ࡱ>  |~stuvwxyz{%` bjbj BA̟̟1!  f f f D z6| \d"4}\\\\\\\$_h8b\f ݑ"\ W\ooo8 lf }\o}\oo,`: ,f 6 )lӰT?0\@\0\0 c'c66cf 7}ok0\\ d\ $ D ĺ$    VIRGINIAS COMPREHENSIVE CROSS-GOVERNMENTAL STRATEGIC PLAN TO ASSURE CONTINUED COMMUNITY INTEGRATION OF VIRGINIANS WITH DISABILITIES 2008 Update and Progress Report Adopted Pursuant to Executive Directive 6 (2007) By the Community Integration Implementation Team and the Community Integration Advisory Commission August 28, 2008 Table of Contents Page INTRODUCTION 3 How This Plan Was Prepared 3 Our Mission 3 Our Vision 4 Our Goals 4 Our Critical Success Factors 4 Goals #1 and #2: Action Plans That Apply to 7 All Four Types of Facilities Critical Success Factor #1: Plan, Understand, Choose and 7 Self-Direct Services and Supports Critical Success Factor #2: Choose Among Quality Community 10 Providers and Direct Support Professionals Critical Success Factor #3: Obtain Housing 12 Critical Success Factor #4: Locate and Obtain a Job 19 Critical Success Factor #5: Access Transportation 21 Critical Success Factor #6: Surrogate Decision-Making 25 Critical Success Factor #7: Access Ongoing Supports 27 Goals #1 and #2: Action Plans That Apply to a Specific Type of Facility 31 Critical Success Factor #7: Access Ongoing Supports 31 APPENDICES: Appendix I Definition of Planning Terms Appendix II A Guide to Acronyms Used in This Plan Appendix III Executive Directive 6 (2007) VIRGINIAS COMPREHENSIVE, CROSS-GOVERNMENTAL STRATEGIC PLAN TO ASSURE CONTINUED COMMUNITY INTEGRATION OF VIRGINIANS WITH DISABILITIES 2008 Update and Progress Report INTRODUCTION On August 2, 2007 the four Secretariats, two Councils, 21 Executive Branch entities, and six local government and agency representatives comprising the Community Integration Implementation Team (Team), and the 21-member stakeholder Community Integration Advisory Commission (Commission) jointly adopted Virginias first Comprehensive, Cross-Governmental Strategic Plan to Assure Continued Community Integration of Virginians with Disabilities pursuant to Executive Directive 6 (2007). This Plan was submitted to the Honorable Timothy Kaine, Governor, on August 31, 2007. Executive Directive 6 charges the Team to prepare annual updates and report on progress implementing this plan by August 31 of each year. The Team respectfully submits this 2008 Update and Progress Report. How the Updated Plan and Progress Report Were Prepared The Team divided into three smaller groups, each of which included a liaison and an alternate liaison from the Advisory Commission: Services and Supports (Critical Success Factors #1, 6 and 7) Workforce and Employment (Critical Success Factors #2 and 4) Housing and Transportation (Critical Success Factors #3 and 5) The three groups met from September 2007 through March 2008 to develop proposed updates to the Plan, and from April through June 2008 to compile progress reports. The updates were presented to and acted on by the Team on March 25, 2008. On April 1 and May 30, 2008, the Commission considered the updates adopted by the Team. On June 24, the Team considered the Commissions advice. The Commission submitted the updates for public comment from June 16 to July 18. The Commission considered the Teams final updates and public comment on July 29, 2008. Definitions of planning terms and acronyms used in this Plan Update and Progress Report appear at Appendices I and II, respectively. Executive Directive 6 (2007) appears at Appendix III. A. Our Mission The Team shall continue its collaborative efforts to complete and annually update a comprehensive, cross-governmental strategic plan designed to assure continued community integration of Virginians with disabilities. . . .The plan shall be submitted to (the Governor) for (his) approval no later than August 31, 2007, and shall be updated and submitted annually by August 31 of each succeeding year. Executive Directive 6 (2007) B. Our Vision We envision Virginia as one community for all citizensone that welcomes individuals with disabilities and supports them as active members of their own communities. By own community, we mean any location an individual with a disability chooses that affords the individual the opportunity for maximum possible autonomy over his or her daily life. We believe that individuals, of all ages and with any disabilities, have the right to decide where to live, and live as independently as possible, in the most integrated setting. This is the same rightno more and no lessenjoyed by individuals who do not have disabilities. One Community: Final Report of the Task Force to Develop an Olmstead Plan for Virginia (August 28, 2003), as adopted in 2004/2005 by the EO 61 and EO 84 Oversight Advisory Committee, in 2006 by the EO 2 Oversight Advisory Board, and in 2007 and 2008 by the Team and Commission. C. Our Goals Goal #1: Virginians with disabilities who currently reside in a mental health, mental retardation (now intellectual disability), nursing or assisted living facility will have the opportunity to choose to move from these facilities to an appropriate, more integrated setting and stay there. Goal #2: Virginians with disabilities who are at risk of unwanted admission to a mental health, mental retardation (now intellectual disability), nursing or assisted living facility, will have the opportunity to receive services and supports that prevent admission. D. Our Critical Success Factors 1. Virginians with disabilities plan, fully understand and choose among services and supports they need, self-directing them to the extent possible. Choices must be meaningful and driven not by disability labels, but by the unique needs and preferences of individuals with disabilities. We believe that, in order to assure meaningful choices, the Commonwealth must: Provide services and supports that are appropriate to and respectful of the individual, affordable, accessible, available, diverse, reliable, safe and accountable; Allow self-determination and consumer direction of services and supports to the extent possible; Provide maximum opportunities for individuals with disabilities and their families to participate in planning and developing services and supports as well as policy planning; Assure that individuals with disabilities and their families know about these services and supports and the choices that are available to them; Encourage independence and community involvement through livable/walkable communities, beginning with local comprehensive plans and continuing through implementation that provides transportation, housing, employment and access to services; and Address the institutional bias in the State Medicaid Plan by balancing community and institutional services. 2. Virginians with disabilities choose among individuals and agencies qualified to provide the services and supports they select. In order that individuals with disabilities have the opportunity to live, work, and participate in activities in the community of their choosing, needed services and supports must be available from qualified providers. Qualified providers can be individuals or organizations that have a variety of backgrounds, professional expertise and skills that maximize the ability and capacity of individuals with disabilities to live independently in the community of their choosing, with a quality of life that empowers them to fully participate in society. To increase the availability of qualified providers, Virginia should embrace creative solutions, including public/private partnerships, and ensure that adequate compensation is provided for services rendered. 3. Virginians with disabilities locate and obtain housing appropriate to their needs and preferences. Services and supports mean little unless Virginians with disabilities have access to housing that enables them to live as independently as possible according to their individual needs and preferences. A full array of permanent and transitional housing options must, therefore, be available. Transitional and permanent housing for people with disabilities must be affordable and accessible to all individuals who are: 1) institutionalized; 2) living in a setting they consider to be restrictive; 3) at risk of institutionalization; 4) on residential services waiting lists; and 5) homeless. Housing should be separate from supportive services and not be contingent on the receipt of services; however, supportive services must be available, accessible if needed and desired, flexible and individualized. The use of Universal Design should become standard practice in the development of new housing. If embraced at the beginning of the planning process, Universal Design can be an affordable development option. 4. Virginians with disabilities locate and obtain a job if appropriate. A true measure of integration into the community, for every individual who is able and wants to do so, is the individuals opportunity to work. The dignity, responsibility, and economic independence resulting from gainful employment is the most effective way of reducing dependence on public benefits, enhancing self-reliance, changing attitudes, and promoting full community integration of individuals with disabilities. 5. Virginians with disabilities access transportation appropriate to their needs. Transportation is basic in the integration into and survival in community living for individuals with disabilities; it is what allows all citizens to work, go to the doctor, visit friends, shop, and participate in activities in the manner they choose. Transportation of all kinds must be consistently available, affordable, accessible, reliable, and safe, and meet the needs of individuals with disabilities throughout the Commonwealth, in both rural and metropolitan areas. Transportation also includes safe and appropriate pedestrian and bicycle facilities (complete streets) and paratransit, which provides complete needs of all individuals participating within the community. 6. Virginians with disabilitiesif they lack capacity to make decisionshave the same choices, options and benefits as other Virginians with disabilities through a surrogate decision-maker qualified to act on their behalf. Most individuals with disabilities are fully capable of making choices and decisions for themselves, just as individuals without disabilities are. We acknowledge that some individuals with disabilities lack the capacity to make some or all decisions and choices for themselves. Every such individual should have a means by which decisions and choices may be made on his or her behalf. Among many other examples, some individuals may have an advance directive, and others may need a surrogate decision-maker appointed and available to act on their behalf. The surrogate decision-maker could be a family member chosen in the order set forth in the Health Care Decisions Act (Va. Code 54.1-2986), a guardian, or other legally authorized representative. Unless the context indicates otherwise, wherever reference is made to a decision or choice by an individual with a disability in the report that follows, the decision or choice may be made by an appropriate surrogate decision-maker if the individual cannot make the decision or choice independently. 7. Virginians with disabilities access ongoing supports in order to stay in the most integrated setting of choice, self-directing them to the extent possible. In order to assure choices to individuals with disabilities, ongoing community support and services must be available and reflect the importance of Virginia's full continuum of care, from self-care through institutional care. ii. GOALS #1 and #2: Action Plans That Apply to All FOUR Types of Facilities Critical Success Factor #1: Plan, Understand, Choose and Self-Direct Services and Supports Action Plan #1.1 ExpectationIndividuals with disabilities will plan, fully understand, choose and direct their own services.StrategyIdentify individuals with disabilities or their families who have had successful experiences with directing their services and supports and include them in state and local initiatives (for example, training and mentor programs) to assure that service providers and disability communities share a commitment to maximize principles of self-direction and choice.Measurable outcomes1) The number of individuals with disabilities who plan, fully understand, choose and direct their own services will increase. 2) The number of individuals with disabilities living in the most integrated setting will increase. 3) Education and training of community service providers, individuals with disabilities and families is well coordinated and consistently provided. 4) The media is educated.Implementation ActionsDate/sResponsible agency/ciesCost/s1. Identify best practice or promising practice models in other states that support self direction. Email a request to DMAS, VDA, DMHMR/IDSAS, VDOE, DSS, DRS, and IHEs for models from other states that are considered best or promising practice efforts in Virginia that demonstrate intent to promote best practices and are supportive of self direction. Include a summary of best practices in the 2008 update to the Governor.06/08DMAS, VDA, VDOE, DMHMR/IDSAS, DSS, DRS, DVS, IHEs$02. Incorporate self-direction language and promotion of person-centered practices (PCP) in policies and documents of state and local agencies, including training materials. Follow progress of Systems Transformation Grant (STG) implementation.OngoingIT$03. Develop strategies to identify and address the disparity among communities with regard to knowledge about self-direction and PCP. Follow progress of Systems Transformation Grant (STG) implementation, including major outreach and training initiatives; development of a technical assistance cadre; development and disbursement of PCP Toolkits, training materials, etc.; and a Virginia self-direction conference.2011Agencies collaborating on STG$04. Identify responsible entities to coordinate statewide education and training efforts. Follow progress of STG implementation, including major outreach and training initiatives; development of a technical assistance cadre; and development and disbursement of PCP Toolkits, training materials, and so forth.2011Agencies collaborating on STG$05. Encourage IHEs to include a curriculum that places priority on concepts of self direction and PCP in all appropriate fields. Share STG-developed Person-Centered Principles with SCHEV to distribute to the IHEs. Support requests for technical assistance and training on curriculum development.12/08SCHEV$0Action Plan #1.1 ~ 2008 Progress Report: Implementation Action #1: OCI has sent an e-mail request to the agencies. Once responses are received, the Team will include them in updates to the Governor and work on including best practices in self direction from other states and Virginia Departments. Implementation Action #2: House Bill 760 and Senate Bill 620, enacted in the 2008 Session of the Virginia General Assembly, will change the term Mental Retardation to Intellectual Disability in the Code of Virginia if reenacted in the 2009 Session of the General Assembly. This moves Virginia closer to the incorporation of person-centered language into laws. In this 2008 Plan Update and Progress Report, the term mental retardation (MR) will be followed by /intellectual disability (/ID) in anticipation of reenactment of the legislation in the 2009 Session of the General Assembly. A subcommittee of the Systems Transformation Grant Goal #2 Resource Team has been reviewing and providing feedback to state agencies on regulations and policies for the inclusion of self-direction language and person-centered practices. The subcommittee worked on Medicaid Waiver regulations and an Appendix to the Policy Manual related to the Money Follows the Person Demonstration Project, and DMHMR/IDSAS Licensing regulations, among others. The group will also review the forthcoming DMAS Omnibus Waiver Regulations. A draft plan has been developed for review of regulations and policies as they come up for periodic review through 2011 and is scheduled to be considered by the STG Goal 2 Resource Team on September 3. It is expected that the passage of House Bill 760 and Senate Bill 620 will support agencies in making changes to their regulations and policies. Implementation Action #3: In collaboration with the PCP Leadership Team, the STG Goal #2 Resource Team has developed a training schedule on PCP awareness, PCP planning processes and tools, and person-centered thinking capacity to a variety of audiences. In addition, a person-centered support plan has been developed and field tested for individuals with intellectual disabilities. Expansion of the supports plan to other populations is underway. A variety of resource bank tools has been developed and/or reviewed by the Resource Team, including Person-Centered Principles and Practices, I Want a Good Life Workbook, a Glossary, and individual and organizational assessment tools. These resources will be available later this year on the Partnership for People with Disabilities and Virginia Easy Access websites. The Goal #2 Resource Team is also working on a guide to self-direction for individuals who self direct. The Money Follows the Person Operational Protocol contains extensive information on self direction. DMAS is developing a guide to self direction of assistive technology and environmental modifications. VDOE is completing its second Im Determined video, which has a student to student connection and also held its first youth summit in March 2008, with 40 students attending. Another summit is being planned for March 2009. Implementation Action #4: DMAS, DMHMRSAS and the Partnership for People with Disabilities trained approximately 200 case managers, transition coordinators and others in person-centered planning for Money Follows the Person. See also #3 above. Implementation Action #5: The Principles and Guidelines have been shared with SCHEV, and a meeting will take place September 5 to discuss dissemination of the information to colleges and universities.  Action Plan #1.2 ExpectationIndividuals with disabilities will have a variety of choices to support their selected community integration option.Strategy #1.2.1Expand self-direction options in all service environments to increase utilization.Measurable outcomeThe number of individuals using self-direction options will increase.Implementation ActionsDate/sResponsible agency/ciesCost/s1. Identify best or promising practice models in other states that maximize self-direction choices and options. Email request to DMAS, VDA, DMHMR/IDSAS, VDOE, DSS, DRS, and IHEs for models from other states that are considered best or promising practice efforts for Virginia that demonstrate the intent to promote best practices and are supportive of self-direction and choice at each point of the service continuum. Include a summary of best practices in the 2008 update to Governor.06/08DMAS, VDA, VDOE, DMHMR/IDSAS, DSS, DRS, IHE, VDH TBD2. Develop new self-direction community integration options for Virginians, including, where applicable, adding self-direction to home and community-based waivers. Support current efforts to address Goal 2 within the Systems Transformation Grant (STG). Use recommendations from the DMHMR/IDSAS Person-Centered Planning Leadership Team to support this strategy. Promote awareness of the best practice models identified through #2 above.2011 Current Current 02/09Agencies collaborating on the STGTBD3. Promote increased usage of self-direction options through education and outreach.OngoingAgencies collaborating on the STG4. Involve the SILC, the Centers for Independent Living (CILs), Area Agencies on Aging (AAAs), Community Services Boards (CSBs), and private case management organizations in creating implementation plans for new targeted community integration best practices referenced above including transitional start-up costs. Compile a summary of new services and changes to be made through adoption of best practice models. Collaborate on establishing priorities based on populations in need, funding, and implementation plans. Work with identified agencies to determine options for funding the models. Implement the models. Assure that Virginia policy reflects the expanded options and funding mechanisms.12/08 1/09- 06/09 12/10 1/11Agencies collaborating on the STGTBDAction Plan #1.2.1 ~ 2008 Progress Report: Implementation Action #1: See Progress Report for Strategy #1.1 above. Implementation Action #2: DMAS continues to develop a self-directed individual supported employment option for the MR/ID, DD and Day Support Waivers. Self-direction of waiver services continues to increase rapidly, with the following numbers of individuals self directing in the four indicated waivers: From January-December 2007 As of March 2008 EDCD 2,294 3,144 Aids Waiver 2 4 DD 64 352 MR/ID 288 1,156 Implementation Action #3: See 2008 Progress Report for Strategy #1.1 above.  Strategy #1.2.2Develop an infrastructure to support individuals with disabilities to choose how their allocated funding is spent, with appropriate accountability.Measurable outcomeThe number of individuals using individualized budgeting will increase.Implementation ActionsDate/sResponsible agency/ciesCost/s1. Adopt Money Follows the Person initiatives. Follow progress of Systems Transformation Grant (STG) implementation: Determine budget authority and methodology; amend waivers. Design and field test pilots by waiver. Define roles of fiscal employer/agent and broker. System change complete.2011Agencies collaborating on the STGTBD Action Plan #1.1.2 ~ 2008 Progress Report: Implementation Action #1: DMAS and the STG Goal 2 Resource Team completed a study and review of individual budgeting options and have begun to work on strategies for implementation. The Money Follows the Person Projects Operational Protocol was approved by the Centers for Medicare and Medicaid Services and began as scheduled July 1, 2008. Critical Success Factor #2: Choose Among Quality Community Providers and Direct Support Professionals Action Plan #2.1 ExpectationAn environment conducive to attracting and maintaining an adequate network of quality community providers and direct support professionals will be created.Strategy #2.1.1Publish/communicate complete career ladder of certifications and licensure for individuals serving individuals with disabilities.Measurable outcomeThe number of quality community providers and direct support professionals in Virginia will increase. Implementation ActionsDate/sResponsible agency/ciesCost/s1. Continue to support existing career pathways for direct support professionals, including the College of Direct Support.OngoingIT, DBVI, DRS, DMHMR/IDSAS, DMAS2. Track the implementation of recommendations from the Health Reform Commission.OngoingIT, DBVI, DRS, DMHMR/IDSAS, DMASAction Plan #2.1.1 ~ 2008 Progress Report: NOTE: The Team will work to define the term community providers. Once more clearly defined, the Team suggests that VEC or VCCS spearhead this project with the assistance of the Team. Implementation Action #1: The College of Direct Support has been extended for two yearsyear one funded by DMHMR/IDSAS, and year two funded from the Direct Service Worker grant. As a part of the Direct Service Worker Grant, the Partnership for People with Disabilities (PPD) conducted a survey of all personal care agencies and consumer-directed attendants. A report, which is available on the PPD website, found that peoples understanding of health insurance differs. The Direct Service Worker Grant funding purchased one year of training from RRTC Net for the Virginia Association of Home Care and Hospice. DMHMR/IDSAS Human Resources Office is working on a career ladder for staff working in the DMHMR/IDSAS and CSB systems. The Virginia Association of Personal Care Assistants has been formed. Implementation Action #2: The Team is continuing to track recommendations of the Health Reform Commission.Strategy #2.1.2Adequately reimburse quality community providers and direct support professionals so that they can afford to do business.Measurable outcomeReimbursement of quality community providers and direct support professionals in Virginia will increase.Implementation ActionsDate/sResponsible agency/ciesCost/s1. Continue to monitor compensation and pay rate for direct support professionals.OngoingOCI2. Issue a report to the Governor.2007CommissionTBD3. Advocate and educate the Governors Office and the General Assembly about the need.OngoingOCI, IT$04. Facilitate activity between public and private entities to encourage collaboration and create a cohesive effort to increase rates.OngoingOCI, IT, Commission TBDAction Plan #2.1.2 ~ 2008 Progress Report: Implementation Action #1: The Team continues to monitor increases in the rate of pay of direct support professionals; OCI will present on the current rate structures September 9. No increases were funded in the 2008 Session of the General Assembly for personal assistants. The General Assembly provided an additional $5.0 million in the first year and $5.0 million in the second year from SGF and a like amount of matching federal Medicaid funds to increase reimbursement for congregate residential group home services for individuals served through the MR/ID waiver by 3.6 percent beginning in fiscal year 2009. Implementation Action #2: The Community Integration Advisory Commission included the following recommendation in its 2007 Report to the Governor: Recommendation 2: Increase Medicaid reimbursement rates for Direct Support Professionals, beginning with Personal Aides and Service Facilitators. Assistance from these providers is necessary for many individuals moving into and living independently in the community. Virginia's low payment level is a disincentive to recruitment, retention, and sustainability of an adequate workforce to support individuals with disabilities who wish to live in the community. As recently noted by your Heath Reform Commission, wages for direct support professionals in Virginia are lower than the national average. In fact, at 44th, Virginia falls well into the bottom 10 states for hourly wages for personal and home care aides, at $7.07 per hour. We are very concerned that these low hourly wages may be interpreted to reflect a comparatively low value that the Commonwealth places on community living -- an anomaly during a time of unprecedented support for community living opportunities for individuals with disabilities and those who are aging. (The Health Care Reform Commission made a First Tier recommendation for a 10% reimbursement increase for Medicaid Waiver Consumer-Directed Personal Attendant Services and a Second Tier recommendation for a 10% reimbursement increase for Medicaid Waiver Non-Consumer-Directed Personal Attendant Services.) The Commission has also indicated that it will feature this issue in its 2008 Report to the Governor this fall.Strategy #2.1.3Identify methods of encouraging exemptions of publicly-funded skilled services where appropriate so that individuals who direct their own services have sufficient flexibility to choose to have a direct support professional to perform the duties.Measurable outcomeThe number of quality community providers and direct support professionals in Virginia will increase.Implementation ActionsDate/sResponsible agency/ciesCost/s1. Identify medicine and nursing code sections and agency regulations that need to be changed or amended to increase the flexibility of individuals to direct their own publicly-funded skilled care that would not counter current delegation regulations.2008IT, DRS, DMAS, OCI, DHPTBD2. Consider amending Section 54.1-3408 (P) of the Drug Control Act to say normally self-administered drugs and not limit the route of administration. 2008OCI, IT, DHPTBD3. Work with the General Assembly to provide tax incentives for private care providers for employee training and certification. 2008OCI, Secretary of Finance TBDAction Plan #2.1.3 ~ 2008 Progress Report: Implementation Action #1: The Code sections have been identified as 54.1-2901, 54.1-3001, and 54.1-3408. Appropriate revisions are being considered. Implementation Action #2: This revision is being considered as a part of #1 above.  Critical Success Factor #3: Obtain Housing Action Plan #3.1 ExpectationHousing will be accessible for individuals leaving institutions or at risk of becoming institutionalized.StrategyEliminate physical, social and other barriers that impede an individuals ability to live in the most integrated environment possible. (Accessibility means different things for different individuals. For an individual with a mobility limitation the elimination of structural barriers might result in accessibility. For an individual with a developmental disability, accessibility might be a system of supports that mitigate limitations and perhaps include a congregate living model.)Measurable outcomes1) The number of individuals getting accessible housing will increase. 2) The number of individuals in supportive housing will increase.Implementation ActionsDate/sResponsible agency/ciesCost/s1. Approach the Money Follows the Person Housing Task Force to develop a strategy for standardizing data collection.TBDVHDA, DHCD, DSS, DMASTBD 2. Identify the barriers to accessible housing and how to address them. Work with building code officials that are responsible for ensuring that buildings are in compliance to develop recommendations on addressing barriers through programmatic responses. Promote acceptance of Universal Design as the standard for development of new housing. 10/08 DPOR, VHDA, DHCD3. Increase awareness of how to comply with Section 504 of the Rehabilitation Act.4. Evaluate the need for additional program resources to assist the development of accessible units in appropriate locations, and recommend the allocation of additional resources as needed. Recommend that the General Assembly Housing Commission participate. Explore funding sources for the fund expansion. Identify appropriate agencies to submit grant applications or to take the lead on state budget initiatives. Encourage Universal Design features for all new construction.Ongoing 12/08VBPD, DHCD, VHDA, DMHMR/IDSAS, DRS, OCI, DSS, DMAS$35,0005. Monitor and follow the work of the Money Follows the Person Housing Task Force.OngoingDHCD, VHDA, DMAS, DMHMR/IDSAS, DRS, VBPD Action Plan #3.1 ~ 2008 Progress Report: NOTE: The Teams housing and transportation group reports the following from its May 9 meeting. While some progress has been made in marginal areas of the plan there was consensus among committee members that further progress was unlikely unless and until certain recommendations were implemented in Virginia. Those recommendations follow: The Governor should take quick and decisive action administratively to bring the Auxiliary Grant program into compliance with the Olmstead Supreme Court decision. Committee members were in agreement that the continued forced placement of individuals with disabilities into Assisted Living Facilities solely because of funding was not in keeping with the intent of the Olmstead decision. Funding available under the Auxiliary Grant program should follow the individual to the most appropriate community services. The Virginia General Assembly and the Governor should move quickly to provide rent supports for individuals transitioning from state facilities and nursing homes under the guidance of the Olmstead Supreme Court decision. Further transition of individuals from institutions to communities is unreasonably restricted because there is not a single county or city in Virginia where a person with a disability can rent even a one-room apartment using 30% of their SSI payment. Until some form of rent subsidies are provided to the poorest and most confined Virginians, further transition will remain unjustifiably restricted. For those Virginians between 50% and 80% of their Area Medium Income the General Assembly and the Governor should create a fund designed to provide non-profit organizations with very low financing incentives. If providers of housing are able to access very low interest loans to construct affordable, accessible housing, those individuals of modest means could reasonably be expected to live independently. Without access to these very low interest loans the non-profit community lacks the necessary resource to make any substantial progress in this area. The Virginia General Assembly should move quickly to include Source of Income among the protected classes in the Virginia Fair Housing Law and provide for a Continuing Violation Theory for those builders and developers who knowingly and willfully violate the Virginia Fair Housing Law. These recommendations are not meant to be inclusive or exhaustive. They are, rather, only the most urgent, if Virginia is to keep pace with its commitment to the spirit of the Olmstead decision. Substantial progress cannot continue unless both the Executive and Legislative branches of the Commonwealth turn an attentive eye to the insurmountable obstacles faced by the poorest and most confined Virginians. These recommendations we trust will be addressed in the most urgent manner possible. The following 2008 Progress Reports were provided by other members of the Team: Implementation Action #1: (Note: Studies referenced in the 2007 Plan have been reviewed and incorporated into Money Follows the Person (MFP) strategies; this implementation action was, therefore eliminated form the 2008 updated plan). The MFP Housing Task Force is currently developing an Annual Housing Action Plan due in September. Members of the Team and Commission who are working with the Task Force had the opportunity to introduce the recommendation to develop standardized data collection. Implementation Action #2: Albemarle County will rehabilitate and preserve 28 existing units and construct 38 units of affordable rental housing to serve low-to-moderate income elderly residents of Albemarle County. The proposed development, to be named Crozet Meadows, will incorporate universal design elements for accessibility and is to be built to using environmentally friendly (EarthCraft) methods. Community Development Block Grant assistance will support the completion of site work including erosion control, water and sewer, curbs and sidewalks, landscaping, and storm water management. The project will directly benefit 83 individuals, all of whom are low-to-moderate income. HOME has worked in several localities with a number of new multiple family builders including Richmond, Virginia Beach, Suffolk and others. Implementation Action #4: Through MFP, DMAS has added environmental modifications to the EDCD and AIDs waivers (this benefit was already available under the MR/ID, DD and Tech Waivers). This means that all individuals who use these five waivers (whether transitioning from an institution or currently living in the community) will have access to needed environmental modifications of up to $5,000 per year if they are living in a house or apartment not operated by a provider. (For individuals who use services in a living arrangement operated by a provider, CMS considers the provider to be responsible for making the modifications). For all individuals transitioning from institutions under MFP, DHCD will provide supplemental home modifications for individuals who need more than the $5,000 limit initially. These funds will be provided from the Commonwealth Housing Priority Fund. For all individuals transitioning under MFP, DHCD HOME funds will provide up to 90 days of rent to cover the time between signing of a lease and completion of the modifications. The draft MFP Protocol provides that case managers and transition coordinators will be trained by DMAS to assure that individuals indicating an interest in participating in MFP and their family member, caregiver, or surrogate decision maker, as appropriate, receive comprehensive, timely and accurate information about whether and what types of housing assistance may be available and how to access that assistance, including accessible housing. The CILS (through Part B funding) are reviewing state/local PHA Plans to determine those that identify housing for individuals with disabilities as a priority and state and local Comprehensive and Consolidated Plans to determine those that identify individuals with disabilities as a priority and allocate specific housing resources for individuals with disabilities. The Housing Task Force is developing an annual action plan containing strategies for an interactive map showing accessible housing and available transportation. The Housing Task Force and the CILs will also provide assistance to local housing offices, local planning authorities and HUD on the existing Housing Registry ( HYPERLINK "http://www.accessva.org" www.accessva.org) and encourage its use by Public Housing Agencies. The Easy Access website contains comprehensive housing accessibility information and resources. Implementation Action #5: The Team continues to monitor the work of the MFP Housing Task Force by receiving regular updates. Several Team and Commission members actively participate as members of the Task Force and Work Group. The Team will receive and consider the Task Forces Annual Action Plan following its completion in September. Action Plan #3.2 ExpectationHousing will be affordable for individuals leaving institutions or at risk of becoming institutionalized.Strategy 3.2.1Produce more units for individuals above 60% of the area median income that can be occupied using no more than 30% of their available income.Strategy 3.2.2Provide income supplements to individuals below 60% of the area median income such that no more than 30% of their available income is spent for housing.Measurable outcomes1) The number of units to house individuals at or below 60% of the area median income will increase. 2) The number of individuals receiving subsidies sufficient to meet their housing needs will increase.Implementation ActionsDate/sResponsible agency/ciesCost/s1. Compile existing data to determine the number of individuals currently in or at risk of admission to facilities needing affordable housing units.2. Identify the type of disability housing needed, targeted income level, and geographic region. (The strategy in Implementation Action 3.1 will also include data for these areas.)7/07DMAS, DMHMR/IDSAS, DSS, VDA$13,0003. Determine the number of affordable housing units needed for the populations identified in 1 and 2 above. Complete an analysis of the data compiled in 1 and 2 above to determine the number of units needed.7/07DHCD, VHDA, DMAS $25,5004. Evaluate the need for additional program subsidies to increase affordability. Research current fair market rents throughout Virginia. Develop program structures to make housing more affordable. Project costs for such programs. Funding of a Statewide Housing Trust Fund in addition to providing resources for Rental Assistance will provide the resources necessary to meet the needs identified in the plan.7/07DHCD, VHDA, VBPD, DMHMR/IDSAS, DRS$35,0005. Preserve affordable, accessible housing where it exists. Identify the funding stream that maintains the affordability of these units. Develop strategies that consider geography and funding sources. Provide resources for rental assistance to help maintain affordability.OngoingVHDA, DHCD TBD6. Develop affordable, accessible housing where it does not exist. Funding of a Statewide Housing Trust Fund in addition to providing resources for Rental Assistance will provide the resources necessary to meet the needs identified in the plan.3/08ITTBDAction Plan #3.2 ~ 2008 Progress Report: NOTE: The Teams housing and transportation group reports the following from its May 9 meeting. While some progress has been made in marginal areas of the plan there was consensus among committee members that further progress was unlikely unless and until certain recommendations were implemented in Virginia. Those recommendations follow: The Governor should take quick and decisive action administratively to bring the Auxiliary Grant program into compliance with the Olmstead Supreme Court decision. Committee members were in agreement that the continued forced placement of individuals with disabilities into Assisted Living Facilities solely because of funding was not in keeping with the intent of the Olmstead decision. Funding available under the Auxiliary Grant program should follow the individual to the most appropriate community services. The Virginia General Assembly and the Governor should move quickly to provide rent supports for individuals transitioning from state facilities and nursing homes under the guidance of the Olmstead Supreme Court decision. Further transition of individuals from institutions to communities is unreasonably restricted because there is not a single county or city in Virginia where a person with a disability can rent even a one-room apartment using 30% of their SSI payment. Until some form of rent subsidies are provided to the poorest and most confined Virginians, further transition will remain unjustifiably restricted. For those Virginians between 50% and 80% of their Area Medium Income the General Assembly and the Governor should create a fund designed to provide non-profit organizations with very low financing incentives. If providers of housing are able to access very low interest loans to construct affordable, accessible housing, those individuals of modest means could reasonably be expected to live independently. Without access to these very low interest loans the non-profit community lacks the necessary resource to make any substantial progress in this area. The Virginia General Assembly should move quickly to include Source of Income among the protected classes in the Virginia Fair Housing Law and provide for a Continuing Violation Theory for those builders and developers who knowingly and willfully violate the Virginia Fair Housing Law. These recommendations are not meant to be inclusive or exhaustive. They are, rather, only the most urgent, if Virginia is to keep pace with its commitment to the spirit of the Olmstead decision. Substantial progress cannot continue unless both the Executive and Legislative branches of the Commonwealth turn an attentive eye to the insurmountable obstacles faced by the poorest and most confined Virginians. These recommendations we trust will be addressed in the most urgent manner possible. The following 2008 Progress Reports were provided by other members of the Team: Implementation Action #1: NOTE: In the 2007 Plan, baselines were included. Progress made on the baselines was as follows: Outcome #1: VHDA has provided the number of units at or below 60% of AMI. DHCD was to provide the number of units for single family at or below 60% of AMI by gathering data from the U.S. Department of Housing and Urban Development (HUD) for units at or below 60% of AMI (Section 8, HUD 202, HUD 811, Housing Choice Vouchers, and Housing Opportunities for Persons With AIDs). Outcome #2: DSS was to provide subsidies data from Auxiliary Grants to determine the baseline. In this updated plan, this Implementation Action was changed to the current language. Implementation Action #2: The type of housing needed has been projected for individuals participating in the MFP Project: Home owned by individual or individuals family member107/year Home or apartment with an individual lease, lockable access & egress, & which includes living, sleeping, bathing, & cooking areas over which the individual or the individuals family has domain and control101/year Adult foster care5/year Assisted Living Facility6/year Sponsored residential service58/year Group home residential43/year Implementation Action #3: See #2 above. Implementation Action #4: The MFP Housing Task Force is considering recommendations for increasing housing stock. An Annual Action Plan will be available in September. DMAS is adding transition benefits to Medicaid waivers. This will provide individuals transitioning from institutions into waiver services in the community (whether or not participating in MFP) a $5,000 maximum lifetime benefit to pay for setting up a household, such as lease and utility deposits and furniture. Implementation Action #5: OSHHR, OCI and DMAS presented on MFP to the Virginia Association of Housing and Community Development s (VAHCDOs) February conference and followed up individually with PHAs who attended and requested additional information, referring them to their local CILs. OCI and DMAS also presented at a MFP Housing workshop at VAHCDOs May conference, and will present a workshop at the Governors Housing Conference in November. The Easy Access website contains information and resources on affordable housing. The draft MFP Protocol provides that case managers and transition coordinators will be trained by DMAS to assure that individuals indicating an interest in participating in MFP and their family member, caregiver, or surrogate decision maker, as appropriate, receive comprehensive, timely and accurate information about whether and what types of housing assistance may be available and how to access that assistance, including affordable housing options. The administration will work with Virginias Congressional Liaison Office to educate HUD on understanding the housing needs of individuals with disabilities and seniors who are currently residing in institutions or at risk of unwanted admission to an institution and to seek targeted voucher rental assistance for these populations and distribute the Rutgers Medicaid Services Primer to housing agencies at the Governors 2008 Housing Conference Governor Kaine wrote to all PHAs in Virginia last fall to stress the importance of affordable housing for MFP participants. The MFP Housing Task Force will develop an annual action plan by September that will: Develop a state community living supplement that would provide a monthly income supplement for individuals who have tried, but cannot access, federal rental assistance. Assure that housing agencies have information about services agencies and a description of the services they offer through Easy Access. Assure that service agencies and advocates have information about housing agencies and a description of the services they offer through Easy Access. Develop a Housing Primer for services agencies and advocates. The CILs are using Part B funds to: Assess local housing capacity needs and develop strategies to address identified needs with appropriate local, state and federal policymakers. Develop a plan for ensuring that housing needs of individuals with disabilities are included permanently in local plans and planning processes. Offer assistance to public housing agencies in follow up to HUD Secretary Jacksons letters and Governor Kaines 2007 letter to PHAs. Provide technical assistance to local housing offices, local planning authorities and HUD on understanding the needs of persons transitioning out of an institution. Provide orientation to Public Housing Agency Plans, the Qualified Allocation Plan, Consolidated Plans, and the Continuum of Care Plan to individuals with disabilities, seniors, advocates, AAAs, CSBs, CILs, Disability Services Boards (DSBs), local DSS, other local services agencies, and the broader disability and aging communities. Ensure that the input of advocates and the broader disability and aging communities is considered in housing agencies Consolidated Plans, the Qualified Allocation Plan and local planning activities by creating a mechanism to track local changes in public policy and relate ongoing needs and solutions to statewide and national housing funding agents and authorities. Develop a contact list for review of local plans for use of HOME, Community Development Block Grant, and Housing Choice Voucher funding and disseminate the list to organizations to encourage their participation in needs statements and priorities for allocation of resources in local plans. Document local changes in public housing policy, and work with the SILC to interface with state and national public policy makers and funding agents to foster and sustain increased housing options for individuals with disabilities and seniors. Implementation Action #6: The MFP Housing Task Force is considering recommendations for increasing housing stock. An Annual Action Plan will be available in September. The Team will monitor and consider all affordable housing recommendations in the VBPD 2008 Biennial Assessment of the Services System. Action Plan #3.3 ExpectationHousing will be available and appropriately located.Strategy 3.3.1Make specific financing resources available.Strategy 3.3.2Increase local capacity to undertake development.Strategy 3.3.3Insure appropriate enforcement of laws and regulations.Measurable outcomes1) The number of new units will increase. 2) The number of developers and design professionals capable of building new units, built to Universal Design standards, in appropriate regions will increase. 3) The number of Fair Housing Complaints, including failure to make reasonable modifications, will decrease. 4) The number of local communities comprehensive plans that reflect the needs of individuals with disabilities and address issues of safe, livable/walkable communities including accessibility, affordability and availability will increase.Implementation ActionsDate/sResponsible agency/ciesCost/s1. Develop a baseline. Outcome 3: Obtain baseline data on the number of Fair Housing Complaints alleging failure to meet the design and construction requirements and failure to make reasonable modifications and accommodations for FY 06. Outcome 4: Review comprehensive plans to evaluate report data on the needs of individuals with disabilities. Consult with the Virginia Association of Counties and the Virginia Municipal League to access data availability. Review the comprehensive plans to evaluate report data that addresses issues of accessibility, affordability, and availability. Consult with the Virginia Association of Counties and the Virginia Municipal League to access data availability.12/07 DPOR, IT$02. Work with local disability organizations and advocates in collaboration with public housing agencies to ensure citizen participation, as required by HUD, is occurring in development of the public housing agency and Consolidated Plans so that accurate data and needs information is being taken into consideration when the plans are developed. Convene regional meetings of CSBs, CILs, AAAs, and DSBs, to determine local capacity needs and determine methods of addressing those needs (programs and delivery models). Include public housing agencies (PHAs).11/07OCI$10,0003. Develop a plan to expand outreach and promote awareness of existing financial and capacity building resources available. Identify populations to be targeted. Develop additional informational publications as needed and distribute them. Conduct information sessions as needed for targeted populations. Determine opportunities to expand the Accessible Housing Registry,  HYPERLINK "http://www.accessva.org" www.accessva.org, as a marketing and outreach tool. Investigate and recommend incentive opportunities to ensure that accessible housing is included and updated on the Accessible Housing Registry,  HYPERLINK "http://www.accessva.org" www.accessva.org (i.e. tax credits). Incorporate a comment and rating option on the website for the Accessible Housing Registry,  HYPERLINK "http://www.accessva.org" www.accessva.org. Ensure that accessible housing developed with the Community Development Block Grant, HOME, Low Income Housing Tax Credit, and other public resources, is included and updated on the Accessible Housing Registry,  HYPERLINK "http://www.accessva.org" www.accessva.org.6/08VHDA, DHCD $10,0004. Develop methods of enhancing enforcement of laws and regulations. Strengthen enforcement of state fair housing laws that require housing developers to include set-asides of accessible units. Educate builders, developers, and state and local housing officials about their obligations under federally financed housing programs. Educate individuals with disabilities and disability advocates about the obligations of builders and developers.6/08DHCD, DPOR $40,000Action Plan #3.3 ~ 2008 Progress Report: NOTE: The Teams housing and transportation group reports the following from its May 9 meeting. While some progress has been made in marginal areas of the plan there was consensus among committee members that further progress was unlikely unless and until certain recommendations were implemented in Virginia. Those recommendations follow: The Governor should take quick and decisive action administratively to bring the Auxiliary Grant program into compliance with the Olmstead Supreme Court decision. Committee members were in agreement that the continued forced placement of individuals with disabilities into Assisted Living Facilities solely because of funding was not in keeping with the intent of the Olmstead decision. Funding available under the Auxiliary Grant program should follow the individual to the most appropriate community services. The Virginia General Assembly and the Governor should move quickly to provide rent supports for individuals transitioning from state facilities and nursing homes under the guidance of the Olmstead Supreme Court decision. Further transition of individuals from institutions to communities is unreasonably restricted because there is not a single county or city in Virginia where a person with a disability can rent even a one-room apartment using 30% of their SSI payment. Until some form of rent subsidies are provided to the poorest and most confined Virginians, further transition will remain unjustifiably restricted. For those Virginians between 50% and 80% of their Area Medium Income the General Assembly and the Governor should create a fund designed to provide non-profit organizations with very low financing incentives. If providers of housing are able to access very low interest loans to construct affordable, accessible housing, those individuals of modest means could reasonably be expected to live independently. Without access to these very low interest loans the non-profit community lacks the necessary resource to make any substantial progress in this area. The Virginia General Assembly should move quickly to include Source of Income among the protected classes in the Virginia Fair Housing Law and provide for a Continuing Violation Theory for those builders and developers who knowingly and willfully violate the Virginia Fair Housing Law. These recommendations are not meant to be inclusive or exhaustive. They are, rather, only the most urgent, if Virginia is to keep pace with its commitment to the spirit of the Olmstead decision. Substantial progress cannot continue unless both the Executive and Legislative branches of the Commonwealth turn an attentive eye to the insurmountable obstacles faced by the poorest and most confined Virginians. These recommendations we trust will be addressed in the most urgent manner possible. The following 2008 Progress Reports were provided by other members of the Team: Implementation Action #1: DPOR has compiled data for Outcome #3 as follows: FY 2006 75 complaints received based on disability; 50 of those were alleging failure to make reasonable accommodations/modifications and 3 alleged failure to meet the design and construction requirements. FY 2007 53 complaints received based on disability; 41 of those were alleging failure to make reasonable accommodations/modifications and 2 alleged failure to meet the design and construction requirements. FY 2008 67 complaints received based on disability; 48 of those were alleging failure to make reasonable accommodations/modifications and 2 alleged failure to meet the design and construction requirements. Implementation Action #2: DHCD invited the disability community to participate in Consolidated Plan input sessions. The CILs are using Part B funding to: Promote the existing Transportation and Housing Alliance Toolkit as a resource for local planning entities to use in gathering information and data. Work with local disability organizations/advocates in collaboration with PHAs to ensure citizen participation, as required by HUD, is occurring in development of the PHA and Consolidated Plans so that accurate data/needs information is being taken into consideration when the plans are developed. Convene regional meetings of CSBs, CILs, AAAs, SILC, and DSBs, to determine local capacity needs and determine methods of addressing those needs (programs and delivery models). Include PHAs. Implementation Action #3: The MFP Operational Protocol provides that case managers and transition coordinators will be trained by DMAS to assure that individuals indicating an interest in participating in MFP and their family member, caregiver, or surrogate decision maker, as appropriate, receive comprehensive, timely and accurate information about whether and what types of housing assistance may be available and how to access that assistance, including available housing. The Administration will consider the use of any federal Housing Trust Fund monies that may become available. The MFP Housing Task Force is developing an annual action plan that: Explores the need to make further amendments to the Qualified Allocation Plan Low Income Housing Tax Credit program, considering incentives to develop housing near on-demand transportation routes. Explores the possible sources and use of below market loans and consider whether one entity can apply to the current SPARC program for multiple single family dwellings. Produces new housing units for individuals leaving institutions. Creates incentives to develop housing on public transportation routes. Assists individuals to locate housing and transportation in each geographic area of the Commonwealth via an interactive website. Encourage public housing agencies to list accessible housing units on  HYPERLINK "http://www.accessva.org" www.accessva.org. VHDA and DHCD will apply any funding remaining from the DHCD supplemental modifications and temporary rent funds to increase housing stock (see 3.1 above). The Virginia Easy Access website contains information and resources on available housing. DMAS has revised waiver regulations to permit individuals using the EDCD waiver to receive waiver services in adult foster care and assisted living facilities. An Easy Living Home Coalition was created in Virginia to improve access to single family homes. Implementation Action #4: DPOR and Housing Opportunities Made Equal (HOME) have continued their partnership agreement for training and audit compliance with the design and construction requirements of the Virginia Fair Housing Law.  Critical Success Factor #4: Locate and Obtain a Job Action Plan #4.1 ExpectationIndividuals with significant disabilities transitioning out of institutions will have the option to become employed.StrategyMake available information and resources to pursue and obtain employment.Measurable outcomeThe number of referrals to organizations that provide services to assist individuals with disabilities to become employed will increase.Implementation ActionsDate/sResponsible agency/ciesCost/s1. Ensure that all information about job location, availability and training/education needed is up to date and available to those who are transitioning into the community.OngoingIT, VEC, Workforce Office, DRS, DBVI2. Ensure that the availability of employment information is consistent with the Money Follows the Person Protocol.2008/OngoingDRS, DBVI, VEC, DMAS Action Plan #4.1 ~ 2008 Progress Report: Implementation Action #1: Information related to employment options is available through the Easy Access website, DRS, DBVI and other employment-related agencies via Internet and print media. VDOE will be collaborating in a demonstration project with VCUs RRTC and Richmond City Schools. This project is a replication of Project Search at the Cincinnati Childrens Hospital, designed to show that youth with significant disabilities can work. Implementation Action #2: The MFP Operational Protocol provides that case managers and transition coordinators will be trained by DMAS to assure that individuals indicating an interest in participating in MFP and their family member, caregiver, or surrogate decision maker, as appropriate, receive comprehensive, timely and accurate information about employment options that may be available to them. Action Plan #4.2 ExpectationIndividuals with disabilities will have informed choice in their employment options, including self-employment.StrategyDevelop knowledge of available employment options and the means to attain them.Measurable outcomeAt least 100 individuals in nursing homes, 100 individuals in institutions, and 100 other individuals transitioning to the community under the Money Follows the Person Demonstration will receive employment services options packages and will understand the various options.Implementation ActionsDate/sResponsible agency/ciesCost/s1. Working with advocates, disseminate the employment services options package to appropriate bodies, including those assisting individuals who are transitioning, in hard copy and through websites.10/07DRS, DBVI, DMHMR/IDSAS, DMASTBD2. Working with CILs and ESOs, train staff, including staff involved in institutional discharge planning, on employment services options and informed choice so that they can support individuals with disabilities to obtain desired employment.OngoingDRS, DBVITBDAction Plan #4.2 ~ 2008 Progress Report: Implementation Action #1: DMAS continues to work to expand the individual supported employment model to include consumer direction in the MR/ID, DD and Day Support Waivers. Personal assistance is now available in the Medicaid Works program. Implementation Action #2: The training component has been included in SPIL activities, and is already carried out on an informal basis.  Action Plan #4.3 ExpectationOpportunities for employment will exist.StrategyIncrease job opportunities and the capacity of employment support services.Measurable outcome The unemployment of individuals with disabilities will decrease.Implementation ActionsDate/sResponsible agency/ciesCost/s1. Develop a baseline, using the unemployment rate for individuals with disabilities and Census and DOL data.3/06IT, DRS, DBVI, with RRTCTBD2. Encourage use of the Medicaid Works Program and increase the initial financial eligibility criteria to 300% of income.2008DMAS, General Assembly, Governors Office, OCITBD3. Working with providers, individuals with disabilities, advocates and the General Assembly, recommend removal of financial disincentives for individuals with disabilities to become employed.OngoingIT, DMAS, DSS, DRS, Department of TaxationTBD4. Expand personal assistance services by increasing appropriations for the DRS program and by increasing rates for both the DRS program and DMAS providers.OngoingDRS, DMASTBD5. Make supported employment, assistive technology, and home modifications as applicable, an option in all Medicaid waivers; fund supported employment consistently with DRS rates.OngoingDMASTBD6. Expand funding and capacity of long-term employment supports.2008DRSTBDAction Plan #4.3 ~ 2008 Progress Report: Implementation Action #2: DMAS has convened an active advisory committee that is currently developing a strategic plan for increasing participation in the Medicaid Works program. Personal assistance is now available in the Medicaid Works program. Implementation Action #4: The General Assembly equalized the Medicaid and DRS supported employment rates as of 7/1/08. Rates of pay are monitored through DRS and DMAS. Implementation Action #5: Consumer directed individual supported employment is being added to the MR/ID, DD and Day Support Waivers. Critical Success Factor #5: Access Transportation Action Plan #5.1 ExpectationIndividuals with disabilities leaving institutions or at risk will be aware of available transportation options.StrategyEducate and publicize available transportation options to individuals with disabilities.Measurable outcomeThe number of individuals utilizing transportation services will increase.Implementation ActionsDate/sResponsible agency/ciesCost/s1. Determine what data is readily available. Get information from agencies on the type of data they collect. Assess whether that data is useful.OCI, DMAS, DBVI, VDA, MHMR/IDSAS, DRS $02. Support DRPT in coordinating local plans. DRPT will conduct a third round of local workshops. DRPT will prepare a state plan with data obtained at workshops. DRPT will implement a coordinated program of universal access Americans with Disabilities Act (ADA) paratransit, i.e. a qualified user in one community can access paratransit in other Virginia communities.10/08 7/08DRPT$03. Develop a mechanism to educate individuals with disabilities and other stakeholders about transportation access and opportunities, including the benefits of collaboration/cooperation between local jurisdictions through VirginiaNavigator and disability services.10/08DRPT$04. Make recommendations for the use of vouchers and other incentives for transportation. Research other states mileage reimbursement, volunteer driver, and voucher programs. Research other states incentive programs for individuals with disabilities.10/08VBPD TBDAction Plan #5.1 ~ 2008 Progress Report: Implementation Action #1: The Transportation and Housing Alliance toolkit has been developed and provides a tool for gathering data by region. The CILs are encouraging its use. Implementation Action #2: DRPT is conducting a major statewide initiative, with help from national consultants, to provide technical assistance to 20 rural and small urban areas to develop Coordinated Human Service Mobility Plans using a bottom up approach (i.e., all plans are developed by Planning District Commissions (PDCs) and local representatives of public, private and non-profit transportation and human service providers and participation by members of the public. Financial feasibility studies by DRPT can also be requested. During Spring 2007, 11 workshops had been conducted to educate PDCs on new federal requirements and to assist in regional needs and gap assessments. In Fall 2007, 13 workshops were held to develop region-specific strategies to address gaps (20 plans drafted). New grant opportunities were explained (S5310, JARC, and a New Program the New Freedom). In May/June 2008, 14 regional sessions were held to obtain final approval on the local plans before promulgation to public/state/local entities. Twenty (20) local plans have been finalized and can be accessed at  HYPERLINK "http://www.kfhgroup.com/drpt-chsmplans.htm" \o "http://www.kfhgroup.com/drpt-chsmplans.htm" \t "_parent" http://www.kfhgroup.com/drpt- HYPERLINK "http://www.kfhgroup.com/drpt-chsmplans.htm" \o "http://www.kfhgroup.com/drpt-chsmplans.htm" \t "_parent" chsmplans.htm . A second round of New Freedom grant opportunities is now being explained to the regions. Plans for future Section 5310, New Freedom, and JARC grant applications have to have been incorporated generally within the regional planning. In FFY09, DRPT is making grant awards to 43 recipients (77 vehicles) in the amount of $3,134,000 and seven New Freedom grants were given out in the 1st round ($690,000). To increase local change, a 2nd grant solicitation will be held using state GF as match for federal dollars (Summer 08) (only 5% local match will be required) ($2 million total available). DRPT, through Coordinated State Plan Requirements, has also: convened the State Agency Coordination Council; developed a Memorandum of Understanding (MOU) signed by the Secretaries of Transportation and Health and Human Resources; conducted an agency by agency analysis of transportation polices, rules and regulations; and incorporated State Agency Council recommendations for the Final Coordinated State Plan (8/2008). State agency by state agency analyses of transportation activities are now ongoing as a result of the MOU. The DRPT workgroup has discussed data systems and software systems needed. The state agency council strongly believes a regional pilot is necessary to pilot test systems and make modifications based on the actual practice as needed. Agencies may be able to work together with New Freedom funds (including a subcontract from DMAS Logisticare contract) to pilot test systems that will work for a given region. The 2007 Virginia General Assembly directed that the Director of DRPT work with local transit systems to implement by June 30, 2008, a streamlined universal access system for riders eligible for Para-Transit services. Currently, eligible individuals have to qualify for each local system and certifications are good for only 30 days. Effective June 30, 2008 qualified individuals eligibility will now transfer to all Virginia Transit fixed route transit systems for 60 days over the course of one year. This process was to be available on VirginiaNavigator June 30. Implementation Action #3: The Easy Access website contains comprehensive information on transportation, including transportation education. DMAS has developed a Users Guide to Logisticare, which is posted on the DMAS website and attached to the MFP protocol. The Administration will clearly identify and disseminate information about transportation providers that offer accessible vehicles, including 5310, Job Access Reverse Commute, and New Freedom Initiative vehicles and widely disseminate information about new services that become available under the New Freedom Grants. The MFP Operational Protocol contains the following additional educational information for MFP participants: Transportation to and from Medicaid-covered services Public Transit Specialized Transportation Modifications to Primary Vehicles Vehicle loans through the NewWell fund DMAS has added environmental modifications to the EDCD and AIDs Waivers, meaning that individuals who use the MR/ID, DD, Tech, EDCD, and HIV/AIDS waivers will have access to $5,000 per year for environmental modifications, which includes modifications to primary vehicles. This is true regardless of whether the individual using the waiver services participates in MFP or lives in the community. Case managers and transition coordinators will be trained by DMAS to assure that individuals indicating an interest in participating in MFP and their family member, caregiver, or surrogate decision maker, as appropriate, receive comprehensive, timely and accurate information about whether and what types of transportation assistance may be available and how to access that assistance. The MFP Task Force will develop a plan to assist individuals to locate housing and transportation in each geographic area of the Commonwealth via an interactive website. Medicaid now funds travel trainers and escorts; however, DMAS reports few requests for these services. The CILs will use Part B funds to provide orientation to transportation planning to individuals with disabilities, seniors, advocates, AAAs, CSBs, CILs, DSBs, local DSSs, other local services agencies, and the broader disability and aging communities. Implementation Action #4: The DRPT workgroup received information on two transportation voucher programs. The most promising one was a volunteer driver program with vouchers to reimburse gas. All agreed there would need to be a tremendous amount of up-front work required to develop such a program and it might be an excellent New Freedom program. The MFP Task Force is considering recommendations regarding the use of transportation vouchers. Action Plan #5.2 ExpectationIndividuals with disabilities leaving institutions or at risk will know how to take advantage of available transportation services and the process to file an appropriate complaint.StrategyTrain CILs, CSBs, AAAs, ESOs, case managers and other key personnel to train end users.Measurable outcomeThe number of individuals trained to take advantage of their transportation choices will increase.Implementation ActionsDate/sResponsible agency/ciesCost/s1. Identify training needs and create a training model. Request agencies to submit existing training activities; compile existing training activities. Identify processes to redress violations of the transportation provisions of the Americans with Disabilities Act. Develop training tools to share existing training activities. Identify key audiences.10/08DMAS, VDA, DRS, DMHMR/IDSAS, DSS, DRPT, VDDHH, DBVI$02. Provide training. Incorporate training materials into a format usable by the 2-1-1 VIRGINIA system. Provide CILs, CSBs, AAAs, ESOs, case managers and other key personnel training materials. Groups identified will begin sharing information and/or developing a training curriculum.10/08DMAS, DRPT, VDA, DRS, DBVI, HMR/IDSAS, DSS, DRPT, VDDHH $0.5 millionAction Plan #5.2 ~ 2008 Progress Report: Implementation Action #1: Case managers and transition coordinators are being trained by DMAS to assure that individuals indicating an interest in participating in MFP and their family member, caregiver, or surrogate decision maker, as appropriate, receive comprehensive, timely and accurate information about whether and what types of transportation assistance may be available and how to access that assistance, including public transit. Implementation Action #2: The Easy Access website contains comprehensive information on transportation and filing of complaints. The Users Guide to Logisticare, which is posted on the DMAS website, contains information about how to file complaints. The MFP Task Force is developing a plan to assist individuals to locate housing and transportation (including public transportation) in each geographic area of the Commonwealth via an interactive website. The CILs are using Part B funds to provide orientation to transportation planning to individuals with disabilities, seniors, advocates, AAAs, CSBs, DSBs, local DSSs, other local services agencies, and the broader disability and aging communities. Action Plan #5.3 ExpectationThe State will leverage funding to support current and increased transportation services.StrategyCoordinate transportation services to maximize efficiencies to support additional transportation services. Measurable outcome1) A plan will be submitted to the Governor by October 2008. 2) The current level of transportation services will increase as measured by the number of trips, miles, and riders.Implementation ActionsDate/sResponsible agency/ciesCost/s1. Identify transportation needs/barriers by compiling data from local coordination service plans.10/07DRPT, Human Services Transportation Committee$02. Local Coordination plans will identify coordination/improved efficiency opportunities. Include coordination with housing, medical, and employment transportation.10/08DRPT, VHDA, DHCD, VEC, DRS$03. Develop a State Human Services Transportation Plan.10/08DRPT$500,0004. Establish mobility long range goals with performance measures in cooperation with other modal agencies during development of the next Statewide Transportation Plan.12/09VDOT, DBVI$05. Explore options to develop a strategy to hold transportation services accountable to individuals with disabilities for failure to provide agreed services.TBDIT $06. Consider incentives for transportation providers to provide services including incentives to coordinate transportation services and disincentives for those who do not. 10/08DRPT$0Action Plan #5.3 ~ 2008 Progress Report: Implementation Action #1: The CILs are promoting the existing Transportation and Housing Alliance Toolkit as a resource for local planning entities to use in gathering information and data. Implementation Action #3: The Secretaries of Health and Human Resources and Transportation have entered into a Memorandum of Understanding that address coordination of human services transportation. A cross agency team has been created to develop integrated Human Services Transportation Plan that includes public transportation. Implementation Action #6: The New Freedom program is providing incentives for service providers and will provide new transportation services to individuals with disabilities that expand beyond the requirements of the ADA. The State has agreed to fund these grants at 95%, with a 5% local match. The MFP Housing Task Force is developing an Annual Plan that addresses the potential for a transportation voucher system and incentives: For specialized transportation providers to coordinate their services beyond geographic boundaries. For specialized transportation providers to provide door through door transportation. To develop housing on public transportation routes. $75,000 was appropriated to AARP for a Senior Connections project. CTAV has arranged a group insurance rate for private transportation providers. Critical Success Factor #6: Surrogate Decision-Making Action Plan #6.1 ExpectationA qualified surrogate will be available to each individual statewide who needs one; if an individual cannot afford one, one will be provided.StrategyIdentify appropriate human and financial resources needed and develop mechanisms to make the resources accessible.Measurable outcomeThere will be no unmet surrogate decision-making needs.Implementation ActionsDate/sResponsible agency/ciesCost/s1. Conduct a statewide assessment of individuals who have unmet surrogate service needs. Determine the need based on current data available and identify gaps where data are not available.12/08 DMHMR/IDSAS, DSS, DRS, DMAS, VDA$02. Develop an estimate of the cost for the appropriate level of service based on the data available regarding unmet need.01/09 DMHMR/IDSAS, VDA, DSS, DRS, DMAS $03. Develop a budget amendment to implement the action steps.08/09 DMHMR/IDSAS, VDA DSS, DRS, DMAS $0Action Plan #6.1 ~ 2008 Progress Report: Implementation Action #1: Initial information on unmet surrogate decision making needs has been collected from one segment of the service system. Additional information will be compiled by December 2008. Implementation Action #2: The information in #1 will be used to develop a cost estimate by January 2009. Implementation Action #3: Due to ongoing budget reductions, DSS is unable to pursue the budget amendment this year. Action Plan #6.2: ExpectationFor those who have a surrogate decision-maker, the surrogate will represent the best interests of the individual without exceeding the level of services required in accordance with applicable law and regulations.StrategyProvide training for surrogate decision-makers on respect for individual values, person-centered practices, self direction, appropriate standards, and consistency with the needs of the individual.Measurable outcomeAll surrogate decision makers will receive training prior to serving as surrogates.Implementation ActionsDate/sResponsible agency/ciesCost/sAction Plan #6.2 ~ 2008 Progress Report: Action Plan #6.2 is being revised in consultation with the Public Guardian and Conservator Advisory Board to identify existing resources and projected costs of a training initiative. Critical Success Factor #7: Access Ongoing Supports Action Plan #7.1 ExpectationAll individuals with disabilities will have accessible, quality medical, dental, vision and hearing care in their communities.StrategyIncrease the number of accessible (including physically accessible) medical, dental, vision and hearing providers in communities that offer services to individuals with disabilities.Measurable outcomeThe number of accessible medical, dental, vision and hearing providers offering services to individuals with disabilities will increase by 20%.Implementation ActionsDate/sResponsible agency/ciesCost/s1. Collect needs picture by locality with assistance from DSBs, CSBs, CILS and AAAs. 12/08 DMHMR/IDSAS, DSS, VDH, VDOE, DMAS, VDA$02. Follow implementation of recommendations of the Governors Health Reform Commission in Roadmap for Virginias Health. Follow implementation of the VDH Health Promotion Grant.OngoingITTBD3. Add dental care as a covered service by Medicaid for adults.TBD DMASTBDAction Plan #7.1 ~ 2008 Progress Report: Implementation Action #1: An Implementation Team subcommittee is developing an email survey/questionnaire for dissemination to the various responsible agencies and community-based partners. This information will be used to identify needs at a local level and potential solutions to barriers. Implementation Action #2: The Governors Health Reform Commission completed its study and report in September 2007. The Commission divided its work into four areas of focus: (1) Access to Care, (2) Quality, Transparency, and Prevention, (3) Healthcare Workforce, and (4) Long-Term Care. Related to Action Plan #7.1, the Access to Care work group recommended that Medicaid be expanded to include dental coverage for parents of Medicaid-eligible children, that Medicaid be expanded for children, and that a private health insurance option be created for uninsured individuals below 200% of Federal Poverty Level. No legislative action was taken as a result of the Commissions recommendations. Action Plan #7.2: ExpectationServices will be flexible and targeted to all Olmstead populations.StrategyPursue Medicaid options under the 2005 Deficit Reduction Act.Measurable outcome/sTBDImplementation ActionsDate/sResponsible agency/ciesCost/s1. Identify new state plan option services to maximize benefits to all citizens.TBDDMAS, DMHMR/IDSASTBD2. Apply for Centers for Medicare and Medicaid Services grant funds for demonstration projects.TBDDMAS, DMHMR/IDSASTBD3. Obtain allocation from the General Assembly for project(s) sustainability.TBDOSHHR, DMAS, DMHMR/IDSASTBD4. Change all applicable policies and regulations.TBDOSHHR, DMAS, DMHMR/IDSASTBDAction Plan #7.2 ~ 2008 Progress Report: Implementation Action #1: While DRA provisions now allow for a prescribed set of home and community based serves to individuals that earn less than 150% of the Federal Poverty Level, Virginia will not be pursuing this option in the Medicaid State Plan at this time. Proposed regulations from CMS currently jeopardize the allowable activities of targeted case management (TCM) and DMAS is working to minimizeany impact the TCM regulations mayhave on service delivery and willcontinue to work closelywith both CMS and DMAS constituenciesas the TCM regulations are finalized. Implementation Action #2: Virginia successfully pursued a Money Follows the Person Demonstration Project which began July 1. As a result, over $28 million federal dollars have been made available to directly support over 1,000 individuals in transitioning from nursing facilities, ICFs/MR(ID) and long-stay hospitals. Over the past year, a diverse group of stakeholders wrote a comprehensive person-centered Operational Protocol (Program Guidebook) for this Project. A Money Follows the Person website was developed at  HYPERLINK "http://www.olmsteadva.com/mfp" www.olmsteadva.com/mfp. The website contains a copy of the Protocol and other related information. Implementation Action #3: The Transformation Leadership Team has formed a subcommittee to explore ways to sustain the MFP Project, among others. Implementation Action #4: DMAS policies and regulations have been changed to incorporate changes in the waivers pursuant to the MFP project.  Action Plan #7.3 ExpectationWaiver services will be available for all who want them.StrategyExpand existing waivers.Measurable outcome100% of individuals eligible for existing waivers will receive desired waiver services.Implementation ActionsDate/sResponsible agency/ciesCost/s1. Develop a baseline on 1/1/08 using MR/ID, Day Support, and DD Waiver urgent and non-urgent wait list information.01/08IT, DMHMR/IDSAS, DMAS $02. Using the MR/ID System Study waiting list phase out plan, the MR/ID and DD waiver waiting lists will be phased out in equal increments over a 4-year period. 06/08DMAS, DMHMR/IDSAS $03. Identify additional needed services. Utilize the MR/ID System Study as a model for how to identify additional needed services. Identify additional needed services for other waivers.OngoingOSHHR, DMAS, DMHMR/IDSASTBD4. Obtain appropriation for additional services.OngoingOSHHR, DMAS, DMHMR/IDSASTBD5. Develop an outreach and information dissemination plan about Medicaid Waiver for students with disabilities and their families.12/08DMHMRSAS, VDOE and DMASTBDAction Plan #7.3 ~ 2008 Progress Report: Implementation Action #1: As of January 1, 2008, there were 3,905 individuals on the waiting list for the MR/ID Waiver and 549 individuals on the waiting list for the DD Waiver. Implementation Action #2: The 2008 General Assembly appropriated funding for an additional 30 DD Waiver slots and an additional 220 MR/ID Waiver slots (for the biennium) to implement the Money Follows the Person Demonstration. The MR/ID Waiver received 600 slots for individuals on the urgent care waiting list. Implementation Action #3: The following new Medicaid Waiver services have been created in connection with the Money Follows the Person Project and are available on a permanent basis to everyone using the applicable waivers: Transition Services (EDCD, MR/ID, DD, Tech, and AIDS Waivers)--a maximum $5,000 lifetime benefit to help individuals transitioning from institutions to the community set up a household Transition Coordination (EDCD Waiver)--a 12-month service to assist individuals in transitioning from institutions to the community. The following existing Waiver services have been added to other waivers as follows in connection with the MFP Project: and are available on a permanent basis to everyone using the applicable waivers: Personal Emergency Response System (AIDs and Tech Waivers) Assistive Technology (EDCD and AIDs Waivers) Environmental Modifications (EDCD and AIDS Waivers) DMAS continues to develop a consumer-directed individual supported employment option for the MR/ID, DD and Day Support Waivers The Team will explore whether there is an equitable way of individuals on the DD waiver moving to the MR/ID waiver if and when they later qualify for the MR/ID Waiver, and for individuals on the MR/ID waiver moving to the DD Waiver to avoid loss of services. The Team will review the policy and administrative waiver barriers identified in the VBPD Biennial Assessment of the Services System and elsewhere, and focus on eliminating them. Implementation Action #4: Sufficient funding is available for the services addressed in #3. The General Assembly appropriated funding for the additional slots addressed in #2. NOTE: Although not directly related to the Implementation Actions in Action Plan 7.3, the Team notes that the following actions by the General Assembly are consistent with and support community integration of individuals with disabilities of all ages: Added funding and language modifying the local share of funding for community and residential services provided through the Comprehensive Services Act (CSA). Language also requires the Secretary of Health and Human Resources to establish a work group to assist in the implementation of a system of financial incentives to localities to use community-based services in lieu of residential services for children in CSA. Language lowers the local share of funding for community-based services by 50 percent beginning in fiscal year 2009, as an incentive for localities to provide services to children who can be appropriately cared for in the community. In addition, language raises the local share of funding for residential services by 15 percent beginning January 1, 2009, and by 25 percent beginning in fiscal year 2010, after the first $200,000 in annual residential care expenditures. Language is added to require localities to review their caseloads for those individuals who can be served in the community and to transition those cases to the community for services. Added funding in the amount of $200,000 was added for brain injury services. Through House Joint Resolution 105, directed the Joint Legislative Audit and Review Committee to study autism services in Virginia to identify and evaluate best practices in the provision of services for the diagnosis, treatment, and management of autism; methods of providing services to persons with autism; ways to disseminate information regarding best practices; and autism education and training for law enforcement and judicial personnel. Action Plan #7.4: ExpectationMedicaid will cover all needed services for individuals with mental illness.StrategyCreate Medicaid-reimbursable wellness management, peer supports, and supported employment services.Measurable outcomeAt least three new services will be established.Implementation ActionsDate/sResponsible agency/ciesCost/s1. In conjunction with CSBs, pilot supported employment practices. DMHMR/IDSAS, DRS, and DMAS plan pilot approach. Issue DMAS provider manual changes re Mental Health Support Services (MHSS) in workplace. Issue Request for Proposals (RFP) to CSBs working with DRS vendors. Conduct supported employment Pilot. 1/07 4/07 6/07-6/08 DMHMR/IDSAS$100,0002. In conjunction with CSBs, pilot Peer Support practices. Issue RFP to Peer Specialist Training Programs. Confirm curricula compliance with DMAS Qualified Mental Health Para-Professional requirements. Conduct Peer Specialist Trainings.2007 DMHMR/IDSAS$1,658,0003. In conjunction with CSBs, pilot Wellness Management practices. Continue Peer Training Programs in Wellness Recovery Action Plan (WRAP) facilitation. Continue CSB regional trainings in Recovery and include the hospitals in each planning region.2007 DMHMR/IDSAS$377,0004. Seek additional State General Funds (SGF) in Governors budget to help underwrite start-up and transition costs associated with transforming the mental health system towards a more recovery-oriented focus on employment.2007 DMHMR/IDSAS$1,000,0005. Seek additional SGF in Governors budget to expand the supported employment Pilot to develop programs to train CSB staff in the importance of employment in the process of recovery and utilizing the most effective technologies to help individuals with mental health issues get and keep competitive employment.2007 DMHMR/IDSAS$250,0006. Seek additional SGF in Governors budget to develop, plan, and deliver regional training on trauma-informed Wellness Management practices to mental health provider staff and peer providers.2007 DMHMR/IDSAS$250,0007. Seek additional SGF in Governors budget to promote the implementation of both the evidence-based Illness Management and Recovery and Illness Self-Management programs in all state psychiatric facilities and local mental health programs.2007 DMHMR/IDSAS$75,0008. Seek additional SGF in Governors budget to collaborate with statewide partners and individuals with mental health issues to design, create and support a Virginia Mental Health Recovery Institute to provide comprehensive training/recovery education/ongoing consultation to state and local mental health agencies in the transformation of the mental health system to one that truly embraces a culture of recovery.2007 DMHMR/IDSAS$700,000Action Plan #7.4 ~ 2008 Progress Report: Implementation Action #1: DMHMR/IDSAS funded a Supported Employment pilot with the Fairfax CSB, PRS, Inc., and the Lori Mitchell Employment Center in Fairfax to serve 30 mental health consumers with Medicaid Mental Health Support Services (MHSS) to complement DRS-funded employment services. Based on a review of clinical notes by DMHMR/IDSAS and DMAS, a how-to manual will be completed for distribution to CSBs by October 1, 2008. Funds were not available for the Governors budget to support items in #7 and #8. Action Plan #7.5 ExpectationSpecialized services and supports will be available to permit individuals to continue to live in their homes, through such supports as the Older Blind Program, the Companion Program, and the Caregivers Grant.Strategy 7.5.1Provide increased community-based adjustment to blindness training and specialized adaptive equipment distribution to older individuals experiencing vision loss.Strategy 7.5.2Provide increases to the companion program.Strategy 7.5.3Provide grants to caregivers of older individuals.Measurable outcomes1) The frequency of rehabilitation teacher contacts with older blind customers will increase. 2) The percentage of eligible individuals receiving services will increase. 3) Caregiver grants will be available statewide.Implementation ActionsDate/sResponsible agency/ciesCost/s1. Request budget increases to make sufficient older blind services available to all eligible individuals.OngoingDBVI$250,0002. Identify unmet needs related to the Caregivers Grant program to close the current service gap.OngoingDSS$03. Request a budget increase for home-based services for elders and adults with disabilities who are on the waiting list.OngoingDSS$2.0MAction Plan #7.5 ~ 2008 Progress Report: Implementation Action #1: Ongoing budget reductions which are absorbed by state agencies prevented progress on this action during 2008. DBVI will pursue a budget increase request at such time as improved revenues are realized. DBVI continues to provide services to more than 2,000 older blind individuals annually. Implementation Action #2: In an update to the 2007 numbers, DSS actually received 1,393 applications for the Caregivers Grant last year. The 2007 number initially reported included duplicative cases. 1,246 applications received awards and 147 were denied. The grant amount was $500. To date, DSS has keyed in 1,512 applications but there are still some applications pending. DSS continues to evaluate costs and possible funding options for this program. The 2008 General Assembly passed HB 861, amending 63.2-2203 B of the Code of Virginia to allow a licensed physician's assistant or nurse practitioner to sign the grant application form for the Caregivers Grant. Prior to this amendment, only private physicians were authorized to do the certifications. Funding for the Caregiver's Grant was reduced by the 2008 General Assembly, and it is unknown whether further reductions are to be expected. Senate Joint Resolution 102 directs the Joint Commission on Health Care to study support services for family caregivers of the frail elderly and disabled and community-based caregiver support organizations. Implementation Action #3: Due to ongoing budget reductions, DSS is unable to pursue the budget amendment this year. iii. Goals #1 and #2: Action Plans That Apply to a Specific Type of Facility Critical Success Factor #7: Access Ongoing Supports Action Plan #7.1-F: Assisted Living Facilities ExpectationInformation about community-based options will be readily available.StrategyProvide information on all community living opportunities to individuals with disabilities who receive auxiliary grants. Measurable outcome100% of individuals of auxiliary grant recipients living in assisted living facilities will receive community-based options information.Implementation ActionsDate/sResponsible agency/ciesCost/s1. Utilize lessons learned from VACILs nursing home transition grant for assisted living facilities.07/08DMHMR/IDSAS, DSS, VBPD, VDA TBD2. Educate and train appropriate staff on available resources and service options.7/08DSS, DMHMR/IDSASTBD3. Mandate communication of options to all individuals covered by this Plan.7/09DSS, DMHMR/IDSASTBDAction Plan #7.1-F ~ 2008 Progress Report: Implementation Action #2: All individuals who use an Auxiliary Grant in an Assisted Living Facility are required to be reassessed at least yearly using the Uniform Assessment Instrument to determine if they continue to meet the criteria for the appropriate level of care. The reassessment is completed by a face-to face visit. All public human service agencies that have accepted the case management responsibility for this reassessment (CSBs, AAAs, etc.) must report their finding to the appropriate local department of social services in order for the individual to maintain eligibility for an Auxiliary Grant. Depending on the outcome of the reassessment, both the individual and the case manager have the opportunity to discuss alternate service delivery, such as moving to a facility with the appropriate level of care or back to the community if there are sufficient resources and services available to support the resident in the community. If the individual can be discharged back to the community, the case manager assists with that discharge by arranging for appropriate services. Action Plan #7.2-F: Assisted Living Facilities ExpectationMoney will follow the person.StrategyUse auxiliary grants for other community living options.Measurable outcomeThe auxiliary grant will fund 250 individuals living in other community options.Implementation ActionsDate/sResponsible agency/ciesCost/s1. Explore a portable auxiliary grant option; identify requirements for implementing pilot.8/06 DSS, DMHMR/IDSASTBD2. Submit to General Assembly for approval and administrative funding of the pilot.11/06DSSTBD3. Implement the pilot for two years to test a portable auxiliary grant option.12/07DSS, DMHMR/IDSAS$160,0004. Evaluate for program outcomes and costs; identify needed policy changes.9/09OSHHR, DSS, DMHMR/IDSASTBD5. Seek approval and appropriation for statewide implementation and, if necessary, authority for regulatory changes as of 7/10.5/10OSHHR, DSS, DMHMR/IDSASTBD6. Revise regulations.7/10OSHHR, DSS, DMHMR/IDSASTBDAction Plan #7.2-F ~ 2008 Progress Report: Implementation Action #1: Report Document #30 entitled, A Report on the Feasibility of Restructuring Auxiliary Grants for Certain CSB Case Management Consumers , was submitted to the General Assembly with the finding that it is feasible to restructure the Auxiliary Grant program to make it a portable benefit. The MFP Housing Task Force is developing recommendations for auxiliary grant portability for all populations. Implementation Action #2: The 2008 General Assembly instructed the Secretary of HHR to develop and submit a plan to allow for the portability of auxiliary grant for individuals who use case management services from a CSB and who are found eligible for or are currently receiving the auxiliary grant. The plan is to be submitted by November 1, 2008 and will include information on eligibility, the number of consumers to be served, financing, program monitoring and quality assurance and information about the roles in the operation of the program for state agencies, CSBs, local DSS, and local governments. Implementation Action #5: Due to ongoing budget reductions, DSS is unable to pursue the budget amendment this year. Appendix I Definition of Planning Terms Action plan: A brief outline of expectations, strategies, measurable outcomes, implementation actions, dates, responsible agency/cies, and cost/s that would result in success for the applicable critical success factor. Cost/s: If known, the cost of implementing each action. Critical success factor: A key area in which the Commonwealths satisfactory performance is required in order for Virginians with disabilities who currently reside in, or are at risk of unwanted admission to, a state mental health, intellectual disabilities, nursing or assisted living facility to achieve their goal of community integration. Date/s: For each implementation action, the date by which implementation should begin. Expectation: A sentence that describes what Virginians with disabilities expect. Implementation Actions: Action statements that describe sequentially how each strategy would be implemented. Measurable outcome/s: For each strategy, a sentence that describes how success would be measured if the strategy were implemented. Responsible agency/cies: For each implementation action, the agency or agencies that would actually implement the action. Strategy: A phrase that describes what is needed to meet the expectations. There can be more than one strategy for an expectation. Appendix II A Guide to Acronyms Used in this Plan AAAs Area Agencies on Aging ADA Americans with Disabilities Act AMI Area Median Income CILs Centers for Independent Living CSA Comprehensive Services Act CSBs Community Services Boards DBVI Department for the Blind and Vision Impaired DD Developmental Disabilities DHCD Department of Housing and Community Development DHP Department of Health Professions DMAS Department of Medical Assistance Services DMHMR/IDSAS Department of Mental Health, Mental Retardation/Intellectual Disability and Substance Abuse Services DOL U.S. Department of Labor DPOR Department of Professional and Occupational Regulation DRPT Department of Rail and Public Transportation DRS Department of Rehabilitative Services DSB Disability Services Board DSS Department of Social Services DVS Department of Veterans Services EDCD Elderly or Disabled with Consumer Direction ESO Employment Services Organization HUD U.S. Department of Housing and Urban Development IHE Institutions of Higher Education ID Intellectual Disabilities IT Implementation Team MFP Money Follows the Person MH Mental Health MHSS Mental Health Support Services MOU Memorandum of Understanding MR Mental Retardation OCI Office of Community Integration OSHHR Office of the Secretary of Health and Human Resources PCP Person-Centered Practices PDC Planning District Commission PHA Public Housing Agency PPD Partnership for People with Disabilities RFP Request for Proposals RRTC Rehabilitation and Research Center SCHEV State Council of Higher Education for Virginia SGF State General Funds SILC Statewide Independent Living Council STG Systems Transformation Grant TBD To Be Determined TCM Targeted Case Management VACIL Virginia Association of Centers for Independent Living VBPD Virginia Board for People with Disabilities VCCS Virginia Community Colleges System VCU Virginia Commonwealth University VDA Virginia Department for the Aging VDDHH Virginia Department for the Deaf and Hard of Hearing VDH Virginia Department of Health VDOE Virginia Department of Education VDOT Virginia Department of Transportation VEC Virginia Employment Commission VHDA Virginia Housing Development Authority VOPA Virginia Office for Protection and Advocacy WRAP Wellness Recovery Action Plan   COMMUNITY INTEGRATION TEAM Virginians with disabilities have a right to enjoy the same benefits of society and freedoms of everyday life that Virginians without disabilities enjoy. The Commonwealth has an obligation under the U.S. Supreme Courts Olmstead v. L.C. decision, the Americans with Disabilities Act, and the Virginians with Disabilities Act to provide appropriate opportunities for people with disabilities to become fully integrated into the community if they choose to do so. This is more than a legal obligationit is a moral imperative. State government must continue to have appropriate structures and plans in place to facilitate the integration of Virginians with disabilities into every community in the Commonwealth. By virtue of the authority vested in me as Governor under Article V, Section 1 of the Constitution of Virginia and Sections 2.2-103 and 2.2-104 of the Code of Virginia, I hereby direct the following Cabinet Secretaries and their respective executive branch agencies and councils to continue their collaborative efforts to complete and annually update a comprehensive, cross-governmental strategic plan designed to assure continued community integration of Virginians with disabilities: Secretary of Commerce and Trade Department of Housing and Community Development Department of Professional and Occupational Regulation Virginia Housing Development Authority Virginia Employment Commission Secretary of Education Department of Education State Council of Higher Education for Virginia Virginia Community Colleges System Secretary of Health and Human Resources Department for the Blind and Vision Impaired Department of Health Professions Department of Medical Assistance Services Department of Mental Health, Mental Retardation and Substance Abuse Services Department of Rehabilitative Services Department of Social Services Mental Health Planning Council Office of Comprehensive Services for At-Risk Youth and Families Statewide Independent Living Council Virginia Board for People with Disabilities Virginia Department for the Aging Virginia Department for the Deaf and Hard of Hearing Virginia Department of Health Secretary of Public Safety Department of Veterans Services Secretary of Transportation Department of Rail and Public Transportation Virginia Department of Transportation Special Advisor to the Governor for Workforce Development The goals of this strategic plan shall be to provide individuals with disabilities the opportunity to choose to move from institutions to appropriate, more integrated settings and to avoid unwanted institutionalization. The plan shall contain strategies that comprehensively address community services and supports, housing, transportation, employment and workforce issues, and shall be accompanied by a report on statewide progress in addressing these issues. The plan shall be submitted to me for my approval no later than August 31, 2007, and shall be updated and submitted annually by August 31 of each succeeding year. I hereby direct the Cabinet Secretaries, executive branch agencies and councils to work in close collaboration with the Community Integration Advisory Commission established pursuant to 2.2-2524 2529 of the Code of Virginia, and to provide any information requested by the Commission to carry out its charge of monitoring community integration in the Commonwealth. I further direct the Cabinet Secretaries, executive branch agencies and councils to work in close collaboration with local governments and local government agencies in the Commonwealth. The Director of Community Integration for People with Disabilities shall coordinate and oversee this initiative and provide staff support to the Community Integration Advisory Commission. This executive directive will remain in full force and effect unless amended or rescinded by further executive action. Given under my hand and under the Seal of the Commonwealth of Virginia, this 18th day of May, 2007. Timothy M. Kaine, Governor  In this Plan, the term consumer direction and the term self direction are synonymous.  A livable/walkable community is one that has affordable and appropriate housing, supportive community features and services, adequate mobility options and encourages employment opportunities for all who want to work, which together facilitate the public sense of safety, personal independence and engagement of residents in civic and social life.     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" # $ % & ' ( ) * Oh+'0dDPht    , 8DLT\Comprehensive, Cross-Governmental Strategic Plan to Assure Continued Community Integration of Virginians with Disabilities: 2008 Update and Progress ReportBrandon Leonard@On August 2, 2007 the four Secretariats, two Councils, 21 Executive Branch entities, and six local government and agency representatives comprising the Community Integration Implementation Team (Team), and the 21-member stakeholder Community Integration Advisory Commission (Commission) jointly adopted Virginias first Comprehensive, Cross-Governmental Strategic Plan to Assure Continued Community Integration of Virginians with Disabilities pursuant to Executive Directive 6 (2007). This Plan was submitted to the Honorable Timothy Kaine, Governor, on August 31, 2007.  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