Individual Budgets: Better Lives with the Same Funding Patricia Carver, Community Drive, Inc. Jim Conroy, Center for Outcome Analysis

Our Topic Today 4 Somehow, we have to attach public dollars to people 4 Purpose: to support good lives 4 We have to figure out how much for each person 4 Right now, we do this by putting people into categories 4 Person-Centered Budgeting is a better way 4 We should try & evaluate PCB in VA

How About You? 4 Do you have a Person-Centered Plan? 4 How does it work? 4 Does anyone ever talk about the money for rent, staff, transportation? 4 Anyone know how much your supports cost?

How Do We Set Budgets Now?  Most often we estimate  Based on the “kind of person”  How much money a provider will need  To provide safe & decent living & working  We do NOT usually “cost out” the price of relationships, belonging, community  Instead, we try to buy little more than health & safety

Funding by “Kind of Person” 4 Most states have set up a funding formula 4 Usually 4 to 10 “kinds of people” 4 From High Need to Low Need 4 Based on medical, behavioral, and self-help levels of need 4 But not the person’s existing connections, or hopes & dreams & relationships

Jean Needs Just A Little Support

Jackie Needs Lots of Support

For Each “Type of Person,” A Fixed System Cost 4 Medically fragile……………………$220,000 4 Behaviorally challenging……………$200,000 4 Low self-care ability………………...$130,000 4 Medium ability……………………......$90,000 4 High ability……………………………$60,000 4 In-home support needs only…………..$25,000 4 Once the “Type of Person” or “Group” or “Band” is set, the person’s funding future is determined 4 And it’s pretty much forever. 4 Is this person-centered?

Person-Centered Planning, But NOT Person-Centered Budgeting? Why? 4 And now the fastest growing method is the SIS, or Supports Intensity Scale 4 All the methods are crude estimates 4 They are the farthest thing possible from Person- Centered 4 Why after 30 years …. 4 Do we accept Person-Centered Planning ….. 4 But NOT Person-Centered Budgeting?

Past Surprises – Share Surplus 4 New Hampshire’s self-determination pilot 4 Families were invited to figure out money 4 They set dollars to needs until…. 4 They saw every real need met…. 4 And they still had money left over…. 4 They asked “I wonder if someone on the Waiting List could use some of this?” 4 This CANNOT happen in traditional funding!

Ray & Debbie

A Modest Proposal: Demonstrate & Evaluate 4 Why not try individual budgeting 4 With some of the folks who are leaving institutions 4 Instead of assigning them to “funding groups” 4 Build their individual $$$ needs up from the Person-Centered Planning process

Start With 168 Hours 4 Look at every hour in a week 4 How much support from human beings will be needed 4 Add on other 4 Add what they do during the day 4 Add support coordination – how much, how often 4 Total it up & compare to “Type of Person” approach 4 Here’s a tool for that: Simple Excel worksheet 4 We may get a BIG SURPRISE

SUPPORTS PLANNING GRID

Imagine This: 4 A person now in an institution 4 Who is planning to move 4 Adds Person-Centered Budgeting to the Person- Centered Planning process 4 Use simple tools to translate individual support needs into dollars 4 The institution costs $216,000 4 How much would a Person-Centered Budget come out to? 4 Evidence says: less than the current system!

Jim Conroy 426-B Darby Road, Havertown PA , Pat Carver 5833 Community Drive Brighton, MI