January 23, 2002 Work Group Meeting Minutes
The William S. Cohen Community Center, Hallowell, Maine

MORNING SESSION

Services Sub-Group 

Present:  Deb Parker Wolfenden, Steve Hoad, Chandra Murphy; Dixie Leavitt, Kathryn Kazenski, Myra Champagne, Shirley Bastien, RuthAnne Spence (Muskie staff), Eileen Griffin (Muskie staff).  Steve Hoad is a new member of the Work Group and the Services Sub-Group.  RuthAnne Spence is staff from the Muskie School who will be working on the Flexible Funding project on the Quality Choices grant.  She joined the meeting to get a better sense of the Work Group’s ideas on flexible funding.  

The Services Sub-Group worked on its two remaining drafts titled “Flexible Funding/Choice and Control” and “Making Sure Services Are Funded.” 

The Services Sub-Group discussed the idea that the Flexible Funding draft was broader than about giving people money to buy their own services.  They agreed that it is about meeting individual needs and about giving the individual (or the family, if appropriate) the right to define those needs.  RuthAnne discussed her work on the Integrated Case Management project which focused on children.  This project looked at two pilot programs trying to integrate the work of multiple case managers in two different communities.  In one community, an independent facilitator was hired to work with the family to identify the child’s and the family’s needs.  The facilitator would then bring together all of the people that could help meet those needs.  The people included case managers and providers, family members, and members of the community.  Together the group would sort out who would take responsibility for meeting which needs.  Through that process, the group would also sort out which case manager would be the lead case manager for that family or individual and the transition would be made.   RuthAnne reported that the other community did not have funding for the facilitator role and they discovered at the end that a facilitator would have been a big help.   RuthAnne also reported that the Integrated Case Management model did end up saving money.  The group also talked about provider resistance pooled funding.

The Sub-Group discussed the facilitator role and decided that this was an important role to include in their report.  They agreed on the following:

• It is critical that the facilitator be independent and not provide any other service except the facilitator service;

• The facilitator supports the individual or the family to develop a comprehensive resource plan.

• In developing the resource plan, the facilitator works with the individual or family to identify strengths, needs and resources. 

• The resource plan is driven by the individual’s or family’s needs, not by the services that are available.

• The resource plan considers not just resources provided by the State, but local private or community (e.g., church) resources, as well as family and friends.

• It was agreed that including community and personal resources was critical to the success of the plan.

• In addition to being independent, the facilitator needs to have good facilitation skills and knowledge of the services available across different service systems as well as the different ways of thinking for different types of providers.

• The group talked about the need for quality assurance and for accountability for both the family/individual and for the service system and the State. 

• There needs to be a “circle of accountability” including the individual or family, the providers/system and the community.  When someone on the resource team (including the individual or family) does not hold up to their end of the agreement, the team meets again to find another way of accomplishing the goals.

• The group agreed that it would be important to have ongoing evaluation, and that the evaluation would have to be done by someone who did not provide a service so that consumers would be comfortable being honest.

• The State’s role is critical for this idea to work.  The departments within the State need to be at the table to address some of the systemic barriers to integrating services. 

The Services Sub-Group also discussed their draft about planning and agreed that the focus should be broader than special education.  The State should be anticipating the budget impact of other age group transitions, including people aging from young adult to older adult.  The State should be anticipating budget needs associated with “Olmstead transitions” from a less integrated to more integrated setting.  In addition, the State needed to anticipate the needs of people at risk of institutionalization.  The State should have better data and budget planning should be data driven.  And the State should be taking into account trends, including the aging of our population.  The  group agreed that the data elements identified in the Roadmap for Data System Integration and in the “Olmstead element” memo enclosed in today’s mailing should be incorporated into the document. 

The Sub-Group agreed to meet by phone to discuss revised drafts on February 11, at 10:30.  Eileen will let people know how the conference call would work.  For people who could not participate, the draft would be considered again by the Sub-Group at the February meeting. 

Coordination Sub-Group

Present:  John Baillargeon, Linda Jariz, Stephanie Crystal, Stuart Bratesman (Muskie staff), Danny Westcott (Muskie staff). 

The Coordination Sub-Group discussed the case management draft and made significant progress.  Further revisions to the drafts will be made for the next Work Group meeting. 

AFTERNOON SESSION

Present:  Stuart Bratesman (Muskie staff), Danny Wescott (Muskie staff), Stirling Kendall (Muskie staff), Steve Hoad, Kathryn Kazenski, John Baillargeon, Donna Lerman, RuthAnne Spence, Linda Jariz, Deb Parker Wolfenden, Stephanie Crystal, Jonathan Connick, Chandra Murphy, Dixie Leavitt, Shirley Bastien, Myra Champagne, John Shattuck, Eileen Griffin (Muskie staff).

Not Present:   Nat Hussey, Drew Bolduc, Christine Bartlett, Helen Bailey, Cary Gifford, Alice Conway, Tom Bancroft, Chris Zukas-Lessard, Peter Driscoll, Ron Welch, Tonya Labbe, Lora Perry, Cynthia Sudheimer, Jane Gallivan.

In Cary Gifford’s absence, Donna Lerman acted as chair.

1.  Check-in and Roll Call
Today’s meeting was the first Work Group meeting for Steve Hoad, a new member of the Work Group named by the State Rehabilitation Council for the Blind & Visually Impaired, replacing Jane O’Loughlin French.  Today’s meeting was also the first meeting for Danny Westcott who will be taking over as primary staff to the Work Group.  Donna also noted that today’s meeting would be Stuart’s last meeting and asked Work Group members to join in thanking Stuart for all of his work.  Donna also explained that Stirling Kendall would be taking over for her as facilitator beginning at the next Work Group meeting. 

2.  Vision Statement
The Work Group read its vision statement:  “Together in community with equality in rights and dignity, in pursuit of happiness and fulfillment.” 

3.   Meeting Minutes
The Work Group approved the December 19 meeting minutes without revision.

4.  Reports from Sub-Groups

Public Communications Team (PCT). The Public Communications Team met on January 22 and discussed stipends, revisions to the brochure, posters and flyers, and other matters relating to the public communications strategy.  The PCT reported that after talking about all of the work that would go into the large public meetings, no one was very confident that anyone would come.  The PCT asked the Work Group for guidance on whether the large public meetings would be worth all of the effort and whether or not it would be more effected to do a series of small targeted meetings with the different advisory councils and other selected groups.  Some members expressed concern that, even though large group meetings would not be a very effective way to get input, the Work Group might get some backlash for not having them.  Some members said that it is easier to work in small groups and for people without regular access to transportation, it is smart to take advantage of small group meetings where people will already be located.  After some discussion the Work Group agreed that the small group meetings would probably be a better approach.  The Work Group also agreed that it would target provider association meetings in addition to consumers for the small group meetings, to make sure that providers have an opportunity for input as well.  Jonathan said that small group meetings work well in the deaf community and that he could help arrange a small group meeting with one of the deaf clubs meeting around the state.

Steering Committee. At their last meeting, the Steering Committee had a brief discussion about the future role of the Work Group after the roadmap is complete.

Drafting.  At the last meeting of the drafting group, they discussed ways of reorganizing the draft and made other revisions.

CHCS Activities.  Eileen reported that this months meeting materials included two final reports for activities funded under the Center for Health Care Strategies grant.  One is called Stakeholders Speak and is a series of eight different reports based on interviews and conversations with people from around the state.  The other is the Roadmap for Data System Integration which describes a design for integrating data.

Quality Choices.  Eileen reported that the Work Group members of the four Technical Advisory Groups will be meeting in February:

• Person Center Services, February 5, 1:00 to 2:30

• Access, February 5, 2:30 to 4:00

• Quality, February 12, 1:00 to 2:30

• Data Integration, February 12, 2:30 to 4:00

At this meeting, Work Group members and the project staff will talk about how the process is going to work, the projects and who else should be part of the TAG.

5.  Work Group’s Mission and Olmstead
The Work Group agreed to table this discussion since the memo under discussion was incorporating comments from Helen and Nat and they were not present.  Deb reported that she heard that Texas and Missouri both had Olmstead plans that addressed the “meat and potatoes.”  She said she would share a link to these plans on the listserv and Stuart suggested that they be posted on the Work Group’s website.

6.  Data
The data discussion was also tabled since it relates closely to the discussion about the kinds of things the roadmap needs to address and should be addressed at the same time the Mission/Olmstead discussion takes place.  

7.  Transportation
Discussion of this draft was tabled so that Work Group members will have an opportunity to review for the next Work Group meeting.

8.  Employment
Discussion of this draft was tabled so that Work Group members will have an opportunity to review for the next Work Group meeting.   Chandra commented that it costs money to get a job, getting to a job, etc., and that for may people, the expense of having a job ends up eating up a lot of the money that would pay for health insurance, going to a movie, bowling, etc.  Linda noted that the draft needs to be updated. 

9.  Services Sub-Group Report
Discussion of this draft was tabled so that Work Group members will have an opportunity to review for the next Work Group meeting. 

10.  Drafting Meeting
A sign-up sheet was passed around for members to sign up for the drafting meeting scheduled for January 30, 1:00 to 3:00.

11.  Announcements
It was noted that the agenda had the wrong date for the next Work Group meeting.  The next meeting is February 27, not February 28.  Also, Eileen asked Work Group members to turn in their sign up sheets for participating in the public communications process. 

12.  Next Meeting
Agenda items for the February meeting include:  sub-group activities in the morning, review of transportation and employment drafts; review of one of Services Sub-Group drafts; carry over of Olmstead and the Work Group’s mission discussion; carryover of the data discussion.  The January meeting is scheduled for Wednesday, February 27 from 9:30 to 4:00 p.m. at the Cohen Center.  Christine Bartlett is the chair of this meeting.