|
|
|
|
|
Transportation Committee Present: Lisa Kagan, Harvey Rosenthal, Greg Montague (Chair from DOT), Bob Boehlert (CQC), Susan Peerless Greg opened the meeting by saying that there will be time for public input at the end of the meeting. I. Review and analyze the Responses from MISCC member agencies: Greg advised that all agencies that are represented on the MISCC were contacted to identify any transportation programs that they run. The Committee has received responses from DOT, OMRDD, SOFA, OASAS and DOH. Two things that Greg noticed while looking through the material that the agencies submitted is that transportation is complex and there are successful programs out there. Greg suggested that the Committee focuses on best practices. II. Identification and documentation of "best practices": Committee members received documentation of "best practices". DOT submitted information on a transportation program that is run by the ARC in Utica. Niagara ARC also runs a similar program. The ARC in Utica, through the 5310 program, leases vehicles to a private bus company to provide transportation to ARC consumers and the general public. This was noted as an example of a "best practice". DOT also discussed a program in Monroe County that is run by Medical Motor Services of Rochester. Medical Motors provides transportation for over 100 agencies. Vehicles are either owned by Medicaid Motors, obtained via the 5310 program and owned by Medicaid Motors, or are vehicles that other agencies obtained through the 5310 program and are now leased to Medical Motors. Medical Motors provides transportation for people with developmental disabilities, people with physical disabilities, seniors and the general public. Lisa Kagan discussed transportation through OMRDD. OMRDD has Medicaid transportation funds. Day programs and Residential programs have money built into their rates for transportation of consumers. There is also transportation for supported employment and pre-vocational programs. Under the HCBS Medicaid Waiver program, travel training is provided to people with developmental disabilities so that they can use public transportation. Bob B. questioned if there is data on how much travel training is provided? Lisa stated that this data is not available. There is a program that ARC has been involved with in Schoharie County. Public transportation is involved. Funding for this program comes from federal rural transportation monies (Section 5311 program). SOFA submitted information on transportation programs in Schoharie and Chemung Counties. The program in Chemung County utilizes volunteers. Liability has not been a major concern. The driver not only volunteers to drive someone to appointments, but also to stay with the person (i.e. if the person is receiving dialysis). Some of the programs are demand response; other programs run by SOFA require 24-hour notice. The AAAs run the programs and have subcontractors. These programs receive money through the CSE program and Title 3B funding. The people utilizing the services are encouraged to make a contribution, but this is not mandatory. Harvey discussed a program in Lewis and Jefferson County which is run by the Northern Regional Center for Independent Living (NRCIL). This program uses volunteers. It is not an integrated program but it is a model. III. Discussion of findings, areas of further research, next steps: The Committee agreed to invite representatives of the transportation programs in Monroe, Schoharie and Jefferson Counties to speak to the Committee. Susan will ask them to speak and ask them how much time they will need to make a presentation to the Committee. They will be asked to emphasize integrated transportation and discuss how people with disabilities were incorporated into the programs. Harvey advised that Cliff Hymowitz from NYAPRS attended the National Rural Transportation Summit. Cliff will be invited to address the Committee. Harvey suggested that the Committee look into half fare programs offered by public transportation authorities offer to people with disabilities. A representative from DOT advised that any public transportation provider that receives money from the Federal Transit Administration (FTA) must have a half fare program for people with disabilities and seniors. Harvey noted that different places do it differently. There was a lawsuit in NYC to get half fare for people with psychiatric disabilities. Susan announced that Henry Sloma, a new appointee to the MISCC, will be joining the Transportation Committee. IV. Public Input: Bruce Darling questioned if transport is available for non-medical reasons in the transportation programs that were noted as "best practices". Bruce also questioned if the transportation programs were physically accessible, the percentage of the rides provided and the cost to the consumer. Bruce encouraged the Committee to not only look at "best practices", but also look at where the gaps are. Bruce suggested looking at how the gaps in transportation reinforce the institutional bias. For example, the OMRDD transportation dollars are tied to institutional settings (IRAs). Bruce also noted that public transportation is a big issue. This is a big issue not only for consumers, but also for workers. For example, people with disabilities can't move to nice housing in the suburbs because the workers can't get the transportation needed to get there. Harvey advised that the Committee should do outreach to the public to get feedback on the gaps in the system. He questioned if the Committee should ask ILCs for input. Chris Hilderbrant noted that the Committee should also look at paratransit and look at brining paratransit in compliance with the Americans with Disabilities Act (ADA). Bruce also suggested that the Committee look at taxis because they are often not accessible for some people with physical disabilities. Susan Peerless advised that we'll ask the Best Practices agencies to identify gaps, but we'll hear from more groups at the public hearings. Bruce suggested that at the public hearings, the Committee asks specific questions about transportation. Mike Baker (DOT), advised that the local ARC in Orleans County is working with the DDPC to find way to get the transportation needs of consumers met. RGRTA extended public transportation routes to Oleans County to assist in getting needs met. The DDPC will get information to the Committee about this. Chris Hilderbrant noted that the Committee should not over-emphasize integrated transportation. The Committee should not forget the end goal of integration into the community. Bob Boehlert stated that a major issue is finding a way to create a transportation system in areas where there is no public transportation. Susan Peerless noted that at the full Council meeting, Commissioner Maul will discuss future committee meetings. Community Services Committee Present: Kathy Kuhmerker, Harvey Rosenthal, Susan Peerless, Lisa Kagan, Michael Parker, Bob Boehlert, Kim Hill, Constance Laymon, Tim Williams (OASAS), Kathy Bunnell (via phone) I. Introductions: Committee members and members of the audience introduced themselves. II. Review of decisions and actions taken at April 22, 2004 Meeting: 1. Gather information on community based services for people of all ages with disabilities. 2. Include services which assist the target population to remain at home. 3. Gather information on public and non-public programs. Information was sent out to the Committee members. III. Review responses to information request: Committee members received the responses that were submitted by DOH, SOFA and CQC. Susan noted that responses are still coming in and they will be sent out as a draft to Committee members. Bob Boehlert suggested having the Committee look at each response as it comes in to decide if it is relevant. Kathy asked the Committee what they thought about the data they have received from DOH, SOFA and CQC? CQC: Bob summarized the response by saying there are two major areas: · Surrogate decision making program · Network of Protection and Advocacy programs and CAP program. This is designed to provide access to people with disabilities for legal and administrative support services. The programs are categorical in nature. Kathy suggested that the Committee discuss how people can get a hold of each of the community-based programs. She noted that at Point of Entry (POE) system is one means of doing this. There was a discussion about how someone can find a service. Hotlines? DSS? Phone book? Kathy questioned if we should ask the state agencies how people get information about their programs. She noted that the Committee needs to develop recommendations on how to make it easier to access services. Bob B. expressed that he has concerns about referring people to call their local Department of Social Services about accessing services. Harvey commented that he thought this is supposed to be a policy discussion, not a discussion about developing a phone book for accessing services. He stated that this should be more of a macro discussion. We should be cataloging what services are out there now and then determine how they can be made better. There was a discussion of format for the responses. Kathy noted that they received data in chart form from DOH and narrative form from SOFA and CQC. Kathy asked what format the Committee prefers? It was discussed that chart form might be easier to comprehend and that it could be sorted by agency and by program. IV. Next steps: The Committee will continue getting data so they can make recommendations. Kim suggested that we get a sense from committee members of what other information should be asked for. Kathy advised that they could start to compile a list of what other information would be useful. V. Public Comment and other business: Bruce advised that the next logical question is how can each agency support people to remain in the most integrated setting? What are the things you have to do so that community services are as easy to access as nursing home placement? The Committee could build off of the SOFA/DOH Discharge Planning Workgroup. Kathy asked if there are best practice models out there? The Committee needs to find out what's out there, what isn't there and what gaps exist. VI. Next Meeting: The next meeting will be June 14th from 1:30-3:00 pm. Quality Assurance/Quality Improvement Committee Present: Neal Lane, Kim Hill, Lisa Kagan, Bob Boehlert, Greg Jones, Sharon Flom Neal Lane noted that as we look at improving the long-term care system and implementing the Olmstead decision, central to that is the consumer. The needs, preferences and desires of the consumer should always inform us as to how we can reform services so that services are in line with the desires and needs of the consumer. Neal asked Committee members what they see as important outcomes of quality assurance tools? Greg Jones said that he is interested in seeing what other Q.A. tools are out there. We need to determine the quality of service from a customer viewpoint and where and how those services are delivered. Sharon noted the importance of focusing on different populations that will be served. Any evaluation should focus on unique populations. Greg suggested that the OCFS coordinate with the MISCC in terms of the out of state placement population. Bob noted that the consumer satisfaction survey might not tell you a whole lot. We need to be able to ask questions in terms of if services were appropriate, if the person had choices, what particular aspects of the services allowed you to live in the most integrated setting and what barriers the person encountered. Lisa advised that she hopes to determine that there was informed choice and how much that was made available to the person. How do you evaluate that the person knew about what all of their choices were? Kim said that she is anxious to see where the gaps are. We need to make sure that the tools use open-ended questions. She wants to know bout what tools are out there and noted that advocates are putting together a model tool. Bob noted that the Committee is looking at quality of life satisfaction versus looking at consumer satisfaction. Bob said that we should also be asking how much the service helped or hindered the person from living in the most integrated setting. Harvey noted that he'd like to make sure that the QA tool promotes informed choice, promotion of hope, full integration and self-determination. Neal noted that we also need to discuss what regulations will prevent reform of the system. Neal then asked the Committee what they want to see as the qualities and characteristics of a quality assurance tool. The QA tool needs to be able to focus on different populations, promote choice, promote systems change and system enhancement. Neal advised that tools the Committee has collected will be emailed out to all Committee members. The homework will be for all Committee members to look at the tools. Neal encourages whoever has ideas and/or new models to share them with the Committee. Committee members should be thinking about how to identify gaps and weaknesses with the tools. Committee members should identify aspects of the tools that they believe are strengths and should be included in future tools. Look at the data elements that comprise a well functioning tool. Consistency in the data elements is important, as we need to be able to measure across the system. Bob questioned if Neal was looking to define a universal QA instrument. Neal advised that there may have to be multiple instruments, but there should be consistency. The Committee might just want to specify the critical elements and that these need to be further developed. Greg noted that assuring that people were aware of all of their choices is extremely important. The manner of how the survey is given should also be taken into consideration. Is it face to face? Is it anonymous? Lisa advised that peers should be administering the survey. Harvey noted that in his experience, when people are asked multiple-choice questions they say things are great, but on the same survey people are describing something far different when asked open-ended questions. He noted that people gave more honest responses in open-ended questions when a peer was proctoring them. Privacy is also important. Neal asked Susan Peerless to invite Sharon Carpinello (OMH) to the next Committee meeting. Technical Experts and Timing: Neal asked the Committee if there are technical experts that would be useful to the Committee. Kim suggested Bruce Darling, Tracie Crandell and Greg Olsen. Lisa suggested the Self Advocacy Association. Harvey suggested Cheryl McNeil. Neal asked Susan Peerless to make sure that the technical experts get a copy of the QA tools that will be sent to Committee members and ask them to attend meetings. Public Input: Bruce Darling advised that the Committee should look at content analysis to compare qualitative data with quantitative data. He also noted that the time you do the survey is extremely important, particularly for people who are in nursing homes. Tracie Crandell advised that there needs to be a reconciliation between the provider perspective and the consumer perspective and that dignity of risk must be accounted for. Next Meeting: June 14th at 10:00 am. |