Efforts by the DD Council to enhance the quality of life for individuals with limited connections to their community received a big boost this past legislative session with the passage of Senate Bill 6564—Providing protections for persons with developmental disabilities (O’Ban R-28).
One of the programs created by the new law identifies certain clients of the Developmental Disabilities Administration (DDA) who may need additional time and attention by Case Resource Managers due to limited contact with anyone outside their home.
Known as Enhanced Case Management, the initiative sets a lower caseload ratio of 1:40 Case Resource Manager (CRM) to clients, as compared to a waiver caseload ratio of 1:75. The lower caseload will allow more visits and the ability to provide more intensive case management to roughly 700 DDA clients living in the community.
According to Teresa Martin of DDA, there are three main criteria for individuals receiving Enhanced Case Management. “[The client] lives with a paid provider. They have limited ability to supervise their provider. And they have few outside contacts. Some folks may have some other services, such as respite, but it’s outside the home, and there’s no one else really inside the home.”
Martin explains that CRMs are expected to meet with clients at least every four months, with more visits if needed. Additionally, CRMs may do an unannounced visit if there are environmental concerns. She stresses a benefit of the program is about making an effort to improve community involvement, and quality of life.
“All of us at DDA are seeing this as an opportunity to do more person-centered planning and help people have the lives that they want, with the hope that if there are concerns, we can prevent negative outcomes before they get more serious.”
Ed Holen, Executive Director of the DD Council, says the legislation behind Enhanced Case Management is about creating conditions for the person to live a life that’s meaningful to them. “A tool we have offered [DDA] is the Council’s Peer Connections project, which was born a year ago out of the same concern that there are people on the DDA caseload with only a provider in their life.”
The project, coordinated by Kathy Easton, has trained about 15 volunteers throughout the state to meet with individuals referred by their DDA Case Resource Manager. The criteria are similar to the Enhanced Case Management program: people living in isolation with just a care provider for contact.
“It’s another set of eyes,” says Easton. “We make observations about living conditions and find out how people are doing.” If Peer Connections volunteers pick up on problems, they report back with their findings. “In one case, we were able to support an original report that indicated the provider could no longer care for the two individuals we met with. It was a good visit, and the individuals enjoyed talking with us. They agreed that they needed to move [to another living situation], so we talked to them about the other living option.”
Easton says there have been a few people they visited who were more in need of a Peer Mentor (a service provided by DDA that connects people to a knowledgeable peer in their community). In that case, Peer Connections volunteers help where they can. “We research what’s available in the place we’re visiting and take that information with us. But mainly, we are there to see how the individual is doing.”
One of the project’s volunteers, George Adams, points to the need to have more than one person to trust. “When someone’s really isolated, who are they supposed to tell [if there’s a problem]? The person should have somebody to talk to other than the case manager.”
Tim McCue of Self Advocates of Washington agrees. “I have to say that something like this is so incredibly important because of how easy it is for individuals to become isolated, where there isn’t another set of eyes to make sure they’re not being treated poorly, that they’re getting the care they need. Things like that can escalate super quickly.”
A third effort, part of the same legislation that funded Enhanced Case Management, creates an Office of the Developmental Disabilities Ombuds to monitor and report on services to persons with developmental disabilities. The DD Ombuds program, which is still in the early stages of defining its mission and scope, will be operated by an independent non-profit contracted by the Department of Commerce.
Holen points to the shared mission of Enhance Case Management, Peer Connections, and the DD Ombuds program. “We all have the same goal, which is to see that people are living good, safe, meaningful lives.”