Dental services for adults on Medicaid have been reinstated with passage of the budget bills for fiscal year 2011. Beginning October 1st, 2010, adults 21 and over may again receive dental services. For a comprehensive look at the services available, see the Dental Database for 2010.
Funding that made it possible to restore dental benefits is temporary, however, and will probably not be available next year. Even before the next fiscal year begins in October 2011, the next Governor could rescind these benefits through an executive order.
Some dental services require prior authorization from Medicaid before the service is provided. To assure that needed dental work gets done, adults on Medicaid should see a dentist as soon as possible to get authorization for Medicaid covered procedures. As long as authorization is obtained now, these services will be covered.
On the first Friday of every month from 6 p.m to 9 p.m., responsible volunteers provide parents of special needs children a break at St. Luke Lutheran Church in Ann Arbor.
The Special Needs Ministry of St. Luke Lutheran Church sponsors respite care with enjoyable activities, snacks, music, and fun in a safe environment for children with special needs. Siblings are welcome! The program is open to all ages.
Registration providing information about the child and family is required. An R.S.V.P. is required no later than the Tuesday before the Friday respite care evening. There are spaces for 25 children. A waiting list is maintained in case there are cancellations.
The next respite evenings will be on November 5th and December 3rd, 2010.
For more information contact:
Pam Kamrath at 734.474.0573 or pkmrath@comcast.net
St. Luke Lutheran Church
4205 Washtenaw Ave.
Ann Arbor
A former teacher's aide for the Washtenaw Intermediate School District, Michael Beasley, was sentenced to probation for slapping a special education student in a WISD program for autistic students at Scarlett Middle School in Ann Arbor. He had already been convicted of another misdemeanor in a related case.
At first, when reports surfaced in 2008 that students had been mistreated by the aide, the WISD investigated and then transferred the aide to High Point School in Ann Arbor. Parents, dissatisfied with the WISD response to the charges, contacted the police who did their own investigation that led to criminal charges against the aide. The Director of Special Education for the WISD at the time resigned and other administrators were reassigned. The aide was fired based on a reinvestigation of the case by the WISD.
As reported by AnnArbor.com on September 8, 2010, the aide pleaded no contest to the charge of slapping a special education student in exchange for dropping a felony charge against him. He was later sentenced to one year of probation for a misdemeanor charge of assault.
According to AnnArbor.com, the mother of the autistic student said her son was hit so hard his face had a red mark for 15 minutes and that allegations from other parents showed a pattern of abuse. She said, "...My son could not communicate this abuse, and you cannot imagine how that made me feel.”
The aide's attorney said the sentence was redundant because Beasley is already on probation through the 15th District Court for a separate but related conviction.
For background information on this case see previous blog entries with links to reports from the Ann Arbor News.
This is a note from Anne Rogers, the Director of Special Olympics for Washtenaw and Livingston Counties:
Now that the school year is in full swing I wanted to send some dates for the upcoming year so you can plan for them.
We will have basketball practices starting December 6 at 6:00 at High Point School on Wagner in Ann Arbor next to the WISD. ALL abilities are welcome.
Our Spring Bowling Tournament is scheduled for April 29 at Bellmark.
Our Spring Games is scheduuled for May 17 at Saline High.
Our Polar Plunge is scheduled for February 19 at U of M golf club. We are looking for people to help plan this and to take the plunge.
I am always available to speak to groups that want to find out more about Special Olympics - just let me know.
Please forward to anyone that you think may be interested.
Anne Rogers,
Special Olympics Michigan
Director, Livingston and Washtenaw
phone: (734) 222-8283
fax: (734) 222-9895
Special Olympics Michigan Website
E-mail: mi27so@yahoo.com
A few weeks ago, I made a trip to Ottawa County in Western Michigan and visited what many consider a model program for people with the most severe developmental disabilities. I am always on the look-out for homes that care for people like my sons and these were outstanding by any measure.
Harbor House Ministries in Jenison, Michigan (just west of Grand Rapids in eastern Ottawa County), is a faith-based non-profit organization that grew out of a need for housing for people with severe disabilities. Parents and caregivers designed the residences (three buildings, each containing two 6-bed group homes) based on their conception of an ideal living situation for their loved-ones.
The homes are spacious, accessible for wheelchairs, and well-equipped for this population. For each six-bed unit, there is a spacious living and dining area. This is separated from the bedrooms by a firewall that would take two hours to burn through if there were ever a fire - it takes a mother to think of something like that. Each resident has his or her own large bedroom, furnished and decorated according to their personalities and wishes. One of the residents is so enamored of McDonald's that he would spend all his waking hours there if he could. His room is decorated in McDonald's red and yellow colors and contains all the images familiar to McDonald's fans.
Most of the residents at Harbor House have moved there from their family homes and they bring their own beds and familiar furnishings. Each bedroom has its own bathroom. Many families have provided a sleeper-sofa in case they need to spend the night if their family member needs them. Each room is temperature controlled and the floor is heated for the residents who crawl and spend time on the floor. Each 6-bed unit has a large fully-equipped shower and bathroom.
I have been in group homes that have a television blaring full-time (more often for the staff than for the residents), but at Harbor House, there were no TV's except in a few residents' rooms. They do show DVD's for the residents for entertainment, but there is a lot more at Harbor House to do than stare at a TV all day.
A large activity center was built for a day program and other recreational and therapeutic activities. The building includes a therapy pool heated to 92 degrees that 3 or 4 residents can use at a time. It is used every day. A kitchen for preparing evening meals for residents is also part of the spacious activity center. Residents participate in community activities according to their individual needs and abilities.
Peggy Dreisenga, the Community Relations Director for Harbor House, says that they are most proud of the care they give residents. The staff-to-resident ratio is 1:2. A nurse is on staff days and evenings and always on-call for emergencies. They hire staff based on their compassion, integrity, energy, and joy and encourage close relationships with families. " We can train the specific tasks of care, but we can't teach a person to be caring...It is our goal to provide the opportunity for a great life, not just a great place to live," says Peggy.
There are many other factors that make this program a success:
- The organization operates debt-free so that all the funds coming in are spent on residents and maintaining the facilities.
- They have strong community support from family groups, local churches, their local Community Mental Health agency, and other community organizations.
- Harbor House recognizes that families of adults with severe developmental disabilities are the best advocates for their adult family members. Families meet regularly and help with various tasks in the homes.
- It costs less to place a person at Harbor House than it does in other group homes in Ottawa County.
- Staff makes on average a dollar more per hour than staff in other group homes and there are other incentives to keep good people on staff such as flexible hours, especially important for college students and parents.
Harbor House is not expanding its facilities, but the organization is willing to help others who are interested in providing excellent care for their severely disabled family members.
For more information, contact:
Peggy Driesenga, Community Relations Director
616-797-0810
pdriesenga@harborhouseministries.org
Harbor House Ministries
919 44th Street Jenison, Michigan 49428
(616) 797-9920
(616) 797-9921 Fax
The Website for Harbor House Ministries provides more information and pictures of their facilities.
Michael Head from the Michigan Department of Community Health (MDCH) has extended the comment period for the draft policy on guardianship until October 31st, 2010.
Although the cover letter for the MDCH draft "Technical Advisory" said that all Community Mental Health stakeholders were encouraged to comment, most parents and many CMH Board members from around the state, had not seen it. If you have suggestions on how to improve the distribution of documents such as this from the MDCH, include that in your comments on the draft policy.
One suggestion would be for the MDCH Website for mental health issues to include a contact number or e-mail address for people wanting to receive these materials in the future.
I am generally well-informed on issues affecting my developmentally disabled sons, but this took me by surprise. The Role of Guardians in Arrangements that Support Self-Determination for Individuals with Developmental Disabilities Technical Advisory (I'll simplify this and call it the RGASSDIDDTA) is a draft of a policy that was sent out for public comment in August 2010. It is addressed to all the Community Mental Health programs, consumers, families, advocates, and stakeholder's in Michigan's mental health system, but I doubt that many people are aware of it. I did not see it until last Friday and today was the due date for comments.
If you have not seen this and want to make your views known on guardianship for people with developmental disabilities, send an e-mail to Michael Head at the Michigan Department of Community Health (MDCH) in care of Ellen Sugrue Hyman at hymane@michigan.gov and ask that the comment period be extended beyond September 30 to allow families and organizations time to consider the impact this might have on their loved-ones. Even if the comment period is not extended, send in your comments anyway and let the MDCH know what you think about this.
The RGASSDIDDTA contains many references to law and policy that are difficult to check, especially ones from the Michigan Medicaid Provider Manual, a large and cumbersome document. References from law are mixed in with state guidelines and opinion, as if they all have equal weight. Some are taken out of context or are misleading. For example, there is a quote from the Honorable John Kirkendall that supposedly supports the idea that guardianship is not necessary to support people with developmental disabilities. Before he retired, Judge Kirkendall was the Washtenaw County Probate Court Judge who routinely granted guardianship to parents of adults with developmental disabilities. He signed the court orders for guardianship for both of my sons.
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My comments on the RGASSDIDDTA to the MDCH:
Danny and Ian are severely physically and mentally disabled. They are unable to communicate in any specific way or to care for themselves. They are not able to speak on their own behalf or to exercise their rights under law. For these reasons, my husband and I were appointed co-guardians for both of our sons through the Washtenaw County Probate Court.
Guardianship is an invaluable tool that protects my sons and others like them from neglect, abuse, and exploitation. With the authority that comes with guardianship, families are better able to monitor living situations and services, to assure that rights are respected, and to take action when things go wrong. Community Mental Health (CMH) agencies are not immune from making unwise and uninformed decisions about people with developmental disabilities. Sometimes a guardian who intervenes on behalf of their disabled loved-one is the only line of defense for a vulnerable person placed in harm’s way.
When a plenary or full guardian is appointed, the Probate Court must specify that the individual is totally without capacity to care for himself or herself. In the case of a partial guardianship, the court determines the areas that should remain under the control of the individual and specifies in what areas the person does not have the capacity to make decisions. This draft policy from the MDCH fails to recognize the responsibility and the authority of Court-appointed guardians to make decisions in areas where a person has “legal disabilities”. This and an earlier policy from 2003 (the MDCH Self-Determination Policy and Practice Guideline) are both flawed in this respect.
Self-Determination is a method of delivering services to people with developmental disabilities that allows the individual with a disability to have more control over the services they receive, the people who provide the services, and the expenditure of public funds to pay for the services. This is an option that must be made available by CMH agencies for anyone who desires it, including people with the most severe disabilities who have guardians who speak on their behalf. People who want and need a more traditional program of services may choose not to use Self-Determination.
In any case, CMH agencies are obligated to use the person-centered planning process to develop an Individual Plan of Services. This process must promote community life and honor the individual’s preferences, choices, and abilities. When there is a real or perceived disagreement between the guardian and the individual, the draft policy wrongly assumes that the guardian is dismissing the “preferences, choices, and abilities” of the individual.
Many people with developmental disabilities, though certainly not all, have difficulty expressing themselves and their communication may be easily misinterpreted. If someone answers “Yes” to every question that is put to them, it would be wrong to interpret this as a definitive expression of a choice. If an individual’s judgment is impaired, as when a person makes decisions impulsively and without reflection, others need to take into consideration the safety and welfare of the person before making this the basis for an important decision. Some people with developmental disabilities are so eager to please that they will agree to almost anything - another reason to proceed cautiously before coming to an agreement on a plan of services. Person-centered planning is a cooperative effort, but ultimately the guardian’s opinion is a stand-in for that of the individual in areas where the person is unable to make their own decisions. The agency can agree or disagree with the guardian and either side can pursue administrative or other legal remedies to resolve the dispute. But to limit access or restrict the use of Self-Determination by a guardian who is supposedly in conflict with the expressed goals of the consumer is wrong and discriminatory.
This draft policy encourages CMH agencies to use the most aggressive methods available for dispute resolution with guardians, who are most often parents, siblings, other family members, or family friends of the disabled person. Other than suggesting the use of mediation services, the policy leaves out other administrative remedies that must be available to settle disputes such as Medicaid fair hearings. Instead it suggests direct court challenges to guardianship, equating disagreement over the person-centered plan with a guardian’s failure to fulfill his or her responsibilities under the guardianship law. This does great damage to a process that is supposed to be a cooperative effort to design services that best meet the needs of a vulnerable person. Challenges to guardianship are legal and necessary in some cases, but to encourage the use of this legal tool to punish and pressure guardians to conform with the wishes of a local CMH agency is an improper use of these legal procedures.
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I sent copies of my comments to Janet Olszewski [ norris@michigan.gov ], the Director of MDCH, family organizations for people with developmental disabilities. and Senate and House Health Policy Committees. You might also send your comments to your state legislator and anyone else who might have an interest in this.
This is a copy of the Michigan Mental Health Code. Guardianship is covered in Chapter 6 beginning on page 87.
Here is an interesting court case where a CMH tried to have a guardian removed because "The current Guardian is not acting in the ward's best interest in the areas of health, social and vocational opportunities, and proper housing/residential." What did the guardian do to deserve this? The guardian complained about injuries her sister received in her group home, she was upset that no one was helping her sister with her laundry, and she brought her sister hot dogs at the group home when she didn't like the dinner that was being served. This is on the Website of Martha Churchill, an attorney from Milan, Michigan.
Dental services for adults on Medicaid have been reinstated with passage of the budget bills for fiscal year 2011. Beginning October 1st, 2010, adults 21 and over may again receive dental services. For a comprehensive look at the services available, see the Dental Database for 2010. 
