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Developmental Disabilities Reform Act Draft Review and Revision Meeting 11 July 23, 2009 Martin Luther King, Jr.

Library Room A-9 Meeting Notes In attendance: Mark Back, DDS; Sandy Bernstein, University Legal Services; Tina Campanella, Quality Trust; Laura Flegel, Quality Trust; Arthur Ginsberg, St. John’s Community Services; Sudie Johnson, DC Developmental Disabilities Council; Erin Leveton, Quality Trust; Mat McCollough, Office of Disability Rights; Mary Lou Meccariello, The Arc of DC; Victor Robinson, Quality Trust/Project ACTION!; David Rosenblatt, SEIU; Elaine Saunders; T.J. Sutcliffe, The Arc of DC; Morgan Whitlatch, Quality Trust; Bob Williams, DDS Meeting notes: 1. Welcome and Introductions The group welcomed all participants.

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2. Updates a. The third meeting on mandatory reporting of abuse and neglect was on Monday, July 13. The group met with the interim head of Adult Protective Services and the head of the Department on Disability Services (DDS) Quality Management division. The group will have its last meeting on Tuesday July 28 at 2:00 p.m. at The Arc of DC, 415 Michigan Avenue, NE. b. At the last review and revision meeting (Meeting 10), there was a recommendation to get more information from the Superior Court about the court advocacy program. On July 22nd, Sandy Bernstein, Tina Campanella and Mary Lou Meccariello met with representatives from the court. The court advocacy program is currently interviewing to hire two new case reviewers. They are also working to determine the number of advocates. All advocates are being required to complete a criminal background check. Additionally, the court plans to offer advocates a $50 per month stipend, but that has not yet begun.

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3. Discussion of legal services, advocates and Court access, and transition from admission and commitment processes and procedures. The group discussed a variety of issues under this topic. Key comments included the following: It’s important to get away from the idea that “one size fits all.” People may need and want different levels of support from advocates, attorneys, and the court. At the last meeting, the group discussed the Department of Mental Health’s model of community commitment. After further research, the Drafting Subcommittee does not believe that this model would be appropriate for people with developmental disabilities to receive services at the Developmental Disabilities Administration (DDA). It’s difficult to separate the ideal (all the supports that may be beneficial) from the reality of cost. Currently, it appears that the court’s annual funding for lawyers is approximately $1.5 million. If the DDRA becomes law, to maintain a comparable level
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of access to the court the District would need to take on the cost of paying for lawyers. At various times, a number of additional supports that would cost money have been discussed. These include: o Advocates; o A fact-finding grievance system; o Use of the Office of Administrative Hearings (OAH) for all DDA services (not just Medicaid services); and o An external ombudsman / quality entity. The advocacy program and attorneys would ideally work closely together (and most likely be housed together). Increasing advocates may in some cases reduce the need for attorneys. However, other factors may increase need for attorneys. It may also be useful to identify ways to target advocates (and possibly, attorneys) to people who need them the most. Benefits and costs associated with a fact-finding grievance system, greater use of OAH, and an external ombudsman need to be explored.

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In general, there is more trust in advocacy and quality supports (a “check in”) that are outside of government / DDS. Massachusetts, New York and Oregon may have found ways to use Medicaid home and communitybased funds to help pay for advocates, called “support brokers” and/or “peer support.” The group had a long discussion about how commitment might be phased out under the new law. The current proposal is as follows: When the new law takes effect: 1. All current and new DDA service recipients would have access to the court and informal court procedures. 2. For new people, no commitment / admission. 3. Everyone who is currently committed and all Evans class members would have a permanent entitlement to services. During a 3-year transition period:

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1. Everyone who is currently committed would continue to be committed and have attorneys and an annual hearing. 2. The District would create access to legal services and advocates, funded by the District, for people who are not committed (e.g., people who were previously admitted and people who are new to the system). 3. The District would implement additional supports which may include a grievance system, quality controls, etc. At the end of 3 years: Commitment ends for everyone, only if certain benchmarks are met. Signoff on benchmarks would probably be done by the DC Council through a reporting, oversight and public hearing process. A key question is whether there should be an option for people who are currently committed to be permanently “grandfathered” – even if all the benchmarks are met. 4. Next steps

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The Drafting Subcommittee will work over the next several weeks to incorporate the discussion into a new draft. There will be a Saturday or evening meeting in September to discuss changes to the draft with families and others who cannot make a daytime meeting, prior to introduction of the bill.

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