Wright County’s Mental Health/Developmental Disability (MH/DD) fund currently pays a for a portion (The non-federal share) of Supported Community Living Services (SCL) as well as Prevocational and Day Habilitation Services (PreVoc, Day Hab) through the Home and Community Based Waiver Service (HCBS). HCBS is, basically, federal funds used to offset the cost of services to local taxpayers. Thus the total cost of a service may be $100.00 but the Wright County MH/DD fund only pays $38.00 of the cost while the federal government pays $62.00. Of course, whenever you include federal funding you have to provide documentation to prove you are using their dollars appropriately. In this case service providers are asked for inordinate amounts of documentation to prove to the Federal Government that their money is being well spent. Unfortunately, providers are spending so much time documenting that they can barely provide the services they are being paid for and it drives the cost of the services higher than it needs to be. In addition to these requirements these services are regulated by all sorts of administrative rules that rule both the disabled community member and the provider into a box that they can never extricate themselves from.

Current services available to the disabled community member have lost their flexibility and ability to be creative, and the county’s unwillingness to expose the taxpayer to the full cost of a service further exacerbates the situation. The result is that the disabled community member is isolated in a culture of disability. A culture of disability, for the purpose of our mission, is defined as spending your time in a setting where the majority of the people you are with are disabled while those who are not disabled receive a primary income for the sole purpose of supervising or teaching you and the other disabled people with you. This includes outings where more than one disabled person is taken to a place in the community by a person who receives a primary income for the sole purpose of supervising you. The result is that the disabled community member lives in a home filled with disabled people, works in a setting full of disabled people and moves within the community as an exclusive group of disabled persons not enabled to mingle or develop relationships with community members.

In order to break out of this box Wright County has proposed the Community Partnership Initiative (CPI). The outcome of this initiative will be that a disabled person supported by the Wright County MH/DD fund will be matched with a community partner so that the community partner can introduce the disable person to the non-disabled culture. The two persons will spend one on one time together with the community partner's family, friends and be involved in the community partner's social activities. This could also include having the disabled person being matched with a community merchant so that the disabled person can be introduced to the non disabled work culture. Community partners can be reimbursed for their expenses or merchants can be given a stipend for business expenses. The county would also be willing on a case by case basis to pay funds up to a maximum based on historical expenditures. The hope is that through the use of strictly county funds that require little to no documentation and no administrative rules, tax payer funds can be provided directly back to individual taxpayers so that they can partner with disabled community members in leaving the isolation of a culture of disability and joining the community as a whole. The first step in helping disabled community members break free from their isolation is to reject the current status quo of the human service system. This takes direction away from a distant state and federal government and puts both the responsibility and the reward back in the hand of the tax payers and their local government.

This will be accomplished by conducting a significant advertising campaign. The hope is to contact community based volunteer organizations such as the Martha’s and the Mary’s, the ECHO group, The Lion's Club, The Knight's of Columbus, The Rotary, Kiwanis and etc. to begin to get the word out about the initiative and how it will work. Local news papers will also be contacted to help spread the word about the initiative to the community. Local business owners and managers will be contacted about the initiative as well. Brochures will be printed and the Community Services Web site will include information about the initiative.

Funds from the local MH/DD budget at a ‘cost neutral level’ that will nearly eliminate the risk to the taxpayer and disabled community member will be provided as incentives to volunteers. (This is discussed in more detail below) The disabled community member’s advocate, the Targeted Case Manager (TCM) or Case Worker (CW), and a Mediator will work together to link Community Partners to disabled community members. Community Partners will then be given a range of incentives to provide care and support to the disabled community member to enable them to be reasonably safe and healthy members of the community as a whole.

The TCM or CW will continue to work with the disabled community member to develop a plan of action that will lead to desired outcomes for each disabled community member. Thus the TCM or CW will continue to develop an Individual Comprehensive Plan (ICP) according to state and federal guidelines. They will then coordinate with a Mediator to facilitate the ICP. The Mediator will act as a direct care worker and a service coordinator all rolled into one. Both the TCM or CW and the Mediator will work together to locate and prescreen community partners that ‘match’ the disabled community member's personality and are able to meet the needs of the disabled community member. The Mediator will then coordinate the partnership of the Community Partner and the disabled community member and report progress to the TCM or CW.

Potential Community Partners will meet with the TCM or CW and the Mediator so that they fully understand what their role will be and to enable the TCM and Mediator to find a disabled community member that will make a good partnership with the community partner. Community partners will be screened for dependent adult and child abuse as well as criminal history to ensure the safety of the disabled community member. They will also be asked to review and sign a confidentiality statement. Community Partner roles will vary based upon the disabled community members they are partnered with. Some disabled community members have more physical needs than others, while other disabled community members may have more emotional or behavioral needs. Thus a good ‘match’ will be sought and care and support will be provided based upon the ability of the community partner. Other needs will be met by licensed and professional staff such as nurses, psychologists and etc. The community partner must be a person of good community reputation, have no past criminal history or founded reports of dependant adult or child abuse and demonstrate that they have a stable life and home environment. A community partner can be a family member but cannot be the disabled community member’s guardian. The community partner will fulfill the role of a direct care worker for the disabled community member. They will assist the disabled community member in learning new skills, taking them shopping, paying bills and budgeting and involve them in social activities and etc.

The Mediator will perform the role of linking disabled community members to community partners and maintaining those links. This will be accomplished by the Mediator getting to know both the disabled community member and community partner through interviews of the parties and persons close to the parties, review of the disabled community member’s case files, and observing both parties at home, work and play. The Mediator will identify partners in the community and make contacts with them. The mediator will follow up on community partner contacts and links that have been established with disabled community members. The Mediator will report to the TCM each month on the disabled community member’s financial status, developmental progress on learning, change in routine, relationships, and use of supports, reinforcements, communications, appearance, behaviors and other factors. The TCM will use this information to document progress in the disabled community member’s ICP. The Mediator will be supervised by the TCM and will follow the ICP as outlined by the disabled community member. The Mediator will ‘mediate’ relational conflicts between the disabled community member and the community partner and will report to the TCM any needs the disabled community member or community partner brings to their attention. The disabled community member, of course, can terminate their relationship with the community partner, Mediator or TCM at anytime for any reason.

Both the Mediator will be reimbursed based upon a contracted rate while the community partner will be given incentives with the disabled community member’s total expenditures not exceeding the history of the disabled community member’s service costs to the county MH/DD budget. Thus if the county’s cost for a disabled community member’s SCL is on average $8,000.00 a year and their Pre Voc services were $2,400 a year, then the disabled community member’s total expenditures would not be allowed to exceed $10,400 a year. Community partners will be provided a range of incentives such as reimbursement for expenses all the way to monthly stipends for care and support. Examples of community partner expenses could be travel expenses, entertainment expenses, food expenses and the like. By reimbursing expenses the community partner will be encouraged to include the disabled community member in social activities without fear of the disabled community member’s involvement being a personal financial cost. Merchants who allow disabled community members to be involved in their ‘business culture’ would be reimbursed for costs to the business, such as time spent with the disabled community member instead of on job responsibilities and the like. Some community partners could be given a monthly allotment to provide direct and ongoing personal cares to the disabled community member in addition to the inclusion of the disabled community member in social activities.

This program will start small with a few disabled community members and will hopefully grow to include a majority of the disabled community members served. Though having volunteers that will take a disabled community member out once a week or once a month is good the goal is not to have sporadic involvement, but for the volunteers to remove the disabled community member from the culture of disability and into a non-disabled culture. This initiative is not mandated and it is understood that this will not benefit every disabled community member as some prefer the security of the current service system and are not comfortable or are not medically able to be outside their current environment.