Monday, May 11, 2009

System Reform 101

The state of Oregon's developmental disabilities system is crying out for reform. 36 counties doing things 36 different ways. 5 county programs being taken over by the state. In Umatilla County they recently found the county’s program suffered from a backlog of protective-service investigations, sporadic file documentation and a shaky handle on crisis intervention.

Who's suffering because of this dysfunction? It's not the administrators, politicians, or DHS. It's people with developmental disabilities. And if this mess isn't straightened out soon, those with silent voices will be to blame. From the Walla Walla Union-Bulletin...

Developmental-disabilities program control shifts
Umatilla County commissioners recently relinquished control of the program
By SHEILA HAGAR of the Walla Walla Union-Bulletin

Umatilla County residents with developmental disabilities are seeing services delivered differently than in the past, officials say.

Last month, county commissioners voluntarily relinquished control of the Umatilla County Community Developmental Disabilities Program, said Connie Caplinger, director of Umatilla’s Department of Human Services.

An in-depth, on-the-ground visit by state officials brought to light numerous problems for developmentally-disabled clients and their families, she said.

Statewide standardization of developmental-disability programs has never been established, Caplinger said. “Each county interpreted Oregon’s administrative rules differently. This year Oregon did site reviews and they discovered 36 counties doing it 36 different ways.”

In October, 11 state reviewers arrived to look over documents, talk to clients, family members and case managers in a site review.

“We didn’t come out very well,” Caplinger noted.

The county’s program suffered from a backlog of protective-service investigations, sporadic file documentation and a shaky handle on crisis intervention. Investigators also talked to parents of service consumers and “some of them had issues with how we did things,” she said.

“All of those things were taken into consideration. The state felt we had real communication problems and (they) were worried about the health and safety of clients,” which number about 300, ranging from those requiring 24-hour supervision to others using just a little help from the program.

Given all that and adding in tighter federal funding, county officials decided against trying to retool the program. “When the state starts using terms like ‘loss of confidence,’ the commissioners decided to relinquish,” Caplinger said.

The loss of control of the program does not affect the county’s budget, she added. As well, county staff working in the program became state employees in what was renamed the Community Developmental Disabilities Program for Umatilla County.

The goal was to make a seamless transition, said Mary Lee Fay, state administrator of Seniors and People with Disabilities Division.

In looking at the most serious issues Umatilla County had and possible solutions, “it made the most sense the state should manage these programs,” Fay said. “We had been discussing problems for over a year and half ... we had been trying to work through those.”

Umatilla County is the fifth county for which state officials took over, “all for different reasons,” she said. “And in those other situations we contracted with a contractor, but for Umatilla we really had to some work to improve services. We knew this would happen to us some day with some county.”

Lawmakers in Oregon recently passed a bill allowing the state to run a county developmental-disability program for the long term, Fay said, adding that Oregon has 18,000 people enrolled in case management for developmental disabilities services.

Part of the new work will be creating an environment of openness to the community and to help the public know how to apply for services, she said. In addition, training in case management and family support has been brought into the Pendleton office.

The former county employees have “embraced” the measures, Fay said. “I think they have a lot to contribute, I think they feel it is a fresh start for everyone.”

In conversations with Umatilla County commissioners, commitments from the state were made, she added. “We promised that just because this is a state staff, we really feel it is a local program. And we asked to have a standing quarterly meeting with the commissioners to give updates so they can give answers to people in the county.”

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