Minutes for May 13/14, 2004

Meeting Location: Best Western Hotel, Marshall, MN

Present: Lois Johnson, Karen Larson, Sharon Johnson, Mary Pennington, Ann Zick, Bryan Jensen, Linda Lingen, Phyllis Coppess, Mark Eggen, Bradley Westerlund, William Bauer.

Absent: David Hancox (excused), Roseann Faber (excused).

Guests:  Steve Thovson, Mark Mertens, Dr. C. Paul Martin, Carol Flesner, Geanette Aguire, Bonnie Kotval, Don Robertson.

May 13, 2004 Training Session.

Call to order: The May 13, 2004 out state training meeting of the Statewide Independent Living Council (SILC) was called to order at 9:00 a.m. Introductions of SILC members and guests followed.

Approval of May 13-14 Agenda:  Sharon Johnson requested time during the May 14 business meeting to distribute and discuss the acronym list. The agenda was approved as revised.

Disability Oppression and Racism:  Don Robertson, Director of the Cultural Diversity Office of Southwestern State University, opened his remarks with the question, "What do you do when you are confronted with a racist comment?" It is a personal decision, but there is a connection between the social ills of homophobia, racism and disability oppression. Mr. Robertson used the "bird cage" analogy for his definition of oppression; i.e., there is more free space than wire, but the wire is strategically placed to keep the bird in the cage.

Mr. Robertson discussed immigrants, and his belief that it takes three generations for immigrant families to become fully integrated into social networks. Bilingualism is generally lost in three generations.

Questions and answers pertaining to disability culture followed.

Rural VR Service-delivery Issues: Mark Mertens, IL-VR counselor from the Willmar WFC, provided a brief biography, and discussed the invaluable role Centers play in the VR process. The primary issue in both IL and VR service-delivery is money, but IL services are crucial to his BR consumers -- if one cannot live independently, chances are one's VR services are not going to be successful. Rural IL and VR service-providers frequently have to be more creative than their urban colleagues.

Questions and answers followed. William Bauer advised Mr. Mertens to contact him whenever he, Mr. Mertens, found himself running short on, or out of, funding for SILS.

Physician as Advocate -- Beware and Prepare: Dr. C. Paul Martin, a recently retired physician from Marshall, opened his training by sharing his experiences as a rural medical doctor. In brief, there is too much need and not enough resources. What does the medical profession think about the needs of people with disabilities? He answered that question by stating that many physicians are frightened by people with disabilities. Doctors are educated in disease, and not in human and social services. He encouraged people with disabilities to be proactive in their dealings with their physicians and to be armed with knowledge of potential resources when a physician's authorization is required. Dr. Martin discussed "vertical integration," or what many physicians view as the role of a patient, which includes preparation for care, and anticipation of future problems (see handout). He then provided his list of the top ten health mistakes; e.g., not having a single primary care physician, failing to participate in preventive care, failing to have a plan for managing medications, not seeking medical help after early warning symptoms, reluctance to discuss problems with doctors, not understanding what a doctor tells you, disregarding the seriousness of minor illnesses and, most important, not asking loved ones or the government for assistance (see handout). Dr. Martin asks service-providers to encourage their consumers to work with their primary care physicians, to use one pharmacy, to use their social care advisors, to be aware of their benefits and the benefits' requirements, and to keep their needs and expectations reasonable.

Questions and answers followed.

Rural Transportation Services:  Geanette Aguire, transit director with Western Community Action, and Carol Flesner, SWCIL community relations coordinator, addressed transportation services and employment in Southwestern Minnesota. In 2002, SWCIL, in partnership with VR and Western Community Action, received a grant to provide employment-related transportation services for people with disabilities. Titled "Travelers Check," the program currently has thirty-two consumers and a waiting list. A "buy-in" was initiated; i.e., if a consumer requires 300 miles per month, the grant pays for 250. The per mile cost for the consumer is thirty-five cents. It was also found that people who own cars don't always have the money to keep those vehicles running; thus, the program can reimburse twenty cents a mile under such circumstances. Consumers awarded the miles under this program can use them as they see fit; however, the grantor (APRIL) ended that approach because the grant funds must be linked to a consumer's employment. The program has brought many new consumers to SWCIL. A search is now in place for funds to sustain the Travelers Check program.

Geanette Aguire discussed the positive working relationship between her program (Western Community Action) and SWCIL. WCA provides services in five southwestern Minnesota counties and has fourteen lift-equipped busses. WCA utilizes both paid and volunteer drivers. WCA serves seven to ten consumers per hour.

Questions and answers followed.

Rural IL Service-delivery: Steve Thovson, SWCIL executive director, discussed some of the challenges his Center faces in the provision of IL core-services. SWCIL has a nine county service-area with a total population of approximately 121,000; or about twenty-two people per square mile. Forty point eight percent of this population resides in "cities," and over twelve percent of the population in these nine counties reside in rural areas.

Mr. Thovson said the challenge is how far do you travel to deliver IL services. SWCIL staff traveled over 68,000 miles, and spent 1240 hours of travel time in 2003. At a cost to the Center of about fifteen dollars per hour, and with funding cuts, mileage parameters had to be established. The budget cuts of 2003 are "coming home to roost" in 2004 according to Steve Thovson, and the service-delivery verses travel costs challenge does not go away. "Do I travel to Round Lake to serve two students?" The Centers' base-funding took a quantum leap backwards in 2003. There is now the possibility of the addition of a fifth core-service. Less than five point seven percent of the state's nursing home beds are in SWCIL's service-area. The prevention of institutionalization, therefore, is the greater concern for SWCIL according to Steve Thovson. The greatest challenges to SWCIL are employment, transportation and recreation.

Questions and answers followed.

Visitor Comments:  Bonnie Kotval, a member of SWCIL's governing board, commented that insufficient funding is the Center's primary issue. SWCIL is not able to fully serve all counties in the Center's service-area. SWCIL's board is reviewing the Center's annual and three-year plans to focus on those matters and issues that are essential. Service-delivery and mileage parameters have dropped thirty percent, and the question has become whom does the Center serve and whom does it not serve.

May 14, 2004 Business Meeting.

Call to order, Introductions: The May 14 business meeting was called to order at 9:30 a.m. by Lois Johnson. Introductions followed to record attendance, and all members present during the May 13 training were in attendance on the fourteenth.

Approval of April Minutes and May 14 Agenda:  Sharon Johnson moved, Mark Eggen seconded, that the April 8-9, 2004 minutes be approved as written. There was no discussion and the motion carried. Karen Larson requested time to provide a brief review of a recent home and community-based services audit following Sharon Johnson's discussion of the acronym list. There were no further requests for revisions, and the revised May 14 agenda was approved by consensus.

Linda Lingen commented on last month's question as to whether the SRC minutes are posted on DEED's external web, which are currently posted on RSB's internal web. She stated that the SRCB's minutes are posted on the external web. SILC members were reminded that the SILC's minutes are posted on the SILC web-site.

Lois Johnson read a thank you letter from Steve Thovson to the SILC for conducting the annual training meeting in Marshall . Steve Thovson also submitted a list of comments on the 2005-2007 SPIL. These comments will be filed with all other comments concerning the new SPIL.

Acronyms and Definitions List: Sharon Johnson distributed the latest edition of the list and stated that the list will require continual updates. She will e-mail the current edition to William Bauer for filing and formatting.

Home and Community-based Waivers Audit:  Karen Larson provided a brief review concerning four points in this recent audit. She discussed amounts, percentages and her concerns/issues with these four points.

CIL Update: Due to David Hancox's absence, Lois Johnson read a written report submitted by Mr. Hancox as follows:

There are four items to report.

MCIL and SEMCIL have recently been awarded contracts from the MN Department of Human Services to provide Disability Linkage Line (DLL) services to greater Minnesota. MCIL will cover the entire northern half of the state, with SEMCIL covering the southern half. DLL services are electronic disability related IR and A services provided to consumers, vendors, and interested others using an extensive data base provided by the MN Department of Human Services. The initial contract is for approximately 18 months, with annual renewal required. Prior to this contract, MCIL and SEMCIL had been under contract to provide DLL services to their respective multi-county service areas.

MACIL will be holding a “mini” retreat in July to address issues raised during this legislative season, and specifically addressing questions from legislators around the nursing home relocation efforts and their associated cost savings to the state. More on this subject later.

MACIL is beginning the next phase of the CMS contract with the initiation of a survey of 5 counties to determine the need for accessible and affordable housing. The initial field study was conducted in one rural county and the findings were used to refine the survey instrument. This second field study will involve 5 counties with a mix of rural, suburban and urban counties. Results will be reported when complete.

As reported last month, the MOU has successfully worked its way through the legislative process, and as of this writing is awaiting signature in the governor’s office.

State Rehabilitation Council Update:  Lois Johnson reported that the SRC will be submitting a letter requesting her to continue to serve on the SRC as the SILC's representative. She is a voting member on the SRC.

The SRC is reviewing its fundamentals book to find items that should be shared with the public.

The SRC discussed the MOU between VR and the eight Centers.

Governor's Council on Developmental Disabilities Update: Ann Zick reported that The DD Council staff and members attended the ARRM (Association of Residential Resources in MN) conference and disseminated publications on May 12-13, 2004. Last year over 2,000 publications were distributed.

The third e-learning course is being designed and will be ready for release in the fall. The third module will cover quality, and inclusive education options for students with disabilities. The first two modules are entitled "Making Your Case," which is a 3 hour course on how to communicate with public officials and a 6 hour course teaching people with disabilities and family members about finding employment and creating careers.

Sixteen people with developmental disabilities began work at DHS headquarters scanning historical documents. The Council has handled all the arrangements in brokering the contract. Another two individuals with developmental disabilities have been hired as regular employees in the Rochester area doing this type of digital imaging work. The "How to" manual on digital imaging work is on the Council web-site.

State Rehabilitation Council for the Blind Update: Due to Roseann Fabers absence, there was no report.

Committee Reports:  Ann Zick, Advocacy and Education Committee, reported that the planned Region Ten Quality Assurance training for next month is cancelled due to the speaker's inability to participate on the date of the June meeting. Karen Larson and William Bauer will attempt to reschedule the training for the September meeting. It was suggested that the SILC conduct a "brainstorming" session to prepare training topics for the upcoming year.

SPIL 2005-2007 Final Review: William Bauer reviewed Attachments three and four with SILC members. There were no revisions.

SILC members were reminded that the SPIL's public hearing is scheduled for June 3, 2004 from 1:00 p.m. to 3:00 p.m. at DEED, 390 N. Robert Street, St. Paul, in the lower level conference room. ASL interpreters have been scheduled, as well as a court reporter to provide a transcript of the hearing. Notices for the hearing were published in May in the Star Tribune, Pioneer Press, and the State Register. Print and e-copies of the notice were sent to the eight Centers in early May, and Center directors were asked to post the notice and/or provide copies to consumers. Bauer will be sending print copies of the public hearing notice to everyone on the SILC's mailing list on May 17, and will also e-mail the notice and the 2005-2007 SPIL to appropriate individuals and service-providers listed in his various address books on that date. The notice advises consumers/service-providers/other interested individuals to contact Bauer should they wish an advance copy of the proposed SPIL. For those unable to attend the June third public hearing, they may telephone, e-mail or submit written comments to William Bauer up to the day of the hearing. Print, audio tape, braille and disc copies of the 2005-2007 SPIL are now available, and will also be on hand at the hearing site.

All SILC members are encouraged to attend the public hearing. Lois Johnson will be unable to attend; thus, Karen Larson will be present to assist William Bauer in chairing the hearing.

Sharon Johnson moved, Mark Eggen seconded, that SPIL 2005-2007 attachments one through four be approved as written. There was no discussion and the motion carried. Karen Larson then moved, Sharon Johnson seconded, that the entire 2005-2007 SPIL (forms and attachments one through four) be approved as written. There was no discussion and the motion carried unanimously.

Issues, Announcements, Correspondence: Ann Zick reminded council members of the necessity to adhere rigidly to the speaker schedule during the out state training meetings. Discussion followed. Phyllis Coppess praised the excellence of all the May 13 speakers.

Ann Zick requested that revisions to future state plans be highlighted. A rather heated discussion ensued concerning full disclosure and SILC members' responsibility to fully and entirely review the various drafts of new state plans.

Next Meeting, Adjournment:  The next SILC meeting will be held on June 10, 2004 from 9:00 a.m. to 3:00 p.m. at the Four Points Midway Sheraton, St. Paul . The May 14 SILC business meeting adjourned at 11:45 a.m.