October 3, 2012

Losing choice or gaining independence?

Opposition mounts over proposed regulatory changes targeting disabled adults

Built like a linebacker, sporting a shortly cropped Mohawk, Eric Huggins’ gentle, precise paintbrush strokes produce art that hangs in Los Angeles galleries and New York living rooms.

Standing in StudioWorks, a spacious gallery and art studio dedicated to developmentally disabled adults, Huggins holds up his latest in a series of music-inspired paintings — a portrait of Billie Holliday.

“I’m happy to be here,” Huggins says. “I’ve wanted to be an artist all my life.”

On this gray, rainy morning, about six of StudioWorks’ 32 artists quietly draw and paint as public radio plays overhead. Three staff members, all experienced in fine arts, occasionally lean over offering help.

Located in the Highlands for the last two years, StudioWorks offers a tranquil, creative setting five days a week. It’s a program of the Zoom Group, a nonprofit that offers day training and work opportunities for disabled adults.

Proposed regulatory changes that would affect programs like StudioWorks have caused great concern among advocates and providers, Zoom Group included.

Underneath the long list of bureaucratic tweaks being made to the Supports for Community Living Medicaid waiver program lies an ideological shift at the federal level.

In September, the Center for Medicaid and Medicare Services issued guidance to states emphasizing the need to integrate disabled adults into the work force in hopes of achieving greater personal independence.

“Trying to push people into this stereotypical vision of what it means to be productive isn’t entirely fair,” says Donovan Fornwalt, executive director of The Council on Developmental Disabilities. “We’d like to think that everyone can build a career and everyone can go to college. Or everyone can land a job that pays at least minimum wage. That’s not always true. I think it’s more important to meet people where they’re at.”

Sitting in the gallery of StudioWorks, Kim Prather, Zoom Group’s director of programs, echoes that sentiment. She says while some individuals may fit well working at a restaurant or grocery store, others have extreme needs, be it physical or behavioral, that won’t suit a professional setting.

Furthermore, Prather wants individuals to have the freedom to choose how they spend their days.

She asks a resident artist, Julie Baldyga, an outgoing woman whose popular paintings reflect a fascination with electronics, whether she’d like a job “out in the community.” Baldyga shakes her head no.

“(I) don’t want job in the community,” Baldyga answers. “Half the people won’t be nice to me, won’t want to shake my hand.”

But Stephen Hall, Kentucky’s commissioner of the Department for Behavioral Health, Developmental and Intellectual Disabilities, tells LEO the changes will not diminish choice, but enhance future prospects.

Still, advocates say if you look at where the money’s going, it seems certain programs that have been around for decades are threatened.

Utilizing both federal and Cabinet for Health and Family Services funds, the Supports for Community Living (SCL) waiver program cost close to $265 million last year and served about 3,500 people.

Under the proposed changes, reimbursement rates for day training and certain supervised work programs would drop, from $10-$12 an hour to under $9 an hour. The way the system is set up, for every hour a provider spends with one individual, they’ll receive that per-hour reimbursement. The seemingly small drop can add up, says Prather, whose Zoom Group serves around 200 clients in programs potentially affected by this rate reduction.

“They don’t want us to keep bringing more clients here. They want to encourage us to get those we have out of here,” she says. “So how do you do that? You reduce the reimbursement rate.”

Meanwhile, the reimbursement rate for programs that support disabled adults in a regular job out in the community will double, from $22 an hour to just over $40. Zoom Group currently has 75 clients in this so-called “supported employment” setting.

A significant change to the SCL waiver targets what’s known as “sheltered workshops.”

These are highly supervised settings devoted to piecemeal-type work. For instance, Zoom Group runs one at UPS where their clients package small items. Under the Fair Labor Standards Act, these disabled employees do not necessarily get paid minimum wage. Rather, they’re compensated based on productivity.

It’s a practice deemed unfair by the National Council on Disability. New federal guidelines indicate that Medicaid funds should not be made available to sheltered work settings where individuals are supervised “for the primary practice of producing goods or performing services.”

Stephen Zaricki, president of the Kentucky Association of Private Providers (KAPP), which Zoom Group is a part of, says in an ideal world, all individuals, no matter their disability, would earn minimum wage. But a complex reality prevails.

“It’s certainly reasonable that people feel those things should be phased out. However … not everyone with a disability can work in a job — a regular job — because of their disability,” Zaricki says. “By eliminating that opportunity to do something that they can get paid for in a setting where they’re safe and they don’t require a job coach to be with them the entire time, that’s meaningful work for them.”

(Under the supported employment model, a job coach trains the individual for work and checks in with them about once a month.)

Cindy Goodin’s sister, Donna Shirley, works in Zoom Group’s UPS facility. Goodin, an energetic woman who fiercely defends her developmentally disabled sister, says the sheltered work setting provides a dignified space for those with special needs. She’s witnessed her sister face cruel stares. Goodin can’t help but worry what will happen if Shirley applies for a “normal” job.

“I would challenge these people making these decisions to walk up and down the street with these individuals and see how they’re treated,” she says with tears in here eyes. “And to think that they can walk out in the community and be given a chance is not realistic.”

At least not everybody will be given a chance, she adds.

In the 1980s, Kentucky sat in the top 10 states in the nation for community-based employment of people with developmental disabilities, says Commissioner Stephen Hall. Now Kentucky ranks near the bottom.

Hall hopes the boosted reimbursement rates for supported employment will reverse that. Still, he says Kentucky is not eliminating day training and sheltered work programs, as many fear. He tells LEO individuals can still choose to stay in whatever program they desire.

But case managers must work with clients to devise a formal plan for their future and ensure participation in career planning activities. Also, under the amended waiver, case managers cannot come from the same company that’s providing the client with day training or other services.

“The federal government is absolutely insisting that the person who oversees the quality of the services and supports … is not employed by the same company that’s paid to actually deliver those services,” Hall says.

Dubbed “conflict free” case managers, the idea is that these independent third parties will better assess whether someone could pursue paths that involve joining the work force. (Individuals can keep their current case manager if a long-standing relationship exists.)

Stephen Zaricki, with KAPP, admits many proposed changes are positive. He’s pleased with the focus on individual needs.

“I believe that the true intentions of everyone in this process has been to help people with disabilities to have the very best quality of life,” he tells LEO.

Still, a slew of concerns remain: cuts to therapeutic and behavioral supports, a host of new training and paperwork that Zaricki calls “unfunded mandates.”

But at StudioWorks, worry remains rooted in this push toward community-based employment. Judy Erwin, Zoom Group’s director of regulatory compliance, says forcing career training onto individuals who consider themselves thriving artists doesn’t make sense.

“Again, we’re not against people being in the community,” Erwin says. “We just think the focus should be on them and their choices and let them decide.”

A public comment period on these proposed changes closed Oct. 1. In order to become regulation, they must pass through legislative committees.

She vowed to hold public

By cciting
She vowed to hold public forums as events warrant.192.168.1.1

Watch

By joson
Wow this is a great post. This contain have many useful information. Please post more information to share with us.Brandwatchbase

Oh look. Here we go -

By Kennedy
Oh look. Here we go - another day, another biased partisan pub bore tantrum about Losing choice or gaining independence?. I am fed up with hearing folks rail against best rated essay service . And I never thought that I would be saying that.

Still, advocates say if you

By sarazara2
Still, advocates say if you look at where the money’s going, it seems certain programs that have been around for decades are threatened. wot cheats

This posting is marvelous

By 9cxvdrj
This posting is marvelous and what a fantastic research that you have done. It has helped me a lot. thank you very much yachtbooker

Daftar Hp Android Tercanggih

By resepkueenak
Car Comparison adalah situs www.carscomparison.net terdiri dari mobil bekas terbaik dan terpopuler sepanjang masa. harganya pun ada harga mobil bekas 100 juta serta ada juga mobil bekas 65 juta hyundai dan daihatsu ayla bekas 60 juta . memilih hp android murah terbaik adalah cukup penting untuk diketahui. agar hp yang kita beli adalah hp terbaik berkualitas. seperti hp acer 1 jutaan dari blog harga tablet hp dan harga hp lenovo serta android Quadcore murah dari desain rumah minimalis

It is no wonder since in

By sarazara2
It is no wonder since in hospitals also they serve all the preserved food which is less nutritious that could end up making you gain weight or lose weight but not maintain healthy weight. the shaukeens trailer release date

When some one want to loose

By Jinsonkv
When some one want to loose his choice, it is then called the absence of independence. I happen to see that India is going to celebrate 68th independence this year. India is going to celebrate 68th independence this year. but what they gained so far? the complete illustration is given in the following website: http://www.independence-day-2014.in

Resources like the one you

By franklin56
Resources like the one you mentioned here will be very useful to me! I will post a link to this page on my blog. I am sure my visitors will find that very useful I am always using mrqe promo code I have found your post to be very rousing and full of good information. mrqe.in and usa promo code

Thanks for sharing such a

By Katty Smith
Thanks for sharing such a great information. This information is really enhance our knowledge level. hosted ip pbx voip pbx systems sip trunking sip trunks

Harga Bekas

By resepkueenak
Resep Masakan Indonesia merupakan Resep Bolu Gulung salah satu kue yang sering menjadi pilihan untuk dijadikan kue lebaran. Resep Kari Ayam Rasanya yang renyah dan manis disukai Resep Ikan Tongkol banyak orang. Nah, mau tau cara bikin Kue Kuping Gajah ini. Simak resep yang satu ini yach.... Resep Sup Jagung dan Resep Opor Ayam serta Resep Keripik Pisang . terima kasih

push simply stumbled upon

By marycam
push simply stumbled upon your weblog and wanted to say that I have really loved browsing your blog posts.Simply wish to say your article is as astonishing. AutoPartsPromoCode The clarity in your post is simply great and i could assume you are an expert on this subject. Well with your permission let me to grab your RSS feed to keep updated with forthcoming post. InkPromoCodeThanks a million and please keep up the gratifying work.I was very encouraged to find this site. I am sure to all the commenters here! It's always nice when you can not only be informed, but also entertained! I'm sure you had fun writing this article

Great Admin

By prakash1997
Just awesome work yur too good keep working Happy Veterans day Prayers, Veterans day Images, Veterans day messages Happy Veterans day quotes Happy Veterans day sayings Veterans day Poems 2014 Happy Veterans day Poems Thank you Veterans day quotes also veterans day images, veterans day for facebokk

Over time, if you get

By lassehuovinen
Over time, if you get recurring looks or concerns, this can have a damaging impact on your personality and self assurance, and if you are used to having obvious epidermis as well as skin tone, you are advised of the situation whenever you look in the reflection. Best Car Covers

Good Post

By ayushrdr
Really one of the Awesome article i have read it. Thanks for the article. Also i have made a Blog on Song Lyrics . Thnaks & Regards. And have a look on my another blog of Feliz Navidad 2014 .Will be visiting your blog next time for other awesome stuff. Well you really did and awesome Job Man. Made a Really resourceful article, contains all the new stuff and good for readers. Also i have made a Blog on i.e. Merry Christmas 2014. Have a Look on it and waiting for the Feedback from you. Thanks for it.