Caseload Forecasting for Disabilities

Silhouette of people with sunset.

Senator Emily Randall (D- 26th Leg. District, WA) has introduced SB 6056 – Concerning the budgeting process for services for individuals with developmental disabilities

This is a hopeful beginning to the generation of appropriate funding for the needed supports to allow the people in this vulnerable population to be included in their communities as they would desire, improve their quality of life and help provide a more meaningful life as they would choose.

In our opinion, this means more choices and less restrictions, appropriate assessments of needs and supports and increased stability in all areas of life – home, work and community.

This bill will help address the issue of the mysterious people who live in the world of “the  no-paid services caseload” withing DDA.  No one knows who these people are, if they are even in our state or alive or what their support needs may be.  It will at least provide case managers for this population in hopes of being able to provide supports if these people are in need.

But, caseload forecasting is not just counting heads.  We need to understand what the range of support needs is and how many people are in each acuity level in each setting to better assess appropriate funding for these supports.

The Joint Legislative Executive Committee on Planning for Aging and Disability Issues (JLEC) had a work session on January 9, 2020.  A link to the session is highlighted.

 

JLEC – January 9, 2020   (Olympic Neighbors presentation begins at 48.00)

Olympic Neighbors, Father’s Group of Jefferson County, Developmental Disabilities Funding Crisis Task Force (DDFTF) members provided much information to the committee.  The chart below is taken from their information.

State Funding for Supports - Jefferson County Father's Group

Regarding residential supports – in theory the SOLA and Supported Living are essentially the same supports – the difference is that the SOLA is state operated and Supported Living is typically private-non-profit/profit agencies providing the support.

There is a significant difference in the wages for the caregivers in these residential settings – that of the state employee versus agency employees – but does that alone account for the difference in cost for these residential settings?

I think there may also be differences in acuity levels of the residents in these settings.  There may be higher percentage of higher acuity residents in the SOLAS which also could be reflected in the higher cost.

This is an issue that hopefully can be addressed in Caseload Forecasting.  We cannot base our funding on the “Average” for the whole population.  We must break out acuity levels and look at the average for that level.  This method will provide a much better understanding of the necessary funds for appropriate supports.

 

Cognitive Bias

As the legislative session is fast approaching we need to be aware of cognitive bias – a phenomenon that we have witnessed many time over the past years.  Cognitive bias is especially prevalent with issues related to care, supports and cost of that care for people with intellectual/developmental disabilities.

Take a peek at this site to read about the following 10 Cognitive Biases that distort our thinking – remember this is only a list of 10 of these biases – there are many more that have been identified.

Confirmation Bias

Hindsight Bias

Anchoring Bias

Misinformation Effect

The Actor-Observer Bias

The False Consensus Effect

The Halo Effect

The Self-Serving Bias

The Availability Heuristic

The Optimism Bias

Let’s plan for more conversation and collaboration with regards to caseload forecasting.  Keep in mind the issue of cognitive bias and how these biases have affected discussions in the past.

Have people been heard and questions answered?

Have concerns been addressed?

Let’s listen to each other and collaborate.

 

18-cognitive-bias-examples

Cognitive bias illustration from https://www.visualcapitalist.com/wp-content/uploads/2018/03/18-cognitive-bias-examples.html                                                               

 

 

 

subminimumwages@usccr.gov – We support Section 14(c) accommodations

Section 14(c) of the Fair Labor Standards Act (FLSA) is an ACCOMMODATION  – an accommodation for those with the most significant intellectual and developmental disabilities.  Section 14(c) is an accommodation that can be used by the employees choice in order to gain skills and maintain employment.

The purpose of Section 14(c) is to prevent curtailment of employment opportunities for those who may be unable to work in other settings.  Employment under Section 14(c) is not the first choice offered to people but it needs to be one of the alternative routes to training and employment for those who may need more time or hands-on support to learn a skill.

We all have a right to work  – many of us may need some sort of accommodation, if even temporary, at some time in our life, in order to maintain employment.  Why should those with significant disabilities not have that right too with Section 14(c) accommodation?

One of the major problems that has been agreed upon is that there has not been enough information for people to know what is even going on – who is working, where they are working, what they are doing or what they are earning.  Without this information, including that for those working in integrated employment settings,  how can we evaluate what has already occurred?  We need time to assess what has happened in areas that have eliminated choices and discover if those affected are satisfied with the changes.

Have these people been able to have equal opportunity, full participation, independent living, and economic self-sufficiency as they may have been promised by those who took their choices away?

The Wage and Hour Division  (WHD) of the Department of Labor (DOL) has recently taken steps to modernize its oversight and enforcement of the 14(c) program.  The process is now electronic and there is great opportunity to collect, aggregate, and analyze information which was not possible when paper applications were being used. WHD has already produced improvements with recent investigations and back wages being repaid to the employees.

We say “take a step back” and take time to gather information and evaluate.   We need to allow the improved oversight with investigational teams time to weed out the abusers of a system before we eliminate another accommodation and impose more restrictions for this population.

 

email subminimumwages@usccr.gov, with “I Support 14c” in the subject line. The e-mail may also be copied to federal legislators at www.usa.gov/elected-officials,

United States Commission on Civil Rights

USCCR Briefing Agenda – December 15, 2019

 

What is all this about sub-minimum wage?

Is it a “loop hole” or an accommodation?  It depends on how you use it and who you use it for and if you are following the regulations as intended.

Don’t fall for the argument that this is a loop hole – or at least if you do, stop exploitation of those who abuse the system rather than using it to promote employment and community engagement.

White Picket Fence

Section 14 (c) of the Fair Labor Standards Act (FLSA) was not intended to be a “loop-hole” to exploit anyone.  It was also not written to apply to whole populations of people with any type of disability.  The fact that a worker may have a disability is not in and of itself sufficient to warrant the payment of a subminimum wage.

The Special Minimum Wage Provision Section 14c of the FLSA is a vital tool that allows individuals with significant disabilities to work in an environment where they are compensated commensurate with their productivity, have friendships, support and purposeful activity – this can be in any work setting that they choose.  Often, it is in community settings which also enables the employee to build natural supports.

Everyone has a right to work. Support this right for our most vulnerable citizens!

Take a look at this fence – yes, there is a problem – what is the best way to fix it?  Tear the whole fence down or fix that one board?  My vote would be to fix the board and keep the fence.  The same with Section 14 (c) – fix the problem but keep the regulation.

As with many laws and regulations set up to protect people and provide choices and alternatives, there are always those who will exploit and abuse.  This does not mean that the system was bad or caused the exploitation but that those who abuse and exploited were doing evil actions.  Those are the ones that should be held accountable for their wrong-doing – not those who are in need of choice, alternatives and protections.

We should not punish our vulnerable citizens because there are others who will exploit them.  Without certain protections in place our vulnerable citizens will be at risk of much more danger.  What we need to do is call out the evil-doers and hold them accountable for their actions.

Department of Labor fact sheet.

 

 

Person-Centered Planning – Buzz Word or Reality?

We believe in Person-Centered Planning which means looking at cultural humility and competency, taking into account the whole person, including the complexity of his or her world view.

Man walking and balancing on rope over precipice in mountains

How can this be done when advocates do not even speak to other advocates, assuming rumors they have heard about other peoples beliefs rather than talking to the people directly?  How can this be done with family, parent, and care-giving advocates are blocked from Parent to Parent groups or blocked from publicly funded advocacy agencies such as Disability Rights Washington, (Protection and Advocacy Agency for Washington Stated) or The Arc Franchises (which are non-profit but receive public funds for outreach and advocacy) – or from participating in the Developmental Disabilities Council – which is a Federal-State partnership working to plan for and with people with developmental disabilities and their families.

Connect collaborate communicate contribute

There is a huge abyss that so much hard work, passion and caring is falling into because of this lack of ability to communicate with others.

Disability advocacy should not be a tug-of-war between 2 opposing sides – but that is what has been going on for years and it seems to just be getting worse. Disability – and in particular intellectual/developmental disabilities – is a complex web of abilities, independence and inter-dependence.  Many systems, which often are in their own silos, must be pieced together to make person-centered planning work for each individual.  This is no easy task – especially when people, agencies and advocates do not communicate with each other.

In order to make things work, we need to communicate.  We may not need to agree on everything but we need to communicate so that people know and have opportunities to understand what supports and services are needed in order to function in our communities.

Without communication and listening to those who actually use the supports and services, how can we, as a community help provide appropriate resources.  Communication is critical in avoiding unintended and detrimental consequences such as the person becoming disengaged in the process.

We need to ensure that people who use the supports and services, in addition to families and caregivers, have opportunities to be involved in new program developments.  The value of their life experiences is necessary in evaluation and feedback regarding the system and advising on policy decisions.  These are the stakeholders who we need to communicate with – not just the “professionals” or service providers.

Any changes need to be transparent from planning, monitoring, implementation and evaluation of changes made, to those who will be utilizing the services.  The individual,  their families, direct support caregivers and friends are the experts that need to be heard with their collective voice of supporting the person who is the center of the plan.

 

 

 

 

 

 

“Abled” Disabled make decisions

Here is a perfect example of how people who identify as disabled act as ableist as they claim “ableds” act with regards to making decisions about their lives.

“Bickley said it’s frustrating that people without disabilities want to make decisions for others, without knowing or understanding their experiences.”

King County bans employers from paying below minimum wage to people with disabilities

To those people who are quoted in the article and the organizations they work for, it would be helpful to have discussions regarding concerns of people who are ACTUALLY affected by these changes rather than blocking them.  Stand up and listen!

“Everyone deserves equal opportunity to provide for themselves so they can be financially independent and live an independent life,” said Councilmember Dave Upthegrove, who sponsored the legislation.

Excuse me, Councilmember Upthegrove – did you happen to read the JLARC report that came out last year regarding this issue.  This ordinance has nothing to do with improving wages or helping people be financially independent and live an independent life.  That’s called “Magical Thinking” – I don’t think this ordinance is going to be magical.

In case you did not read the report, here is one quote from it

5,110 clients (73%) were employed. They worked an average of 47 hours per month and earned an average wage of $583 per month. Unemployed clients may be in the job development phase.

Clients with high support needs work fewer hours and are more likely to be unemployed

JLARC staff analysis of data for the clients in individual supported employment during fiscal year 2018 found that:

  • 44% of clients with high support needs were unemployed. This is double the rate for clients with medium support needs and five times the rate for clients with low support needs.
  • Clients with high support needs who were employed worked 21 hours per month on average. This is less than half the average hours for clients with medium support needs, and a quarter of the hours for the clients with low support needs.
  • 99% of clients with high support needs earned less than the federal poverty level.

@RealChangeNews – help us understand

 

Please, Councilmember Upthegrove, explain to us all how someone who will only be working 8 hours or less a week will enable them to make enough money to have the “independence everyone wants”

Please review the JLARC report and evaluate the changes that have already occurred before blasting ahead with more changes which will eliminate jobs and opportunities for many in this vulnerable population community.

October was National Disability Employment Awareness Month (#NDEAM).  With this, let us not forget about Person-Centered Planning and Individual Choice.

Evelyn Perez, Assistant Secretary for Developmental Disabilities Administration (DDA)  in Washington State, has started off every presentation I have seen her in the past couple of years with “We are Person-Centered and provide individual choices”  Maybe she does not understand the policies of some of the supports and services in DDA – particularly that of EMPLOYMENT FIRST in Washington State.

We believe people have choices and Washington state denies people their rights in regards to employment and community supports under DDA.  In March 2012, Washington State Legislature passed restrictive legislation with regards to employment.

Employment needs to be the first choice for adults of working age.  If after 9 months they are not satisfied and had an unsuccessful job search, only then may they request a transition to the community access program.  These are two mutually exclusive support services regardless of how few hours a person may utilize.  There is only one service option at a time.

“Please remember that Employment First does not say that people with disabilities have to work at a community job.  They can still work at a facility based program or workshop, or not work at all if that is what they really want to do.”  RTC on Community Living video “What is Employment First?

WAC 388-828-9335

How does DDA determine your employment service level?

DDA determines your employment service level using the following table:

If your

employment

support level in WAC 388-828-9205 is:

And your

employment

status in WAC 388-828-9330 is:

Then your employment service level is: And your employment service hours per month are:
None Working A 0
Working at sub-minimum wage or in job development B 0
Low Working C 4
Working at sub-minimum wage or in job development D 7
Medium Working E 7
Working at sub-minimum wage or in job development F 9
High Working G 11
Working at sub-minimum wage or in job development H 12