Fairfax-Falls Church Community Services Board

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8221 Willow Oaks Corporate Drive
Fairfax, Virginia 22031
Daryl Washington
Executive Director

Innovation Challenge Summer 2017 - Ideas Received

Summer 2017, the CSB solicited ideas on how to provide various levels of service, for the greatest number of people, while containing costs. Below is feedback received from our online submission form.

(Learn more about the Innovation Challenge.)

Idea 1

  • Innovative idea serves more people
  • Summary:

    Instead of only considering criteria like “exceptional hardship” in allocating services, we recommend a multi-pronged approach driven by person-centered planning. In the fall of their final year of school, graduates should meet with Community Services Board staff to begin discussions about their needs and preferences, as well as any urgent need criteria.

    Factors to be weighted heavily in the decision for services should come from these meetings. We recommend they include:

    1. A preference for employment. Employment for people with the full range of developmental disabilities has long been a national best practice. It is a key focus of Virginia’s legal settlement with the Department of Justice and a focal point of the Medicaid Waiver redesign. Employment services are significantly less expensive than traditional day services, they empower the person with a disability, and move people towards greater independence over time. The families of the up and coming graduates are more interested in integrated, employment-focused opportunities than ever before. This trend and cost effectiveness were highlighted in a March 14, 2013 report from Transcen, a consultant hired by Fairfax County to look at ways to preserve and maximize funding for our graduates. That report is attached to our email.
    2. A preference for self-directed services. Fairfax County’s innovative self-directed services program saves at least 20% cost per person per year over traditional day programs. The flexible program allows families to select services and options that are most supportive and meaningful to the person with a disability. The program has a very high satisfaction rating. We would further suggest that the self-directed services program be re-introduced and marketed to existing users of County funds for other day options to see if this more affordable program, now with a decade plus experience, is a better fit for them. We suspect many people, including people looking to “retire,” would have an interest in this option.
    3. A willingness to delay start times. Families across Virginia are no stranger to endless waiting lists between Waivers, housing options, and other core services that seem elusive. However, a seemingly endless wait is very different than a one-time planned delay. We would suggest a delay in starting employment and day options until the fall season after graduation. These few months represent a significant savings in funding for the first year after a graduate leaves FCPS, yet is not so long that parents cannot plan in advance to make one-time support arrangements.

    Outside of person-centered planning, there are several other approaches we think should be explored to maximize services while managing cost limitations.

    1. Local Match Waivers. The 2013 Transcen consultant report referenced above focused heavily on the possibility of a “local match Waiver.” Such Waivers have been used elsewhere in the country by localities similar to Fairfax County. In these local match Waivers, a contract is written between a locality and the federal government, with support from the state, which allows for a 50/50 cost division for funding of services between the County and federal government. Fairfax County should explore this option and not only decrease costs for future graduates, but also for anyone currently receiving Fairfax County funding. There is no doubt that this option would take time and effort to pursue. There is also significant uncertainty at the federal level surrounding Medicaid. However, recent proposals to block grant Medicaid, which would have reduced funding overtime, have failed. It is also reasonable to assume our political climate may change at some point and be more Medicaid friendly again.
    2. Utilizing the Consolidated Community Funding Pool (CCFP) and other tools to incentivize creative support development. The CCFP is a tremendous tool to incentivize growth and development in needed areas. We suggest a preference for projects that offer long-term employment and other meaningful day options for people with developmental disabilities that could be started in the private non-profit sector.
    3. Considering a sliding scale option for service costs. It troubles all of us to think of families having to pay for employment and day options, but it is even more troubling to think of individuals sitting at home and parents having to leave their jobs to support them 24/7. An examination of families sharing some of the cost, based upon a sliding scale, is worth exploring to ensure that the maximum number of individuals are served.
  • How can this idea be explored further in the next 30 days? Work with stakeholders to set up a system that weights factors like preference for employment and SDS and delayed start times to ensure that we're serving as many people as possible in the most integrated settings possible

Idea 2

  • Innovative idea serves more people
  • Summary:

    My organization's ideas serve more people while containing costs. These ideas are submitted on behalf of The Arc of Northern Virginia. We recommend a multi-pronged approach driven by person-centered planning. In the fall of their final year of school, graduates should meet with Community Services Board staff to begin discussions about their needs and preferences, as well as any urgent need criteria. Factors to be weighted heavily in the decision for services should come from these meetings. We recommend they include:

    1. A preference for employment. Employment for people with the full range of developmental disabilities has long been a national best practice. It is a key focus of Virginia’s legal settlement with the Department of Justice and a focal point of the Medicaid Waiver redesign. Employment services are significantly less expensive than traditional day services, they empower the person with a disability, and move people towards greater independence over time. The families of the up and coming graduates are more interested in integrated, employment-focused opportunities than ever before. This trend and cost effectiveness were highlighted in a March 14, 2013 report from Transcen, a consultant hired by Fairfax County to look at ways to preserve and maximize funding for our graduates.
    2. A preference for self-directed services. Fairfax County’s innovative self-directed services program saves at least 20% cost per person per year over traditional day programs. The flexible program allows families to select services and options that are most supportive and meaningful to the person with a disability. The program has a very high satisfaction rating. We would further suggest that the self-directed services program be re-introduced and marketed to existing users of County funds for other day options to see if this more affordable program, now with a decade plus experience, is a better fit for them. We suspect many people, including people looking to “retire,” would have an interest in this option.
    3. A willingness to delay start times. Families across Virginia are no stranger to endless waiting lists between Waivers, housing options, and other core services that seem elusive. However, a seemingly endless wait is very different than a one-time planned delay. We would suggest a delay in starting employment and day options until the fall season after graduation. These few months represent a significant savings in funding for the first year after a graduate leaves FCPS, yet is not so long that parents cannot plan in advance to make one-time support arrangements.

    Outside of person-centered planning, there are several other approaches we think should be explored to maximize services while managing cost limitations.

    1. Local Match Waivers. The 2013 Transcen consultant report referenced above focused heavily on the possibility of a “local match Waiver.” Such Waivers have been used elsewhere in the country by localities similar to Fairfax County. In these local match Waivers, a contract is written between a locality and the federal government, with support from the state, which allows for a 50/50 cost division for funding of services. Fairfax County should explore this option and not only decrease costs for future graduates, but also for anyone currently receiving Fairfax County funding. There is no doubt that this option would take time and effort to pursue. There is also significant uncertainty at the federal level surrounding Medicaid. That uncertainty, however, focuses on decreasing Medicaid matches slowly overtime, not eliminating them. Any match would be greater than what Fairfax County has now. It is also reasonable to assume our political climate may change at some point and be more Medicaid friendly again.
    2. Utilizing the Consolidated Community Funding Pool (CCFP) and other tools to incentivize creative support development. The CCFP is a tremendous tool to incentivize growth and development in needed areas. We suggest a preference for projects that offer long-term employment and other meaningful day options for people with developmental disabilities that could be started in the private non-profit sector.
    3. Considering a sliding scale option for service costs. It troubles all of us to think of families having to pay for employment and day options, but it is even more troubling to think of individuals sitting at home and parents having to leave their jobs to support them 24/7. An examination of families sharing some of the cost, based upon a sliding scale, is worth exploring to ensure that the maximum number of individuals are served.
  • How can this idea be explored further in the next 30 days? The Arc of Northern Virginia is ready, willing, and able to meet and work with the Community Services Board to come up with a plan for 2018 and beyond that is as fair and equitable as possible.

Idea 3

  • Innovative idea serves people with specific support needs
  • Summary: I have already set up an activity center for our 30 year old intellectually disabled daughter. I call it The H-A-R-K Center - Hobby-Activity-Recycling-Kraft center. I have rented a small office space in the Panera building in Falls Church City. We only use "donated, used, materials" for intellectually disabled adults (with caregivers) to recycle & make craft items to donate to others who have less. People in the community donate their used holiday & other cards & we make gift tags, cards, gift totes, other. We offer them throughout the community for a small "donation". People in the community donate unused yarn & we make tubular scarves, "Handi-holders" & puppets. We have already donated more than 40 scarves to 2 different homeless shelters in the nearby communities. Also, 2 of our daughter's special needs friends from school come to visit & work with her 1-2 days per week. This office space is small - could accommodate only about 4 adults(each with a caregiver) but is good for those adults who need a more "quiet, less stimulating" day/work environment. I would love to expand this concept to more H-A-R-K centers close to the communities where other adults with intellectual/developmental disabilities live. These local centers would give the adults a close activity/day program & keep them more involved & visible in their own community.
  • How can this idea be explored further in the next 30 days? [No response.]

Idea 4

  • Innovative idea serves people with specific support needs
  • Summary: Allow Med-cottages (AKA Granny Pods) to be occupied by caregivers and to be used by sponsored residential caregivers. Background: Current Commonwealth law restricts pods to occupancy by a disabled person only, severely restricting the utility of such dwellings. Many of the most medically fragile who could use the pod in their long term care plan by having a caregiver "living in" are prohibited from doing so. Discussion: Allowing caregiver occupancy means the disabled person can remain in their home until/unless the disabled client requires the built-in medial supports of the pods. By keeping the disabled client in their same environment, neighborhood, programs, etc., that are already a part of the client's life minimizes transition trauma as well as costs. Allowing sponsored residential caregivers to employ the pods significantly enlarges the potential pool of caregivers, as many capable and loving caregivers cannot afford moving to another house or putting an addition on their current home. The pods can be reused and should be allowed only on properties with a disabled client meeting exiting criteria. Modifying the current directives to enable the above use translates to a long term care model that can attract private capital, enables the disabled clients to apply for rent subsidies currently prohibited, is significantly less expensive than institutionalized care, and keeps the disabled client in a community based setting where his/her residence is paying taxes like all other home occupiers.
  • How can this idea be explored further in the next 30 days? I had been exploring the provision of med cottages/pods as a "B" corporation business until finding the above mentioned restriction. Such a restriction mean very few pods can be used by the disabled thus severely limiting the market and making the business plan moot. The goal was to demonstrate that such pods could , through reasonable rents integrated with tax credits for depreciation and installation fees, make the investment interesting to private investors

Idea 5

  • Innovative idea contains costs
  • Summary: Involve the Leadership Fairfax program in the CSB's Engagement efforts - perhaps a team could work on fleshing out a promising idea from the idea bank or even create and map out a new idea.
  • How can this idea be explored further in the next 30 days? I do not know the Leadership Fairfax program personnel, but someone within the CSB would surely be able to reach out and involve them. I think that would be more effective than if I were to cold-call the program.

Idea 6

  • Innovative idea serves people with specific support needs
  • Summary: Create a database or link to existing database for matching disability friendly businesses with families who might want to invest in exchange for an employment opportunity for their family member; database could also match likeminded families who might want to go in together on a new business in which their family members could work. Could partner with Fairfax's office for Public/Private Partnerships and/or Chamber of Commerce and office for Economic Development. Run webinars/seminars for interested businesses and families showcasing those who have created/are running disability-friendly businesses and explaining appropriate business models; partner with GMU entrepreneurship program to educate interested families on how to get started and how to succeed once up and running.
  • How can this idea be explored further in the next 30 days? Bring together CSB with Public/Private Partnership office, Office for Economic Development and Fairfax County Chamber of Commerce to discuss. Maybe include Service Providers like Service Source who may have engaged in some entrepreneurial ventures.

Idea 7

  • Innovative idea contains costs
  • Summary: : I have been looking for meaningful ways to help with the Innovation and Resource Challenge. As a parent, I would like to see more availability of small group employment that is tailored to the needs of the individuals served. I am wondering if I could assist through writing some sort of grant. See the link below. This is something that New York has been doing. Any thoughts as to where to begin with grant writing? I will begin by posting the idea on the link and see what happens! https://opwdd.ny.gov/opwdd_services_supports/employment_for_people_with_disabilities
  • How can this idea be explored further in the next 30 days? I need to collaborate with others on this idea. Please link me with others of like mind.

 

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