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Commonwealth of MassachusettsExecutive Office of Health and Human ServicesDepartment of Developmental Services2017 MASC MASSJoint Conference.November 3 2017Turning 22 Challenges and StrategiesVictor Hernandez Ed M Deputy Assistant Commissioner Parental Concerns. Transition is a word that has a unique meaning to families with a son ordaughter aging out of the entitlement of education Fear anxiety and dread are just a few words that come to mind aroundthis anticipated change As parents they felt fairly competent with the educational terminology . Now they must learn a new lingo Ch 688 ITP ISP Prioritization Waiver Self Direction Shared Living Also transportation takes on a whole new meaning when the busdoesn t stop at their house any more Parents ask When do we start Who is involved What are our.options Where do we go for help We don t even know all of thequestions we need to ask Transition Developing A Vision for a Good LifeHigh Expectations Expanding Possibilities .Consider the following areas Work career Housing Social relationships Recreation fun. Family connections Community Connections Spiritual Life Transportation The School and Transition. There are two laws that provide two very different typestransition requirements for youth with disabilities They can be confusing because although they both arecalled transition and they involve many of the sameplayers but the two transition processes do very different. IDEA The School and Transition IDEA The federal special education law Individuals with DisabilitiesEducation Act IDEA contains a number of requirements related totransition which focus on the school district s obligation to providetransition services before a young adult graduates or turns 22 and.exits SPED The school and related services are designed to meet the student sunique needs and help to prepare them for further education employment and independent living What supports and services will be necessary for the student to make.progress towards achieving his her postsecondary goals How can the student develop self determination skills and be preparedboth academically and functionally transition to post school activitiesto achieve his her post secondary vision Massachusetts Chapter 688. Chapter 688 a MA state law establishes a process which helps todetermine which state human service agency will be responsible foradult services and begins the transition process when they graduate or A law to highlight the needs of students who will lose their SPEDentitlement. Provides a two year planning process A process for accessing appropriate the adult service agency forstudent after SPED Transitional Agency will develop an Individual Transition Plan ITP Is not a continuation of SPED services nor is an entitlement for services.after SPED Who is Eligible for Chapter 688 To be eligible for Chapter 688 services a person must Be receiving special education paid for by the Commonwealth ofMassachusetts . Need continuing habilitative services at the time of turning 22 orgraduating from special education and Be unable to work competitively without specialized supports formore than 20 hours per week at the time of leaving school Note An individual is automatically eligible for Chapter 688 if receiving.SSI receiving SSDI or registered with the Massachusetts Commissionfor the Blind How is a Chapter 688 Referral made Only the local school district LEA can make a 688 referral The referral must be made while the student is still in school . DDS prefers referrals sooner around age 18 The student s IEP team selects the adult services agency that provides theservices and expertise that most closely resemble the student s areas of need and sends the 688 referral to that agency The receiving agency then becomes the Transitional Agency .Listing of Eligible Chapter 688 State Agencies o Department of Children and Families DCF o Department of Developmental Services DDS o Department of Mental Health DMH o Department of Youth Services DYS .o Massachusetts Commission for the Blind MCB o Massachusetts Commission for the Deaf and Hard of Hearing MCDHH o Massachusetts Rehabilitation Commission MRC New Chapter 688 Referral Process Beginning September 1 2017 the Bureau of Transitional Planning. BTP is no longer accepting paper Chapter 688 referrals on behalf ofstudents with disabilities This includes submissions directly to human service agencies as wellas to the BTP All referrals should be submitted using the new electronic T22 Chapter.688 referral application which is accessed through the EOHHS Virtual The Role of the Parent Student The 688 referral should be discussed at the IEP Team meeting andsubmitted before the student is 18 The parent student may want to consider applying for Supplemental.Security Income SSI and to MassHealth Utilize Transition Timelines Student s Role in transition self advocacy responsibility Families Role Ways to promote independence responsibility athome and in community. Maximize educational services to promote learning opportunities thatsupport goals for life after school DDS Transition Coordinator 688TC The DDS Transition Coordinator 688TC is the case manager whoworks at the local DDS Area Office . The 688 TC is the student s primary link to assistance from DDSthe transition from special education to adult life The 688 TC visits the student s programs and attends IEP meetingsneeded in preparation for the Individual Transition Plan ITP development . The 688 TC will work with the individual and their family from lessrestrictive alternatives to a court appointed guardian The Individual Transition Plan ITP specifies what kinds of supportstudent family is requesting upon leaving special education The ITP meeting is normally held about one year before the student.ready to leave school The purpose of an ITP meeting is to develop a plan that includes theinterests skills and needs of the person The ITP does not contain specific goals and objectives or identifyspecific provider agencies. Supports identified in the ITP are not guaranteed or create anentitlement they are subject to prioritization appropriation andavailability Benefits of the 688 Process The 688 process ensures that the student is working with the.appropriate adult human service agency before exiting SPEDentitlement Provides very specific timelines for planning and transition to the new The ITP enables the adult agency to understand the students needsand to begin programmatic and fiscal planning. By specifying an individual s needs before exiting SPED the familyagency can plan and advocate as appropriate Any student is free to apply directly to an adult agency outside of the688 process but going through the process ensures that the agencieshave enough time to set up a transition . Key Points to Remember Regarding the 688 Process Not a continuation of special education services adult services aresubject to funding and availability DDS receives specialized funding each fiscal year for studentstransitioning within that year. A 688 referral is not the same as the DDS adult eligibility A 688 referral is still needed if known to DDS as a child or alreadydetermined adult eligible DDS Transition Coordinator plays key role in planning DDS Eligibility. DDS Eligibility In order to receive supports from DDS eligibility must be determined Determination occurs through one of the 4 Regional Teams Springfield Waltham Danvers and Middleboro Criteria for Eligibility is the same throughout the state. All eligibility determinations are made by a DDS Licensed Psychologist When thinking about transition and DDS adult supportsELIGIBILITY FOR ADULT SERVICES IS KEY DDS Eligibility 115 CMR 2 01Intellectual Disability means consistent with the standard contained in.the Definition Classification and Systems of Supports of the11th edition 2010 of the American Association of Intellectual Disabilities significantly sub average intellectual functioning existing concurrentlywith and related to significant limitations in adaptive functioning Intellectual Disability.originates before age 18 A person with intellectual disability may be considered to be mentally illas defined in 104 CMR Department of Mental Health provided that noperson with intellectual disability shall be considered to be mentally illsolely by reason of his or her intellectual disability . DDS Eligibility 115 CMR 2 01 cont Significant Limitations in Adaptive Functioning means an overallcomposite adaptive functioning limitation that is approximately twostandard deviations below the mean or approximately two standarddeviations below the mean in one of the three domains of the appropriate.norming sample determined from the findings of assessment using acomprehensive standardized measure of adaptive behavior interpretedby a qualified practitioner The domains of adaptive functioning that are assessed shall be a areas of independent living practical skills . b cognitive communication and academic conceptual skills and c social competence social skills DDS Eligibility 115 CMR 2 01 cont Significantly Sub average Intellectual Functioning means anintelligence test score that is indicated by a score of approximately 70 or.below as determined from the findings of assessment using valid andcomprehensive individual measures of intelligence that are administeredin standardized formats and interpreted by qualified practitioners Eligibility Update Have a primary diagnosis of Autism Spectrum Disorder ASD based on the most.recent addition of the Diagnostic and Statistical Manual DSM V Have a primary diagnosis of Prader Willi Syndrome based on medical evidencewhich includes genetic testing results Have a primary diagnosis of Smith Magenis Syndrome based on medicalevidence which includes genetic testing results . Have substantial functional impairment in three or more areas of the seven areas ofmajor life activities The seven areas are selfcare expressive communication receptive communication learning mobility capacity for selfdirection economicself sufficiency IQ is not a relevant determinative factor . Maintains IQ and Functional limitations criteria for those with an ID diagnosis Changes the age of adult eligibility from its current 18 years of age to 22 years of DDS Prioritization MASSCAP stands for the Massachusetts ComprehensiveAssessment. DDS created the MASSCAP for adults in order to determine whattypes of services the person needs It addresses the question of Who needs DDS funded residentialsupports defined as 24 7 out of home 24 hour 7 days a week MASSCAP also addresses the question that if an individual does not.need 24 7 out of home residential supports what other types ofsupports would meet the person s need The MASSCAP assists the Area Office in making prioritizationThe MASSCAP assesses The functional limitations of an individual. What resources are currently available to support the individual Specific characteristics of the individual such as unique medical mental health or forensic issues Caregiver capacity to provide care since an individual s need forout of home residential support is an interaction between the person s.needs and the ability of the caregiver s to provide careThe MASSCAP is not Used to determine general DDS eligibility for services Involved in who is the most appropriate person for a particular Used to proscribe the specific service and provider of the service.needed for the individual Medicaid Home and Community Based Services Waiver Medicaid Home and Community Based Services An arrangement between the state and the federal Medicaid. Waives some Medicaid rules to create more choice aboutservices received and how they are provided Individual must have MassHealth in order to apply for one of theWaiver programs Massachusetts is reimbursed from the federal government for.part of the cost of providing DDS services in the community about 50 DDS is required under law to maximize its federalreimbursement so that it can help to serve individuals with thefunding it receives . Medicaid Home and Community Based Services In addition to helping fund services participation in the WaiverProgram provides participants with important rights includingchoice in providers and protection from a reduction or change inservices being provided to individuals . Individual waiver participants have a right to needed services Parental Concerns. Transition is a word that has a unique meaning to families with a son or daughter aging out of the entitlement of education. Fear, anxiety and dread are just a few words that come to mind around this anticipated change.