1. SW 644: Issues in Developmental Disabilities Introduction to Module C: Structure & Organizations of Services and Supports Lecture Presenter: Don Anderson, M.S.S.W.

2. Specialized Social Service Delivery System  Wisconsin service delivery system – program model  Different perspectives on services and support Parent Guardian or caretaker Case manager County board member Consumer

3. Legislative History  President Kennedy Downsizing of institutions Community living opportunities Fuller recognition for citizenship  Dramatic decrease in institutional population during 1960s and 1970s  Challenges remain

4. Public Laws and State Statutes  Birth to 3 – Public Law 99-457  Ages 3 to 21 – Public Law 94-142 and state statute, Chapter 115  Focus of lecture is on services for adults

5. Public Law and State Statutes (cont.)  Adulthood at age 18  Question of guardianship and protective services  Federal Social Security Act of 1935 as umbrella legislation Supplement Security Income Medical Assistance Medicare Medicaid

6. National Service Delivery Direction  Public Law 94-103 (1975) – Developmental Disabilities Assistance Act  Established state planning and policy monitoring councils  Required the establishment of legal and civil rights protection

7. The Role of County Human Service Departments – Service Delivery  Strong county government in Wisconsin  Service delivery either direct or contracted out 

8. The Role of County Human Service Departments – Core Services  Core services for children and families - case management, Birth to 3, respite care, family support program, foster care  Core services for adults – information and referral, intake and assessment, case management, vocational services, residential supports, recreational and alternative activities, in-home support, specialized transportation, daily living skills

9. The Role of County Human Service Departments - Eligibility  Eligibility requirements Must meet state definition of DD Substantial deficit in three or more areas of life activity Residency in county where application filed

10. The Role of County Human Service Departments - Funding  Funding issues Complicated process for consumers Shifts in political power  Funding sources State community aids and matching county levied tax dollars Social Security incomes Medical Assistance Title 19 and Waiver funds

11. A Representative Support Plan  Individual Service Plan Typically one-year periods Culmination of interviews, assessments, information gathering, and problem solving Case manager / service coordinator involvement  Example: “Robert Green”

12. Waiting Lists  Emergence in late 1970s and 1980s  Unmet funding requests and revenue generating needs  5% annual growth  Significant number with elderly parent or caretaker

13. Video Clip  As A Matter of Fact

14. State Institutions  Northern Center at Chippewa Falls  Central Center in Madison  Southern Center near Union Grove  Total population – 1400  Annual budget - $293 million  Average daily cost - $260/day per resident  Less than 6% of total DD population receiving more than 64% of all available funding

15. Current Values and Attitudes  Paradigm shift has led to downsizing institutions  Movement towards community membership  Consumer empowerment highlighted through Family Support Program, Birth to 3, and Medical Assistance Waiver program