Community Outreach, Engagement, and Volunteerism

Community Outreach, Engagement, and Volunteerism Overview To address demographic shifts in the Texas population, DADS provides additional supports to state government, local communities, and individuals to address aging- and disability-related issues. DADS has a strategic priority to create opportunities that lead to increased selfsufficiency and independence for older Texans and those with disabilities. DADS programs and services address a number of related issues, including meeting the need for building community capacity, promoting wellness, and increasing access to caregiver support services. supports projects that promote wellness and healthy aging, including: demonstration projects that promote the adoption of evidence-based programs to improve health status and symptom management; technical assistance to local communities seeking to measure and improve their ability to serve a growing aging population; research and publications providing data and analysis of the needs of older Texans; and partnerships with public and private organizations to build community capacity to serve the aging population. Direct service workers provide an estimated 70 to 80 percent of the long-term services and supports to individuals who are aging or living with disabilities or other chronic conditions. The works to positively impact the challenges of recruitment and retention faced by providers and recipients of home and community-based services and by the workers themselves. The is designed to improve competitive, integrated employment (including self-employment) outcomes for persons with disabilities. The s primary purpose is to coordinate resources for individuals with autism spectrum disorder and their families by: disseminating information and research on autism and other pervasive developmental disorders; conducting training and development activities for some professionals; coordinating with local entities that provide services; and providing support to families affected by autism. Texas Lifespan Respite Program Respite services provide temporary relief to informal, unpaid caregivers (often relatives and friends of the individual) from their duties and may be provided in home or institutional 165 DADS

settings. For example, a respite program might offer in-home care for an aging individual to allow her spouse to go grocery shopping. The Texas Lifespan Respite Program was established to: update the inventory of respite services in Texas; disseminate training toolkits for caregivers and respite providers; maintain a website of respite-related resources and information; replicate innovative models of service to educate and support caregivers; and provide direct respite services, as funding is available, for caregivers who are unable to obtain those services through other avenues. Through, DADS develops partnerships with public, private, non-profit, and faith-based organizations to help create awareness of programs and services and to expand and enhance existing resources. One community engagement effort undertaken by is Texercise, a statewide health promotions program designed to educate and involve individuals and communities in physical activity and proper nutrition. 166 DADS

A. Provide the following information at the beginning of each program description. Name of Program or Function Community Outreach, Engagement and Volunteerism Location/Division 701 W. 51 st Street, Austin, TX 78751/ Access & Intake Division; Center for Policy and Innovation; Center for Consumer and External Affairs Contact Name Actual Expenditures, FY 2012 Number of Actual FTEs as of June 1, 2013 Statutory Citation for Program Elisa Garza, Assistant Commissioner for Access & Intake Lynn Blackmore, Director of the Center for Policy and Innovation Allison Lowery, Director of the Center for Consumer and External Affairs Actual expenditures for these programs are captured under Access, Intake and Eligibility Services and Operational Support. FTEs are allocated among the above divisions. B. What is the objective of this program or function? Describe the major activities performed under this program. The purpose of the Initiative is to encourage Texans to prepare for aging and to facilitate state and local preparedness for the rapidly growing older population. Major strengths include: the Advisory Committee, which advises and provides feedback to DADS on the development of the Plan, aging policy issues, state government readiness, and community preparedness; the Plan, which documents initiatives carried out by DADS and its partners; the Indicators Survey, which gathers data about the conditions and needs of Texans age 60 and older living in the community by asking participants questions on topics such as life satisfaction, health, finances, legal preparedness for end of life needs, and the communities in which they live; issue briefs, which build on indicator survey results and explore topics such as nutrition, physical activity and obesity, mental health and substance abuse, physical health, financial preparedness, and social engagement and recreation; Evidence-based Clearinghouse, which promotes the adoption of 167 DADS

evidence-based programs to improve health status and symptom management, caregiving, and many other life areas; and Community Assessment Toolkit, which provides evaluation tools to cities and counties seeking to improve their ability to serve a growing aging population. The objective of the is to positively impact the challenges of recruitment and retention faced by providers and recipients of home and community-based services and by the workers themselves. Staff are preparing a report and overseeing contracts to develop a matching system and an on-line training system. The objectives of the are: removing disincentives to employment; providing outreach, training, and resources; seeking input from providers and stakeholders through the Promoting Independence Advisory Committee, Subcommittee on Employment for People with Disabilities; participating in the State Employment Leadership Network through which technical assistance and collaborative opportunities are available through other states; coordinating activities with the Department of Assistive and Rehabilitative Services (DARS); collecting and reporting employment data; and positioning the state to improve options for integrated competitive employment for persons with disabilities as required under the Americans with Disabilities Act and related court rulings. The provides research and resources on autism spectrum disorder. The Consortium, a collaborative of state agencies, education service centers, university-based autism programs, and non-profit organizations, was formed to implement and advise the Center. arises from a 2009 federal grant from the Administration on Aging to create an inventory of respite services and best practice tools, hold forums for providers, and coordinate outreach and awareness activities aimed at caregivers. This initiative focuses on caregivers caring for individuals, regardless of age, disability, or healthcare condition, and specifically focuses on help for caregivers who cannot get respite care through any other program. The program includes respite services available through traditional providers, the use of vouchers for families to obtain their own respite care, the use of trained volunteer caregivers, and some emergency respite care. 168 DADS

Volunteerism and community engagement opportunities provide individuals, communities, and businesses with options for engaging in activities and programs that enrich and improve the quality of life for older Texans and people with intellectual or developmental disabilities (IDD). Through health and wellness programs, volunteer opportunities and collaborative partnerships, : promotes the development of local health and wellness programs to enhance the lives of individuals and communities through DADS internationally recognized Texercise program; supports volunteerism across all agency programs promotes and supports the service of volunteers and contributions from public/private partnerships; oversees the recruitment, placement, and policies that govern the agency s internship opportunities; serves as the agency s primary point of contact for education, awareness, information, and referral for volunteer and community engagement efforts benefiting DADS consumers at state and local levels; identifies, evaluates, and develops appropriate partnership opportunities that enhance awareness and service delivery and generate resources; develops tools, resources, and materials to promote and enhance volunteerism and partnership opportunities; and recognizes DADS volunteers and partners through the annual statewide DADS Vision Ceremony. C. What evidence can you provide that shows the effectiveness and efficiency of this program or function? Provide a summary of key statistics and performance measures that best convey the effectiveness and efficiency of this function or program. The Administration on Aging awarded DADS two cycles of Texas Healthy Lifestyle grants (2006 2009 and 2010 2012) to develop and make available evidence-based programs to 240 Texas counties. In May 2013, 226 users visited the website, with the majority accessing the Evidence-Based Clearinghouse and the Resources and Reports sections. The Direct Service Workforce initiative: produced two realistic job previews, which DADS loaded on its website and other organizations widely use; requested and received Legislative Budget Board (LBB) and Governor s Office authority to conduct a report on the survey and evaluation of direct support workers (2013 2014); 169 DADS

requested and received LBB and Governor s Office authority to contract to develop an employee/employer matching system (2014 2015); and requested and received LBB and Governor s Office authority to contract to develop an on-line training system (2014 2015). In FY 2011, 5 percent of clients with IDD received employment services. In FY 2011, 1 percent of DADS clients received DARS vocational rehabilitation services. In 2009/2010, sampled programs had a 9 percent average employment rate among adult clients. The center s website received over 10,000 website visits in May 2013. Autism researchers have submitted over 100 requests, questions, study proposals, or calendar suggestions to the center since January 2013. The center delivered training to 301 first responders and 166 community members at five sites around the state on autism recognition and response. The center hosted the Texas Autism Research Conference, an annual two-day event that was attended by 170 researchers, other professionals, and family members in 2012. created the Take Time Texas website in response to an HHSC survey. The survey found that half of respondents didn t know about types of respite care available in their area and two-thirds didn t know how to find a licensed, reputable respite care provider. Between October 1, 2012 and March 31, 2013, three local community partners provided respite services to 143 caregivers who were caring for individuals under 60 years of age. These individuals would not have had access to respite services without the Texas Lifespan Respite Care program, as the age of the care recipient would have been an issue for most existing programs. For FY 2012, DADS State Supported Living Centers had approximately 2,460 volunteers and interns who gave more than 87,000 hours of service. According to the Independent Sector, the dollar value of the hours of service is $1.88 million. Volunteer and Community Engagement recruits volunteers but does not track volunteer numbers or activities in other facility types. Since its inception, Texercise has distributed over 150,000 copies of the Texercise handbook and provided over 28,000 T-shirts to communities and local programs to help them recognize and motivate their participants. developed the Texercise 12-week program, coordinators kit, and the Texercise Champions program. 170 DADS

D. Describe any important history regarding this program not included in the general agency history section, including how the services or functions have changed from the original intent. In August 2009, then-hhsc Executive Commissioner Tom Suehs directed HHSC and DADS to establish a Workforce Advisory Council and specified that DADS provide staff support to the Council with assistance from HHSC. After the completion of the Council s work, at their request, a vehicle was created to continue their interest and advocacy for their issues through the direct service workforce subcommittee of the Promoting Independence Advisory Committee. Because direct service workers are critical to community-based services, federal monies from the Money Follows the Person Initiative funded parts of the initiative s activities. In 2006, DADS joined the national State Employment Leadership Network. Partly because of the network s IDD focus, DADS initiative originally included only IDD programs; however, DADS expanded the initiative to include all DADS programs serving persons with disabilities. Senate Bill 1226, 83 rd, Legislature, Regular Session, 2013, established a statewide employmentfirst policy and task force to promote competitive employment opportunities that provide a living wage for individuals with disabilities. E. Describe who or what this program or function affects. List any qualifications or eligibility requirements for persons or entities affected. Provide a statistical breakdown of persons or entities affected. impacts the population of Texans over the age of 65, which is projected to increase from 2.8 million in 2013 to 7.5 million in 2040. The Texas Workforce Commission estimates that there are currently 278,450 direct service workers in Texas. These workers are impacted by the Direct Service Workforce Initiative. The affects all of DADS programs. Services and resources provided through focus on individuals, families, and professionals affected by Autism Spectrum Disorder. In 2012, HHSC estimated that 299,900 Texans had Autism Spectrum Disorder. affects caregivers caring for individuals of any age, any disability, or chronic healthcare condition. The program also targets caregivers who cannot access respite care through any other program, due to the programs specific, limiting criteria or due to other gaps in the service system. opportunities are available to all Texans. staff work with State Supported Living Center 171 DADS

staff to ensure that organizations conduct required volunteer background checks, administer trainings, and track donations to the state appropriately. F. Describe how your program or function is administered. Include flowcharts, timelines, or other illustrations as necessary to describe agency policies and procedures. Indicate how field/regional services are used, if applicable. Federal and state priorities, objectives, and mandates support the Initiative. The DADS Center for has primary responsibility for the administration, policy development, and planning functions. The Advisory Committee advises, informs, and works to involve the statewide community in setting and achieving the goals of the Initiative. staff collaborate with other DADS and Department of State Health Services programs and staff who serve older Texans. The is staffed by contractors, with oversight from the DADS Center for Policy and Innovation. The Centers for Medicare & Medicaid Services provide funding through the Money Follows the Person Demonstration. The is administered by the DADS Center for Policy and Innovation. Staff coordinate and work in collaboration with staff in other areas of DADS to amend rules and waivers and to provide policy clarifications, as needed. Staff also work with rate staff at HHSC to establish rates for newly adopted services and with staff from other state agencies to coordinate services, policies, and training. An interagency agreement between DADS and HHSC outlines the responsibilities with respect to developing the collaborative, website, and the. The DADS Center for Policy and Innovation administers the Texas Autism Research and Resource Center in collaboration with HHSC. A collaborative of state agencies, university-based autism programs, non-profits, and others involved in service provision participates in and advises DADS and HHSC on the development of the center. The DADS Center for Policy and Innovation is responsible for developing policies and procedures. The Special Projects Unit within DADS Access & Intake Division administers the Texas Lifespan Respite Care Program, with a grant coordinator responsible for the oversight of the program. The DADS Center for Consumer and External Affairs administers Volunteer and Community Engagement activities. The program s policies and procedures can be found at 172 DADS

http://dadsview.dads.state.tx.us/handbooks/vcepph. DADS staff share information with regional and field offices about recruiting and retaining volunteers, and policies and procedures, including the community services and supports area and State Supported Living Centers. DADS staff hold monthly conference calls with all local volunteer managers at the State Supported Living Centers. A toll-free telephone number, 1-800-889-8595, is available for the public to contact. G. Identify all funding sources and amounts for the program or function, including federal grants and pass-through monies. Describe any funding formulas or funding conventions. For state funding sources, please specify (e.g., general revenue, appropriations rider, budget strategy, fees/dues).,,, and The funding sources for these programs include General Revenue, federal funds, and other funds. DADS has no funds designated for this initiative. The agency funds activities through the DADS Center for Policy and Innovation s operating budget, which includes General Revenue, federal funds, and other funds. The Money Follows the Person demonstration funds the. HHSC, the Texas Council on Autism and Pervasive Developmental Disorders, and DADS each provide the with funds annually through an interagency agreement. Program General Revenue Federal Total Texas Autism Research and Resource Center $151,126 $151,126 $376,906 $376,906 $151,785 $227,678 $379,463 173 DADS

H. Identify any programs, internal or external to your agency, that provide identical or similar services or functions to the target population. Describe the similarities and differences. Although the Mental Health Transformation initiative within DSHS has a Behavioral Health evidence-based clearinghouse, it has a different target population and encompasses different areas of research. The Age Well Live Well program and Texercise within DADS Volunteer and Community Engagement section complement the focus areas of promotion of older adult physical health and community engagement. However, serves as a broad umbrella initiative, influencing DADS and state policy. At the state level, this initiative and the related Promoting Independence Advisory Committee subcommittee serve as an umbrella for information regarding the direct service workforce, eliminating most duplication. At the national level, federal funds, often from the Centers for Medicare & Medicaid Services (CMS), help support the efforts of other states and national groups. CMS houses the National Direct Service Workforce Resource Center, which provides information and resources about the direct service workforce. Both DADS and DARS offer employment services. The Vocational Rehabilitation program at DARS helps people who have physical or mental disabilities prepare for, find, or keep employment. DARS services generally are considered short-term. For individuals who are not eligible for DARS services, DADS programs offer a similar service to help the individual prepare for and find employment. However, unlike DARS, DADS programs also offer ongoing and longterm support to help an individual maintain employment. Within DADS, individuals in several programs have the option to receive day activity services instead of being employed and receiving employment services Many state and local units of government provide specific services to individuals and families with Autism Spectrum Disorder. The does not provide these direct services, but rather coordinates resources, research, and information sharing. Some of these entities include DARS, the Texas Education Agency, local school districts, and local authorities. In Texas, respite services are available through three primary channels: DADS services and programs funded under the Older Americans Act, Medicaid, non- Medicaid, and other state-funded programs; other health and human services agencies programs and services; and 174 DADS

disease-, disability-, or age-specific advocacy groups and community-based organizations. The program differs from other respite care resources in that it is targeted to persons who cannot obtain respite services through any other program. I. Discuss how the program or function is coordinating its activities to avoid duplication or conflict with the other programs listed in Question H and with the agency s customers. If applicable, briefly discuss any memorandums of understanding (MOUs), interagency agreements, or interagency contracts. The Advisory Committee includes members from a wide range of public and private entities and, through the communication of this statewide committee, coordinates all proposals and deliverables with other divisions in DADS and in the larger aging network. DADS and DARS have established under what circumstances each agency will fund employment services and have clarified roles and responsibilities to better coordinate services. The agencies have also engaged in various activities intended to improve service coordination and employment outcomes. DADS has formed a collaborative of state agencies, university-based autism programs, nonprofits, and others involved in providing services to individuals with Autism Spectrum Disorder and their families to participate in and advise DADS on the development of the Texas Autism Research and Resource Center. An interagency agreement between DADS and HHSC outlines the responsibilities of DADS with respect to developing the collaborative, website, and center. The program is not limited to certain population groups, diseases, or disabilities. Further, this program is available to caregivers who cannot access respite care through any other program. DADS requires staff working in this program to be familiar with respite resources available through other programs and agencies, and to make referrals to these entities, as appropriate. and 175 DADS

J. If the program or function works with local, regional, or federal units of government, include a brief description of these entities and their relationship to the agency. The Community Assessment Toolkit provides support to counties, cities, and other governmental and non-governmental organizations in their efforts to plan for an aging population. also coordinates with the Texas Statewide Health Coordinating Council and the Texas Higher Education Coordinating Board to monitor recruitment and retention of healthcare providers trained in geriatrics. works closely with DSHS on the Texas Behavioral Health and Aging Collaborative. The Promoting Independence office maintains a close relationship with and reports regularly to the project funding source, the Centers for Medicare & Medicaid Services. The initiative does not work with local or regional units of government. As part of assisting individuals find and maintain employment, DADS case managers/service coordinators and providers work with community partners, including DARS, the Texas Workforce Commission, local school districts, and the Social Security Administration. DADS contracts with the Texas Association of Regional Councils (TARC) to serve as the state Texas Respite Coordination Center. TARC is a statewide nonprofit association that assists and provides resources to 24 local regional councils of government (quasi-governmental agencies). Additionally, DADS contracts with two Aging and Disability Resource Centers and the Area Agency on Aging of the Capital Area to expand the availability of respite services at the local level. Through health and wellness programs, volunteer opportunities, and collaborative partnerships, the program works with local Area Agencies on Aging, parks and recreation departments, local Mayor s Fitness Councils, and other community organizations to develop community projects that support DADS vision. These projects include opportunities for older adults to engage in physical activity or to volunteer and share information about DADS programs and services. 176 DADS

K. If contracted expenditures are made through this program please provide: a short summary of the general purpose of those contracts overall; the amount of those expenditures in fiscal year 2012; the number of contracts accounting for those expenditures; top five contracts by dollar amount, including contractor and purpose; the methods used to ensure accountability for funding and performance; and a short description of any current contracting problems., DADS maintains a $35,000/year membership in the State Employment Leadership Network. DADS also received approximately $1,000,000 in funding for a Money Follows the Person employment pilot, which funds a contracted employee at DADS, a part-time employee at DARS, and grants to providers of IDD services to improve employment outcomes of individuals served. There are no known contracting problems. The center uses contracts for specialized autism recognition and response training to first responder organizations and community members, conference planning, conference hosting, and to develop a resource guide for communities wanting to assess and improve local autism services. There are no known contracting problems. The program has four contracts. The contracting facilitates statewide project coordination implementation and evaluation. Accountability methods include desktop and onsite monitoring, budget workbook submissions, and federal program and financial reports. There are no known contracting problems. has issued one contract with Texas A&M Health Sciences Center School of Rural Public Health to evaluate the Texercise program. The goal of the evaluation is to achieve evidence-based status by the Administration on Aging Title IIID. For FY 2012, the contract is not to exceed $200,000. Biweekly telephone conference calls and preagreed upon performance deliverables and measures ensure accountability. DADS knows of no current contracting problems. L. Provide information on any grants awarded by the program. In 2013, the DADS Access & Intake division awarded three $50,000 grants to conduct the Aging 177 DADS

Texas Well Community Assessment Toolkit project. The initiative monitors and provides technical assistance to the awardees. and The center and the Texas Council on Autism awarded a $40,000 grant to the UT-Dallas Pathways Efficacy Study to examine the efficacy of Pathways Early Autism Intervention (Pathways), a developmental behavioral, parent-mediated, research-guided intervention on toddlers with autism spectrum disorder. Dependent upon the availability of funding from either federal grants or state General Revenue, DADS may issue grants in the form of competitive procurements for the Texas Lifespan Respite Care program. HHSC Enterprise Contract and Procurement Services administers the competitive procurement process, in collaboration with the DADS program area, Legal Services, and Chief Operating Officer Contracts Oversight and Support. is collaborating with Access & Intake to award five Area Agencies on Aging with Age Well Live Well grants. The grants are for developing community collaborations focused on health and wellness, volunteerism, and sharing information resources. The grants total $125,000 over a two-year period. The Access & Intake division administers these funds. M. What statutory changes could be made to assist this program in performing its functions? Explain. N. Provide any additional information needed to gain a preliminary understanding of the program or function. Demand for direct support workers in the U.S. is increasing rapidly due to a number of factors: growing U.S. population; aging of the baby boom generation; aging of family caregivers; and increasing national commitment to and steady expansion of community and in-home services for individuals needing long-term services and supports. 178 DADS

O. Regulatory programs relate to the licensing, registration, certification, or permitting of a person, business, or other entity. For each regulatory program, if applicable, describe: why the regulation is needed; the scope of, and procedures for, inspections or audits of regulated entities; follow-up activities conducted when non-compliance is identified; sanctions available to the agency to ensure compliance; and procedures for handling consumer/public complaints against regulated entities. P. For each regulatory program, if applicable, provide the following complaint information. The chart headings may be changed if needed to better reflect your agency s practices. 179 DADS