The governor's council on developmental disabilities : 5 year strategic plan, 2006-2011 : creating real lives for people with developmental disabilities in Georgia

The Governor's Council on Developmental Disabilities 5 Year Strategic Plan 2006 2011
Creating Real Lives for People with Developmental Disabilities in Georgia
August 2006

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The term developmental disabilities means a severe,

This five-year plan builds on the

chronic disability of an individual five years of age or

Governor's Council on

older that -(A) is attributable to a mental or physical
impairment or combination of mental and physical impairments; (B) is manifested before the individual attains age 22; (C) is likely to continue indefinitely; (D) results in substantial functional limitations in three

Developmental Disabilities (GCDD or Council) previous achievements and is a compass for the GCDD and the community to use to determine if the Council's efforts result in "increased independence, productivity,

or more of the following areas of major life

inclusion and integration, and

activity: (i) self-care; (ii) receptive and

self-determination for people

expressive language; (iii) learning; (iv) mobility; (v) self-direction; (vi) capacity for independent living; and (vii) economic self-sufficiency; and (E) reflects the individual's need for a combination and sequence of special, interdisciplinary, or generic services, supports, or other assistance that is of lifelong or extended duration and are individually planned and coordinated; except

with developmental disabilities and their families." It should be used as an opportunity to strengthen the GCDD's role as a leader in the advocacy community and to offer its services to policymakers and the media

that such term when applied to infants and

interested in creating change for

young children, means individuals from birth to

people with developmental

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."

disabilities and their families. As it responds to a changing environment, the GCDD must continue to improve how it operates and supports its role as

advocate; systems change agent and investor of public dollars. By adopting this plan, the

Council and Georgia have embarked on a journey that will result in increased opportunities for

all of Georgia's citizens.

The Council
Statutory Authority The Georgia Governor's Council on Developmental Disabilities was first established in 1971 by Executive Order under the authority granted to the Governor of Georgia by the Developmental Disabilities Assistance and Bill of Rights Act. On June 5, 1996, the GCDD was designated its own administering agency and attached to the Department of Human Resources for administrative purposes only. The scope and authority of the Council's activities derives from Section 8, Title 30 of the Official Code of Georgia Annotated (O.C.G.A. S 30-8-1).
Vision, Mission, and Values The Mission of the GCDD is "to collaborate with Georgia citizens, public and private advocacy organizations, and policy makers to positively influence public policies that enhance the quality of life for people with disabilities and their families. The GCDD promotes collaboration through information and advocacy activities, program implementation and funding, and public policy analysis and research."
The vision for Georgia of the Governor's Council on Developmental Disabilities is a "State in which all persons are included in all facets of community life and have choices while exercising control over their lives."
To realize our mission and vision, the Council follows nine guiding values:
1. We value people with developmental disabilities with their own gifts and talents, and as independent contributors to a collaborative community.
2. We value available, accessible, flexible, and responsive services, which enhance people's participation in the community.
3. We value a diverse Council with informed, motivated and active members who disseminate accurate information.
4. We value a knowledgeable, diverse, and well-supported staff, which shares open and honest communication with Council members.
5. We value educated and supported families who make significant contributions to caring for and assisting people with developmental disabilities in preparing for their futures.
6. We value public policy founded on sound research, accurate information, and best practices in alignment with the principles of the Developmental Disabilities Act.
7. We value public advocacy that is founded on the development of relationships with stakeholders and the legislative community.
8. We value communities, which are designed to be inclusive, allowing for full participation by all people, physically, economically, organizationally, and environmentally.
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9. We value communities that educate, respect, promote, and protect the rights of people, thus offering a wealth of opportunities, and which have the capacity to find solutions.
Role of the Council The Developmental Disabilities Bill of Rights and Assistance Act of 2000 defines the role of Councils as to (1) engage in advocacy, capacity building, and systemic change activities; and (2) contribute to a coordinated, consumer- and family-centered, consumer- and family-directed, comprehensive system of community services, individualized supports, and other forms of assistance that enable individuals with developmental disabilities to exercise self-determination, be independent, be productive, and be integrated and included in all facets of community life1
In Georgia, the GCDD is working to eliminate the barriers that prevent people with developmental disabilities and their families from being included in their communities. Individuals with developmental disabilities and their families want to be contributing members of their community. To be fully participating members of their community, individuals need access to opportunities for (1) a safe, affordable and often accessible home; (2) productive and meaningful careers; (3) an education that reflects the goals and standards of all children; (4) influence over the decisions being made about their lives; and (5) quality supports that allow individuals to participate in the community. The GCDD's role is to use its human and financial resources to create the change necessary for people to have access to these five areas. (See Figure 1)
The GCDD believes it can have the greatest impact on creating systemic change by: (1) working with local, state, and federal policymakers to develop and implement public policies and practices; (2) funding and supporting projects that demonstrate "best practices" and which can be used to support systemic change within the generic systems of services as opposed to the "disability" systems, and, (3) working in partnership with individuals, families and advocates to provide educational opportunities, information, and support local and statewide grassroots advocacy efforts. By utilizing these core functions, the GCDD is able to direct its resources toward specific activities. Over the last five years, the Council has worked to create change in Georgia and strengthen its role in the State by working (1) in coalitions with persons with developmental disabilities, family members and others who care about people with disabilities; (2) with elected officials and other policymakers to create and change policies that impact the lives of persons with developmental disabilities and their families; (3) to educate members of the media about the importance of telling the story of both the successes of individuals with developmental disabilities and the barriers that exist for many to live meaningful lives; and (4) in communities to increase opportunities for individuals with developmental disabilities to be welcomed and contributing members. In addition, the GCDD has funded and supported projects that demonstrate "best practices" and support systemic change within the generic systems of services as opposed to the "disability" systems. For instance, change to support children with disabilities in schools needs to occur within the regular education program rather than within the special education program.
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Figure 1
Real Careers

Real Influence

Real support

Belonging To community

Council Acting to Change Community

Contributing to community

Real Learning

Real Homes

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Council Membership Council members serve as the link between people with developmental disabilities, their families and the organization. The 21 members of the Council are appointed by the Governor in accordance with the formula provided by P.L. 106-492, the Developmental Disabilities Assistance and Bill of Rights Act Amendments of 2000. The Act allows members to serve terms up to four years and be reappointed. Members are representative of the State and its geographic, ethnic, and disability diversity.
In compliance with federal legislation, at least 60% of the Council membership consists of people with developmental disabilities, their parents, or guardians. Of the 60%, one-third must be individuals with developmental disabilities. One-third must be parents of children with developmental disabilities and immediate relatives or guardians of adults with mentally impairing disabilities.

Representatives of State agencies that provide services to people with developmental disabilities and other state agencies that provide generic supports help to provide broad representation to the Council. The GCDD has representation from five state level departments and one Department of Human Resource division, the Institute on Human Development and Disability at the University of Georgia (University Center for Excellence in Developmental Disability Research, Education and Service), and the Georgia Advocacy Office (Protection and Advocacy Agency). Each State agency director is responsible for appointing a representative with the authority to engage in policy, planning, and implementation on behalf of the agency they represent.

Council members serve as the link between people with developmental disabilities, their families and the organization. They are committed to the ethical, businesslike, and lawful conduct of activities including proper use of authority and appropriate decorum when acting as GCDD members. The role of Council members is to engage in ongoing planning activities as necessary to determine the mission of the organization, to define specific goals and objectives related to the mission, and to evaluate the success of the organization's programs toward achieving the mission.

Federal Statutory Members Person with a Developmental Disability

Name of Member
Michelle Aulthouse Tom Connelly David Cowen Tameeka Hunter Cheryl Laurendeau Lenora Maynard

Date of Appointment 7/20/05 7/20/05 10/29/98 7/23/02 10/29/98 10/29/98

Date of Term Expiration 07/01/07 07/01/08 07/1/06 07/01/08 07/1/05 07/1/09

Parent or Guardian of Person with a Developmental Disability

Julia Bowen Lynnette Bragg Vallorie Butler (ViceChairperson) Scott Crain Reggie Heinrich Chris Hunnicutt

3/20/06 07/01/92 10/29/98
7/20/05 2/28/02 2/28/02

3/20/10 07/1/07 07/1/05
07/01/06 07/01/05 07/01/03

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Julie Lee Bruce Lindemann Millicent Powell Tom Seegmueller (Chairperson) Denny Spear Licheng Tien

7/23/02 7/20/05 7/23/02 2/28/02
7/20/05 2/28/02

07/01/06 07/01/08 07/01/04 07/01/06
07/01/07 07/01/03

Principle State Agencies

All Appointments by Position

Department of Labor, Division of Rehabilitation Services

Michael Thurmond Designee: Susan Sherman

Education

Marlene Bryar Designee: Nancy O'Hara

Community Health

Rhonda Meadows Designee: Marilyn Ellis

Human Resources

B.J. Walker Designee: Darlene Meador

5) Mental Health, Developmental Disabilities, Addictive Diseases

Gwen Skinner Designee: Steve Hall

6) Community Affairs UCEDD
State Protection and Advocacy Other

Mike Beatty Designee: Don Watt Zolinda Stoneman Ph.D. Ruby Moore
Phil Pickens

7/20/05

Position By Appointment Position By Appointment 07/01/09

Advisory Committee of the Council In 1998, The GCDD agreed to select a group of individuals, not appointed by the Governor, to provide additional input into the discussions about the needs of persons with developmental disabilities. These individuals are chosen from across the state to serve a two-year term and have all the roles and responsibilities as Council members except the opportunity to vote on GCDD business.

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Name of Member Dawn Alford Kathy Crowder Debra Noonan-Elber
Vicki Gordon
Sabrina Jordan

Designation Individual with a Developmental Disability Individual with a Developmental Disability Parent of a Child with a Developmental Disability Sibling of a Person with a Developmental Disability Parent of a Child with a Developmental Disability

Council Staff Figure 2 depicts the organizational chart of the Council program and its staff. The GCDD has a staff of eleven. Council staff names, titles and descriptions of responsibilities are described.

Eric Jacobson, Executive Director: The Executive Director provides information, guidance and direction to the Council. This is accomplished through recruitment and supervision of staff and consultants; serving as a visible advocate on issues related to people with developmental disabilities; working with public and private sector at Federal, regional, and State levels to maximize resources available to Council.

Patricia Nobbie, PhD, Deputy Director: The role of the Deputy Director is to oversee the programmatic operations of the Council. The Deputy Director is responsible for implementing the Council's legislative agenda, strategic planning and evaluation process. These activities require an overall picture of what is occurring throughout the organization and assists in tying all programmatic activities together.

Dottie Adams, Individual and Family Support Director: The Individual and Family Support Director coordinates, directs, and participates in Council initiatives related to providing supports to individuals and families. This includes developing written products for Council members, performing research participating in coalitions and managing contracts related to selfdetermination, family support, early intervention, and employment.

Gary Childers, Fiscal Officer: The Fiscal Officer coordinates and directs the fiscal operations of the Council. The Fiscal Officer is responsible for the development and maintenance of budgets and budgetary systems, contracts management, and computer networks to support Council activities.

Eric Foss, Receptionist: The Receptionist is responsible for answering the telephone and performing a variety of clerical duties.
Drelda Mackey, Program Manager Associate: The Program Associates provides administrative support to the Fiscal Officer including coordinates a Project Tracking System and development of contracts and reimbursement to vendors.

Susanna Mitchell, Program Associate: The Program Associate serves as the assistant to the Advocacy Director and Family and Individual Support Director. The Program Associate is responsible for performing a variety of office management, administrative, and clerical duties with primary emphasis on relieving the programmatic staff of administrative details.

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Kim Person, Executive Secretary: The Executive Secretary serves as the assistant to the Executive Director. The Executive Secretary is responsible for performing a variety of office management, administrative, and clerical duties with primary emphasis on relieving the Executive Director of administrative detail.
Darlene Spearman, Public Information Program Associate: The Program Associate serves as the assistant to the Public Information Director. The Program Associate is responsible for performing a variety of office management, administrative, and clerical duties with primary emphasis on relieving the programmatic staff of administrative details.
Valerie Meadows Suber, Public Information Director: The Public Information Director plans, develops and implements marketing and public relations projects and/or agency and program campaigns for the Council. Provides agency-related information to the press and general public. Prepares news releases, sets up news/press conferences, responds to inquiries from the public and the media. Prepares speeches, agency briefings and audio-visual productions. Develops, edits and prints agency newsletters, informational brochures, or other promotional material.
Vacant, Advocacy Director: The Advocacy Director coordinates, directs, and participates in Council initiatives related to building and supporting grassroots advocacy efforts in Georgia. This includes developing written products for Council members, performing research, providing technical assistance to local grassroots organizations, overseeing contracts that support this goal, and participating in coalitions.

Figure 2

Governor's Council on Developmental Disabilities Staff Organizational Chart

Chairperson Tom Seegmueller

Eric Jacobson Executive Director

Kim Person Executive Secretary

Pat Nobbie, DPA Deputy Director

Eric Foss Receptionist

Gary Childers Director of Finance
Drelda Mackey Program Associate

Vacant Advocaacy Director

Dottie Adams Individual and Family Support Director

Valerie Meadows-Suber Public Information Director

Susanna Mitchell Program Associate

Dee Spearman Program Associate

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Council Committee Structure According to the National Center for Nonprofit Boards, the basic role of standing committees is to draft changes to standing policies and present them to the board for adoption. The committee might also serve as a sounding board, giving advise to the senior staff member responsible for managing the area of the committee's responsibility.2 Committees are one way that an organization organizes itself to be more efficient. Many organizations are turning to a structure that establishes few standing committees that deal only with governance and financial issues.
The Council uses committees as a way to educate members to make wise recommendations for full Council policy. Throughout implementation of the current plan, committees were organized based on staff functions and projects. There has been confusion about the roles of the committees and members' roles concerning oversight of projects. Projects were often moved from one committee to the next as staff changed or when new projects emerged. A committee receives' an assignment based on which staff member has shown an interest in the project and then which committee has the time to oversee the new project.
GCDD members agreed that the Council committee structure should reflect the current work of the organization and must be flexible. GCDD member participation and decision-making is driven by the commitment of its members and an organizational structure that encourages and allows participation. Figure 3 depicts the organizational structure of the Council. The committee structure establishes standing committees that assist the GCDD in creating policy and support member participation while establishing ad hoc committees that are focused and time limited to address specific issues. Council members may choose to participate on either standing committee or on ad hoc committees that are in areas of their interest. This structure places a greater emphasis on the GCDD's strategic plan and the outcomes identified because it not only drives GCDD member discussions but also staff operations. The Council would empower the staff to address the issues identified in the strategic plan and the staff would report regularly on the status of its effort. Oversight of projects is accomplished first by staff that have the time to deal with projects on a daily basis and second by creating opportunities for members to meet with project staff both in meetings and onsite.
The following committees are established by this plan:
The Executive Committee is comprised of the Council chairperson and vice-chairperson, the chairpersons of the Governance and Finance Committee, three at-large members and the immediate past chairperson if that individual is still a member of the Council. At least one of the at-large members shall be an advisory committee member, and like the immediate past chairperson, will not vote. The Executive Committee is responsible for providing oversight of Council operations and policy and working in support of, or occasionally in place of, the full board.
The GCDD has established two standing committees that must have at least five (5) governor appointed members. Council members will have an opportunity to serve on either committee, however if there are not enough volunteers, the chairperson and executive director may assign individuals to serve a one (1) year term. The committee membership should be at least 60 percent individuals with disabilities and family members. Each committee shall elect a chairperson from the governor appointed members. The committee chairperson may ask noncommittee members to participate on subcommittees or ad hoc committees to assist with the committee's work. The two current standing committees are:
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Governance Committee: The Governance Committee is responsible for ongoing review and recommendations to enhance the quality of the members and for developing rules for members' conduct.

Finance Committee: The Finance Committee is responsible for assisting the GCDD in ensuring the organization is in good fiscal health and in compliance with State and Federal financial rules and regulations.

The full Council, a committee or staff can recommend that the Council establish an ad hoc committee. This is a time limited and objective- specific committee created to help the GCDD accomplish its work. This might include examining issues of potential GCDD involvement, monitoring GCDD supported projects for performance, or determining how GCDD will expend funds for a potential project. The full Council must approve the establishment of an ad hoc committee. In the case of emerging issues, the Executive Board may establish an ad hoc committee, but it must be approved at the next meeting of the full Council. Ad hoc committees shall have a minimum of five (5) governor- appointed members. The Council chairperson shall appoint the ad hoc committee chairperson from the voting members who volunteered to participate. If possible, the committee should have at least 60% individuals with disabilities and family members. The number of ex-officio members on an ad hoc committee shall not exceed the number of voting members. The ad hoc committee may involve individuals who are not involved in the Council in committee activities.

Figure 3

Governor's Council onDevelopmental Disabilities Committee Organization Chart

Governor's Council onDevelopmental Disabilities Tom Seegmueller Chairperson
Executive Committee TomSeegmuel er,Chairperson
Eric Jacobson, Staff Chair, Vice-Chair, Chairs of Standing Commitees, 3 At-Large

Governance Committee LynnetteBragg, Chairperson
Eric Jacobson, Staff Pat Nobbie, Staff

Finance Committee Bruce Lindemann, Chairperson
Gary Childers, Staff Drelda Mackey, Staff

Ad Hoc Committees Chair appointed by Council Chairperson Staff appointedby Executive Director

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Planning Methodology
The GCDD's activities are identified, shaped and focused through a comprehensive assessment and the state plan development process that is designed to reflect the changing needs of stakeholders as well as shifts in the state's policy, regulatory and fiscal environment. The Council undertook a two-year process to develop this strategic plan that included both an internal assessment of its strengths and weaknesses and an external assessment of the needs of individuals with developmental disabilities and their families. The Council Executive Committee acted as the lead planning committee for this process, although most quarterly meetings of the full Council included some planning activities during this period. Throughout the effort to examine how the Council operated and its role, members were actively engaged in discussions and provided input and solutions.
In accordance with the Developmental Disabilities Bill of Rights and Assistance Act of 2000, the Council conducted a comprehensive review and analysis to determine the extent to which services and supports are available to individuals with developmental disabilities and their families. The Council examined data, met with key stakeholders, conducted a public input process and received public comment on its proposed activities. Over three hundred individuals participated in an on-line and paper survey and five public forums to gather input from individuals with developmental disabilities and their families. Survey and forum participants were asked to identify the barriers to services and possible solutions. The public forums were held in Atlanta, Macon, Gainesville, Savannah and Albany. Another source of information was an environmental scan of the strategic plans of the State of Georgia and those state agencies that provide services and supports to individuals with developmental disabilities.
Council members used the information gathered from the public input process and analysis of the system to determine goals, objectives and action steps. Members participated in four workgroups: Real Jobs, Real Homes, Real Learning and Real Influence to create recommendations. Members prioritized the recommendations of the workgroups based on the following criteria:
Is it in line with the mission, vision and values of the Council? Does it lead to systems change, capacity building or advocacy? Is this done best by the Council or should some other group take the lead? Will it result in people being independent, included, integrated, productive and self-
determined? Are the goal and objectives concrete, measurable and achievable?
One significant recommendation of the prioritization process was the creation of a fifth "Real Area" entitled "Real Supports". This was created in recognition that many people with developmental disabilities need supports to be contributing members of their community.
Overview of Public Comments Once the Council had identified its projected goals, objectives and action steps, it allowed the public to comment on its proposed activities through an on-line survey, mail and e-mail comments, telephone comments and a public hearing held on June 1, 2006. Over 150 individuals provided comments on the Councils proposed plan. The following were significant comments made during the public comment process:
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Real Careers
Real Homes
Real Learning
Real Influence

I support your efforts to adopt and implement a Medicaid buy in, develop an Institute (hope the private sector is heavy involved) and provide Discovery Tours (consider moving to Real Learning).
Although transportation is a separate category, an Employment First objective cannot be furthered without discussing transportation as a part of it in the action steps.
Customized, integrated & competitive employment is a must. Is there any reason why Concrete Change could/should not be listed in paragraph
about partnerships with Easy Living Coalition?
I'd continue to develop/promote partnerships like the one in Macon Would like to have better guidelines available for group homes and how to start
one including the means to seek out for the cost to run a group home.
The Council might examine how well Fair Housing and other housing laws are being enforced.
I like the fact that the Council is trying to make it possible for high school students with disabilities to graduate without having to pass the tests.
I'd increase your investment in and move Partnerships Funds (self directed leadership development) to Real Influence.
I would add a goal about integrating the individual into school and community, before going to work.
However, I would change the goal from focusing on "high school education and transition" to include elementary and middle school as well. Self-determination is important for elementary and middle-school age children
The objective for Integration could be to start a peer/parent group, to raise awareness. The individual with disabilities could have the option of participating in some regular school activities/classes.
Focus on changing the way colleges train teachers, so there is no separate special education field. Every person who studies to be any kind of teacher should take all of the special education classes as part of regular education training. I think that is the key to getting students with disabilities in regular classes.
The plan should continue to support the AADD's Partners in Policymaking Program. GVTC is an essential piece in having people with disabilities hired and out in the community. It would be detrimental if it were to go away. It is a true collaboration between Developmental Disabilities and Independent Living (this is rarely done in other states). It is cross disability
Have you thought about running leadership training programs every few years (like maybe 5?) for groups like Partners and Voices but having the interim years be ongoing support of grads to help them get involved in existing advocacy efforts and direct their efforts a bit more.
I strongly support the evaluation of all leadership development programs. I'd encourage the Council to take a organizing approach to its Objectives/Action
Steps, offer advocates who've been through GVTC, Partners, Youth, etc. the opportunity to work on with support the Council Objectives/Action Steps and/or support organizers to work with them to mobilize them for specific activities.
I'd encourage the development of a disability community (not just Council) Communications plan.
Also please add a disability voting initiative.

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Real Support
Other Comments

Would appreciate a DD Council financial support and staff member to help with the planning the Long Road Home.
I particularly like the emphasis on moving children out of nursing homes and hospitals.
I'm particularly pleased with the goals intended to provide support services for living in communities and also with the goals to provide transportation and employment opportunities.
I'd move the 2011 MFP date to 2009 to coincide with the 10th anniversary of the Olmstead decision.
Transportation - Whatever you do, I'd encourage you to work with Project Action and the aging community.
Add objective about transition services as part of self-determination. Even though transition is understood as part of self-determination, it still needs to appear in black and white or the concept gets lost.
We suggest funding a full time coordinator for the Navigator Teams "Study the effectiveness/pervasiveness of consumer directed component of ICW." Concerned about aging people with developmental disability. People are living
longer but are aging earlier.
I was pleased that many of the problems and suggestions posed at the meetings this spring were incorporated into the strategic plan. I'm pleased with the information included
I would like to ask you to have special consideration for including rural counties away from the metro areas in your plans in funding. Because we lack the network and personal contacts we often do not know about programs, grants, and funds until they are gone.
I suggest that for each goal area, an advisory council, made up of community and business leaders in the area of the goal (and people with disabilities), be established to provide guidance and assistance around issues related to inclusionary efforts.

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Environmental Scan
There are many barriers that exist to individuals with developmental disabilities and their families that prohibit them from accessing the five Real Area life domains. The following are factors that must be considered as decisions are made concerning policy and the issues impacting persons with developmental disabilities and their families.
Population Growth3 Georgia's population grew from 6,478,149 to 8,186,453 in the decade from 1990 to 2000. This increase was 1,708,304 or 26.4 percent. Only the states of California, Texas and Florida added more people. On a percentage basis, Georgia was the fastest growing state east of the Rockies. Georgia's estimated 2007 population is 9,179,972.
Growth in Georgia has been driven by a high level of migration, both from other states and other nations. Less than one half of population growth in Georgia is the result of natural increase. The remainder is due to foreign and domestic migration. The most recent estimates show that Georgia had a net gain through domestic migration of 665,000 between 1990 and 1999. Florida was the only state with a higher level of domestic migration. Foreign migration has also been substantial.
The overwhelming majority of Georgia counties (110 of 159) saw population increases of at least 10 percent. The highest levels of growth continued to be in the Atlanta metropolitan region. The 20 county region had a growth rate of 39 percent, with Henry and Forsyth growing by over 100 percent. Although growth rates in other parts of Georgia were lower than in Atlanta, there was still significant growth in other regions of the state. The central and northeast Georgia mountain counties all experienced growth levels in excess of 20 percent. Some of this was due to the movement of persons out from metropolitan Atlanta. Another factor is the high level of migration by retired persons into the area. Only eight counties lost population during the decade (compared to 40 during the 1980s). Six of these were in Southwest Georgia. This part of the state had the slowest population growth of any region.
Prevalence of Developmental Disabilities Many state Councils on Developmental Disabilities and the Administration on Developmental Disabilities accept a national prevalence rate of 1.8 percent of the population (Gollay and Associates, 1988). There are many limitations to this figure that does not take into account state-specific geographic and cultural demographics. In Georgia, no state agency uses the federal definition of developmental disability in determining eligibility or keeping statistics. The Department of Human Resources, Division of Mental Health, Developmental Disabilities, Addictive Diseases defines developmental disabilities as any condition that includes mental retardation and other neurologically disabling conditions, including epilepsy, cerebral palsy, and autism which requires treatment similar to that for individuals with mental retardation. The Division requires regional planning units to estimate the number of people with developmental disabilities in their area. Using this definition, the Division estimates that 1.1% of the population is eligible to receive services through the Division of Mental Health, Developmental Disabilities, Addictive Diseases.
Much of the literature on disabilities suggests there are several variables that increase the likelihood of an occurrence of developmental disability including socio-economic status, ethnicity, gender, urban-rural residence, geographic location, age, and other birth factors. As a
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state, Georgia's population ranks high nationally in those factors that indicate an increased likelihood for the occurrence of developmental disability. A study conducted by the Institute on Human Development and Disability for the Council in 1993 suggested that because of the "compelling socio-demographics and current disability population, a more reasonable estimate of the population with developmental disability should be minimally estimated at 2 percent of the total resident population."

While the Council recognizes that Georgia's demographics suggest a higher prevalence of developmental disability than a national average, it has accepted the national prevalence rate of 1.8 percent. In 1999, the Council estimated that by 2010 there would be 165,788 individuals with developmental disabilities in Georgia. Because of the growth in Georgia's total population, the Council believes that we have nearly reached that projection and that there an estimated 165,239 citizens with developmental disabilities currently living in Georgia.

Georgia's Economy Figure 4
of the U.S.

Georgia has witnessed its share of economic and budgetary hardship over the last four years, but expectations are for continued growth in the state economy. States around the country felt the impact of the 2001 recession, and responded to it in various ways from tax increases to the reduction of public programs. Georgia's growth is now accelerating, the State's personal income growth exceeds that of the U.S. and the State's employment growth rate is expected to catch and surpass that

While the current economic outlook is one of accelerating growth, there are several notes of caution including higher energy prices, a housing market that has peaked, and rising interest rates. The current economic conditions are expected to deliver moderate growth in revenues for the State. General Fund revenues grew by 7.0% in FY 2004 and by 8.4% in FY 2005, the first two full years of economic growth following the recession.

Racial & Ethnic Changes Migration patterns have significantly changed the racial composition of Georgia. Throughout most of the state's history, racial distinctions were limited to black and white. The numbers from Census 2000 reflected a change in this distinction. The African American percentage of Georgia's population rose from 27 percent to 28.7 percent. Latinos, who can be of any race, grew from only 108,000 in 1990 to 435,000 in 2000. They now number over 5 percent of the state's population and are found in significant numbers throughout the state. The change in demographics has been especially profound in the Atlanta region. In 2000, the 20 county area of the Atlanta Metropolitan Area the minority population exceeded 40 percent of the total population. In Hall and Whitfield counties, one person in five is Latino. In Gwinnett County the number is close to one in nine. The Asian population also doubled in the decade to 176,000.

15

Although only 2 percent of the state population, it is highly concentrated in the Atlanta region. In Gwinnett over 7 percent of the population is now Asian.
Although the growth of Georgia's Latino and Asian minorities was the most reported result of Census 2000, the strong growth of the African American population should not be understated. Between 1990 and 2000 Georgia's African American population grew from 1,746,000 to 2,349,000. This was an increase of almost 35 percent. Much of this increase is the result of migration patterns. Only New York and Texas now have larger African American populations. At current growth rates, Georgia will pass both Texas and New York in the next few years to have the largest African American population of any state.

The growing numbers of persons of color is reflected

at the school level and in the number of students

Ages 6-21

with disabilities. While the percentage of students

Georgia % General Population

Georgia % Students with Disabilities

of color in special education does not equal the same Fiscal Year

2004

2004

number as the total of all students, it is expected that the numbers will increase.4

%

American Indian 0.15%

Asian

2.69%

% 0.14% 1.10%

Aging Population The Division of Aging Services in the Department of Human Resources reported that 9.6 percent of the

Black Hispanic White

39.00% 7.52% 50.63%

40.47% 5.40% 52.88%

total population in the 2000 Census was age 65 and over. Georgia has the third smallest

percentage of its population over 65 of any state in the nation. This is partially due to its large

minority population and migration from other states to Georgia. The aging of Georgians is one

of the most significant trends affecting the State. This trend is expected to continue until the

baby boom generation reaches this age cohort and by 2010, it is expected that 1,621,899

individuals age 60 and over will reside in Georgia.

For people with developmental disabilities, there are two important factors to consider regarding age. First, according to the Aging and Developmental Disabilities Coalition there are approximately 17,118 individuals with a developmental disabilities living in a household with caregivers who are age 60 and over. The aging of these caretakers translates into an increased need for services. Second, individuals with developmental disabilities are living longer. In 1900 the average live span of persons with developmental disabilities was 20 years of age. In 2000 the life span for a person with developmental disabilities had increased to 66 years of age.

Rural/Urban Divide Georgia has 159 counties and of those, 118 are designated as rural counties. Poverty rates for rural counties exceed those in urban counties by 58%. The rural counties have approximately half as many physicians and have dramatic shortages of nurses, therapists, and nutritionists (per capita) compared to the metro counties5.

Poverty rates in rural areas of Georgia have been historically higher than in non-rural areas, and today remain significantly higher than in urban and suburban areas of the state. Poverty in rural communities was less responsive to the economic expansion of the 1990's. According to the Georgia Rural Development Council, 91 of Georgia's counties are considered to be in persistent poverty. Georgia's median earnings in 2000 were $24,111. Only 26 of the 159 counties in the state had higher median earnings than the state.
Welfare Reform6

16

Between 1997 and 2001 the number of families receiving TANF (Temporary Assistance to Needy Families) was cut in half, with a slight rise in caseload through July 2002 due to the recession. The decrease in the number of families on TANF did not, however, translate to success in moving people out of poverty. Georgians leaving welfare averaged wages of $9,344 per year during 2002, substantially below any measure for family poverty7.
Another study of women who left TANF in Georgia found that the greatest difference between TANF leavers and stayers is educational levels. Only 24% of leavers did not have a high school diploma or GED, compared with 45% of stayers.
Home and Community-Based Services One of the greatest indications of the nation's and state's commitment to make it possible for people with disabilities to experience "real living" is reflected in the amount of resources allocated to home and community based services. Nationally, the amount of community spending in relation to spending for congregate settings with more than 16 people has increased for the past 20 years. For the first time in 1989, the amount of public funds allocated to support persons with mental retardation and developmental disabilities in community settings (defined as less than 16 persons) exceeded the amount of funds allocated for institutions and other congregate settings (more than 16 persons). In 2005, 68% of all MR/DD funding was being used to support individuals in settings with less than 16 people.8
The State of the States in Developmental Disabilities, 2004 edition, provides information and data on how Georgia and other states are allocating resources for people with developmental disabilities. Although the progress has been slow, Georgia has increased the percentage of Medicaid longterm care dollars allocated to home and community-based services. In FY 1993, $645,825,060 or 93% of Medicaid long-term care dollars were spent on nursing facility services while only $49,453,317 or 7% were spent on Medicaid HCBS waiver services.9 Compared to other states, Georgia has much room for improvement:
Fiscal Effort for Community Settings (State of the States defines as less than 16 people): During the late 1970's, Georgia was ranked 7th of the 50 states for providing the most resources per person with mental retardation or developmental disabilities in Community settings.10 In 1988, Georgia fell to a rank of 31st and in 1992 continued the decline in comparison to other states to 43rd. In 1996, Georgia fell to 46th and only four states having a lower ranking (Hawaii, Florida, Kentucky, and Nevada).11 In 2004, (based on 2002 data) Georgia ranked 45th in community spending.
Fiscal Effort for Congregate MR/DD Settings (State of the States as more than 16 people): Georgia ranked 25th for fiscal effort in congregate spending in 1997, fell to 33rd in 1988, then 30th in 1992, was ranked 29th in 1996, and 35th in 2004.12
Overall Fiscal Effort for MR/DD Residential Settings: From 1977 to 1996, Georgia has continually declined in its fiscal effort in comparison to other states. In 2004, Georgia ranked 47th in MRDD total spending. In 1996, Georgia ranked 46th. Previously, Georgia ranked 44th in 1992; 37th in 1988; and 33rd in 1977.13
Federal Home and Community Based Waiver Spending in FY 2002: Georgia ranked 40th for its federal home and community-based spending for people with MR/DD. Since the 1996 State of the States in Developmental Disabilities report, Georgia closed Brook Run, a
17

large public institution in Atlanta, reducing the public institution population by 364 people and the legislature allocated additional funds for community based services for MR/DD.
Per Capita Spending for Home and Community Based Services (HCBS): In FY 2002, Georgia ranked 40th for federal waiver funds for people with MR/DD per member of the general population. Georgia spent $26 per person per capita and the national average was $45. States spending the most per capita for federal home and community-based waivers were Connecticut, Rhode Island, Vermont, Maine, Wyoming, and Minnesota, spending between $108 and $149 per person.
Placements in Settings with 6 or fewer People: When looking at placements of persons with MR/DD in residential settings of 6 or fewer persons, Georgia ranked 38th in 2002. Fifty-four percent of MR/DD services were provided in settings of 1-6 persons in 2002.
U.S. Supreme Court Olmstead v. L.C. and E.W. Decision The Supreme Court found that "confinement in an institution severely diminishes the everyday life of individuals, including family relations, social contacts, work options, economic independence, educational achievement and cultural enrichment" and that unnecessary institutionalization of people with developmental disabilities is a form of discrimination under the Americans with Disabilities Act.
Georgia still has almost 1200 persons with developmental disabilities living in State ICF/MRs or facilities with 16 plus beds, and 1800 living in nursing homes. During the period of 2000-2002, Georgia was the only state that increased the percentage of individuals living in state-operated 16+ person settings. Georgia institutionalized 1489 people in 2000 and 1,571 in 2002 for an increase of 6%.14 Georgia ranks 19th for its rate of placing people with MR/DD in nursing homes when compared to its general population. In 2002, Georgia had 1,636 people with MR/DD who had no choice but to call a nursing home their home. In 2004, 1,808 persons with MR/DD lived in nursing homes.
As off June 2006, Georgia spent $1,065,938,986 of its Medicaid long-term care dollars on nursing facility services (nursing homes, ICF/MR institutions, swing beds). In contrast, Georgia spent $419,092,665 of its Medicaid long-term care dollars on Medicaid home and community based waiver services (Community Care Services Program, Mental Retardation Waiver, Community Habilitation and Support Services Waiver, Model Waiver, Source Program, Dedicated Case management, and Independent Care Waiver Program). See the graph below:15
FY 1998 Medicaid Long-term Care Dollars Institution v. Community
HCBS 39%
Institutional 61%
18

In 2005, Legislature passed House Resolution 633, requiring five agencies, (Departments of Community Health, Human Resources, Education, Juvenile Justice and Labor), to create a multiple year plan to move all children under the age of 21 from state hospital s and private ICFMRs and nursing homes. The State begins to move 50 children in FY 2007. Medicaid Reform Georgia is currently undertaking several managed care programs serving over 1,000,000 individuals on Medicaid, and several new proposals are scheduled to go up for bid in the near future. Advocates are concerned about the gate-keeping, prior authorization, and evidence of medical necessity practices that are being implemented that may limit people from seeking or keeping services, and which may also discourage Medicaid providers from staying in the network. Already, many parts of the state do not have enough doctors, and sometimes no specialists to see individuals with developmental disabilities. Furthermore, these initiatives have proposed to save the state tens of millions of dollars in the Medicaid budget, but most got off to a slow start. If the promised savings are not realized by the time budgets are being formed for next fiscal year, the state will be forced to cut funds from Medicaid, which tends to jeopardize optional services most.
19

Overview of the Current System of Services for Individuals with Developmental Disabilities and their Families
Real Careers
Almost 50 million Americans with disabilities have skills and talents to bring to the workplace. According to recent national statistics, only three in ten working-age (18-64) adults with disabilities are employed full or part-time, compared to eight in ten working-age adults without disabilities (32% versus 81%)16. The presence of a disability seems to prevent a clear majority of unemployed persons with disabilities from participating in the workforce. Two out of three unemployed persons with disabilities would prefer to be working. As is the case nationally, individuals with developmental disabilities in Georgia remain significantly unemployed or underemployed. The Georgia Statistical Abstract for 2004-2005 identified 611,559 individuals between the ages of 21 and 64 with disabilities. Recent national studies verify that only 35 percent of people with disabilities report that they are employed full or part time.17 The 2004 Disability Status Reports 18 estimate that roughly one-third of Georgians with a disability are working. The State lacks a coordinated system and infrastructure designed to integrate employment services for individuals with disabilities in a manner which is consumer-directed and user friendly and which offers meaningful choice and exploration of creative, non-traditional employment options. In 2002 the Division of Mental Health, Developmental Disabilities, Addictive Diseases reported that 4,427 individuals with developmental disabilities were in supported employment programs and the State spent $18, 401, 865 for this program. The Division of Rehabilitation Services, Department of Labor served 16, 528 individuals with disabilities in 2005 in competitive employment settings. Figure 5 shows the number of individuals with disabilities served by the Division of Rehabilitation Services since 200219.
Figure 5
According to the State of the States of Developmental Disabilities, 2004, 24 percent of all vocational and day program participants in the United States worked in supported or competitive employment while the remaining individuals received services in sheltered workshops, day activity or day habilitation programs. In Georgia, of the 8,931 individuals who
20

receive day supports, only 3,371 are in supported employment services. This most often happens because providers receive a higher reimbursement rate for day habilitation services than they do for supported employment, creating an incentive to keep individuals in sheltered workshop environments.
The Georgia General Assembly directed the Department of Community Health to conduct a study of the feasibility of a Medicaid Buy-In Program, to be completed by December 1, 2006. This would allow individuals to continue working and keep their Medicaid benefits. For many employers the cost of healthcare benefits proves to be a barrier to hiring individuals with disabilities.
Real Homes
Whether or not you have a disability, having a home, largely depends on a person's income. The federal government considers a home affordable if a household pays less than 30% of their gross income for housing, including utilities. A low-income household may not have sufficient money for other necessities such as food, clothing, and childcare. Historically, renter households are more likely than owner households to be cost- burdened. In Georgia, over half of all households (includes both renters and homeowners) pays at least 30% of their income for housing. Approximately 10% of all households are severely cost burdened, devoting at least 50% of their income on housing costs. The Department of Community Affairs estimates that 40% of all Georgia households are of low or moderate income.20
In the United States, three times as many people with disabilities live in poverty (with an annual household income below $15,000) as those without disabilities. For a person with a disability, sufficient income is required to cover the cost of the home as well as ongoing supports and/or modifications the person needs to make the home accessible. Without adequate health insurance or a home and community-based waiver to assist with the cost of providing support services, many people with disabilities must live in institutional settings, or remain at home without formal support. Also, the one-time cost to retrofit an existing home can be extremely expensive for people with mobility disabilities, creating a barrier to living in a real home.
For very low-income persons with developmental disabilities, affordable housing usually means subsidized housing that is either developed or rented through government housing programs or disability service providers. According to Priced Out in 2004, an individual in Georgia receiving Supplemental Security Income (SSI) assistance would spend 107.8% of the SSI to rent a onebedroom housing unit.21
A 2004 report People with Disabilities and Housing in Georgia compiled by the Council and the Department of Community Affairs identified the disconnect between community support services and housing supports as the number one barrier to housing for people with disabilities22. According to this report there are significant portions of Georgia that are recognized as high-cost housing markets and where the cost of a one-bedroom unit was higher than monthly SSI payments.
The Department of Community Affairs has developed a disability housing strategic plan. The overall goal of the Department is to promote housing for individuals with disabilities that is affordable, safe, decent and promotes independent living options. The primary objectives of the plan are to expand homeownership, rental opportunities and informed decision making. Over
21

the last few years, the Department has undertaken several initiatives to increase housing opportunities for individuals with disabilities. Figure 6 is an overview of these efforts.

Figure 6 Expand Homeownership Home at Last Program that uses Section 8 payments to pay for homeownership mortgages. Projected to close on 8 units in 2006 CHOICE program provides enhanced down payment assistance to individuals with disabilities. Since 2004, 42 loans have been purchased Home Access Program assists in creating accessible owner occupied homes. Over $1,000,000 has been leveraged for this program.
Credit Able Loan Guarantee program to allow for home modifications.

Expand Rental Opportunities Permanent Supportive Housing program provides capital funding with rental assistance. Over 150 units produced since 2000.
Shelter Care Plus provides rental assistance to individuals with disabilities who are homeless. Currently serving 1200 individuals.
Low Income Tax Credit program provides equity and low interest loans to produce affordable housing. There is a 5% set aside for individuals with disabilities and additional incentives for permanent supportive housing.
400 housing vouchers have been set aside by DCA to support individuals moving from nursing homes and institutions into the community.

Creation of the Georgia Housing Search webbased database to assist individuals trying to local accessible rental units.

Real Learning

The Individuals with Disabilities Education Act (IDEA) provides that a child with a disability is provided a free and appropriate education in the least restrictive environment possible. It also allows for a child to have an appropriate evaluation, an individualized education program (IEP); a right for parent and child to participate in the decision-making, and certain procedural safeguards.

Children served through IDEA are divided among three programs: Early Intervention for Infants and Toddlers, age 0-2; Preschool Education for children age 3-5; and Education for School Age children, age 6-21. The data for Georgia from the 1999 Child Count23 indicated that one in ten students' ages 3-21 was receiving special education services. This percentage increased over the past five years from 9.0% (129,234 children) in 1994 to 10.2% (155, 754 children) in 1998, and to 12.61% (195,928 children) in 2004.

Early Intervention Program In Georgia, the Department of Human Resources', Division of Public Health Babies Can't Wait (BCW) program is responsible for providing the early intervention services funded by IDEA. BCW serves children from birth up to their third birthday, regardless of income, who meet one of the following criteria:

22

Have a diagnosed physical or mental condition which is known to result in a

developmental delay, such as blindness, Down syndrome, or Spina Bifida; or Have a diagnosed developmental delay confirmed by a qualified team of professionals.
Babies Can't Wait provides multidisciplinary evaluation and assessments to determine eligibility for services and the scope of services needed and service coordination that assists the family and other professionals in developing a plan to enhance the child's development. In addition, Babies Can't Wait offers access to those services identified in child's plan based on a sliding fee scale. Services offered include assistive technology

Part C of the Individuals with Disabilities Education Act says that to the maximum extent appropriate, early intervention services must be provided in natural environments, including home and community settings in which children without disabilities participate. Services can only be provided in a setting other than a natural environment when early intervention cannot be achieved satisfactorily in a natural environment. [Sec. 632 (4) (G) and Sect. 635 (a) (16)
(B)].

devices, audiology, family training and counseling, health

services, medical diagnostic services, certain nursing services, nutrition services, occupational

therapy, physical therapy, psychological services, social work, special instruction, speech-

language pathology, vision services, and transportation to services.

Before a child leaves the program, a transition plan must be developed to ensure that the appropriate community referrals are made and that the family becomes familiar with their public preschool personnel, private preschool and other community options. Such options may include, but not be limited to the Georgia Department of Education Division for Exceptional Students that offers special education services for children ages 3-21.. Other options may include Head Start, Child Care and Pre-K services as administered by the Bright from the Start: Georgia Department of Early Care and Learning. In addition, as children and families prepare to transition from Babies Can't Wait, service coordinators can assist in applying for other services and resources such as PeachCare for Kids, free or low-cost health insurance for Georgia's children, Right from the Start Medicaid, Medicaid coverage for pregnant women and children under the age of 19, Social Security Administration for Social Security benefits information, and various Medicaid programs administered through the Georgia Department of Community Health. Resources and funding to help meet the unmet health care needs of medically fragile children may also be available through the Foundation for Medically Fragile Children.

Figure 7 shows the number of children served by Babies Can't Wait from December 1, 2000 December 1, 2005 and the State and Federal funds for this program24.

Children Served
(as of December 1)
Federal Part C funds State Funds

2000 3427

2001 3770
$10,918,523 $10,576,161

2002 4086
$12,265,577 $9,924,314

2003 4907
$12,772,091 $9,924,314

2004 5450
$14,112,001 $9,924,314

2005 5576
$13,981,852 $9,924,314

2006
$13,888,437 $9,924,314

23

Preschool Education Since 1992, Congress has required each State to provide a free and appropriate education to children with disabilities ages 3-5 in order to receive federal funds under the Preschool Grants
Program under IDEA. There are two Pre-Kindergarten programs available for all young children. The Georgia Pre-K Program was established in 1993 with Georgia lottery funds to provide Georgia's four-year-old children with Pre-Kindergarten learning opportunities. The Head Start program is a national program to provide comprehensive developmental services for low-income preschool children and their families. Often a child with disabilities would receive a preschool education within these programs with additional IDEA support services provided.

K-12 Education The percentage of students' ages 3-21 receiving special education services increased from 9.0% (129,234 children) in 1994 to 12.61% (195,928 children) in 2004. Figure 5 presents the numbers of students with disabilities as of the December 1, 2004 child count. Between 1998, and 2004, the number of children ages 3-21 with disabilities enrolled in special education increased by 40,000 students. 25

FEDERAL CHILD COUNT REPORT 1-Dec-04

AREA OF DISABILITY

AGE 3-5

AGE 6-21

MENTAL RETARDATION HEARING IMPAIRMENTS SPEECH OR LANGUAGE IMPAIRMENTS VISUAL IMPAIRMENTS EMOTIONAL DISTURBANCE ORTHOPEDIC IMPAIRMENTS OTHER HEALTH IMPAIRMENTS SPECIFIC LEARNING DISABILITIES DEAF-BLINDNESS MULTIPLE DISABILITIES AUTISM TRAUMATIC BRAIN INJURY DEVELOPMENTAL DELAY * TOTAL: (Sum of all of the above)

690 197 11617 56 259 80 340 141 10 0 504 16 6891 20801

26986 1599 37708 624 23818 1004 22606 53274 19 0 4667 463 2359 175127

For the past five years, the state has been developing indicators and tracking outcomes for ten performance goals related to special education. The following indicators were adopted by the Department of Education:
Decrease the percentage of students with disabilities who drop out of school. Increase the percentage of students with disabilities who earn a regular education
diploma
Decrease the gap in performance of students with and without disabilities on statewide achievement tests.
Increase the percentage of time students with disabilities receive instruction in the general education setting with appropriate supports and accommodations.
Increase the percentage of students with disabilities who transition to their desired post school outcome.

24

Increase the percentage of parents of students with disabilities who are active and satisfied participants in their child's education.
Decrease the percentage of students with disabilities who are removed from school for disciplinary reasons.
Increase the percentage of young children receiving early intervention services. Decrease the disproportionate representation of minority students with disabilities to
reflect the demographics of the general population.
One of the most significant results of these efforts is that not only are the percentages of students with disabilities passing the statewide assessment increasing, but the gap between the performance of students with and without disabilities is decreasing.26 The inclusion of children with disabilities in the regular education curriculum for increasingly greater portions of the day resulted in greater percentages of children being included in, and succeeding in passing, the state's assessment, the Criterion-Referenced Competency Tests (CRCT), now given in 4 core subject areas from grades 1 through 8. Superintendent of Schools Kathy Cox reported to the No Child Left Behind (NCLB) Commission that there was an increase in the percentage of students with disabilities passing the CRCT in every grade in every subject with this year's testing. Scores in the 3rd, 5th, and 8th grades serve as gateway measures. Children not passing tests at these levels are recommended for remediation, and subsequent retention if they cannot pass again after remediation. The 2005-06 school year is the first year that the retention policy was in effect for all three grades. The pressure of the gateway tests has brought attention to the need for early identification and remediation for students who are at risk of failure.
Currently Georgia has 5 diplomas: College Preparatory, College Prep/ Technical education dual seal, Technical Education seal, Special Education Diploma and Certificate of Attendance. In 2005, 8200 special education and certificate of attendance diplomas were given out. These diplomas restrict the options to students. In many cases, only poor high school planning prohibits the students from acquiring the standard diploma. National trends indicate that states are creating alternative routes that are comparably rigorous so that students with disabilities can demonstrate their high school competencies through portfolios, internships or apprenticeships, paid work, etc.
Real Influence
In the past 5 years, the economy has impacted the amount of funds available for human services. Georgia is a balanced budget state, so the budget is constructed against the Governor's revenue estimate. Because of the uncertainty of the economy, the Governor instructed state agencies to develop differing scenarios when developing annual budgets. Governor's instructions resulted in agencies experiencing from 4% increases across the board to 2% reductions across the board. For the 2008 fiscal year budget, the instructions were flat funding, and no enhancements without corresponding cuts.
Real Supports
Waiting List for Home and Community-Based Services While progress has been made to address the waiting list for home and community=based services there are currently over 6,000 Georgians with developmental disabilities who are waiting for home and community-based services due to a lack of funding for services. Additionally, there are 17,118 Georgians with developmental disabilities living with caregivers 60 years old or older27 In addition, each year approximately 700 children with developmental
25

disabilities exit the Department of Education's special education program. Due to a lack of funding for home and community-based services, most of these young adults remain at home while receiving no services. In many cases, this creates a crisis for parents who must work and cannot stay at home and care for their family member. Finally, there are approximately 1,100 individuals with developmental disabilities living in Georgia's state operated institutions. This includes at least 44 children whose needs could best be met in community settings. In 2004, the Legislature passed House Resolution 1307directing the Departments of Human Resources and Community Health to create a five-year funding plan that would reduce the waiting lists to a reasonable pace. Department of Human Resources began requesting funds to match the goals of the plan in 2005. Figure 8 shows all Medicaid Waivers and the number of individuals on the waiting list.

Figure 8

LTC Program

FY 06

Expenditures

Community Care Services Program

$97,697,732

Independent Care Waiver Program

$26,493,926

Mental Retardation Wavier Program

$152,278,360

Community

Habilitation and Support Services

$55,337,963

Waiver Program

Waivered Home Care Services (Model Waiver)

$23,836

SOURCE (pilot project)

$44,584,586

GAPP In-home private duty nurse

$20,298,515

GAPP Medically Fragile Daycare

$6,321356

Total Medicaid Dollars for Community Based Services

$403,036,274

Institutional Services

Skilled Nursing

/Intermediate Care/Mental

$120,338,942

Retardation Facility

Nursing Facility Services

$945,244,530

Swing Bed Services $355,514

Total Medicaid

Dollars for Institutional

$1,065,938,986

Services

FY 98 Enrollees

Cost Per Recipient

13,980

$6,988.39

622

$42,594

7,060

$21,569

1,197

$46,230

7 7,222 393 200
30,681

$3,405 $6,173 $51,650 $31,606
$26,276 (average)

1445
40,629 267
42,321

$73,115
$23,265 $1,331 $33,570 (average)

Waiting List in January 2006
5,000
12
6,411 Numbers included with the MR Waiver
Program

Self-Determination Development of self-determination skills and programs is beginning to permeate the service system in 2006. The state has incorporated self-directed options into the new waiver structure.

26

Acumen, the financial support service, provided training this spring. Additional efforts will be made to bring families together who are self directing so they can learn from each other. Other trainings on topics such as individual budgets, being an employer, and development of circles of support will be offered as requested.

The Division of Mental Health Developmental Disabilities Addictive Diseases (MHDDAD) funded the development of a Peer Support Project for individuals with developmental disabilities to provide trained mentors for individuals learning to navigate the service system. A peer support curriculum was developed under grant CFDA 93.779 from the U.S. Department of Health and Human Services, Center for Medicare and Medicaid Service. Peer support is valuable because the peer supporter offers the benefit of his or her own personal experiences. They are not counselors, but encourage and support people with disabilities as they take control of their lives. Many self advocates participated in the development of the curriculum content. Almost 100 individuals were trained and certified as peer supporters in 2005.

Family Support In 2003, the Mental Retardation Waiver Program (MRWP) was amended to include "Natural Supports Enhancement (NSE)," a family support model. Over 4,000 individuals were brought into waiver programs through a "revenue Maximization" effort that re-evaluated persons being served, determined their Medicaid eligibility, and capitalized on the draw down of federal dollars. In FY '01, $1,064,003 was added for autism family support, and $1,224,595 for DD family support. In FY `023, $4,212,000 was added for 324 Natural support waiver services. The selfdirected option for the natural support enhancement waiver became available on June 7, 2006.

Shortage of Direct Support Professionals Workforce recruitment, training, and retention issues are problematic across the country. Low wages paid to direct care workers and inequitable rates paid by different agencies to providers of the same services restrain the development of community infrastructure, as does a lack of a geographic rate differential for providers in high cost areas. A resolution was passed in the legislature in February 2006 that acknowledged the valuable work of direct support professionals.

Projected Implementation of New Medicaid Waivers In 2006, the State delivered a proposal to redesign the MRWP programs. This is the first major rewrite since the waiver's inception. The NOW waiver includes self-directed option through a fiscal intermediary, and will cover transportation, dental, support coordination, and includes "community guides" to enhance individuals ability to integrate successfully in their communities. The most comprehensive waiver reform in the state's history challenges the system on many levels, but also will provide new opportunities.



Alignment of needs as assessed through the Supports Intensity Scale, with an individual

budget should provide a closer match between needs of the person with DD and

available resources



Addition of transportation, dental, support coordination and community guides as paid

services under the waiver



Ability of families to hire friends and family to provide support

27

Transportation Georgia's transportation system for people with disabilities will face increasing demand over the next few years due to a growing older population, more people with disabilities gaining integrated employment and an emphasis on teens with disabilities transitioning to work after high school, disabled veterans returning after Iraq, and just the fact that Georgia is one of the fastest growing populations in the country. A recent article in the Atlanta Journal Constitution highlighted the status of paratransit in the Metro Atlanta area. MARTA (Metro Atlanta Rapid Transit Authority) has an average daily ridership of 500,000 people per day. They count an average of 786 paratransit riders per day. The fee for one MARTA trip for the non-disabled rider is $1.75, and is $3.50 for the paratransit rider. However, the paratransit cost per ride is $31.88, compared to only $1.87 cost for rail and $2.33 for bus transit for the standard MARTA service. Paratransit is a demand-response system, and ridership has doubled in the past 6 years, to 300,000 trips per year. However, metropolitan markets similar to Atlanta's, such as Houston and Kansas city, average more than 1,000,000 paratransit trips per year, more than three times as many as Atlanta. MARTA paratransit ridership increased from 2800 eligible in 2001, to 4,800 in 2006. MARTA expects to have 6,100 eligible riders next year.
Outside the Atlanta area, few communities have extensive paratransit systems, and the ones that do exist cover limited areas, or have so few accessible vehicles that passengers have long waits for rides.
Healthcare The affordability and accessibility of health care and the shortage of specialty providers are significant general concerns for people with disabilities. In 2004, 19% or 1,510,609 Georgians were without any kind of health care coverage. Among healthcare services, the lack of adequate, affordable dental care is most urgent. Poor dental care is a major contributor to poor general health. There have been two efforts to address health care needs for Georgians. The first is a movement toward managed care as a way to control costs and increase the quality of care provided. Medicaid has contracted with three care management organizations to provide administrative oversight and utilization management for the non-Aged, Blind and Disabled population. For those considered aged, blind or disabled not in Medicaid waiver programs, a disease management program is being established with two contractors (north and south) whose goal is to decrease visits to emergency rooms and increase access to primary care physicians.
The second effort to address health care needs is the State Children's Healthcare Insurance Program (SCHIP). In Georgia, this program is called PeachCare for Kids and is a new program rather than an expansion of Medicaid. Over 200,000 children are enrolled in PeachCare. PeachCare for Kids exceeded its two-year enrollment goal in its first year of operations. Currently, Georgia ranks fourth nationally in numbers of enrolled children. Only California, New York and Florida have enrolled more children.
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Overview of Current Council Efforts
The Council engages in a variety of activities to meet its federal mandate and support efforts in Georgia:
Real Careers
Jobs for All Jobs for All has been the Council's primary employment project for the past three years. This is a joint effort between the Institute on Human Development and Disability, Cobb/Douglas CSB and the Council. Jobs for All has focused on getting people jobs through a customized employment model, which includes self-employment, job carve outs and resource ownership. This project was funded through a grant from the US Department Of Labor Office of Disability Employment Policy (ODEP).
As part of Jobs for All, a steering committee developed and recommended an "Employment First in Georgia" policy. This policy recommendation suggests that employment should become the primary option for people with developmental disabilities and that the agencies responsible for supporting people with disabilities should adopt the necessary policy and structural changes to support this. Recommendations include valuing integrated employment more than nonemployment or segregated employment, developing funding structures that favor employment outcomes and choice for individuals, decreasing segregated employment over the next five years, requiring that new day service dollars fund employment outcomes, and focusing employment projects on all children coming out of schools. So far, the Departments of Human Resources and Education have signed on to this policy.
Discovery Tour The Council will sponsor its fifth annual Discovery Tour on October 25, 2005. This was established to educate business leaders and others about disability in Atlanta. In previous years, participants visited sites and discussed issues such as homes, education, spirituality, recreation, civil rights, assistive technology, and employment. In an effort to create a stronger focus and encourage more participation, this year's focus is on employment and diversity in the workplace. The Home Depot and Southern Company are co-sponsors of the event. Over 25 individuals participate in this event on annual basis.
Business Leadership Network The Council has been working with the reconstituted Business Leadership Network. This is a group of businesses that meets to discuss how they can employ more people with disabilities. We have presented to the group and are working with them to educate businesses about employment.
Real Homes
Housing Partner Coalition In recent years the Council, along with other advocacy organizations formed a partnership with the Georgia Department of Community Affairs (DCA), the state Housing Authority. Through the Council's placement of a disability housing coordinator within DCA in 2001, the interests of people with disabilities are increasingly at the forefront of each program initiated by DCA. The focus of this coalition is on how to increase home ownership and other housing options for individuals with disabilities. The coalition's efforts resulted in the Department increasing the funds available to provide individuals with down payment assistance on new housing. In 2003,
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this collaboration sponsored forums around the state to identify the needs and create recommendations on how to improve the housing options for individuals with disabilities. The number one recommendation was to develop formal connections between the supports that people need and housing. Collaboration between entities that provide services such as the Department of Human Resources and the entities that provide housing such as the Department of Community Affairs need to be formalized.

EasyLiving The Easy Living Home program is the most recent development in the effort to promote more accessible housing for individuals with disabilities. For many years, advocates tried to pass legislation requiring homebuilders to build homes that incorporated various accessibility features. Most of this legislation was defeated; however in 2000, legislation was passed that requires certain accessible features in publicly financed housing. In 1999 a coalition was formed that included American Association of Retired Persons, Concrete Change, the Council, the Georgia Department of Community Affairs, the Home Builders Association of Georgia, Shepherd Center and the Statewide Independent Living Council. The coalition now includes the Atlanta Regional Commission, Fannie Mae, and the Universal Design Alliance.

Homes that receive the EasyLiving Certification include the following features:

A zero step entrance or an even threshold.

The central living area contains at least one bedroom, a kitchen, some entertainment

space, and one full bathroom



Throughout the home all interior passage doors (including bathroom doors) provide at

least 32 inches clear opening.

There have been almost 600 homes built in Georgia with the EasyLiving features and there are more under construction. These homes range in price from low income housing to very expensive homes. In addition, three states, West Virginia, New Hampshire and Texas, have become affiliated members and are working to implement EasyLiving homes in their states.

Real Learning
Early Intervention A representative from the Council was added to the State Interagency Coordinating Council(SICC) for the birth to three program. A grant to the Division of Public Health's Family Health Branch, established a partnership and funding to develop a strategic plan for early childhood in Georgia. Interest then turned to discovering ways that families who are caring for members with a disability could be more naturally and completely included in their local communities.

The Council was asked to participate in developing the Early Childhood Comprehensive Systems (ECCS) federal grant. The Council served as co-convener with the Family Connection Partnership for the Family Support Work Team. This grant is focusing on children birth to five. The Family Support Work Team recommended that Navigator Teams be a part of the ECCS grants recommendations. The ECCS Steering Committee ranked Navigator Teams as their top priority out of 126 recommendations.

From May 2005 December 1, 2005, the ECCS Planning Committee members served as liaisons to the House Study Committee on Children: Newborns to Age Five (Manning Study Committee). The House Study Committee commended the ECCS group for its thorough efforts.

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There was acknowledgement of placing a greater emphasis on systems integration and providing the framework for large-scale agency collaboration. The Study Committee wanted to see support for programs that demonstrate positive outcomes for young children and their families. The members felt that there needed to be creative problem solving by partners at both the state and community levels to promote positive outcomes for Georgia's children and families.
Project WINS The State Department of Education (DOE) worked collaboratively with the Council on a model for inclusive schooling, which involved substantial teacher training in collaborative and coteaching models, scheduling for planning and for establishing classrooms where regular ed and special education teaching professionals could work side by side with several students with disabilities included in the regular classroom for the entire day Teachers also learned methods for modifying curriculums with the principles of universal design. The Council funded project sought districts with complete pathways from elementary to high school so students could be fully included their entire schooling. Project WINS, as it was called, worked with 26 schools in some 11 districts. Project Winning Team, a DOE funded project that was implemented simultaneously with WINS, worked in an additional 35 districts in the same model. At the end of the five-year grant period, the knowledge gained through the projects was incorporated into the state's Least Restrictive Environment (LRE) project, which set aggressive goals for increasing the percentage of children who were removed from regular classrooms less than 21% of the day. The state has made steady progress on this goal. Each school district must design activities and provide training to address this performance goal.
Special Education Funding Formula One of the significant outcomes of the Project WINS and WINNING Teams projects was the discovery that the state special education funding formula will not adequately support inclusive models because of the weighted structure and class size limitations. The number of students necessary to earn a FTE special education teacher in the regular classroom to work side by side with a regular education teacher surpassed any workable class size. Building principals learned to "game" the system by masterminding scheduling, moving students to take the counts, etc. The formula disincentivized best practice. Realizing that the state's general education funding formula revision (Quality Basic Education formula) was past due, and that the Governor intended to work on it, the GCDD funded a Special Education Funding Formula work group to make recommendations to the state for revising the formula to support inclusive education teaching models. A national consultant from the American Institutes on Research conducted the research and a broad-based committee of parents, teachers, legal advocates, DOE data staff, special ed directors, principals, college professors and superintendents met several times over a year to conduct the study, make recommendations and publish a "white paper" on the conclusions. The paper was completed in time to be considered in the context of the QBE funding task force's work, so the formulas would be revised together. Early this spring, the Division for Exceptional Students was asked to submit a white paper28 to the QBE Funding Task Force that outlined the desired elements of a quality special education program. The Division pulled together staff, and several members of the State Advisory Panel and individuals who had participated on the Special Education Funding Committee. The paper outlines the elements that need to be included in any funding restructuring in order to sustain a cohesive, effective program for students with special needs.
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Transition The Council has also been working with the DOE Division of Exceptional Students on improving the post school outcomes for students with disabilities leaving high school through better transition services, including training in self-determination and person centered planning. Several initiatives are occurring in this arena. The GCDD, with the state DOE, has coordinated a Statewide Transition Steering Committee that convenes at least quarterly, and is composed of all the agencies that should assist with transition; district Special Education and Transition directors, Vocational Rehabilitation, Medicaid, Children's Medical Services. Department of Technical and Adult Education, The Georgia Advocacy Office, Parent Mentor Program, Mental Health, Developmental Disabilities and Addictive Diseases, etc., and parents. In the past three years, the Transition Steering Committee provided advice and assistance to the DOE on policy matters, technical assistance to districts, and networking opportunities and information to parents and students. The group is charged with implementation of one of the state's goals in the 3 year transition plan, (implementing self-determination curriculums in each school district) and serves in an advisory capacity to the Employment Technical Assistance Institute Transition Center, which will provide technical assistance on employment options for students with significant disabilities leaving high school.

Partnership for Success The GCDD is funding a high school grant, Partnership for Success, which is establishing inclusive school clubs, self-determination training and person-centered planning activities for 6 high schools in the Gainesville area. In this last year, the project will produce kits to assist other districts in replicating this effort.

Better All Together Conference The Council sponsored its 6th Better All Together in March 2006. The conference is an opportunity for individuals with disabilities, family members, advocates, providers, teachers and school personnel to learn about best practices in supporting people with disabilities. The sessions covered a wide range of topics from early education to employment. In addition, several "institutes" took place that specialized with topics for direct support professionals and school principals. Over 725 people attended this conference.

Partnership Funds

The Council continues to offer a consumer empowerment fund that allows parents and

individuals with disabilities small grants to enable them to attend conferences, workshops and

trainings to help them learn more about their disability and network with others dealing with

similar issues. On average, the Council annually provides grants to 23 organizations. The awards ranged from $350.00 to $2500.00 and supports over 1,000 individuals with disabilities and family members to attend conferences and trainings.
Parent Leadership and Training The GCDD has been a leader in creating and supporting the Parent Leadership Coalition (PLC), a group of 10 parent support organizations that meet regularly to share resources and develop projects that reach out to parents of student with disabilities. This group was initially organized in 2002 in an effort to better communicate with each other and to make sure there was not duplication of efforts. The shared values and beliefs of contributing
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PLC Members Atlanta Alliance on Developmental Disabilities Babies Can't Wait, Project SCEIs Parent Educators DOE / Division for Exceptional Students Parent Mentor Program Governor's Council on Developmental Disabilities Parent to Parent of Georgia Parents Educating Parents and Professionals Office of Developmental Disabilities Family Connections Institute on Human
Development and Disability
Department of Early Care and Learning

organizations are: Access and Choice; Parents as Experts; Support and educational opportunity; Collaboration; Local access / local resources; Diverse family needs and Successful outcomes. The goals are to improve collaboration among Georgia's parent leadership programs; and to develop informed parent community networks.

Real Influence
Information Dissemination Good quality research on the different aspects of supports and services for people with developmental disabilities is necessary to both make the case for change and to provide evidence of the effectiveness of new policies and programs. The Council's research has emphasized specific research from the field to inform policymakers on best practices and how other states have dealt with similar challenges. The Council began to generate short white papers and memorandums on specific policy issues that were under consideration by the state several years ago, finding these to be the most effective way to provide concise, focused information to agency officials, policy makers and legislators. See Appendix B for an overview of white papers and memorandums produced by the Council over the past five years.

Publications The Council produces publications that are widely distributed to the Council mailing database, or distributed via e-mail or the website.

Publication Community Calendar Moving Forward
Making A Difference
Annual Report

Purpose This is a schedule of disability, training and advocacy events that is organized in two-month intervals and posted on the GCDD website. "The Developmental Disabilities' Advocates Guide to Legislation." This publication is a legal-size, 2 sided newsletter that is produced weekly during the Georgia Legislative Session. The newsletter covers the details of the proposed budget allocations for the Departments of Human Resources, Community Health, Labor/VR and Education, and lists all legislation relevant to the DD Community, providing bill numbers, sponsors, brief description, and status as of Thursday morning each week. The Council alternates hard-copy mailing with e-mail distribution, and also posts it on the website each week. 43,250 issues of Moving Forward are sent out annually. This is a quarterly magazine that is issued around the same time as the Council's Quarterly meetings. The issues are themed, such as Education, Transition, Employment, Early Childhood, Advocacy, etc. Some of the features are: Letter from the Governor, GCDD Viewpoint from the Executive Director, Letter from the Chairperson, News and Events, Feature Articles on the theme of that issue, Perspectives, Expert Update and Calendar of Events. 20,000 issues of "MAD" are distributed annually. A summary of the Council's Projects, and financial status, produced in of each year. Distribution is 1000 annually.

Public Policy Advocacy The Council has made a concerted effort to improve the process by which it researches, tracks and informs on issues before the Georgia General Assembly which operates on a two-year session. The collection of interests and information on possible legislative items occurs nearly

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year-round. The Councils annually adopts a public policy agenda that includes both legislative and budget priorities. The criteria used by the Council to determine if the Council should support policy and budget requests are:
The issue directly or indirectly affects the Council's constituents and / or organization. Supporting or opposing the issue is in concert with the mission, vision and values of the
GCDD. The issue draws upon our knowledge and expertise as an organization. The Council has the capability to develop a realistic plan for how to implement the
policy stand, communicate our plan to the appropriate people and make use of the stand in our work, and adopt this plan at the same time we finalize our position.
Disability Day at the Capitol For eight years, the Council has sponsored an annual event during the legislative session that allows individuals with disabilities, family members, advocates and providers to meet with elected officials and discuss legislative and budgetary concerns. Individuals have an opportunity to learn about how to meet with legislators. Annually, there are a number of elected officials and other dignitaries that speak and attend this event. Over the last three years, attendance from this event has exceeded over 1,000 annually and has grown to one of the largest events during the legislative session.
Leadership and Advocacy Training The GCDD has funded several leadership and advocacy training projects over the years. Partners in Policymaking (Partners) has been running for 15 years, and has produced 435 graduates. In 2003, the project started a Partners alumni group in an attempt to reconnect with trained participants to keep them active advocates. The Alumni sponsor an annual get -together in addition to being maintained on the database and listerves. Voices that Count (Voices) is a Partners-like leadership-training project targeted specifically at people with significant disabilities to help them become better self-advocates. Voices has been sponsored for 4 years, and has produced 57 graduates. The Council has also provided funding for the Parent Leadership Support Project which prepares parents to serve as advocates for parents with children with special needs in the school system, and the Parent Links, education focused parent advocates who worked with local PTAs to keep parents of children with special needs involved in mainstream school activities.
Real Supports
Unlock the Waiting List Campaign The Unlock the Waiting List campaign was started in 1997 to address the accumulating numbers of individuals with developmental disabilities that are waiting for Medicaid Waiver slots. In the past five years, Unlock has positioned itself to be the authoritative voice on home and community-based services, and is recognized by legislators and agency directors as a source of reliable, accurate, current information on the need and progress in developing HCBS resources. Unlock is now a coalition of over 300 community-based advocacy organizations. The campaign maintains a website where advocates can read the latest information on legislative activities, download fact sheets, find out who their legislators are and contact them directly via e-mail.
The Division of Mental Health, Developmental Disabilities and Addictive Diseases recently asked the GCDD to research the waiting list protocols in other states in an effort to bring equity,
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consistency and reliability to the process of removing people from the waiting list based on most in need. The GCDD wrote "Managing State Waiting Lists for Residential Services" which surveyed five states with fairly rigorous processes, and made several recommendations.
Self-Determination The GCDD contracted with the Center for Self Determination for a consultant to help provide training to families who receive natural support enhancement services, intake and evaluation team members, and support coordinators. Six trainings were held around the state from June 2005 December 2005. Support Coordinators were required to take a test following the training and pass with 85% in order to support people who would be doing consumer directed natural support enhancement.
In addition, the Council hosted the Self-Determination Immersion Conference in 2004. Individuals from across the country came to learn about how to develop self-determination efforts.
Family Support The Council has provided much of the leadership in addressing family support in Georgia. The Council held numerous Family Support Forums to get stakeholder input to the proposed family support policies and procedures. The services under these procedures were expanded and service categories were more clearly defined.
In the first year of Family Support activities, a Statewide Family Support Conference was held that focused on best practices in Family Support. The conference held 600 people attended June 10-12, 2001. In year 2, intensive six-day trainings were held around the state using the Family Support Curriculum. One hundred and sixty-five people attended the trainings with 80 of those being family members. The other 85 people were self-advocates and service providers. At least 60 of the attendees were trained to be trainers of Family Support. Many of these trainers have continued to provide Family Support Training in their local communities upon request. By 2004, the total number of people who had been trained in Family Support was approximately 476, not including individuals who had been trained by trainers in their local communities.
The second phase of the development of family support was to assist individuals to become included in more natural and informal settings and activities outside the formal service delivery system. Family support DD was linked with Family Connection to lead to full inclusion and integration of families with disability into their respective communities, and to extend the informal, natural supports that support all families in the community. The four primary goals of this phase were:
To disseminate and promulgate the principles of Family Support developed by the State Family Support Council to Local Family Support Councils.
To set standards for, model, and promote the delivery of Family Support services on a statewide basis that are consistent, reliable, resource-based and person-centered, adapted to local community needs, and easy to find and easy to use.
To collaborate with and build upon existing support networks for families that are not currently focused on developmental disability (such as Family Connection) by providing training, technical assistance and support around issues of disability, while continually
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working to integrate people with disabilities into those community networks in the most inclusive way possible. To expand the participation of local families and people with disabilities in the development of policies, practices and programs which directly impact their lives in the community.
The concept of Navigator Teams in Georgia was first discussed at a Family Support Think Tank hosted by the Council where national experts and Georgia stakeholders met to discuss concerns and strategies to move family support for families that have members with disabilities forward in Georgia. The participants recognized that 1) services were available in many areas but families were unaware of those services, 2) many state agencies and non-profits have trained families to assist other families in their communities but there was no coordination of these efforts, and 3) parents often sought other parents to assist them in navigating the confusing bureaucracies that exist to obtain services.
Currently there are ten counties in Georgia who are in various stages of organization and implementation of a navigator team. These include Butts, Crawford, Dougherty, Floyd, Jasper, Lowndes, Muscogee, Richmond, Walton, and Whitfield Counties. The selection process included criteria of trying to have geographic representation, having some rural and some urban counties, and working in counties where there were people willing to come together to support this effort. The members attended an orientation for Navigator Teams held at Callaway Gardens in January. The navigator teams have assisted 300 families to date since January and have provided information to 7730 people at various resource fairs, workshops, and community festivals. Each team is composed of parent leaders along with some professionals.
Direct Support Professionals Concerns about the quality of the individuals who provide support led the GCDD to consider the state of the direct support workforce, and to design a curriculum that was taught by instructors trained and experienced in adult education and developmental disabilities, accessible to workers and persons interested in working in the field throughout Georgia, and based on a firm foundation of the values of workers and the people they serve. The Direct Support Professional Certificate Program is now in place in 7 communities in Georgia. The goals of the project were to:
Advocate increasing pay and benefits and reward acquisition of new skills for direct support workers.
Adopt the Community Support Skill Standards and the Direct Service Professional Code of Ethics as Georgia's foundation for workforce development.
Develop a network to share learning about curricula and delivery methods. Enable a community of practice focused on improving teachers' competencies in
development opportunities for people with developmental disabilities: Develop resources to support community providers in re-designing themselves to
increase opportunities to improve direct support worker performance.
Nearly 100 workers have been trained to date, with three new sites beginning in the fall. Instructors and students alike have expressed very positive reviews of the courses and practicum experiences.
In May 2005, a group of direct support professionals gathered at Timber Ridge for a
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leadership summit where they organized the Georgia Alliance for Direct Support Professionals. The group developed a mission and strategies for recruiting other direct support professionals. A core steering committee for the GA Alliance for DSPs meets regularly with Bruce Blaney who provides supports to the group. They have put out three newsletters. They have started chapters in Savannah, Athens, Tifton/Fitzgerald, Macon, and Atlanta.
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Key Challenges
For the Council
Continuing to support Council projects and provide resources (human and financial) when the Council's federal dollars have remained level or been reduced over the past few years.
Having a protocol to make decisions and having the resources to address legislative and budgetary issues not identified before the legislative session.
Having the resources to monitor all the issues that impact individuals with developmental disabilities and their families.
Determining if Council funded advocacy training efforts resulted in a statewide, informed, effective, proactive advocacy network that can be called upon to act when important issues facing the disability community arise. Among the questions are: o Does the considerable investment of Council resources result in the production of advocates with the skills necessary to be called upon to work on issues at the state level? o Does the content and time spent in training significantly shift individual's perspectives along the advocacy continuum from self-empowerment to systems change? o Does the participation in advocacy and leadership training produce advocates that are effective in producing system change in their local communities? o Is Partners in Policymaking and Voices that Count the best way to train advocates? o Should we be moving toward more mainstream leadership training like county Leadership programs that do not specifically work on disability related issues, but focus on community development as a whole? o Should the GCDD consider Community Organizing as a way to shift attitudes, and consider expending more resources on fewer individuals supported for a greater period of time? o How do we evaluate the acquisition of advocacy skill and advocacy and leadership training?
Presenting fairly complex information on budget and policy in language that is accessible to consumers.
Maintaining the quality and integrity of the DSP curriculum by keeping a cadre of GCDD trained instructors available to teach, and increasing the professional profile and public awareness of this workforce as one critical to quality of services, and economic development of local communities.
The Service System
Real Learning Changes taking place in education for children as the state implements No Child Left
Behind and aligning those efforts, programs and activities for the special needs populations. Addressing the challenges posed by the highly qualified provisions of NCLB so the state does not lose professional capacity to educate students with significant disabilities. Continuing the effort to increase the percentage of students removed from the regular classroom for less than 21% of the day.
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Revising the regular education funding formula, and the special education funding formula to remove the disincentives for teaching children with disabilities in the regular classroom
Improving the post school outcomes for students with disabilities leaving high school through better transition services, including training in self-determination and person centered planning
Restructuring the diploma options in the state so that all students can get a standard diploma, but can meet the requirements through multiple routes.
The "highly qualified" teacher mandate of NCLB increased pressure on school districts to hire teachers who meet the requirements, and to retool existing staff. This pressure is likely to increase the demand for teachers who fit the qualifications of this federal legislation.
Real Influence Increasing pressure to get better control of the Medicaid budget through a variety of
different methods including managed care and caps on services. Gaining access to the budget process and boards for state departments other than the
Department of Human Resources. Maintaining fair, bipartisan relationships in an increasingly politicized environment. Balancing the need to continue addressing the waiting list for home and community
services while developing and supporting new policy and budget initiatives such money follows the person, Medicaid buy-in, de-institutionalization and family support.
Real Supports The number of people with MR/DD residing in nursing homes declined by 13%
nationally from 1992 to 1996. However, Georgia was one of six states that increased its population by more than 100 people. It is unclear the reason, but from 1986 to 1996, Georgia has slightly increased its placement of people with mental retardation or developmental disabilities in its nursing homes. In 1986, 1845 people with MR/DD resided in nursing homes; in 1990, 1,807; and in 1996, 1,897 people. In 2004, Georgia reports 1808 persons with DD living in nursing homes. Implementing the new Medicaid Waivers will face many challenges: o Retooling the provider array and options, and challenging providers to support
self-direction. New provider businesses will need incubation, and tradition providers will have to reconfigure o Family and consumer education: Families and consumers need education, training and support to take advantage of the new services in the waivers, and to self-direct o Medicaid billing system re-alignment: the new waiver requires new billing codes, and the current fiscal provider has experienced numerous difficulties in making even minor changes to the system. o Continued waiting lists o Matching the quality assurance system with the new self-directed opportunities
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Strategic Planning Priorities for FFY 2007-2011
The strategic planning priorities of the Council build on efforts already supported by the organization. The plan recognizes that many of the activities the Council has funded and participated in will require a long-term commitment of financial and organizational resources. All the efforts the Council is undertaking are aimed at the strategic outcome of Georgia having A Conceptually coherent policy for integrated life in the community for people with developmental disabilities and the people who support them. While each individual activity of the Council will be evaluated to determine its impact on promoting coherent policies, overall the Council will be able to evaluate the success of its efforts on three criteria: 1) do Council efforts promote collaboration? 2) are people with developmental disabilities and family members included and supported at all levels and in all aspects of decision making? And, 3) do Council efforts create relationships for people with disabilities in the community?
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Real Careers
Federal Area of Emphasis: Employment The federal definition for this Area of Emphasis is: People get and keep employment consistent with their interests, abilities and needs.
Priority: People with developmental disabilities want to work, yet nationally 70% of people with disabilities are unemployed. Current practices in service delivery often look at the individual's deficits and label them as being unemployable. To build on the work of the Jobs for All United State Department of Labor, Office of Disability Employment Policy grant, the Council's priority for Real Careers is that there needs to be a vision that people with significant developmental disabilities can work and this can take place by replicating best practices in employment such as customized employment. These employment opportunities will be enhanced by building relationships with business leaders and employers as well as through policies and practice that acknowledge the value of people with developmental disabilities in the workforce.
Outcome Indicators: The Council expects that its efforts in the area of Real Careers will result in the following outcomes for people with developmental disabilities.
Increase the number of adults with developmental disabilities who have jobs of their choice through Council efforts Increase the number of employers who provide vocational supports to students on the job Increase the number of businesses/employers who employ people with developmental disabilities Increase the number of employment programs/policies created/improved Increase the number of people engaged in systems advocacy about employment

Resources:
% of Resources for Per Diem and Consultants 4.6%

Recommendation for FY 07 $74,039

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Goals State policy and practices will support people with developmental disabilities working in competitive, integrated employment settings
People with developmental disabilities will have Real Careers through customized, integrated and competitive employment opportunities

Objectives By 2008 the State will adopt an Employment First Policy and promote public awareness about the Initiative especially with state agencies and business leaders.

Possible Action Steps Years 1-2 continue conversations with DOL and DCH about support of policy including identifying barriers and solutions that address their concerns. Pursue legislative or policy changes.
Years 2-5 provide technical assistance to agencies at the local level to implement the principles of the Employment First Initiative

Years 1-5 gather stories that illustrate successful examples of people with developmental disabilities working. This will involve multi-media approaches to tell stories

By 2009, the State will adopt and implement a Medicaid Buy-In that will allow people to go to work and keep their Medicaid

Years 1-5 the Council will work to develop relationships and connections with businesses and local chambers of commerce. Years 1-5 the Council will support and participate in coalitions that are working to develop and implement a Medicaid Buy-In.
The Council will develop easy to understand materials addressing people's fear of losing Medicaid or their benefits because of employment

By 2011 increase opportunities to replicate promising practices in employment of people with developmental disabilities

Years 2-5, provide funds to work with ten agencies/schools where there are local hospitals to replicate Project Search
Years 2-5 establish and develop an Employment Institute that can provide technical assistance to replicate promising practices in employment such as customized, micro-enterprises, work co-ops, or supported employment

Years 1-5 develop and provide technical assistance and resources to communities to offer Discovery Tours to educate business leaders about employing people with disabilities.

Possible Partners
Department of Labor/Vocational Rehabilitation Services
Department of Labor Career Centers
Coalition implementing the "Jobs for All" Grant
Business leaders and state and local chambers of commerce
Business Leadership Network
Universities Department of
Technical and Adult Education Foundations

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Real Homes
Federal Area of Emphasis: Housing The Federal definition of this area of emphasis is: Adults choose where and with whom they live.
Priority: To live in and contribute to communities of their choice, people with developmental disabilities deserve decent, safe and affordable housing as well as access to the necessary supports and services. The Council's priority for Real Homes is to promote policies that recognize that housing is inherently linked to income. This means ensuring that there are enough resources so that Georgians with developmental disabilities can acquire accessible and affordable housing, especially for individual's transitioning from institutions and nursing homes.
Outcome Indicators: The Council expects that its efforts in the area of Real Homes will result in the following outcomes for people with developmental disabilities.
Increase the number of individuals that have homes of their choices through Council efforts Increase the number of people moved from congregate settings to homes in the community Increase the number of units of affordable, accessible housing Increase the number of people active in systems advocacy in housing Increase the number of people trained in systems advocacy in housing Increase the dollars leveraged for housing Increase the number of housing programs/policies created/improved

Resources:

% of Resources for Per Diem and Consultants 6.1%

Recommendation for FY 07 $98,183

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Goals People with developmental disabilities will live in Real Homes with adequate support

Objectives By 2011, increased collaboration between agencies that provide housing and agencies that provide support services on the federal, state and local levels.

Possible Action Steps Years 1-2 the Council will evaluate effectiveness of current collaborations (DCA-DHR, DCA-SILC and Macon Housing Authority-Disability Connections) to determine the feasibility of replicating these programs Years 1-5 the Council will support efforts develop Housing 101 training and disseminate information about innovative options and Best Practice Models and resources available including opportunities for home ownership.
Years 3-5 the Council will support efforts to develop a model of collaboration, create training materials, and provide technical assistance to housing and service providers looking to replicate the model. This will include an evaluation component.
The Council will research the relationship between income and housing and explore options that can be used to increase income alternatives that can be used for room and board.

Possible Partners Department of
Community Affairs Centers for Independent Living and the Statewide Independent Living Center Concrete Change Realtor and Home Builder Associations Institute on Human Development and Disability AARP and other organizations that advocate on behalf of older adults Habitat for Humanity Christmas in April Building Supply Stores such as Home Depot and Lowes AmeriCorp Foundations

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People with developmental disabilities will live in Real Affordable and Accessible Homes

By 2011 the federal, state and local policies will be adopted to promote the ability of people with developmental disabilities to afford housing

Years 1-5 the Council will provide information and advocacy opportunities surrounding proposed local, state, and federal legislation on affordable housing.
Years 1-5 the Council will support efforts to increase the role and representation of people with developmental disabilities in conversations and meetings of affordable housing advocates, providers and funding entities.

By 2011, increase awareness of and market demand for accessible features

Years 1-2 the Council will work with Department of Community Affairs (DCA) to establish a priority for people with disabilities to receive affordable rental opportunities through the Section 8 voucher program. In Year 3-4, the Council will evaluate the DCA priority model, if adopted and identify opportunities to introduce the model to other housing providers. Years 1-3 the Council should support efforts to promote partnerships with EasyLiving Home Coalition, Habitat for Humanity, Concrete Change, the aging population, and the public/private sectors. This will include supporting efforts by the EasyLiving Home Coalition to develop a marketing campaign to increase the general public's awareness of accessible features.

Years 2-3 the Council will evaluate the feasibility of continuing to fund the EasyLiving Home Campaign.

Years 1-2 the Council will advocate and support state funding for accessibility modifications at the homes of individuals with disabilities and evaluate the success of any implementation model adopted.

Years 2-3 the Council will evaluate its role in trying to increase resources for home modification.

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Real Learning

Federal Area of Emphasis: Education and Early Intervention The Federal definition of this area of emphasis is: Students reach their educational potential and infants and young children reach their developmental potential.

Priority: An estimated 3800 number of students with disabilities exit school each year, either with a regular education diploma, or a special education diploma, and for a large percentage, the post-school outcomes are not that positive. In the 2004-2003 school year, 430 students with disabilities dropped out of high school. Over 1800 left with a certificate only, leaving them ill-equipped for post-school activity, such as further education, technical training, or paid employment. Far too many students exit school to sit home.

Key Components of IDEA 2004 (Public Law 108446.)
Children should have access to "general education curriculum in the regular classroom, to the maximum extent possible, in order to meet developmental goals, to the maximum extent possible, and challenging expectations that have been established for all children; and be prepared to lead productive and independent adult lives, to the maximum extent possible."
"Parents and schools should be given expanded opportunities to resolve their disagreements in positive and constructive ways."
"As graduation rates for children with disabilities continue to climb, providing effective transition services to promote successful post-school employment or education is an important measure of accountability for children with disabilities."

The Department of Education and the Division of Exceptional Students has formed a state transition team to work on these issues, and within the 10 performance outcomes that the state is working on to improve the outcomes of children with disabilities, three are directly related to transition. In addition, the Governor's Council and the DES has formed and run a Statewide Transition Steering Committee that has been meeting on a quarterly basis for three years. This group has been very productive in considering related policy that affects the transitioning student, and there are activities in the State's Transition Action Plan on which the Statewide Transition Steering Committee has agreed to work.
Most of the groups considering better transition outcomes for students agree that several components are involved. First, students in high school need constructive transition planning, and that planning needs to start prior to the beginning of HS, if students have hopes of completing successfully. Second, HS students need to learn the skills to be actively engaged in their own planning, to express their wishes, problem solve and self-advocate. Third, the state's graduation policies need to accommodate students who cannot complete HS by traditional routes. Fourth, members of the teaching and administrative professions could benefit by better and more frequent interaction with the disability community network so they can share ideas, challenges and solutions, and move forward together. Finally, parents of students with special needs need to be supported in their efforts to

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advocate for their children, to share information with each other, and to learn how to navigate the systems that serve their children.

Therefore, the priority is stated as A Georgia where high school students with disabilities experience effective transition planning that includes the practice of self-determination, alternative diploma routes, professional collaboration and positive parent support that leads to better post-school outcomes.

Outcome Indicators: The Council expects that its efforts in the area of Real Learning will result in the following outcomes for people with developmental disabilities.

Increase the number of students that have the education and support they need to reach their educational goals Increase the number of students successfully transitioned from school to community and jobs Increase the number of parents, teachers, and administrators trained in best practices around education Increase the number people active in systems advocacy in education Increase the number of education programs/policies created or improved Increase the number of adults with developmental disabilities who participate in community leadership programs

Resources:

% of Resources for Per Diem and Consultants 23.4%

Recommendation for FY 07 $376,636

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Goals Students with developmental disabilities receive appropriate high school education and transition planning that leads to productive post-school activities.
Education professional leadership shares and promotes information on best practices for educating students with disabilities in regular education settings.

Objectives By 2011, all school districts in Georgia will incorporate selfdetermination training in integrated settings (i.e. regular classes) for all students with developmental disabilities
By 2011, rate of students with disabilities graduating with general education diploma through one of multiple routes will be improved 25%. By 2008, create and formalize mechanisms to communicate and consult with professional education leadership organizations (Georgia Learning Resource Services, Regional Education Services Agency, Georgia Association of Education Leadership, Council for Exceptional Children, Georgia Council Administers of Special Education , GA Curriculum Assoc.)

Possible Action Steps Year 1 the Council will survey all districts to determine state of self-determination instruction, report to state.
Years 1-5 provide resources to districts that want to establish self-determination curriculums.
Years 1-5 reproduce and disseminate "how-to" kit on starting self-determination classes.
Years 2-5 help contiguous districts network and learn from each other using district liaisons from Division of Exceptional Students as network linkage between districts Years 1-5 the Council will advocate for students with disabilities to receive a general education diploma.
Year 1 contact directors of professional organizations, introduce work of council, share news on projects,
Year 1 host information sharing meeting with leadership and Council.
Years 2-4 support Better All Together Conference as a way to promote best practices for educating students with disabilities in regular education settings.
Years 2-5 get on the agenda in the new directors academy for sessions on parent involvement, self-determination, regular Diploma option, etc.

Possible Partners
Department of Education
State and local PTA's
Department of Labor/Vocational Rehabilitation Services
Superintendent Association
Special Education Directors Association
Statewide Transition Steering Committee
Family Connections Partnership
Georgia Advocacy Office
The ARC of Georgia
ADA Resource Center
Parent Mentors Local School
Districts Parents Foundations

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Parents of children with special needs have increased access to positive education, advocacy, resources and strategies through the coordination of activities in the Parent Leadership Coalition

By 2011 there will be an increase in parent education, training and capacity building and advocacy coordinated through the Parent Leadership Coalition (PLC) in a one-stop model particularly with parents in the mentor programs, Parent Leadership Support Program (PLSP), and Partners in Policymaking graduates providing assistance in schooling issues

Years 2-5 the Council will support a coordinator for the PLC
Years 1-5 begin PLC newsletter and work on website to provide better access
Years 1-5 refer parents to and/or financially support PLC, PLSP and Parent Mentor Program

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Real Influence
Federal Area of Emphasis: Quality Assurance The federal definition of this area of emphasis is: People have the information, skills, opportunities, and support to live free of abuse, neglect, financial and sexual exploitation, and violation of their human and legal rights and the inappropriate use of restraints and seclusion. Quality assurance systems contribute to and protect self-determination, independence, productivity, integration and inclusion in all facets of community life.
Priority: During the early part of the planning process, Council members identified the need to better market the Council, its name and its product as a top priority. The Council currently publishes several publications whose outcome is to provide people with the information necessary to make informed decisions about their lives and advocate for changes in the system. Making a Difference and Moving Forward are sent to over 3500 individuals through the mail, e-mail and the Internet. The Council's website continues to be a tool that people can use to find information. Council staff is continually meeting with members of the media to respond to questions and pitch stories. In addition, media roundtables are held when the Council's quarterly meeting is held in sites other than Atlanta. The Council's priority for Real Influence is to increase awareness of the Council's activities and promote initiatives supporting its goal and mission.
Advocates throughout the state look to the Council as a leader in assisting individuals with developmental disabilities and their families to become better advocates and have the skills need to support initiatives throughout the State. In addition, the Council has worked in coalition to educate elected officials about the needs of persons with developmental disabilities and their families. The development of effective, bi-partisan relationships with legislators enables the Council to be viewed as the fair and reliable authority on policy and budget issues affecting people with developmental disabilities. In addition, the Council continues to be invited in discussions because it provides timely responses to requests for information from legislators, thorough, well-conducted research and strategic dissemination of information. Leadership provided during the General Assembly has resulted in increased funding and passage of legislation that continues to move the State in the right direction. With the upcoming reauthorization of the Developmental Disabilities Bill of Rights and Assistance Act, the need to develop the same kinds of relationship with federal legislators is very apparent.
These efforts will require a strong advocacy voice and the Council continues to support efforts to train individuals with developmental disabilities and family members to become a united voice. The continuous, active engagement of citizens who have completed advocacy training provides the Council with a powerful voice at the Capitol and other policy-making tables. Leadership training needs to be incorporated in the mainstream citizen advocacy that local communities conduct if disability is to be seen as a natural life experience. The Council priority will be to continue supporting coalitions and advocates that promote positive public policies for people with developmental disabilities and their families.
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Outcome Indicators: The Council expects that its efforts in the area of Real Influence will result in the following outcomes for people with developmental disabilities.

Increase the number of copies of products distributed to policymakers, people with developmental disabilities, family members, advocates and providers about issues related to Council Initiatives
Increase the members of the general public estimated to have been reached by Council public education, awareness and media initiatives
Increase the number of public policymakers educated by Council about issues related to Council initiatives Increase the number of people trained in leadership, self-advocacy, and self-determination Increase the number of people who have attained membership on public and private bodies and other leadership coalitions Increase the number of entities participating in partnerships or coalitions created or sustained as a result of Councils efforts

Resources:

% of Resources for Per Diem and Consultants 35.7%

Recommendation for FY 07 $574,611

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Goals People with developmental disabilities, family members, advocates and others have the necessary information to become better advocates

Objectives By 2008, the Council will support development and implementation of a strategic communication plan

Possible Action Steps Year 1-2 the Council will contract with a consultant to develop a strategic Communication Plan. An ad hoc committee of the Council will work with staff to determine how best to implement the recommendations of the plan.

Years 2-3 the Council will begin Implementation of the recommendations

By 2011, the Council will provide pertinent information about best practices to key stakeholders including individuals with disabilities, families, service providers, advocates and the public through publications, the media and the Council's web site.

Years 2-5, the Council will work with advocates to develop a disability communication plan Years 1-5 the Council will continue to produce and expand distribution of Making a Difference magazine
Years 1-5 the Council will produce and distribute other publications such as an annual report as determined by the Council.
Years 1-2 the Council will improve web site so that it is better able to distribute and collect information

Years 1-5 the Council will explore, develop and produce materials, publications and its website in languages other than English

Possible Partners Faith based
organizations Organizations that
support individuals from diverse cultures and the media that work in those communities Local and statewide leadership development organizations Advocacy organizations outside the disability community Public Television Parent leadership coalitions Unlock the Waiting List Coalition People First Foundations

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Promote the necessary changes in Georgia's public policy that better serve the best interest of individuals with developmental disabilities and their families and identify needed revisions in the systems that provide services and supports so that they encourage choice and selfdirection and strengthens and supports the caregiving efforts of families

By 2011, there will be an increase in federal and state public policy makers' knowledge, understanding, and awareness of developmental disability issues so that these individuals create well-crafted laws and policies that improve the quality of life
The Council will identify and advocate for the necessary changes to state laws and policies where research and/or experience indicate is appropriate By 2011, provide information resources for developmental disabilities issues to individuals, family member, advocates and policy-makers through Council publications and educational materials

Years 1-5 the Council will host an annual gathering of advocates to discuss budget and legislative issues. The Council will use this gathering to create a legislative agenda and will provide legislative comment and testimony on issues that impact the lives of people with developmental disabilities and their families
Years 1-5 the Council will support coalitions that are developed to address legislative and budget issues
Year 1-5 the Council will continue to publish Moving Forward during the legislative session through mail and Constant Contact. At the same time, the Council will explore other options for tracking and distributing information concerning legislation including CapWiz and Capital Impact
Year 1-5 the Council will continue to sponsor Disability Day at the Capitol as a way to inform legislators about the needs of people with disabilities

Year 1-5 the Council will explore opportunities to increase the number of people with developmental disabilities who exercise their right to vote.

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People with developmental disabilities and their families will have opportunities to exercise leadership in organizations and in the disabilities rights movement

By 2011, increase the number of people with developmental disabilities and family members that have the information and skills to exercise leadership, self-advocacy and selfdetermination in order to organize effective local and statewide grassroots efforts.
By 2011 increase the number of individuals with developmental disabilities and family members who receive stipends that to participate in leadership activities and attend educational/policy events

Year 1 the Council will evaluate all previous leadership development programs to determine effectiveness (Partners in Policymaking, Georgia Voices that Count, Youth Leadership Forum)
Years 2-5 develop an initiative to develop networks that connect people GCDD trained or not, to give them opportunities to focus on collective action and "influence" and that promotes self-advocacy and family advocacy. Any initiative should also include a component of outreach to culturally diverse populations including offering training in languages other than English. Years 1-5 continue to offer Partnership Funds. The focus of Partnership Funds should be to support and recruit self-advocates to participate in leadership development programs such as Leadership DeKalb

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Real Supports
Federal Areas of Emphasis: Formal and Informal Community Supports The Federal Definition of this Area of Emphasis is: The Federal definition of this area of emphasis is Individuals have access to other services available or offered in a community, including formal and informal community supports that affect their quality of life
Priority: Over the past seven years, the Unlock the Waiting List Campaign has resulted in thousands of individuals receiving supports that would have not otherwise been available. However, there remain over 5,000 people with developmental disabilities on the waiting list for home and community based services. This number is expected to grow. People with developmental disabilities are living longer and aging earlier than individuals without developmental disabilities. There are growing numbers of individuals who are residing with parents who are in their 70's or 80's, who are in need of their own supports. A multi-year funding plan was developed to address this growing waiting list and is being used as the benchmark for future requests for funding. In addition, a question remains about the capacity of providers to meet the growing need based on the number of providers, the reimbursement rates provided and the quality of the workforce available to work with individuals and families. The Council's priority is to continue its efforts to increase funding for home and community based services as well as the quality of those supports.
During the past year, the Council in collaboration with the Georgia Advocacy Office, Institute on Human Development and Disability, Statewide Independent Living Council and People First supported efforts to move the remaining 40 children from state hospitals into the community. There still remain approximately 100 children in nursing homes or private ICF/MRs. Children should not grow up in institutions but instead need to be in loving, stable homes. The reason many children ended up in facilities is because families did not have the supports they needed to care for children with developmental disabilities or chronic medical conditions. The only option given to many families was placement in a state or private institution. The priority for the Council is a Georgia where children are prevented from going into institutions/facilities or are brought home safely from institutions/facilities into homes and families.
Outcome Indicators: The Council expects that its efforts in the area of Real Supports will result in the following outcomes for people with developmental disabilities.
Increase the number of people receive formal/informal community supports through Council efforts Increase the dollars leveraged for formal/informal community supports Increase the number of formal/informal community supports programs/policies created/improved Increase the number of people active in systems advocacy about formal/informal community support Increase the number of people trained in systems about formal/informal community supports Increase the number of people have transportation services through Council efforts Increase the number of people active in systems advocacy about transportation Increase the dollars leveraged for transportation Increase the number of transportation programs/policies created/improved
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Resources:
% of Resources for Per Diem and Consultants 30.2%

Recommendation for FY 07 $486,085

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Goals People with developmental disabilities and their families will have the resources to access needed services and supports

Objectives By 2009, the multi-year funding plan for home and communitybased services will be fully implemented.

People with developmental disabilities and their families will have more control over the flexible resources needed to meet their needs

By 2009, the State will adopt legislation that monies follow the person from institutions to the community By FY 2008 increase efforts to implement flexible family supports
By FY 2008, increase efforts to implement self-determination for individuals 18 years and older

Possible Action Steps Years 1- 5 continue to work with DHR, DCH, OPB, the Governor's office, and legislators to address the waiting list by increasing funds in the budget for home and community-based services
Years 1-5 support the grassroots advocacy capacity of the Unlock the Waiting List Campaign through supporting participating of self-advocates and family members. Years 1-5 the Council will Work with People First and other advocates to develop and advocate for legislation that allows money to follow the person from institutions to the community Years 1-5 support efforts by the Navigator Teams to assist families in accessing services and act as a conduit for sharing information with diverse populations culturally and ethnically
Years 3-5 develop a project to promote natural supports and family supports including those parents who are aging in planning for the needs of their family members future. Years 1-5 provide training to individuals with developmental disabilities and family members who will begin self-directing their services including individual budgets, building circles of support and being an employer.
Year 2 support efforts to get the Peer Support Initiative that promotes people with disabilities assisting others with disabilities approved as a Medicaid billable service.

Possible Partners Local technical
colleges and schools Department of Human Resources Division of Mental Health, Developmental Disabilities, Addictive Diseases Area Agencies on Aging Department of Transportation Advocates for early childhood Georgia Advocacy Office Institute on Human Development and Disability The Arc of Georgia People First Statewide Independent Living Council

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Direct Support Professionals will have the training and wages that result in a valued career path

By 2011 there will be an increase the number of direct support professionals who complete participate in training and opportunities to learn from each other.

Year 1 the Council will conduct an evaluation of all DSP activities and determine effectiveness and ways to connect the DSP Alliance and curriculum offered through technical collages.
Years 1-5 work with technical colleges to expand the number offering the curriculum

Years 1-5 develop and offer an instructor's institute to assist those who are teaching the curriculum

Years 1-3 work with MHDDAD/DHR to develop requirements/standards for direct support professionals training

Family Connections Partnership
Rosalyn Carter Institute
Children's Trust Fund
Faith Based Community
Advocates for older adults
Peer Supporters Foundations

Years 1-5 the Council will advocate for increased salary for direct support professionals in the community and for financial incentives to those who complete training

Ensure that no children in Georgia reside in public or private institutions or nursing homes

By 2011, the will be no more children in state or private ICF/MRs and nursing homes and children will not be at risk for institutionalization in the future.

Years 1-5 support efforts to expand the DSP Alliance statewide. Years 1-5 the Council will support and participate in a collaborative effort to achieve the goals of the Children's Freedom Initiative. This will include efforts to help develop recommendations concerning flexible family support through the Division of MHDDAD
Years 1-3 the Council will advocate for funding in the DCH and DHR budgets that will support moving children from institutions

Years 1-5 the Council will research other states and legislation that requires children be served in the community. Based on research will develop and advocate for legislation that keeps children and at home and not in institutions.

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By 2011, children with developmental disabilities currently in Department of Juvenile Justice or Division of Family and Children Services custody will receive appropriate supports in the community.

Years 2-5 the Council will develop strategies to address the children with developmental disabilities who are currently in DJJ or DFCS custody. This should include exploring legislative and regulatory barriers that exist which support children remaining in DJJ or DFCS custody

Federal Area of Emphasis: Transportation The federal definition for this area of emphasis is: Individuals with disabilities have access to and use of transportation

Priority: In almost every forum ever held by the Council to identify the needs of people with developmental disabilities and their families, transportation is identified as a need. According to a 2004 Harris survey, people with disabilities are twice as likely to have inadequate transportation (31% versus 13%) as those without disabilities.29 In both rural and metropolitan areas flexible and accessible transportation is needed so that people can get to work, the doctor, recreation, and home. There have been efforts over the years to address this problem but it has proved difficult and not very effective. In addition, for those who live in many parts of Georgia, lack of transportation is a problem for all people, not just those with disabilities. The Council priority is to support efforts to increase transportation options for people with disabilities and their families.

Goals People with disabilities and their families will have access to public and private transportation systems that are affordable and accessible, and result in people being able to travel when and where they need.

Objectives By 2011, the Council will promote awareness of the needs of persons with disabilities for transportation that will enhance their involvement in their communities

Possible Action Steps Year 1 the Council will explore the ways that other Councils have attempted to address transportation
Years 1-5 the Council will support efforts to develop a multi-disability coalition to address transportation efforts

Explore efforts to support a staff position at the Department of Transportation for the purposes of increasing awareness of needs of persons with developmental disabilities and expanding services

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Cross Cutting

Federal Area of Emphasis: Cross- Cutting The Federal Definition of this area of emphasis is: The Council activities that impact all Areas of Emphasis.

Priority: Delivering valued services to people with developmental disabilities, their families, advocates, and policy makers must continue to

be the primary concern of the Council, its members, and staff. The Council must continue to make wise choices so that waste is eliminated

and maximum benefits are derived from its financial and human resources. To ensure that the Council continues to become ever more

efficient and effective in the services it offers, its members and staff must continue to focus efforts on programs that are achieving desired and

demonstrable results.

Goals

Objectives

Possible Action Steps

The Council will continue to By 2008, the Council will improve its Year 1-2 the Council will review and evaluate the current grants

improve its operations while grants, monitoring, and project

and contracts process and the methods it uses to monitor and

meeting the requirements of evaluation processes to promote fiscal evaluate its efforts. This includes a tool that is included in every

the Developmental

and programmatic responsibility among contract and customer satisfaction process as required by the

Disabilities Bill of Rights and grant recipients while remaining

Administration on Developmental Disabilities. Through an ad hoc

Assistance Act

accessible and responsive to the public committee, the Council will determine which recommendations

to implement.

Continue using federal funds to enhance

the capacity of local communities to

In Year 1-2, the Council will implement recommendations

welcome and support individuals with

developmental disabilities

Year 1-2 the Council will improve the Project Tracking System so

that it is better able to assist staff in tracking financial and

programmatic aspects of projects as well as allowing vendors to

submit reimbursement requests and reports on line.

By 2011, the Council will increase

Year 1-5 the Council will continue to provide opportunities for

opportunities for Council members and Council members and staff to attend national and state

staff to participate in learning and

conferences.

training opportunities on the state and

national levels

Years 1-5 the Council will provide diversity training for members

and staff. This will include cultural competency as a component

of "ambassadors" training for members.

Year 1-5 the Council will continue to belong and participate in NACDD.

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By 2011, the Council will improve its efforts to make sure that all mandates by funding sources are met

Years 1-5 the Council will Implement all requirements of the DD Act

Federal Area of Emphasis: Quality Assurance The Federal Definition of this area of emphasis is: People have the information, skills, opportunities, and support to live free of abuse, neglect, financial and sexual exploitation, and violation of their human and legal rights and the inappropriate use of restraints and seclusion. Quality assurance systems contribute to and protect self-determination, independence, productivity, integration and inclusion in all facets of community life.
Priority: Georgia is becoming a more diverse state, geographically, ethnically and racially. This means that we have a population that lives in both rural and metropolitan areas. The needs of both areas are very different based on those who live there and the services that are available. While Georgia has always been seen as a racially diverse state, this has changed over the past few years as more people from Mexico, Central America, South America and Asia settle in cities and towns across the state. This has also led to more people speaking languages other than English that are presenting themselves and families members in need of services and supports. The Council's priority is to support outreach efforts to those individuals and areas of the state that are unserved or underserved.
Outcome Indicators: The Council expects that its efforts in the area of Cultural Diversity will result in the following outcomes for people with developmental disabilities.

Increase in the number of people who are culturally or ethnically diverse will benefit from Council efforts. Increase the number of people who are culturally or ethnically diverse that have been reached by Council public education, awareness
and media initiatives
Increase the number of people who are culturally or ethnically diverse trained in leadership, self-advocacy, and self-determination Increase the number of entities representing culturally or ethnically diverse populations participating in partnerships or coalitions
created or sustained as a result of Councils efforts

Goals The needs of individuals with disabilities and their families who are who are culturally and ethnically diverse will be better met by the Council.

Objectives By 2011, the Council will increase its efforts to understand ethnic and cultural competency and include this as a part of all Council initiatives

Possible Action Steps Years 1-5 The Council will make sure that diversity issues are included and addressed in all Request For Proposals (RFP) and projects.. There will be a criterion in the rating process on addressing diversity. Outreach to increase bids and contracts to diverse companies document it.

Years 1-5 the Council will identify and actively collaborate with existing coalitions from culturally and ethnically diverse communities.
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By 2011, the Councils membership will reflect the demographics and diversity of Georgia

Years 1-5 the Council will conduct outreach and recruit members and ex-officio members from communities under represented on the Council. The Council will encourage the Governor to appoint members that reflect the demographics and diversity of Georgia

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Evaluation of Progress
With a new strategic plan about to begin, the GCDD can also rethink the way in which it evaluates progress on the different initiatives it plans to undertake. It is important to plan evaluation to be informative to staff, Council members and the community at large on how well a project achieved its anticipated aims. As such, evaluations should follow accepted research methods and to the extent possible, use valid and reliable measures. It is also more efficient if the Council's evaluation efforts translate easily to the indicators by which ADD measures Councils' activities for the federal performance report. Therefore, we want to measure our progress in a meaningful way for our constituents, and in a useful way for our federal accountability.
Customer Satisfaction: The Administration on Developmental Disabilities has developed a customer satisfaction process that each Council is required to implement. It includes surveys and focus groups with individuals with developmental disabilities, family members and those who receive Council grants.
Program Performance: Council has conducted the evaluation of the Family Support Project according to this structure. Sometimes called "Theory of Change" model, we attempted to examine how the interaction of resources, activities and early and intermediate outcomes in the relevant contexts, resulted in the ultimate outcome we desired. We have used other evaluation methods to develop the indicators and collect data elements, such as using the web with Survey Monkey web-based survey design resource, and through QMethodology, which enabled us to elicit evidence that intensive advocacy training does result in a shift in participant's thinking and attitudes.
Annual Indicators of Progress: The Council will use a modified dashboard process annually to assess overall organizational performance. The Council will develop a simple method of determining how well the organization is performing in areas such as programming, finance, human resources, and governance.

Satisfaction

$9,924,314


Individual levelsatisfaction w/activities
Systems level

Systems Change
Demonstrations Outreach
Training

Collaboration
DD Network
Other
Capacity Building
Collaboration/coalition building
Accessibility & Sharing resources
Systems design/redesign

Performance
Performance Indicators
Narratives
Advocacy
Informing policymakers Public education
Other

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ASSURANCES
(A) IN GENERAL.--The plan shall contain or be supported by assurances and information described in subparagraphs (B) through (N) that are satisfactory to the Secretary.
(B) USE OF FUNDS --With respect to the funds paid to the State under section 122, the plan shall provide assurances that--
(i) not less than 70 percent of such funds will be expended for activities related to the goals described in paragraph (4);
(ii) such funds will contribute to the achievement of the purpose of this subtitle in various political subdivisions of the State;
(iii) such funds will be used to supplement, and not supplant, the non-Federal funds that would otherwise be made available for the purposes for which the funds paid under section 122 are provided;
(iv) such funds will be used to complement and augment rather than duplicate or replace services for individuals with developmental disabilities and their families who are eligible for Federal assistance under other State programs;
(v) part of such funds will be made available by the State to public or private entities; (vi) at the request of any State, a portion of such funds provided to such State under this subtitle for
any fiscal year shall be available to pay up to \1/2\ (or the entire amount if the Council is the designated State agency) of the expenditures found to be necessary by the Secretary for the proper and efficient exercise of the functions of the designated State agency, except that not more than 5 percent of such funds provided to such State for any fiscal year, or $50,000, whichever is less, shall be made available for total expenditures for such purpose by the designated State agency; and (vii) not more than 20 percent of such funds will be allocated to the designated State agency for service demonstrations by such agency that--
(I) contribute to the achievement of the purpose of this subtitle; and (II) are explicitly authorized by the Council.
(C) STATE FINANCIAL PARTICIPATION --The plan shall provide assurances that there will be reasonable State financial participation in the cost of carrying out the plan.
(D) CONFLICT OF INTEREST --The plan shall provide an assurance that no member of such Council will cast a vote on any matter that would provide direct financial benefit to the member or otherwise give the appearance of a conflict of interest.
(E) URBAN AND RURAL POVERTY AREAS --The plan shall provide assurances that special financial and technical assistance will be given to organizations that provide community services, individualized supports, and other forms of assistance to individuals with developmental disabilities who live in areas designated as urban or rural poverty areas.
(F) PROGRAM ACCESSIBILITY STANDARDS --The plan shall provide assurances that programs, projects, and activities funded under the plan, and the buildings in which such programs, projects, and activities are operated, will meet standards prescribed by the Secretary in regulations and all applicable Federal and State accessibility standards, including accessibility requirements of the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.), section 508 of the Rehabilitation Act of 1973 (29 U.S.C. 794d), and the Fair Housing Act (42 U.S.C. 3601 et seq.).
(G) INDIVIDUALIZED SERVICES --The plan shall provide assurances that any direct services provided to individuals with developmental disabilities and funded under the plan will be provided in an individualized
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manner, consistent with the unique strengths, resources, priorities, concerns, abilities, and capabilities of such individual. (H) HUMAN RIGHTS --The plan shall provide assurances that the human rights of the individuals with developmental disabilities (especially individuals without familial protection) who are receiving services under programs assisted under this subtitle will be protected consistent with section 109 (relating to rights of individuals with developmental disabilities). (I) MINORITY PARTICIPATION --The plan shall provide assurances that the State has taken affirmative steps to assure that participation in programs funded under this subtitle is geographically representative of the State, and reflects the diversity of the State with respect to race and ethnicity. (J) EMPLOYEE PROTECTIONS --The plan shall provide assurances that fair and equitable arrangements (as determined by the Secretary after consultation with the Secretary of Labor) will be provided to protect the interests of employees affected by actions taken under the plan to provide community living activities, including arrangements designed to preserve employee rights and benefits and provide training and retraining of such employees where necessary, and arrangements under which maximum efforts will be made to guarantee the employment of such employees. (K) STAFF ASSIGNMENTS --The plan shall provide assurances that the staff and other personnel of the Council, while working for the Council, will be responsible solely for assisting the Council in carrying out the duties of the Council under this subtitle and will not be assigned duties by the designated State agency, or any other agency, office, or entity of the State. (L) NONINTERFERENCE --The plan shall provide assurances that the designated State agency, and any other agency, office, or entity of the State, will not interfere with the advocacy, capacity building, and systemic change activities, budget, personnel, State plan development, or plan implementation of the Council, except that the designated State agency shall have the authority necessary to carry out the responsibilities described in section 125(d)(3). (M) STATE QUALITY ASSURANCE --The plan shall provide assurances that the Council will participate in the planning, design or redesign, and monitoring of State quality assurance systems that affect individuals with developmental disabilities. (N) OTHER ASSURANCES --The plan shall contain such additional information and assurances as the Secretary may find necessary to carry out the provisions (including the purpose) of this subtitle.
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Appendix A: Overview of Current Medicaid Waiver Programs

Waiver

Description

Eligibility

Services

Community Care Services Program
Established in 1982

Home and Community-based care for the functionally impaired elderly or disabled.

Any age
Risk of Institutionalization Requires level of care that
could be provided in nursing home Medicaid Eligible Must be able to live in the community safely with services provided.

Home Delivered Meals Emergency Response Respite Care Alternative Living Services
(personal care home services) Adult Day Rehabilitation Personal Support Services
(assistance with bathing, house chores, etc.)

Home Health Services

Mental Retardation Waiver
Established in 1989

Home and Community-based care for people with developmental disabilities.

Must be 21 years of age or older and have a form of MR or related condition.
Must require a level of care in the home that is provided in a state institution.
Meet income eligibility.

Through MR service provider, receive day habilitation services and residential training and supervision.
Home health Respite Care Personal Support Services Other home-based services Natural Support

Model Waiver or Waivered Home Care Services

Home and community-based care for children up to age 21 who are oxygen or ventilator-dependent.

Child must be 21 years of age or younger.
Child must be eligible for Medicaid.
Child must require a level of care in the home equivalent to that provided in a hospital, skilled nursing facility, or intermediate care facility.
Child's home provides a safe and appropriate care environment.
Total annual cost to Medicaid for home care must not exceed the amount Medicaid would pay for institutionalization.

Pediatric private duty nurse of the family's choice for up to 24 hour care for 2-3 months. Nurse must be under a doctor's supervision and be authorized to received Medicaid payments.
More commonly, provides for 12 hour care up to 7 days a week for a period of 6 months. Family can re-qualify for services by reapplying every 6 months for several years.
Medical day care.

Independent Care Waiver
Established in 1992

Home and Community-based care for the persons with severe disabilities or traumatic brain injuries.

Must be 21 years of age.
Adult must require a level of care in the home that is typically provided in a hospital, skilled nursing facility, or intermediate facility.
Adult can be provided safe and appropriate care in their own home.
Total annual cost to Medicaid for home care must not be greater than the amount of Medicaid would pay for the person's care in

Case Management Companion Services Counseling Emergency Response System Environmental Modifications Homemaker Services Occupational Therapy Personal Care Services Skilled Nursing Specialized Medical
Equipment and Supplies Transportation

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Community Habilitation and Support Services Waiver
Established in 1996

Home and Community-based care for those persons with developmental disabilities in the community and those impacted by the closure of Brook Run.

an institution.
Usually a person with MR/DD who leaves an institution because of closure

Managed care model Home Health Day Habilitation Supported Employment Respite Care Residential training &
supports Personal Support Services Emergency Response Vehicle Adaptation Home Modifications Other Specific Services

SOURCE Shepherd Care

Primary care and HCB care for the elderly & disabled emphasizing preventive care and case management. Coordinated casemanagement and home and communitybased care for severely physically disabled adults within a specific geographic area.

Frail elderly or disabled who are SSI eligible.

Services similar to the Community Care Services Program (CCSP) provided in a holistic approach. Primary care is integrated with CCSP through case mgmt.

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White Paper, Date Blue Ribbon Task Force Report, 2001
Family Support, 2001
Olmstead Plan, 2001
A Quality Workforce Means Quality Services, 2003
Implications of the Proposed Fee Scale for Families Enrolled in the Katie Beckett Waiver Program, 2004 People with Disabilities and Housing in Georgia, 2004 Reconsidering Special Education Funding in Georgia, 2005
Memorandum on Pathways for All Students to Achieve a Standard Diploma, 2005 Managing State Waiting Lists for Residential Services, 2005
Understanding the Challenges and Options of Transitioning People with Developmental Disabilities from Institutions to Community Living, 2005 Strengthening the Service System for People with Developmental Disabilities, 2005 Georgia's Direct Support Professional Certificate

Appendix B: Council White Papers

Purpose

Audience

Collaborative Effort with Aging and Mental Health to generate support

Governor's Office, Legislature, State Agencies

for strategic, multiple year funding for home and community based services

To describe the purpose, scope and effectiveness Governor's Office, Program of Family Support Programs, reviewed existing specialists from DHR, Office of

services in Georgia, compared services with 5 MHDDAD, advocates, providers

other states, and offered recommendations.

Collaborative effort with Aging and Mental health to address Supreme Court decision,

Governor's Office, State Agencies, CMS

Olmstead v L.C. and E.W. 1999, by creating a comprehensive state plan to move people from institutions and keep those at risk from institutional placements out.

(The plan was never submitted, by was watered down and publicized by subsequent governor)

Provided a concise description of the issues

Developmental Disabilities

surrounding direct support staffing problems, the challenges in addressing the issues, and

provider community, potential funding agencies, State agencies,

proposed recommendations for a multi-year

advocacy community

effort to work on the problem.

Reported survey data on 325 families who received Medicaid through Katie Beckett and

Legislators, policy makers

the impact a sliding fee scale would have on

their ability to care for their medically fragile children

Reported on data collected from public forums and research about housing options and the barriers to housing for people with disabilities Describes and provides data and analysis of the anomalies and disincentives in the current special education funding formula that works against including children with disabilities in the regular classroom with support.
Presents the legal, ethical, curricular and economic reasons why GA should return to a standard diploma, and provide alternate routes for students to obtain it. Provided an overview of several state's waiting lists protocols and policies in response to a Division of Mental Health, Developmental Disabilities and Addictive Diseases desire to revisit the current waiting list policies and put in place a system that was more rigorous and responsive to most in need. Outlined the important barriers that the state faces in transitioning individuals from institutions to the community; employers, wages, provider capacity, cost of dual systems, etc.

Policy makers including the Departments of Community Affairs and Human Resources The Governor's Quality Basic Education Funding Task Force, DOE, State Board of Education and Legislators
State Advisory Panel for Special Education, State Board of Education, Legislators
Division of MHDDAD, Department of Human Resources, advocates
MHDDAD / DHR; Governor's Office, legislators, providers, advocates, Alliance for Direct Support Professionals, SEIU Union.

Presents recommendations about what the future system for people with developmental disabilities should like and the changes in the components of that system. Describes the status of the Workforce Development Project that is established at

MHDDAD/DHR, Governor's Office, advocates, legislators
Department of Human Resources, public and private

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Program, 2006
Real Influence Begins with You! The DD Council's Guide to Legislative Advocacy, 2006

several Department of Technical and Adult Education colleges, the curriculum, requirements, instructor training, and results of the program's first year. Provides clear, easy to read overview of the Georgia General Assembly, how bills become law, the budget process, and how to build relationships and advocate successfully.

provider community, Office of Economic Development and legislators
Widely distributed at D Day at the Capitol, other advocacy training events.

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Endnotes

1Public Law 106-402, Developmental Disabilities Bill of Rights and Assistance Act of 2000, Subtitle B, Section 121,

October 2000. 2Robert Andriga and Ted Engstrom, Nonprofit Board Answer Book: Practical Guidelines for Board Members and Chief

Executives (Washington, D.C National Center for Nonprofit Boards 1997) page 63. 3 "Your Georgia Census Data Research," Georgia Office of Planning and Budget, Planning, Research and Evaluation

Division< http://www.gadata.org>. 4 The Annual Report of the State Advisory Panel for Special Education 2004-2005 (Atlanta: Georgia Department of

Education, 2005). 5 "Rural Georgia Health Facts," Georgia Rural Health Association < http://www.garuralhealth.org>. 6 Lesa Nitchy Hope and Zolinda Stoneman, Real People-Complex Lives: Understanding the Stories of Women and Their

Children: Welfare Reform in Georgia, (Athens, GA: Institute of Human Development and Disabilities, University of Georgia

2002). 7 Women's Policy Education Fund, A Look at Welfare Reform in Georgia's Rural Communities, vol. 2 (Atlanta: May

2003). 8David Braddock, Amy Pomeranz-Essley, Richard Hemp, and Mary Rizzolo, The State of the States in Developmental

Disabilities, (Washington, D.C.: AAMR, 2004) 5. 9 The Annual Report of the Georgia Department of Medical Assistance 1992-93 (Atlanta: GDMA, 1993). 10 Braddock, et al 49.

11 Id.

12 Id.

13 Id.

14 Id. 27. 15 The Annual Report of the Georgia Department of Medical Assistance 1992-93 (Atlanta: GDMA, 1998). 16 "2004 Harris Survey finds people with disabilities still face pervasive disadvantages," DD Quarterly Summer 2004: 15.

17 Georgia Department of Labor, Georgia Workforce 2012: A Comprehensive Analysis of Long-Term Employment Trends.

(Atlanta: GDOL, 2005). 18 Rehabilitation Research and Training Center on Disability Demographics and Statistics, 2004 Disability Status

Reports, (Ithica, NY: Cornell University, 2005), 20.

19 "2006 State Plan Update, Georgia Division of Rehabilitation Services, Department of Labor, July 2005<

http://www.vocrehabga.org/plnindex06.html>. 20 Karen Tinsley and Brenda Cude, Georgia State of the State's Housing, Georgia Department of Community Affairs,

July 2003, < http://www.dca.state.ga.us/housing/housingdevelopment/programs/regionalHousingReports.asp>. 21 "Priced Out in 2004. The Escalating Housing Crisis Affecting People with Disabilities," Opening Doors: A Housing

Publication for the Disability Community 27 (October 2005) Technical Assistance Collaborative. 22Danielle Doughman, Beth Spinning, Scott Walker, People with Disabilities and Housing in Georgia, (Atlanta: GCDD,

February 2004). 23 Special Education Data Booklet, Georgia Department of Education, (Atlanta: GDOE, 1999). 24 Stephanie Moss, "Status of Funding and Source of Support, State Interagency Coordinating Council, January 26, 2006. 25 Federal Child Count Report: December 1, 2004, Georgia Division for Exceptional Students, Department of Education,

2005.

26 The Annual Report of the State Advisory Panel 27 Braddock, et al. 28 Essential Elements of a Special Education Program; Submitted to the Governor's Quality Basic Education Funding

Task Force, March 20, 2006. 29 DD Quarterly , 15.

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