We have the opportunity to have real choice here in West Virginia.  This is a ammendment to the existing community based waiver which would add self determination to the existing options, it was developed by a number of disability rights groups.  On March 24th we will be meeting at Damons Resturaunt in Clarksburg from 10:30 - 3:00 to draft a finnal copy of this document.  We are asking that the Department of Health and Human Resources arrange  to meet with us by April 7th to begin to bring about real choice.  If this does not happen we will submit our proposal to the Health Care Finance Administration.  Join us on the 24th and MAKE YOUR VOICE HEARD!!

Dear Bill Davis,

Enclosed is West Virginia’s request to amend its Home and Community and Aged and Disabled Waiver for persons with Mental Retardation or Related Conditions. The amendments will assist West Virginia in its efforts to promote the self determination of persons with disabilities and their full participation in community life. We request that these amendments be approved effective July1, 2000.

The enclosed amendments modify service parameters of the current approved plan and allow coverage of additional services. Changes to the waiver are shown with strikeout of deleted language or the underlining of additions to the current text. Service utilization projections have been adjusted to account for the amendments. Additional funding to implement the amendments is not requested. The cost neutrality formula has been updated to account for recent legislative action providing cost of living increases to home and community-based waiver programs, such as the Ron Yost Personal Assistance Bill.

Changes to a current service parameter are proposed for caregiver training and education, housing service access, and respite care. Specifically we are raising the annual limit on caregiver training and education expenses to Removing the cost limit on housing service access and allowing respite care to be provided beyond the 2160 hours in a fiscal year. Individual service planning teams will specify the amount and frequency of the needed service costs will be managed within the allowable average established by the provider agency.

A. Additionally West Virginia requests coverage of the following services under this waiver:

B. Caregiver living expenses

C. Attendant services

D. Consumer-directed community supports

E. Consumer training and education including person centered planning

The individual person centered plan will:

A. Specify how consumers, families, and other natural supports identified by the consumer were involved in developing the plan and will be involved in ongoing oversight of the plan.

B. Specify how the selected provider will provide information about consumer-directed support options to consumers, families and other natural supports, guardians, and providers.

C. Specify how participating consumers and their families guardians and other natural supports, will be supported; to know their rights as citizens and consumers, to learn about the methods provided by the consumer-directed supports plan to take greater control of decision-making; and to develop skills to be more effective in identifying and implementing personal goals.

Establish support for development of person-centered support plans which are based on individual goals and preferences and which allow the person with a disability to live in the community, establish meaningful community associations, and make valued contributions to his/her community.

D. Provide for mechanisms for consultation, problem-solving, technical assistance and financial management assistance to assist consumers in accessing and developing the desired support(s), and to assist in securing administrative and financial management assistance to implement the supports and to maintain the parameters of the individual budget specified by the team. The consumer may recommend to the team the transfer of budget line items to meet his/her specific desires as outlined buy the plan. The consumer may maintain control of carry over funds for 24 months or until it is evident those funds are not needed or are voluntarily released by the consumer. Those previously committed funds shall be used only to fund unmet needs of other individuals within the waiver.

E. Establish a mechanism for allocating resources to individuals for the purpose of purchasing consumer-directed community support services based upon identified factors. These factors may include the persons functional skills, his/her environment, the supports available to the person, and the specialized support needs of the person.

F. Describe how the provider agency will promote use of informal and generic sources of support.

G. Describe how the state will promote availability of a flexible array of services that is able to provide supports to meet identified needs and that is able to provide consumer choice as to nature, level and location of services.

H . Describe how the agency will assure that consumer directed community supports meet the persons health and safety needs.

I. Provide for consumer-directed outcome-based quality assurance methods

Consumer-directed supports will be provided by entities which meet the unique recipient needs and preferences of the consumer as specified in the persons individual future plan or personal support plan. Local agencies are responsible to work with the consumer and his/her legal guardian to assure that the consumer-directed supports meet the consumer’s health and safety needs and preferences, and are directed at the desired consumer outcomes.

Consumer education and training

consumer education and training services are services designed to help a person with a disability develop self-advocacy skills, exercise civil rights, and acquire skills needed to exercise control and responsibility over support services. Training and educational goals related to these outcomes will be documented in the individual.

Consumer-directed supports are services which provide support, care and assistance to an individual with a disability, prevent the persons institutionalization and allow the person to live an inclusive life of their choice. Consumer directed supports are designed to build strengthen or maintain networks of community support for the person. Consumer-directed supports include the following specific activities at the request and direction of the consumer or his/her legal representative.

A. Provision of services and supports which assist the person, family or friends to:

1. Identify and access formal support systems;

2. Develop a meaningful consumer support plan; or

3. Increase and/or maintain the capacity to direct formal or informal resources.

B. Completion of activities which assist the person, his/her friends to determine his/her own future.

C. Development and implementation of person-centered support plans which provide the

direction, assistance and support to allow the person with a disability to live in the community, establish meaningful community associations and make valued contributions to his/her community.

D. Ongoing consultation, community support, training, problem-solving, technical assistance and financial management assistance to assure successful implementation of his/her person-centered plan.

E. Development and implementation of community support strategies which aid and strengthen the involvement of community members who assist the person to live in the community.

Services provided under a plan for consumer-directed supports may not duplicate any other services provided to the person. Components of the consumer-directed will be documented as necessary to prevent the person’s institutilization. In the individual service plan/personal support plan. Additionally, the local agency shall document how the community support services enable the person to lead an inclusive community life, build a viable network of support services, and result in outcomes specified by the consumer or his/her legal guardian.

Payment Parameters

West Virginia will cover consumer directed supports in areas of the state in which local agencies have memorandums of understanding with the state agency to demonstrate the feasibility and effectiveness of consumer-directed community supports. Each local agency offering consumer-directed support services will develop a written plan to implement consumer-directed community support options, which will provide for payment ranges of wages, fees, devices, transportation, emergency services, housing, recreation, and other specified needs and preferences as identified by the individual futures plan.

The state will offer flexible payment options to include vouchers, direct cash, delayed billing including direct deposit and withdrawal. This system may be administered by an individual service organization with a reasonable administrative fee paid by the state

Assistive Technology Devices any device or piece of Equipment which increases the independence and quality of life for an individual as defined by the consumer. Devices may include, but are not limited to the following:

1. wheelchairs, mobility devices

2. Household modifications

3. Vehicle modifications

4. Communication devices

5. Other devices as defined by the consumer

Service Coordinator the express purpose of the service coordinator is to assist in the ongoing development and implementation of the personal futures plan as developed by the consumer and their selected team provision of services must be based on functional need rather than diagnosis.

Functional Need is defined as: need based on abilities and limitations of individual consumer regardless of age, medical diagnosis or other category of disability