and that we aren't just getting data from the state agencies. Through a note from Donna Gillette who was in the audience at the meeting, Harvey was able to advise that some ILCs have already done transportation studies. The committee agreed that they could look at these studies as part of the second tier. The time frame for obtaining data from the state agencies is as follows: · Get contact persons (for data and best practices) from state agencies by April 28th. · Obtain data and case studies/best practices from the state agency contact people by May 12th. · Compile all of the information by May 19th. · Transportation Committee will meet on May 24th in Meeting Room 2 at Empire State Plaza from 10:00am-11:00am. · Report back to full MISCC at their next meeting on May 26th. Bruce Darling, who was a member of the audience, asked if they would be seeking to get information from the public transit authorities, specifically related to compliance with the ADA. Mr. Montague from DOT advised that DOT has information on the public transit authorities, but they are not part of the first tier of questions that will go out. Susan Peerless advised that there will be at least 4 public forums for the MISCC in July and August to be held in Buffalo, Syracuse, NYC and Albany. They may also try to hold one in Binghamton. Harvey suggested holding one in the North Country. Susan also asked that Committee members email her with suggestions about accessible state agency locations. Harvey advised that the state of Indiana may have some software that we may want to look at for transportation. Quality Assurance/Improvement Committee Present: Susan Peerless, Lisa Kagan, Kim Hill, Michael Paris, Harvey Rosenthal, Pat Fratangelo (via phone) I. Identify the disability groups that the committee will focus on in determining how quality assurance and quality improvement be conducted effectively: The committee discussed various disability groups, including blind/visually impaired, psychiatric, physical, seniors, developmental disabilities, traumatic brain injury, cognitive disabilities and deaf/hearing impaired. II. Identify the issues involved in the evaluation of services to achieve the most integrated setting: Committee discussed that they could evaluate consumer satisfaction and evaluate providers. The use of open-ended questions and peer interviewers is important. A quality assurance tool should ask "Are you actually receiving what you want and need?" Harvey pointed out that satisfaction may not be an indication of outcome. Other issues to be considered include is the service in an accessible location, issues of cultural competence and the hours of operation. We must also find out answers to questions such as "What is a job to you?", "What services are important to you?", "What does a "home" mean to you?", "What is your home like?". Should we do something else other than asking the consumer? Kim suggested that we ask agencies and trade organizations if the services they are providing are what the person needs. We could interview case managers, advocacy groups, and survey agencies about what they need to run successful programs. III. Decide on products as well as the tasks, methods/means to produce the Committee's report: The Committee needs to gather the tools that state agencies administer. Harvey suggested developing focus groups and surveys if the agencies don't have up to date data. Kim advised that the Committee should reach out to advocacy groups to find out what they currently use and see what information they want. Some groups to consider are CTIONY, ILCs, and mental health groups. The Committee needs to know, "What are your tools and how do you use them?" Everyone on the committee should email Susan a list of agencies and advocacy groups that the committee should ask. The committee will not only ask what tools are currently in use, but will get input about what a good tool would look like. At this point Bruce Darling, a member of the audience, wanted to make a suggestion. Susan Peerless advised that she "checked" and the audience cannot participate in the committee meetings. She said the committee could invite people to provide testimony, but other than that the audience could not speak at the meetings and could not be invited to join a committee. Kim advised that she is going to speak to Commissioner Maul regarding the audience speaking at committee meetings. Susan advised that Commissioner Maul said that the audience could not speak at the meetings. IV. Scope of the Committee's Report: The report will include what the Committee found out from agencies and advocacy groups. Within 2 weeks, the Committee will get the information from agencies on what tools are currently being used and how they are being used. There are two tasks, (1) the committee needs to ask the state agencies to identify what tools are being used and (2) the committee needs to ask advocacy groups what tools they use or if they have suggestions on how to develop a tool. Kim will deal with CTIONY and other groups, Harvey will deal with the mental health advocacy groups, and Pat will deal with the Developmental Disability Advocacy groups. Kim, Harvey and Pat will send a list of names and email addresses to Susan. The email will go out to the advocacy groups and the state agencies at the same time. The next meeting is scheduled for May 24th from 11:30-1:00pm in Meeting Room 2 at Empire State Plaza. Data and Assessment Committee The committee decided that they need technical experts from each state agency to make recommendations. The question is, "What does the MISCC Committee need to know about each data system to make recommendations?" Lisa Kagan advised that as we collect the data, the problems will become apparent. The goal is to have each state agency collect the same data so that we are comparing apples to apples. A main issue to find out is if there is an adequate bridge between data collection and planning. Susan will let the rest of the committee know who are technical experts are from each state agency. Bruce Darling (speaking from the audience) suggested that MMIS Data be used as it is already available. Lisa Kagan reported that no one volunteered for the Assessment Committee. She passed out information that is contained in the MIS Law. The main question is, "How do we assess people?" It was decided that a portion of the Data Committee Meetings will be used to address assessment issues. The Assessment Committee will utilize the Data Committee to collect data related to assessment. Community Services Committee The Committee discussed the need to inventory services and how each service is funded. Kathy Kuhmerker advised that at the public forums, the Committee will hear about things that don't work and also things that do work. Kathy advised that the Committee recommendations for improving the system will be general rather than specific. She also pointed out that the Committee cannot solve all of the problems. The Committee discussed the level of detail they should be collecting. They also noted that they shouldn't just be collecting information on Medicaid services. Some agencies receive funding from places like United Way to run programs. What are the categories/approaches that the Committee should take? State-agency funded programs are a place to start. The Committee will want to know what kinds of community-based services for persons with disabilities does the agency certify, fund, operate, license or regulate. There was a discussion of what is considered a community based service and who the MIS Law covers. Some of the state agencies to be questioned include DOH, OMRDD, OMH, SOFA, OASAS, OCFS, SED, DOT, DHCR, DOL, OTDA, Parks & Rec., CQC. The information that the Committee wants to collect is: Name and description of the program, eligibility requirements, who is served by the program, approximate annual number of people served, if the program has a capacity limit (is it a capped or entitlement program), funding sources, whether the program is statewide or has a catchment area. It was decided that the Committee will first collect the inventories of programs from the agencies that are represented on the MISCC. At the next meeting the Committee will discuss how to define integration in terms of services. Does the consumer have a choice as to where they receive services? The next meeting will be held on May 24th, from 1:30pm-3:00pm in Meeting Room 2 at Empire State Plaza. Commentary The decision to hold the committee meetings in a Developmental Center, a completely segregated setting, was utterly offensive. Aside from the clearly inappropriate message that this choice of location gives, holding the meeting in an institution prevents people with disabilities from participating in these meetings. Many people with disabilities who have been in such institutional settings simply could not go back into one because of the emotional pain associated with such places. Perhaps the state agency representatives assumed that an institution would be accessible. This was not the case. In fact, there were a number of significant accessibility barriers. · The facility itself was not reachable by public transportation. · The "Alternative Handicapped Accessible" route was far too long for many people to navigate independently. Many people with disabilities would be unable to travel such a long distance from the parking lot to the meeting room. · The "Alternative Handicapped Accessible" route was far too complicated and wan not adequately marked with signage. At one point, you only learned where to go after you physically entered an elevator and waited for the doors to close behind you! It was also disappointing to note that the committees did not provide materials in accessible formats for persons unable to read regular print, such as people with visual impairments. Advocates are also unaware of ANY provisions to allow Deaf persons to request sign language interpreters. The lack of even basic accessibility precludes the MISCC for having anything resembling an open process. While some disability community members have been able to attend the meetings, we have not been allowed to participate in them. It is of GREAT concern that the MISCC is not allowing non-Council members to join the committees. In other states, Olmstead Planning Councils have worked directly with the disability community to develop a comprehensive effectively working Olmstead Implementation Plan. In New York, the deck is clearly stacked against us. To begin with, there are more state agency representatives on the MISCC than consumer/community representatives. Now, state agency council members are being allowed to bring in other state agency staff to sit at the table during the committee meetings and provide input. The community representatives on the MISCC are not allowed to do this. At the last full Council meeting, Commissioner Maul specifically said that outreach to the public was permissible, and in fact, told Harvey Rosenthal that he could bring non-Council members to the Transportation Committee meeting. However, when Bruce Darling tried to speak at the meeting, Susan Peerless said, "I checked; audience members are not allowed to speak at the committee meetings." Susan Peerless informed the audience and committee members that public forums will be held during the months of July and August. However, giving testimony at a public forum is far different than having meaningful input into the process. Scheduling public forums just three months before the MISCC's plan is due leads us to question the sincerety of the MISCC's interest in public input. Why weren't these forums held in the beginning of the process, when we suggested they should be? While it is true that we do have community representatives on the MISCC, the state agency representatives run the meetings, shape the discussions at the meetings and are chairs of the committees. While the MISCC has formed committees and is putting on a show of being busy, we have to question if their work is really going to change anything. Will more people with disabilities and seniors be able to live in the most integrated setting after the MISCC than before? Truthfully, that looks doubtful. There are real indicators that we should be concerned. The state agencies have repeatedly avoided trying to measure the people NOT getting services. During the Community Services Committee meeting, Kathy Kuhmerker specifically said that they should make their recommendations general and that they couldn't solve all of the problems. However, how is the MISCC going to make a comprehensive, effectively working plan if they don't make specific recommendations? They need to come up with a plan by November of 2004. Because they are only scheduling four public forums and not allowing us to truly participate and provide input, is this plan only going to be an inventory of existing services? Are they treading water and waiting to see what is going to happen with the Governor's proposed reform of the long-term care system? Noticeably absent from any of the discussions of the committees is the subject of workers. Without a sufficient number of community based direct care workers, people with disabilities will not have access to necessary community-based services. The MISCC has yet to tackle the real problems with the current system. They have shut the disability community out of the process. They have left little room for dissent from community representatives as the state agency bureaucrats shape every discussion. According to the U.S. Supreme Court, a state will have a defense against a lawsuit if they have an effectively working plan. General recommendations do not constitute such a plan, and thousands of seniors and people with disabilities are still going to remain institutionalized against their will. This was not the intent of the MIS Law and should not be the outcome of this process. The disability community must be allowed to participate; our voices must be heard. We cannot afford to sit in silence. |