Changing the Conversation at the Front Door Erin Slide Presenter Duration 1-7 Erin 10 minutes 8-10 Michelle 5 minutes 11-12 Erin 5 minutes 13 Alison 5 minutes 14 Rhonda 3 minutes 15-18 Joan 10 minutes 19-20 Rhonda 5 minutes 21-23 Joan 5 minutes 24 Erin 3 minutes 25 Michelle 3 minutes 26-27 Erin 1 minute   55 minutes total

About Us Erin Leveton DC Department on Disability Services Program Manager, State Office of Disability Administration Project Director, DC Supporting Families CoP & No Wrong Door erin.leveton@dc.gov Mark Agosto DC Department on Disability Services Project Manager, No Wrong Door mark.agosto@dc.gov Everyone Michelle Hawkins DC Department on Disability Services Community Outreach Specialist, Developmental Disabilities Administration Parent & Family Planning Together Trainer michelle.hawkins@dc.gov

DC Supporting Families CoP Core Team Members Erin

Stakeholder Input People with disabilities, seniors and family members have told us they want: Help navigating the system Single case management system for all services Continuity of support throughout the lifespan Better coordination between government agencies Great customer service Focus on what people can do Support to live in the community as independently as possible Person centered counseling, planning and service delivery Support for family caregivers Holistic approach that goes beyond just paid LTSS Community-based (access and services) On-line with one website for everything We aim to make access to Long Term Services and Supports person and family centered, easy to navigate, and one that builds upon and supports the many strengths of families and community. Stakeholder ideas and experience has helped to advise us, as government leaders, about how intake and referral is currently working; the value that they receive from the current processes; what they wish were different; and their ideas for change.

Front Door to DDA Person-Centered Planning starting at intake Like and Admire to determine strengths Working/ Not Working to identify LTSS needs Trajectory to identify goals Guided conversation on employment Integrated Supports Star to match to supports Start eligibility for public LTSS, only if needed Aligns with Initial ISP at DDA An important part of the journey for DDA to become a PCO is to engage in a critical self-examination of our policies and practices to see where we are being person-centered and where we are creating a barrier to people having a good life. We took a hard look at our Intake process recently – to reframe our front door to services. People and families come to state agencies for help, often when they are in crisis and need supports. Our process in DC, like many state DD systems, is eligibility-based. That means that it can take months from the time a person calls for help until they are linked with a waiver service to meet their needs. It also means that we are starting our conversation with people and their families by asking them typical eligibility questions that require them to show that they are disabled enough to receive our services. We wanted to reframe the front door to DDA supports – and eventually all DC LTSS – to make them person-centered and strength based, with a goal to connect people to community-based supports as quickly as possible. We started by looking at all of our requirements for application packets and were able to remove many of the clinical assessments we were requiring. We realized that they harkened back and were carryovers from the time when most people in supports went into ICFs. Instead, we created a new guided conversation at DDA that starts by talking with people and their families about their strengths, using the PCT Like and Admire Tool. Next, we will talk to people about what’s Working and Not Working in terms of the person being supported to identify gaps and needs for LTSS. Based on that information, we will problem solve with the person and his or her family and immediately offer referrals to community based supports. If needed, we will also then start the process for eligibility for public LTSS. The information we gathered at intake will flow into the DDA ISP and, if the person is being referred to another agency and consents, be shared with that agency for service planning. Early thoughts: Takes longer to use the tool, but getting to know families better and able to make referrals to a variety of resources, including government and advocates. Previously just walked people through the intake application and that was it. Now we plant seeds and get them to think about the future. Give examples of success.

Front Door to VR Joint intake application with DDA & RSA DC Learners & Earners: Partners in Employment Project https://dds.dc.gov/page/dc-learners-and-earners

DDA Front Door In Action https://youtu.be/vL0bhwIuLP0

Front Door to LTSS No Wrong Door System No Wrong Door Vision To have easy and reliable access to a full range of long-term supports and services, which are person and family centered, culturally and linguistically responsive and coordinated across a person’s life. Started with DD agency, but pursued of No Wrong Door grants to expand District’s vision for transformation in all of LTSS For DC, we decided to take a cross agency approach. When we talked with stakeholders from our Supporting Families CoP, we learned that people who used supports rarely interacted with a single government agencies. Their lives, as families, were entangled with many health and human services agencies. Think about a family with an adult child who is dually diagnosed with an intellectual disability and mental health condition. While the main supports would come from the Developmental Disabilities agency, the mental health services will come from another agency. There may be financial support through food stamps, from the Department of Human Services. The Department of Health is licensing. The Medicaid agency is paying. And, the parents might be getting some help from the Aging and Disability Resource Center. Each agency has their own application form and process, and many require some sort of case management. It’s confusing.

Resources Across the Lifespan Developing a NWD Resource Portal Resource Portal We must be matching people, right at the front door, not only with existing disability and aging public supports, but also to a range of diverse, community based supports wherever possible. Developing resource portal to match people to community-based supports so intake workers have easy way to link people to public and private supports When we think about supports for people living with developmental disabilities, we typically think about people who receive supports from the Developmental Disabilities Administration. But, that represents less than 25% of DC residents with I/DD. In this regard, we look a lot like the rest of the country. In DC and around the nation, the majority of people living with intellectual and developmental disabilities do not get any governmental long term services and supports –because they do not know about them; they do not want them; or they do not qualify for them. Part of our job as a Community of Practice is to be thinking about what we call “the all” – so that when we are designing access and supports, both within the government structure and within the community, we are thinking about what we can do that benefits all families of people with disabilities , not just those in the formal service system. That’s why we worked with the 211, Answers Please and the Aging and Disability Resource Center so that families could advise government on how we can best share information about resources both from the government and the many things that are available throughout the community. We did a guided community brainstorming about the resources we all know and use, so that families who are reaching out for information will have the benefit of our collective experience and expertise. The resource list we developed together was be added to the District of Columbia’s 211 database so that as a City when families call for help, the resources we share with them are as helpful as possible. They will also be added into the NWD Resource Portal

Shared Resource Folder Across LTSS

Thank you!!! Questions? Erin