SZ2S s a 362.4 and D10AR 1998-2000 STATE PLAN FOR PERSONS WITH DEVELOPMENTAL DISABILITIES Planning! FOR THE Future of services MONTANA IN I W ;| W III 1" J%? :.1#- %«:*? %I. I-s- :aI.. ,/M II .11 .1 :¥:i:-:::::::;:¥? ':>....;.¥•• ¥.,._.¥• '•¥....¥*' 5 "*S. >..:••Ijg f':I_. ..*^:>:>.;?.* .£.;*¥ * » rf? f :¥ •.¥:¥. 9 .•:¥¥.. >;....:• ..: :.;. ¥;.:y T/ze Developmental Disabilities Planning and Advisory Council and Human The Department ofHealth and Services Digitized by the Internet Archive in 2012 with funding from Montana State Library http://archive.org/details/annualreportofst3862mont e>a%s MontanaStateLibrary UBRAW LEGISLATIVE MONTANA 3 0864 1006 0386 2 STATE PLAN FOR PERSONS WITH DEVELOPMENTAL DISABILITIES FOR FISCAL YEARS 1998 - 2000 1998 Fiscal Year State of Montana PREPARED AND SUBMITTED BY: The Developmental Disabilities Planning and Advisory Council, in consultation with the State of Montana Department of Public Health and Human Services Greg A. Olsen, Executive Director Tom Price, Chairperson State of Montana State of Montana Developmental Disabilities Developmental Disabilities Planning and Advisory Council Planning and Advisory Council August 15, 1997 TASLE O? CONTENTS INTRODUCTION 1 SECTION I DstfinfHon. And Impact Do^slopiMtgmftail DisaMMHss £21 M@niana 2 Philosophy and Mission of the Developmental Disabilities Planning and Advisory Council 2 Application of the Federal Definition of Developmental Disabilities By The State of Montana 2 The Number of Persons With Developmental Disabilities in Montana 6 SECTION II Sialics Program Organization 10 The Organization of the Montana Developmental Disabilities Planning and 10 Advisory Council and the Role of the Developmental Disabilities Basic State Grant Program Council Membership 12 Members of the Montana Developmental Disabilities Planning and 16 Advisory Council Staff of the Developmental Disabilities Planning and Advisory Council 18 Role of the Developmental Disabilities Planning and Advisory Council 19 in the Service System Overview of the Status of Services in Montana 19 The Designated State Administering Agency 23 SECTION III Tlh® Sop® ©if D®v®lopinm®niial Disaibiilii'Hss Ssrvisss in Montana 26 An Overview of Federa, State and Private Non-Profit Programs Affecting the 26 Developmental Disabilities System in Montana Selection of Federal Priority Areas 77 Unserved and Underserved Groups Needing Services 81 The State Plan Review Process 83 SECTION IV Tkts Goals, Olbjjcestiiws aimed AcHviiiss ci ii® Mratana Siaft® Plan 86 Goals, Objectives and Activities of the 1998 - 2000 Montana State Plan for 86 Persons with Developmental Disabilities SECTION V Assurances 94 , SECTION VI 3udgs-: Data 97 SECTION VII Appendices 98 INTRODUCTION Every three years, the State of Montana Developmental Disabilities Planning and Advisory Council is required by federal law to provide the Department of Health and Human Services, Administration on Children and Families, Administration on Developmental Disabilities, with a plan detailing the Council's efforts for the upcoming period. The Plan has two major purposes. First, it serves as a review of the existing service system in the State, in which the needs of those receiving or in need of service are evaluated, goals and objectives are determined in response to those needs and efforts to implement change to meet the needs are undertaken by the Council. Second, the Plan is required by the United States Human Department of Health and Services Administration on Children and Families as a condition to participation in the Basic State Grant Program of Public Law 104-183, The Developmental Disabilities Assistance and Bill of Rights Act of 1996. This Plan was developed through the efforts of the Council and its' staff, the designated state administering agency for the Council (the Department of Public Health and Human Services), input from other State agencies, and a variety of groups and organizations providing and/or We advocating for services throughout Montana. hope that the effort was effective in assessing the status and needs of persons with developmental disabilities and that it will be effective in providing a blueprint for the future. — SECTION I Definition and Impact Developmental Disabilities in Montana Philosophy and Mission of the Developmental Disabilities Planning and Advisory Council The State of Montana Developmental Disabilities Planning and Advisory Council believes: that all persons have the potential to direct their own lives and are strengthened by the opportunity to do so; that all persons can make positive contributions to society and must have the opportunity to interact with the community to do so; that all persons can be productive members of the community in which they live, and may need initial assistance to achieve this status; that all persons should be provided with individualized assistance that will give them the skills and abilities to achieve these opportunities; in order to assist persons with developmental disabilities and their families in achieving these goals, the Council advocates for the expansion of and improvement of services and supports for persons with developmental disabilities and provides advice and input as to the manner in which these improvements can best be achieved. Application of the Federal Definition of Developmental Disabilities by the State of Montana The Developmental Disabilities Bill of Rights and Assistance Act, as amended in 1996 by Public Law 104-183, defines developmental disabilities as: The term "developmental disability" means a severe, chronic disability of a person 5 years of age or older which (A) is attributable to a mental or physical impairment or combination of mental and physical impairments; (B) is manifested before the person attains age twenty-two; (C) is likely to continue indefinitely; (D) results in functional limitations in three or more of the following areas of major life activity: (i) self-care, (ii) receptive and expressive language, (iii) learning, (iv) mobility, (v) self- direction, (vi) capacity for independent living, and (vii) economic self-sufficiency; and (E) reflects the person's need for a combination and sequence of special, interdisciplinary, or generic care, treatment, or other services which are of lifelong or extended duration and are individually planned and coordinated; except that such term, when applied to infants and young children means individuals from birth to age five, inclusive, who have substantial developmental delay or specific congenital or acquired conditions with a high probability of resulting in developmental disabilities if services are not provided. Montana's definition of developmental disabilities, according to Title 53 Chapter 20 Part 202 of the Montana Code Annotated, is: Developmental disabilities means disabilities attributable to mental retardation, cerebral palsy, epilepsy, autism, or any other neurological handicapping condition closely related to mental retardation and requiring treatment similar to that required by mentally retarded individuals if the disability originated before the person attained age 18, has continued or can be expected to continue indefinitely, and constitutes a substantial handicap of the person. The Montana definition, and corresponding statutes relating to the provision of services, was written as a part of the Montana Developmental Disabilities Services and Facilities Act of 1974, at a time when the federal and the majority of other state definitions were similar to the Montana law. In 1978, research into the causes and treatment of developmental disabilities resulted in a change in the federal law, removing the "categorical" requirement (e.g. mental retardation, autism*, cerebral palsy etc.) and replacing those diagnoses with more general statements regarding the presence of a mental and/or physical disability and extent and severity of the results of the disability. Since the time that the federal definition was rewritten, the difference between the two has usually been considered to be one of "category versus effect". That is, the Montana definition has been generally considered to rely on the presence of a diagnosed condition while the federal defines eligibility based upon the extent of the disability and its' impact on the person's life. This is not necessarily the case. An examination of the definitions shows that both require: 1. a mental or physical disability. (The Montana definition could conceivably allow eligibility for a person with a primary diagnosis of some form of physical disability if that resulted in a secondary disability similar to mental retardation and requiring treatment of a sort similar to that necessary for a person with mental retardation. A possible example would be some form of degenerative muscular disease that is accompanied by lessened cognitive functioning. This might be acceptable assuming the age of onset requirement was met. In any event, the number of persons eligible for services in this manner would be extremely small.) 2. that the disability be present before a specified age (the age limit is eighteen for the state definition and twenty-two for the federal), 3. that there be an indefinite continuation of the disability and 4. the disability have a substantial impact on the person. It is the Montana requirement that treatment similar to that needed by persons with mental retardation be necessary for a person to be eligible for services that constitutes the real difference in eligibility. Practically, this service level requirement has prevented many persons from receiving developmental disabilities services because the treatment that they need is not similar to that required for a person with mental retardation. The test for eligibility in Montana has become: 1. the presence of a diagnosis of mental retardation, or; 2. the presence of a diagnosis of cerebral palsy, autism or other neurological handicap that also requires treatment similar to that required for a person with mental retardation. As such, persons with a disability who do not meet the level of treatment requirement are not eligible for services. This would include persons with epilepsy, cerebral palsy, deafness, blindness, learning disabilities, mental illness with an identifiable organic cause and other disabilities, who are within normal limits intellectually or cognitively. A practical application of the federal definition, while requiring substantial functional limitations in three or more listed areas of the person's life, does not require as stringent a level of limitation for eligibility as the Montana requirement. With the exception of agencies operating under Public Law 104-183, the State of Montana does not follow the federal definition in determining eligibility for state operated or contracted developmental disabilities services. A significant issue in determining whether or not the State of Montana could or should make the switch to the federal definition of developmental disabilities is cost. While it is clear that the State has continually and significantly expanded the level of program expenditures (a 800% increase in funding for services in the state since 1977) (See Graph below)1, it is equally clear that the number of persons who are in need of and desire services under the current state definition continues to rise at an equally impressive rate. The number of persons waiting for services has risen from approximately 250 in 1978 to 1068 in February of 1997.2 The growth in this number is a function of several variables; the maturing of the system, of improved methods of identifying persons in need, of improved services that more closely reflect the life style