April 23, 2003 Work Group Meeting Minutes
The William S. Cohen Community Center, Hallowell, Maine

Present:  Chris Zukas-Lessard (Chair), Christine Bartlett, Nat Hussey, Stirling Kendall (Muskie facilitator), Stephanie Crystal, John Baillargeon, Deb Parker Wolfenden , Shirley Bastien, Leyton Sewell, Steve Hoad, Eileen Griffin (Muskie) and Danny Westcott (Muskie), Mark Richards (Muskie), Louise Olsen (Muskie), Catherine Ormond (Muskie), Helen Bailey, Debbie Williams, and Taryn Bowe (Muskie) 

Not Present:  Tom Bancroft, Ron Welch, Cynthia Sudheimer, Jane Gallivan, Alice Conway, Tonya Labbe, Debbie Rogers, Kate Brogan, Jonathan Connick, Peter Driscoll, Cary Gifford, Debbie Rogers, Myra Champagne, Linda Jariz, and Lora Perry

The afternoon session began at noon with lunch. Chris Zukas-Lessard was chair.  Stirling Kendall facilitated the meeting.

1. Check-in and Roll Call
Meeting participants introduced themselves.

2. Mission Statement and Vision Statement
Chris read the Work Group’s revised vision statement: “All of us together, in community with equality in rights and dignity, in pursuit of happiness and fulfillment.”

3. Meeting Minutes
The Work Group approved the minutes of the January 22, 2003 meeting with minor revisions.

4.  Review of the Agenda
Chris reviewed the agenda which includes 10 reports from Quality Choices project staff and an open discussion of the Work Group role facilitated by Stirling Kendall.

5.  Report on Quality Choices Project Activities
The Work Group’s possible role in augmenting and helping to sustain Quality Choices activities was the focus of the meeting.  To provide a context for the discussion, project directors and staff were invited to describe current project activities within Quality Choices, including project goals, initial findings, and next steps.  Note:  Work Group comments specific to each project are recorded in project descriptions sections.  Following the presentations, the Work Group entered into a discussion about its role going forward. 

Housing.  Eileen Griffin reported that the purpose of this project is to fund two to three demonstrations for improving access to housing for persons with disabilities.  Muskie issued an RFP in the fall and seven proposals were received.  In January, three applications were selected by the Review Committee: CEI’s Center for Housing Information in Maine (CHIME); a joint proposal by Ingraham and Amistad to develop a toolkit for identifying housing resources and provide landlord-tenant advice in the Portland area; and Tri-County Mental Health Services’ Needs Assessment leading to one-call access for housing services in Franklin County.  In the next phase, the agencies will conduct their demonstration projects and will determine how well the projects met their objectives.

Quality Management.  Taryn Bowe reported that QM staff has been interviewing departmental representatives from BMS, BEAS, BDS, DOC, DOL, and DOE who are responsible for monitoring the quality of Home and Community-Based Services. QM staff will identify, with guidance from the Quality TAG, one or two projects where there is (1) sufficient leadership and commitment to collaborate in more than two departments, and (2) ample resources to address the topic in a meaningful and sustained manner. Two ideas have surfaced as possible areas of collaboration: collaboration around individuals with multiple service needs (e.g., an elderly person served by BEAS who also has an MH service need); and collaboration around data sharing or data standardization.  The role of the TAG will be to set up preliminary criteria for selecting a topic and developing a plan for implementation.

Quality Indicators. Louise Olsen reported that the goal of the Quality Indicators project is to arrive at a core set of indicators that can be used across departments to measure the quality of home and community-based services.  Beginning with close to 500 indicators, the Quality TAG has worked on selecting a small number of domains or areas of interest and on reducing the recommended number of indicators to between 5 and 10.  The Quality TAG will continue to trim down the list of indicators and to select the final domains at the next TAG meeting.

Comments about the QM/QI project:  In discussing some of the issues (using frequency of hospitalizations as a core indicator, cross-agency case coordination and utilization and review vs. person-centered planning, how wait lists are managed), the Work Group discussed the importance of being able to weigh in on TAG activities to ensure that these activities further Roadmap goals.

Data Integration.  Eileen Griffin reported that under earlier funding by the Center for Health Care Strategies (CHCS), the Data Integration project developed a strategy for integrating data across departments.  The current project addresses a series of constraints (e.g., exchanging information within confidentiality regulations, and controlling departmental data) that slow down the State’s efforts to integrate data.  The project has also developed a virtual information system, IDA, that allows departments to define who gets the data, under what circumstances, and for which use. The goal now is to find a way to exert some influence so that IDA is implemented with the Governor’s support.

Transportation.  Mark Richards reported that the goal of the transportation project is to make transportation services more available and responsive to people with disabilities.  A principal activity for the project is funding several transportation demonstration projects.  A second initiative involves the development and refinement of a transportation resource guide, called GRO-Trans (Guide to Resources and Opportunities for Transportation Advocacy). 

From the six proposals received in response to an RFP issued in November, the review team selected 3 for funding. They are:  (1) “Trip Interface Between Paratransit and Fixed Route Transportation in Cumberland County”, a regional transportation program funded to purchase a trip interface software module as an add-on to the paratransit reservation, scheduling and dispatching system; (2) A Maine Parent Federation initiative, “Project TOT (Taking On Transportation)”, to develop a ride-share bulletin board and to recruit and train volunteer drivers in western counties and Aroostook County; (3). “Sitting at the Table” (a plan from the Independence Association for the Brunswick, Topsham communities) to create the Mid-Coast Collaborative for Access to Transportation that will be used in soliciting community input regarding transportation needs for people with disabilities.

Access to Recreation.  Mark Richards reported on four major activities related to the Access to Recreation and Social/Cultural activities project: (1) working with the State-wide Committee for Accessible Leisure, Arts and Recreation to develop a self assessment survey tool to evaluate accessibility and improve access to facilities; (2) publishing a column in the Maine Tourism Association Newsletter focused on access; (3) developing a toolkit for fitness facilities; and (4) replicating “Portland Connections” by the Maine Parent Federation through their LINK Maine site, a local community calendar of low-cost events.

Access to Information.  Catherine Ormond gave an overview of the Access to Information project and presented on-line the accessmaine.org site that’s under development.  The idea for the Access to Information project grew out of discussions with focus groups and interviews early on; its purpose is to improve access to information for consumers, family members, and providers.  Catherine described the site’s structure, functions, and navigation, noting special features including a language translator function recommended by the TAG, a site search function, and the rating function.  Spread around the site are popular Tip Sheets or short resource guides—“Talking with your doctor”, “Guide to using the Internet”, “Home Modification”, and “Vehicle Adaptation”, for example.  The site will be tested by consumers next month and then will be marketed and opened up.  The Work Group discussed the challenge of keeping the site current and how it would be maintained and possibly expanded over time. 

Flexible Funding.  RuthAnne Spence reported that the flexible funding project is designed to demonstrate ways parents, school transition specialists, and service providers can access and use funds flexibly to support successful transition plans for youths (ages 17-20) with developmental disabilities.  This summer, in Penobscot and Piscataquis Counties, project staff will interview 30 families with youths who are transitioning from children’s to adult services and from home or school to independent living.  Project staff will recommend changes in funding streams that could improve the experience of transitioning youth after the interview data is compiled and successes and barriers to coordinated service delivery are identified. 

Comments about the Flexible Funding Project:  The discussion centered on the selection of the target group (17-20 y/o), the problems in serving youths with DD once they are out of school (no agency is responsible, in many cases), and opportunities for building funding flexibility into the waivers that will be renewed this year.

Fiscal/Employer Agent.  The intent of the FEA project is to provide administrative supports (e.g., payroll tax withholding, workman’s compensation, worker referral service possibly) to people who want to self direct.   Louise described current activities under the FEA project, including weighing the pros and cons for issuing a Request for Information (RFI) or Request for Proposal (RFP) and hosting a conference call on April 11^th to gauge interest from possible vendors.  Fourteen organizations participated in the call, signaling a keen interest in having this service option available in Maine.  As a next step, the State will consider how to incorporate FEAs into current and future self-directing programs. 

Personal Assistance Services Association (PASA).  Eileen provided an overview of the Maine Personal Assistance Services Association (Maine PASA).  In the last year, Elise Scala has helped to support direct care workers and personal assistants in building Maine PASA, a coalition of people employed to provide, for persons with disabilities and elders, direct care, assistance, and supports for independent living.  The Association’s objectives are to empower workers, build opportunities, and improve the quality of jobs.  Two hundred people are now on the mailing list for a newsletter that goes out every two months.  In addition, Maine PASA members are meeting with peers from other New England states to identify opportunities for working together, including possibly developing a region-wide Workers’ Registry.  A challenge going forward is to secure funding beyond the grant period as direct care workers cannot afford membership dues needed for sustaining the Association.

6. CMS Grant Solicitations
The Work Group discussed how best to weigh-in on the upcoming CMS grant solicitations when the Notices of Funding Availability are issued.  Muskie will send information to the Work Group and invite Work Group members to attend a special meeting to discuss funding opportunities

7. Consumer Participation and Work Group Role Going Forward

Consumer Participation. The Work Group discussed what to do to bring consumers and consumer organizations back to the table and whether to recruit new members now or later.  Before contacting consumers, the Work Group needs to be clear about what it will ask members to do, why it wants to bring them together, and what role the Work Group will play in furthering the recommendations in the Roadmap.  After a lengthy discussion, the Work Group decided to contact old members and member organizations first.

Work Group Roles.  The Work Group listed activities and possible roles for the Work Group going forward:

• Finish the Roadmap, disseminate findings, and work to realize its goals;
• Steer Quality Choices TAGs; advise projects at important decision points;
• Review grant opportunities, recommend grants to pursue, what activities within the grants to include;
• Promote Roadmap recommendations and principles whenever possible (e.g., DHS-BDS merger planning; waiver renewals);
• Further clarify the Work Group’s purpose;
• Recruit new members and member organizations.

8.  Next Meeting
The next meeting is scheduled for Wednesday, July 23, 2003 from 1:00 p.m. to 4:00 p.m. The Cohen Center will not provide lunch. Stephanie Crystal Wolfstone Francis will be chair.