1 Little Things Mean a LotSupports Outside of the Virginia Developmental Disabilities Medicaid Waivers . . . and a few underappreciated Waiver benefits for The Arc of Virginia 2016 Convention, August 8-10, Williamsburg, VA by The Arc of Southern Virginia

2 All of whom may be eligible for other programsFor Whom? -Individuals ineligible* for DD** Waivers -Individuals on the DD Waiver Waiting list -Individuals with a DD Waiver All of whom may be eligible for other programs *Why would a person with a significant developmental disability be ineligible for a DD Waiver? -May have been diagnosed with an existing developmentally disability after twenty-two. -May have acquired a physical or cognitive disability after twenty-two. -May not meet functional eligibility based on VIDES screening administered by local CSBs -May not be financially eligible for Medicaid Long Term Care Waivers ** In keeping with Virginia Waiver Redesign the term “DD” Waiver will be used exclusively throughout this presentation. An Intellectual Disability, which is a Developmental Disability, is included in “DD.”

3 More than you might think!What is available for those ineligible for DD Waivers or on the DD Waiver Waiting List ? More than you might think!

4 What’s Out There? First, some examples of “littlethings that mean a lot” to the DD Community.

5 A Few Light Hearted Little ThingsChallenge Air Mission: Challenge Air for Kids & Friends exists to build confidence and self-esteem in children and youth with special needs through the gift of flight. Since 1993, they have been committed to making a difference in the lives of children with special needs. With a network of 3,500 volunteers nationwide, they continue to grow through events called “Fly Days.” 8001 Lemmon Ave, Suite 280, Dallas, Texas 75209 (214) Free Tickets to Bright Stars Night at the Circus for Special Guests Hosted by Easter Seals MD, DC & VA Verizon Center, Washington, DC Wednesday, March 30, 2016 Join Easter Seals as it teams up with Ringling Bros. & Barnum & Bailey Circus for an exciting night of fun at the Verizon Center in Washington, D.C. For each ticket to the circus additional tickets will be donated to people with disabilities, active duty military personnel, veterans and their families.

6 ….and a few more Miss Amazing Girls and women with disabilities haveFree Children’s Dental Clinic Day for Very Young Children and Children with Special Health Care Needs When? Saturday, July 25, 2015 Where? Sentara Halifax Dental Clinic 101 Aubrey’s Loop South Boston, Virginia 24592 Who qualifies for this free clinic? Children 6 months to three years old Children with special health care needs under 21 years old How do I make an appointment? Call (434) What about my income? There are no income restrictions for this program. Who can bring my child? A legal guardian must be present to sign the consent for dental treatment and remain at the clinic during the child’s care. Co-sponsored by the Virginia Department of Health, Virginia Dental Association, and Virginia Dental Association Foundation. Miss Amazing Girls and women with disabilities have every ability to accomplish amazing things. Miss Amazing shines a spotlight on those accomplishments. OUR MISSION To provide opportunities for girls and women with disabilities to build confidence and self-esteem in a supportive environment. https://missamazingpageant.com, https://www.facebook.com/pages/Virginia-Miss-Amazing-Pageant/

7 DMV Parking Placards & Plates for Virginians with disabilitiesTravel Programs DMV Parking Placards & Plates for Virginians with disabilities Individuals having physical and/or cognitive disabilities are eligible. To apply see: AMTRAK Accessible Travel Services -handicapped accessible sleeper cars -15% traveling companion or attendant discount (must be 18+) -Accessible Travel Requests for travel planning, meals, station access, oxygen, service animals, etc. See:

8 Travel Programs #2 Local OptionsSome communities offer free or low cost door to door local transportation to hospital, grocery store, etc. for seniors and people with disabilities. Virginia Assistive Technology System (VATS) (little known and under appreciated) VATS has a marvelous website to help disabled people and their families obtain assistive technology for various purposes, including wheelchairs with customized seating, adapted vans, etc., and obtaining financing. See Several private companies offer financing for adapted vehicles. See:

9 Travel Programs #3 Air TravelWings for Autism The Wings for Autism program of the Arc of the United States prepares children with ASDs and their families’ airport experience and the flight. Check for cities and airports offering the program. See: Transportation Safety Administration -TSA Notification Card for Individuals with Disabilities and Medical Conditions -Screening Assistance with Passenger Support Specialists -Keep Moving. TSA Pre✓® saves time and stress. With a 5 year,$85 membership, you can speed through security and don’t need to remove your: shoes, laptops, liquids, belts and light jackets. -Call TSA Cares. Travelers or families of passengers with disabilities and medical conditions may call TSA Cares at seventy-two hours prior to traveling for information about screening policies, procedures and what to expect at security checkpoints. See:

10 Federal Life Line Phone & Internet Service for Low Income Customers over 18-Free cell phones for qualifying individuals. The two programs in Virginia are Assurance Wireless and SafeLink Wireless. With SafeLink you can bring your own phone if needed for user accommodations. See: Customer Service Customer Service -Life Line home phone Federal and Virginia discounts for as long as the customer remains eligible. See: https: scc.virginia.gov/puc/univ.aspx -Life Line customers may have either a land line or a cell phone. -Low cost internet DSL plan, “Internet Basics” for qualifying individuals, includes instruction and tech support. Century Link’s plan is $15 to $25 per month depending on speed with 3 to 5 year contracts. See: -Century Link offers an iPad Mini 2 for $150 ($130 discount) for customers enrolled in their “Internet Basics” program. Interest free time payments can be arranged.

11 Recreation 1 National & Virginia Park Disabilities PassesNational Park Services American the Beautiful Access Pass: Free for U.S. citizens & permanent residents with permanent disabilities, obtain in person at federal recreation sites or by mail. See: Virginia State Parks DISABILITY PASSPORTS, Disability Passport (free of charge), good for parking and entrance at ALL Virginia State Parks See:

12 Recreation 2 Camping Camp Easter Seals-UCP VA & NC, New Castle, Craig Co., VA For children and adults, scholarships, some FREE Respite Weekends, Family Camp & Family Weekends, eligible campers accepted into the CIT/Counselor-in-Training-Program receive a discounted fee for the summer camp session during which they work as a CIT. Camp Baker, Chesterfield, VA For children and adults, weekday programs, summer camp & respite care weekends, Accepts Medicaid Waiver Respite Care hours, Camp Jay Cee, Bedford, VA Summer Camp and Respite Care Weekends for children and adults, Camp Rainbow Connection, Various Virginia Locations Virginia Conference United Methodist Church camp, non-sectarian for staff & campers, 16 and up with an ID diagnosis, 2 one week summer camp sessions offered at various Virginia United Methodist Camps and Conference Centers, Others?

13 Recreation 3 YMCA Check your local YMCA for disabilities friendly programs. Some offer reduced Fees and special programs for people with disabilities. Ask about fee free admission for care givers of children and ults who have disabilities. Sensory Friendly Films: Ask your local theater to schedule selected sensory*-friendly showings. see: *Dimmed lights, sound volume reduced, no one cares if kids are loud or wiggle worms. Local Community Rec programs Example: Danville, VA has a marvelous Parks & Rec Program with options for “Special Populations.” See: playdanvilleva.com Sports -Special Olympics Virginia, must meet diagnostic criteria, see: specialolympicsva.org -American Youth Soccer Association VIP Soccer, see: -Challenger Baseball, see:

14 Recreation 4 Infinity Acres Petting RanchA Memory Making Family or Group Outing Destination Infinity Acres Petting Ranch Infinity Acres Ranch is a 501(c)(3) Non Profit Educational Ranch that offers Animal Based Learning Opportunities to Local Youth & Individuals with Disabilities Outdoor, Nature-Based, Animal Interactive, Hands On Activities, Games And Fun!! Guided Interactive Tours Chinchillas, Rabbits and other pets for Sale! "Trading Post" Gift Shop for unusual gifts! Pet supplies too. Animal Adventure Summer Day Camp. COMING SOON: the ENABLE Program* (Enriching, Nurturing Animal Based Learning Experience) We ENABLE Individuals with Disabilities *DD Day Support Program Proud to Partners with: Ms Wheelchair Virginia, Boys & Girls Club of the Blue Ridge, Piedmont Community Services, Family Preservation of Martinsville, Blue Ridge Independent Living, Rouse's Group Home-Eden NC, Tackfully Teamed Therapeutic Riding, MHC SPCA. Virginia Museum of Natural History, Quest Recycling Contact Information: 136 Joppa Road, Ridgeway, Henry County, VA (276) , / /www.facebook.com/infinityacresranch/

15 Swimming and Water Safety Scholarship FundRecreation 5 Autism Speaks Swimming and Water Safety Scholarship Fund https://www.autismspeaks.org/family-services/grants/swimming The Autism Speaks Swimming and Water Safety Scholarship Fund selects eligible organizations and programs to identify qualified financially disadvantaged individuals with autism and offer scholarship funds for swimming and water safety lessons. Organizations that provide qualified swimming and water safety lessons specifically for individuals with autism are encouraged to apply for scholarship funding. Applications will be accepted on a continuing basis, and up to $2,000 in scholarship funds will be awarded to organizations on a quarterly basis. Organizations may be granted up to four quarters, depending on how often the swimming and water safety program runs. Program Grant Recipient in VA: Little Fish Swimming Fredericksburg, VA

16 Recreation 6 Theme Parks-Services vary by Theme Park. Call ahead or go to guest services and ask about services for guests with disabilities. -Bush Gardens Williamsburg, VA, see: Offers wrist bands to track guests with disabilities should they become separated from their caregivers, 60 wheelchair accessible parking spaces with 96 inch wide accessible aisles, aggregate, smooth, pebbled pathways some with steep grades requiring assistance for persons in wheelchairs, Accessible and Companion restroom facilities, most Dining facilities accessible to guests in wheelchairs, ... and more. -Kings Dominion, Doswell, VA Offers a wide range of services to Guests with disabilities. Download their disabilities services guide at: %20pages%20-%20Final%20for%20web(3).pdf

17 Recreation 7 Virginia Therapeutic Riding Programs/TRPTherapeutic Riding Association of Virginia, Inc. The Professional Association of Therapeutic Horsemanship International (PATH) was founded 1969 as the North American Riding for the Handicapped Association (NARHA) to promote safe, effective, therapeutic horseback riding throughout the US and Canada. Today, PATH Intl. has over 850 member centers and nearly 7,600 individual members in countries all over the world, who help and support more than 54,000 children and adults with special needs each year through a variety of equine-assisted activities and therapies. PATH programs are located throughout Virginia, including, but not limited to: Bedford, Boones Mill, Boyce, Crozet, Glen Allen, Fredericksburg, Leesburg, McLean, Purcelville, Sedley, Upperville and Williamsburg. For more information see TRAV website above. TRP is expensive and out of reach for many families but individual sponsorships, scholarships and even no cost funding options are available in some communities. Individual and Family Support Program*/IFSP grants, which are only available go Individuals on the DD Waiver Waiting List, are an good source of TRP funding. DD Waivers do not fund TRP programs. *IFSP will be introduced in a subsequent slide.

18 Under Appreciated Virginia Medicaid ServicesReimbursement for per mile by LogistiCare paid to Family and Friends driving Medicaid enrollees to appointments paid by Medicaid. LogistiCare will also transport the enrollee and a caregiver to local and medical appointments. Family and Friends Drivers Must be registered with LogistiCare. See: Health Insurance Premium Payment/HIPP for adults & HIPP for Kids pays partial premium reimbursement for private health insurance for Medicaid enrollees also enrolled in their parent/family member employee (but not retiree) health insurance plan. Early and Periodic Screening, Diagnosis, and Treatment or “EPSDT” is a Federally mandated preventive and comprehensive health service for Medicaid eligible children from birth up to age 21. It children to get medical exams, checkups, follow-up treatment, and special care they need to make sure they enjoy the benefits of good health. See Federal EPSDT site at: Early and Periodic Screening, Diagnostic, and Treatment, [PDF] EPSDT Fact Sheet – Virginia, dmasva.dmas.virginia.gov/Content_atchs/mch/mch-epsdt_fs.pdf Medicaid Works allows workers earning up to $35,118 per year (for 2016) to keep their Medicaid! For eligibility & program details. See: [PDF] MEDICAID WORKS Fact Sheet:

19 Another Under Appreciated Medicaid Program: the EDCD WaiverThe Elderly & Disabled with Consumer Direction/“EDCD” Medicaid Waiver provides support services to frail elderly persons and children & adults who are disabled and/or medically frail so they can live in the community vs. a nursing home or other institutional placement. Eligibility is based on medical-nursing needs. Services include personal care, respite care and, as needed, an electronic emergency alert system. The EDCD Waiver currently does not have a waiting list. The VA Dept. of Medicaid Assistance Services has issued clear instructions to local DSS offices re. processing applications for DD children and adults, however a good deal of disparity in understanding the process remains throughout Virginia. Therefore, Applicants for this Waiver should not attempt to apply for it without adequate preparation. For help contact a local Arc Chapter, other Virginia Disabilities advocacy organizations or families who have successfully navigated the EDCD Waiver application process. A few hours of EDCD Waiver care before and after school for a DD child may be all that is needed for a caretaker parent to stay employed to better provide for the entire families.

20 UNDER APPRECIATED SSA GEMS!SSI AND CHILD SUPPORT -There is a 1/3 reduction of countable child support for SSI applicants. -As long as a high school transition students between 18 and 22 who receive child support remain enrolled in school they will retain the SSA status of “Child” and remain eligible for the 1/3 reduction. -If a Court Order has directed Child Support to be paid to a Special Needs Trust it will be excluded from SSI (and/or Medicaid) financial eligibility calculations. THE “CHILD IN CARE BENEFIT!” Spouses up to 62 caring for a child under 16 or an adult child disabled before 22 may be eligible for an early SSA benefit for a “Child in Care” based on the earnings record of spouse who is receiving a disability or retirement benefit or has dies. The applicant’s spouse does not necessarily need to be the child’s biological parent. These children may also be eligible on a step-parent’s or grandparent’s record. Interested parents need to know that if they receive an early SSA benefit while employed they will be limited to 2016 earnings of $15,720 after which the benefit will be reduced. This is tremendous benefit for retired and stay-at-home care giver parents.

21 Department of Social Services Benefits in Addition to Medicaid ProgramsAdults with disabilities living independently may also be eligible for: SNAP (formerly known as Food Stamps) Heating & Electricity Assistance Rental Assistance

22 Benefits for Transition Age High School StudentsI’m Determined Conferences* & Local School Programs (*free to students, stipend for parents) I'm Determined is the Virginia Department of Education's Self-Determination Project. Student’s Develop self-determination skills though various activities tailored their needs and interests. Students learn to advocate for themselves through the their own IEP process as they develop a deeper understanding of their learning challenges and their individual rights as a student. Students and parents may attend annual I’m Determined Conferences, however the student must complete the application. Parents attend Transition information planning sessions and are lodged separately from the I’m Determined student attendees. See:

23 Benefits for Transition Age High School Students #2Children’s Services Act*/CSA Funding for High School Transition Services CSA funding can make a huge difference in the lives and futures of transition students with disabilities whose high schools provide little to no IDEA mandated Transition Services. Supplemental support for IEP Transition Services can provide off campus vocational or life skills/independent living training programs included in an IEP. CSA provides State-local match general funding for services for at-risk children and youth. Funding requests and service planning are handled by the local Family Advocacy Planning Team/FAPT. Funding requests and service planning for non educational needs such as psychological services, therapeutic mentoring, In-Home Supports, residential placements, etc., are presented by multi-agency team representatives from the courts, Child Protective Services, therapists, etc. Supplemental Special Education Services are presented by the Local Education Authority through the IEP or 504 process. Special Education requests included in an IEP must be funded. See: [PDF] CSA and Special Education FOQs, *The Community Services Act was renamed the Children's Services Act July 1, 2015

24 Benefits for Transition Age High School Students #3SSA Student Earned Income Exclusion* The earnings of a student under 22 who is regularly attending school are excluded from financial eligibility calculations for Supplemental Security Income. For 2016 the earnings limit is $1,780 monthly up to a yearly maximum of $7,180. For a complete program description and eligibility requirements see: *This program is not open to students who receive a Child Disability Benefit (SSA Social Security Disability Insurance/SSDI) on a parent record. The 2016 earnings limit for SSDI recipients is $1166 per month. Free or Reduced Cost School Meals Students receiving SNAP, SSI and/or Medicaid are automatically eligible for this Federally needed program because their parent/family income is NOT considered . As legal adults they are enter ONLY your child’s income. Put a footnote on the application explaining that your child is legally an dependent economic unit for whom family income is excluded from eligibility calculations. If the school does not understand this, contact your Local Schools Central Office or your local Arc Chapter for assistance. If you do not have a Power of Attorney or Guardianship Order for the student then student must sign the program application.

25 Helpful Health Care Options for People with DDsThe REACH* Program: Crisis Mental Heath Services for ALL DD Virginias: REACH (*Regional, Education, Assessment, Crisis Services, Habilitation) is a 24/7 mobile crisis intervention program providing crisis support to persons with intellectual and developmental disabilities experiencing a crisis due to behavioral or psychiatric needs. REACH provides home and community based mental health crisis assistance services to individuals and their families to improve their quality of life and decrease confinements and hospitalizations. This program is available to ALL Virginians with a DD; those who have a DD Waiver, those on Waiver Waiting List and those who are ineligible for DD Waivers. REACH is a program of the Department of Behavioral Health and Developmental Services created in response to the 2012 US Department of Justice Settlement Agreement with the Commonwealth. To find the REACH program in your area of Virginia, see:

26 Helpful Health Care Options for People with DDs #2Healthy Athletes® Special Olympics Virginia People with intellectual disabilities typically receive sub-standard health care, or virtually no health care at all. Many SO athletes have neglected health problems. In Virginia, Healthy Athletes offers free of charge Health care services to Athletes at several events, including Summer Games and Fall Championships, including: FUNfitness® Physical therapists assessments. Healthy Hearing® Trained audiologists screenings. Lions Club International Opening Eyes® Doctors complete eye exams and provide athletes with free prescription eyeglasses or designer sunglasses upon completion of their screening. Special Smiles® Through a partnership with Missions of Mercy, full dental services are provided to athletes in need of cleaning, fillings and extractions at no cost to athletes or their families. MedFest® MedFest offers free pre-participation Special Olympics Athlete sports physicals and periodic updated physicals for seasoned Special Olympics Athletes. For more information on Healthy Athletes®, including how to get involved as an athlete, sponsor, volunteer, or healthcare provider, contact: Vice President of Program, Dave Pawlowski,

27 Health Insurance for OT, ST & PTHelpful Health Care Options for People with DDs #3 Maximizing Your Private Health Insurance I Health Insurance for OT, ST & PT With a physician or primary care provider order, private health insurance, Medicare and/or Medicaid may cover habilitative* services such as Occupational Therapy (OT) skills and independent living skills. For example, an OT may train a client in the use of an iPad or how to safely use public transportation. A Speech and Language Pathologist/SLP may work with a client on reciprocity in conversation, how to ask for help when lost, how to use the phone, etc. Physical Therapists may work with clients on Sensory Integration. OTs, PTs and SLPs may be valuable members of Medicaid Waiver Plan of Care Teams, FAPT Teams, IEP Teams, etc. OT, ST and PT may be considered qualified Medical/Nursing needs for EDCD Waiver eligibility. *Habilitative services help a person to learn, retain, or improve skills and functional abilities not developed on a typical childhood growth and development timeline. For example, a child who was not talking at the expected age or an adult with significant autism who remains non verbal as an adult. Both children and adults can benefit from habilitative services.

28 Virginia Autism Insurance LawHelpful Health Care Options for People with DDs #3 Maximizing Your Private Health Insurance II Virginia Autism Insurance Law The 2011 Law: Health insurance; mandated coverage for autism spectrum disorder. Requires health insurers, health care subscription plans, and health maintenance organizations to provide coverage for the diagnosis of autism spectrum disorder (ASD) and treatment for ASD in individuals from age two to six, subject to an annual maximum benefit of $35,000 of coverage for applied behavior analysis. Treatment for ASD includes applied behavior analysis when provided or supervised by a board certified behavior analyst, who shall be licensed by the Board of Medicine, and the prescribing to provide coverage will not apply to individual or small group policies, contracts, or plans. The mandate will apply to the state employees' health insurance plan and to the local choice health program. This measure will not apply to an insurer, corporation, or health maintenance organization, or to government employee programs if the costs associated with coverage exceed one percent of premiums charged over the experience period. This bill is identical to SB 1062.HB 2512 is incorporated. (Source for this material is:

29 What the Affordable Care/ACA Means for You & Your FamilyHelpful Health Care Options for People with DDs #3 Maximizing Your Private Health Insurance III What the Affordable Care/ACA Means for You & Your Family People with Disabilities: Private health insurance may be hard to come by if you are living with a disability. Even if you can afford it, it probably doesn’t cover all of your needs. Worrying about where to get coverage and the cost of care is the last thing you want to do. The ACA is expanding your options for more affordable health insurance. Ending Insurance Company Abuses: Thanks to the Affordable Care Act, insurers can no longer put a lifetime cap on how much care they will pay for if you get sick, or cancel your coverage when you make a mistake on your paperwork. Coverage for Pre-Existing Conditions: Insurers can no longer deny coverage or charge more because of a pre-existing condition like asthma and diabetes. Access to Affordable Insurance: Americans who may have been locked out or priced out of getting quality health insurance have new access to affordable coverage. The Health Insurance Marketplace in every state offers a range of plans, and millions qualify for financial assistance. Learn more and sign up at: HealthCare.gov. From:

30 Helpful Health Care Options for People with DDs #4 Mental Health ServicesConsidering CSB and/or Private Mental Health/Behavioral Health Services for those who are Ineligible for, on the Waiting List for, or who have a DD Waiver People with DDs often have a co occurring mental health diagnosis but may never have considered exploring CSB or private Mental Health/Behavioral Health services. Medicaid, Medicare and/or private health insurance can fund a wide range of MH services. Private payment on a sliding scale may also be an affordable funding option. Both CSB and Private Mental Health Day Support Programs may be more well tailored to the needs of some people Autism or other DDs than Waiver funded DD Day Support Programs. Medicaid will fund Mental Health Day Support Services for people with basic Medicaid, EDCD Waivers or DD Waivers, all of which include Medicaid funded transportation. Psychiatric care, psychological services, medication management, counseling/therapy, Mental Heath Case Management (in some cases), Skill Building Services, etc., may also be of interest to DD Consumers. For children and youth MH In- Home services, Therapeutic Mentoring and CSB Children's & Family Services are also options worth exploring.

31 The Individual and Family Support Program (IFSP)Benefits for Children and Adults While Remaining on the DD Waiver Waiting List CSB DD Service Coordination (formerly “Case Management”) CSB Service Coordination may be available for DD consumers with Medicaid who are ineligible for Waivers or who are on the Waiver Waiting list. The Individual and Family Support Program (IFSP) The IFSP, established by the Department of Justice Settlement Agreement with the Commonwealth, provides some financial help to individuals on the DD Waiver Waiting list and their families. The IFSP provides cash grants to support individuals’ ability to remain in their home or their family’s home. Funds may be used for services such as respite care, program tuition, special needs summer camp, home safety modifications, tech support and devices, dental care, mental health care and medical services not covered by insurance, legal fees for guardianships, powers of attorney and special needs trusts. It can also be to supplement rent and utilities. Many of the needs are not covered by Medicaid or Medicaid Waivers. See:

32 Under Appreciated DD Waiver BenefitsDD Waiver Group Supported Employment Community based, full-time permanent job coach, minimum wage base pay $7.25 per hour, transportation provided. “Special Earnings Allowance“ A Home & Community Based Waivers Work Incentive, significant earnings are excluded for calculating financial eligibility. See: VA Medicaid Manual, DSS, Volume XIII. M , c. Special Earnings Allowance for EDCD and DS, ID and DD Waivers. Medicaid Manual language has not been updated with the Redesigned DD Waiver Terms. Tech Support Such as support individuals living in the community, requires Occupational Therapy Life skills evaluation, and as needed on going OT support. A DD Waiver Tech Support Team may conduct a home based needs assessment and develop a Tech Support Plan. Home Modifications For safety such as ramps for accessible entrances, toilets, bathtubs or showers, induction stoves (non heated surfaces), Virginia Electrical Code upgrades to Ground Fault Circuit Interrupter Electrical Outlets to prevent accidental electrocution should appliances come in contact with water, etc.

33 The Department of Aging & Rehabilitative Services (DARS)It’s NOT just about employment!

34 The Department of Aging and Rehabilitative Services (DARS) Community Based Services #1DARS provides Community Based Services to eligible applicants. Some DARS Community Based Services are similar to or comparable to those offered by the DD Waivers. Persons who are ineligible for DD Waivers may want to explore DARS community based services. Note: Persons on the DD Waiver Waiting List may not be eligible for some DARS Community Based Services.

35 The Department of Aging and Rehabilitative Services (DARS) Community Based Services #2DARS Community Based Services include: Assistive Technology System Assistive Technology Loan Fund Brain Injury Services Coordination Unit Centers for Independent Living Respite Care Grants for Caregivers of Disabled Family Members Personal Assistance Services Community Rehabilitation Case Management Services

36 The Department of Aging and Rehabilitative Services (DARS) Community Based Services #3Virginia Assistive Technology System (VATS) The mission of the Virginia Assistive Technology System (VATS) is to ensure that Virginians of all ages and abilities can acquire the appropriate, affordable assistive and information technologies and services they need to participate in society as active citizens. Explore our site to learn more about our programs and services and all you have ever wanted to know about assistive technology. The Assistive Technology Loan Authorithy The Assistive Technology Loan Fund Authority offers creative and flexible services to open doors for individuals who might not otherwise be eligible for borrowing. Our mission is to provide alternative funding resources for Virginians with disabilities to acquire assistive technology that can enhance their independence and improve their quality of life. Any Virginian with a disability can apply for a loan with us, regardless of income and no matter how small a loan they might need.

37 (Sounds a lot like DD Waiver Services!)The Department of Aging and Rehabilitative Services (DARS) Community Based Services #4 Personal Assistance Services (PAS) PAS may be provided through DARS to individuals with physical disabilities such as spinal cord injuries, cerebral palsy, or muscular dystrophy, who require assistance from another person to perform non- medical activities of daily living. Personal assistance services mean a range of services to assist an individual with a disability to perform daily living activities on or off the job. These services must be designed to increase the individual's control in life and ability to perform everyday activities on or off job. A PAS Application and Assessment is needed to request PAS services. Comparable programs, such as Medicaid Waivers, must be applied for and ruled out before PAS services may be considered. (Sounds a lot like DD Waiver Services!) Contact Information for the DARS PAS Program Phone: Toll free: ; TTY Or visit our web ite:www.vadrs.org/cbs/pas.htm

38 The Department of Aging and Rehabilitative Services (DARS) Community Based Services #5Community Rehabilitation Case Management Services (CRCMS) Program CRCMS assists people with severe physical and sensory disabilities to build a quality of life of their choosing through self-Direction personal dependency. CRCMS Rehabilitation Specialists match an individual's rehabilitative needs with appropriate services and supports in the community. Services: Assistive Technology, Education, Financial and Legal Support, Housing, Independent Living Services, Individual/Family Counseling, Job Training/Placement, Medical Treatment/Services, Social/Recreation/Leisure Opportunities, Respite/Day Services, Support Groups, Transportation, Other services as needed. Edibility: Individuals have a physical or sensory disability; require a special combination of lifelong or extended duration services, and their disability results in substantial limitations in three or more of the following life areas: Communication, Economic Sufficiency, Independent Living, Learning, Mobility, Self- Care, Self-Direction. There is a Waiting List for the CRCMS program, however it is possible to receive a slot within a year. (Sounds a lot like a DD Waiver!!!)

39 Department of Aging and Rehabilitative Services/ (DARS) Community Based Services #6Respite Care Grants The Virginia Lifespan Respite Voucher Program provides reimbursement vouchers to home based family caregivers of up to $400 for temporary, short-term respite care provided to family members with disabilities (children and adults, including elderly persons). This is a Federal Grant supported project. To apply for the Virginia Lifespan Respite Voucher Program see the following DARS website links.* Frequently Asked Questions: Program Overview: FY 2016 Application: Caregiver Burden Inventory: *Program information for the FY 17 grants was not yet available at the time of this presentation, August For current information contact: (800)

40 The Department of Aging and Rehabilitative Services (DARS) Community Based Services #7Brain Injury Services Coordination Unit, The Brain Injury Services Coordination (BISC) Unit, located within the Community Based Services Division in the Richmond Central Office, manages numerous programs/services, contracts, and a federal grant that provides brain injury services throughout the Commonwealth.  The BISC Unit serves as a point of contact for customers seeking general or agency-specific information about brain injury resources and rehabilitation. Centers for Independent Living, Centers for Independent Living, often referred to as "CILs", are non residential places of action and coalition designed and operated by people with disabilities. CILs work with individuals to promote leadership and independence as well as with local communities to remove barriers to independence.

41 About DARS Order of Selection CategoriesThe Department of Aging and Rehabilitative Services (DARS) Community Based Services #8 About DARS Order of Selection Categories Once applicants who are determined to be eligible for services they are placed in a priority category. If the priority category is funded they will be served. If it's closed they will be placed on a waiting list. Federal served first. DARS has four priority categories, as follows” Priority Category I: An individual who is most significantly disabled, i.e., has a significant disability that results in serious functional limitations in three or more functional capacities. Priority Category II: An individual with a significant disability that results in serious functional limitations in two functional capacities. Priority Category III: An individual with a significant disability that results in a serious functional limitation in one functional capacity.  Priority Category IV: All other individuals determined eligible for the vocational rehabilitation program. For detailed information see:

42 Safety Tips Ideas for ID Cards for Children and Adults with DD VA Non Driver ID Cards for Children and Adults, may add ASD notation VA Drivers Licenses, may add an ASD notation US Passport or Passport Card (*Passport Cards are limited to travel to Canada & Mexico) Employment and School IDs Military Dependent ID Health Insurance, Medicaid, Medicare, Social Security Card, etc. Medical ID for first responders Police Department fingering printing and photo IDs for children Other ideas? Worried about letting your DD family member carry ID information lest it become lost? Here’s an idea: Make two photo copies of all ID cards, laminate one set for the person with DD to carry. Keep originals in a safe place. Due to the risk of identity theft, Social Security Cards should not be carried in wallet by anyone. Paper Medicare Cards do not hold up over time but can be preserved with lamination.

43 Another Safety Tip Rethinking Landline Phones in a Cell Phone World:Safety Considerations More and more households have “cut the cord” to their landline phones in favor of cell phones only for the whole family. Why spend a lot unnecessarily on a landline that only seems to ring for telemarketer calls? But there are people who “can not live without” a cell phone who hang on to their landlines at great expense because of safety concerns. Wireless phones cannot be relied upon to locate 911 callers who may not be able to give the call center their exact location or address. Emergency call centers can locate an address associated with a landline. People who have kept their landlines are advised to call their local 911 call center’s non emergency phone umber to ask them to note that a child or adult with a medical need, autism or other disabilities lives at the address associated with the landline phone number. But what about the extra expense? Ask the local phone company for their most basic phone plan. Inquire about Lifeline and other discount programs. For example, Virginia Century Link customers who have DSL service but do not have a home phone plan can still use a land line to call 911 (and only 911) at no additional cost.

44 Big Red Safety Box® | FOUNDSafety Resources 1 Big Red Safety Box® | FOUND The National Autism Association is committed to those with Autism Spectrum Disorders who may wander off from a safe environment, are unable to recognize danger and/or stay safe. The Big Red Safety Box is a free-of-charge toolkit given to autism families as a means to raise awareness and share simple tools that may assist them and other families with preventing and responding to wandering-related emergencies. The Big Red Safety Box includes: wandering-prevention resources with an emergency plan, Alert Window Clings for car or home windows, an Alert Wristband and shoe tag, and other resources and tools. Those with ASDs who are at risk of wandering from a safe environment qualify to receive a Big Red Safety Box while supplies allow. Limit 1 per family. Recipients must agree to terms and conditions. NAA’s Big Red Safety Boxes are packaged and shipped with care by a company employing adults with autism and other developmental disabilities.

45 The Medic Alert Foundation: Medical Emergency Services IDsSafety Resources 2 The Medic Alert Foundation: Medical Emergency Services IDs Medic Alert provides services connecting your medical ID to emergency services specifically designed to save your life in an emergency and ensure you are quickly reunited with loved ones. Members submit their emergency contacts and medical information for entry into the Medic Alert data base. Members receive a distinctive metal bracelet or necklace tag which is worn at all times. The identifying information and the phone number on the Tag is used by first responders, such as emergency medical personnel or law-enforcement agents, to access the wearer’s contact information, medical history and special needs. The Membership Fee is $50 annually. The Medic Alert Foundation is a non-profit company founded in 1956, headquartered in Turlock, California See:

46 Project Lifesaver International: Bringing Loved Ones HomeSafety Resources 3 Project Lifesaver International: Bringing Loved Ones Home The task of searching for wandering or lost individuals with Alzheimer’s, autism, Down syndrome, dementia or other cognitive conditions is a growing, serious, responsibility. Without effective procedures and equipment, searches can involve multiple agencies, hundreds of officers, countless man hours and thousands of dollars. More importantly, because time is of the essence, every minute lost increases the risk of tragic outcomes. Working hand in hand with public safety agencies, Project Lifesaver International will Help you save time, money and most importantly, your loved ones. The following list includes many, but not all, Virginia communities supporting a Project Lifesaver program: Sheriff's Office City of Alexandria, County of Chesterfield, Police City of Williamsburg, Hampton Sheriff's Department, Project Lifesaver Fairfax County, Project Lifesaver Chesapeake, Virginia Beach Project Lifesaver, Project Lifesaver Richmond, Halifax County Sheriff’s Department. If your community is not listed see to see if it is. You will also find information about how to bring Project Lifesaver to your community.

47 Tax Tips for Children & Adults with DisabilitiesTax Exemptions, Deductions & Credits SSI: Supplemental Security Income benefits are not included in gross income. Deductions: Itemized Medical Expenses as allowed per IRS regulations. Dependents: Children of any age may be claimed as a dependent if they are permanently and totally disabled (see links below for definition of qualifying disabilities.) Credits*; Health Coverage Tax Credit, Earned Income Tax Credit/EIC**, Child Tax Credit, Dependent Care Tax Credit, Tax Credit for the Disabled and Elderly, Adoption Credit for parents who adopt a child *Each credit has its own specific set of operative rules, see links below. ** The Earned Income Tax Credit, EITC or EIC, is a benefit for working people between the ages of 25 and 64 who have low to moderate income. To qualify, you must meet certain requirements and file a tax return, even if you do not owe any tax or e not required to file. EITC reduces the amount of tax you owe and may give you a refund. See: Living & Working with a Disability ww.irs.gov/pub/irs-pdf/p3966.pdf, The Life Cycle Series

48 Best Buddies InternationalGeneral Misc. 1 Best Buddies International One-to-One Friendships Builds friendships between people with and without IDD, offering social mentoring while improving the quality of life and level of inclusion. Integrated Employment Secures jobs for people with IDD, allowing them to earn an income, pay taxes, and support themselves Leadership Development Educates and empowers people with and without IDD, to be leaders, public speakers and advocates. Best Buddies International, see Official Site: bestbuddies.org

49 Annual iPad Grant ProgramGeneral Misc. 2 Autism Speaks Annual iPad Grant Program December 2015 Autism Speaks awarded more than 1,000 iPads to financially disadvantaged children and adults with autism. We asked the families to send photo and video updates. Watch some of the recipients' reactions in the video above. iPads have become valuable tools for many individuals on the autism spectrum, allowing them to access apps that help advance communication and learning skills. Eligible applicants are individuals who: Have been diagnosed with Autism Spectrum Disorder by a licensed professional -Reside in the United States -Have limited income and cannot afford to purchase an iPad -Applications must be submitted by the person with autism, an immediate family member of the person with autism, or a licensed teacher, social worker or therapist. The Technology Grant Review Committee will review applications and select the iPad award recipients See: https: Questions or comments?  Contact us at or (888)

50 General Misc. 3 Learn Free.Org* http://www.gcflearnfree.org/For more than a decade, the GCFLearnFree.org program has helped millions around the world learn the essential skills they need to live and work in the 21st century. From Microsoft Office and to reading, math, and more, GCFLearnFree.org offers 125 tutorials, including more than 1,100 lessons, ideos, and interactives, completely free. If you’re willing to learn, we’re ready to teach. View one tutorial. Complete an entire class. We believe there's freedom in the ability to learn what you want, when you want, regardless of income or circumstances. We offer 125 tutorials on the subjects you need to continue your education—or get it started. Learn anywhere, anytime. Our classroom is open 24 hours a day and serves people from around the world. Join the 18 million people from all walks of life who have come to the site to learn the essential skills they need to live and work in the 21st century. All you need is an Internet connection. *A program of the Goodwill Community Foundation® and Goodwill Industries of Eastern NC, Inc.® (GIENC®), all GCFLearnFree.org® educational content is designed and produced in the GCF Global Learning® building in Downtown Raleigh, NC.

51 General Misc. 4 SuggestionsBe open to joining research studies, it can be very rewarding and may provide compensation and/or free care and you will be helping others with DD. Join disabilities organizations’ lists, you will find yourself gleaning for terrific information and opportunities. You might want to use a separate address for this purpose. Explore what faith based communities are offering for the full inclusion of children and adults with disabilities in their congregations. Be a catalyst for full inclusion in your own faith community, see Many service organizations’ Mission includes outreach to children and/or adults with medical or DD specific needs, including: Knights of Columbus, I/DD Lions Club, eye care (eye care) Kiwanis, under served children Others

52 Voters with Special NeedsVirginia Department of Elections Any person, regardless of their disability status, has the right to register to vote at any office or agency that provides such a service. These offices include but are not limited to: Department of Motor Vehicles (DMV), Department of Health (VDH), Department of Social Services (DSS), Department of Behavioral Health & Developmental Services (DBHDS), Department for Aging and Rehabilitative Services (DARS), Department for the Deaf and Hard of Hearing (VDDHH), and the Department for the Blind and Vision Impaired (DBVI). Your local Registrar’s Office also has registration forms and should be able to accommodate any special need. For individuals with vision impairments, your local Registrar's Office can instruct you how to obtain large print versions of all materials. Please contact the Virginia Department of Elections if needed. Individuals with cognitive disabilities can register to vote if not adjudicated mentally incapacitated by a court of law. However, upon request, Guardianship Orders may retain the right to vote. This is a bare bones introduction to the subject which does not provide enough information for a first time voter to be prepared for Election Day, See: the Virginia Department of Elections “Voters with Special Needs.”

53 Tips for Military “Special Needs” Families 1Incapacitated Dependent Program Disabled children over eighteen with an active duty or retired parent may be eligible for indefinite “Incapacitated Family Member” status providing them with a military ID card, Tri Care health care coverage and other military benefits. (Otherwise, military dependent benefits, including Tri Care, expire at age 21 or 23 for a full time college student.) See: PFD Important Information You Should Know about Adult Children’s Benefits, https://www.dmdc.osd.mil/milconnect/help/pdf/tyabrochure.pdf Tri Care Military Heath Care Coverage TRICARE (formerly known as the Civilian Health and Medical Program of the Uniformed Services/CAMPUS), is a health care program of the United States Department of Defense Military Health System. Tricare provides civilian health benefits for U.S Armed Forces military personnel, military retirees, and their dependents, including some members of Reserve Components. See: Tricare Official Site, tricare.mil

54 Tips for Military Special Needs” Families 2TRICARE Young Adult TRICARE Young Adult is a plan that allows qualified adult children up to 26 to purchase coverage after eligibility for "regular" TRICARE coverage ends at age 21 (or 23 if enrolled in college.) TRICARE Young Adult meets or exceeds the requirements for Affordable Care Act minimum essential requirements for basic health care coverage. If you don’t have coverage, you may have to pay a fee for each month you aren’t covered under the Affordable Care Act. (This program is not open to young adults who are eligible to enroll in their own employer-sponsored health plan.) For more information see:

55 Tips for Military “Special Needs” Families 3Exceptional Family Member Program/EFMP The US Military Exceptional Family Member Program (EFMP) provides Active Duty Families with supports and services for their disabled children up 18. Services include: case management, individualized service plans and special medical, dental, mental health, developmental or educational requirements, wheelchair accessibility, adaptive equipment or assistive technology devices and services. See: [PDF] Department of Defense Exceptional Family Member Program, download.militaryonesource.mil/.../ResourceGuides/EFMP_Benchmark.pdf Extended Health Care Option/ECHO ECHO is a Tricare Waiver-like program for disabled children under 18 but in some circumstances eligibility may be extended beyond 18. See:

56 Tips for Military “Special Needs” Families 4Tricare Autism Demonstration Project Tricare covers medical and behavior modification services for beneficiaries diagnosed with autism spectrum disorders (ASD). Tricare benefits include occupational therapy, physical therapy, physician services, psychological services, psychological testing, prescription drugs, and speech therapy. Additionally, a four year Autism Demonstration Project operating through December 2018 is offering Applied Behavior Analysis/ABA separate from the Tricare medical benefit that provides coverage of the medical services listed above. ABA services are covered for all qualifying children and adult children who are dependents of Active Duty Service members (ADSMs), Retirees and certain National Guard, Reserve and Retired Reserve members. That is, eligibility for enrollment in the Exceptional Family Member Program and the Extended Health Care Option is extended to adult disabled children over eighteen eligible to participate in the Autism Demonstration. See: PFD Autism Demonstration Fact Sheet:

57 Tips for Military “Special Needs” Families 5Military Child Protection Act (December 2104) A new Federal law, the Military Child Protection Act, allows Military Retired parents to designate a Special Needs Trust as the beneficiary of their Survivor Benefit Plan. This is the single exception to a regulation that Federal (now only civilian) Survivor Benefit Plans may be paid “only to a person.” See: DD Waiver Waiting List Exception for Virginia Military Families Per [S 1036] Approved March 27, 2015, VIRGINIA ACTS OF ASSEMBLY SESSION - CHAPTER 671: An Act to require the Department of Medical Assistance Services to amend waiver eligibility criteria to allow dependents of active duty military members to remain on waiting lists for services when stationed outside the Commonwealth. *For full text see:

58 Tips for Military “Special Needs” Families 6Dental Care for Military Families Eligible family members of Active Duty Military Members are enrolled in the Tricare Active Duty Dental Program. Eligible family members of Non-Active Duty Military members may enroll in premium based Military Member dental plans though the Tricare website as follows: Met Life National Guard and Reserve Dental Plan Delta Dental Military Retiree Plan See: More Information? “Tips for Military Families” has provided only an elemental introduction to this subject. However, a wealth of resources are only a mouse click away. For help with an online investigation of what is available and how it can be accessed see: Military Connection,

59 Last but Not Least, Something NEWLast but Not Least, Something NEW! PILOT MOBILE REHAB ENGINEERING TEAM - page 1 Mobility Equipment Maintenance a Repair Services in the Community for Individuals with Intellectual and Developmental Disabilities PILOT MOBILE REHAB ENGINEERING TEAM Office of Integrated Health, Department Of Behavioral Health & Developmental Services Who in the DD Community has ever heard of the DBHDS OFFICE OF INTEGRATED HEALTH? Their PILOT MOBILE REHAB ENGINEERING TEAM program is so new that it does not yet have a separate website address and can’t yet be found on the DBHDS website (as of August 2016.) This is Not a Waiver Program, it serves all qualifying Virginians with I/DD. The Health Services Division of the Virginia Department of Behavioral Health and Developmental Services (DBHDS) would like to introduce our new pilot Mobile Rehab Engineering (MRE) team. Our team includes Durable Medical Equipment (DME) rehabilitation engineers and technicians and our Registered Nurse Care Consultants (RNCCs). Our RNCC's will be guiding the team's mission, which is to provide mobility equipment maintenance and repair services in the community to individuals with intellectual and developmental disabilities (who don't have these services currently available). The ultimate goal is to reduce barriers to access to community based activities through improved equipment functionality and safety. Our MRE team understands how frustrating it is when mobility is impacted due to equipment failure. We also understand how time consuming it can be for families and Direct Service Providers (DSPs) to facilitate maintenance and repairs.

60 PILOT MOBILE REHAB ENGINEERING TEAM - page 2The MAE Team is determined to make repairs quickly and competently. In order to accomplish this goal our RNCC's will contact providers to inform them of the pilot program and indentify needs. Our team will then schedule an appointment time to do an assessment. During the assessment, the MRE team will determine if the broken part can be repaired and/or replaced. The MRE team will also provide safety assessments and education as needed. In the event that the part can be repaired and/or replaced, the MRE team will complete this service free of charge. Typically most DME can be repaired in one visit on site at the residential home or day support program, but occasionally an additional bolt or special tool is required to complete the repair which may require a second visit by the MRE team. If any individual has any Durable Medical Equipment in need of a repair, (wheelchairs, walkers, bath seats, toileting seats, etc.), please request MRE Form #101, the Request for Durable Medical Equipment Assessment.” Contact: In Regions, 1,2, & 3, Tammie Williams at: or Susan Rudolph at: In Region4 & 5- Susan Moon at: or Brenett Dickerson at: If you have any questions relating to the MRE Team and/or any other questions relating to DME repairs, please contact the Registered Nurse Care Consultants (RNCC's) assigned to your Region. Office of Integrated Health, DBHDS, 1220 Bank Street, Richmond, VA 23219, (804)

61 “I get by with a little help from my friends. ” ”Sgt“I get by with a little help from my friends.” ”Sgt. Pepper's Lonely Hearts Club Band“, -The Beetles, 1967 Your help is needed to share what you have learned from the “Little Things Mean a Lot” catalog and what you learn at the 2016 Arc of Virginia Convention because it can make a very big difference to DD individuals and their families or even your own family. And “little things” can help a family with little or no help to hang on to hope and not lose heart. So …. Spread the word about these supplemental resources Add your own Encourage your CSB, DSS, IEP teams, local Chapters of the Arc of Virginia, etc., to maintain their own catalogs of resources, which will vary from community to community

62 The Arc of Southern Virginia, Inc.“Little Things Mean a Lot” was compiled by a DD Waiver mom who welcomes your comments, additions and suggestions. You may contact her at: Elsie May Gladding The Arc of Southern Virginia, Inc. P.O. Box 252, Halifax, VA 24558