Post on 12-Dec-2021
transcript
A Place Where Anything Is Possible
Summer 2009
Relationship
sA PlaceWhereAnythingIs Possible
Oklahoma Department of Human Services Developmental Disabilities Services Division
TA B L E O F C O N T E N T S
Summer 2009
Innerthoughts Thinking of Warren
1
Insurance Mandates Autism TreatmentsFail to Pass Oklahoma
Legislature
8
11th Circuit Rules Doctors Donrsquot Trump Stateon Medicaid Care for Children
with Disabilities
9
Compassion Friendship and Longevity
A Good Measure of Success
13
Best of the Best In Direct Support Services Honored
3
Governorrsquos Disability Employment
Awards Showcase Oklahomarsquos Reason to Brag
4
DDSD Employees Win Advocacy Awards
5
Quality Awards Best of the Best
6
DDSD Nicholson Receives Award for Contributions to College
of Allied Health 7
Health and Human Services Rescinds
Medicaid Regulations Affecting Case Management 10
Oklahoma Documentary on Developmental
Disabilities History to Air on OETA
12
State Legislative News 14
A Dream Come True 6
Residents of a Group Home in Vinita Display their CPR Certificates
9
Imagining Everest 10
Waiting and Hoping 11
DDSD Fiscal Year 2010 Budget Outlook
12
Elves Work Year Round to Make Christmas Special for DDSD Clients
16
Our MottoThe name Interface was chosen for this publication
because it reflects our purpose to create a common
boundary where diverse groups interact Interface
represents our effort to bring together different groups
for the benefit of Oklahomans with developmental
disabilities We hope to provide information encourshy
agement and insight
Please send your ideas for news and features to
Sheree PowellWritershyEditor Developmental Disabilities Services Division
Community and Provider Relations
PO Box 25352 Oklahoma City OK 73125
(405) 521shy4972
INTERFACE NEWSLETTER James M Nicholson Division Director of
Developmental Disabilities Services Division
Sheree Powell WritershyEditor
Danny Phillips Graphic Artist
Caroline Miller Sheree Powell Photographer (unless otherwise noted)
S09455 OKDHS Issued 1009 This publication is authorized by the Oklahoma Commission for Human Services in accordance with state and federal regulations and printed by the Oklahoma Department of Human Services at a cost of $557700 for 9295 copies Copies have been deposited with the Publications Clearinghouse of the Oklahoma Department of Libraries
Oklahoma Department of Human Services Developmental Disabilities Services Division
I N T E R F A C E
INNERTHOUGHTS
James Nicholson
Thinking of Warren
Warren Edds one of the first selfshyadvocates I met after
coming to DDSD in 1988 died on
June 22 at his home in Enid I had
not talked to Warren in a number of years but I used to see him
frequently at Oklahoma People
First meetings rallies and other events He was very active in the
selfshyadvocacy movement and was not bashful about making sure his voice and opinion were heard
The most memorable talk we had
was at a Governorrsquos Conference in
Tulsa many years ago I was scheduled to do a breakshyout session called ldquoA Conversation with Jim
Nicholsonrdquo targeted towards selfshyadvocates As the
start time approached I was surprised at the large
number of people who were in attendance The
topics discussed in these sessions usually centered on
service delivery concernsmdashgood and bad providers or staff not being allowed enough freedom of choice not being listened to etc
During this session Warren stood and began
talking about his life experiences and how they
affected him Everyone who knew Warren knew him
as a very happy guy who always had a smile on his face But this was a different Warren He talked
about his mother leaving him as a small child at Enid
State School and how it pained him to think about being unwanted and abandoned Tears came to his eyes as he struggled to come to grips with memories of many decades past He created one of those
moments for which there is no real response possible
other than a thoughtful respectful silence and a
touch on the shoulder When Warren finished and sat down other selfshy
advocates stood and talked about their life
experiences and the incidents that caused them pain
People you would never expect revealed underlying wounds that they continued to struggle with That afternoon Warren opened the
way for many selfshyadvocates to
honestly share and thus lighten their burdens
After leaving Enid State School as an adult Warren became a wellshyknown figure in that community He established relationships with
everyone he came in contact with
from mayors and city councilmen to
several generations of workers at the
local McDonaldrsquos restaurant When the city dedicated
a new bridge many years ago Warren was invited to be
the first to officially cross it in his famous threeshywheeled cycle
Warren also went on to enjoy a rewarding career volunteering as a camera operator for the Enid public
access television station The Enid News and Eagle
printed a wonderful article marking his passing ldquoDeath of Warren Edds has an impact on communityrdquo As I read it I remembered our session in Tulsa and the
barriers Warren had overcome to become the person
everyone remembered as having a ldquocheery smile and
a kind heartrdquo Great success doesnrsquot come easy and it certainly didnrsquot for Warren
You can see a video clip of Warren that appears in
the documentary ldquoLiving in the Freedom Worldrdquo at httpwwwmnddcorgparallels2onevideovideo76b
shyfreedomworldhtml He was a star on both sides of the camera
James M Nicholson Director Developmental Disabilities Services Division
Oklahoma Department of Human Services 1 Developmental Disabilities Services Division
I N T E R F A C E
Death of Warren Edds has an impact on communityBy Robert Barron Staff Writer Enid News and Eagle
(reprinted from June 24 2009)
Warren Edds never held a public
office He never was successful in business and there are no statues of him
in townBut everybody knew Edds and everyone
was used to seeing him ride his threeshywheeled cycle around town
His death at age 59 has had an impact in
Enid on people who knew him or even just knew who he was
Edds was supposed to wear oxygen at all times since becoming ill with pneumonia in
May He had not been seen for two or three
days when his body was found by a
neighbor inside his apartment about 8 pm Monday June 22 (Enid Police Department is investigating it as an unattended death
and said there is nothing suspicious) His funeral will be 10 am Thursday at
Davis Park Christian Church with the Rev Alan Seibel officiating Burial will follow at Enid State School under the direction of BrownshyCummings Funeral Home An
account has been set up at Central National Bank for funeral expenses The funeral home has asked friends for anecdotes to use
in his obituary Those stories may be sent to familyfirst
brownshycummingscom Edds was born Aug 19 1949 to Thomas
R and Cheryl Holland Edds He lived at Enid State School until earning his statute
of independent living He was a member of Davis Park Christian Church since 1975
He is survived by his father who lives in
Florida brother Steve Smith of Broken
Arrow sister Sandy Brown of Ohio and
aunt Gina Crotty of Stillwater
Edds volunteered at PEGASYS Enidrsquos publicshyaccess television station for 26
years regularly assisting with camera work He also was known for his support for Oklahoma State University athletics
ldquoHe always had something positive to say
about everyonerdquo said Wendy Quarles PEGASYS executive director and a friend
of Edds Edds could be seen frequently around
town riding an adult tricycle donated to
him by local business and groups or at McDonaldrsquos at Maine and Van Buren
engaging people in a spirited conversation
about OSU athletics Edds was a charter member and first
president of the Yes We Can Civitan
Club which consisted largely of people
with special needs He originated the
name of the club and was nominated as regional director of Civitans for Oklahoma and Arkansas He also was the
clubrsquos highest point producer earning the
name ldquoMr 400rdquo Edds scheduled regular programs on PEGASYS and the club
established the ldquoChiller Challengerdquo competition in which people jump into
freezing water to raise money for the
Special Olympics program Edds was 1981 Special Olympian of the Year
ldquoItrsquos people with special needs saying lsquoWe can do thatrsquordquo said Kathy Eck a
sponsor of the club ldquoHe was an icon in this town Even if
people didnrsquot know his name they knew
him because of him riding all over the
community on his tricycle with the orange
safety flag They knew of him He had an
infectious smile and was always concerned
about people He was just a kind personrdquo Eck said
The Enid News amp Eagle Web site
received a number of postings Tuesday after word of Eddsrsquo death became known
ldquoEnid has lost a great man a faithful friend and a dedicated volunteer Warren
will truly be missedrdquo said Lindy Chambers executive director of Main Street Enid
Another stated ldquoWarren will be missed He always said hello to anyone that would
listen OSU has lost a fanrdquo People who saw him casually said it was a
pleasure to know him that he always put a
smile on their face Mayor John Criner said Edds was a good
resident and encouraged him and the city
commission He went to the Public Library
of Enid and Garfield County daily to
remain informed on city matters When the
city dedicated a new bridge on West Randolph in 2007 Edds was the first to
ride across on his bicycle Molly Helm director of communications
and marketing for Autry Technology
Center recalled being a camp counselor at Campfire Camp in high school when some
of the clients at Sunnyside Nursing Home
came for the day Warrenrsquos nickname was Jabber as was Helmrsquos and she said they
immediately struck up a friendship ldquoYears later it has been especially heartshy
warming to see him working the cameras for PEGASYS doing something he
lovedrdquo Helm said ldquoHis cheery smile and
his kind heart will be missedrdquo mdash This article has been reprinted
with permission from the
Enid News and Eagle
Oklahoma Department of Human Services 2 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
Best of the Best in Direct Support Services honored
The statersquos most outstanding direct support professionals were recognized for their work
during the Governorrsquos Conference on Developmental Disabilities March 2 2009 at the Tulsa Renaissance
Hotel and Convention CenterThe annual Awards of Excellence in Direct Support
Services sponsored by the Developmental Disabilities Services Division honors individuals working in direct care in a variety of settings Nominations are sent to DDSD
from all over the state from provider agencies family
members and individuals with disabilities All of the direct support professionals recognized were presented with Awards of Excellence Out of the award winners the Best of the Best were chosen and featured in video presentations at the ceremony Awards of Excellence in Direct Support Services were presented to Will Watkins Rescare OklahomaLarry Lamm Supported Community LifestylesLora Catlett Gatesway FoundationAngel Balenti Phoenix Residential ServicesCharity Mormon Magna Community Living ServicesStephanie Lackas Reach Out IncRandy Brewer Gatesway FoundationKrystal Lewis Goodwill Industries of Southwest OklahomaSteve Poland Oklahoma Life Skills AssociationMattWeintz Volunteers of AmericaNancy Newson Kibois Community Action FoundationPatricia Harper Garvin County Community Living CenterMary Williams Rescare OklahomaLucinda Flynn People IncApril Thompson Independent Opportunities IncLaDonna Lang Central State Community ServicesDneta Carr Central State Community ServicesDaniel Escojido Supported Community LifestylesCindy Simmons Kibois Community Action FoundationDavid Pitts Homelife AssociationBeverly Kichler Volunteers of AmericaFreda Kretchmar BIOSAnnette Bounds Big Five Community ServicesGenea Shatto INCA Career Opportunities
Awards of Excellence in Direct Support Services winners (Back Row from left) Daniel Escojido Larry Lamm Will Watkins David Pitts Stephanie Lackas Patricia Harper Randy Brewer Matt Weintz and Krystal Lewis (Front Row from left) Genea Shatto April Thompson Lucinda Flynn Mary Williams Angel Balenti Charity Mormon Lora Catlett and Steve Poland
The Best of the Best in Direct Support Services Awards were presented to (From Left) Larry Lamm Will Watkins Stephanie Lackas Mikayla Angel Balenti Charity Mormon and Lora Catlett
Mark your calendars The 2010 Governorrsquos Conference on Developmental Disabilities will be held March 8shy9 To nominate someone for the Direct Support Services Awards contact the Developmental Disabilities Services Division at (405) 521shy6254
Oklahoma Department of Human Services 3 Developmental Disabilities Services Division
I N T E R FA C E
Governorrsquos Disability Employment Awards
Showcase
Steve Scott (Right) receives a 2008 Governorrsquos Disability Employment Award for his outstanding work from Howard Hendrick Cabinet Secretary of Human Services and Director of the Oklahoma Department of Human Services Scott was recognized for working 19 years with the same WalshyMart store in Sand Springs During that time Scott has received several promotions and pay raises
Oklahom
arsquos
reason to
brag
Oklahoma may be best known around the country for excellence in many
things from college football to producing awardshywinning countryshywesternmusic stars Probably not as well known is the fact that Oklahoma is the best state
in the nation at supporting people with developmental disabilities to work
in competitive jobs according to an independent ranking by the Institute
for Community Inclusion at the University of Massachusetts BostonldquoFor the past three years Oklahoma has led the nation in assisting people with
developmental disabilities to find competitive jobs and become working taxpayersrdquo said James Nicholson Director of the OKDHS Developmental Disabilities Services Division ldquoToday more than 60 percent of individuals with developmental disabilities served by our division participate in supported employment servicesrdquo
The Governorrsquos Disability Employment Awards are held each October to
recognize individuals with disabilities for their outstanding achievements at work
through the supported employment program Also recognized are businesses that hire people with disabilities and members of the media who promote supported
employment programs The Governorrsquos Disability Employment Awards are coshysponsored by Governor
Brad Henry and Lt Governor Jari Askins along with OKDHSshyDDSD the Department of Rehabilitation Services and the Oklahoma Association
of Persons in Supported Employment
The 2009 Governorrsquos Disability Employment awards will be held on
Oct 22 130 pm at the Governorrsquos Mansion Pavilion in Oklahoma City
InterFace NEWSLETTER
The 2008 award Receipeints wereBUS INESS WINNERS
Gene LukerAramark Glass Plant Tulsa
Gary CookMcDonaldrsquos Ardmore
WalshyMartCushing
Mike amp Terry GentryMcDonaldrsquos Lawton
Joyce and Fred HannahLektron LED Lighting Tulsa
Pizza HutCushing
Guest InnArdmore
JonMilneSODEXO Langston
WalshyMartMoore
City of Muskogee
Angela OwensSonic DriveshyIn Ardmore
WalshyMart Super CenterSand Springs
WalshyMart Super CenterVinita
MED IA WINNER
Dawndee Bostwichreporter Duncan Banner
EMPLOYEE WINNERS
Bobby Bailey
Bob Bennett
Tammie Burrall
Andy Cheater
Tommy Coleman
Jeff Dickson
Chad Joyce
Allen Kouba
Linda Prowell
Phillip Reed
Peter Rowland
Steve Scott
Kenneth Smith
Judy Wolfe
James Young
Oklahoma Department of Human Services 4 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
DDSD employees win advocacy awards
Angela King DDSD Area II case manager and Cindy
Jennings DDSD Area III nurse received awards from TARC in December 2008 King received the
AdvocateshyCase Manager of the Year award while
Jennings was recognized with a Special Achievement in
Advocacy AwardKing has nearly 20 years of experience in DDSD
case management working with individuals on every
type of waiver including the pilot project for the InshyHome Support waiver King began her career in the
field as a direct support professional before
becoming a recreational therapist and case
manager transitioning individuals from The
Hissom Memorial Center King gives each
person on her caseload the individual attention
they need regardless of the time it takes As a
recent example of her advocacy and
dedication she assisted a woman on her caseload in the process of obtaining
a divorce from her husband of many
years King referred the woman to a
community resource for legal advice
assisted her in completing all of the legal paperwork attended
court hearings with her and then took the woman apartment hunting
King even helped her move into the new apartment unpack and
decorate King has been known for her attention to detail and is extremely conscientious exemplifying her commitment to those
she servesJennings has volunteered for Oklahoma People First for the last
11 years assisting in the establishment of new chapters planning
state conferences writing grants to secure funding and soliciting
donations for conferences As an OPF volunteer Jennings is passionate about teaching individuals to advocate for themselves Her belief in their abilities empowers them to have faith in
themselves and in their abilities to make choices She educates OPF members on increasing their independence vocational opportunities voting relationships and community involvement Jennings empowers OPF members by offering them a support network to turn to when in need of assistance By doing so she
teaches others to recognize how much persons with developmental disabilities can do for themselves if given the right supports
InterFace NEWSLETTER
To see Oklahomarsquos ranking as compared to other states in regard to the numbers of persons with developmental disabilities in competitive jobs (supported employment)go to
wwwstatedatainfo
This website is a project of the Institute for Community Inclusion at UMass Boston supported in part by the Administration on Developmental Disabilities US Department of Health and Human Services under cooperative agreement with additional support from the National Institute on Disability and Rehabilitation Research of the US Department of Education
Angela King DDSD Area II case manager is presented with the AdvocateshyCase Manager of the Year award by John Gajda executive director TARC
Cindy Jennings DDSD Area III nurse is presented with a Special Achievement in Advocacy Award by John Gajda executive director TARC
Oklahoma Department of Human Services 5 Developmental Disabilities Services Division
I N T E R F A C E
Quality
AwardsBest of the Best
Regina ChacePrograms Manager for DDSD Employment Services
Regina Chace Program Manager for DDSD Employment Services receives an OKDHS Quality Award Best of the Best for her leadership in this program Chace ensures there are policies and processes which support participants to have a full range of opportunities for employment As a result Oklahoma has been recognized as the nationrsquos leader in achieving impressive outcomes in integrated employment for people with
disabilities InterFace NEWSLETTER
A Dream Come True Bobby Cooper and his parents were invited by Governor Brad Henry to meet with him and visit the capitol Tom Cooper Bobbyrsquos father is a member of the Governorrsquos Council for United We Ride representing people with disabilities Tom mentioned to Governor Henry in a letter that it had been Bobbyrsquos dream to meet him after seeing him speak on television during his reshyelection Governor Henry was so flattered by Bobbyrsquos request that he invited the whole family for a visit to the capitol in November 2008 They took a few moments to pose for this photograph in the Governorrsquos Blue Room From left Tom Cooper BobbyGovernor Henry and Ruth Cooper
Oklahoma Department of Human Services 6 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
James Nicholson Director of the OKDHS Developmental Disabilities Services Division is presented with a 2009 College of Allied Health Citation for Special Contributions (Left to Right) Jeff Berry Chair College of Allied Health Awards and Honors Committee College Dean Kevin Rudeen Nicholson and Martha Ferretti Professor and Chair Physical Therapy Department of Rehabilitation Sciences College of Allied Health
DDSD Nicholson receives award for contributions to College of Allied Health
On April 2 2009 James Nicholson Director of the OKDHS Developmental Disabilities Services
Division was presented with the 2009 College of AlliedHealth Citation for Special Contributions Nicholson was nominated for this award by Martha
Ferretti Professor and Chair Physical Therapy Department of Rehabilitation Sciences College of Allied Health University of Oklahoma Health Sciences Center In the nomination for this award Ferretti wrote ldquoMr Nicholsonrsquos background is one of diversity and richness
His work ethic sets a standard for us all to follow His calmness humor and general goodwill in the midst of controversy is obvious and remarkable And first and foremost his dedication to improving the lives of children and adults with developmental disabilities has set a standard for us all to emulate Mr Nicholsonrsquos creativity thoughtfulness and ability to target a goal and accomplish it regularly in collaboration with a number of formal and informal partners prove the importance of reaching beyond onersquos own resourcesldquoAs a visionary in the field of developmental disabilities early in his
role as director Mr Nicholson caught the attention of both supporters and detractors His vision was a perfect match for what our faculty were striving to accomplish in preparing our students and in providing servicesin the field of developmental disabilities ldquoWe approached Mr Nicholson shortly after he became the director with
a proposal for introducing assistive technology into the DDSD system differently than had been accomplished at that point Over the past 18 years
he and members of his staff have continued that collaboration on projects that addressed both major and minor challenges
about policy and services for Oklahomans with developmental disabilities
ldquoOur faculty has learned so much from this very politically astute and professional state leader Before the state was aware of its challenges emerging from children with autism and their families Mr Nicholson quietly accepted the mantle of addressing what we have come to know are unbelievable challenges presented by the impact of autism Seven years ago he convened a multishyagency multishydisciplinary task force that included parents of individuals with autism to develop the Oklahoma State Plan for Autism and the Oklahoma Autism Network We are honored by him placing the OAN within the structure of the College
ldquoMr Nicholson has stimulated us to mature as educators researchers and service providers to more effectively address many of Oklahomarsquos needs in the field of
developmental disabilitiesrdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 7 Developmental Disabilities Services Division
Nickrsquos Law
I N T E R F A C E
Insurance Mandates for autism treatments fail once again to pass Oklahoma legislature
For the second consecutive year bills that would have mandated insurance companies to cover
treatments for autism failed to pass through the Republicanshycontrolled legislatureIn February the House Economic Development and
Financial Services Committee voted down House Bill 1312 also known as ldquoNickrsquos Lawrdquo which would have required insurance providers to cover autism treatment The only autismshyrelated bills that did receive enough
support to pass were House Bill 2027 and its companion Senate Bill 135 The Senate version made it through the legislative process and will enact a licensing process for national board certified behavior analysts and enhance existing state programs that would train doctors to diagnose and treat autism Critics of this bill question whether it will actually produce
significant new services if insurance doesnrsquot cover the cost of treatment and parents canrsquot afford to pay the bill
ldquoSadly this bill will do nothing to relieve the pressure on families struggling to care for children with autismrdquo said Sen Jay Paul Gumm author of lsquoNickrsquos Lawrsquo legislation ldquoThis measure was designed to relieve political pressure on legislators who refuse to even consider Nickrsquos Lawrdquo
When Governor Henry signed Senate Bill 135 he said the measure was just a small step in the effort to help affected Oklahoma families He urged lawmakers to pass legislation to mandate insurance coverage for the treatment of autism
ldquoThere is nothing wrong with this bill just like there is nothing wrong with a pack of shingles at a construction siterdquo said Sen Gumm ldquoIf you try to put the shingles on before you pour the foundation you are doomed to failure As Governor Henry wisely noted when he signed the bill the foundation is insurance coverage of autism Absent that Senate Bill 135 is doomed to failurerdquo
Republican legislative leaders oppose insurance mandates saying they drive up the cost of health insurance despite reports from states with similar insurance mandates that show no significant increase in the cost of premiums
Republicans attempted to pass House Bill 1975 which would only allow insurance legislation to be introduced in oddshynumbered years and approved in evenshynumbered years The bill would have also required a 75 percent supershymajority vote to do away with the mandate in the case of an emergency
Henry vetoed that bill and said it would have unreasonably ldquotied the hands of state policy makers on a very important issuerdquo
ldquoThis would empower a small minority of legislators to thwart legitimate state efforts to address a pressing public policy issue and ensure that the restriction would rarely if ever be liftedrdquo Henry said
Henry also questioned why HB 1975 restrictions were only applied to a single issue area saying it raised legitimate concerns regarding why only one subject would be singled out for special treatment
Autism cont on page 9
Oklahoma Department of Human Services 8 Developmental Disabilities Services Division
SUMMER 2009
Autism cont from page 8
ldquoOklahoma and its citizens are better served when policy makers are allowed the freedom to address any pressing issue in the Legislature without the hindrance of arbitrary restrictionsrdquo Henry said Democrats offered a compromise mdash to put autism coverage in highshy
risk insurance pools as a last resort for families who canrsquot afford the coverage elsewhere Republicans again declined and instead went forward with SB 135 This year three more states enacted Autism Mandate legislation bringing
the total to 11 states that now require insurance companies to cover treatment for autism InterFace NEWSLETTER
Proudly displaying their CPR (Cardio Pulmonary Resuscitation) certificates are (From Left) Guy Bivens Allen Larimore Steve Sposato Andy Edwards Joshua Johnson and Tino Hensley residents of the Independence House
Residents of the Independence House at the Home of Hope in Vinita recently became CPR certified after a fellow resident had a heart attack A staff member used CPR to save Allen Larimorersquos life and he has since received a pacemaker Although staff members must be CPR certified this event inspired Larimorersquos housemates to take the class so they could also be prepared ndash just in case Donna Marlow a CPR trainer from the OKDHS Developmental Disabilities Services Division held the class free of charge at the agency and was proud that all the men passed their tests with flying colors
11th Circuit Rules Doctors donrsquot trump state on Medicaid care for children with disabilities by Alyson M Palmer
A federal appeals panel has declared that treating doctors donrsquot have the final say in how much nursing care the state must provide
children with disabilities under MedicaidOn April 24 the 11th US Circuit Court of Appeals reversed a district
judgersquos decision that had said the state must provide the amount of nursing care that a North Georgia girlrsquos doctor said she needs
Despite a slew of amicus briefs by state governments and Medicaid plan administrators the panel dispatched the case in a twoshypage unpublished unsigned opinion that came out a month after oral argument
Holland amp Knight partner Robert S Highsmith Jr who represented a proshystate friend of the court that provides managed care services for Medicaid programs said his client WellCare of Georgia had been concerned about language in US District Judge Thomas W Thrash Jrrsquos ruling that suggested anything ordered by a treating physician is medically necessary under the law ldquoThat one sentence just had to get reversedrdquo said Highsmith ldquoWe are very excited that they saw and reversed that clear errorrdquo
But an advocate for the teenage girl at the center of the case Atlanta Legal Aid Society General Counsel David A Webster said Monday that the decision ldquodoesnrsquot mean muchrdquo and says little about the relationship between the state and the treating physician ldquoThatrsquos going to be open for future litigationrdquo said Webster Webster said the case of his client Anna C Moore will go back to Thrash for the judge to consider the
11th Circuit Rules cont on page 15
Oklahoma Department of Human Services 9 Developmental Disabilities Services Division
I N TERFACE
ImaginingEverest The Story of LaelBy Adrienne Benz
ldquoI prayed for God to open the eyes of my understanding and the pieces began to fall into place Mollyrsquos future had been planned since she was a young girl she would marry andhave a bright healthy family known for their intelligence andkindness However the birth of her first born quickly dispelled the myth of the stereotypically perfect family as Molly learns her son Lael has Down syndrome Struggling to accept the disconcerting news and understand Godrsquos perfect plan Molly faces a challenge no more daunting than the climbing of the greatMt Everest she often dreamed of as a child Guilt hope grief and happiness take Molly and Lael across rocky terrain and risky edges but faith and the resonant voice of God bring mother and son up the emotional mountain 30 years in the making ndash a mountain that revealed the aptitude of Mollyrsquos beloved son and the kindness of others By Imagining Everest Molly and Lael forge a unique and amazing relationship which allows them to overcome even the most intimidating ascension into the unknownrdquo
Molly Mathewrsquos son Lael currently receives services through the OKDHSDDSD community waiver program
264 pages shy $1499 (paperback) This book is available online through Tate Publishing wwwtatepublishingcombookstore
Health and Human Services rescinds Medicaid regulations affecting case management
Department of Health and Human Services (HHS) Secretary
Kathleen Sebelius announed June 29 that the administration will rescind all or part of three Medicaid regulations that were previously
issued and delay the enforcement of a fourth regulation Each of these
rules in whole or in part had been subject to Congressional moratoria
set to expire on July 1 2009ldquoThese regulations if left in place would have potentially adverse
consequences for Medicaid beneficiaries some of our nationrsquos most vulnerable peoplerdquo said Secretary Sebelius ldquoBy rescinding
these rules we can expect that children will continue receiving
services through their schools beneficiaries will be able to
access all available case management resources to help them
better manage their health care and outpatient hospital and
clinic services can continue to be covered in the most efficient mannerrdquo
This ruling was crucial to Oklahomarsquos Developmental Disabilities Services as the state could have lost the ability
to bill Medicaid for 100 percent of the cost of providing
case management services to waiver service recipients which totals approximately $22 million per year
ldquoThe actions we are taking today are necessary to
ensure that the states have the flexibility they need to
fully serve Medicaidshyeligible individualsrdquo said
Secretary Sebelius
The Centers for Medicare amp Medicaid
Services (CMS) and HHS arebull Rescinding provisions of an interim final rule
published Dec 4 2007 which would have restricted beneficiary access to case management services These provisions appeared to in practice restrict beneficiary access to needed covered case management services and limit state flexibility in determining efficient and effective delivery systems for case management services
Regulations Expiring cont on page 11
Oklahoma Department of Human Services 10 Developmental Disabilities Services Division
SUMMER 2 0 0 9
Regulations Expiring cont from page 10
bull Rescinding a final rule published Dec 28 2007 that would have eliminated reimbursement for schoolshybased administrative costs and costs of transportation to and from schools The rescission reflects concern that the rule could limit the Medicaid administrative outreach activities of schools and that the overall budgetary impact on schools could potentially impact their ability to offer Medicaid services to students
bull Rescinding a rule published Nov 7 2008 that would have limited the outpatient hospital and clinic service benefit for Medicaid beneficiaries to the scope of services recognized as an outpatient hospital service under Medicare This rule was rescinded because CMS became aware that coverage beyond that scope could not be easily moved to other benefit categories resulting in great impact than previously anticipated
bull Delaying until June 30 2010 the enforcement of portions of a regulation that clarified limitations on health care related tax programs so that CMS could determine whether states need additional clarification or guidance CMS may also further review the potential impact of the regulation and give additional consideration to alternative approaches InterFace NEWSLETTER
Waiting and HopingBy Adrienne Benz
Sad is like sitting here when I donrsquot have a home to run away to
So there on the street just waiting for something to eat somewhere to stay and a bed to sleep on and someone to hold
And hoping Irsquom still there the next day
They have to get up from the street in the park sitting on a cold chair in the dark
Just waiting for someone to take them in their home Waiting to open up and talk about their hidden feelings
like they canrsquot wait any longer
Adrienne Benz was a child in state custody when she wrote this poem She is now an adult reunited with her family
Oklahoma Department of Human Services 11 Developmental Disabilities Services Division
I N T E R FA C E
DDSD Fiscal Year 2010 Budget Outlook OKDHS Director Howard Hendrick
presented the agencyrsquos Fiscal Year 2010 budget to the Commission for Human Services on June 16 Hendrick emphasized that even with the additional federal stimulus money and other oneshytime funds the agencyrsquos overall funding will be approximately $50 million short of anticipated spending levels To achieve a balanced budget cuts would have to be made within each division The Developmental Disabilities Services Divisionrsquos
share of the cuts amount to approximately 3 percent of the divisionrsquos operating budget ($17 million) Another $200000 had to be identified to fund the new initiative for Applied Behavior Analysis mandated by Senate Bill 135 this legislative sessionDDSD was able to accomplish the budget cuts without
impact to any programs or services through reductionsat the Northern and Southern Oklahoma ResourceCenters The rest of the savings came from reductions in training and professional contracts the divisions holds with various entitiesOver the next year DDSD will be under a selfshyimposed hiring
freeze for all positions except for case management direct care professionals and registered nursesIf monthly state revenue collections continue to fall below
expected levels additional reductions may be required of all stateagenciesrsquo operating budgets
Interim StudiesThere will be two interim legislative studies conducted this summer that could impact DDSD and service recipients
One of these studies will investigate a possible provider feetax on agencies providing waiver community services If the provider feetax is found to be within federal Medicaid guidelines it could possibly be used to fund rate increases in waiver services
The other legislative study will look into the pros and cons of online training versus classroom training specifically for providers of DDSD community services
Money Follows the PersonAs of this date DDSD has transitioned eight people from Northern Oklahoma Resource Center of Enid and Southern Oklahoma Resource Center into community homes using the federal Money Follows the Person grant Utilizing these federal funds DDSD has been able to save approximately $21000 in the community services provided to those individuals
Oklahoma documentary on developmental disabilities history to air on OETA
an
Oklahoma
document
ary
Adocumentary showing Oklahomarsquos history serving people with intellectual and developmental disabilities is
scheduled to begin airing on OETA (Oklahomarsquos Education Television Authority) in October during national Disabilities Awareness Month
The video ldquoWagons to Waivers A Century of Changerdquo narrated by Oklahomarsquos own country music star Reba McEntire will be broadcast on the OETAshyOklahoma channel starting on Oct 24th at 5 pm and on Nov 5th at 830 pm The program will be
aired a couple times a month
The documentary takes viewers on an emotional journey from the days of the Dust Bowl and covered wagons and shows the statersquos progression from institutional services to full community inclusion for persons with intellectual disabilities Oklahomarsquos story begins in 1909
with the creation of the Institute for the Feeble Minded in Enid and includes the
tears and efforts of parents the stories ofpeople who grew up in institutions the legal struggles and the triumph of selfshyadvocacy The video was produced by the Oklahoma Department of Human Services Developmental Disabilities Services Division
OETAshyOKLA is Cox Cable channel 112 but other television carriers as well as satellite users can access the channel which is devoted to Oklahomashyspecific programming Check your local television lis tings for specific programming dates and times
Oklahoma Department of Human Services 12 Developmental Disabilities Services Division
SUMMER 2009Compassion friendship and longevity A good measure of success
The day had finally come and Danny waited anxiously on the sofa He watched quietly as the
nursing staff set up the hospital bed and made his friend Carl comfortable The minute all was clear Danny went to Carl and told him how much he had missed him and that he needed him to get better Dannyrsquos longshytime friend had just undergone surgery
to remove a malignant brain tumor Danny didnrsquot understand the procedure or Carlrsquos prognosis ndash all that mattered was that his best friend was home It just wasnrsquot home without CarlCarl is considered the head of the household that he shares
with Danny and his other friend Hershel Carl was always the one who planned their meals said the prayers at the diningroom table and got them involved in Special Olympics events When Carl became ill and went to the hospital it was Danny
who stepped up and tried to fill in ndash just until Carl came home ldquoThe Three Musketeersrdquo (thatrsquos what their staff call them) have
been friends and have lived together for more than 30 years
Danny (lef
t) spends
hours by
Carlrsquos sid
e
encourag
ing him in his
recovery
They met as boys at The Hissom Memorial Center the nowshyclosed institution in Sand Springs for persons with developmental disabilities When they aged out of Hissom the three moved about the same time to a private facility where they lived for many years
In 1993 The Musketeers were given the opportunity to move together once again into a house in their community supported through the DDSD Medicaid Community Waiver program Since
that time they have lived in the house withsome of the same staffmembers who havecared for them for morethan 20 years
The Three Musketeers Danny (left) shows his excitement over his friend Carlrsquos (right) return from the hospital after brain surgery Shy Hershel (center) wipes tears from his eyes
Carl is recoveringfrom his surgery andworking on his abilityto speak and onregaining the use of theleft side of his bodyThe staff in the home
often has to make Danny go to bed at 1 am when hersquos still sitting beside Carl encouraging him to get better so he can go back to work
All three men have jobs and love their work ndash Carlmost of all Danny somehow knows that if Carl canjust get back to work life will continue as they onceknew it
ldquoTheyrsquore like a wellshysettled familyrdquo said Gretchen Moser their DDSD case manager ldquoEven their families consider these guys a family and respect their wishesrdquo
These days there are many opinions about what constitutes a family or even success But there are stories that transcend those discussions Stories like these that remind us success can also be measured by the love and longevity of a friend InterFace NEWSLETTER
Relations
hips
Oklahoma Department of Human Services 13 Developmental Disabilities Services Division
I N T E R F A C E
StateLegislativeNews
Of the thousand or more bills filed at the beginning of the 2009 legislative session only a few made it through the entire process that will have an impact on persons with developmental disabilities families and professionals in the field They are
HB 1007 mdash Wesselhoft Leftwich Signed by the Governor Requires specific Physically Disabled person signage to be posted as a reserved area for the parking of a vehicle displaying a valid permit
HB 1019 mdash WrightSigned by the Governor Recreates the Group Homes for Persons with Developmental or Physical Disabilities Advisory Board
HB 1048 mdash Banz AldridgeSigned by the Governor Relates to the collection of delinquent real property taxes removes physically disabled from ldquoincapacitatedrdquo persons granted additional time to redeem personal items reduces time to collect excess sale proceeds by half
HB 1065 mdash Faught Crain Signed by the Governor Relates to the Continuum of Care and Assisted Living Act adds definition and requires inspection results to be posted on website
HB 1424 mdash Protor Signed by the Governor Requires treatment facilities transitional living facilities halfway houses and any house or facility that may be used for medical or nonmedical detoxification to mail notification to property owners within a quarter mile radius if zoning changes are proposed
HB 1461 mdash Sears Ford Signed by the Governor A school that does not make adequate yearly progress for two straight years shall utilize the assistance of a school support team formed by the State Department of Education EMERGENCY
HB 1581 mdash Coody Jolley Signed by the Governor School teacher candidates that wish to teach elementary early childhood education or special education programs must study the five elements of reading instruction EMERGENCY
HB 1763 mdash Enns Reynolds Signed by the Governor Requires the state Department of Education to provide special education training for process hearing officers to ensure adequate knowledge in special education laws and proceduresEMERGENCY
HB 1893 mdash Peterson Anderson Signed by the Governor Creates the Aging and Disability Resource Consortium to work with other agencies in developing and implementing a singleshypointshyofshyentry concept for aging and disability groups in Oklahoma
SB 135 mdash Johnson Mike Signed by the Governor Provides for the licensing of certain persons to practice as a licensed behavior analyst or a licensed assistant behavior analyst and to study children with autism and their behaviors directs funds to be used by the Department of Human Services Developmental Disabilities Services division for training SoonerStart providers to treat children with autism spectrum disorders provides for a behavorial analysis research pilot project provides legislative intent
SB 518 mdash Justice Osborn Signed by the Governor Adds grandparents as members of immediate family
SB 871 mdash Anderson Signed by the Governor Modifies membership of the Electronic and Information Technology Accessibility Advisory Council
Oklahoma Department of Human Services 14 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
11th Circuit Rules cont from page 9
matter again Moore a teenager living in North Georgia who goes by ldquoCallierdquo has been receiving inshyhome nursing care paid for by Medicaid for about a decade The state has been trying to cut the number of hours of care she receives each week
The 11th Circuit interpreted a federal law that says states participating in the Medicaid program must provide ldquoearly and periodic screening diagnostic and treatment servicesrdquo that are necessary to ldquocorrect or ameliorate defects and physical and mental illnessesrdquo in Medicaidshyeligible children The primary ways children become eligible for Medicaid are that they come from a lowshyincome family or have a disability according to Joshua H Norris another one of Calliersquos lawyers
Georgiarsquos Department of Community Health operates a program to administer Medicaidshyfunded nursing services for several hundred children who need nursing care It delegates the decisions about approval of such services to an organization called the Georgia Medical Care Foundation
According to Thrashrsquos order Callie is disabled because of a stroke she experienced in utero and suffers from various chronic conditions including mental retardation and cerebral palsy She lives at home and according to the statersquos brief attends an elementary school in Athens Ga three days a week Her lawyers have said she requires constant care
The statersquos lawyers have said that nursing hours can be reduced when the patientrsquos medical condition stabilizes positing that a goal of the program is to teach parents and other caregivers to take care of their children on their own The Mooresrsquo lawyers have contended that the statersquos system of ldquoweaningrdquo patients off their nursing services as long as theyrsquore staying out of the hospitaland not getting worse follows a different standard than that set by federal law
In 2006 the state informed Calliersquos mother that it was reducing Calliersquos nursing hours from 94 hours a week to 84 contrary to the recommendation of Calliersquos primary care physician Calliersquos mother filed suit
The Mooresrsquo lawyers convinced Thrash that the reduction was improper Afterissuing multiple injunctions in Calliersquos favor he denied the statersquos motion for summary judgment and granted the Mooresrsquo motion in part concluding the state must provide for the amount of skilled nursing care that Calliersquos treating physician deems necessary The panel that ruled in favor of the state in its appeal was comprised of Senior 11th Circuit Judge R Lanier Anderson III 11th Circuit Judge Gerald B Tjoflat and US District Judge Lisa Godbey Wood visiting from the Southern District of Georgia
The panel said both the state and Calliersquos physician have roles in determining whatrsquos medically necessary to correct or ameliorate Calliersquos medical conditions It cited a federal regulation that says a Medicaid agency ldquomay place appropriate limits on a service based on such criteria as medical necessity or utilization control proceduresrdquo
ldquoA private physicianrsquos word on medical necessity is not dispositiverdquo the panel concluded
Assistant Attorney General Virginia B Fuller made the successful oral argument for the state last month Attorney General Thurbert E Bakerrsquos spokesman Russ Willard said in an eshymail that the state ldquois appreciative of the Court of Appeals decision recognizing the role of the Medicaid program in providing for this treatmentrdquo
Norris who also is director of legal advocacy for a nonprofit that advocates for people with disabilities said the 11th Circuit gave Thrash
an opportunity to say more about the roles of treating doctors and the state in deciding what care the state needs to provide Norris noted that Thrash wrote on the subject last year in another nursing care case about a Savannah Ga boy who nearly drowned when he was 2Thrash barred the state from enforcing a policy of not providing nursing care for patients requiring 16
to 24 hours per day for more than one week he said that criteria isnrsquot based on whatrsquos medically necessary under federal Medicaid law
On the other handThrash denied the plaintiff rsquos request based on the
treating physicianrsquos recommendation for 24shyhourshyashyday private nursing services for an
indefinite period of time Thrash deemed such a prescription ldquoan abuse of the Medicaid systemrdquo
The state has limited discretion to deny a providerrsquos request for care under the ldquoearly and periodic
screening diagnostic and treatment servicesrdquo portion of the Medicaid Act said Thrash He added that ldquo[t]he statersquos discretion is limited to a review of the request for fraud abuse of the Medicaid system and whether the service is within the reasonable
standards of medical carerdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 15 Developmental Disabilities Services Division
klahoma Department of Human Services
I N T E R F A C E
DDSD Area II Project Elves get together to wrap all the presents and make sure they are delivered to the individuals before Christmas Elves work year round
to make Christmas special for DDSD clients For the past eight years individuals with
developmental disabilities who donrsquot have families or who would otherwise not receive gifts have had their Christmas wishes come true thanks to caring DDSD ldquoelvesrdquo in Area II Project Elf is the brainchild of ldquoThe Men in Recrdquo namely
Steve Pitts and Roger McDaniel DDSD Area II recreational therapists and Joe Stie DDSD case manager ldquoDDSD serves a lot of people with developmental
disabilities who donrsquot have families to celebrate the holidays withrdquo said Pitts ldquoAlthough our services meet their basic needs therersquos still a gap when it comes to those special things that families do for one anotherrdquoThat gap has been filled by The Men in Rec who work all year
long coordinating various events to raise money to buy Christmas presents for individuals ldquoWe raise all of the funds and no OKDHS money is usedrdquo said
Pitts ldquoThis year we are selling Blue and Gold sausage and Amish jams We also have an annual Christmas Carol fundraising performance which is donated to Project Elf by the American Theater Company We are given 300 tickets that we can sell and last year we sold 225rdquoDDSD coshyworkers got together and purchased 44 of those theater
tickets last year for the children who happened to be in the Laura Dester Center Shelter around the holidays ldquoWe have also set up a sponsorship program where people can purchase
the gift and return it wrapped and ready for the elf (aka case manager) to deliver This last Christmas we had 108 sponsors 30 of whom were the case managers themselvesrdquo
The Men in Rec also recruit fellow DDSD workers to help shop for the gifts and wrap themldquoWe could not accomplish this awesome Project Elf without the assistance of so many of our coshyworkers and our community volunteersrdquo he said ldquoItrsquos such a pleasure to share these gifts at Christmas time and let our customers know that they have a family through our good service to themrdquoThe Men in Rec are currently working to raise money for this yearrsquos Christmas gifts If you would like to join the rank of DDSD Elves by donating funds or becoming a sponsor please contact Steve Pitts at stevepittsokdhsorg or call918shy794shy7625 InterFace NEWSLETTER
Steve Pitts (right) DDSD Area II recreational therapist gives a donated WalshyMart gift card to case manager Roy Willett to purchase a Christmas gift for one of the people on his caseload
Oklahoma Department of Human Services 16 Developmental Disabilities Services Division
shy shyshy shy
shy shy
shy shy
shy shy
shy shy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
Developmental Disabilities Services Area Offices and Resource Centers
CUSTER
ELLIS
BECKHAM WASHITA CADDO
McCLAIN
SEM
INO
LE HUGHES HASKELL
LE FLORELATIMER PITTSBURG
COAL
ATOKA
PONTOTOC
JOHNSTON
GARVIN
MURRAY
CARTER
LOVE
BRYAN CHOCTAW
PUSHMATAHA McCURTAIN
GRADY
KIOWA
TILLMAN
JACKSON HA
RM
ON
GREER
COTTON
JEFFERSON
STEPHENS
COMANCHE
McINTOSH
CLEVELAND
POTT
AWAT
OM
IE
DEWEY BLAINE
CANADIAN
MAJOR
GRANT KAY OSAGE
WA
SHIN
GTO
N CRAIG
ROGERS
CH
ERO
KEE
ADAIR TULSA
WAGONER
MAYES
OKMULGEE
CREEK
LINCOLN
LOGAN
PAYNE
KINGFISHER
OKLAHOMA OKFUSKEE
MUSKOGEE SEQUOYAH
DEL
AWA
RE
OTTAWA NOATTA
GARFIELD NOBLE
PAWNEE
WOODS ALFALFA HARPER BEAVER TEXASCIMARRON
WOODWARD
ROGER MILLS
MARSH
Oklahoma CityOklahoma City
Tulsa
Area II
Area III
Area I
Pauls Valley
Enid
wwwokdhsorg
State Officetoll free 1shy866shy521shy3571
AREA Itoll free 1shy800shy522shy1064
AREA IItoll free 1shy800shy522shy1075
AREA IIItoll free 1shy800shy522shy1086
Greer Center (Enid)2501 NE Delaware Enid OK 73701
580 237 10272599 FAX 580 213 2799
Northwest Oklahoma Resource Center at Enid (NORCE)2600 E Willow
Enid OK 73701
580 237 1027
FAX 580 548 2600
Southern Oklahoma Resource Center at Pauls Valley (SORC)3210 Chickasaw St
Pauls Valley OK 73075 6822
405 238 6401
FAX 405 238 8261
DDSD Area I Office (Enid)729 Overland Trail Enid OK 73703
580 548 8900 FAX 580 548 8964
DDSD Area I Office (Oklahoma City)4545 N Lincoln Blvd
Oklahoma City OK 73105 405 522 6925
FAX 405 522 6995
DDSD Area II Office (Tulsa)Laura Dester Center 1427 E 8th Tulsa OK 74120
918 560 4848 FAX 918 560 4898
DDSD Area III Office (Pauls Valley)301 S Indian Meridian Rd Pauls Valley OK 73075
405 238 4700 FAX 405 238 4740
If you would like to find out what the DevelopmentalDisabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
If you would like to find out what the Developmental Disabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
This will take you to the main Oklahoma Department of Human Services Web page From there just click on Divisions and Offices and the Developmental Disabilities Services Division On our Web site you will find information about services the division offers how to apply for services eligibility policies contract provider agencies and much more
Come visit us today You may be surprised at what you will learn
OKLAHOMA DEPARTMENT OF HUMAN SERVICES Developmental Disabilities Services DivisionPO Box 25352 Oklahoma City OK 73125
TA B L E O F C O N T E N T S
Summer 2009
Innerthoughts Thinking of Warren
1
Insurance Mandates Autism TreatmentsFail to Pass Oklahoma
Legislature
8
11th Circuit Rules Doctors Donrsquot Trump Stateon Medicaid Care for Children
with Disabilities
9
Compassion Friendship and Longevity
A Good Measure of Success
13
Best of the Best In Direct Support Services Honored
3
Governorrsquos Disability Employment
Awards Showcase Oklahomarsquos Reason to Brag
4
DDSD Employees Win Advocacy Awards
5
Quality Awards Best of the Best
6
DDSD Nicholson Receives Award for Contributions to College
of Allied Health 7
Health and Human Services Rescinds
Medicaid Regulations Affecting Case Management 10
Oklahoma Documentary on Developmental
Disabilities History to Air on OETA
12
State Legislative News 14
A Dream Come True 6
Residents of a Group Home in Vinita Display their CPR Certificates
9
Imagining Everest 10
Waiting and Hoping 11
DDSD Fiscal Year 2010 Budget Outlook
12
Elves Work Year Round to Make Christmas Special for DDSD Clients
16
Our MottoThe name Interface was chosen for this publication
because it reflects our purpose to create a common
boundary where diverse groups interact Interface
represents our effort to bring together different groups
for the benefit of Oklahomans with developmental
disabilities We hope to provide information encourshy
agement and insight
Please send your ideas for news and features to
Sheree PowellWritershyEditor Developmental Disabilities Services Division
Community and Provider Relations
PO Box 25352 Oklahoma City OK 73125
(405) 521shy4972
INTERFACE NEWSLETTER James M Nicholson Division Director of
Developmental Disabilities Services Division
Sheree Powell WritershyEditor
Danny Phillips Graphic Artist
Caroline Miller Sheree Powell Photographer (unless otherwise noted)
S09455 OKDHS Issued 1009 This publication is authorized by the Oklahoma Commission for Human Services in accordance with state and federal regulations and printed by the Oklahoma Department of Human Services at a cost of $557700 for 9295 copies Copies have been deposited with the Publications Clearinghouse of the Oklahoma Department of Libraries
Oklahoma Department of Human Services Developmental Disabilities Services Division
I N T E R F A C E
INNERTHOUGHTS
James Nicholson
Thinking of Warren
Warren Edds one of the first selfshyadvocates I met after
coming to DDSD in 1988 died on
June 22 at his home in Enid I had
not talked to Warren in a number of years but I used to see him
frequently at Oklahoma People
First meetings rallies and other events He was very active in the
selfshyadvocacy movement and was not bashful about making sure his voice and opinion were heard
The most memorable talk we had
was at a Governorrsquos Conference in
Tulsa many years ago I was scheduled to do a breakshyout session called ldquoA Conversation with Jim
Nicholsonrdquo targeted towards selfshyadvocates As the
start time approached I was surprised at the large
number of people who were in attendance The
topics discussed in these sessions usually centered on
service delivery concernsmdashgood and bad providers or staff not being allowed enough freedom of choice not being listened to etc
During this session Warren stood and began
talking about his life experiences and how they
affected him Everyone who knew Warren knew him
as a very happy guy who always had a smile on his face But this was a different Warren He talked
about his mother leaving him as a small child at Enid
State School and how it pained him to think about being unwanted and abandoned Tears came to his eyes as he struggled to come to grips with memories of many decades past He created one of those
moments for which there is no real response possible
other than a thoughtful respectful silence and a
touch on the shoulder When Warren finished and sat down other selfshy
advocates stood and talked about their life
experiences and the incidents that caused them pain
People you would never expect revealed underlying wounds that they continued to struggle with That afternoon Warren opened the
way for many selfshyadvocates to
honestly share and thus lighten their burdens
After leaving Enid State School as an adult Warren became a wellshyknown figure in that community He established relationships with
everyone he came in contact with
from mayors and city councilmen to
several generations of workers at the
local McDonaldrsquos restaurant When the city dedicated
a new bridge many years ago Warren was invited to be
the first to officially cross it in his famous threeshywheeled cycle
Warren also went on to enjoy a rewarding career volunteering as a camera operator for the Enid public
access television station The Enid News and Eagle
printed a wonderful article marking his passing ldquoDeath of Warren Edds has an impact on communityrdquo As I read it I remembered our session in Tulsa and the
barriers Warren had overcome to become the person
everyone remembered as having a ldquocheery smile and
a kind heartrdquo Great success doesnrsquot come easy and it certainly didnrsquot for Warren
You can see a video clip of Warren that appears in
the documentary ldquoLiving in the Freedom Worldrdquo at httpwwwmnddcorgparallels2onevideovideo76b
shyfreedomworldhtml He was a star on both sides of the camera
James M Nicholson Director Developmental Disabilities Services Division
Oklahoma Department of Human Services 1 Developmental Disabilities Services Division
I N T E R F A C E
Death of Warren Edds has an impact on communityBy Robert Barron Staff Writer Enid News and Eagle
(reprinted from June 24 2009)
Warren Edds never held a public
office He never was successful in business and there are no statues of him
in townBut everybody knew Edds and everyone
was used to seeing him ride his threeshywheeled cycle around town
His death at age 59 has had an impact in
Enid on people who knew him or even just knew who he was
Edds was supposed to wear oxygen at all times since becoming ill with pneumonia in
May He had not been seen for two or three
days when his body was found by a
neighbor inside his apartment about 8 pm Monday June 22 (Enid Police Department is investigating it as an unattended death
and said there is nothing suspicious) His funeral will be 10 am Thursday at
Davis Park Christian Church with the Rev Alan Seibel officiating Burial will follow at Enid State School under the direction of BrownshyCummings Funeral Home An
account has been set up at Central National Bank for funeral expenses The funeral home has asked friends for anecdotes to use
in his obituary Those stories may be sent to familyfirst
brownshycummingscom Edds was born Aug 19 1949 to Thomas
R and Cheryl Holland Edds He lived at Enid State School until earning his statute
of independent living He was a member of Davis Park Christian Church since 1975
He is survived by his father who lives in
Florida brother Steve Smith of Broken
Arrow sister Sandy Brown of Ohio and
aunt Gina Crotty of Stillwater
Edds volunteered at PEGASYS Enidrsquos publicshyaccess television station for 26
years regularly assisting with camera work He also was known for his support for Oklahoma State University athletics
ldquoHe always had something positive to say
about everyonerdquo said Wendy Quarles PEGASYS executive director and a friend
of Edds Edds could be seen frequently around
town riding an adult tricycle donated to
him by local business and groups or at McDonaldrsquos at Maine and Van Buren
engaging people in a spirited conversation
about OSU athletics Edds was a charter member and first
president of the Yes We Can Civitan
Club which consisted largely of people
with special needs He originated the
name of the club and was nominated as regional director of Civitans for Oklahoma and Arkansas He also was the
clubrsquos highest point producer earning the
name ldquoMr 400rdquo Edds scheduled regular programs on PEGASYS and the club
established the ldquoChiller Challengerdquo competition in which people jump into
freezing water to raise money for the
Special Olympics program Edds was 1981 Special Olympian of the Year
ldquoItrsquos people with special needs saying lsquoWe can do thatrsquordquo said Kathy Eck a
sponsor of the club ldquoHe was an icon in this town Even if
people didnrsquot know his name they knew
him because of him riding all over the
community on his tricycle with the orange
safety flag They knew of him He had an
infectious smile and was always concerned
about people He was just a kind personrdquo Eck said
The Enid News amp Eagle Web site
received a number of postings Tuesday after word of Eddsrsquo death became known
ldquoEnid has lost a great man a faithful friend and a dedicated volunteer Warren
will truly be missedrdquo said Lindy Chambers executive director of Main Street Enid
Another stated ldquoWarren will be missed He always said hello to anyone that would
listen OSU has lost a fanrdquo People who saw him casually said it was a
pleasure to know him that he always put a
smile on their face Mayor John Criner said Edds was a good
resident and encouraged him and the city
commission He went to the Public Library
of Enid and Garfield County daily to
remain informed on city matters When the
city dedicated a new bridge on West Randolph in 2007 Edds was the first to
ride across on his bicycle Molly Helm director of communications
and marketing for Autry Technology
Center recalled being a camp counselor at Campfire Camp in high school when some
of the clients at Sunnyside Nursing Home
came for the day Warrenrsquos nickname was Jabber as was Helmrsquos and she said they
immediately struck up a friendship ldquoYears later it has been especially heartshy
warming to see him working the cameras for PEGASYS doing something he
lovedrdquo Helm said ldquoHis cheery smile and
his kind heart will be missedrdquo mdash This article has been reprinted
with permission from the
Enid News and Eagle
Oklahoma Department of Human Services 2 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
Best of the Best in Direct Support Services honored
The statersquos most outstanding direct support professionals were recognized for their work
during the Governorrsquos Conference on Developmental Disabilities March 2 2009 at the Tulsa Renaissance
Hotel and Convention CenterThe annual Awards of Excellence in Direct Support
Services sponsored by the Developmental Disabilities Services Division honors individuals working in direct care in a variety of settings Nominations are sent to DDSD
from all over the state from provider agencies family
members and individuals with disabilities All of the direct support professionals recognized were presented with Awards of Excellence Out of the award winners the Best of the Best were chosen and featured in video presentations at the ceremony Awards of Excellence in Direct Support Services were presented to Will Watkins Rescare OklahomaLarry Lamm Supported Community LifestylesLora Catlett Gatesway FoundationAngel Balenti Phoenix Residential ServicesCharity Mormon Magna Community Living ServicesStephanie Lackas Reach Out IncRandy Brewer Gatesway FoundationKrystal Lewis Goodwill Industries of Southwest OklahomaSteve Poland Oklahoma Life Skills AssociationMattWeintz Volunteers of AmericaNancy Newson Kibois Community Action FoundationPatricia Harper Garvin County Community Living CenterMary Williams Rescare OklahomaLucinda Flynn People IncApril Thompson Independent Opportunities IncLaDonna Lang Central State Community ServicesDneta Carr Central State Community ServicesDaniel Escojido Supported Community LifestylesCindy Simmons Kibois Community Action FoundationDavid Pitts Homelife AssociationBeverly Kichler Volunteers of AmericaFreda Kretchmar BIOSAnnette Bounds Big Five Community ServicesGenea Shatto INCA Career Opportunities
Awards of Excellence in Direct Support Services winners (Back Row from left) Daniel Escojido Larry Lamm Will Watkins David Pitts Stephanie Lackas Patricia Harper Randy Brewer Matt Weintz and Krystal Lewis (Front Row from left) Genea Shatto April Thompson Lucinda Flynn Mary Williams Angel Balenti Charity Mormon Lora Catlett and Steve Poland
The Best of the Best in Direct Support Services Awards were presented to (From Left) Larry Lamm Will Watkins Stephanie Lackas Mikayla Angel Balenti Charity Mormon and Lora Catlett
Mark your calendars The 2010 Governorrsquos Conference on Developmental Disabilities will be held March 8shy9 To nominate someone for the Direct Support Services Awards contact the Developmental Disabilities Services Division at (405) 521shy6254
Oklahoma Department of Human Services 3 Developmental Disabilities Services Division
I N T E R FA C E
Governorrsquos Disability Employment Awards
Showcase
Steve Scott (Right) receives a 2008 Governorrsquos Disability Employment Award for his outstanding work from Howard Hendrick Cabinet Secretary of Human Services and Director of the Oklahoma Department of Human Services Scott was recognized for working 19 years with the same WalshyMart store in Sand Springs During that time Scott has received several promotions and pay raises
Oklahom
arsquos
reason to
brag
Oklahoma may be best known around the country for excellence in many
things from college football to producing awardshywinning countryshywesternmusic stars Probably not as well known is the fact that Oklahoma is the best state
in the nation at supporting people with developmental disabilities to work
in competitive jobs according to an independent ranking by the Institute
for Community Inclusion at the University of Massachusetts BostonldquoFor the past three years Oklahoma has led the nation in assisting people with
developmental disabilities to find competitive jobs and become working taxpayersrdquo said James Nicholson Director of the OKDHS Developmental Disabilities Services Division ldquoToday more than 60 percent of individuals with developmental disabilities served by our division participate in supported employment servicesrdquo
The Governorrsquos Disability Employment Awards are held each October to
recognize individuals with disabilities for their outstanding achievements at work
through the supported employment program Also recognized are businesses that hire people with disabilities and members of the media who promote supported
employment programs The Governorrsquos Disability Employment Awards are coshysponsored by Governor
Brad Henry and Lt Governor Jari Askins along with OKDHSshyDDSD the Department of Rehabilitation Services and the Oklahoma Association
of Persons in Supported Employment
The 2009 Governorrsquos Disability Employment awards will be held on
Oct 22 130 pm at the Governorrsquos Mansion Pavilion in Oklahoma City
InterFace NEWSLETTER
The 2008 award Receipeints wereBUS INESS WINNERS
Gene LukerAramark Glass Plant Tulsa
Gary CookMcDonaldrsquos Ardmore
WalshyMartCushing
Mike amp Terry GentryMcDonaldrsquos Lawton
Joyce and Fred HannahLektron LED Lighting Tulsa
Pizza HutCushing
Guest InnArdmore
JonMilneSODEXO Langston
WalshyMartMoore
City of Muskogee
Angela OwensSonic DriveshyIn Ardmore
WalshyMart Super CenterSand Springs
WalshyMart Super CenterVinita
MED IA WINNER
Dawndee Bostwichreporter Duncan Banner
EMPLOYEE WINNERS
Bobby Bailey
Bob Bennett
Tammie Burrall
Andy Cheater
Tommy Coleman
Jeff Dickson
Chad Joyce
Allen Kouba
Linda Prowell
Phillip Reed
Peter Rowland
Steve Scott
Kenneth Smith
Judy Wolfe
James Young
Oklahoma Department of Human Services 4 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
DDSD employees win advocacy awards
Angela King DDSD Area II case manager and Cindy
Jennings DDSD Area III nurse received awards from TARC in December 2008 King received the
AdvocateshyCase Manager of the Year award while
Jennings was recognized with a Special Achievement in
Advocacy AwardKing has nearly 20 years of experience in DDSD
case management working with individuals on every
type of waiver including the pilot project for the InshyHome Support waiver King began her career in the
field as a direct support professional before
becoming a recreational therapist and case
manager transitioning individuals from The
Hissom Memorial Center King gives each
person on her caseload the individual attention
they need regardless of the time it takes As a
recent example of her advocacy and
dedication she assisted a woman on her caseload in the process of obtaining
a divorce from her husband of many
years King referred the woman to a
community resource for legal advice
assisted her in completing all of the legal paperwork attended
court hearings with her and then took the woman apartment hunting
King even helped her move into the new apartment unpack and
decorate King has been known for her attention to detail and is extremely conscientious exemplifying her commitment to those
she servesJennings has volunteered for Oklahoma People First for the last
11 years assisting in the establishment of new chapters planning
state conferences writing grants to secure funding and soliciting
donations for conferences As an OPF volunteer Jennings is passionate about teaching individuals to advocate for themselves Her belief in their abilities empowers them to have faith in
themselves and in their abilities to make choices She educates OPF members on increasing their independence vocational opportunities voting relationships and community involvement Jennings empowers OPF members by offering them a support network to turn to when in need of assistance By doing so she
teaches others to recognize how much persons with developmental disabilities can do for themselves if given the right supports
InterFace NEWSLETTER
To see Oklahomarsquos ranking as compared to other states in regard to the numbers of persons with developmental disabilities in competitive jobs (supported employment)go to
wwwstatedatainfo
This website is a project of the Institute for Community Inclusion at UMass Boston supported in part by the Administration on Developmental Disabilities US Department of Health and Human Services under cooperative agreement with additional support from the National Institute on Disability and Rehabilitation Research of the US Department of Education
Angela King DDSD Area II case manager is presented with the AdvocateshyCase Manager of the Year award by John Gajda executive director TARC
Cindy Jennings DDSD Area III nurse is presented with a Special Achievement in Advocacy Award by John Gajda executive director TARC
Oklahoma Department of Human Services 5 Developmental Disabilities Services Division
I N T E R F A C E
Quality
AwardsBest of the Best
Regina ChacePrograms Manager for DDSD Employment Services
Regina Chace Program Manager for DDSD Employment Services receives an OKDHS Quality Award Best of the Best for her leadership in this program Chace ensures there are policies and processes which support participants to have a full range of opportunities for employment As a result Oklahoma has been recognized as the nationrsquos leader in achieving impressive outcomes in integrated employment for people with
disabilities InterFace NEWSLETTER
A Dream Come True Bobby Cooper and his parents were invited by Governor Brad Henry to meet with him and visit the capitol Tom Cooper Bobbyrsquos father is a member of the Governorrsquos Council for United We Ride representing people with disabilities Tom mentioned to Governor Henry in a letter that it had been Bobbyrsquos dream to meet him after seeing him speak on television during his reshyelection Governor Henry was so flattered by Bobbyrsquos request that he invited the whole family for a visit to the capitol in November 2008 They took a few moments to pose for this photograph in the Governorrsquos Blue Room From left Tom Cooper BobbyGovernor Henry and Ruth Cooper
Oklahoma Department of Human Services 6 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
James Nicholson Director of the OKDHS Developmental Disabilities Services Division is presented with a 2009 College of Allied Health Citation for Special Contributions (Left to Right) Jeff Berry Chair College of Allied Health Awards and Honors Committee College Dean Kevin Rudeen Nicholson and Martha Ferretti Professor and Chair Physical Therapy Department of Rehabilitation Sciences College of Allied Health
DDSD Nicholson receives award for contributions to College of Allied Health
On April 2 2009 James Nicholson Director of the OKDHS Developmental Disabilities Services
Division was presented with the 2009 College of AlliedHealth Citation for Special Contributions Nicholson was nominated for this award by Martha
Ferretti Professor and Chair Physical Therapy Department of Rehabilitation Sciences College of Allied Health University of Oklahoma Health Sciences Center In the nomination for this award Ferretti wrote ldquoMr Nicholsonrsquos background is one of diversity and richness
His work ethic sets a standard for us all to follow His calmness humor and general goodwill in the midst of controversy is obvious and remarkable And first and foremost his dedication to improving the lives of children and adults with developmental disabilities has set a standard for us all to emulate Mr Nicholsonrsquos creativity thoughtfulness and ability to target a goal and accomplish it regularly in collaboration with a number of formal and informal partners prove the importance of reaching beyond onersquos own resourcesldquoAs a visionary in the field of developmental disabilities early in his
role as director Mr Nicholson caught the attention of both supporters and detractors His vision was a perfect match for what our faculty were striving to accomplish in preparing our students and in providing servicesin the field of developmental disabilities ldquoWe approached Mr Nicholson shortly after he became the director with
a proposal for introducing assistive technology into the DDSD system differently than had been accomplished at that point Over the past 18 years
he and members of his staff have continued that collaboration on projects that addressed both major and minor challenges
about policy and services for Oklahomans with developmental disabilities
ldquoOur faculty has learned so much from this very politically astute and professional state leader Before the state was aware of its challenges emerging from children with autism and their families Mr Nicholson quietly accepted the mantle of addressing what we have come to know are unbelievable challenges presented by the impact of autism Seven years ago he convened a multishyagency multishydisciplinary task force that included parents of individuals with autism to develop the Oklahoma State Plan for Autism and the Oklahoma Autism Network We are honored by him placing the OAN within the structure of the College
ldquoMr Nicholson has stimulated us to mature as educators researchers and service providers to more effectively address many of Oklahomarsquos needs in the field of
developmental disabilitiesrdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 7 Developmental Disabilities Services Division
Nickrsquos Law
I N T E R F A C E
Insurance Mandates for autism treatments fail once again to pass Oklahoma legislature
For the second consecutive year bills that would have mandated insurance companies to cover
treatments for autism failed to pass through the Republicanshycontrolled legislatureIn February the House Economic Development and
Financial Services Committee voted down House Bill 1312 also known as ldquoNickrsquos Lawrdquo which would have required insurance providers to cover autism treatment The only autismshyrelated bills that did receive enough
support to pass were House Bill 2027 and its companion Senate Bill 135 The Senate version made it through the legislative process and will enact a licensing process for national board certified behavior analysts and enhance existing state programs that would train doctors to diagnose and treat autism Critics of this bill question whether it will actually produce
significant new services if insurance doesnrsquot cover the cost of treatment and parents canrsquot afford to pay the bill
ldquoSadly this bill will do nothing to relieve the pressure on families struggling to care for children with autismrdquo said Sen Jay Paul Gumm author of lsquoNickrsquos Lawrsquo legislation ldquoThis measure was designed to relieve political pressure on legislators who refuse to even consider Nickrsquos Lawrdquo
When Governor Henry signed Senate Bill 135 he said the measure was just a small step in the effort to help affected Oklahoma families He urged lawmakers to pass legislation to mandate insurance coverage for the treatment of autism
ldquoThere is nothing wrong with this bill just like there is nothing wrong with a pack of shingles at a construction siterdquo said Sen Gumm ldquoIf you try to put the shingles on before you pour the foundation you are doomed to failure As Governor Henry wisely noted when he signed the bill the foundation is insurance coverage of autism Absent that Senate Bill 135 is doomed to failurerdquo
Republican legislative leaders oppose insurance mandates saying they drive up the cost of health insurance despite reports from states with similar insurance mandates that show no significant increase in the cost of premiums
Republicans attempted to pass House Bill 1975 which would only allow insurance legislation to be introduced in oddshynumbered years and approved in evenshynumbered years The bill would have also required a 75 percent supershymajority vote to do away with the mandate in the case of an emergency
Henry vetoed that bill and said it would have unreasonably ldquotied the hands of state policy makers on a very important issuerdquo
ldquoThis would empower a small minority of legislators to thwart legitimate state efforts to address a pressing public policy issue and ensure that the restriction would rarely if ever be liftedrdquo Henry said
Henry also questioned why HB 1975 restrictions were only applied to a single issue area saying it raised legitimate concerns regarding why only one subject would be singled out for special treatment
Autism cont on page 9
Oklahoma Department of Human Services 8 Developmental Disabilities Services Division
SUMMER 2009
Autism cont from page 8
ldquoOklahoma and its citizens are better served when policy makers are allowed the freedom to address any pressing issue in the Legislature without the hindrance of arbitrary restrictionsrdquo Henry said Democrats offered a compromise mdash to put autism coverage in highshy
risk insurance pools as a last resort for families who canrsquot afford the coverage elsewhere Republicans again declined and instead went forward with SB 135 This year three more states enacted Autism Mandate legislation bringing
the total to 11 states that now require insurance companies to cover treatment for autism InterFace NEWSLETTER
Proudly displaying their CPR (Cardio Pulmonary Resuscitation) certificates are (From Left) Guy Bivens Allen Larimore Steve Sposato Andy Edwards Joshua Johnson and Tino Hensley residents of the Independence House
Residents of the Independence House at the Home of Hope in Vinita recently became CPR certified after a fellow resident had a heart attack A staff member used CPR to save Allen Larimorersquos life and he has since received a pacemaker Although staff members must be CPR certified this event inspired Larimorersquos housemates to take the class so they could also be prepared ndash just in case Donna Marlow a CPR trainer from the OKDHS Developmental Disabilities Services Division held the class free of charge at the agency and was proud that all the men passed their tests with flying colors
11th Circuit Rules Doctors donrsquot trump state on Medicaid care for children with disabilities by Alyson M Palmer
A federal appeals panel has declared that treating doctors donrsquot have the final say in how much nursing care the state must provide
children with disabilities under MedicaidOn April 24 the 11th US Circuit Court of Appeals reversed a district
judgersquos decision that had said the state must provide the amount of nursing care that a North Georgia girlrsquos doctor said she needs
Despite a slew of amicus briefs by state governments and Medicaid plan administrators the panel dispatched the case in a twoshypage unpublished unsigned opinion that came out a month after oral argument
Holland amp Knight partner Robert S Highsmith Jr who represented a proshystate friend of the court that provides managed care services for Medicaid programs said his client WellCare of Georgia had been concerned about language in US District Judge Thomas W Thrash Jrrsquos ruling that suggested anything ordered by a treating physician is medically necessary under the law ldquoThat one sentence just had to get reversedrdquo said Highsmith ldquoWe are very excited that they saw and reversed that clear errorrdquo
But an advocate for the teenage girl at the center of the case Atlanta Legal Aid Society General Counsel David A Webster said Monday that the decision ldquodoesnrsquot mean muchrdquo and says little about the relationship between the state and the treating physician ldquoThatrsquos going to be open for future litigationrdquo said Webster Webster said the case of his client Anna C Moore will go back to Thrash for the judge to consider the
11th Circuit Rules cont on page 15
Oklahoma Department of Human Services 9 Developmental Disabilities Services Division
I N TERFACE
ImaginingEverest The Story of LaelBy Adrienne Benz
ldquoI prayed for God to open the eyes of my understanding and the pieces began to fall into place Mollyrsquos future had been planned since she was a young girl she would marry andhave a bright healthy family known for their intelligence andkindness However the birth of her first born quickly dispelled the myth of the stereotypically perfect family as Molly learns her son Lael has Down syndrome Struggling to accept the disconcerting news and understand Godrsquos perfect plan Molly faces a challenge no more daunting than the climbing of the greatMt Everest she often dreamed of as a child Guilt hope grief and happiness take Molly and Lael across rocky terrain and risky edges but faith and the resonant voice of God bring mother and son up the emotional mountain 30 years in the making ndash a mountain that revealed the aptitude of Mollyrsquos beloved son and the kindness of others By Imagining Everest Molly and Lael forge a unique and amazing relationship which allows them to overcome even the most intimidating ascension into the unknownrdquo
Molly Mathewrsquos son Lael currently receives services through the OKDHSDDSD community waiver program
264 pages shy $1499 (paperback) This book is available online through Tate Publishing wwwtatepublishingcombookstore
Health and Human Services rescinds Medicaid regulations affecting case management
Department of Health and Human Services (HHS) Secretary
Kathleen Sebelius announed June 29 that the administration will rescind all or part of three Medicaid regulations that were previously
issued and delay the enforcement of a fourth regulation Each of these
rules in whole or in part had been subject to Congressional moratoria
set to expire on July 1 2009ldquoThese regulations if left in place would have potentially adverse
consequences for Medicaid beneficiaries some of our nationrsquos most vulnerable peoplerdquo said Secretary Sebelius ldquoBy rescinding
these rules we can expect that children will continue receiving
services through their schools beneficiaries will be able to
access all available case management resources to help them
better manage their health care and outpatient hospital and
clinic services can continue to be covered in the most efficient mannerrdquo
This ruling was crucial to Oklahomarsquos Developmental Disabilities Services as the state could have lost the ability
to bill Medicaid for 100 percent of the cost of providing
case management services to waiver service recipients which totals approximately $22 million per year
ldquoThe actions we are taking today are necessary to
ensure that the states have the flexibility they need to
fully serve Medicaidshyeligible individualsrdquo said
Secretary Sebelius
The Centers for Medicare amp Medicaid
Services (CMS) and HHS arebull Rescinding provisions of an interim final rule
published Dec 4 2007 which would have restricted beneficiary access to case management services These provisions appeared to in practice restrict beneficiary access to needed covered case management services and limit state flexibility in determining efficient and effective delivery systems for case management services
Regulations Expiring cont on page 11
Oklahoma Department of Human Services 10 Developmental Disabilities Services Division
SUMMER 2 0 0 9
Regulations Expiring cont from page 10
bull Rescinding a final rule published Dec 28 2007 that would have eliminated reimbursement for schoolshybased administrative costs and costs of transportation to and from schools The rescission reflects concern that the rule could limit the Medicaid administrative outreach activities of schools and that the overall budgetary impact on schools could potentially impact their ability to offer Medicaid services to students
bull Rescinding a rule published Nov 7 2008 that would have limited the outpatient hospital and clinic service benefit for Medicaid beneficiaries to the scope of services recognized as an outpatient hospital service under Medicare This rule was rescinded because CMS became aware that coverage beyond that scope could not be easily moved to other benefit categories resulting in great impact than previously anticipated
bull Delaying until June 30 2010 the enforcement of portions of a regulation that clarified limitations on health care related tax programs so that CMS could determine whether states need additional clarification or guidance CMS may also further review the potential impact of the regulation and give additional consideration to alternative approaches InterFace NEWSLETTER
Waiting and HopingBy Adrienne Benz
Sad is like sitting here when I donrsquot have a home to run away to
So there on the street just waiting for something to eat somewhere to stay and a bed to sleep on and someone to hold
And hoping Irsquom still there the next day
They have to get up from the street in the park sitting on a cold chair in the dark
Just waiting for someone to take them in their home Waiting to open up and talk about their hidden feelings
like they canrsquot wait any longer
Adrienne Benz was a child in state custody when she wrote this poem She is now an adult reunited with her family
Oklahoma Department of Human Services 11 Developmental Disabilities Services Division
I N T E R FA C E
DDSD Fiscal Year 2010 Budget Outlook OKDHS Director Howard Hendrick
presented the agencyrsquos Fiscal Year 2010 budget to the Commission for Human Services on June 16 Hendrick emphasized that even with the additional federal stimulus money and other oneshytime funds the agencyrsquos overall funding will be approximately $50 million short of anticipated spending levels To achieve a balanced budget cuts would have to be made within each division The Developmental Disabilities Services Divisionrsquos
share of the cuts amount to approximately 3 percent of the divisionrsquos operating budget ($17 million) Another $200000 had to be identified to fund the new initiative for Applied Behavior Analysis mandated by Senate Bill 135 this legislative sessionDDSD was able to accomplish the budget cuts without
impact to any programs or services through reductionsat the Northern and Southern Oklahoma ResourceCenters The rest of the savings came from reductions in training and professional contracts the divisions holds with various entitiesOver the next year DDSD will be under a selfshyimposed hiring
freeze for all positions except for case management direct care professionals and registered nursesIf monthly state revenue collections continue to fall below
expected levels additional reductions may be required of all stateagenciesrsquo operating budgets
Interim StudiesThere will be two interim legislative studies conducted this summer that could impact DDSD and service recipients
One of these studies will investigate a possible provider feetax on agencies providing waiver community services If the provider feetax is found to be within federal Medicaid guidelines it could possibly be used to fund rate increases in waiver services
The other legislative study will look into the pros and cons of online training versus classroom training specifically for providers of DDSD community services
Money Follows the PersonAs of this date DDSD has transitioned eight people from Northern Oklahoma Resource Center of Enid and Southern Oklahoma Resource Center into community homes using the federal Money Follows the Person grant Utilizing these federal funds DDSD has been able to save approximately $21000 in the community services provided to those individuals
Oklahoma documentary on developmental disabilities history to air on OETA
an
Oklahoma
document
ary
Adocumentary showing Oklahomarsquos history serving people with intellectual and developmental disabilities is
scheduled to begin airing on OETA (Oklahomarsquos Education Television Authority) in October during national Disabilities Awareness Month
The video ldquoWagons to Waivers A Century of Changerdquo narrated by Oklahomarsquos own country music star Reba McEntire will be broadcast on the OETAshyOklahoma channel starting on Oct 24th at 5 pm and on Nov 5th at 830 pm The program will be
aired a couple times a month
The documentary takes viewers on an emotional journey from the days of the Dust Bowl and covered wagons and shows the statersquos progression from institutional services to full community inclusion for persons with intellectual disabilities Oklahomarsquos story begins in 1909
with the creation of the Institute for the Feeble Minded in Enid and includes the
tears and efforts of parents the stories ofpeople who grew up in institutions the legal struggles and the triumph of selfshyadvocacy The video was produced by the Oklahoma Department of Human Services Developmental Disabilities Services Division
OETAshyOKLA is Cox Cable channel 112 but other television carriers as well as satellite users can access the channel which is devoted to Oklahomashyspecific programming Check your local television lis tings for specific programming dates and times
Oklahoma Department of Human Services 12 Developmental Disabilities Services Division
SUMMER 2009Compassion friendship and longevity A good measure of success
The day had finally come and Danny waited anxiously on the sofa He watched quietly as the
nursing staff set up the hospital bed and made his friend Carl comfortable The minute all was clear Danny went to Carl and told him how much he had missed him and that he needed him to get better Dannyrsquos longshytime friend had just undergone surgery
to remove a malignant brain tumor Danny didnrsquot understand the procedure or Carlrsquos prognosis ndash all that mattered was that his best friend was home It just wasnrsquot home without CarlCarl is considered the head of the household that he shares
with Danny and his other friend Hershel Carl was always the one who planned their meals said the prayers at the diningroom table and got them involved in Special Olympics events When Carl became ill and went to the hospital it was Danny
who stepped up and tried to fill in ndash just until Carl came home ldquoThe Three Musketeersrdquo (thatrsquos what their staff call them) have
been friends and have lived together for more than 30 years
Danny (lef
t) spends
hours by
Carlrsquos sid
e
encourag
ing him in his
recovery
They met as boys at The Hissom Memorial Center the nowshyclosed institution in Sand Springs for persons with developmental disabilities When they aged out of Hissom the three moved about the same time to a private facility where they lived for many years
In 1993 The Musketeers were given the opportunity to move together once again into a house in their community supported through the DDSD Medicaid Community Waiver program Since
that time they have lived in the house withsome of the same staffmembers who havecared for them for morethan 20 years
The Three Musketeers Danny (left) shows his excitement over his friend Carlrsquos (right) return from the hospital after brain surgery Shy Hershel (center) wipes tears from his eyes
Carl is recoveringfrom his surgery andworking on his abilityto speak and onregaining the use of theleft side of his bodyThe staff in the home
often has to make Danny go to bed at 1 am when hersquos still sitting beside Carl encouraging him to get better so he can go back to work
All three men have jobs and love their work ndash Carlmost of all Danny somehow knows that if Carl canjust get back to work life will continue as they onceknew it
ldquoTheyrsquore like a wellshysettled familyrdquo said Gretchen Moser their DDSD case manager ldquoEven their families consider these guys a family and respect their wishesrdquo
These days there are many opinions about what constitutes a family or even success But there are stories that transcend those discussions Stories like these that remind us success can also be measured by the love and longevity of a friend InterFace NEWSLETTER
Relations
hips
Oklahoma Department of Human Services 13 Developmental Disabilities Services Division
I N T E R F A C E
StateLegislativeNews
Of the thousand or more bills filed at the beginning of the 2009 legislative session only a few made it through the entire process that will have an impact on persons with developmental disabilities families and professionals in the field They are
HB 1007 mdash Wesselhoft Leftwich Signed by the Governor Requires specific Physically Disabled person signage to be posted as a reserved area for the parking of a vehicle displaying a valid permit
HB 1019 mdash WrightSigned by the Governor Recreates the Group Homes for Persons with Developmental or Physical Disabilities Advisory Board
HB 1048 mdash Banz AldridgeSigned by the Governor Relates to the collection of delinquent real property taxes removes physically disabled from ldquoincapacitatedrdquo persons granted additional time to redeem personal items reduces time to collect excess sale proceeds by half
HB 1065 mdash Faught Crain Signed by the Governor Relates to the Continuum of Care and Assisted Living Act adds definition and requires inspection results to be posted on website
HB 1424 mdash Protor Signed by the Governor Requires treatment facilities transitional living facilities halfway houses and any house or facility that may be used for medical or nonmedical detoxification to mail notification to property owners within a quarter mile radius if zoning changes are proposed
HB 1461 mdash Sears Ford Signed by the Governor A school that does not make adequate yearly progress for two straight years shall utilize the assistance of a school support team formed by the State Department of Education EMERGENCY
HB 1581 mdash Coody Jolley Signed by the Governor School teacher candidates that wish to teach elementary early childhood education or special education programs must study the five elements of reading instruction EMERGENCY
HB 1763 mdash Enns Reynolds Signed by the Governor Requires the state Department of Education to provide special education training for process hearing officers to ensure adequate knowledge in special education laws and proceduresEMERGENCY
HB 1893 mdash Peterson Anderson Signed by the Governor Creates the Aging and Disability Resource Consortium to work with other agencies in developing and implementing a singleshypointshyofshyentry concept for aging and disability groups in Oklahoma
SB 135 mdash Johnson Mike Signed by the Governor Provides for the licensing of certain persons to practice as a licensed behavior analyst or a licensed assistant behavior analyst and to study children with autism and their behaviors directs funds to be used by the Department of Human Services Developmental Disabilities Services division for training SoonerStart providers to treat children with autism spectrum disorders provides for a behavorial analysis research pilot project provides legislative intent
SB 518 mdash Justice Osborn Signed by the Governor Adds grandparents as members of immediate family
SB 871 mdash Anderson Signed by the Governor Modifies membership of the Electronic and Information Technology Accessibility Advisory Council
Oklahoma Department of Human Services 14 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
11th Circuit Rules cont from page 9
matter again Moore a teenager living in North Georgia who goes by ldquoCallierdquo has been receiving inshyhome nursing care paid for by Medicaid for about a decade The state has been trying to cut the number of hours of care she receives each week
The 11th Circuit interpreted a federal law that says states participating in the Medicaid program must provide ldquoearly and periodic screening diagnostic and treatment servicesrdquo that are necessary to ldquocorrect or ameliorate defects and physical and mental illnessesrdquo in Medicaidshyeligible children The primary ways children become eligible for Medicaid are that they come from a lowshyincome family or have a disability according to Joshua H Norris another one of Calliersquos lawyers
Georgiarsquos Department of Community Health operates a program to administer Medicaidshyfunded nursing services for several hundred children who need nursing care It delegates the decisions about approval of such services to an organization called the Georgia Medical Care Foundation
According to Thrashrsquos order Callie is disabled because of a stroke she experienced in utero and suffers from various chronic conditions including mental retardation and cerebral palsy She lives at home and according to the statersquos brief attends an elementary school in Athens Ga three days a week Her lawyers have said she requires constant care
The statersquos lawyers have said that nursing hours can be reduced when the patientrsquos medical condition stabilizes positing that a goal of the program is to teach parents and other caregivers to take care of their children on their own The Mooresrsquo lawyers have contended that the statersquos system of ldquoweaningrdquo patients off their nursing services as long as theyrsquore staying out of the hospitaland not getting worse follows a different standard than that set by federal law
In 2006 the state informed Calliersquos mother that it was reducing Calliersquos nursing hours from 94 hours a week to 84 contrary to the recommendation of Calliersquos primary care physician Calliersquos mother filed suit
The Mooresrsquo lawyers convinced Thrash that the reduction was improper Afterissuing multiple injunctions in Calliersquos favor he denied the statersquos motion for summary judgment and granted the Mooresrsquo motion in part concluding the state must provide for the amount of skilled nursing care that Calliersquos treating physician deems necessary The panel that ruled in favor of the state in its appeal was comprised of Senior 11th Circuit Judge R Lanier Anderson III 11th Circuit Judge Gerald B Tjoflat and US District Judge Lisa Godbey Wood visiting from the Southern District of Georgia
The panel said both the state and Calliersquos physician have roles in determining whatrsquos medically necessary to correct or ameliorate Calliersquos medical conditions It cited a federal regulation that says a Medicaid agency ldquomay place appropriate limits on a service based on such criteria as medical necessity or utilization control proceduresrdquo
ldquoA private physicianrsquos word on medical necessity is not dispositiverdquo the panel concluded
Assistant Attorney General Virginia B Fuller made the successful oral argument for the state last month Attorney General Thurbert E Bakerrsquos spokesman Russ Willard said in an eshymail that the state ldquois appreciative of the Court of Appeals decision recognizing the role of the Medicaid program in providing for this treatmentrdquo
Norris who also is director of legal advocacy for a nonprofit that advocates for people with disabilities said the 11th Circuit gave Thrash
an opportunity to say more about the roles of treating doctors and the state in deciding what care the state needs to provide Norris noted that Thrash wrote on the subject last year in another nursing care case about a Savannah Ga boy who nearly drowned when he was 2Thrash barred the state from enforcing a policy of not providing nursing care for patients requiring 16
to 24 hours per day for more than one week he said that criteria isnrsquot based on whatrsquos medically necessary under federal Medicaid law
On the other handThrash denied the plaintiff rsquos request based on the
treating physicianrsquos recommendation for 24shyhourshyashyday private nursing services for an
indefinite period of time Thrash deemed such a prescription ldquoan abuse of the Medicaid systemrdquo
The state has limited discretion to deny a providerrsquos request for care under the ldquoearly and periodic
screening diagnostic and treatment servicesrdquo portion of the Medicaid Act said Thrash He added that ldquo[t]he statersquos discretion is limited to a review of the request for fraud abuse of the Medicaid system and whether the service is within the reasonable
standards of medical carerdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 15 Developmental Disabilities Services Division
klahoma Department of Human Services
I N T E R F A C E
DDSD Area II Project Elves get together to wrap all the presents and make sure they are delivered to the individuals before Christmas Elves work year round
to make Christmas special for DDSD clients For the past eight years individuals with
developmental disabilities who donrsquot have families or who would otherwise not receive gifts have had their Christmas wishes come true thanks to caring DDSD ldquoelvesrdquo in Area II Project Elf is the brainchild of ldquoThe Men in Recrdquo namely
Steve Pitts and Roger McDaniel DDSD Area II recreational therapists and Joe Stie DDSD case manager ldquoDDSD serves a lot of people with developmental
disabilities who donrsquot have families to celebrate the holidays withrdquo said Pitts ldquoAlthough our services meet their basic needs therersquos still a gap when it comes to those special things that families do for one anotherrdquoThat gap has been filled by The Men in Rec who work all year
long coordinating various events to raise money to buy Christmas presents for individuals ldquoWe raise all of the funds and no OKDHS money is usedrdquo said
Pitts ldquoThis year we are selling Blue and Gold sausage and Amish jams We also have an annual Christmas Carol fundraising performance which is donated to Project Elf by the American Theater Company We are given 300 tickets that we can sell and last year we sold 225rdquoDDSD coshyworkers got together and purchased 44 of those theater
tickets last year for the children who happened to be in the Laura Dester Center Shelter around the holidays ldquoWe have also set up a sponsorship program where people can purchase
the gift and return it wrapped and ready for the elf (aka case manager) to deliver This last Christmas we had 108 sponsors 30 of whom were the case managers themselvesrdquo
The Men in Rec also recruit fellow DDSD workers to help shop for the gifts and wrap themldquoWe could not accomplish this awesome Project Elf without the assistance of so many of our coshyworkers and our community volunteersrdquo he said ldquoItrsquos such a pleasure to share these gifts at Christmas time and let our customers know that they have a family through our good service to themrdquoThe Men in Rec are currently working to raise money for this yearrsquos Christmas gifts If you would like to join the rank of DDSD Elves by donating funds or becoming a sponsor please contact Steve Pitts at stevepittsokdhsorg or call918shy794shy7625 InterFace NEWSLETTER
Steve Pitts (right) DDSD Area II recreational therapist gives a donated WalshyMart gift card to case manager Roy Willett to purchase a Christmas gift for one of the people on his caseload
Oklahoma Department of Human Services 16 Developmental Disabilities Services Division
shy shyshy shy
shy shy
shy shy
shy shy
shy shy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
Developmental Disabilities Services Area Offices and Resource Centers
CUSTER
ELLIS
BECKHAM WASHITA CADDO
McCLAIN
SEM
INO
LE HUGHES HASKELL
LE FLORELATIMER PITTSBURG
COAL
ATOKA
PONTOTOC
JOHNSTON
GARVIN
MURRAY
CARTER
LOVE
BRYAN CHOCTAW
PUSHMATAHA McCURTAIN
GRADY
KIOWA
TILLMAN
JACKSON HA
RM
ON
GREER
COTTON
JEFFERSON
STEPHENS
COMANCHE
McINTOSH
CLEVELAND
POTT
AWAT
OM
IE
DEWEY BLAINE
CANADIAN
MAJOR
GRANT KAY OSAGE
WA
SHIN
GTO
N CRAIG
ROGERS
CH
ERO
KEE
ADAIR TULSA
WAGONER
MAYES
OKMULGEE
CREEK
LINCOLN
LOGAN
PAYNE
KINGFISHER
OKLAHOMA OKFUSKEE
MUSKOGEE SEQUOYAH
DEL
AWA
RE
OTTAWA NOATTA
GARFIELD NOBLE
PAWNEE
WOODS ALFALFA HARPER BEAVER TEXASCIMARRON
WOODWARD
ROGER MILLS
MARSH
Oklahoma CityOklahoma City
Tulsa
Area II
Area III
Area I
Pauls Valley
Enid
wwwokdhsorg
State Officetoll free 1shy866shy521shy3571
AREA Itoll free 1shy800shy522shy1064
AREA IItoll free 1shy800shy522shy1075
AREA IIItoll free 1shy800shy522shy1086
Greer Center (Enid)2501 NE Delaware Enid OK 73701
580 237 10272599 FAX 580 213 2799
Northwest Oklahoma Resource Center at Enid (NORCE)2600 E Willow
Enid OK 73701
580 237 1027
FAX 580 548 2600
Southern Oklahoma Resource Center at Pauls Valley (SORC)3210 Chickasaw St
Pauls Valley OK 73075 6822
405 238 6401
FAX 405 238 8261
DDSD Area I Office (Enid)729 Overland Trail Enid OK 73703
580 548 8900 FAX 580 548 8964
DDSD Area I Office (Oklahoma City)4545 N Lincoln Blvd
Oklahoma City OK 73105 405 522 6925
FAX 405 522 6995
DDSD Area II Office (Tulsa)Laura Dester Center 1427 E 8th Tulsa OK 74120
918 560 4848 FAX 918 560 4898
DDSD Area III Office (Pauls Valley)301 S Indian Meridian Rd Pauls Valley OK 73075
405 238 4700 FAX 405 238 4740
If you would like to find out what the DevelopmentalDisabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
If you would like to find out what the Developmental Disabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
This will take you to the main Oklahoma Department of Human Services Web page From there just click on Divisions and Offices and the Developmental Disabilities Services Division On our Web site you will find information about services the division offers how to apply for services eligibility policies contract provider agencies and much more
Come visit us today You may be surprised at what you will learn
OKLAHOMA DEPARTMENT OF HUMAN SERVICES Developmental Disabilities Services DivisionPO Box 25352 Oklahoma City OK 73125
I N T E R F A C E
INNERTHOUGHTS
James Nicholson
Thinking of Warren
Warren Edds one of the first selfshyadvocates I met after
coming to DDSD in 1988 died on
June 22 at his home in Enid I had
not talked to Warren in a number of years but I used to see him
frequently at Oklahoma People
First meetings rallies and other events He was very active in the
selfshyadvocacy movement and was not bashful about making sure his voice and opinion were heard
The most memorable talk we had
was at a Governorrsquos Conference in
Tulsa many years ago I was scheduled to do a breakshyout session called ldquoA Conversation with Jim
Nicholsonrdquo targeted towards selfshyadvocates As the
start time approached I was surprised at the large
number of people who were in attendance The
topics discussed in these sessions usually centered on
service delivery concernsmdashgood and bad providers or staff not being allowed enough freedom of choice not being listened to etc
During this session Warren stood and began
talking about his life experiences and how they
affected him Everyone who knew Warren knew him
as a very happy guy who always had a smile on his face But this was a different Warren He talked
about his mother leaving him as a small child at Enid
State School and how it pained him to think about being unwanted and abandoned Tears came to his eyes as he struggled to come to grips with memories of many decades past He created one of those
moments for which there is no real response possible
other than a thoughtful respectful silence and a
touch on the shoulder When Warren finished and sat down other selfshy
advocates stood and talked about their life
experiences and the incidents that caused them pain
People you would never expect revealed underlying wounds that they continued to struggle with That afternoon Warren opened the
way for many selfshyadvocates to
honestly share and thus lighten their burdens
After leaving Enid State School as an adult Warren became a wellshyknown figure in that community He established relationships with
everyone he came in contact with
from mayors and city councilmen to
several generations of workers at the
local McDonaldrsquos restaurant When the city dedicated
a new bridge many years ago Warren was invited to be
the first to officially cross it in his famous threeshywheeled cycle
Warren also went on to enjoy a rewarding career volunteering as a camera operator for the Enid public
access television station The Enid News and Eagle
printed a wonderful article marking his passing ldquoDeath of Warren Edds has an impact on communityrdquo As I read it I remembered our session in Tulsa and the
barriers Warren had overcome to become the person
everyone remembered as having a ldquocheery smile and
a kind heartrdquo Great success doesnrsquot come easy and it certainly didnrsquot for Warren
You can see a video clip of Warren that appears in
the documentary ldquoLiving in the Freedom Worldrdquo at httpwwwmnddcorgparallels2onevideovideo76b
shyfreedomworldhtml He was a star on both sides of the camera
James M Nicholson Director Developmental Disabilities Services Division
Oklahoma Department of Human Services 1 Developmental Disabilities Services Division
I N T E R F A C E
Death of Warren Edds has an impact on communityBy Robert Barron Staff Writer Enid News and Eagle
(reprinted from June 24 2009)
Warren Edds never held a public
office He never was successful in business and there are no statues of him
in townBut everybody knew Edds and everyone
was used to seeing him ride his threeshywheeled cycle around town
His death at age 59 has had an impact in
Enid on people who knew him or even just knew who he was
Edds was supposed to wear oxygen at all times since becoming ill with pneumonia in
May He had not been seen for two or three
days when his body was found by a
neighbor inside his apartment about 8 pm Monday June 22 (Enid Police Department is investigating it as an unattended death
and said there is nothing suspicious) His funeral will be 10 am Thursday at
Davis Park Christian Church with the Rev Alan Seibel officiating Burial will follow at Enid State School under the direction of BrownshyCummings Funeral Home An
account has been set up at Central National Bank for funeral expenses The funeral home has asked friends for anecdotes to use
in his obituary Those stories may be sent to familyfirst
brownshycummingscom Edds was born Aug 19 1949 to Thomas
R and Cheryl Holland Edds He lived at Enid State School until earning his statute
of independent living He was a member of Davis Park Christian Church since 1975
He is survived by his father who lives in
Florida brother Steve Smith of Broken
Arrow sister Sandy Brown of Ohio and
aunt Gina Crotty of Stillwater
Edds volunteered at PEGASYS Enidrsquos publicshyaccess television station for 26
years regularly assisting with camera work He also was known for his support for Oklahoma State University athletics
ldquoHe always had something positive to say
about everyonerdquo said Wendy Quarles PEGASYS executive director and a friend
of Edds Edds could be seen frequently around
town riding an adult tricycle donated to
him by local business and groups or at McDonaldrsquos at Maine and Van Buren
engaging people in a spirited conversation
about OSU athletics Edds was a charter member and first
president of the Yes We Can Civitan
Club which consisted largely of people
with special needs He originated the
name of the club and was nominated as regional director of Civitans for Oklahoma and Arkansas He also was the
clubrsquos highest point producer earning the
name ldquoMr 400rdquo Edds scheduled regular programs on PEGASYS and the club
established the ldquoChiller Challengerdquo competition in which people jump into
freezing water to raise money for the
Special Olympics program Edds was 1981 Special Olympian of the Year
ldquoItrsquos people with special needs saying lsquoWe can do thatrsquordquo said Kathy Eck a
sponsor of the club ldquoHe was an icon in this town Even if
people didnrsquot know his name they knew
him because of him riding all over the
community on his tricycle with the orange
safety flag They knew of him He had an
infectious smile and was always concerned
about people He was just a kind personrdquo Eck said
The Enid News amp Eagle Web site
received a number of postings Tuesday after word of Eddsrsquo death became known
ldquoEnid has lost a great man a faithful friend and a dedicated volunteer Warren
will truly be missedrdquo said Lindy Chambers executive director of Main Street Enid
Another stated ldquoWarren will be missed He always said hello to anyone that would
listen OSU has lost a fanrdquo People who saw him casually said it was a
pleasure to know him that he always put a
smile on their face Mayor John Criner said Edds was a good
resident and encouraged him and the city
commission He went to the Public Library
of Enid and Garfield County daily to
remain informed on city matters When the
city dedicated a new bridge on West Randolph in 2007 Edds was the first to
ride across on his bicycle Molly Helm director of communications
and marketing for Autry Technology
Center recalled being a camp counselor at Campfire Camp in high school when some
of the clients at Sunnyside Nursing Home
came for the day Warrenrsquos nickname was Jabber as was Helmrsquos and she said they
immediately struck up a friendship ldquoYears later it has been especially heartshy
warming to see him working the cameras for PEGASYS doing something he
lovedrdquo Helm said ldquoHis cheery smile and
his kind heart will be missedrdquo mdash This article has been reprinted
with permission from the
Enid News and Eagle
Oklahoma Department of Human Services 2 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
Best of the Best in Direct Support Services honored
The statersquos most outstanding direct support professionals were recognized for their work
during the Governorrsquos Conference on Developmental Disabilities March 2 2009 at the Tulsa Renaissance
Hotel and Convention CenterThe annual Awards of Excellence in Direct Support
Services sponsored by the Developmental Disabilities Services Division honors individuals working in direct care in a variety of settings Nominations are sent to DDSD
from all over the state from provider agencies family
members and individuals with disabilities All of the direct support professionals recognized were presented with Awards of Excellence Out of the award winners the Best of the Best were chosen and featured in video presentations at the ceremony Awards of Excellence in Direct Support Services were presented to Will Watkins Rescare OklahomaLarry Lamm Supported Community LifestylesLora Catlett Gatesway FoundationAngel Balenti Phoenix Residential ServicesCharity Mormon Magna Community Living ServicesStephanie Lackas Reach Out IncRandy Brewer Gatesway FoundationKrystal Lewis Goodwill Industries of Southwest OklahomaSteve Poland Oklahoma Life Skills AssociationMattWeintz Volunteers of AmericaNancy Newson Kibois Community Action FoundationPatricia Harper Garvin County Community Living CenterMary Williams Rescare OklahomaLucinda Flynn People IncApril Thompson Independent Opportunities IncLaDonna Lang Central State Community ServicesDneta Carr Central State Community ServicesDaniel Escojido Supported Community LifestylesCindy Simmons Kibois Community Action FoundationDavid Pitts Homelife AssociationBeverly Kichler Volunteers of AmericaFreda Kretchmar BIOSAnnette Bounds Big Five Community ServicesGenea Shatto INCA Career Opportunities
Awards of Excellence in Direct Support Services winners (Back Row from left) Daniel Escojido Larry Lamm Will Watkins David Pitts Stephanie Lackas Patricia Harper Randy Brewer Matt Weintz and Krystal Lewis (Front Row from left) Genea Shatto April Thompson Lucinda Flynn Mary Williams Angel Balenti Charity Mormon Lora Catlett and Steve Poland
The Best of the Best in Direct Support Services Awards were presented to (From Left) Larry Lamm Will Watkins Stephanie Lackas Mikayla Angel Balenti Charity Mormon and Lora Catlett
Mark your calendars The 2010 Governorrsquos Conference on Developmental Disabilities will be held March 8shy9 To nominate someone for the Direct Support Services Awards contact the Developmental Disabilities Services Division at (405) 521shy6254
Oklahoma Department of Human Services 3 Developmental Disabilities Services Division
I N T E R FA C E
Governorrsquos Disability Employment Awards
Showcase
Steve Scott (Right) receives a 2008 Governorrsquos Disability Employment Award for his outstanding work from Howard Hendrick Cabinet Secretary of Human Services and Director of the Oklahoma Department of Human Services Scott was recognized for working 19 years with the same WalshyMart store in Sand Springs During that time Scott has received several promotions and pay raises
Oklahom
arsquos
reason to
brag
Oklahoma may be best known around the country for excellence in many
things from college football to producing awardshywinning countryshywesternmusic stars Probably not as well known is the fact that Oklahoma is the best state
in the nation at supporting people with developmental disabilities to work
in competitive jobs according to an independent ranking by the Institute
for Community Inclusion at the University of Massachusetts BostonldquoFor the past three years Oklahoma has led the nation in assisting people with
developmental disabilities to find competitive jobs and become working taxpayersrdquo said James Nicholson Director of the OKDHS Developmental Disabilities Services Division ldquoToday more than 60 percent of individuals with developmental disabilities served by our division participate in supported employment servicesrdquo
The Governorrsquos Disability Employment Awards are held each October to
recognize individuals with disabilities for their outstanding achievements at work
through the supported employment program Also recognized are businesses that hire people with disabilities and members of the media who promote supported
employment programs The Governorrsquos Disability Employment Awards are coshysponsored by Governor
Brad Henry and Lt Governor Jari Askins along with OKDHSshyDDSD the Department of Rehabilitation Services and the Oklahoma Association
of Persons in Supported Employment
The 2009 Governorrsquos Disability Employment awards will be held on
Oct 22 130 pm at the Governorrsquos Mansion Pavilion in Oklahoma City
InterFace NEWSLETTER
The 2008 award Receipeints wereBUS INESS WINNERS
Gene LukerAramark Glass Plant Tulsa
Gary CookMcDonaldrsquos Ardmore
WalshyMartCushing
Mike amp Terry GentryMcDonaldrsquos Lawton
Joyce and Fred HannahLektron LED Lighting Tulsa
Pizza HutCushing
Guest InnArdmore
JonMilneSODEXO Langston
WalshyMartMoore
City of Muskogee
Angela OwensSonic DriveshyIn Ardmore
WalshyMart Super CenterSand Springs
WalshyMart Super CenterVinita
MED IA WINNER
Dawndee Bostwichreporter Duncan Banner
EMPLOYEE WINNERS
Bobby Bailey
Bob Bennett
Tammie Burrall
Andy Cheater
Tommy Coleman
Jeff Dickson
Chad Joyce
Allen Kouba
Linda Prowell
Phillip Reed
Peter Rowland
Steve Scott
Kenneth Smith
Judy Wolfe
James Young
Oklahoma Department of Human Services 4 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
DDSD employees win advocacy awards
Angela King DDSD Area II case manager and Cindy
Jennings DDSD Area III nurse received awards from TARC in December 2008 King received the
AdvocateshyCase Manager of the Year award while
Jennings was recognized with a Special Achievement in
Advocacy AwardKing has nearly 20 years of experience in DDSD
case management working with individuals on every
type of waiver including the pilot project for the InshyHome Support waiver King began her career in the
field as a direct support professional before
becoming a recreational therapist and case
manager transitioning individuals from The
Hissom Memorial Center King gives each
person on her caseload the individual attention
they need regardless of the time it takes As a
recent example of her advocacy and
dedication she assisted a woman on her caseload in the process of obtaining
a divorce from her husband of many
years King referred the woman to a
community resource for legal advice
assisted her in completing all of the legal paperwork attended
court hearings with her and then took the woman apartment hunting
King even helped her move into the new apartment unpack and
decorate King has been known for her attention to detail and is extremely conscientious exemplifying her commitment to those
she servesJennings has volunteered for Oklahoma People First for the last
11 years assisting in the establishment of new chapters planning
state conferences writing grants to secure funding and soliciting
donations for conferences As an OPF volunteer Jennings is passionate about teaching individuals to advocate for themselves Her belief in their abilities empowers them to have faith in
themselves and in their abilities to make choices She educates OPF members on increasing their independence vocational opportunities voting relationships and community involvement Jennings empowers OPF members by offering them a support network to turn to when in need of assistance By doing so she
teaches others to recognize how much persons with developmental disabilities can do for themselves if given the right supports
InterFace NEWSLETTER
To see Oklahomarsquos ranking as compared to other states in regard to the numbers of persons with developmental disabilities in competitive jobs (supported employment)go to
wwwstatedatainfo
This website is a project of the Institute for Community Inclusion at UMass Boston supported in part by the Administration on Developmental Disabilities US Department of Health and Human Services under cooperative agreement with additional support from the National Institute on Disability and Rehabilitation Research of the US Department of Education
Angela King DDSD Area II case manager is presented with the AdvocateshyCase Manager of the Year award by John Gajda executive director TARC
Cindy Jennings DDSD Area III nurse is presented with a Special Achievement in Advocacy Award by John Gajda executive director TARC
Oklahoma Department of Human Services 5 Developmental Disabilities Services Division
I N T E R F A C E
Quality
AwardsBest of the Best
Regina ChacePrograms Manager for DDSD Employment Services
Regina Chace Program Manager for DDSD Employment Services receives an OKDHS Quality Award Best of the Best for her leadership in this program Chace ensures there are policies and processes which support participants to have a full range of opportunities for employment As a result Oklahoma has been recognized as the nationrsquos leader in achieving impressive outcomes in integrated employment for people with
disabilities InterFace NEWSLETTER
A Dream Come True Bobby Cooper and his parents were invited by Governor Brad Henry to meet with him and visit the capitol Tom Cooper Bobbyrsquos father is a member of the Governorrsquos Council for United We Ride representing people with disabilities Tom mentioned to Governor Henry in a letter that it had been Bobbyrsquos dream to meet him after seeing him speak on television during his reshyelection Governor Henry was so flattered by Bobbyrsquos request that he invited the whole family for a visit to the capitol in November 2008 They took a few moments to pose for this photograph in the Governorrsquos Blue Room From left Tom Cooper BobbyGovernor Henry and Ruth Cooper
Oklahoma Department of Human Services 6 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
James Nicholson Director of the OKDHS Developmental Disabilities Services Division is presented with a 2009 College of Allied Health Citation for Special Contributions (Left to Right) Jeff Berry Chair College of Allied Health Awards and Honors Committee College Dean Kevin Rudeen Nicholson and Martha Ferretti Professor and Chair Physical Therapy Department of Rehabilitation Sciences College of Allied Health
DDSD Nicholson receives award for contributions to College of Allied Health
On April 2 2009 James Nicholson Director of the OKDHS Developmental Disabilities Services
Division was presented with the 2009 College of AlliedHealth Citation for Special Contributions Nicholson was nominated for this award by Martha
Ferretti Professor and Chair Physical Therapy Department of Rehabilitation Sciences College of Allied Health University of Oklahoma Health Sciences Center In the nomination for this award Ferretti wrote ldquoMr Nicholsonrsquos background is one of diversity and richness
His work ethic sets a standard for us all to follow His calmness humor and general goodwill in the midst of controversy is obvious and remarkable And first and foremost his dedication to improving the lives of children and adults with developmental disabilities has set a standard for us all to emulate Mr Nicholsonrsquos creativity thoughtfulness and ability to target a goal and accomplish it regularly in collaboration with a number of formal and informal partners prove the importance of reaching beyond onersquos own resourcesldquoAs a visionary in the field of developmental disabilities early in his
role as director Mr Nicholson caught the attention of both supporters and detractors His vision was a perfect match for what our faculty were striving to accomplish in preparing our students and in providing servicesin the field of developmental disabilities ldquoWe approached Mr Nicholson shortly after he became the director with
a proposal for introducing assistive technology into the DDSD system differently than had been accomplished at that point Over the past 18 years
he and members of his staff have continued that collaboration on projects that addressed both major and minor challenges
about policy and services for Oklahomans with developmental disabilities
ldquoOur faculty has learned so much from this very politically astute and professional state leader Before the state was aware of its challenges emerging from children with autism and their families Mr Nicholson quietly accepted the mantle of addressing what we have come to know are unbelievable challenges presented by the impact of autism Seven years ago he convened a multishyagency multishydisciplinary task force that included parents of individuals with autism to develop the Oklahoma State Plan for Autism and the Oklahoma Autism Network We are honored by him placing the OAN within the structure of the College
ldquoMr Nicholson has stimulated us to mature as educators researchers and service providers to more effectively address many of Oklahomarsquos needs in the field of
developmental disabilitiesrdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 7 Developmental Disabilities Services Division
Nickrsquos Law
I N T E R F A C E
Insurance Mandates for autism treatments fail once again to pass Oklahoma legislature
For the second consecutive year bills that would have mandated insurance companies to cover
treatments for autism failed to pass through the Republicanshycontrolled legislatureIn February the House Economic Development and
Financial Services Committee voted down House Bill 1312 also known as ldquoNickrsquos Lawrdquo which would have required insurance providers to cover autism treatment The only autismshyrelated bills that did receive enough
support to pass were House Bill 2027 and its companion Senate Bill 135 The Senate version made it through the legislative process and will enact a licensing process for national board certified behavior analysts and enhance existing state programs that would train doctors to diagnose and treat autism Critics of this bill question whether it will actually produce
significant new services if insurance doesnrsquot cover the cost of treatment and parents canrsquot afford to pay the bill
ldquoSadly this bill will do nothing to relieve the pressure on families struggling to care for children with autismrdquo said Sen Jay Paul Gumm author of lsquoNickrsquos Lawrsquo legislation ldquoThis measure was designed to relieve political pressure on legislators who refuse to even consider Nickrsquos Lawrdquo
When Governor Henry signed Senate Bill 135 he said the measure was just a small step in the effort to help affected Oklahoma families He urged lawmakers to pass legislation to mandate insurance coverage for the treatment of autism
ldquoThere is nothing wrong with this bill just like there is nothing wrong with a pack of shingles at a construction siterdquo said Sen Gumm ldquoIf you try to put the shingles on before you pour the foundation you are doomed to failure As Governor Henry wisely noted when he signed the bill the foundation is insurance coverage of autism Absent that Senate Bill 135 is doomed to failurerdquo
Republican legislative leaders oppose insurance mandates saying they drive up the cost of health insurance despite reports from states with similar insurance mandates that show no significant increase in the cost of premiums
Republicans attempted to pass House Bill 1975 which would only allow insurance legislation to be introduced in oddshynumbered years and approved in evenshynumbered years The bill would have also required a 75 percent supershymajority vote to do away with the mandate in the case of an emergency
Henry vetoed that bill and said it would have unreasonably ldquotied the hands of state policy makers on a very important issuerdquo
ldquoThis would empower a small minority of legislators to thwart legitimate state efforts to address a pressing public policy issue and ensure that the restriction would rarely if ever be liftedrdquo Henry said
Henry also questioned why HB 1975 restrictions were only applied to a single issue area saying it raised legitimate concerns regarding why only one subject would be singled out for special treatment
Autism cont on page 9
Oklahoma Department of Human Services 8 Developmental Disabilities Services Division
SUMMER 2009
Autism cont from page 8
ldquoOklahoma and its citizens are better served when policy makers are allowed the freedom to address any pressing issue in the Legislature without the hindrance of arbitrary restrictionsrdquo Henry said Democrats offered a compromise mdash to put autism coverage in highshy
risk insurance pools as a last resort for families who canrsquot afford the coverage elsewhere Republicans again declined and instead went forward with SB 135 This year three more states enacted Autism Mandate legislation bringing
the total to 11 states that now require insurance companies to cover treatment for autism InterFace NEWSLETTER
Proudly displaying their CPR (Cardio Pulmonary Resuscitation) certificates are (From Left) Guy Bivens Allen Larimore Steve Sposato Andy Edwards Joshua Johnson and Tino Hensley residents of the Independence House
Residents of the Independence House at the Home of Hope in Vinita recently became CPR certified after a fellow resident had a heart attack A staff member used CPR to save Allen Larimorersquos life and he has since received a pacemaker Although staff members must be CPR certified this event inspired Larimorersquos housemates to take the class so they could also be prepared ndash just in case Donna Marlow a CPR trainer from the OKDHS Developmental Disabilities Services Division held the class free of charge at the agency and was proud that all the men passed their tests with flying colors
11th Circuit Rules Doctors donrsquot trump state on Medicaid care for children with disabilities by Alyson M Palmer
A federal appeals panel has declared that treating doctors donrsquot have the final say in how much nursing care the state must provide
children with disabilities under MedicaidOn April 24 the 11th US Circuit Court of Appeals reversed a district
judgersquos decision that had said the state must provide the amount of nursing care that a North Georgia girlrsquos doctor said she needs
Despite a slew of amicus briefs by state governments and Medicaid plan administrators the panel dispatched the case in a twoshypage unpublished unsigned opinion that came out a month after oral argument
Holland amp Knight partner Robert S Highsmith Jr who represented a proshystate friend of the court that provides managed care services for Medicaid programs said his client WellCare of Georgia had been concerned about language in US District Judge Thomas W Thrash Jrrsquos ruling that suggested anything ordered by a treating physician is medically necessary under the law ldquoThat one sentence just had to get reversedrdquo said Highsmith ldquoWe are very excited that they saw and reversed that clear errorrdquo
But an advocate for the teenage girl at the center of the case Atlanta Legal Aid Society General Counsel David A Webster said Monday that the decision ldquodoesnrsquot mean muchrdquo and says little about the relationship between the state and the treating physician ldquoThatrsquos going to be open for future litigationrdquo said Webster Webster said the case of his client Anna C Moore will go back to Thrash for the judge to consider the
11th Circuit Rules cont on page 15
Oklahoma Department of Human Services 9 Developmental Disabilities Services Division
I N TERFACE
ImaginingEverest The Story of LaelBy Adrienne Benz
ldquoI prayed for God to open the eyes of my understanding and the pieces began to fall into place Mollyrsquos future had been planned since she was a young girl she would marry andhave a bright healthy family known for their intelligence andkindness However the birth of her first born quickly dispelled the myth of the stereotypically perfect family as Molly learns her son Lael has Down syndrome Struggling to accept the disconcerting news and understand Godrsquos perfect plan Molly faces a challenge no more daunting than the climbing of the greatMt Everest she often dreamed of as a child Guilt hope grief and happiness take Molly and Lael across rocky terrain and risky edges but faith and the resonant voice of God bring mother and son up the emotional mountain 30 years in the making ndash a mountain that revealed the aptitude of Mollyrsquos beloved son and the kindness of others By Imagining Everest Molly and Lael forge a unique and amazing relationship which allows them to overcome even the most intimidating ascension into the unknownrdquo
Molly Mathewrsquos son Lael currently receives services through the OKDHSDDSD community waiver program
264 pages shy $1499 (paperback) This book is available online through Tate Publishing wwwtatepublishingcombookstore
Health and Human Services rescinds Medicaid regulations affecting case management
Department of Health and Human Services (HHS) Secretary
Kathleen Sebelius announed June 29 that the administration will rescind all or part of three Medicaid regulations that were previously
issued and delay the enforcement of a fourth regulation Each of these
rules in whole or in part had been subject to Congressional moratoria
set to expire on July 1 2009ldquoThese regulations if left in place would have potentially adverse
consequences for Medicaid beneficiaries some of our nationrsquos most vulnerable peoplerdquo said Secretary Sebelius ldquoBy rescinding
these rules we can expect that children will continue receiving
services through their schools beneficiaries will be able to
access all available case management resources to help them
better manage their health care and outpatient hospital and
clinic services can continue to be covered in the most efficient mannerrdquo
This ruling was crucial to Oklahomarsquos Developmental Disabilities Services as the state could have lost the ability
to bill Medicaid for 100 percent of the cost of providing
case management services to waiver service recipients which totals approximately $22 million per year
ldquoThe actions we are taking today are necessary to
ensure that the states have the flexibility they need to
fully serve Medicaidshyeligible individualsrdquo said
Secretary Sebelius
The Centers for Medicare amp Medicaid
Services (CMS) and HHS arebull Rescinding provisions of an interim final rule
published Dec 4 2007 which would have restricted beneficiary access to case management services These provisions appeared to in practice restrict beneficiary access to needed covered case management services and limit state flexibility in determining efficient and effective delivery systems for case management services
Regulations Expiring cont on page 11
Oklahoma Department of Human Services 10 Developmental Disabilities Services Division
SUMMER 2 0 0 9
Regulations Expiring cont from page 10
bull Rescinding a final rule published Dec 28 2007 that would have eliminated reimbursement for schoolshybased administrative costs and costs of transportation to and from schools The rescission reflects concern that the rule could limit the Medicaid administrative outreach activities of schools and that the overall budgetary impact on schools could potentially impact their ability to offer Medicaid services to students
bull Rescinding a rule published Nov 7 2008 that would have limited the outpatient hospital and clinic service benefit for Medicaid beneficiaries to the scope of services recognized as an outpatient hospital service under Medicare This rule was rescinded because CMS became aware that coverage beyond that scope could not be easily moved to other benefit categories resulting in great impact than previously anticipated
bull Delaying until June 30 2010 the enforcement of portions of a regulation that clarified limitations on health care related tax programs so that CMS could determine whether states need additional clarification or guidance CMS may also further review the potential impact of the regulation and give additional consideration to alternative approaches InterFace NEWSLETTER
Waiting and HopingBy Adrienne Benz
Sad is like sitting here when I donrsquot have a home to run away to
So there on the street just waiting for something to eat somewhere to stay and a bed to sleep on and someone to hold
And hoping Irsquom still there the next day
They have to get up from the street in the park sitting on a cold chair in the dark
Just waiting for someone to take them in their home Waiting to open up and talk about their hidden feelings
like they canrsquot wait any longer
Adrienne Benz was a child in state custody when she wrote this poem She is now an adult reunited with her family
Oklahoma Department of Human Services 11 Developmental Disabilities Services Division
I N T E R FA C E
DDSD Fiscal Year 2010 Budget Outlook OKDHS Director Howard Hendrick
presented the agencyrsquos Fiscal Year 2010 budget to the Commission for Human Services on June 16 Hendrick emphasized that even with the additional federal stimulus money and other oneshytime funds the agencyrsquos overall funding will be approximately $50 million short of anticipated spending levels To achieve a balanced budget cuts would have to be made within each division The Developmental Disabilities Services Divisionrsquos
share of the cuts amount to approximately 3 percent of the divisionrsquos operating budget ($17 million) Another $200000 had to be identified to fund the new initiative for Applied Behavior Analysis mandated by Senate Bill 135 this legislative sessionDDSD was able to accomplish the budget cuts without
impact to any programs or services through reductionsat the Northern and Southern Oklahoma ResourceCenters The rest of the savings came from reductions in training and professional contracts the divisions holds with various entitiesOver the next year DDSD will be under a selfshyimposed hiring
freeze for all positions except for case management direct care professionals and registered nursesIf monthly state revenue collections continue to fall below
expected levels additional reductions may be required of all stateagenciesrsquo operating budgets
Interim StudiesThere will be two interim legislative studies conducted this summer that could impact DDSD and service recipients
One of these studies will investigate a possible provider feetax on agencies providing waiver community services If the provider feetax is found to be within federal Medicaid guidelines it could possibly be used to fund rate increases in waiver services
The other legislative study will look into the pros and cons of online training versus classroom training specifically for providers of DDSD community services
Money Follows the PersonAs of this date DDSD has transitioned eight people from Northern Oklahoma Resource Center of Enid and Southern Oklahoma Resource Center into community homes using the federal Money Follows the Person grant Utilizing these federal funds DDSD has been able to save approximately $21000 in the community services provided to those individuals
Oklahoma documentary on developmental disabilities history to air on OETA
an
Oklahoma
document
ary
Adocumentary showing Oklahomarsquos history serving people with intellectual and developmental disabilities is
scheduled to begin airing on OETA (Oklahomarsquos Education Television Authority) in October during national Disabilities Awareness Month
The video ldquoWagons to Waivers A Century of Changerdquo narrated by Oklahomarsquos own country music star Reba McEntire will be broadcast on the OETAshyOklahoma channel starting on Oct 24th at 5 pm and on Nov 5th at 830 pm The program will be
aired a couple times a month
The documentary takes viewers on an emotional journey from the days of the Dust Bowl and covered wagons and shows the statersquos progression from institutional services to full community inclusion for persons with intellectual disabilities Oklahomarsquos story begins in 1909
with the creation of the Institute for the Feeble Minded in Enid and includes the
tears and efforts of parents the stories ofpeople who grew up in institutions the legal struggles and the triumph of selfshyadvocacy The video was produced by the Oklahoma Department of Human Services Developmental Disabilities Services Division
OETAshyOKLA is Cox Cable channel 112 but other television carriers as well as satellite users can access the channel which is devoted to Oklahomashyspecific programming Check your local television lis tings for specific programming dates and times
Oklahoma Department of Human Services 12 Developmental Disabilities Services Division
SUMMER 2009Compassion friendship and longevity A good measure of success
The day had finally come and Danny waited anxiously on the sofa He watched quietly as the
nursing staff set up the hospital bed and made his friend Carl comfortable The minute all was clear Danny went to Carl and told him how much he had missed him and that he needed him to get better Dannyrsquos longshytime friend had just undergone surgery
to remove a malignant brain tumor Danny didnrsquot understand the procedure or Carlrsquos prognosis ndash all that mattered was that his best friend was home It just wasnrsquot home without CarlCarl is considered the head of the household that he shares
with Danny and his other friend Hershel Carl was always the one who planned their meals said the prayers at the diningroom table and got them involved in Special Olympics events When Carl became ill and went to the hospital it was Danny
who stepped up and tried to fill in ndash just until Carl came home ldquoThe Three Musketeersrdquo (thatrsquos what their staff call them) have
been friends and have lived together for more than 30 years
Danny (lef
t) spends
hours by
Carlrsquos sid
e
encourag
ing him in his
recovery
They met as boys at The Hissom Memorial Center the nowshyclosed institution in Sand Springs for persons with developmental disabilities When they aged out of Hissom the three moved about the same time to a private facility where they lived for many years
In 1993 The Musketeers were given the opportunity to move together once again into a house in their community supported through the DDSD Medicaid Community Waiver program Since
that time they have lived in the house withsome of the same staffmembers who havecared for them for morethan 20 years
The Three Musketeers Danny (left) shows his excitement over his friend Carlrsquos (right) return from the hospital after brain surgery Shy Hershel (center) wipes tears from his eyes
Carl is recoveringfrom his surgery andworking on his abilityto speak and onregaining the use of theleft side of his bodyThe staff in the home
often has to make Danny go to bed at 1 am when hersquos still sitting beside Carl encouraging him to get better so he can go back to work
All three men have jobs and love their work ndash Carlmost of all Danny somehow knows that if Carl canjust get back to work life will continue as they onceknew it
ldquoTheyrsquore like a wellshysettled familyrdquo said Gretchen Moser their DDSD case manager ldquoEven their families consider these guys a family and respect their wishesrdquo
These days there are many opinions about what constitutes a family or even success But there are stories that transcend those discussions Stories like these that remind us success can also be measured by the love and longevity of a friend InterFace NEWSLETTER
Relations
hips
Oklahoma Department of Human Services 13 Developmental Disabilities Services Division
I N T E R F A C E
StateLegislativeNews
Of the thousand or more bills filed at the beginning of the 2009 legislative session only a few made it through the entire process that will have an impact on persons with developmental disabilities families and professionals in the field They are
HB 1007 mdash Wesselhoft Leftwich Signed by the Governor Requires specific Physically Disabled person signage to be posted as a reserved area for the parking of a vehicle displaying a valid permit
HB 1019 mdash WrightSigned by the Governor Recreates the Group Homes for Persons with Developmental or Physical Disabilities Advisory Board
HB 1048 mdash Banz AldridgeSigned by the Governor Relates to the collection of delinquent real property taxes removes physically disabled from ldquoincapacitatedrdquo persons granted additional time to redeem personal items reduces time to collect excess sale proceeds by half
HB 1065 mdash Faught Crain Signed by the Governor Relates to the Continuum of Care and Assisted Living Act adds definition and requires inspection results to be posted on website
HB 1424 mdash Protor Signed by the Governor Requires treatment facilities transitional living facilities halfway houses and any house or facility that may be used for medical or nonmedical detoxification to mail notification to property owners within a quarter mile radius if zoning changes are proposed
HB 1461 mdash Sears Ford Signed by the Governor A school that does not make adequate yearly progress for two straight years shall utilize the assistance of a school support team formed by the State Department of Education EMERGENCY
HB 1581 mdash Coody Jolley Signed by the Governor School teacher candidates that wish to teach elementary early childhood education or special education programs must study the five elements of reading instruction EMERGENCY
HB 1763 mdash Enns Reynolds Signed by the Governor Requires the state Department of Education to provide special education training for process hearing officers to ensure adequate knowledge in special education laws and proceduresEMERGENCY
HB 1893 mdash Peterson Anderson Signed by the Governor Creates the Aging and Disability Resource Consortium to work with other agencies in developing and implementing a singleshypointshyofshyentry concept for aging and disability groups in Oklahoma
SB 135 mdash Johnson Mike Signed by the Governor Provides for the licensing of certain persons to practice as a licensed behavior analyst or a licensed assistant behavior analyst and to study children with autism and their behaviors directs funds to be used by the Department of Human Services Developmental Disabilities Services division for training SoonerStart providers to treat children with autism spectrum disorders provides for a behavorial analysis research pilot project provides legislative intent
SB 518 mdash Justice Osborn Signed by the Governor Adds grandparents as members of immediate family
SB 871 mdash Anderson Signed by the Governor Modifies membership of the Electronic and Information Technology Accessibility Advisory Council
Oklahoma Department of Human Services 14 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
11th Circuit Rules cont from page 9
matter again Moore a teenager living in North Georgia who goes by ldquoCallierdquo has been receiving inshyhome nursing care paid for by Medicaid for about a decade The state has been trying to cut the number of hours of care she receives each week
The 11th Circuit interpreted a federal law that says states participating in the Medicaid program must provide ldquoearly and periodic screening diagnostic and treatment servicesrdquo that are necessary to ldquocorrect or ameliorate defects and physical and mental illnessesrdquo in Medicaidshyeligible children The primary ways children become eligible for Medicaid are that they come from a lowshyincome family or have a disability according to Joshua H Norris another one of Calliersquos lawyers
Georgiarsquos Department of Community Health operates a program to administer Medicaidshyfunded nursing services for several hundred children who need nursing care It delegates the decisions about approval of such services to an organization called the Georgia Medical Care Foundation
According to Thrashrsquos order Callie is disabled because of a stroke she experienced in utero and suffers from various chronic conditions including mental retardation and cerebral palsy She lives at home and according to the statersquos brief attends an elementary school in Athens Ga three days a week Her lawyers have said she requires constant care
The statersquos lawyers have said that nursing hours can be reduced when the patientrsquos medical condition stabilizes positing that a goal of the program is to teach parents and other caregivers to take care of their children on their own The Mooresrsquo lawyers have contended that the statersquos system of ldquoweaningrdquo patients off their nursing services as long as theyrsquore staying out of the hospitaland not getting worse follows a different standard than that set by federal law
In 2006 the state informed Calliersquos mother that it was reducing Calliersquos nursing hours from 94 hours a week to 84 contrary to the recommendation of Calliersquos primary care physician Calliersquos mother filed suit
The Mooresrsquo lawyers convinced Thrash that the reduction was improper Afterissuing multiple injunctions in Calliersquos favor he denied the statersquos motion for summary judgment and granted the Mooresrsquo motion in part concluding the state must provide for the amount of skilled nursing care that Calliersquos treating physician deems necessary The panel that ruled in favor of the state in its appeal was comprised of Senior 11th Circuit Judge R Lanier Anderson III 11th Circuit Judge Gerald B Tjoflat and US District Judge Lisa Godbey Wood visiting from the Southern District of Georgia
The panel said both the state and Calliersquos physician have roles in determining whatrsquos medically necessary to correct or ameliorate Calliersquos medical conditions It cited a federal regulation that says a Medicaid agency ldquomay place appropriate limits on a service based on such criteria as medical necessity or utilization control proceduresrdquo
ldquoA private physicianrsquos word on medical necessity is not dispositiverdquo the panel concluded
Assistant Attorney General Virginia B Fuller made the successful oral argument for the state last month Attorney General Thurbert E Bakerrsquos spokesman Russ Willard said in an eshymail that the state ldquois appreciative of the Court of Appeals decision recognizing the role of the Medicaid program in providing for this treatmentrdquo
Norris who also is director of legal advocacy for a nonprofit that advocates for people with disabilities said the 11th Circuit gave Thrash
an opportunity to say more about the roles of treating doctors and the state in deciding what care the state needs to provide Norris noted that Thrash wrote on the subject last year in another nursing care case about a Savannah Ga boy who nearly drowned when he was 2Thrash barred the state from enforcing a policy of not providing nursing care for patients requiring 16
to 24 hours per day for more than one week he said that criteria isnrsquot based on whatrsquos medically necessary under federal Medicaid law
On the other handThrash denied the plaintiff rsquos request based on the
treating physicianrsquos recommendation for 24shyhourshyashyday private nursing services for an
indefinite period of time Thrash deemed such a prescription ldquoan abuse of the Medicaid systemrdquo
The state has limited discretion to deny a providerrsquos request for care under the ldquoearly and periodic
screening diagnostic and treatment servicesrdquo portion of the Medicaid Act said Thrash He added that ldquo[t]he statersquos discretion is limited to a review of the request for fraud abuse of the Medicaid system and whether the service is within the reasonable
standards of medical carerdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 15 Developmental Disabilities Services Division
klahoma Department of Human Services
I N T E R F A C E
DDSD Area II Project Elves get together to wrap all the presents and make sure they are delivered to the individuals before Christmas Elves work year round
to make Christmas special for DDSD clients For the past eight years individuals with
developmental disabilities who donrsquot have families or who would otherwise not receive gifts have had their Christmas wishes come true thanks to caring DDSD ldquoelvesrdquo in Area II Project Elf is the brainchild of ldquoThe Men in Recrdquo namely
Steve Pitts and Roger McDaniel DDSD Area II recreational therapists and Joe Stie DDSD case manager ldquoDDSD serves a lot of people with developmental
disabilities who donrsquot have families to celebrate the holidays withrdquo said Pitts ldquoAlthough our services meet their basic needs therersquos still a gap when it comes to those special things that families do for one anotherrdquoThat gap has been filled by The Men in Rec who work all year
long coordinating various events to raise money to buy Christmas presents for individuals ldquoWe raise all of the funds and no OKDHS money is usedrdquo said
Pitts ldquoThis year we are selling Blue and Gold sausage and Amish jams We also have an annual Christmas Carol fundraising performance which is donated to Project Elf by the American Theater Company We are given 300 tickets that we can sell and last year we sold 225rdquoDDSD coshyworkers got together and purchased 44 of those theater
tickets last year for the children who happened to be in the Laura Dester Center Shelter around the holidays ldquoWe have also set up a sponsorship program where people can purchase
the gift and return it wrapped and ready for the elf (aka case manager) to deliver This last Christmas we had 108 sponsors 30 of whom were the case managers themselvesrdquo
The Men in Rec also recruit fellow DDSD workers to help shop for the gifts and wrap themldquoWe could not accomplish this awesome Project Elf without the assistance of so many of our coshyworkers and our community volunteersrdquo he said ldquoItrsquos such a pleasure to share these gifts at Christmas time and let our customers know that they have a family through our good service to themrdquoThe Men in Rec are currently working to raise money for this yearrsquos Christmas gifts If you would like to join the rank of DDSD Elves by donating funds or becoming a sponsor please contact Steve Pitts at stevepittsokdhsorg or call918shy794shy7625 InterFace NEWSLETTER
Steve Pitts (right) DDSD Area II recreational therapist gives a donated WalshyMart gift card to case manager Roy Willett to purchase a Christmas gift for one of the people on his caseload
Oklahoma Department of Human Services 16 Developmental Disabilities Services Division
shy shyshy shy
shy shy
shy shy
shy shy
shy shy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
Developmental Disabilities Services Area Offices and Resource Centers
CUSTER
ELLIS
BECKHAM WASHITA CADDO
McCLAIN
SEM
INO
LE HUGHES HASKELL
LE FLORELATIMER PITTSBURG
COAL
ATOKA
PONTOTOC
JOHNSTON
GARVIN
MURRAY
CARTER
LOVE
BRYAN CHOCTAW
PUSHMATAHA McCURTAIN
GRADY
KIOWA
TILLMAN
JACKSON HA
RM
ON
GREER
COTTON
JEFFERSON
STEPHENS
COMANCHE
McINTOSH
CLEVELAND
POTT
AWAT
OM
IE
DEWEY BLAINE
CANADIAN
MAJOR
GRANT KAY OSAGE
WA
SHIN
GTO
N CRAIG
ROGERS
CH
ERO
KEE
ADAIR TULSA
WAGONER
MAYES
OKMULGEE
CREEK
LINCOLN
LOGAN
PAYNE
KINGFISHER
OKLAHOMA OKFUSKEE
MUSKOGEE SEQUOYAH
DEL
AWA
RE
OTTAWA NOATTA
GARFIELD NOBLE
PAWNEE
WOODS ALFALFA HARPER BEAVER TEXASCIMARRON
WOODWARD
ROGER MILLS
MARSH
Oklahoma CityOklahoma City
Tulsa
Area II
Area III
Area I
Pauls Valley
Enid
wwwokdhsorg
State Officetoll free 1shy866shy521shy3571
AREA Itoll free 1shy800shy522shy1064
AREA IItoll free 1shy800shy522shy1075
AREA IIItoll free 1shy800shy522shy1086
Greer Center (Enid)2501 NE Delaware Enid OK 73701
580 237 10272599 FAX 580 213 2799
Northwest Oklahoma Resource Center at Enid (NORCE)2600 E Willow
Enid OK 73701
580 237 1027
FAX 580 548 2600
Southern Oklahoma Resource Center at Pauls Valley (SORC)3210 Chickasaw St
Pauls Valley OK 73075 6822
405 238 6401
FAX 405 238 8261
DDSD Area I Office (Enid)729 Overland Trail Enid OK 73703
580 548 8900 FAX 580 548 8964
DDSD Area I Office (Oklahoma City)4545 N Lincoln Blvd
Oklahoma City OK 73105 405 522 6925
FAX 405 522 6995
DDSD Area II Office (Tulsa)Laura Dester Center 1427 E 8th Tulsa OK 74120
918 560 4848 FAX 918 560 4898
DDSD Area III Office (Pauls Valley)301 S Indian Meridian Rd Pauls Valley OK 73075
405 238 4700 FAX 405 238 4740
If you would like to find out what the DevelopmentalDisabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
If you would like to find out what the Developmental Disabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
This will take you to the main Oklahoma Department of Human Services Web page From there just click on Divisions and Offices and the Developmental Disabilities Services Division On our Web site you will find information about services the division offers how to apply for services eligibility policies contract provider agencies and much more
Come visit us today You may be surprised at what you will learn
OKLAHOMA DEPARTMENT OF HUMAN SERVICES Developmental Disabilities Services DivisionPO Box 25352 Oklahoma City OK 73125
I N T E R F A C E
Death of Warren Edds has an impact on communityBy Robert Barron Staff Writer Enid News and Eagle
(reprinted from June 24 2009)
Warren Edds never held a public
office He never was successful in business and there are no statues of him
in townBut everybody knew Edds and everyone
was used to seeing him ride his threeshywheeled cycle around town
His death at age 59 has had an impact in
Enid on people who knew him or even just knew who he was
Edds was supposed to wear oxygen at all times since becoming ill with pneumonia in
May He had not been seen for two or three
days when his body was found by a
neighbor inside his apartment about 8 pm Monday June 22 (Enid Police Department is investigating it as an unattended death
and said there is nothing suspicious) His funeral will be 10 am Thursday at
Davis Park Christian Church with the Rev Alan Seibel officiating Burial will follow at Enid State School under the direction of BrownshyCummings Funeral Home An
account has been set up at Central National Bank for funeral expenses The funeral home has asked friends for anecdotes to use
in his obituary Those stories may be sent to familyfirst
brownshycummingscom Edds was born Aug 19 1949 to Thomas
R and Cheryl Holland Edds He lived at Enid State School until earning his statute
of independent living He was a member of Davis Park Christian Church since 1975
He is survived by his father who lives in
Florida brother Steve Smith of Broken
Arrow sister Sandy Brown of Ohio and
aunt Gina Crotty of Stillwater
Edds volunteered at PEGASYS Enidrsquos publicshyaccess television station for 26
years regularly assisting with camera work He also was known for his support for Oklahoma State University athletics
ldquoHe always had something positive to say
about everyonerdquo said Wendy Quarles PEGASYS executive director and a friend
of Edds Edds could be seen frequently around
town riding an adult tricycle donated to
him by local business and groups or at McDonaldrsquos at Maine and Van Buren
engaging people in a spirited conversation
about OSU athletics Edds was a charter member and first
president of the Yes We Can Civitan
Club which consisted largely of people
with special needs He originated the
name of the club and was nominated as regional director of Civitans for Oklahoma and Arkansas He also was the
clubrsquos highest point producer earning the
name ldquoMr 400rdquo Edds scheduled regular programs on PEGASYS and the club
established the ldquoChiller Challengerdquo competition in which people jump into
freezing water to raise money for the
Special Olympics program Edds was 1981 Special Olympian of the Year
ldquoItrsquos people with special needs saying lsquoWe can do thatrsquordquo said Kathy Eck a
sponsor of the club ldquoHe was an icon in this town Even if
people didnrsquot know his name they knew
him because of him riding all over the
community on his tricycle with the orange
safety flag They knew of him He had an
infectious smile and was always concerned
about people He was just a kind personrdquo Eck said
The Enid News amp Eagle Web site
received a number of postings Tuesday after word of Eddsrsquo death became known
ldquoEnid has lost a great man a faithful friend and a dedicated volunteer Warren
will truly be missedrdquo said Lindy Chambers executive director of Main Street Enid
Another stated ldquoWarren will be missed He always said hello to anyone that would
listen OSU has lost a fanrdquo People who saw him casually said it was a
pleasure to know him that he always put a
smile on their face Mayor John Criner said Edds was a good
resident and encouraged him and the city
commission He went to the Public Library
of Enid and Garfield County daily to
remain informed on city matters When the
city dedicated a new bridge on West Randolph in 2007 Edds was the first to
ride across on his bicycle Molly Helm director of communications
and marketing for Autry Technology
Center recalled being a camp counselor at Campfire Camp in high school when some
of the clients at Sunnyside Nursing Home
came for the day Warrenrsquos nickname was Jabber as was Helmrsquos and she said they
immediately struck up a friendship ldquoYears later it has been especially heartshy
warming to see him working the cameras for PEGASYS doing something he
lovedrdquo Helm said ldquoHis cheery smile and
his kind heart will be missedrdquo mdash This article has been reprinted
with permission from the
Enid News and Eagle
Oklahoma Department of Human Services 2 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
Best of the Best in Direct Support Services honored
The statersquos most outstanding direct support professionals were recognized for their work
during the Governorrsquos Conference on Developmental Disabilities March 2 2009 at the Tulsa Renaissance
Hotel and Convention CenterThe annual Awards of Excellence in Direct Support
Services sponsored by the Developmental Disabilities Services Division honors individuals working in direct care in a variety of settings Nominations are sent to DDSD
from all over the state from provider agencies family
members and individuals with disabilities All of the direct support professionals recognized were presented with Awards of Excellence Out of the award winners the Best of the Best were chosen and featured in video presentations at the ceremony Awards of Excellence in Direct Support Services were presented to Will Watkins Rescare OklahomaLarry Lamm Supported Community LifestylesLora Catlett Gatesway FoundationAngel Balenti Phoenix Residential ServicesCharity Mormon Magna Community Living ServicesStephanie Lackas Reach Out IncRandy Brewer Gatesway FoundationKrystal Lewis Goodwill Industries of Southwest OklahomaSteve Poland Oklahoma Life Skills AssociationMattWeintz Volunteers of AmericaNancy Newson Kibois Community Action FoundationPatricia Harper Garvin County Community Living CenterMary Williams Rescare OklahomaLucinda Flynn People IncApril Thompson Independent Opportunities IncLaDonna Lang Central State Community ServicesDneta Carr Central State Community ServicesDaniel Escojido Supported Community LifestylesCindy Simmons Kibois Community Action FoundationDavid Pitts Homelife AssociationBeverly Kichler Volunteers of AmericaFreda Kretchmar BIOSAnnette Bounds Big Five Community ServicesGenea Shatto INCA Career Opportunities
Awards of Excellence in Direct Support Services winners (Back Row from left) Daniel Escojido Larry Lamm Will Watkins David Pitts Stephanie Lackas Patricia Harper Randy Brewer Matt Weintz and Krystal Lewis (Front Row from left) Genea Shatto April Thompson Lucinda Flynn Mary Williams Angel Balenti Charity Mormon Lora Catlett and Steve Poland
The Best of the Best in Direct Support Services Awards were presented to (From Left) Larry Lamm Will Watkins Stephanie Lackas Mikayla Angel Balenti Charity Mormon and Lora Catlett
Mark your calendars The 2010 Governorrsquos Conference on Developmental Disabilities will be held March 8shy9 To nominate someone for the Direct Support Services Awards contact the Developmental Disabilities Services Division at (405) 521shy6254
Oklahoma Department of Human Services 3 Developmental Disabilities Services Division
I N T E R FA C E
Governorrsquos Disability Employment Awards
Showcase
Steve Scott (Right) receives a 2008 Governorrsquos Disability Employment Award for his outstanding work from Howard Hendrick Cabinet Secretary of Human Services and Director of the Oklahoma Department of Human Services Scott was recognized for working 19 years with the same WalshyMart store in Sand Springs During that time Scott has received several promotions and pay raises
Oklahom
arsquos
reason to
brag
Oklahoma may be best known around the country for excellence in many
things from college football to producing awardshywinning countryshywesternmusic stars Probably not as well known is the fact that Oklahoma is the best state
in the nation at supporting people with developmental disabilities to work
in competitive jobs according to an independent ranking by the Institute
for Community Inclusion at the University of Massachusetts BostonldquoFor the past three years Oklahoma has led the nation in assisting people with
developmental disabilities to find competitive jobs and become working taxpayersrdquo said James Nicholson Director of the OKDHS Developmental Disabilities Services Division ldquoToday more than 60 percent of individuals with developmental disabilities served by our division participate in supported employment servicesrdquo
The Governorrsquos Disability Employment Awards are held each October to
recognize individuals with disabilities for their outstanding achievements at work
through the supported employment program Also recognized are businesses that hire people with disabilities and members of the media who promote supported
employment programs The Governorrsquos Disability Employment Awards are coshysponsored by Governor
Brad Henry and Lt Governor Jari Askins along with OKDHSshyDDSD the Department of Rehabilitation Services and the Oklahoma Association
of Persons in Supported Employment
The 2009 Governorrsquos Disability Employment awards will be held on
Oct 22 130 pm at the Governorrsquos Mansion Pavilion in Oklahoma City
InterFace NEWSLETTER
The 2008 award Receipeints wereBUS INESS WINNERS
Gene LukerAramark Glass Plant Tulsa
Gary CookMcDonaldrsquos Ardmore
WalshyMartCushing
Mike amp Terry GentryMcDonaldrsquos Lawton
Joyce and Fred HannahLektron LED Lighting Tulsa
Pizza HutCushing
Guest InnArdmore
JonMilneSODEXO Langston
WalshyMartMoore
City of Muskogee
Angela OwensSonic DriveshyIn Ardmore
WalshyMart Super CenterSand Springs
WalshyMart Super CenterVinita
MED IA WINNER
Dawndee Bostwichreporter Duncan Banner
EMPLOYEE WINNERS
Bobby Bailey
Bob Bennett
Tammie Burrall
Andy Cheater
Tommy Coleman
Jeff Dickson
Chad Joyce
Allen Kouba
Linda Prowell
Phillip Reed
Peter Rowland
Steve Scott
Kenneth Smith
Judy Wolfe
James Young
Oklahoma Department of Human Services 4 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
DDSD employees win advocacy awards
Angela King DDSD Area II case manager and Cindy
Jennings DDSD Area III nurse received awards from TARC in December 2008 King received the
AdvocateshyCase Manager of the Year award while
Jennings was recognized with a Special Achievement in
Advocacy AwardKing has nearly 20 years of experience in DDSD
case management working with individuals on every
type of waiver including the pilot project for the InshyHome Support waiver King began her career in the
field as a direct support professional before
becoming a recreational therapist and case
manager transitioning individuals from The
Hissom Memorial Center King gives each
person on her caseload the individual attention
they need regardless of the time it takes As a
recent example of her advocacy and
dedication she assisted a woman on her caseload in the process of obtaining
a divorce from her husband of many
years King referred the woman to a
community resource for legal advice
assisted her in completing all of the legal paperwork attended
court hearings with her and then took the woman apartment hunting
King even helped her move into the new apartment unpack and
decorate King has been known for her attention to detail and is extremely conscientious exemplifying her commitment to those
she servesJennings has volunteered for Oklahoma People First for the last
11 years assisting in the establishment of new chapters planning
state conferences writing grants to secure funding and soliciting
donations for conferences As an OPF volunteer Jennings is passionate about teaching individuals to advocate for themselves Her belief in their abilities empowers them to have faith in
themselves and in their abilities to make choices She educates OPF members on increasing their independence vocational opportunities voting relationships and community involvement Jennings empowers OPF members by offering them a support network to turn to when in need of assistance By doing so she
teaches others to recognize how much persons with developmental disabilities can do for themselves if given the right supports
InterFace NEWSLETTER
To see Oklahomarsquos ranking as compared to other states in regard to the numbers of persons with developmental disabilities in competitive jobs (supported employment)go to
wwwstatedatainfo
This website is a project of the Institute for Community Inclusion at UMass Boston supported in part by the Administration on Developmental Disabilities US Department of Health and Human Services under cooperative agreement with additional support from the National Institute on Disability and Rehabilitation Research of the US Department of Education
Angela King DDSD Area II case manager is presented with the AdvocateshyCase Manager of the Year award by John Gajda executive director TARC
Cindy Jennings DDSD Area III nurse is presented with a Special Achievement in Advocacy Award by John Gajda executive director TARC
Oklahoma Department of Human Services 5 Developmental Disabilities Services Division
I N T E R F A C E
Quality
AwardsBest of the Best
Regina ChacePrograms Manager for DDSD Employment Services
Regina Chace Program Manager for DDSD Employment Services receives an OKDHS Quality Award Best of the Best for her leadership in this program Chace ensures there are policies and processes which support participants to have a full range of opportunities for employment As a result Oklahoma has been recognized as the nationrsquos leader in achieving impressive outcomes in integrated employment for people with
disabilities InterFace NEWSLETTER
A Dream Come True Bobby Cooper and his parents were invited by Governor Brad Henry to meet with him and visit the capitol Tom Cooper Bobbyrsquos father is a member of the Governorrsquos Council for United We Ride representing people with disabilities Tom mentioned to Governor Henry in a letter that it had been Bobbyrsquos dream to meet him after seeing him speak on television during his reshyelection Governor Henry was so flattered by Bobbyrsquos request that he invited the whole family for a visit to the capitol in November 2008 They took a few moments to pose for this photograph in the Governorrsquos Blue Room From left Tom Cooper BobbyGovernor Henry and Ruth Cooper
Oklahoma Department of Human Services 6 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
James Nicholson Director of the OKDHS Developmental Disabilities Services Division is presented with a 2009 College of Allied Health Citation for Special Contributions (Left to Right) Jeff Berry Chair College of Allied Health Awards and Honors Committee College Dean Kevin Rudeen Nicholson and Martha Ferretti Professor and Chair Physical Therapy Department of Rehabilitation Sciences College of Allied Health
DDSD Nicholson receives award for contributions to College of Allied Health
On April 2 2009 James Nicholson Director of the OKDHS Developmental Disabilities Services
Division was presented with the 2009 College of AlliedHealth Citation for Special Contributions Nicholson was nominated for this award by Martha
Ferretti Professor and Chair Physical Therapy Department of Rehabilitation Sciences College of Allied Health University of Oklahoma Health Sciences Center In the nomination for this award Ferretti wrote ldquoMr Nicholsonrsquos background is one of diversity and richness
His work ethic sets a standard for us all to follow His calmness humor and general goodwill in the midst of controversy is obvious and remarkable And first and foremost his dedication to improving the lives of children and adults with developmental disabilities has set a standard for us all to emulate Mr Nicholsonrsquos creativity thoughtfulness and ability to target a goal and accomplish it regularly in collaboration with a number of formal and informal partners prove the importance of reaching beyond onersquos own resourcesldquoAs a visionary in the field of developmental disabilities early in his
role as director Mr Nicholson caught the attention of both supporters and detractors His vision was a perfect match for what our faculty were striving to accomplish in preparing our students and in providing servicesin the field of developmental disabilities ldquoWe approached Mr Nicholson shortly after he became the director with
a proposal for introducing assistive technology into the DDSD system differently than had been accomplished at that point Over the past 18 years
he and members of his staff have continued that collaboration on projects that addressed both major and minor challenges
about policy and services for Oklahomans with developmental disabilities
ldquoOur faculty has learned so much from this very politically astute and professional state leader Before the state was aware of its challenges emerging from children with autism and their families Mr Nicholson quietly accepted the mantle of addressing what we have come to know are unbelievable challenges presented by the impact of autism Seven years ago he convened a multishyagency multishydisciplinary task force that included parents of individuals with autism to develop the Oklahoma State Plan for Autism and the Oklahoma Autism Network We are honored by him placing the OAN within the structure of the College
ldquoMr Nicholson has stimulated us to mature as educators researchers and service providers to more effectively address many of Oklahomarsquos needs in the field of
developmental disabilitiesrdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 7 Developmental Disabilities Services Division
Nickrsquos Law
I N T E R F A C E
Insurance Mandates for autism treatments fail once again to pass Oklahoma legislature
For the second consecutive year bills that would have mandated insurance companies to cover
treatments for autism failed to pass through the Republicanshycontrolled legislatureIn February the House Economic Development and
Financial Services Committee voted down House Bill 1312 also known as ldquoNickrsquos Lawrdquo which would have required insurance providers to cover autism treatment The only autismshyrelated bills that did receive enough
support to pass were House Bill 2027 and its companion Senate Bill 135 The Senate version made it through the legislative process and will enact a licensing process for national board certified behavior analysts and enhance existing state programs that would train doctors to diagnose and treat autism Critics of this bill question whether it will actually produce
significant new services if insurance doesnrsquot cover the cost of treatment and parents canrsquot afford to pay the bill
ldquoSadly this bill will do nothing to relieve the pressure on families struggling to care for children with autismrdquo said Sen Jay Paul Gumm author of lsquoNickrsquos Lawrsquo legislation ldquoThis measure was designed to relieve political pressure on legislators who refuse to even consider Nickrsquos Lawrdquo
When Governor Henry signed Senate Bill 135 he said the measure was just a small step in the effort to help affected Oklahoma families He urged lawmakers to pass legislation to mandate insurance coverage for the treatment of autism
ldquoThere is nothing wrong with this bill just like there is nothing wrong with a pack of shingles at a construction siterdquo said Sen Gumm ldquoIf you try to put the shingles on before you pour the foundation you are doomed to failure As Governor Henry wisely noted when he signed the bill the foundation is insurance coverage of autism Absent that Senate Bill 135 is doomed to failurerdquo
Republican legislative leaders oppose insurance mandates saying they drive up the cost of health insurance despite reports from states with similar insurance mandates that show no significant increase in the cost of premiums
Republicans attempted to pass House Bill 1975 which would only allow insurance legislation to be introduced in oddshynumbered years and approved in evenshynumbered years The bill would have also required a 75 percent supershymajority vote to do away with the mandate in the case of an emergency
Henry vetoed that bill and said it would have unreasonably ldquotied the hands of state policy makers on a very important issuerdquo
ldquoThis would empower a small minority of legislators to thwart legitimate state efforts to address a pressing public policy issue and ensure that the restriction would rarely if ever be liftedrdquo Henry said
Henry also questioned why HB 1975 restrictions were only applied to a single issue area saying it raised legitimate concerns regarding why only one subject would be singled out for special treatment
Autism cont on page 9
Oklahoma Department of Human Services 8 Developmental Disabilities Services Division
SUMMER 2009
Autism cont from page 8
ldquoOklahoma and its citizens are better served when policy makers are allowed the freedom to address any pressing issue in the Legislature without the hindrance of arbitrary restrictionsrdquo Henry said Democrats offered a compromise mdash to put autism coverage in highshy
risk insurance pools as a last resort for families who canrsquot afford the coverage elsewhere Republicans again declined and instead went forward with SB 135 This year three more states enacted Autism Mandate legislation bringing
the total to 11 states that now require insurance companies to cover treatment for autism InterFace NEWSLETTER
Proudly displaying their CPR (Cardio Pulmonary Resuscitation) certificates are (From Left) Guy Bivens Allen Larimore Steve Sposato Andy Edwards Joshua Johnson and Tino Hensley residents of the Independence House
Residents of the Independence House at the Home of Hope in Vinita recently became CPR certified after a fellow resident had a heart attack A staff member used CPR to save Allen Larimorersquos life and he has since received a pacemaker Although staff members must be CPR certified this event inspired Larimorersquos housemates to take the class so they could also be prepared ndash just in case Donna Marlow a CPR trainer from the OKDHS Developmental Disabilities Services Division held the class free of charge at the agency and was proud that all the men passed their tests with flying colors
11th Circuit Rules Doctors donrsquot trump state on Medicaid care for children with disabilities by Alyson M Palmer
A federal appeals panel has declared that treating doctors donrsquot have the final say in how much nursing care the state must provide
children with disabilities under MedicaidOn April 24 the 11th US Circuit Court of Appeals reversed a district
judgersquos decision that had said the state must provide the amount of nursing care that a North Georgia girlrsquos doctor said she needs
Despite a slew of amicus briefs by state governments and Medicaid plan administrators the panel dispatched the case in a twoshypage unpublished unsigned opinion that came out a month after oral argument
Holland amp Knight partner Robert S Highsmith Jr who represented a proshystate friend of the court that provides managed care services for Medicaid programs said his client WellCare of Georgia had been concerned about language in US District Judge Thomas W Thrash Jrrsquos ruling that suggested anything ordered by a treating physician is medically necessary under the law ldquoThat one sentence just had to get reversedrdquo said Highsmith ldquoWe are very excited that they saw and reversed that clear errorrdquo
But an advocate for the teenage girl at the center of the case Atlanta Legal Aid Society General Counsel David A Webster said Monday that the decision ldquodoesnrsquot mean muchrdquo and says little about the relationship between the state and the treating physician ldquoThatrsquos going to be open for future litigationrdquo said Webster Webster said the case of his client Anna C Moore will go back to Thrash for the judge to consider the
11th Circuit Rules cont on page 15
Oklahoma Department of Human Services 9 Developmental Disabilities Services Division
I N TERFACE
ImaginingEverest The Story of LaelBy Adrienne Benz
ldquoI prayed for God to open the eyes of my understanding and the pieces began to fall into place Mollyrsquos future had been planned since she was a young girl she would marry andhave a bright healthy family known for their intelligence andkindness However the birth of her first born quickly dispelled the myth of the stereotypically perfect family as Molly learns her son Lael has Down syndrome Struggling to accept the disconcerting news and understand Godrsquos perfect plan Molly faces a challenge no more daunting than the climbing of the greatMt Everest she often dreamed of as a child Guilt hope grief and happiness take Molly and Lael across rocky terrain and risky edges but faith and the resonant voice of God bring mother and son up the emotional mountain 30 years in the making ndash a mountain that revealed the aptitude of Mollyrsquos beloved son and the kindness of others By Imagining Everest Molly and Lael forge a unique and amazing relationship which allows them to overcome even the most intimidating ascension into the unknownrdquo
Molly Mathewrsquos son Lael currently receives services through the OKDHSDDSD community waiver program
264 pages shy $1499 (paperback) This book is available online through Tate Publishing wwwtatepublishingcombookstore
Health and Human Services rescinds Medicaid regulations affecting case management
Department of Health and Human Services (HHS) Secretary
Kathleen Sebelius announed June 29 that the administration will rescind all or part of three Medicaid regulations that were previously
issued and delay the enforcement of a fourth regulation Each of these
rules in whole or in part had been subject to Congressional moratoria
set to expire on July 1 2009ldquoThese regulations if left in place would have potentially adverse
consequences for Medicaid beneficiaries some of our nationrsquos most vulnerable peoplerdquo said Secretary Sebelius ldquoBy rescinding
these rules we can expect that children will continue receiving
services through their schools beneficiaries will be able to
access all available case management resources to help them
better manage their health care and outpatient hospital and
clinic services can continue to be covered in the most efficient mannerrdquo
This ruling was crucial to Oklahomarsquos Developmental Disabilities Services as the state could have lost the ability
to bill Medicaid for 100 percent of the cost of providing
case management services to waiver service recipients which totals approximately $22 million per year
ldquoThe actions we are taking today are necessary to
ensure that the states have the flexibility they need to
fully serve Medicaidshyeligible individualsrdquo said
Secretary Sebelius
The Centers for Medicare amp Medicaid
Services (CMS) and HHS arebull Rescinding provisions of an interim final rule
published Dec 4 2007 which would have restricted beneficiary access to case management services These provisions appeared to in practice restrict beneficiary access to needed covered case management services and limit state flexibility in determining efficient and effective delivery systems for case management services
Regulations Expiring cont on page 11
Oklahoma Department of Human Services 10 Developmental Disabilities Services Division
SUMMER 2 0 0 9
Regulations Expiring cont from page 10
bull Rescinding a final rule published Dec 28 2007 that would have eliminated reimbursement for schoolshybased administrative costs and costs of transportation to and from schools The rescission reflects concern that the rule could limit the Medicaid administrative outreach activities of schools and that the overall budgetary impact on schools could potentially impact their ability to offer Medicaid services to students
bull Rescinding a rule published Nov 7 2008 that would have limited the outpatient hospital and clinic service benefit for Medicaid beneficiaries to the scope of services recognized as an outpatient hospital service under Medicare This rule was rescinded because CMS became aware that coverage beyond that scope could not be easily moved to other benefit categories resulting in great impact than previously anticipated
bull Delaying until June 30 2010 the enforcement of portions of a regulation that clarified limitations on health care related tax programs so that CMS could determine whether states need additional clarification or guidance CMS may also further review the potential impact of the regulation and give additional consideration to alternative approaches InterFace NEWSLETTER
Waiting and HopingBy Adrienne Benz
Sad is like sitting here when I donrsquot have a home to run away to
So there on the street just waiting for something to eat somewhere to stay and a bed to sleep on and someone to hold
And hoping Irsquom still there the next day
They have to get up from the street in the park sitting on a cold chair in the dark
Just waiting for someone to take them in their home Waiting to open up and talk about their hidden feelings
like they canrsquot wait any longer
Adrienne Benz was a child in state custody when she wrote this poem She is now an adult reunited with her family
Oklahoma Department of Human Services 11 Developmental Disabilities Services Division
I N T E R FA C E
DDSD Fiscal Year 2010 Budget Outlook OKDHS Director Howard Hendrick
presented the agencyrsquos Fiscal Year 2010 budget to the Commission for Human Services on June 16 Hendrick emphasized that even with the additional federal stimulus money and other oneshytime funds the agencyrsquos overall funding will be approximately $50 million short of anticipated spending levels To achieve a balanced budget cuts would have to be made within each division The Developmental Disabilities Services Divisionrsquos
share of the cuts amount to approximately 3 percent of the divisionrsquos operating budget ($17 million) Another $200000 had to be identified to fund the new initiative for Applied Behavior Analysis mandated by Senate Bill 135 this legislative sessionDDSD was able to accomplish the budget cuts without
impact to any programs or services through reductionsat the Northern and Southern Oklahoma ResourceCenters The rest of the savings came from reductions in training and professional contracts the divisions holds with various entitiesOver the next year DDSD will be under a selfshyimposed hiring
freeze for all positions except for case management direct care professionals and registered nursesIf monthly state revenue collections continue to fall below
expected levels additional reductions may be required of all stateagenciesrsquo operating budgets
Interim StudiesThere will be two interim legislative studies conducted this summer that could impact DDSD and service recipients
One of these studies will investigate a possible provider feetax on agencies providing waiver community services If the provider feetax is found to be within federal Medicaid guidelines it could possibly be used to fund rate increases in waiver services
The other legislative study will look into the pros and cons of online training versus classroom training specifically for providers of DDSD community services
Money Follows the PersonAs of this date DDSD has transitioned eight people from Northern Oklahoma Resource Center of Enid and Southern Oklahoma Resource Center into community homes using the federal Money Follows the Person grant Utilizing these federal funds DDSD has been able to save approximately $21000 in the community services provided to those individuals
Oklahoma documentary on developmental disabilities history to air on OETA
an
Oklahoma
document
ary
Adocumentary showing Oklahomarsquos history serving people with intellectual and developmental disabilities is
scheduled to begin airing on OETA (Oklahomarsquos Education Television Authority) in October during national Disabilities Awareness Month
The video ldquoWagons to Waivers A Century of Changerdquo narrated by Oklahomarsquos own country music star Reba McEntire will be broadcast on the OETAshyOklahoma channel starting on Oct 24th at 5 pm and on Nov 5th at 830 pm The program will be
aired a couple times a month
The documentary takes viewers on an emotional journey from the days of the Dust Bowl and covered wagons and shows the statersquos progression from institutional services to full community inclusion for persons with intellectual disabilities Oklahomarsquos story begins in 1909
with the creation of the Institute for the Feeble Minded in Enid and includes the
tears and efforts of parents the stories ofpeople who grew up in institutions the legal struggles and the triumph of selfshyadvocacy The video was produced by the Oklahoma Department of Human Services Developmental Disabilities Services Division
OETAshyOKLA is Cox Cable channel 112 but other television carriers as well as satellite users can access the channel which is devoted to Oklahomashyspecific programming Check your local television lis tings for specific programming dates and times
Oklahoma Department of Human Services 12 Developmental Disabilities Services Division
SUMMER 2009Compassion friendship and longevity A good measure of success
The day had finally come and Danny waited anxiously on the sofa He watched quietly as the
nursing staff set up the hospital bed and made his friend Carl comfortable The minute all was clear Danny went to Carl and told him how much he had missed him and that he needed him to get better Dannyrsquos longshytime friend had just undergone surgery
to remove a malignant brain tumor Danny didnrsquot understand the procedure or Carlrsquos prognosis ndash all that mattered was that his best friend was home It just wasnrsquot home without CarlCarl is considered the head of the household that he shares
with Danny and his other friend Hershel Carl was always the one who planned their meals said the prayers at the diningroom table and got them involved in Special Olympics events When Carl became ill and went to the hospital it was Danny
who stepped up and tried to fill in ndash just until Carl came home ldquoThe Three Musketeersrdquo (thatrsquos what their staff call them) have
been friends and have lived together for more than 30 years
Danny (lef
t) spends
hours by
Carlrsquos sid
e
encourag
ing him in his
recovery
They met as boys at The Hissom Memorial Center the nowshyclosed institution in Sand Springs for persons with developmental disabilities When they aged out of Hissom the three moved about the same time to a private facility where they lived for many years
In 1993 The Musketeers were given the opportunity to move together once again into a house in their community supported through the DDSD Medicaid Community Waiver program Since
that time they have lived in the house withsome of the same staffmembers who havecared for them for morethan 20 years
The Three Musketeers Danny (left) shows his excitement over his friend Carlrsquos (right) return from the hospital after brain surgery Shy Hershel (center) wipes tears from his eyes
Carl is recoveringfrom his surgery andworking on his abilityto speak and onregaining the use of theleft side of his bodyThe staff in the home
often has to make Danny go to bed at 1 am when hersquos still sitting beside Carl encouraging him to get better so he can go back to work
All three men have jobs and love their work ndash Carlmost of all Danny somehow knows that if Carl canjust get back to work life will continue as they onceknew it
ldquoTheyrsquore like a wellshysettled familyrdquo said Gretchen Moser their DDSD case manager ldquoEven their families consider these guys a family and respect their wishesrdquo
These days there are many opinions about what constitutes a family or even success But there are stories that transcend those discussions Stories like these that remind us success can also be measured by the love and longevity of a friend InterFace NEWSLETTER
Relations
hips
Oklahoma Department of Human Services 13 Developmental Disabilities Services Division
I N T E R F A C E
StateLegislativeNews
Of the thousand or more bills filed at the beginning of the 2009 legislative session only a few made it through the entire process that will have an impact on persons with developmental disabilities families and professionals in the field They are
HB 1007 mdash Wesselhoft Leftwich Signed by the Governor Requires specific Physically Disabled person signage to be posted as a reserved area for the parking of a vehicle displaying a valid permit
HB 1019 mdash WrightSigned by the Governor Recreates the Group Homes for Persons with Developmental or Physical Disabilities Advisory Board
HB 1048 mdash Banz AldridgeSigned by the Governor Relates to the collection of delinquent real property taxes removes physically disabled from ldquoincapacitatedrdquo persons granted additional time to redeem personal items reduces time to collect excess sale proceeds by half
HB 1065 mdash Faught Crain Signed by the Governor Relates to the Continuum of Care and Assisted Living Act adds definition and requires inspection results to be posted on website
HB 1424 mdash Protor Signed by the Governor Requires treatment facilities transitional living facilities halfway houses and any house or facility that may be used for medical or nonmedical detoxification to mail notification to property owners within a quarter mile radius if zoning changes are proposed
HB 1461 mdash Sears Ford Signed by the Governor A school that does not make adequate yearly progress for two straight years shall utilize the assistance of a school support team formed by the State Department of Education EMERGENCY
HB 1581 mdash Coody Jolley Signed by the Governor School teacher candidates that wish to teach elementary early childhood education or special education programs must study the five elements of reading instruction EMERGENCY
HB 1763 mdash Enns Reynolds Signed by the Governor Requires the state Department of Education to provide special education training for process hearing officers to ensure adequate knowledge in special education laws and proceduresEMERGENCY
HB 1893 mdash Peterson Anderson Signed by the Governor Creates the Aging and Disability Resource Consortium to work with other agencies in developing and implementing a singleshypointshyofshyentry concept for aging and disability groups in Oklahoma
SB 135 mdash Johnson Mike Signed by the Governor Provides for the licensing of certain persons to practice as a licensed behavior analyst or a licensed assistant behavior analyst and to study children with autism and their behaviors directs funds to be used by the Department of Human Services Developmental Disabilities Services division for training SoonerStart providers to treat children with autism spectrum disorders provides for a behavorial analysis research pilot project provides legislative intent
SB 518 mdash Justice Osborn Signed by the Governor Adds grandparents as members of immediate family
SB 871 mdash Anderson Signed by the Governor Modifies membership of the Electronic and Information Technology Accessibility Advisory Council
Oklahoma Department of Human Services 14 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
11th Circuit Rules cont from page 9
matter again Moore a teenager living in North Georgia who goes by ldquoCallierdquo has been receiving inshyhome nursing care paid for by Medicaid for about a decade The state has been trying to cut the number of hours of care she receives each week
The 11th Circuit interpreted a federal law that says states participating in the Medicaid program must provide ldquoearly and periodic screening diagnostic and treatment servicesrdquo that are necessary to ldquocorrect or ameliorate defects and physical and mental illnessesrdquo in Medicaidshyeligible children The primary ways children become eligible for Medicaid are that they come from a lowshyincome family or have a disability according to Joshua H Norris another one of Calliersquos lawyers
Georgiarsquos Department of Community Health operates a program to administer Medicaidshyfunded nursing services for several hundred children who need nursing care It delegates the decisions about approval of such services to an organization called the Georgia Medical Care Foundation
According to Thrashrsquos order Callie is disabled because of a stroke she experienced in utero and suffers from various chronic conditions including mental retardation and cerebral palsy She lives at home and according to the statersquos brief attends an elementary school in Athens Ga three days a week Her lawyers have said she requires constant care
The statersquos lawyers have said that nursing hours can be reduced when the patientrsquos medical condition stabilizes positing that a goal of the program is to teach parents and other caregivers to take care of their children on their own The Mooresrsquo lawyers have contended that the statersquos system of ldquoweaningrdquo patients off their nursing services as long as theyrsquore staying out of the hospitaland not getting worse follows a different standard than that set by federal law
In 2006 the state informed Calliersquos mother that it was reducing Calliersquos nursing hours from 94 hours a week to 84 contrary to the recommendation of Calliersquos primary care physician Calliersquos mother filed suit
The Mooresrsquo lawyers convinced Thrash that the reduction was improper Afterissuing multiple injunctions in Calliersquos favor he denied the statersquos motion for summary judgment and granted the Mooresrsquo motion in part concluding the state must provide for the amount of skilled nursing care that Calliersquos treating physician deems necessary The panel that ruled in favor of the state in its appeal was comprised of Senior 11th Circuit Judge R Lanier Anderson III 11th Circuit Judge Gerald B Tjoflat and US District Judge Lisa Godbey Wood visiting from the Southern District of Georgia
The panel said both the state and Calliersquos physician have roles in determining whatrsquos medically necessary to correct or ameliorate Calliersquos medical conditions It cited a federal regulation that says a Medicaid agency ldquomay place appropriate limits on a service based on such criteria as medical necessity or utilization control proceduresrdquo
ldquoA private physicianrsquos word on medical necessity is not dispositiverdquo the panel concluded
Assistant Attorney General Virginia B Fuller made the successful oral argument for the state last month Attorney General Thurbert E Bakerrsquos spokesman Russ Willard said in an eshymail that the state ldquois appreciative of the Court of Appeals decision recognizing the role of the Medicaid program in providing for this treatmentrdquo
Norris who also is director of legal advocacy for a nonprofit that advocates for people with disabilities said the 11th Circuit gave Thrash
an opportunity to say more about the roles of treating doctors and the state in deciding what care the state needs to provide Norris noted that Thrash wrote on the subject last year in another nursing care case about a Savannah Ga boy who nearly drowned when he was 2Thrash barred the state from enforcing a policy of not providing nursing care for patients requiring 16
to 24 hours per day for more than one week he said that criteria isnrsquot based on whatrsquos medically necessary under federal Medicaid law
On the other handThrash denied the plaintiff rsquos request based on the
treating physicianrsquos recommendation for 24shyhourshyashyday private nursing services for an
indefinite period of time Thrash deemed such a prescription ldquoan abuse of the Medicaid systemrdquo
The state has limited discretion to deny a providerrsquos request for care under the ldquoearly and periodic
screening diagnostic and treatment servicesrdquo portion of the Medicaid Act said Thrash He added that ldquo[t]he statersquos discretion is limited to a review of the request for fraud abuse of the Medicaid system and whether the service is within the reasonable
standards of medical carerdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 15 Developmental Disabilities Services Division
klahoma Department of Human Services
I N T E R F A C E
DDSD Area II Project Elves get together to wrap all the presents and make sure they are delivered to the individuals before Christmas Elves work year round
to make Christmas special for DDSD clients For the past eight years individuals with
developmental disabilities who donrsquot have families or who would otherwise not receive gifts have had their Christmas wishes come true thanks to caring DDSD ldquoelvesrdquo in Area II Project Elf is the brainchild of ldquoThe Men in Recrdquo namely
Steve Pitts and Roger McDaniel DDSD Area II recreational therapists and Joe Stie DDSD case manager ldquoDDSD serves a lot of people with developmental
disabilities who donrsquot have families to celebrate the holidays withrdquo said Pitts ldquoAlthough our services meet their basic needs therersquos still a gap when it comes to those special things that families do for one anotherrdquoThat gap has been filled by The Men in Rec who work all year
long coordinating various events to raise money to buy Christmas presents for individuals ldquoWe raise all of the funds and no OKDHS money is usedrdquo said
Pitts ldquoThis year we are selling Blue and Gold sausage and Amish jams We also have an annual Christmas Carol fundraising performance which is donated to Project Elf by the American Theater Company We are given 300 tickets that we can sell and last year we sold 225rdquoDDSD coshyworkers got together and purchased 44 of those theater
tickets last year for the children who happened to be in the Laura Dester Center Shelter around the holidays ldquoWe have also set up a sponsorship program where people can purchase
the gift and return it wrapped and ready for the elf (aka case manager) to deliver This last Christmas we had 108 sponsors 30 of whom were the case managers themselvesrdquo
The Men in Rec also recruit fellow DDSD workers to help shop for the gifts and wrap themldquoWe could not accomplish this awesome Project Elf without the assistance of so many of our coshyworkers and our community volunteersrdquo he said ldquoItrsquos such a pleasure to share these gifts at Christmas time and let our customers know that they have a family through our good service to themrdquoThe Men in Rec are currently working to raise money for this yearrsquos Christmas gifts If you would like to join the rank of DDSD Elves by donating funds or becoming a sponsor please contact Steve Pitts at stevepittsokdhsorg or call918shy794shy7625 InterFace NEWSLETTER
Steve Pitts (right) DDSD Area II recreational therapist gives a donated WalshyMart gift card to case manager Roy Willett to purchase a Christmas gift for one of the people on his caseload
Oklahoma Department of Human Services 16 Developmental Disabilities Services Division
shy shyshy shy
shy shy
shy shy
shy shy
shy shy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
Developmental Disabilities Services Area Offices and Resource Centers
CUSTER
ELLIS
BECKHAM WASHITA CADDO
McCLAIN
SEM
INO
LE HUGHES HASKELL
LE FLORELATIMER PITTSBURG
COAL
ATOKA
PONTOTOC
JOHNSTON
GARVIN
MURRAY
CARTER
LOVE
BRYAN CHOCTAW
PUSHMATAHA McCURTAIN
GRADY
KIOWA
TILLMAN
JACKSON HA
RM
ON
GREER
COTTON
JEFFERSON
STEPHENS
COMANCHE
McINTOSH
CLEVELAND
POTT
AWAT
OM
IE
DEWEY BLAINE
CANADIAN
MAJOR
GRANT KAY OSAGE
WA
SHIN
GTO
N CRAIG
ROGERS
CH
ERO
KEE
ADAIR TULSA
WAGONER
MAYES
OKMULGEE
CREEK
LINCOLN
LOGAN
PAYNE
KINGFISHER
OKLAHOMA OKFUSKEE
MUSKOGEE SEQUOYAH
DEL
AWA
RE
OTTAWA NOATTA
GARFIELD NOBLE
PAWNEE
WOODS ALFALFA HARPER BEAVER TEXASCIMARRON
WOODWARD
ROGER MILLS
MARSH
Oklahoma CityOklahoma City
Tulsa
Area II
Area III
Area I
Pauls Valley
Enid
wwwokdhsorg
State Officetoll free 1shy866shy521shy3571
AREA Itoll free 1shy800shy522shy1064
AREA IItoll free 1shy800shy522shy1075
AREA IIItoll free 1shy800shy522shy1086
Greer Center (Enid)2501 NE Delaware Enid OK 73701
580 237 10272599 FAX 580 213 2799
Northwest Oklahoma Resource Center at Enid (NORCE)2600 E Willow
Enid OK 73701
580 237 1027
FAX 580 548 2600
Southern Oklahoma Resource Center at Pauls Valley (SORC)3210 Chickasaw St
Pauls Valley OK 73075 6822
405 238 6401
FAX 405 238 8261
DDSD Area I Office (Enid)729 Overland Trail Enid OK 73703
580 548 8900 FAX 580 548 8964
DDSD Area I Office (Oklahoma City)4545 N Lincoln Blvd
Oklahoma City OK 73105 405 522 6925
FAX 405 522 6995
DDSD Area II Office (Tulsa)Laura Dester Center 1427 E 8th Tulsa OK 74120
918 560 4848 FAX 918 560 4898
DDSD Area III Office (Pauls Valley)301 S Indian Meridian Rd Pauls Valley OK 73075
405 238 4700 FAX 405 238 4740
If you would like to find out what the DevelopmentalDisabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
If you would like to find out what the Developmental Disabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
This will take you to the main Oklahoma Department of Human Services Web page From there just click on Divisions and Offices and the Developmental Disabilities Services Division On our Web site you will find information about services the division offers how to apply for services eligibility policies contract provider agencies and much more
Come visit us today You may be surprised at what you will learn
OKLAHOMA DEPARTMENT OF HUMAN SERVICES Developmental Disabilities Services DivisionPO Box 25352 Oklahoma City OK 73125
S U M M E R 2 0 0 9
Best of the Best in Direct Support Services honored
The statersquos most outstanding direct support professionals were recognized for their work
during the Governorrsquos Conference on Developmental Disabilities March 2 2009 at the Tulsa Renaissance
Hotel and Convention CenterThe annual Awards of Excellence in Direct Support
Services sponsored by the Developmental Disabilities Services Division honors individuals working in direct care in a variety of settings Nominations are sent to DDSD
from all over the state from provider agencies family
members and individuals with disabilities All of the direct support professionals recognized were presented with Awards of Excellence Out of the award winners the Best of the Best were chosen and featured in video presentations at the ceremony Awards of Excellence in Direct Support Services were presented to Will Watkins Rescare OklahomaLarry Lamm Supported Community LifestylesLora Catlett Gatesway FoundationAngel Balenti Phoenix Residential ServicesCharity Mormon Magna Community Living ServicesStephanie Lackas Reach Out IncRandy Brewer Gatesway FoundationKrystal Lewis Goodwill Industries of Southwest OklahomaSteve Poland Oklahoma Life Skills AssociationMattWeintz Volunteers of AmericaNancy Newson Kibois Community Action FoundationPatricia Harper Garvin County Community Living CenterMary Williams Rescare OklahomaLucinda Flynn People IncApril Thompson Independent Opportunities IncLaDonna Lang Central State Community ServicesDneta Carr Central State Community ServicesDaniel Escojido Supported Community LifestylesCindy Simmons Kibois Community Action FoundationDavid Pitts Homelife AssociationBeverly Kichler Volunteers of AmericaFreda Kretchmar BIOSAnnette Bounds Big Five Community ServicesGenea Shatto INCA Career Opportunities
Awards of Excellence in Direct Support Services winners (Back Row from left) Daniel Escojido Larry Lamm Will Watkins David Pitts Stephanie Lackas Patricia Harper Randy Brewer Matt Weintz and Krystal Lewis (Front Row from left) Genea Shatto April Thompson Lucinda Flynn Mary Williams Angel Balenti Charity Mormon Lora Catlett and Steve Poland
The Best of the Best in Direct Support Services Awards were presented to (From Left) Larry Lamm Will Watkins Stephanie Lackas Mikayla Angel Balenti Charity Mormon and Lora Catlett
Mark your calendars The 2010 Governorrsquos Conference on Developmental Disabilities will be held March 8shy9 To nominate someone for the Direct Support Services Awards contact the Developmental Disabilities Services Division at (405) 521shy6254
Oklahoma Department of Human Services 3 Developmental Disabilities Services Division
I N T E R FA C E
Governorrsquos Disability Employment Awards
Showcase
Steve Scott (Right) receives a 2008 Governorrsquos Disability Employment Award for his outstanding work from Howard Hendrick Cabinet Secretary of Human Services and Director of the Oklahoma Department of Human Services Scott was recognized for working 19 years with the same WalshyMart store in Sand Springs During that time Scott has received several promotions and pay raises
Oklahom
arsquos
reason to
brag
Oklahoma may be best known around the country for excellence in many
things from college football to producing awardshywinning countryshywesternmusic stars Probably not as well known is the fact that Oklahoma is the best state
in the nation at supporting people with developmental disabilities to work
in competitive jobs according to an independent ranking by the Institute
for Community Inclusion at the University of Massachusetts BostonldquoFor the past three years Oklahoma has led the nation in assisting people with
developmental disabilities to find competitive jobs and become working taxpayersrdquo said James Nicholson Director of the OKDHS Developmental Disabilities Services Division ldquoToday more than 60 percent of individuals with developmental disabilities served by our division participate in supported employment servicesrdquo
The Governorrsquos Disability Employment Awards are held each October to
recognize individuals with disabilities for their outstanding achievements at work
through the supported employment program Also recognized are businesses that hire people with disabilities and members of the media who promote supported
employment programs The Governorrsquos Disability Employment Awards are coshysponsored by Governor
Brad Henry and Lt Governor Jari Askins along with OKDHSshyDDSD the Department of Rehabilitation Services and the Oklahoma Association
of Persons in Supported Employment
The 2009 Governorrsquos Disability Employment awards will be held on
Oct 22 130 pm at the Governorrsquos Mansion Pavilion in Oklahoma City
InterFace NEWSLETTER
The 2008 award Receipeints wereBUS INESS WINNERS
Gene LukerAramark Glass Plant Tulsa
Gary CookMcDonaldrsquos Ardmore
WalshyMartCushing
Mike amp Terry GentryMcDonaldrsquos Lawton
Joyce and Fred HannahLektron LED Lighting Tulsa
Pizza HutCushing
Guest InnArdmore
JonMilneSODEXO Langston
WalshyMartMoore
City of Muskogee
Angela OwensSonic DriveshyIn Ardmore
WalshyMart Super CenterSand Springs
WalshyMart Super CenterVinita
MED IA WINNER
Dawndee Bostwichreporter Duncan Banner
EMPLOYEE WINNERS
Bobby Bailey
Bob Bennett
Tammie Burrall
Andy Cheater
Tommy Coleman
Jeff Dickson
Chad Joyce
Allen Kouba
Linda Prowell
Phillip Reed
Peter Rowland
Steve Scott
Kenneth Smith
Judy Wolfe
James Young
Oklahoma Department of Human Services 4 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
DDSD employees win advocacy awards
Angela King DDSD Area II case manager and Cindy
Jennings DDSD Area III nurse received awards from TARC in December 2008 King received the
AdvocateshyCase Manager of the Year award while
Jennings was recognized with a Special Achievement in
Advocacy AwardKing has nearly 20 years of experience in DDSD
case management working with individuals on every
type of waiver including the pilot project for the InshyHome Support waiver King began her career in the
field as a direct support professional before
becoming a recreational therapist and case
manager transitioning individuals from The
Hissom Memorial Center King gives each
person on her caseload the individual attention
they need regardless of the time it takes As a
recent example of her advocacy and
dedication she assisted a woman on her caseload in the process of obtaining
a divorce from her husband of many
years King referred the woman to a
community resource for legal advice
assisted her in completing all of the legal paperwork attended
court hearings with her and then took the woman apartment hunting
King even helped her move into the new apartment unpack and
decorate King has been known for her attention to detail and is extremely conscientious exemplifying her commitment to those
she servesJennings has volunteered for Oklahoma People First for the last
11 years assisting in the establishment of new chapters planning
state conferences writing grants to secure funding and soliciting
donations for conferences As an OPF volunteer Jennings is passionate about teaching individuals to advocate for themselves Her belief in their abilities empowers them to have faith in
themselves and in their abilities to make choices She educates OPF members on increasing their independence vocational opportunities voting relationships and community involvement Jennings empowers OPF members by offering them a support network to turn to when in need of assistance By doing so she
teaches others to recognize how much persons with developmental disabilities can do for themselves if given the right supports
InterFace NEWSLETTER
To see Oklahomarsquos ranking as compared to other states in regard to the numbers of persons with developmental disabilities in competitive jobs (supported employment)go to
wwwstatedatainfo
This website is a project of the Institute for Community Inclusion at UMass Boston supported in part by the Administration on Developmental Disabilities US Department of Health and Human Services under cooperative agreement with additional support from the National Institute on Disability and Rehabilitation Research of the US Department of Education
Angela King DDSD Area II case manager is presented with the AdvocateshyCase Manager of the Year award by John Gajda executive director TARC
Cindy Jennings DDSD Area III nurse is presented with a Special Achievement in Advocacy Award by John Gajda executive director TARC
Oklahoma Department of Human Services 5 Developmental Disabilities Services Division
I N T E R F A C E
Quality
AwardsBest of the Best
Regina ChacePrograms Manager for DDSD Employment Services
Regina Chace Program Manager for DDSD Employment Services receives an OKDHS Quality Award Best of the Best for her leadership in this program Chace ensures there are policies and processes which support participants to have a full range of opportunities for employment As a result Oklahoma has been recognized as the nationrsquos leader in achieving impressive outcomes in integrated employment for people with
disabilities InterFace NEWSLETTER
A Dream Come True Bobby Cooper and his parents were invited by Governor Brad Henry to meet with him and visit the capitol Tom Cooper Bobbyrsquos father is a member of the Governorrsquos Council for United We Ride representing people with disabilities Tom mentioned to Governor Henry in a letter that it had been Bobbyrsquos dream to meet him after seeing him speak on television during his reshyelection Governor Henry was so flattered by Bobbyrsquos request that he invited the whole family for a visit to the capitol in November 2008 They took a few moments to pose for this photograph in the Governorrsquos Blue Room From left Tom Cooper BobbyGovernor Henry and Ruth Cooper
Oklahoma Department of Human Services 6 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
James Nicholson Director of the OKDHS Developmental Disabilities Services Division is presented with a 2009 College of Allied Health Citation for Special Contributions (Left to Right) Jeff Berry Chair College of Allied Health Awards and Honors Committee College Dean Kevin Rudeen Nicholson and Martha Ferretti Professor and Chair Physical Therapy Department of Rehabilitation Sciences College of Allied Health
DDSD Nicholson receives award for contributions to College of Allied Health
On April 2 2009 James Nicholson Director of the OKDHS Developmental Disabilities Services
Division was presented with the 2009 College of AlliedHealth Citation for Special Contributions Nicholson was nominated for this award by Martha
Ferretti Professor and Chair Physical Therapy Department of Rehabilitation Sciences College of Allied Health University of Oklahoma Health Sciences Center In the nomination for this award Ferretti wrote ldquoMr Nicholsonrsquos background is one of diversity and richness
His work ethic sets a standard for us all to follow His calmness humor and general goodwill in the midst of controversy is obvious and remarkable And first and foremost his dedication to improving the lives of children and adults with developmental disabilities has set a standard for us all to emulate Mr Nicholsonrsquos creativity thoughtfulness and ability to target a goal and accomplish it regularly in collaboration with a number of formal and informal partners prove the importance of reaching beyond onersquos own resourcesldquoAs a visionary in the field of developmental disabilities early in his
role as director Mr Nicholson caught the attention of both supporters and detractors His vision was a perfect match for what our faculty were striving to accomplish in preparing our students and in providing servicesin the field of developmental disabilities ldquoWe approached Mr Nicholson shortly after he became the director with
a proposal for introducing assistive technology into the DDSD system differently than had been accomplished at that point Over the past 18 years
he and members of his staff have continued that collaboration on projects that addressed both major and minor challenges
about policy and services for Oklahomans with developmental disabilities
ldquoOur faculty has learned so much from this very politically astute and professional state leader Before the state was aware of its challenges emerging from children with autism and their families Mr Nicholson quietly accepted the mantle of addressing what we have come to know are unbelievable challenges presented by the impact of autism Seven years ago he convened a multishyagency multishydisciplinary task force that included parents of individuals with autism to develop the Oklahoma State Plan for Autism and the Oklahoma Autism Network We are honored by him placing the OAN within the structure of the College
ldquoMr Nicholson has stimulated us to mature as educators researchers and service providers to more effectively address many of Oklahomarsquos needs in the field of
developmental disabilitiesrdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 7 Developmental Disabilities Services Division
Nickrsquos Law
I N T E R F A C E
Insurance Mandates for autism treatments fail once again to pass Oklahoma legislature
For the second consecutive year bills that would have mandated insurance companies to cover
treatments for autism failed to pass through the Republicanshycontrolled legislatureIn February the House Economic Development and
Financial Services Committee voted down House Bill 1312 also known as ldquoNickrsquos Lawrdquo which would have required insurance providers to cover autism treatment The only autismshyrelated bills that did receive enough
support to pass were House Bill 2027 and its companion Senate Bill 135 The Senate version made it through the legislative process and will enact a licensing process for national board certified behavior analysts and enhance existing state programs that would train doctors to diagnose and treat autism Critics of this bill question whether it will actually produce
significant new services if insurance doesnrsquot cover the cost of treatment and parents canrsquot afford to pay the bill
ldquoSadly this bill will do nothing to relieve the pressure on families struggling to care for children with autismrdquo said Sen Jay Paul Gumm author of lsquoNickrsquos Lawrsquo legislation ldquoThis measure was designed to relieve political pressure on legislators who refuse to even consider Nickrsquos Lawrdquo
When Governor Henry signed Senate Bill 135 he said the measure was just a small step in the effort to help affected Oklahoma families He urged lawmakers to pass legislation to mandate insurance coverage for the treatment of autism
ldquoThere is nothing wrong with this bill just like there is nothing wrong with a pack of shingles at a construction siterdquo said Sen Gumm ldquoIf you try to put the shingles on before you pour the foundation you are doomed to failure As Governor Henry wisely noted when he signed the bill the foundation is insurance coverage of autism Absent that Senate Bill 135 is doomed to failurerdquo
Republican legislative leaders oppose insurance mandates saying they drive up the cost of health insurance despite reports from states with similar insurance mandates that show no significant increase in the cost of premiums
Republicans attempted to pass House Bill 1975 which would only allow insurance legislation to be introduced in oddshynumbered years and approved in evenshynumbered years The bill would have also required a 75 percent supershymajority vote to do away with the mandate in the case of an emergency
Henry vetoed that bill and said it would have unreasonably ldquotied the hands of state policy makers on a very important issuerdquo
ldquoThis would empower a small minority of legislators to thwart legitimate state efforts to address a pressing public policy issue and ensure that the restriction would rarely if ever be liftedrdquo Henry said
Henry also questioned why HB 1975 restrictions were only applied to a single issue area saying it raised legitimate concerns regarding why only one subject would be singled out for special treatment
Autism cont on page 9
Oklahoma Department of Human Services 8 Developmental Disabilities Services Division
SUMMER 2009
Autism cont from page 8
ldquoOklahoma and its citizens are better served when policy makers are allowed the freedom to address any pressing issue in the Legislature without the hindrance of arbitrary restrictionsrdquo Henry said Democrats offered a compromise mdash to put autism coverage in highshy
risk insurance pools as a last resort for families who canrsquot afford the coverage elsewhere Republicans again declined and instead went forward with SB 135 This year three more states enacted Autism Mandate legislation bringing
the total to 11 states that now require insurance companies to cover treatment for autism InterFace NEWSLETTER
Proudly displaying their CPR (Cardio Pulmonary Resuscitation) certificates are (From Left) Guy Bivens Allen Larimore Steve Sposato Andy Edwards Joshua Johnson and Tino Hensley residents of the Independence House
Residents of the Independence House at the Home of Hope in Vinita recently became CPR certified after a fellow resident had a heart attack A staff member used CPR to save Allen Larimorersquos life and he has since received a pacemaker Although staff members must be CPR certified this event inspired Larimorersquos housemates to take the class so they could also be prepared ndash just in case Donna Marlow a CPR trainer from the OKDHS Developmental Disabilities Services Division held the class free of charge at the agency and was proud that all the men passed their tests with flying colors
11th Circuit Rules Doctors donrsquot trump state on Medicaid care for children with disabilities by Alyson M Palmer
A federal appeals panel has declared that treating doctors donrsquot have the final say in how much nursing care the state must provide
children with disabilities under MedicaidOn April 24 the 11th US Circuit Court of Appeals reversed a district
judgersquos decision that had said the state must provide the amount of nursing care that a North Georgia girlrsquos doctor said she needs
Despite a slew of amicus briefs by state governments and Medicaid plan administrators the panel dispatched the case in a twoshypage unpublished unsigned opinion that came out a month after oral argument
Holland amp Knight partner Robert S Highsmith Jr who represented a proshystate friend of the court that provides managed care services for Medicaid programs said his client WellCare of Georgia had been concerned about language in US District Judge Thomas W Thrash Jrrsquos ruling that suggested anything ordered by a treating physician is medically necessary under the law ldquoThat one sentence just had to get reversedrdquo said Highsmith ldquoWe are very excited that they saw and reversed that clear errorrdquo
But an advocate for the teenage girl at the center of the case Atlanta Legal Aid Society General Counsel David A Webster said Monday that the decision ldquodoesnrsquot mean muchrdquo and says little about the relationship between the state and the treating physician ldquoThatrsquos going to be open for future litigationrdquo said Webster Webster said the case of his client Anna C Moore will go back to Thrash for the judge to consider the
11th Circuit Rules cont on page 15
Oklahoma Department of Human Services 9 Developmental Disabilities Services Division
I N TERFACE
ImaginingEverest The Story of LaelBy Adrienne Benz
ldquoI prayed for God to open the eyes of my understanding and the pieces began to fall into place Mollyrsquos future had been planned since she was a young girl she would marry andhave a bright healthy family known for their intelligence andkindness However the birth of her first born quickly dispelled the myth of the stereotypically perfect family as Molly learns her son Lael has Down syndrome Struggling to accept the disconcerting news and understand Godrsquos perfect plan Molly faces a challenge no more daunting than the climbing of the greatMt Everest she often dreamed of as a child Guilt hope grief and happiness take Molly and Lael across rocky terrain and risky edges but faith and the resonant voice of God bring mother and son up the emotional mountain 30 years in the making ndash a mountain that revealed the aptitude of Mollyrsquos beloved son and the kindness of others By Imagining Everest Molly and Lael forge a unique and amazing relationship which allows them to overcome even the most intimidating ascension into the unknownrdquo
Molly Mathewrsquos son Lael currently receives services through the OKDHSDDSD community waiver program
264 pages shy $1499 (paperback) This book is available online through Tate Publishing wwwtatepublishingcombookstore
Health and Human Services rescinds Medicaid regulations affecting case management
Department of Health and Human Services (HHS) Secretary
Kathleen Sebelius announed June 29 that the administration will rescind all or part of three Medicaid regulations that were previously
issued and delay the enforcement of a fourth regulation Each of these
rules in whole or in part had been subject to Congressional moratoria
set to expire on July 1 2009ldquoThese regulations if left in place would have potentially adverse
consequences for Medicaid beneficiaries some of our nationrsquos most vulnerable peoplerdquo said Secretary Sebelius ldquoBy rescinding
these rules we can expect that children will continue receiving
services through their schools beneficiaries will be able to
access all available case management resources to help them
better manage their health care and outpatient hospital and
clinic services can continue to be covered in the most efficient mannerrdquo
This ruling was crucial to Oklahomarsquos Developmental Disabilities Services as the state could have lost the ability
to bill Medicaid for 100 percent of the cost of providing
case management services to waiver service recipients which totals approximately $22 million per year
ldquoThe actions we are taking today are necessary to
ensure that the states have the flexibility they need to
fully serve Medicaidshyeligible individualsrdquo said
Secretary Sebelius
The Centers for Medicare amp Medicaid
Services (CMS) and HHS arebull Rescinding provisions of an interim final rule
published Dec 4 2007 which would have restricted beneficiary access to case management services These provisions appeared to in practice restrict beneficiary access to needed covered case management services and limit state flexibility in determining efficient and effective delivery systems for case management services
Regulations Expiring cont on page 11
Oklahoma Department of Human Services 10 Developmental Disabilities Services Division
SUMMER 2 0 0 9
Regulations Expiring cont from page 10
bull Rescinding a final rule published Dec 28 2007 that would have eliminated reimbursement for schoolshybased administrative costs and costs of transportation to and from schools The rescission reflects concern that the rule could limit the Medicaid administrative outreach activities of schools and that the overall budgetary impact on schools could potentially impact their ability to offer Medicaid services to students
bull Rescinding a rule published Nov 7 2008 that would have limited the outpatient hospital and clinic service benefit for Medicaid beneficiaries to the scope of services recognized as an outpatient hospital service under Medicare This rule was rescinded because CMS became aware that coverage beyond that scope could not be easily moved to other benefit categories resulting in great impact than previously anticipated
bull Delaying until June 30 2010 the enforcement of portions of a regulation that clarified limitations on health care related tax programs so that CMS could determine whether states need additional clarification or guidance CMS may also further review the potential impact of the regulation and give additional consideration to alternative approaches InterFace NEWSLETTER
Waiting and HopingBy Adrienne Benz
Sad is like sitting here when I donrsquot have a home to run away to
So there on the street just waiting for something to eat somewhere to stay and a bed to sleep on and someone to hold
And hoping Irsquom still there the next day
They have to get up from the street in the park sitting on a cold chair in the dark
Just waiting for someone to take them in their home Waiting to open up and talk about their hidden feelings
like they canrsquot wait any longer
Adrienne Benz was a child in state custody when she wrote this poem She is now an adult reunited with her family
Oklahoma Department of Human Services 11 Developmental Disabilities Services Division
I N T E R FA C E
DDSD Fiscal Year 2010 Budget Outlook OKDHS Director Howard Hendrick
presented the agencyrsquos Fiscal Year 2010 budget to the Commission for Human Services on June 16 Hendrick emphasized that even with the additional federal stimulus money and other oneshytime funds the agencyrsquos overall funding will be approximately $50 million short of anticipated spending levels To achieve a balanced budget cuts would have to be made within each division The Developmental Disabilities Services Divisionrsquos
share of the cuts amount to approximately 3 percent of the divisionrsquos operating budget ($17 million) Another $200000 had to be identified to fund the new initiative for Applied Behavior Analysis mandated by Senate Bill 135 this legislative sessionDDSD was able to accomplish the budget cuts without
impact to any programs or services through reductionsat the Northern and Southern Oklahoma ResourceCenters The rest of the savings came from reductions in training and professional contracts the divisions holds with various entitiesOver the next year DDSD will be under a selfshyimposed hiring
freeze for all positions except for case management direct care professionals and registered nursesIf monthly state revenue collections continue to fall below
expected levels additional reductions may be required of all stateagenciesrsquo operating budgets
Interim StudiesThere will be two interim legislative studies conducted this summer that could impact DDSD and service recipients
One of these studies will investigate a possible provider feetax on agencies providing waiver community services If the provider feetax is found to be within federal Medicaid guidelines it could possibly be used to fund rate increases in waiver services
The other legislative study will look into the pros and cons of online training versus classroom training specifically for providers of DDSD community services
Money Follows the PersonAs of this date DDSD has transitioned eight people from Northern Oklahoma Resource Center of Enid and Southern Oklahoma Resource Center into community homes using the federal Money Follows the Person grant Utilizing these federal funds DDSD has been able to save approximately $21000 in the community services provided to those individuals
Oklahoma documentary on developmental disabilities history to air on OETA
an
Oklahoma
document
ary
Adocumentary showing Oklahomarsquos history serving people with intellectual and developmental disabilities is
scheduled to begin airing on OETA (Oklahomarsquos Education Television Authority) in October during national Disabilities Awareness Month
The video ldquoWagons to Waivers A Century of Changerdquo narrated by Oklahomarsquos own country music star Reba McEntire will be broadcast on the OETAshyOklahoma channel starting on Oct 24th at 5 pm and on Nov 5th at 830 pm The program will be
aired a couple times a month
The documentary takes viewers on an emotional journey from the days of the Dust Bowl and covered wagons and shows the statersquos progression from institutional services to full community inclusion for persons with intellectual disabilities Oklahomarsquos story begins in 1909
with the creation of the Institute for the Feeble Minded in Enid and includes the
tears and efforts of parents the stories ofpeople who grew up in institutions the legal struggles and the triumph of selfshyadvocacy The video was produced by the Oklahoma Department of Human Services Developmental Disabilities Services Division
OETAshyOKLA is Cox Cable channel 112 but other television carriers as well as satellite users can access the channel which is devoted to Oklahomashyspecific programming Check your local television lis tings for specific programming dates and times
Oklahoma Department of Human Services 12 Developmental Disabilities Services Division
SUMMER 2009Compassion friendship and longevity A good measure of success
The day had finally come and Danny waited anxiously on the sofa He watched quietly as the
nursing staff set up the hospital bed and made his friend Carl comfortable The minute all was clear Danny went to Carl and told him how much he had missed him and that he needed him to get better Dannyrsquos longshytime friend had just undergone surgery
to remove a malignant brain tumor Danny didnrsquot understand the procedure or Carlrsquos prognosis ndash all that mattered was that his best friend was home It just wasnrsquot home without CarlCarl is considered the head of the household that he shares
with Danny and his other friend Hershel Carl was always the one who planned their meals said the prayers at the diningroom table and got them involved in Special Olympics events When Carl became ill and went to the hospital it was Danny
who stepped up and tried to fill in ndash just until Carl came home ldquoThe Three Musketeersrdquo (thatrsquos what their staff call them) have
been friends and have lived together for more than 30 years
Danny (lef
t) spends
hours by
Carlrsquos sid
e
encourag
ing him in his
recovery
They met as boys at The Hissom Memorial Center the nowshyclosed institution in Sand Springs for persons with developmental disabilities When they aged out of Hissom the three moved about the same time to a private facility where they lived for many years
In 1993 The Musketeers were given the opportunity to move together once again into a house in their community supported through the DDSD Medicaid Community Waiver program Since
that time they have lived in the house withsome of the same staffmembers who havecared for them for morethan 20 years
The Three Musketeers Danny (left) shows his excitement over his friend Carlrsquos (right) return from the hospital after brain surgery Shy Hershel (center) wipes tears from his eyes
Carl is recoveringfrom his surgery andworking on his abilityto speak and onregaining the use of theleft side of his bodyThe staff in the home
often has to make Danny go to bed at 1 am when hersquos still sitting beside Carl encouraging him to get better so he can go back to work
All three men have jobs and love their work ndash Carlmost of all Danny somehow knows that if Carl canjust get back to work life will continue as they onceknew it
ldquoTheyrsquore like a wellshysettled familyrdquo said Gretchen Moser their DDSD case manager ldquoEven their families consider these guys a family and respect their wishesrdquo
These days there are many opinions about what constitutes a family or even success But there are stories that transcend those discussions Stories like these that remind us success can also be measured by the love and longevity of a friend InterFace NEWSLETTER
Relations
hips
Oklahoma Department of Human Services 13 Developmental Disabilities Services Division
I N T E R F A C E
StateLegislativeNews
Of the thousand or more bills filed at the beginning of the 2009 legislative session only a few made it through the entire process that will have an impact on persons with developmental disabilities families and professionals in the field They are
HB 1007 mdash Wesselhoft Leftwich Signed by the Governor Requires specific Physically Disabled person signage to be posted as a reserved area for the parking of a vehicle displaying a valid permit
HB 1019 mdash WrightSigned by the Governor Recreates the Group Homes for Persons with Developmental or Physical Disabilities Advisory Board
HB 1048 mdash Banz AldridgeSigned by the Governor Relates to the collection of delinquent real property taxes removes physically disabled from ldquoincapacitatedrdquo persons granted additional time to redeem personal items reduces time to collect excess sale proceeds by half
HB 1065 mdash Faught Crain Signed by the Governor Relates to the Continuum of Care and Assisted Living Act adds definition and requires inspection results to be posted on website
HB 1424 mdash Protor Signed by the Governor Requires treatment facilities transitional living facilities halfway houses and any house or facility that may be used for medical or nonmedical detoxification to mail notification to property owners within a quarter mile radius if zoning changes are proposed
HB 1461 mdash Sears Ford Signed by the Governor A school that does not make adequate yearly progress for two straight years shall utilize the assistance of a school support team formed by the State Department of Education EMERGENCY
HB 1581 mdash Coody Jolley Signed by the Governor School teacher candidates that wish to teach elementary early childhood education or special education programs must study the five elements of reading instruction EMERGENCY
HB 1763 mdash Enns Reynolds Signed by the Governor Requires the state Department of Education to provide special education training for process hearing officers to ensure adequate knowledge in special education laws and proceduresEMERGENCY
HB 1893 mdash Peterson Anderson Signed by the Governor Creates the Aging and Disability Resource Consortium to work with other agencies in developing and implementing a singleshypointshyofshyentry concept for aging and disability groups in Oklahoma
SB 135 mdash Johnson Mike Signed by the Governor Provides for the licensing of certain persons to practice as a licensed behavior analyst or a licensed assistant behavior analyst and to study children with autism and their behaviors directs funds to be used by the Department of Human Services Developmental Disabilities Services division for training SoonerStart providers to treat children with autism spectrum disorders provides for a behavorial analysis research pilot project provides legislative intent
SB 518 mdash Justice Osborn Signed by the Governor Adds grandparents as members of immediate family
SB 871 mdash Anderson Signed by the Governor Modifies membership of the Electronic and Information Technology Accessibility Advisory Council
Oklahoma Department of Human Services 14 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
11th Circuit Rules cont from page 9
matter again Moore a teenager living in North Georgia who goes by ldquoCallierdquo has been receiving inshyhome nursing care paid for by Medicaid for about a decade The state has been trying to cut the number of hours of care she receives each week
The 11th Circuit interpreted a federal law that says states participating in the Medicaid program must provide ldquoearly and periodic screening diagnostic and treatment servicesrdquo that are necessary to ldquocorrect or ameliorate defects and physical and mental illnessesrdquo in Medicaidshyeligible children The primary ways children become eligible for Medicaid are that they come from a lowshyincome family or have a disability according to Joshua H Norris another one of Calliersquos lawyers
Georgiarsquos Department of Community Health operates a program to administer Medicaidshyfunded nursing services for several hundred children who need nursing care It delegates the decisions about approval of such services to an organization called the Georgia Medical Care Foundation
According to Thrashrsquos order Callie is disabled because of a stroke she experienced in utero and suffers from various chronic conditions including mental retardation and cerebral palsy She lives at home and according to the statersquos brief attends an elementary school in Athens Ga three days a week Her lawyers have said she requires constant care
The statersquos lawyers have said that nursing hours can be reduced when the patientrsquos medical condition stabilizes positing that a goal of the program is to teach parents and other caregivers to take care of their children on their own The Mooresrsquo lawyers have contended that the statersquos system of ldquoweaningrdquo patients off their nursing services as long as theyrsquore staying out of the hospitaland not getting worse follows a different standard than that set by federal law
In 2006 the state informed Calliersquos mother that it was reducing Calliersquos nursing hours from 94 hours a week to 84 contrary to the recommendation of Calliersquos primary care physician Calliersquos mother filed suit
The Mooresrsquo lawyers convinced Thrash that the reduction was improper Afterissuing multiple injunctions in Calliersquos favor he denied the statersquos motion for summary judgment and granted the Mooresrsquo motion in part concluding the state must provide for the amount of skilled nursing care that Calliersquos treating physician deems necessary The panel that ruled in favor of the state in its appeal was comprised of Senior 11th Circuit Judge R Lanier Anderson III 11th Circuit Judge Gerald B Tjoflat and US District Judge Lisa Godbey Wood visiting from the Southern District of Georgia
The panel said both the state and Calliersquos physician have roles in determining whatrsquos medically necessary to correct or ameliorate Calliersquos medical conditions It cited a federal regulation that says a Medicaid agency ldquomay place appropriate limits on a service based on such criteria as medical necessity or utilization control proceduresrdquo
ldquoA private physicianrsquos word on medical necessity is not dispositiverdquo the panel concluded
Assistant Attorney General Virginia B Fuller made the successful oral argument for the state last month Attorney General Thurbert E Bakerrsquos spokesman Russ Willard said in an eshymail that the state ldquois appreciative of the Court of Appeals decision recognizing the role of the Medicaid program in providing for this treatmentrdquo
Norris who also is director of legal advocacy for a nonprofit that advocates for people with disabilities said the 11th Circuit gave Thrash
an opportunity to say more about the roles of treating doctors and the state in deciding what care the state needs to provide Norris noted that Thrash wrote on the subject last year in another nursing care case about a Savannah Ga boy who nearly drowned when he was 2Thrash barred the state from enforcing a policy of not providing nursing care for patients requiring 16
to 24 hours per day for more than one week he said that criteria isnrsquot based on whatrsquos medically necessary under federal Medicaid law
On the other handThrash denied the plaintiff rsquos request based on the
treating physicianrsquos recommendation for 24shyhourshyashyday private nursing services for an
indefinite period of time Thrash deemed such a prescription ldquoan abuse of the Medicaid systemrdquo
The state has limited discretion to deny a providerrsquos request for care under the ldquoearly and periodic
screening diagnostic and treatment servicesrdquo portion of the Medicaid Act said Thrash He added that ldquo[t]he statersquos discretion is limited to a review of the request for fraud abuse of the Medicaid system and whether the service is within the reasonable
standards of medical carerdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 15 Developmental Disabilities Services Division
klahoma Department of Human Services
I N T E R F A C E
DDSD Area II Project Elves get together to wrap all the presents and make sure they are delivered to the individuals before Christmas Elves work year round
to make Christmas special for DDSD clients For the past eight years individuals with
developmental disabilities who donrsquot have families or who would otherwise not receive gifts have had their Christmas wishes come true thanks to caring DDSD ldquoelvesrdquo in Area II Project Elf is the brainchild of ldquoThe Men in Recrdquo namely
Steve Pitts and Roger McDaniel DDSD Area II recreational therapists and Joe Stie DDSD case manager ldquoDDSD serves a lot of people with developmental
disabilities who donrsquot have families to celebrate the holidays withrdquo said Pitts ldquoAlthough our services meet their basic needs therersquos still a gap when it comes to those special things that families do for one anotherrdquoThat gap has been filled by The Men in Rec who work all year
long coordinating various events to raise money to buy Christmas presents for individuals ldquoWe raise all of the funds and no OKDHS money is usedrdquo said
Pitts ldquoThis year we are selling Blue and Gold sausage and Amish jams We also have an annual Christmas Carol fundraising performance which is donated to Project Elf by the American Theater Company We are given 300 tickets that we can sell and last year we sold 225rdquoDDSD coshyworkers got together and purchased 44 of those theater
tickets last year for the children who happened to be in the Laura Dester Center Shelter around the holidays ldquoWe have also set up a sponsorship program where people can purchase
the gift and return it wrapped and ready for the elf (aka case manager) to deliver This last Christmas we had 108 sponsors 30 of whom were the case managers themselvesrdquo
The Men in Rec also recruit fellow DDSD workers to help shop for the gifts and wrap themldquoWe could not accomplish this awesome Project Elf without the assistance of so many of our coshyworkers and our community volunteersrdquo he said ldquoItrsquos such a pleasure to share these gifts at Christmas time and let our customers know that they have a family through our good service to themrdquoThe Men in Rec are currently working to raise money for this yearrsquos Christmas gifts If you would like to join the rank of DDSD Elves by donating funds or becoming a sponsor please contact Steve Pitts at stevepittsokdhsorg or call918shy794shy7625 InterFace NEWSLETTER
Steve Pitts (right) DDSD Area II recreational therapist gives a donated WalshyMart gift card to case manager Roy Willett to purchase a Christmas gift for one of the people on his caseload
Oklahoma Department of Human Services 16 Developmental Disabilities Services Division
shy shyshy shy
shy shy
shy shy
shy shy
shy shy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
Developmental Disabilities Services Area Offices and Resource Centers
CUSTER
ELLIS
BECKHAM WASHITA CADDO
McCLAIN
SEM
INO
LE HUGHES HASKELL
LE FLORELATIMER PITTSBURG
COAL
ATOKA
PONTOTOC
JOHNSTON
GARVIN
MURRAY
CARTER
LOVE
BRYAN CHOCTAW
PUSHMATAHA McCURTAIN
GRADY
KIOWA
TILLMAN
JACKSON HA
RM
ON
GREER
COTTON
JEFFERSON
STEPHENS
COMANCHE
McINTOSH
CLEVELAND
POTT
AWAT
OM
IE
DEWEY BLAINE
CANADIAN
MAJOR
GRANT KAY OSAGE
WA
SHIN
GTO
N CRAIG
ROGERS
CH
ERO
KEE
ADAIR TULSA
WAGONER
MAYES
OKMULGEE
CREEK
LINCOLN
LOGAN
PAYNE
KINGFISHER
OKLAHOMA OKFUSKEE
MUSKOGEE SEQUOYAH
DEL
AWA
RE
OTTAWA NOATTA
GARFIELD NOBLE
PAWNEE
WOODS ALFALFA HARPER BEAVER TEXASCIMARRON
WOODWARD
ROGER MILLS
MARSH
Oklahoma CityOklahoma City
Tulsa
Area II
Area III
Area I
Pauls Valley
Enid
wwwokdhsorg
State Officetoll free 1shy866shy521shy3571
AREA Itoll free 1shy800shy522shy1064
AREA IItoll free 1shy800shy522shy1075
AREA IIItoll free 1shy800shy522shy1086
Greer Center (Enid)2501 NE Delaware Enid OK 73701
580 237 10272599 FAX 580 213 2799
Northwest Oklahoma Resource Center at Enid (NORCE)2600 E Willow
Enid OK 73701
580 237 1027
FAX 580 548 2600
Southern Oklahoma Resource Center at Pauls Valley (SORC)3210 Chickasaw St
Pauls Valley OK 73075 6822
405 238 6401
FAX 405 238 8261
DDSD Area I Office (Enid)729 Overland Trail Enid OK 73703
580 548 8900 FAX 580 548 8964
DDSD Area I Office (Oklahoma City)4545 N Lincoln Blvd
Oklahoma City OK 73105 405 522 6925
FAX 405 522 6995
DDSD Area II Office (Tulsa)Laura Dester Center 1427 E 8th Tulsa OK 74120
918 560 4848 FAX 918 560 4898
DDSD Area III Office (Pauls Valley)301 S Indian Meridian Rd Pauls Valley OK 73075
405 238 4700 FAX 405 238 4740
If you would like to find out what the DevelopmentalDisabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
If you would like to find out what the Developmental Disabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
This will take you to the main Oklahoma Department of Human Services Web page From there just click on Divisions and Offices and the Developmental Disabilities Services Division On our Web site you will find information about services the division offers how to apply for services eligibility policies contract provider agencies and much more
Come visit us today You may be surprised at what you will learn
OKLAHOMA DEPARTMENT OF HUMAN SERVICES Developmental Disabilities Services DivisionPO Box 25352 Oklahoma City OK 73125
I N T E R FA C E
Governorrsquos Disability Employment Awards
Showcase
Steve Scott (Right) receives a 2008 Governorrsquos Disability Employment Award for his outstanding work from Howard Hendrick Cabinet Secretary of Human Services and Director of the Oklahoma Department of Human Services Scott was recognized for working 19 years with the same WalshyMart store in Sand Springs During that time Scott has received several promotions and pay raises
Oklahom
arsquos
reason to
brag
Oklahoma may be best known around the country for excellence in many
things from college football to producing awardshywinning countryshywesternmusic stars Probably not as well known is the fact that Oklahoma is the best state
in the nation at supporting people with developmental disabilities to work
in competitive jobs according to an independent ranking by the Institute
for Community Inclusion at the University of Massachusetts BostonldquoFor the past three years Oklahoma has led the nation in assisting people with
developmental disabilities to find competitive jobs and become working taxpayersrdquo said James Nicholson Director of the OKDHS Developmental Disabilities Services Division ldquoToday more than 60 percent of individuals with developmental disabilities served by our division participate in supported employment servicesrdquo
The Governorrsquos Disability Employment Awards are held each October to
recognize individuals with disabilities for their outstanding achievements at work
through the supported employment program Also recognized are businesses that hire people with disabilities and members of the media who promote supported
employment programs The Governorrsquos Disability Employment Awards are coshysponsored by Governor
Brad Henry and Lt Governor Jari Askins along with OKDHSshyDDSD the Department of Rehabilitation Services and the Oklahoma Association
of Persons in Supported Employment
The 2009 Governorrsquos Disability Employment awards will be held on
Oct 22 130 pm at the Governorrsquos Mansion Pavilion in Oklahoma City
InterFace NEWSLETTER
The 2008 award Receipeints wereBUS INESS WINNERS
Gene LukerAramark Glass Plant Tulsa
Gary CookMcDonaldrsquos Ardmore
WalshyMartCushing
Mike amp Terry GentryMcDonaldrsquos Lawton
Joyce and Fred HannahLektron LED Lighting Tulsa
Pizza HutCushing
Guest InnArdmore
JonMilneSODEXO Langston
WalshyMartMoore
City of Muskogee
Angela OwensSonic DriveshyIn Ardmore
WalshyMart Super CenterSand Springs
WalshyMart Super CenterVinita
MED IA WINNER
Dawndee Bostwichreporter Duncan Banner
EMPLOYEE WINNERS
Bobby Bailey
Bob Bennett
Tammie Burrall
Andy Cheater
Tommy Coleman
Jeff Dickson
Chad Joyce
Allen Kouba
Linda Prowell
Phillip Reed
Peter Rowland
Steve Scott
Kenneth Smith
Judy Wolfe
James Young
Oklahoma Department of Human Services 4 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
DDSD employees win advocacy awards
Angela King DDSD Area II case manager and Cindy
Jennings DDSD Area III nurse received awards from TARC in December 2008 King received the
AdvocateshyCase Manager of the Year award while
Jennings was recognized with a Special Achievement in
Advocacy AwardKing has nearly 20 years of experience in DDSD
case management working with individuals on every
type of waiver including the pilot project for the InshyHome Support waiver King began her career in the
field as a direct support professional before
becoming a recreational therapist and case
manager transitioning individuals from The
Hissom Memorial Center King gives each
person on her caseload the individual attention
they need regardless of the time it takes As a
recent example of her advocacy and
dedication she assisted a woman on her caseload in the process of obtaining
a divorce from her husband of many
years King referred the woman to a
community resource for legal advice
assisted her in completing all of the legal paperwork attended
court hearings with her and then took the woman apartment hunting
King even helped her move into the new apartment unpack and
decorate King has been known for her attention to detail and is extremely conscientious exemplifying her commitment to those
she servesJennings has volunteered for Oklahoma People First for the last
11 years assisting in the establishment of new chapters planning
state conferences writing grants to secure funding and soliciting
donations for conferences As an OPF volunteer Jennings is passionate about teaching individuals to advocate for themselves Her belief in their abilities empowers them to have faith in
themselves and in their abilities to make choices She educates OPF members on increasing their independence vocational opportunities voting relationships and community involvement Jennings empowers OPF members by offering them a support network to turn to when in need of assistance By doing so she
teaches others to recognize how much persons with developmental disabilities can do for themselves if given the right supports
InterFace NEWSLETTER
To see Oklahomarsquos ranking as compared to other states in regard to the numbers of persons with developmental disabilities in competitive jobs (supported employment)go to
wwwstatedatainfo
This website is a project of the Institute for Community Inclusion at UMass Boston supported in part by the Administration on Developmental Disabilities US Department of Health and Human Services under cooperative agreement with additional support from the National Institute on Disability and Rehabilitation Research of the US Department of Education
Angela King DDSD Area II case manager is presented with the AdvocateshyCase Manager of the Year award by John Gajda executive director TARC
Cindy Jennings DDSD Area III nurse is presented with a Special Achievement in Advocacy Award by John Gajda executive director TARC
Oklahoma Department of Human Services 5 Developmental Disabilities Services Division
I N T E R F A C E
Quality
AwardsBest of the Best
Regina ChacePrograms Manager for DDSD Employment Services
Regina Chace Program Manager for DDSD Employment Services receives an OKDHS Quality Award Best of the Best for her leadership in this program Chace ensures there are policies and processes which support participants to have a full range of opportunities for employment As a result Oklahoma has been recognized as the nationrsquos leader in achieving impressive outcomes in integrated employment for people with
disabilities InterFace NEWSLETTER
A Dream Come True Bobby Cooper and his parents were invited by Governor Brad Henry to meet with him and visit the capitol Tom Cooper Bobbyrsquos father is a member of the Governorrsquos Council for United We Ride representing people with disabilities Tom mentioned to Governor Henry in a letter that it had been Bobbyrsquos dream to meet him after seeing him speak on television during his reshyelection Governor Henry was so flattered by Bobbyrsquos request that he invited the whole family for a visit to the capitol in November 2008 They took a few moments to pose for this photograph in the Governorrsquos Blue Room From left Tom Cooper BobbyGovernor Henry and Ruth Cooper
Oklahoma Department of Human Services 6 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
James Nicholson Director of the OKDHS Developmental Disabilities Services Division is presented with a 2009 College of Allied Health Citation for Special Contributions (Left to Right) Jeff Berry Chair College of Allied Health Awards and Honors Committee College Dean Kevin Rudeen Nicholson and Martha Ferretti Professor and Chair Physical Therapy Department of Rehabilitation Sciences College of Allied Health
DDSD Nicholson receives award for contributions to College of Allied Health
On April 2 2009 James Nicholson Director of the OKDHS Developmental Disabilities Services
Division was presented with the 2009 College of AlliedHealth Citation for Special Contributions Nicholson was nominated for this award by Martha
Ferretti Professor and Chair Physical Therapy Department of Rehabilitation Sciences College of Allied Health University of Oklahoma Health Sciences Center In the nomination for this award Ferretti wrote ldquoMr Nicholsonrsquos background is one of diversity and richness
His work ethic sets a standard for us all to follow His calmness humor and general goodwill in the midst of controversy is obvious and remarkable And first and foremost his dedication to improving the lives of children and adults with developmental disabilities has set a standard for us all to emulate Mr Nicholsonrsquos creativity thoughtfulness and ability to target a goal and accomplish it regularly in collaboration with a number of formal and informal partners prove the importance of reaching beyond onersquos own resourcesldquoAs a visionary in the field of developmental disabilities early in his
role as director Mr Nicholson caught the attention of both supporters and detractors His vision was a perfect match for what our faculty were striving to accomplish in preparing our students and in providing servicesin the field of developmental disabilities ldquoWe approached Mr Nicholson shortly after he became the director with
a proposal for introducing assistive technology into the DDSD system differently than had been accomplished at that point Over the past 18 years
he and members of his staff have continued that collaboration on projects that addressed both major and minor challenges
about policy and services for Oklahomans with developmental disabilities
ldquoOur faculty has learned so much from this very politically astute and professional state leader Before the state was aware of its challenges emerging from children with autism and their families Mr Nicholson quietly accepted the mantle of addressing what we have come to know are unbelievable challenges presented by the impact of autism Seven years ago he convened a multishyagency multishydisciplinary task force that included parents of individuals with autism to develop the Oklahoma State Plan for Autism and the Oklahoma Autism Network We are honored by him placing the OAN within the structure of the College
ldquoMr Nicholson has stimulated us to mature as educators researchers and service providers to more effectively address many of Oklahomarsquos needs in the field of
developmental disabilitiesrdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 7 Developmental Disabilities Services Division
Nickrsquos Law
I N T E R F A C E
Insurance Mandates for autism treatments fail once again to pass Oklahoma legislature
For the second consecutive year bills that would have mandated insurance companies to cover
treatments for autism failed to pass through the Republicanshycontrolled legislatureIn February the House Economic Development and
Financial Services Committee voted down House Bill 1312 also known as ldquoNickrsquos Lawrdquo which would have required insurance providers to cover autism treatment The only autismshyrelated bills that did receive enough
support to pass were House Bill 2027 and its companion Senate Bill 135 The Senate version made it through the legislative process and will enact a licensing process for national board certified behavior analysts and enhance existing state programs that would train doctors to diagnose and treat autism Critics of this bill question whether it will actually produce
significant new services if insurance doesnrsquot cover the cost of treatment and parents canrsquot afford to pay the bill
ldquoSadly this bill will do nothing to relieve the pressure on families struggling to care for children with autismrdquo said Sen Jay Paul Gumm author of lsquoNickrsquos Lawrsquo legislation ldquoThis measure was designed to relieve political pressure on legislators who refuse to even consider Nickrsquos Lawrdquo
When Governor Henry signed Senate Bill 135 he said the measure was just a small step in the effort to help affected Oklahoma families He urged lawmakers to pass legislation to mandate insurance coverage for the treatment of autism
ldquoThere is nothing wrong with this bill just like there is nothing wrong with a pack of shingles at a construction siterdquo said Sen Gumm ldquoIf you try to put the shingles on before you pour the foundation you are doomed to failure As Governor Henry wisely noted when he signed the bill the foundation is insurance coverage of autism Absent that Senate Bill 135 is doomed to failurerdquo
Republican legislative leaders oppose insurance mandates saying they drive up the cost of health insurance despite reports from states with similar insurance mandates that show no significant increase in the cost of premiums
Republicans attempted to pass House Bill 1975 which would only allow insurance legislation to be introduced in oddshynumbered years and approved in evenshynumbered years The bill would have also required a 75 percent supershymajority vote to do away with the mandate in the case of an emergency
Henry vetoed that bill and said it would have unreasonably ldquotied the hands of state policy makers on a very important issuerdquo
ldquoThis would empower a small minority of legislators to thwart legitimate state efforts to address a pressing public policy issue and ensure that the restriction would rarely if ever be liftedrdquo Henry said
Henry also questioned why HB 1975 restrictions were only applied to a single issue area saying it raised legitimate concerns regarding why only one subject would be singled out for special treatment
Autism cont on page 9
Oklahoma Department of Human Services 8 Developmental Disabilities Services Division
SUMMER 2009
Autism cont from page 8
ldquoOklahoma and its citizens are better served when policy makers are allowed the freedom to address any pressing issue in the Legislature without the hindrance of arbitrary restrictionsrdquo Henry said Democrats offered a compromise mdash to put autism coverage in highshy
risk insurance pools as a last resort for families who canrsquot afford the coverage elsewhere Republicans again declined and instead went forward with SB 135 This year three more states enacted Autism Mandate legislation bringing
the total to 11 states that now require insurance companies to cover treatment for autism InterFace NEWSLETTER
Proudly displaying their CPR (Cardio Pulmonary Resuscitation) certificates are (From Left) Guy Bivens Allen Larimore Steve Sposato Andy Edwards Joshua Johnson and Tino Hensley residents of the Independence House
Residents of the Independence House at the Home of Hope in Vinita recently became CPR certified after a fellow resident had a heart attack A staff member used CPR to save Allen Larimorersquos life and he has since received a pacemaker Although staff members must be CPR certified this event inspired Larimorersquos housemates to take the class so they could also be prepared ndash just in case Donna Marlow a CPR trainer from the OKDHS Developmental Disabilities Services Division held the class free of charge at the agency and was proud that all the men passed their tests with flying colors
11th Circuit Rules Doctors donrsquot trump state on Medicaid care for children with disabilities by Alyson M Palmer
A federal appeals panel has declared that treating doctors donrsquot have the final say in how much nursing care the state must provide
children with disabilities under MedicaidOn April 24 the 11th US Circuit Court of Appeals reversed a district
judgersquos decision that had said the state must provide the amount of nursing care that a North Georgia girlrsquos doctor said she needs
Despite a slew of amicus briefs by state governments and Medicaid plan administrators the panel dispatched the case in a twoshypage unpublished unsigned opinion that came out a month after oral argument
Holland amp Knight partner Robert S Highsmith Jr who represented a proshystate friend of the court that provides managed care services for Medicaid programs said his client WellCare of Georgia had been concerned about language in US District Judge Thomas W Thrash Jrrsquos ruling that suggested anything ordered by a treating physician is medically necessary under the law ldquoThat one sentence just had to get reversedrdquo said Highsmith ldquoWe are very excited that they saw and reversed that clear errorrdquo
But an advocate for the teenage girl at the center of the case Atlanta Legal Aid Society General Counsel David A Webster said Monday that the decision ldquodoesnrsquot mean muchrdquo and says little about the relationship between the state and the treating physician ldquoThatrsquos going to be open for future litigationrdquo said Webster Webster said the case of his client Anna C Moore will go back to Thrash for the judge to consider the
11th Circuit Rules cont on page 15
Oklahoma Department of Human Services 9 Developmental Disabilities Services Division
I N TERFACE
ImaginingEverest The Story of LaelBy Adrienne Benz
ldquoI prayed for God to open the eyes of my understanding and the pieces began to fall into place Mollyrsquos future had been planned since she was a young girl she would marry andhave a bright healthy family known for their intelligence andkindness However the birth of her first born quickly dispelled the myth of the stereotypically perfect family as Molly learns her son Lael has Down syndrome Struggling to accept the disconcerting news and understand Godrsquos perfect plan Molly faces a challenge no more daunting than the climbing of the greatMt Everest she often dreamed of as a child Guilt hope grief and happiness take Molly and Lael across rocky terrain and risky edges but faith and the resonant voice of God bring mother and son up the emotional mountain 30 years in the making ndash a mountain that revealed the aptitude of Mollyrsquos beloved son and the kindness of others By Imagining Everest Molly and Lael forge a unique and amazing relationship which allows them to overcome even the most intimidating ascension into the unknownrdquo
Molly Mathewrsquos son Lael currently receives services through the OKDHSDDSD community waiver program
264 pages shy $1499 (paperback) This book is available online through Tate Publishing wwwtatepublishingcombookstore
Health and Human Services rescinds Medicaid regulations affecting case management
Department of Health and Human Services (HHS) Secretary
Kathleen Sebelius announed June 29 that the administration will rescind all or part of three Medicaid regulations that were previously
issued and delay the enforcement of a fourth regulation Each of these
rules in whole or in part had been subject to Congressional moratoria
set to expire on July 1 2009ldquoThese regulations if left in place would have potentially adverse
consequences for Medicaid beneficiaries some of our nationrsquos most vulnerable peoplerdquo said Secretary Sebelius ldquoBy rescinding
these rules we can expect that children will continue receiving
services through their schools beneficiaries will be able to
access all available case management resources to help them
better manage their health care and outpatient hospital and
clinic services can continue to be covered in the most efficient mannerrdquo
This ruling was crucial to Oklahomarsquos Developmental Disabilities Services as the state could have lost the ability
to bill Medicaid for 100 percent of the cost of providing
case management services to waiver service recipients which totals approximately $22 million per year
ldquoThe actions we are taking today are necessary to
ensure that the states have the flexibility they need to
fully serve Medicaidshyeligible individualsrdquo said
Secretary Sebelius
The Centers for Medicare amp Medicaid
Services (CMS) and HHS arebull Rescinding provisions of an interim final rule
published Dec 4 2007 which would have restricted beneficiary access to case management services These provisions appeared to in practice restrict beneficiary access to needed covered case management services and limit state flexibility in determining efficient and effective delivery systems for case management services
Regulations Expiring cont on page 11
Oklahoma Department of Human Services 10 Developmental Disabilities Services Division
SUMMER 2 0 0 9
Regulations Expiring cont from page 10
bull Rescinding a final rule published Dec 28 2007 that would have eliminated reimbursement for schoolshybased administrative costs and costs of transportation to and from schools The rescission reflects concern that the rule could limit the Medicaid administrative outreach activities of schools and that the overall budgetary impact on schools could potentially impact their ability to offer Medicaid services to students
bull Rescinding a rule published Nov 7 2008 that would have limited the outpatient hospital and clinic service benefit for Medicaid beneficiaries to the scope of services recognized as an outpatient hospital service under Medicare This rule was rescinded because CMS became aware that coverage beyond that scope could not be easily moved to other benefit categories resulting in great impact than previously anticipated
bull Delaying until June 30 2010 the enforcement of portions of a regulation that clarified limitations on health care related tax programs so that CMS could determine whether states need additional clarification or guidance CMS may also further review the potential impact of the regulation and give additional consideration to alternative approaches InterFace NEWSLETTER
Waiting and HopingBy Adrienne Benz
Sad is like sitting here when I donrsquot have a home to run away to
So there on the street just waiting for something to eat somewhere to stay and a bed to sleep on and someone to hold
And hoping Irsquom still there the next day
They have to get up from the street in the park sitting on a cold chair in the dark
Just waiting for someone to take them in their home Waiting to open up and talk about their hidden feelings
like they canrsquot wait any longer
Adrienne Benz was a child in state custody when she wrote this poem She is now an adult reunited with her family
Oklahoma Department of Human Services 11 Developmental Disabilities Services Division
I N T E R FA C E
DDSD Fiscal Year 2010 Budget Outlook OKDHS Director Howard Hendrick
presented the agencyrsquos Fiscal Year 2010 budget to the Commission for Human Services on June 16 Hendrick emphasized that even with the additional federal stimulus money and other oneshytime funds the agencyrsquos overall funding will be approximately $50 million short of anticipated spending levels To achieve a balanced budget cuts would have to be made within each division The Developmental Disabilities Services Divisionrsquos
share of the cuts amount to approximately 3 percent of the divisionrsquos operating budget ($17 million) Another $200000 had to be identified to fund the new initiative for Applied Behavior Analysis mandated by Senate Bill 135 this legislative sessionDDSD was able to accomplish the budget cuts without
impact to any programs or services through reductionsat the Northern and Southern Oklahoma ResourceCenters The rest of the savings came from reductions in training and professional contracts the divisions holds with various entitiesOver the next year DDSD will be under a selfshyimposed hiring
freeze for all positions except for case management direct care professionals and registered nursesIf monthly state revenue collections continue to fall below
expected levels additional reductions may be required of all stateagenciesrsquo operating budgets
Interim StudiesThere will be two interim legislative studies conducted this summer that could impact DDSD and service recipients
One of these studies will investigate a possible provider feetax on agencies providing waiver community services If the provider feetax is found to be within federal Medicaid guidelines it could possibly be used to fund rate increases in waiver services
The other legislative study will look into the pros and cons of online training versus classroom training specifically for providers of DDSD community services
Money Follows the PersonAs of this date DDSD has transitioned eight people from Northern Oklahoma Resource Center of Enid and Southern Oklahoma Resource Center into community homes using the federal Money Follows the Person grant Utilizing these federal funds DDSD has been able to save approximately $21000 in the community services provided to those individuals
Oklahoma documentary on developmental disabilities history to air on OETA
an
Oklahoma
document
ary
Adocumentary showing Oklahomarsquos history serving people with intellectual and developmental disabilities is
scheduled to begin airing on OETA (Oklahomarsquos Education Television Authority) in October during national Disabilities Awareness Month
The video ldquoWagons to Waivers A Century of Changerdquo narrated by Oklahomarsquos own country music star Reba McEntire will be broadcast on the OETAshyOklahoma channel starting on Oct 24th at 5 pm and on Nov 5th at 830 pm The program will be
aired a couple times a month
The documentary takes viewers on an emotional journey from the days of the Dust Bowl and covered wagons and shows the statersquos progression from institutional services to full community inclusion for persons with intellectual disabilities Oklahomarsquos story begins in 1909
with the creation of the Institute for the Feeble Minded in Enid and includes the
tears and efforts of parents the stories ofpeople who grew up in institutions the legal struggles and the triumph of selfshyadvocacy The video was produced by the Oklahoma Department of Human Services Developmental Disabilities Services Division
OETAshyOKLA is Cox Cable channel 112 but other television carriers as well as satellite users can access the channel which is devoted to Oklahomashyspecific programming Check your local television lis tings for specific programming dates and times
Oklahoma Department of Human Services 12 Developmental Disabilities Services Division
SUMMER 2009Compassion friendship and longevity A good measure of success
The day had finally come and Danny waited anxiously on the sofa He watched quietly as the
nursing staff set up the hospital bed and made his friend Carl comfortable The minute all was clear Danny went to Carl and told him how much he had missed him and that he needed him to get better Dannyrsquos longshytime friend had just undergone surgery
to remove a malignant brain tumor Danny didnrsquot understand the procedure or Carlrsquos prognosis ndash all that mattered was that his best friend was home It just wasnrsquot home without CarlCarl is considered the head of the household that he shares
with Danny and his other friend Hershel Carl was always the one who planned their meals said the prayers at the diningroom table and got them involved in Special Olympics events When Carl became ill and went to the hospital it was Danny
who stepped up and tried to fill in ndash just until Carl came home ldquoThe Three Musketeersrdquo (thatrsquos what their staff call them) have
been friends and have lived together for more than 30 years
Danny (lef
t) spends
hours by
Carlrsquos sid
e
encourag
ing him in his
recovery
They met as boys at The Hissom Memorial Center the nowshyclosed institution in Sand Springs for persons with developmental disabilities When they aged out of Hissom the three moved about the same time to a private facility where they lived for many years
In 1993 The Musketeers were given the opportunity to move together once again into a house in their community supported through the DDSD Medicaid Community Waiver program Since
that time they have lived in the house withsome of the same staffmembers who havecared for them for morethan 20 years
The Three Musketeers Danny (left) shows his excitement over his friend Carlrsquos (right) return from the hospital after brain surgery Shy Hershel (center) wipes tears from his eyes
Carl is recoveringfrom his surgery andworking on his abilityto speak and onregaining the use of theleft side of his bodyThe staff in the home
often has to make Danny go to bed at 1 am when hersquos still sitting beside Carl encouraging him to get better so he can go back to work
All three men have jobs and love their work ndash Carlmost of all Danny somehow knows that if Carl canjust get back to work life will continue as they onceknew it
ldquoTheyrsquore like a wellshysettled familyrdquo said Gretchen Moser their DDSD case manager ldquoEven their families consider these guys a family and respect their wishesrdquo
These days there are many opinions about what constitutes a family or even success But there are stories that transcend those discussions Stories like these that remind us success can also be measured by the love and longevity of a friend InterFace NEWSLETTER
Relations
hips
Oklahoma Department of Human Services 13 Developmental Disabilities Services Division
I N T E R F A C E
StateLegislativeNews
Of the thousand or more bills filed at the beginning of the 2009 legislative session only a few made it through the entire process that will have an impact on persons with developmental disabilities families and professionals in the field They are
HB 1007 mdash Wesselhoft Leftwich Signed by the Governor Requires specific Physically Disabled person signage to be posted as a reserved area for the parking of a vehicle displaying a valid permit
HB 1019 mdash WrightSigned by the Governor Recreates the Group Homes for Persons with Developmental or Physical Disabilities Advisory Board
HB 1048 mdash Banz AldridgeSigned by the Governor Relates to the collection of delinquent real property taxes removes physically disabled from ldquoincapacitatedrdquo persons granted additional time to redeem personal items reduces time to collect excess sale proceeds by half
HB 1065 mdash Faught Crain Signed by the Governor Relates to the Continuum of Care and Assisted Living Act adds definition and requires inspection results to be posted on website
HB 1424 mdash Protor Signed by the Governor Requires treatment facilities transitional living facilities halfway houses and any house or facility that may be used for medical or nonmedical detoxification to mail notification to property owners within a quarter mile radius if zoning changes are proposed
HB 1461 mdash Sears Ford Signed by the Governor A school that does not make adequate yearly progress for two straight years shall utilize the assistance of a school support team formed by the State Department of Education EMERGENCY
HB 1581 mdash Coody Jolley Signed by the Governor School teacher candidates that wish to teach elementary early childhood education or special education programs must study the five elements of reading instruction EMERGENCY
HB 1763 mdash Enns Reynolds Signed by the Governor Requires the state Department of Education to provide special education training for process hearing officers to ensure adequate knowledge in special education laws and proceduresEMERGENCY
HB 1893 mdash Peterson Anderson Signed by the Governor Creates the Aging and Disability Resource Consortium to work with other agencies in developing and implementing a singleshypointshyofshyentry concept for aging and disability groups in Oklahoma
SB 135 mdash Johnson Mike Signed by the Governor Provides for the licensing of certain persons to practice as a licensed behavior analyst or a licensed assistant behavior analyst and to study children with autism and their behaviors directs funds to be used by the Department of Human Services Developmental Disabilities Services division for training SoonerStart providers to treat children with autism spectrum disorders provides for a behavorial analysis research pilot project provides legislative intent
SB 518 mdash Justice Osborn Signed by the Governor Adds grandparents as members of immediate family
SB 871 mdash Anderson Signed by the Governor Modifies membership of the Electronic and Information Technology Accessibility Advisory Council
Oklahoma Department of Human Services 14 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
11th Circuit Rules cont from page 9
matter again Moore a teenager living in North Georgia who goes by ldquoCallierdquo has been receiving inshyhome nursing care paid for by Medicaid for about a decade The state has been trying to cut the number of hours of care she receives each week
The 11th Circuit interpreted a federal law that says states participating in the Medicaid program must provide ldquoearly and periodic screening diagnostic and treatment servicesrdquo that are necessary to ldquocorrect or ameliorate defects and physical and mental illnessesrdquo in Medicaidshyeligible children The primary ways children become eligible for Medicaid are that they come from a lowshyincome family or have a disability according to Joshua H Norris another one of Calliersquos lawyers
Georgiarsquos Department of Community Health operates a program to administer Medicaidshyfunded nursing services for several hundred children who need nursing care It delegates the decisions about approval of such services to an organization called the Georgia Medical Care Foundation
According to Thrashrsquos order Callie is disabled because of a stroke she experienced in utero and suffers from various chronic conditions including mental retardation and cerebral palsy She lives at home and according to the statersquos brief attends an elementary school in Athens Ga three days a week Her lawyers have said she requires constant care
The statersquos lawyers have said that nursing hours can be reduced when the patientrsquos medical condition stabilizes positing that a goal of the program is to teach parents and other caregivers to take care of their children on their own The Mooresrsquo lawyers have contended that the statersquos system of ldquoweaningrdquo patients off their nursing services as long as theyrsquore staying out of the hospitaland not getting worse follows a different standard than that set by federal law
In 2006 the state informed Calliersquos mother that it was reducing Calliersquos nursing hours from 94 hours a week to 84 contrary to the recommendation of Calliersquos primary care physician Calliersquos mother filed suit
The Mooresrsquo lawyers convinced Thrash that the reduction was improper Afterissuing multiple injunctions in Calliersquos favor he denied the statersquos motion for summary judgment and granted the Mooresrsquo motion in part concluding the state must provide for the amount of skilled nursing care that Calliersquos treating physician deems necessary The panel that ruled in favor of the state in its appeal was comprised of Senior 11th Circuit Judge R Lanier Anderson III 11th Circuit Judge Gerald B Tjoflat and US District Judge Lisa Godbey Wood visiting from the Southern District of Georgia
The panel said both the state and Calliersquos physician have roles in determining whatrsquos medically necessary to correct or ameliorate Calliersquos medical conditions It cited a federal regulation that says a Medicaid agency ldquomay place appropriate limits on a service based on such criteria as medical necessity or utilization control proceduresrdquo
ldquoA private physicianrsquos word on medical necessity is not dispositiverdquo the panel concluded
Assistant Attorney General Virginia B Fuller made the successful oral argument for the state last month Attorney General Thurbert E Bakerrsquos spokesman Russ Willard said in an eshymail that the state ldquois appreciative of the Court of Appeals decision recognizing the role of the Medicaid program in providing for this treatmentrdquo
Norris who also is director of legal advocacy for a nonprofit that advocates for people with disabilities said the 11th Circuit gave Thrash
an opportunity to say more about the roles of treating doctors and the state in deciding what care the state needs to provide Norris noted that Thrash wrote on the subject last year in another nursing care case about a Savannah Ga boy who nearly drowned when he was 2Thrash barred the state from enforcing a policy of not providing nursing care for patients requiring 16
to 24 hours per day for more than one week he said that criteria isnrsquot based on whatrsquos medically necessary under federal Medicaid law
On the other handThrash denied the plaintiff rsquos request based on the
treating physicianrsquos recommendation for 24shyhourshyashyday private nursing services for an
indefinite period of time Thrash deemed such a prescription ldquoan abuse of the Medicaid systemrdquo
The state has limited discretion to deny a providerrsquos request for care under the ldquoearly and periodic
screening diagnostic and treatment servicesrdquo portion of the Medicaid Act said Thrash He added that ldquo[t]he statersquos discretion is limited to a review of the request for fraud abuse of the Medicaid system and whether the service is within the reasonable
standards of medical carerdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 15 Developmental Disabilities Services Division
klahoma Department of Human Services
I N T E R F A C E
DDSD Area II Project Elves get together to wrap all the presents and make sure they are delivered to the individuals before Christmas Elves work year round
to make Christmas special for DDSD clients For the past eight years individuals with
developmental disabilities who donrsquot have families or who would otherwise not receive gifts have had their Christmas wishes come true thanks to caring DDSD ldquoelvesrdquo in Area II Project Elf is the brainchild of ldquoThe Men in Recrdquo namely
Steve Pitts and Roger McDaniel DDSD Area II recreational therapists and Joe Stie DDSD case manager ldquoDDSD serves a lot of people with developmental
disabilities who donrsquot have families to celebrate the holidays withrdquo said Pitts ldquoAlthough our services meet their basic needs therersquos still a gap when it comes to those special things that families do for one anotherrdquoThat gap has been filled by The Men in Rec who work all year
long coordinating various events to raise money to buy Christmas presents for individuals ldquoWe raise all of the funds and no OKDHS money is usedrdquo said
Pitts ldquoThis year we are selling Blue and Gold sausage and Amish jams We also have an annual Christmas Carol fundraising performance which is donated to Project Elf by the American Theater Company We are given 300 tickets that we can sell and last year we sold 225rdquoDDSD coshyworkers got together and purchased 44 of those theater
tickets last year for the children who happened to be in the Laura Dester Center Shelter around the holidays ldquoWe have also set up a sponsorship program where people can purchase
the gift and return it wrapped and ready for the elf (aka case manager) to deliver This last Christmas we had 108 sponsors 30 of whom were the case managers themselvesrdquo
The Men in Rec also recruit fellow DDSD workers to help shop for the gifts and wrap themldquoWe could not accomplish this awesome Project Elf without the assistance of so many of our coshyworkers and our community volunteersrdquo he said ldquoItrsquos such a pleasure to share these gifts at Christmas time and let our customers know that they have a family through our good service to themrdquoThe Men in Rec are currently working to raise money for this yearrsquos Christmas gifts If you would like to join the rank of DDSD Elves by donating funds or becoming a sponsor please contact Steve Pitts at stevepittsokdhsorg or call918shy794shy7625 InterFace NEWSLETTER
Steve Pitts (right) DDSD Area II recreational therapist gives a donated WalshyMart gift card to case manager Roy Willett to purchase a Christmas gift for one of the people on his caseload
Oklahoma Department of Human Services 16 Developmental Disabilities Services Division
shy shyshy shy
shy shy
shy shy
shy shy
shy shy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
Developmental Disabilities Services Area Offices and Resource Centers
CUSTER
ELLIS
BECKHAM WASHITA CADDO
McCLAIN
SEM
INO
LE HUGHES HASKELL
LE FLORELATIMER PITTSBURG
COAL
ATOKA
PONTOTOC
JOHNSTON
GARVIN
MURRAY
CARTER
LOVE
BRYAN CHOCTAW
PUSHMATAHA McCURTAIN
GRADY
KIOWA
TILLMAN
JACKSON HA
RM
ON
GREER
COTTON
JEFFERSON
STEPHENS
COMANCHE
McINTOSH
CLEVELAND
POTT
AWAT
OM
IE
DEWEY BLAINE
CANADIAN
MAJOR
GRANT KAY OSAGE
WA
SHIN
GTO
N CRAIG
ROGERS
CH
ERO
KEE
ADAIR TULSA
WAGONER
MAYES
OKMULGEE
CREEK
LINCOLN
LOGAN
PAYNE
KINGFISHER
OKLAHOMA OKFUSKEE
MUSKOGEE SEQUOYAH
DEL
AWA
RE
OTTAWA NOATTA
GARFIELD NOBLE
PAWNEE
WOODS ALFALFA HARPER BEAVER TEXASCIMARRON
WOODWARD
ROGER MILLS
MARSH
Oklahoma CityOklahoma City
Tulsa
Area II
Area III
Area I
Pauls Valley
Enid
wwwokdhsorg
State Officetoll free 1shy866shy521shy3571
AREA Itoll free 1shy800shy522shy1064
AREA IItoll free 1shy800shy522shy1075
AREA IIItoll free 1shy800shy522shy1086
Greer Center (Enid)2501 NE Delaware Enid OK 73701
580 237 10272599 FAX 580 213 2799
Northwest Oklahoma Resource Center at Enid (NORCE)2600 E Willow
Enid OK 73701
580 237 1027
FAX 580 548 2600
Southern Oklahoma Resource Center at Pauls Valley (SORC)3210 Chickasaw St
Pauls Valley OK 73075 6822
405 238 6401
FAX 405 238 8261
DDSD Area I Office (Enid)729 Overland Trail Enid OK 73703
580 548 8900 FAX 580 548 8964
DDSD Area I Office (Oklahoma City)4545 N Lincoln Blvd
Oklahoma City OK 73105 405 522 6925
FAX 405 522 6995
DDSD Area II Office (Tulsa)Laura Dester Center 1427 E 8th Tulsa OK 74120
918 560 4848 FAX 918 560 4898
DDSD Area III Office (Pauls Valley)301 S Indian Meridian Rd Pauls Valley OK 73075
405 238 4700 FAX 405 238 4740
If you would like to find out what the DevelopmentalDisabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
If you would like to find out what the Developmental Disabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
This will take you to the main Oklahoma Department of Human Services Web page From there just click on Divisions and Offices and the Developmental Disabilities Services Division On our Web site you will find information about services the division offers how to apply for services eligibility policies contract provider agencies and much more
Come visit us today You may be surprised at what you will learn
OKLAHOMA DEPARTMENT OF HUMAN SERVICES Developmental Disabilities Services DivisionPO Box 25352 Oklahoma City OK 73125
S U M M E R 2 0 0 9
DDSD employees win advocacy awards
Angela King DDSD Area II case manager and Cindy
Jennings DDSD Area III nurse received awards from TARC in December 2008 King received the
AdvocateshyCase Manager of the Year award while
Jennings was recognized with a Special Achievement in
Advocacy AwardKing has nearly 20 years of experience in DDSD
case management working with individuals on every
type of waiver including the pilot project for the InshyHome Support waiver King began her career in the
field as a direct support professional before
becoming a recreational therapist and case
manager transitioning individuals from The
Hissom Memorial Center King gives each
person on her caseload the individual attention
they need regardless of the time it takes As a
recent example of her advocacy and
dedication she assisted a woman on her caseload in the process of obtaining
a divorce from her husband of many
years King referred the woman to a
community resource for legal advice
assisted her in completing all of the legal paperwork attended
court hearings with her and then took the woman apartment hunting
King even helped her move into the new apartment unpack and
decorate King has been known for her attention to detail and is extremely conscientious exemplifying her commitment to those
she servesJennings has volunteered for Oklahoma People First for the last
11 years assisting in the establishment of new chapters planning
state conferences writing grants to secure funding and soliciting
donations for conferences As an OPF volunteer Jennings is passionate about teaching individuals to advocate for themselves Her belief in their abilities empowers them to have faith in
themselves and in their abilities to make choices She educates OPF members on increasing their independence vocational opportunities voting relationships and community involvement Jennings empowers OPF members by offering them a support network to turn to when in need of assistance By doing so she
teaches others to recognize how much persons with developmental disabilities can do for themselves if given the right supports
InterFace NEWSLETTER
To see Oklahomarsquos ranking as compared to other states in regard to the numbers of persons with developmental disabilities in competitive jobs (supported employment)go to
wwwstatedatainfo
This website is a project of the Institute for Community Inclusion at UMass Boston supported in part by the Administration on Developmental Disabilities US Department of Health and Human Services under cooperative agreement with additional support from the National Institute on Disability and Rehabilitation Research of the US Department of Education
Angela King DDSD Area II case manager is presented with the AdvocateshyCase Manager of the Year award by John Gajda executive director TARC
Cindy Jennings DDSD Area III nurse is presented with a Special Achievement in Advocacy Award by John Gajda executive director TARC
Oklahoma Department of Human Services 5 Developmental Disabilities Services Division
I N T E R F A C E
Quality
AwardsBest of the Best
Regina ChacePrograms Manager for DDSD Employment Services
Regina Chace Program Manager for DDSD Employment Services receives an OKDHS Quality Award Best of the Best for her leadership in this program Chace ensures there are policies and processes which support participants to have a full range of opportunities for employment As a result Oklahoma has been recognized as the nationrsquos leader in achieving impressive outcomes in integrated employment for people with
disabilities InterFace NEWSLETTER
A Dream Come True Bobby Cooper and his parents were invited by Governor Brad Henry to meet with him and visit the capitol Tom Cooper Bobbyrsquos father is a member of the Governorrsquos Council for United We Ride representing people with disabilities Tom mentioned to Governor Henry in a letter that it had been Bobbyrsquos dream to meet him after seeing him speak on television during his reshyelection Governor Henry was so flattered by Bobbyrsquos request that he invited the whole family for a visit to the capitol in November 2008 They took a few moments to pose for this photograph in the Governorrsquos Blue Room From left Tom Cooper BobbyGovernor Henry and Ruth Cooper
Oklahoma Department of Human Services 6 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
James Nicholson Director of the OKDHS Developmental Disabilities Services Division is presented with a 2009 College of Allied Health Citation for Special Contributions (Left to Right) Jeff Berry Chair College of Allied Health Awards and Honors Committee College Dean Kevin Rudeen Nicholson and Martha Ferretti Professor and Chair Physical Therapy Department of Rehabilitation Sciences College of Allied Health
DDSD Nicholson receives award for contributions to College of Allied Health
On April 2 2009 James Nicholson Director of the OKDHS Developmental Disabilities Services
Division was presented with the 2009 College of AlliedHealth Citation for Special Contributions Nicholson was nominated for this award by Martha
Ferretti Professor and Chair Physical Therapy Department of Rehabilitation Sciences College of Allied Health University of Oklahoma Health Sciences Center In the nomination for this award Ferretti wrote ldquoMr Nicholsonrsquos background is one of diversity and richness
His work ethic sets a standard for us all to follow His calmness humor and general goodwill in the midst of controversy is obvious and remarkable And first and foremost his dedication to improving the lives of children and adults with developmental disabilities has set a standard for us all to emulate Mr Nicholsonrsquos creativity thoughtfulness and ability to target a goal and accomplish it regularly in collaboration with a number of formal and informal partners prove the importance of reaching beyond onersquos own resourcesldquoAs a visionary in the field of developmental disabilities early in his
role as director Mr Nicholson caught the attention of both supporters and detractors His vision was a perfect match for what our faculty were striving to accomplish in preparing our students and in providing servicesin the field of developmental disabilities ldquoWe approached Mr Nicholson shortly after he became the director with
a proposal for introducing assistive technology into the DDSD system differently than had been accomplished at that point Over the past 18 years
he and members of his staff have continued that collaboration on projects that addressed both major and minor challenges
about policy and services for Oklahomans with developmental disabilities
ldquoOur faculty has learned so much from this very politically astute and professional state leader Before the state was aware of its challenges emerging from children with autism and their families Mr Nicholson quietly accepted the mantle of addressing what we have come to know are unbelievable challenges presented by the impact of autism Seven years ago he convened a multishyagency multishydisciplinary task force that included parents of individuals with autism to develop the Oklahoma State Plan for Autism and the Oklahoma Autism Network We are honored by him placing the OAN within the structure of the College
ldquoMr Nicholson has stimulated us to mature as educators researchers and service providers to more effectively address many of Oklahomarsquos needs in the field of
developmental disabilitiesrdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 7 Developmental Disabilities Services Division
Nickrsquos Law
I N T E R F A C E
Insurance Mandates for autism treatments fail once again to pass Oklahoma legislature
For the second consecutive year bills that would have mandated insurance companies to cover
treatments for autism failed to pass through the Republicanshycontrolled legislatureIn February the House Economic Development and
Financial Services Committee voted down House Bill 1312 also known as ldquoNickrsquos Lawrdquo which would have required insurance providers to cover autism treatment The only autismshyrelated bills that did receive enough
support to pass were House Bill 2027 and its companion Senate Bill 135 The Senate version made it through the legislative process and will enact a licensing process for national board certified behavior analysts and enhance existing state programs that would train doctors to diagnose and treat autism Critics of this bill question whether it will actually produce
significant new services if insurance doesnrsquot cover the cost of treatment and parents canrsquot afford to pay the bill
ldquoSadly this bill will do nothing to relieve the pressure on families struggling to care for children with autismrdquo said Sen Jay Paul Gumm author of lsquoNickrsquos Lawrsquo legislation ldquoThis measure was designed to relieve political pressure on legislators who refuse to even consider Nickrsquos Lawrdquo
When Governor Henry signed Senate Bill 135 he said the measure was just a small step in the effort to help affected Oklahoma families He urged lawmakers to pass legislation to mandate insurance coverage for the treatment of autism
ldquoThere is nothing wrong with this bill just like there is nothing wrong with a pack of shingles at a construction siterdquo said Sen Gumm ldquoIf you try to put the shingles on before you pour the foundation you are doomed to failure As Governor Henry wisely noted when he signed the bill the foundation is insurance coverage of autism Absent that Senate Bill 135 is doomed to failurerdquo
Republican legislative leaders oppose insurance mandates saying they drive up the cost of health insurance despite reports from states with similar insurance mandates that show no significant increase in the cost of premiums
Republicans attempted to pass House Bill 1975 which would only allow insurance legislation to be introduced in oddshynumbered years and approved in evenshynumbered years The bill would have also required a 75 percent supershymajority vote to do away with the mandate in the case of an emergency
Henry vetoed that bill and said it would have unreasonably ldquotied the hands of state policy makers on a very important issuerdquo
ldquoThis would empower a small minority of legislators to thwart legitimate state efforts to address a pressing public policy issue and ensure that the restriction would rarely if ever be liftedrdquo Henry said
Henry also questioned why HB 1975 restrictions were only applied to a single issue area saying it raised legitimate concerns regarding why only one subject would be singled out for special treatment
Autism cont on page 9
Oklahoma Department of Human Services 8 Developmental Disabilities Services Division
SUMMER 2009
Autism cont from page 8
ldquoOklahoma and its citizens are better served when policy makers are allowed the freedom to address any pressing issue in the Legislature without the hindrance of arbitrary restrictionsrdquo Henry said Democrats offered a compromise mdash to put autism coverage in highshy
risk insurance pools as a last resort for families who canrsquot afford the coverage elsewhere Republicans again declined and instead went forward with SB 135 This year three more states enacted Autism Mandate legislation bringing
the total to 11 states that now require insurance companies to cover treatment for autism InterFace NEWSLETTER
Proudly displaying their CPR (Cardio Pulmonary Resuscitation) certificates are (From Left) Guy Bivens Allen Larimore Steve Sposato Andy Edwards Joshua Johnson and Tino Hensley residents of the Independence House
Residents of the Independence House at the Home of Hope in Vinita recently became CPR certified after a fellow resident had a heart attack A staff member used CPR to save Allen Larimorersquos life and he has since received a pacemaker Although staff members must be CPR certified this event inspired Larimorersquos housemates to take the class so they could also be prepared ndash just in case Donna Marlow a CPR trainer from the OKDHS Developmental Disabilities Services Division held the class free of charge at the agency and was proud that all the men passed their tests with flying colors
11th Circuit Rules Doctors donrsquot trump state on Medicaid care for children with disabilities by Alyson M Palmer
A federal appeals panel has declared that treating doctors donrsquot have the final say in how much nursing care the state must provide
children with disabilities under MedicaidOn April 24 the 11th US Circuit Court of Appeals reversed a district
judgersquos decision that had said the state must provide the amount of nursing care that a North Georgia girlrsquos doctor said she needs
Despite a slew of amicus briefs by state governments and Medicaid plan administrators the panel dispatched the case in a twoshypage unpublished unsigned opinion that came out a month after oral argument
Holland amp Knight partner Robert S Highsmith Jr who represented a proshystate friend of the court that provides managed care services for Medicaid programs said his client WellCare of Georgia had been concerned about language in US District Judge Thomas W Thrash Jrrsquos ruling that suggested anything ordered by a treating physician is medically necessary under the law ldquoThat one sentence just had to get reversedrdquo said Highsmith ldquoWe are very excited that they saw and reversed that clear errorrdquo
But an advocate for the teenage girl at the center of the case Atlanta Legal Aid Society General Counsel David A Webster said Monday that the decision ldquodoesnrsquot mean muchrdquo and says little about the relationship between the state and the treating physician ldquoThatrsquos going to be open for future litigationrdquo said Webster Webster said the case of his client Anna C Moore will go back to Thrash for the judge to consider the
11th Circuit Rules cont on page 15
Oklahoma Department of Human Services 9 Developmental Disabilities Services Division
I N TERFACE
ImaginingEverest The Story of LaelBy Adrienne Benz
ldquoI prayed for God to open the eyes of my understanding and the pieces began to fall into place Mollyrsquos future had been planned since she was a young girl she would marry andhave a bright healthy family known for their intelligence andkindness However the birth of her first born quickly dispelled the myth of the stereotypically perfect family as Molly learns her son Lael has Down syndrome Struggling to accept the disconcerting news and understand Godrsquos perfect plan Molly faces a challenge no more daunting than the climbing of the greatMt Everest she often dreamed of as a child Guilt hope grief and happiness take Molly and Lael across rocky terrain and risky edges but faith and the resonant voice of God bring mother and son up the emotional mountain 30 years in the making ndash a mountain that revealed the aptitude of Mollyrsquos beloved son and the kindness of others By Imagining Everest Molly and Lael forge a unique and amazing relationship which allows them to overcome even the most intimidating ascension into the unknownrdquo
Molly Mathewrsquos son Lael currently receives services through the OKDHSDDSD community waiver program
264 pages shy $1499 (paperback) This book is available online through Tate Publishing wwwtatepublishingcombookstore
Health and Human Services rescinds Medicaid regulations affecting case management
Department of Health and Human Services (HHS) Secretary
Kathleen Sebelius announed June 29 that the administration will rescind all or part of three Medicaid regulations that were previously
issued and delay the enforcement of a fourth regulation Each of these
rules in whole or in part had been subject to Congressional moratoria
set to expire on July 1 2009ldquoThese regulations if left in place would have potentially adverse
consequences for Medicaid beneficiaries some of our nationrsquos most vulnerable peoplerdquo said Secretary Sebelius ldquoBy rescinding
these rules we can expect that children will continue receiving
services through their schools beneficiaries will be able to
access all available case management resources to help them
better manage their health care and outpatient hospital and
clinic services can continue to be covered in the most efficient mannerrdquo
This ruling was crucial to Oklahomarsquos Developmental Disabilities Services as the state could have lost the ability
to bill Medicaid for 100 percent of the cost of providing
case management services to waiver service recipients which totals approximately $22 million per year
ldquoThe actions we are taking today are necessary to
ensure that the states have the flexibility they need to
fully serve Medicaidshyeligible individualsrdquo said
Secretary Sebelius
The Centers for Medicare amp Medicaid
Services (CMS) and HHS arebull Rescinding provisions of an interim final rule
published Dec 4 2007 which would have restricted beneficiary access to case management services These provisions appeared to in practice restrict beneficiary access to needed covered case management services and limit state flexibility in determining efficient and effective delivery systems for case management services
Regulations Expiring cont on page 11
Oklahoma Department of Human Services 10 Developmental Disabilities Services Division
SUMMER 2 0 0 9
Regulations Expiring cont from page 10
bull Rescinding a final rule published Dec 28 2007 that would have eliminated reimbursement for schoolshybased administrative costs and costs of transportation to and from schools The rescission reflects concern that the rule could limit the Medicaid administrative outreach activities of schools and that the overall budgetary impact on schools could potentially impact their ability to offer Medicaid services to students
bull Rescinding a rule published Nov 7 2008 that would have limited the outpatient hospital and clinic service benefit for Medicaid beneficiaries to the scope of services recognized as an outpatient hospital service under Medicare This rule was rescinded because CMS became aware that coverage beyond that scope could not be easily moved to other benefit categories resulting in great impact than previously anticipated
bull Delaying until June 30 2010 the enforcement of portions of a regulation that clarified limitations on health care related tax programs so that CMS could determine whether states need additional clarification or guidance CMS may also further review the potential impact of the regulation and give additional consideration to alternative approaches InterFace NEWSLETTER
Waiting and HopingBy Adrienne Benz
Sad is like sitting here when I donrsquot have a home to run away to
So there on the street just waiting for something to eat somewhere to stay and a bed to sleep on and someone to hold
And hoping Irsquom still there the next day
They have to get up from the street in the park sitting on a cold chair in the dark
Just waiting for someone to take them in their home Waiting to open up and talk about their hidden feelings
like they canrsquot wait any longer
Adrienne Benz was a child in state custody when she wrote this poem She is now an adult reunited with her family
Oklahoma Department of Human Services 11 Developmental Disabilities Services Division
I N T E R FA C E
DDSD Fiscal Year 2010 Budget Outlook OKDHS Director Howard Hendrick
presented the agencyrsquos Fiscal Year 2010 budget to the Commission for Human Services on June 16 Hendrick emphasized that even with the additional federal stimulus money and other oneshytime funds the agencyrsquos overall funding will be approximately $50 million short of anticipated spending levels To achieve a balanced budget cuts would have to be made within each division The Developmental Disabilities Services Divisionrsquos
share of the cuts amount to approximately 3 percent of the divisionrsquos operating budget ($17 million) Another $200000 had to be identified to fund the new initiative for Applied Behavior Analysis mandated by Senate Bill 135 this legislative sessionDDSD was able to accomplish the budget cuts without
impact to any programs or services through reductionsat the Northern and Southern Oklahoma ResourceCenters The rest of the savings came from reductions in training and professional contracts the divisions holds with various entitiesOver the next year DDSD will be under a selfshyimposed hiring
freeze for all positions except for case management direct care professionals and registered nursesIf monthly state revenue collections continue to fall below
expected levels additional reductions may be required of all stateagenciesrsquo operating budgets
Interim StudiesThere will be two interim legislative studies conducted this summer that could impact DDSD and service recipients
One of these studies will investigate a possible provider feetax on agencies providing waiver community services If the provider feetax is found to be within federal Medicaid guidelines it could possibly be used to fund rate increases in waiver services
The other legislative study will look into the pros and cons of online training versus classroom training specifically for providers of DDSD community services
Money Follows the PersonAs of this date DDSD has transitioned eight people from Northern Oklahoma Resource Center of Enid and Southern Oklahoma Resource Center into community homes using the federal Money Follows the Person grant Utilizing these federal funds DDSD has been able to save approximately $21000 in the community services provided to those individuals
Oklahoma documentary on developmental disabilities history to air on OETA
an
Oklahoma
document
ary
Adocumentary showing Oklahomarsquos history serving people with intellectual and developmental disabilities is
scheduled to begin airing on OETA (Oklahomarsquos Education Television Authority) in October during national Disabilities Awareness Month
The video ldquoWagons to Waivers A Century of Changerdquo narrated by Oklahomarsquos own country music star Reba McEntire will be broadcast on the OETAshyOklahoma channel starting on Oct 24th at 5 pm and on Nov 5th at 830 pm The program will be
aired a couple times a month
The documentary takes viewers on an emotional journey from the days of the Dust Bowl and covered wagons and shows the statersquos progression from institutional services to full community inclusion for persons with intellectual disabilities Oklahomarsquos story begins in 1909
with the creation of the Institute for the Feeble Minded in Enid and includes the
tears and efforts of parents the stories ofpeople who grew up in institutions the legal struggles and the triumph of selfshyadvocacy The video was produced by the Oklahoma Department of Human Services Developmental Disabilities Services Division
OETAshyOKLA is Cox Cable channel 112 but other television carriers as well as satellite users can access the channel which is devoted to Oklahomashyspecific programming Check your local television lis tings for specific programming dates and times
Oklahoma Department of Human Services 12 Developmental Disabilities Services Division
SUMMER 2009Compassion friendship and longevity A good measure of success
The day had finally come and Danny waited anxiously on the sofa He watched quietly as the
nursing staff set up the hospital bed and made his friend Carl comfortable The minute all was clear Danny went to Carl and told him how much he had missed him and that he needed him to get better Dannyrsquos longshytime friend had just undergone surgery
to remove a malignant brain tumor Danny didnrsquot understand the procedure or Carlrsquos prognosis ndash all that mattered was that his best friend was home It just wasnrsquot home without CarlCarl is considered the head of the household that he shares
with Danny and his other friend Hershel Carl was always the one who planned their meals said the prayers at the diningroom table and got them involved in Special Olympics events When Carl became ill and went to the hospital it was Danny
who stepped up and tried to fill in ndash just until Carl came home ldquoThe Three Musketeersrdquo (thatrsquos what their staff call them) have
been friends and have lived together for more than 30 years
Danny (lef
t) spends
hours by
Carlrsquos sid
e
encourag
ing him in his
recovery
They met as boys at The Hissom Memorial Center the nowshyclosed institution in Sand Springs for persons with developmental disabilities When they aged out of Hissom the three moved about the same time to a private facility where they lived for many years
In 1993 The Musketeers were given the opportunity to move together once again into a house in their community supported through the DDSD Medicaid Community Waiver program Since
that time they have lived in the house withsome of the same staffmembers who havecared for them for morethan 20 years
The Three Musketeers Danny (left) shows his excitement over his friend Carlrsquos (right) return from the hospital after brain surgery Shy Hershel (center) wipes tears from his eyes
Carl is recoveringfrom his surgery andworking on his abilityto speak and onregaining the use of theleft side of his bodyThe staff in the home
often has to make Danny go to bed at 1 am when hersquos still sitting beside Carl encouraging him to get better so he can go back to work
All three men have jobs and love their work ndash Carlmost of all Danny somehow knows that if Carl canjust get back to work life will continue as they onceknew it
ldquoTheyrsquore like a wellshysettled familyrdquo said Gretchen Moser their DDSD case manager ldquoEven their families consider these guys a family and respect their wishesrdquo
These days there are many opinions about what constitutes a family or even success But there are stories that transcend those discussions Stories like these that remind us success can also be measured by the love and longevity of a friend InterFace NEWSLETTER
Relations
hips
Oklahoma Department of Human Services 13 Developmental Disabilities Services Division
I N T E R F A C E
StateLegislativeNews
Of the thousand or more bills filed at the beginning of the 2009 legislative session only a few made it through the entire process that will have an impact on persons with developmental disabilities families and professionals in the field They are
HB 1007 mdash Wesselhoft Leftwich Signed by the Governor Requires specific Physically Disabled person signage to be posted as a reserved area for the parking of a vehicle displaying a valid permit
HB 1019 mdash WrightSigned by the Governor Recreates the Group Homes for Persons with Developmental or Physical Disabilities Advisory Board
HB 1048 mdash Banz AldridgeSigned by the Governor Relates to the collection of delinquent real property taxes removes physically disabled from ldquoincapacitatedrdquo persons granted additional time to redeem personal items reduces time to collect excess sale proceeds by half
HB 1065 mdash Faught Crain Signed by the Governor Relates to the Continuum of Care and Assisted Living Act adds definition and requires inspection results to be posted on website
HB 1424 mdash Protor Signed by the Governor Requires treatment facilities transitional living facilities halfway houses and any house or facility that may be used for medical or nonmedical detoxification to mail notification to property owners within a quarter mile radius if zoning changes are proposed
HB 1461 mdash Sears Ford Signed by the Governor A school that does not make adequate yearly progress for two straight years shall utilize the assistance of a school support team formed by the State Department of Education EMERGENCY
HB 1581 mdash Coody Jolley Signed by the Governor School teacher candidates that wish to teach elementary early childhood education or special education programs must study the five elements of reading instruction EMERGENCY
HB 1763 mdash Enns Reynolds Signed by the Governor Requires the state Department of Education to provide special education training for process hearing officers to ensure adequate knowledge in special education laws and proceduresEMERGENCY
HB 1893 mdash Peterson Anderson Signed by the Governor Creates the Aging and Disability Resource Consortium to work with other agencies in developing and implementing a singleshypointshyofshyentry concept for aging and disability groups in Oklahoma
SB 135 mdash Johnson Mike Signed by the Governor Provides for the licensing of certain persons to practice as a licensed behavior analyst or a licensed assistant behavior analyst and to study children with autism and their behaviors directs funds to be used by the Department of Human Services Developmental Disabilities Services division for training SoonerStart providers to treat children with autism spectrum disorders provides for a behavorial analysis research pilot project provides legislative intent
SB 518 mdash Justice Osborn Signed by the Governor Adds grandparents as members of immediate family
SB 871 mdash Anderson Signed by the Governor Modifies membership of the Electronic and Information Technology Accessibility Advisory Council
Oklahoma Department of Human Services 14 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
11th Circuit Rules cont from page 9
matter again Moore a teenager living in North Georgia who goes by ldquoCallierdquo has been receiving inshyhome nursing care paid for by Medicaid for about a decade The state has been trying to cut the number of hours of care she receives each week
The 11th Circuit interpreted a federal law that says states participating in the Medicaid program must provide ldquoearly and periodic screening diagnostic and treatment servicesrdquo that are necessary to ldquocorrect or ameliorate defects and physical and mental illnessesrdquo in Medicaidshyeligible children The primary ways children become eligible for Medicaid are that they come from a lowshyincome family or have a disability according to Joshua H Norris another one of Calliersquos lawyers
Georgiarsquos Department of Community Health operates a program to administer Medicaidshyfunded nursing services for several hundred children who need nursing care It delegates the decisions about approval of such services to an organization called the Georgia Medical Care Foundation
According to Thrashrsquos order Callie is disabled because of a stroke she experienced in utero and suffers from various chronic conditions including mental retardation and cerebral palsy She lives at home and according to the statersquos brief attends an elementary school in Athens Ga three days a week Her lawyers have said she requires constant care
The statersquos lawyers have said that nursing hours can be reduced when the patientrsquos medical condition stabilizes positing that a goal of the program is to teach parents and other caregivers to take care of their children on their own The Mooresrsquo lawyers have contended that the statersquos system of ldquoweaningrdquo patients off their nursing services as long as theyrsquore staying out of the hospitaland not getting worse follows a different standard than that set by federal law
In 2006 the state informed Calliersquos mother that it was reducing Calliersquos nursing hours from 94 hours a week to 84 contrary to the recommendation of Calliersquos primary care physician Calliersquos mother filed suit
The Mooresrsquo lawyers convinced Thrash that the reduction was improper Afterissuing multiple injunctions in Calliersquos favor he denied the statersquos motion for summary judgment and granted the Mooresrsquo motion in part concluding the state must provide for the amount of skilled nursing care that Calliersquos treating physician deems necessary The panel that ruled in favor of the state in its appeal was comprised of Senior 11th Circuit Judge R Lanier Anderson III 11th Circuit Judge Gerald B Tjoflat and US District Judge Lisa Godbey Wood visiting from the Southern District of Georgia
The panel said both the state and Calliersquos physician have roles in determining whatrsquos medically necessary to correct or ameliorate Calliersquos medical conditions It cited a federal regulation that says a Medicaid agency ldquomay place appropriate limits on a service based on such criteria as medical necessity or utilization control proceduresrdquo
ldquoA private physicianrsquos word on medical necessity is not dispositiverdquo the panel concluded
Assistant Attorney General Virginia B Fuller made the successful oral argument for the state last month Attorney General Thurbert E Bakerrsquos spokesman Russ Willard said in an eshymail that the state ldquois appreciative of the Court of Appeals decision recognizing the role of the Medicaid program in providing for this treatmentrdquo
Norris who also is director of legal advocacy for a nonprofit that advocates for people with disabilities said the 11th Circuit gave Thrash
an opportunity to say more about the roles of treating doctors and the state in deciding what care the state needs to provide Norris noted that Thrash wrote on the subject last year in another nursing care case about a Savannah Ga boy who nearly drowned when he was 2Thrash barred the state from enforcing a policy of not providing nursing care for patients requiring 16
to 24 hours per day for more than one week he said that criteria isnrsquot based on whatrsquos medically necessary under federal Medicaid law
On the other handThrash denied the plaintiff rsquos request based on the
treating physicianrsquos recommendation for 24shyhourshyashyday private nursing services for an
indefinite period of time Thrash deemed such a prescription ldquoan abuse of the Medicaid systemrdquo
The state has limited discretion to deny a providerrsquos request for care under the ldquoearly and periodic
screening diagnostic and treatment servicesrdquo portion of the Medicaid Act said Thrash He added that ldquo[t]he statersquos discretion is limited to a review of the request for fraud abuse of the Medicaid system and whether the service is within the reasonable
standards of medical carerdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 15 Developmental Disabilities Services Division
klahoma Department of Human Services
I N T E R F A C E
DDSD Area II Project Elves get together to wrap all the presents and make sure they are delivered to the individuals before Christmas Elves work year round
to make Christmas special for DDSD clients For the past eight years individuals with
developmental disabilities who donrsquot have families or who would otherwise not receive gifts have had their Christmas wishes come true thanks to caring DDSD ldquoelvesrdquo in Area II Project Elf is the brainchild of ldquoThe Men in Recrdquo namely
Steve Pitts and Roger McDaniel DDSD Area II recreational therapists and Joe Stie DDSD case manager ldquoDDSD serves a lot of people with developmental
disabilities who donrsquot have families to celebrate the holidays withrdquo said Pitts ldquoAlthough our services meet their basic needs therersquos still a gap when it comes to those special things that families do for one anotherrdquoThat gap has been filled by The Men in Rec who work all year
long coordinating various events to raise money to buy Christmas presents for individuals ldquoWe raise all of the funds and no OKDHS money is usedrdquo said
Pitts ldquoThis year we are selling Blue and Gold sausage and Amish jams We also have an annual Christmas Carol fundraising performance which is donated to Project Elf by the American Theater Company We are given 300 tickets that we can sell and last year we sold 225rdquoDDSD coshyworkers got together and purchased 44 of those theater
tickets last year for the children who happened to be in the Laura Dester Center Shelter around the holidays ldquoWe have also set up a sponsorship program where people can purchase
the gift and return it wrapped and ready for the elf (aka case manager) to deliver This last Christmas we had 108 sponsors 30 of whom were the case managers themselvesrdquo
The Men in Rec also recruit fellow DDSD workers to help shop for the gifts and wrap themldquoWe could not accomplish this awesome Project Elf without the assistance of so many of our coshyworkers and our community volunteersrdquo he said ldquoItrsquos such a pleasure to share these gifts at Christmas time and let our customers know that they have a family through our good service to themrdquoThe Men in Rec are currently working to raise money for this yearrsquos Christmas gifts If you would like to join the rank of DDSD Elves by donating funds or becoming a sponsor please contact Steve Pitts at stevepittsokdhsorg or call918shy794shy7625 InterFace NEWSLETTER
Steve Pitts (right) DDSD Area II recreational therapist gives a donated WalshyMart gift card to case manager Roy Willett to purchase a Christmas gift for one of the people on his caseload
Oklahoma Department of Human Services 16 Developmental Disabilities Services Division
shy shyshy shy
shy shy
shy shy
shy shy
shy shy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
Developmental Disabilities Services Area Offices and Resource Centers
CUSTER
ELLIS
BECKHAM WASHITA CADDO
McCLAIN
SEM
INO
LE HUGHES HASKELL
LE FLORELATIMER PITTSBURG
COAL
ATOKA
PONTOTOC
JOHNSTON
GARVIN
MURRAY
CARTER
LOVE
BRYAN CHOCTAW
PUSHMATAHA McCURTAIN
GRADY
KIOWA
TILLMAN
JACKSON HA
RM
ON
GREER
COTTON
JEFFERSON
STEPHENS
COMANCHE
McINTOSH
CLEVELAND
POTT
AWAT
OM
IE
DEWEY BLAINE
CANADIAN
MAJOR
GRANT KAY OSAGE
WA
SHIN
GTO
N CRAIG
ROGERS
CH
ERO
KEE
ADAIR TULSA
WAGONER
MAYES
OKMULGEE
CREEK
LINCOLN
LOGAN
PAYNE
KINGFISHER
OKLAHOMA OKFUSKEE
MUSKOGEE SEQUOYAH
DEL
AWA
RE
OTTAWA NOATTA
GARFIELD NOBLE
PAWNEE
WOODS ALFALFA HARPER BEAVER TEXASCIMARRON
WOODWARD
ROGER MILLS
MARSH
Oklahoma CityOklahoma City
Tulsa
Area II
Area III
Area I
Pauls Valley
Enid
wwwokdhsorg
State Officetoll free 1shy866shy521shy3571
AREA Itoll free 1shy800shy522shy1064
AREA IItoll free 1shy800shy522shy1075
AREA IIItoll free 1shy800shy522shy1086
Greer Center (Enid)2501 NE Delaware Enid OK 73701
580 237 10272599 FAX 580 213 2799
Northwest Oklahoma Resource Center at Enid (NORCE)2600 E Willow
Enid OK 73701
580 237 1027
FAX 580 548 2600
Southern Oklahoma Resource Center at Pauls Valley (SORC)3210 Chickasaw St
Pauls Valley OK 73075 6822
405 238 6401
FAX 405 238 8261
DDSD Area I Office (Enid)729 Overland Trail Enid OK 73703
580 548 8900 FAX 580 548 8964
DDSD Area I Office (Oklahoma City)4545 N Lincoln Blvd
Oklahoma City OK 73105 405 522 6925
FAX 405 522 6995
DDSD Area II Office (Tulsa)Laura Dester Center 1427 E 8th Tulsa OK 74120
918 560 4848 FAX 918 560 4898
DDSD Area III Office (Pauls Valley)301 S Indian Meridian Rd Pauls Valley OK 73075
405 238 4700 FAX 405 238 4740
If you would like to find out what the DevelopmentalDisabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
If you would like to find out what the Developmental Disabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
This will take you to the main Oklahoma Department of Human Services Web page From there just click on Divisions and Offices and the Developmental Disabilities Services Division On our Web site you will find information about services the division offers how to apply for services eligibility policies contract provider agencies and much more
Come visit us today You may be surprised at what you will learn
OKLAHOMA DEPARTMENT OF HUMAN SERVICES Developmental Disabilities Services DivisionPO Box 25352 Oklahoma City OK 73125
I N T E R F A C E
Quality
AwardsBest of the Best
Regina ChacePrograms Manager for DDSD Employment Services
Regina Chace Program Manager for DDSD Employment Services receives an OKDHS Quality Award Best of the Best for her leadership in this program Chace ensures there are policies and processes which support participants to have a full range of opportunities for employment As a result Oklahoma has been recognized as the nationrsquos leader in achieving impressive outcomes in integrated employment for people with
disabilities InterFace NEWSLETTER
A Dream Come True Bobby Cooper and his parents were invited by Governor Brad Henry to meet with him and visit the capitol Tom Cooper Bobbyrsquos father is a member of the Governorrsquos Council for United We Ride representing people with disabilities Tom mentioned to Governor Henry in a letter that it had been Bobbyrsquos dream to meet him after seeing him speak on television during his reshyelection Governor Henry was so flattered by Bobbyrsquos request that he invited the whole family for a visit to the capitol in November 2008 They took a few moments to pose for this photograph in the Governorrsquos Blue Room From left Tom Cooper BobbyGovernor Henry and Ruth Cooper
Oklahoma Department of Human Services 6 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
James Nicholson Director of the OKDHS Developmental Disabilities Services Division is presented with a 2009 College of Allied Health Citation for Special Contributions (Left to Right) Jeff Berry Chair College of Allied Health Awards and Honors Committee College Dean Kevin Rudeen Nicholson and Martha Ferretti Professor and Chair Physical Therapy Department of Rehabilitation Sciences College of Allied Health
DDSD Nicholson receives award for contributions to College of Allied Health
On April 2 2009 James Nicholson Director of the OKDHS Developmental Disabilities Services
Division was presented with the 2009 College of AlliedHealth Citation for Special Contributions Nicholson was nominated for this award by Martha
Ferretti Professor and Chair Physical Therapy Department of Rehabilitation Sciences College of Allied Health University of Oklahoma Health Sciences Center In the nomination for this award Ferretti wrote ldquoMr Nicholsonrsquos background is one of diversity and richness
His work ethic sets a standard for us all to follow His calmness humor and general goodwill in the midst of controversy is obvious and remarkable And first and foremost his dedication to improving the lives of children and adults with developmental disabilities has set a standard for us all to emulate Mr Nicholsonrsquos creativity thoughtfulness and ability to target a goal and accomplish it regularly in collaboration with a number of formal and informal partners prove the importance of reaching beyond onersquos own resourcesldquoAs a visionary in the field of developmental disabilities early in his
role as director Mr Nicholson caught the attention of both supporters and detractors His vision was a perfect match for what our faculty were striving to accomplish in preparing our students and in providing servicesin the field of developmental disabilities ldquoWe approached Mr Nicholson shortly after he became the director with
a proposal for introducing assistive technology into the DDSD system differently than had been accomplished at that point Over the past 18 years
he and members of his staff have continued that collaboration on projects that addressed both major and minor challenges
about policy and services for Oklahomans with developmental disabilities
ldquoOur faculty has learned so much from this very politically astute and professional state leader Before the state was aware of its challenges emerging from children with autism and their families Mr Nicholson quietly accepted the mantle of addressing what we have come to know are unbelievable challenges presented by the impact of autism Seven years ago he convened a multishyagency multishydisciplinary task force that included parents of individuals with autism to develop the Oklahoma State Plan for Autism and the Oklahoma Autism Network We are honored by him placing the OAN within the structure of the College
ldquoMr Nicholson has stimulated us to mature as educators researchers and service providers to more effectively address many of Oklahomarsquos needs in the field of
developmental disabilitiesrdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 7 Developmental Disabilities Services Division
Nickrsquos Law
I N T E R F A C E
Insurance Mandates for autism treatments fail once again to pass Oklahoma legislature
For the second consecutive year bills that would have mandated insurance companies to cover
treatments for autism failed to pass through the Republicanshycontrolled legislatureIn February the House Economic Development and
Financial Services Committee voted down House Bill 1312 also known as ldquoNickrsquos Lawrdquo which would have required insurance providers to cover autism treatment The only autismshyrelated bills that did receive enough
support to pass were House Bill 2027 and its companion Senate Bill 135 The Senate version made it through the legislative process and will enact a licensing process for national board certified behavior analysts and enhance existing state programs that would train doctors to diagnose and treat autism Critics of this bill question whether it will actually produce
significant new services if insurance doesnrsquot cover the cost of treatment and parents canrsquot afford to pay the bill
ldquoSadly this bill will do nothing to relieve the pressure on families struggling to care for children with autismrdquo said Sen Jay Paul Gumm author of lsquoNickrsquos Lawrsquo legislation ldquoThis measure was designed to relieve political pressure on legislators who refuse to even consider Nickrsquos Lawrdquo
When Governor Henry signed Senate Bill 135 he said the measure was just a small step in the effort to help affected Oklahoma families He urged lawmakers to pass legislation to mandate insurance coverage for the treatment of autism
ldquoThere is nothing wrong with this bill just like there is nothing wrong with a pack of shingles at a construction siterdquo said Sen Gumm ldquoIf you try to put the shingles on before you pour the foundation you are doomed to failure As Governor Henry wisely noted when he signed the bill the foundation is insurance coverage of autism Absent that Senate Bill 135 is doomed to failurerdquo
Republican legislative leaders oppose insurance mandates saying they drive up the cost of health insurance despite reports from states with similar insurance mandates that show no significant increase in the cost of premiums
Republicans attempted to pass House Bill 1975 which would only allow insurance legislation to be introduced in oddshynumbered years and approved in evenshynumbered years The bill would have also required a 75 percent supershymajority vote to do away with the mandate in the case of an emergency
Henry vetoed that bill and said it would have unreasonably ldquotied the hands of state policy makers on a very important issuerdquo
ldquoThis would empower a small minority of legislators to thwart legitimate state efforts to address a pressing public policy issue and ensure that the restriction would rarely if ever be liftedrdquo Henry said
Henry also questioned why HB 1975 restrictions were only applied to a single issue area saying it raised legitimate concerns regarding why only one subject would be singled out for special treatment
Autism cont on page 9
Oklahoma Department of Human Services 8 Developmental Disabilities Services Division
SUMMER 2009
Autism cont from page 8
ldquoOklahoma and its citizens are better served when policy makers are allowed the freedom to address any pressing issue in the Legislature without the hindrance of arbitrary restrictionsrdquo Henry said Democrats offered a compromise mdash to put autism coverage in highshy
risk insurance pools as a last resort for families who canrsquot afford the coverage elsewhere Republicans again declined and instead went forward with SB 135 This year three more states enacted Autism Mandate legislation bringing
the total to 11 states that now require insurance companies to cover treatment for autism InterFace NEWSLETTER
Proudly displaying their CPR (Cardio Pulmonary Resuscitation) certificates are (From Left) Guy Bivens Allen Larimore Steve Sposato Andy Edwards Joshua Johnson and Tino Hensley residents of the Independence House
Residents of the Independence House at the Home of Hope in Vinita recently became CPR certified after a fellow resident had a heart attack A staff member used CPR to save Allen Larimorersquos life and he has since received a pacemaker Although staff members must be CPR certified this event inspired Larimorersquos housemates to take the class so they could also be prepared ndash just in case Donna Marlow a CPR trainer from the OKDHS Developmental Disabilities Services Division held the class free of charge at the agency and was proud that all the men passed their tests with flying colors
11th Circuit Rules Doctors donrsquot trump state on Medicaid care for children with disabilities by Alyson M Palmer
A federal appeals panel has declared that treating doctors donrsquot have the final say in how much nursing care the state must provide
children with disabilities under MedicaidOn April 24 the 11th US Circuit Court of Appeals reversed a district
judgersquos decision that had said the state must provide the amount of nursing care that a North Georgia girlrsquos doctor said she needs
Despite a slew of amicus briefs by state governments and Medicaid plan administrators the panel dispatched the case in a twoshypage unpublished unsigned opinion that came out a month after oral argument
Holland amp Knight partner Robert S Highsmith Jr who represented a proshystate friend of the court that provides managed care services for Medicaid programs said his client WellCare of Georgia had been concerned about language in US District Judge Thomas W Thrash Jrrsquos ruling that suggested anything ordered by a treating physician is medically necessary under the law ldquoThat one sentence just had to get reversedrdquo said Highsmith ldquoWe are very excited that they saw and reversed that clear errorrdquo
But an advocate for the teenage girl at the center of the case Atlanta Legal Aid Society General Counsel David A Webster said Monday that the decision ldquodoesnrsquot mean muchrdquo and says little about the relationship between the state and the treating physician ldquoThatrsquos going to be open for future litigationrdquo said Webster Webster said the case of his client Anna C Moore will go back to Thrash for the judge to consider the
11th Circuit Rules cont on page 15
Oklahoma Department of Human Services 9 Developmental Disabilities Services Division
I N TERFACE
ImaginingEverest The Story of LaelBy Adrienne Benz
ldquoI prayed for God to open the eyes of my understanding and the pieces began to fall into place Mollyrsquos future had been planned since she was a young girl she would marry andhave a bright healthy family known for their intelligence andkindness However the birth of her first born quickly dispelled the myth of the stereotypically perfect family as Molly learns her son Lael has Down syndrome Struggling to accept the disconcerting news and understand Godrsquos perfect plan Molly faces a challenge no more daunting than the climbing of the greatMt Everest she often dreamed of as a child Guilt hope grief and happiness take Molly and Lael across rocky terrain and risky edges but faith and the resonant voice of God bring mother and son up the emotional mountain 30 years in the making ndash a mountain that revealed the aptitude of Mollyrsquos beloved son and the kindness of others By Imagining Everest Molly and Lael forge a unique and amazing relationship which allows them to overcome even the most intimidating ascension into the unknownrdquo
Molly Mathewrsquos son Lael currently receives services through the OKDHSDDSD community waiver program
264 pages shy $1499 (paperback) This book is available online through Tate Publishing wwwtatepublishingcombookstore
Health and Human Services rescinds Medicaid regulations affecting case management
Department of Health and Human Services (HHS) Secretary
Kathleen Sebelius announed June 29 that the administration will rescind all or part of three Medicaid regulations that were previously
issued and delay the enforcement of a fourth regulation Each of these
rules in whole or in part had been subject to Congressional moratoria
set to expire on July 1 2009ldquoThese regulations if left in place would have potentially adverse
consequences for Medicaid beneficiaries some of our nationrsquos most vulnerable peoplerdquo said Secretary Sebelius ldquoBy rescinding
these rules we can expect that children will continue receiving
services through their schools beneficiaries will be able to
access all available case management resources to help them
better manage their health care and outpatient hospital and
clinic services can continue to be covered in the most efficient mannerrdquo
This ruling was crucial to Oklahomarsquos Developmental Disabilities Services as the state could have lost the ability
to bill Medicaid for 100 percent of the cost of providing
case management services to waiver service recipients which totals approximately $22 million per year
ldquoThe actions we are taking today are necessary to
ensure that the states have the flexibility they need to
fully serve Medicaidshyeligible individualsrdquo said
Secretary Sebelius
The Centers for Medicare amp Medicaid
Services (CMS) and HHS arebull Rescinding provisions of an interim final rule
published Dec 4 2007 which would have restricted beneficiary access to case management services These provisions appeared to in practice restrict beneficiary access to needed covered case management services and limit state flexibility in determining efficient and effective delivery systems for case management services
Regulations Expiring cont on page 11
Oklahoma Department of Human Services 10 Developmental Disabilities Services Division
SUMMER 2 0 0 9
Regulations Expiring cont from page 10
bull Rescinding a final rule published Dec 28 2007 that would have eliminated reimbursement for schoolshybased administrative costs and costs of transportation to and from schools The rescission reflects concern that the rule could limit the Medicaid administrative outreach activities of schools and that the overall budgetary impact on schools could potentially impact their ability to offer Medicaid services to students
bull Rescinding a rule published Nov 7 2008 that would have limited the outpatient hospital and clinic service benefit for Medicaid beneficiaries to the scope of services recognized as an outpatient hospital service under Medicare This rule was rescinded because CMS became aware that coverage beyond that scope could not be easily moved to other benefit categories resulting in great impact than previously anticipated
bull Delaying until June 30 2010 the enforcement of portions of a regulation that clarified limitations on health care related tax programs so that CMS could determine whether states need additional clarification or guidance CMS may also further review the potential impact of the regulation and give additional consideration to alternative approaches InterFace NEWSLETTER
Waiting and HopingBy Adrienne Benz
Sad is like sitting here when I donrsquot have a home to run away to
So there on the street just waiting for something to eat somewhere to stay and a bed to sleep on and someone to hold
And hoping Irsquom still there the next day
They have to get up from the street in the park sitting on a cold chair in the dark
Just waiting for someone to take them in their home Waiting to open up and talk about their hidden feelings
like they canrsquot wait any longer
Adrienne Benz was a child in state custody when she wrote this poem She is now an adult reunited with her family
Oklahoma Department of Human Services 11 Developmental Disabilities Services Division
I N T E R FA C E
DDSD Fiscal Year 2010 Budget Outlook OKDHS Director Howard Hendrick
presented the agencyrsquos Fiscal Year 2010 budget to the Commission for Human Services on June 16 Hendrick emphasized that even with the additional federal stimulus money and other oneshytime funds the agencyrsquos overall funding will be approximately $50 million short of anticipated spending levels To achieve a balanced budget cuts would have to be made within each division The Developmental Disabilities Services Divisionrsquos
share of the cuts amount to approximately 3 percent of the divisionrsquos operating budget ($17 million) Another $200000 had to be identified to fund the new initiative for Applied Behavior Analysis mandated by Senate Bill 135 this legislative sessionDDSD was able to accomplish the budget cuts without
impact to any programs or services through reductionsat the Northern and Southern Oklahoma ResourceCenters The rest of the savings came from reductions in training and professional contracts the divisions holds with various entitiesOver the next year DDSD will be under a selfshyimposed hiring
freeze for all positions except for case management direct care professionals and registered nursesIf monthly state revenue collections continue to fall below
expected levels additional reductions may be required of all stateagenciesrsquo operating budgets
Interim StudiesThere will be two interim legislative studies conducted this summer that could impact DDSD and service recipients
One of these studies will investigate a possible provider feetax on agencies providing waiver community services If the provider feetax is found to be within federal Medicaid guidelines it could possibly be used to fund rate increases in waiver services
The other legislative study will look into the pros and cons of online training versus classroom training specifically for providers of DDSD community services
Money Follows the PersonAs of this date DDSD has transitioned eight people from Northern Oklahoma Resource Center of Enid and Southern Oklahoma Resource Center into community homes using the federal Money Follows the Person grant Utilizing these federal funds DDSD has been able to save approximately $21000 in the community services provided to those individuals
Oklahoma documentary on developmental disabilities history to air on OETA
an
Oklahoma
document
ary
Adocumentary showing Oklahomarsquos history serving people with intellectual and developmental disabilities is
scheduled to begin airing on OETA (Oklahomarsquos Education Television Authority) in October during national Disabilities Awareness Month
The video ldquoWagons to Waivers A Century of Changerdquo narrated by Oklahomarsquos own country music star Reba McEntire will be broadcast on the OETAshyOklahoma channel starting on Oct 24th at 5 pm and on Nov 5th at 830 pm The program will be
aired a couple times a month
The documentary takes viewers on an emotional journey from the days of the Dust Bowl and covered wagons and shows the statersquos progression from institutional services to full community inclusion for persons with intellectual disabilities Oklahomarsquos story begins in 1909
with the creation of the Institute for the Feeble Minded in Enid and includes the
tears and efforts of parents the stories ofpeople who grew up in institutions the legal struggles and the triumph of selfshyadvocacy The video was produced by the Oklahoma Department of Human Services Developmental Disabilities Services Division
OETAshyOKLA is Cox Cable channel 112 but other television carriers as well as satellite users can access the channel which is devoted to Oklahomashyspecific programming Check your local television lis tings for specific programming dates and times
Oklahoma Department of Human Services 12 Developmental Disabilities Services Division
SUMMER 2009Compassion friendship and longevity A good measure of success
The day had finally come and Danny waited anxiously on the sofa He watched quietly as the
nursing staff set up the hospital bed and made his friend Carl comfortable The minute all was clear Danny went to Carl and told him how much he had missed him and that he needed him to get better Dannyrsquos longshytime friend had just undergone surgery
to remove a malignant brain tumor Danny didnrsquot understand the procedure or Carlrsquos prognosis ndash all that mattered was that his best friend was home It just wasnrsquot home without CarlCarl is considered the head of the household that he shares
with Danny and his other friend Hershel Carl was always the one who planned their meals said the prayers at the diningroom table and got them involved in Special Olympics events When Carl became ill and went to the hospital it was Danny
who stepped up and tried to fill in ndash just until Carl came home ldquoThe Three Musketeersrdquo (thatrsquos what their staff call them) have
been friends and have lived together for more than 30 years
Danny (lef
t) spends
hours by
Carlrsquos sid
e
encourag
ing him in his
recovery
They met as boys at The Hissom Memorial Center the nowshyclosed institution in Sand Springs for persons with developmental disabilities When they aged out of Hissom the three moved about the same time to a private facility where they lived for many years
In 1993 The Musketeers were given the opportunity to move together once again into a house in their community supported through the DDSD Medicaid Community Waiver program Since
that time they have lived in the house withsome of the same staffmembers who havecared for them for morethan 20 years
The Three Musketeers Danny (left) shows his excitement over his friend Carlrsquos (right) return from the hospital after brain surgery Shy Hershel (center) wipes tears from his eyes
Carl is recoveringfrom his surgery andworking on his abilityto speak and onregaining the use of theleft side of his bodyThe staff in the home
often has to make Danny go to bed at 1 am when hersquos still sitting beside Carl encouraging him to get better so he can go back to work
All three men have jobs and love their work ndash Carlmost of all Danny somehow knows that if Carl canjust get back to work life will continue as they onceknew it
ldquoTheyrsquore like a wellshysettled familyrdquo said Gretchen Moser their DDSD case manager ldquoEven their families consider these guys a family and respect their wishesrdquo
These days there are many opinions about what constitutes a family or even success But there are stories that transcend those discussions Stories like these that remind us success can also be measured by the love and longevity of a friend InterFace NEWSLETTER
Relations
hips
Oklahoma Department of Human Services 13 Developmental Disabilities Services Division
I N T E R F A C E
StateLegislativeNews
Of the thousand or more bills filed at the beginning of the 2009 legislative session only a few made it through the entire process that will have an impact on persons with developmental disabilities families and professionals in the field They are
HB 1007 mdash Wesselhoft Leftwich Signed by the Governor Requires specific Physically Disabled person signage to be posted as a reserved area for the parking of a vehicle displaying a valid permit
HB 1019 mdash WrightSigned by the Governor Recreates the Group Homes for Persons with Developmental or Physical Disabilities Advisory Board
HB 1048 mdash Banz AldridgeSigned by the Governor Relates to the collection of delinquent real property taxes removes physically disabled from ldquoincapacitatedrdquo persons granted additional time to redeem personal items reduces time to collect excess sale proceeds by half
HB 1065 mdash Faught Crain Signed by the Governor Relates to the Continuum of Care and Assisted Living Act adds definition and requires inspection results to be posted on website
HB 1424 mdash Protor Signed by the Governor Requires treatment facilities transitional living facilities halfway houses and any house or facility that may be used for medical or nonmedical detoxification to mail notification to property owners within a quarter mile radius if zoning changes are proposed
HB 1461 mdash Sears Ford Signed by the Governor A school that does not make adequate yearly progress for two straight years shall utilize the assistance of a school support team formed by the State Department of Education EMERGENCY
HB 1581 mdash Coody Jolley Signed by the Governor School teacher candidates that wish to teach elementary early childhood education or special education programs must study the five elements of reading instruction EMERGENCY
HB 1763 mdash Enns Reynolds Signed by the Governor Requires the state Department of Education to provide special education training for process hearing officers to ensure adequate knowledge in special education laws and proceduresEMERGENCY
HB 1893 mdash Peterson Anderson Signed by the Governor Creates the Aging and Disability Resource Consortium to work with other agencies in developing and implementing a singleshypointshyofshyentry concept for aging and disability groups in Oklahoma
SB 135 mdash Johnson Mike Signed by the Governor Provides for the licensing of certain persons to practice as a licensed behavior analyst or a licensed assistant behavior analyst and to study children with autism and their behaviors directs funds to be used by the Department of Human Services Developmental Disabilities Services division for training SoonerStart providers to treat children with autism spectrum disorders provides for a behavorial analysis research pilot project provides legislative intent
SB 518 mdash Justice Osborn Signed by the Governor Adds grandparents as members of immediate family
SB 871 mdash Anderson Signed by the Governor Modifies membership of the Electronic and Information Technology Accessibility Advisory Council
Oklahoma Department of Human Services 14 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
11th Circuit Rules cont from page 9
matter again Moore a teenager living in North Georgia who goes by ldquoCallierdquo has been receiving inshyhome nursing care paid for by Medicaid for about a decade The state has been trying to cut the number of hours of care she receives each week
The 11th Circuit interpreted a federal law that says states participating in the Medicaid program must provide ldquoearly and periodic screening diagnostic and treatment servicesrdquo that are necessary to ldquocorrect or ameliorate defects and physical and mental illnessesrdquo in Medicaidshyeligible children The primary ways children become eligible for Medicaid are that they come from a lowshyincome family or have a disability according to Joshua H Norris another one of Calliersquos lawyers
Georgiarsquos Department of Community Health operates a program to administer Medicaidshyfunded nursing services for several hundred children who need nursing care It delegates the decisions about approval of such services to an organization called the Georgia Medical Care Foundation
According to Thrashrsquos order Callie is disabled because of a stroke she experienced in utero and suffers from various chronic conditions including mental retardation and cerebral palsy She lives at home and according to the statersquos brief attends an elementary school in Athens Ga three days a week Her lawyers have said she requires constant care
The statersquos lawyers have said that nursing hours can be reduced when the patientrsquos medical condition stabilizes positing that a goal of the program is to teach parents and other caregivers to take care of their children on their own The Mooresrsquo lawyers have contended that the statersquos system of ldquoweaningrdquo patients off their nursing services as long as theyrsquore staying out of the hospitaland not getting worse follows a different standard than that set by federal law
In 2006 the state informed Calliersquos mother that it was reducing Calliersquos nursing hours from 94 hours a week to 84 contrary to the recommendation of Calliersquos primary care physician Calliersquos mother filed suit
The Mooresrsquo lawyers convinced Thrash that the reduction was improper Afterissuing multiple injunctions in Calliersquos favor he denied the statersquos motion for summary judgment and granted the Mooresrsquo motion in part concluding the state must provide for the amount of skilled nursing care that Calliersquos treating physician deems necessary The panel that ruled in favor of the state in its appeal was comprised of Senior 11th Circuit Judge R Lanier Anderson III 11th Circuit Judge Gerald B Tjoflat and US District Judge Lisa Godbey Wood visiting from the Southern District of Georgia
The panel said both the state and Calliersquos physician have roles in determining whatrsquos medically necessary to correct or ameliorate Calliersquos medical conditions It cited a federal regulation that says a Medicaid agency ldquomay place appropriate limits on a service based on such criteria as medical necessity or utilization control proceduresrdquo
ldquoA private physicianrsquos word on medical necessity is not dispositiverdquo the panel concluded
Assistant Attorney General Virginia B Fuller made the successful oral argument for the state last month Attorney General Thurbert E Bakerrsquos spokesman Russ Willard said in an eshymail that the state ldquois appreciative of the Court of Appeals decision recognizing the role of the Medicaid program in providing for this treatmentrdquo
Norris who also is director of legal advocacy for a nonprofit that advocates for people with disabilities said the 11th Circuit gave Thrash
an opportunity to say more about the roles of treating doctors and the state in deciding what care the state needs to provide Norris noted that Thrash wrote on the subject last year in another nursing care case about a Savannah Ga boy who nearly drowned when he was 2Thrash barred the state from enforcing a policy of not providing nursing care for patients requiring 16
to 24 hours per day for more than one week he said that criteria isnrsquot based on whatrsquos medically necessary under federal Medicaid law
On the other handThrash denied the plaintiff rsquos request based on the
treating physicianrsquos recommendation for 24shyhourshyashyday private nursing services for an
indefinite period of time Thrash deemed such a prescription ldquoan abuse of the Medicaid systemrdquo
The state has limited discretion to deny a providerrsquos request for care under the ldquoearly and periodic
screening diagnostic and treatment servicesrdquo portion of the Medicaid Act said Thrash He added that ldquo[t]he statersquos discretion is limited to a review of the request for fraud abuse of the Medicaid system and whether the service is within the reasonable
standards of medical carerdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 15 Developmental Disabilities Services Division
klahoma Department of Human Services
I N T E R F A C E
DDSD Area II Project Elves get together to wrap all the presents and make sure they are delivered to the individuals before Christmas Elves work year round
to make Christmas special for DDSD clients For the past eight years individuals with
developmental disabilities who donrsquot have families or who would otherwise not receive gifts have had their Christmas wishes come true thanks to caring DDSD ldquoelvesrdquo in Area II Project Elf is the brainchild of ldquoThe Men in Recrdquo namely
Steve Pitts and Roger McDaniel DDSD Area II recreational therapists and Joe Stie DDSD case manager ldquoDDSD serves a lot of people with developmental
disabilities who donrsquot have families to celebrate the holidays withrdquo said Pitts ldquoAlthough our services meet their basic needs therersquos still a gap when it comes to those special things that families do for one anotherrdquoThat gap has been filled by The Men in Rec who work all year
long coordinating various events to raise money to buy Christmas presents for individuals ldquoWe raise all of the funds and no OKDHS money is usedrdquo said
Pitts ldquoThis year we are selling Blue and Gold sausage and Amish jams We also have an annual Christmas Carol fundraising performance which is donated to Project Elf by the American Theater Company We are given 300 tickets that we can sell and last year we sold 225rdquoDDSD coshyworkers got together and purchased 44 of those theater
tickets last year for the children who happened to be in the Laura Dester Center Shelter around the holidays ldquoWe have also set up a sponsorship program where people can purchase
the gift and return it wrapped and ready for the elf (aka case manager) to deliver This last Christmas we had 108 sponsors 30 of whom were the case managers themselvesrdquo
The Men in Rec also recruit fellow DDSD workers to help shop for the gifts and wrap themldquoWe could not accomplish this awesome Project Elf without the assistance of so many of our coshyworkers and our community volunteersrdquo he said ldquoItrsquos such a pleasure to share these gifts at Christmas time and let our customers know that they have a family through our good service to themrdquoThe Men in Rec are currently working to raise money for this yearrsquos Christmas gifts If you would like to join the rank of DDSD Elves by donating funds or becoming a sponsor please contact Steve Pitts at stevepittsokdhsorg or call918shy794shy7625 InterFace NEWSLETTER
Steve Pitts (right) DDSD Area II recreational therapist gives a donated WalshyMart gift card to case manager Roy Willett to purchase a Christmas gift for one of the people on his caseload
Oklahoma Department of Human Services 16 Developmental Disabilities Services Division
shy shyshy shy
shy shy
shy shy
shy shy
shy shy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
Developmental Disabilities Services Area Offices and Resource Centers
CUSTER
ELLIS
BECKHAM WASHITA CADDO
McCLAIN
SEM
INO
LE HUGHES HASKELL
LE FLORELATIMER PITTSBURG
COAL
ATOKA
PONTOTOC
JOHNSTON
GARVIN
MURRAY
CARTER
LOVE
BRYAN CHOCTAW
PUSHMATAHA McCURTAIN
GRADY
KIOWA
TILLMAN
JACKSON HA
RM
ON
GREER
COTTON
JEFFERSON
STEPHENS
COMANCHE
McINTOSH
CLEVELAND
POTT
AWAT
OM
IE
DEWEY BLAINE
CANADIAN
MAJOR
GRANT KAY OSAGE
WA
SHIN
GTO
N CRAIG
ROGERS
CH
ERO
KEE
ADAIR TULSA
WAGONER
MAYES
OKMULGEE
CREEK
LINCOLN
LOGAN
PAYNE
KINGFISHER
OKLAHOMA OKFUSKEE
MUSKOGEE SEQUOYAH
DEL
AWA
RE
OTTAWA NOATTA
GARFIELD NOBLE
PAWNEE
WOODS ALFALFA HARPER BEAVER TEXASCIMARRON
WOODWARD
ROGER MILLS
MARSH
Oklahoma CityOklahoma City
Tulsa
Area II
Area III
Area I
Pauls Valley
Enid
wwwokdhsorg
State Officetoll free 1shy866shy521shy3571
AREA Itoll free 1shy800shy522shy1064
AREA IItoll free 1shy800shy522shy1075
AREA IIItoll free 1shy800shy522shy1086
Greer Center (Enid)2501 NE Delaware Enid OK 73701
580 237 10272599 FAX 580 213 2799
Northwest Oklahoma Resource Center at Enid (NORCE)2600 E Willow
Enid OK 73701
580 237 1027
FAX 580 548 2600
Southern Oklahoma Resource Center at Pauls Valley (SORC)3210 Chickasaw St
Pauls Valley OK 73075 6822
405 238 6401
FAX 405 238 8261
DDSD Area I Office (Enid)729 Overland Trail Enid OK 73703
580 548 8900 FAX 580 548 8964
DDSD Area I Office (Oklahoma City)4545 N Lincoln Blvd
Oklahoma City OK 73105 405 522 6925
FAX 405 522 6995
DDSD Area II Office (Tulsa)Laura Dester Center 1427 E 8th Tulsa OK 74120
918 560 4848 FAX 918 560 4898
DDSD Area III Office (Pauls Valley)301 S Indian Meridian Rd Pauls Valley OK 73075
405 238 4700 FAX 405 238 4740
If you would like to find out what the DevelopmentalDisabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
If you would like to find out what the Developmental Disabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
This will take you to the main Oklahoma Department of Human Services Web page From there just click on Divisions and Offices and the Developmental Disabilities Services Division On our Web site you will find information about services the division offers how to apply for services eligibility policies contract provider agencies and much more
Come visit us today You may be surprised at what you will learn
OKLAHOMA DEPARTMENT OF HUMAN SERVICES Developmental Disabilities Services DivisionPO Box 25352 Oklahoma City OK 73125
S U M M E R 2 0 0 9
James Nicholson Director of the OKDHS Developmental Disabilities Services Division is presented with a 2009 College of Allied Health Citation for Special Contributions (Left to Right) Jeff Berry Chair College of Allied Health Awards and Honors Committee College Dean Kevin Rudeen Nicholson and Martha Ferretti Professor and Chair Physical Therapy Department of Rehabilitation Sciences College of Allied Health
DDSD Nicholson receives award for contributions to College of Allied Health
On April 2 2009 James Nicholson Director of the OKDHS Developmental Disabilities Services
Division was presented with the 2009 College of AlliedHealth Citation for Special Contributions Nicholson was nominated for this award by Martha
Ferretti Professor and Chair Physical Therapy Department of Rehabilitation Sciences College of Allied Health University of Oklahoma Health Sciences Center In the nomination for this award Ferretti wrote ldquoMr Nicholsonrsquos background is one of diversity and richness
His work ethic sets a standard for us all to follow His calmness humor and general goodwill in the midst of controversy is obvious and remarkable And first and foremost his dedication to improving the lives of children and adults with developmental disabilities has set a standard for us all to emulate Mr Nicholsonrsquos creativity thoughtfulness and ability to target a goal and accomplish it regularly in collaboration with a number of formal and informal partners prove the importance of reaching beyond onersquos own resourcesldquoAs a visionary in the field of developmental disabilities early in his
role as director Mr Nicholson caught the attention of both supporters and detractors His vision was a perfect match for what our faculty were striving to accomplish in preparing our students and in providing servicesin the field of developmental disabilities ldquoWe approached Mr Nicholson shortly after he became the director with
a proposal for introducing assistive technology into the DDSD system differently than had been accomplished at that point Over the past 18 years
he and members of his staff have continued that collaboration on projects that addressed both major and minor challenges
about policy and services for Oklahomans with developmental disabilities
ldquoOur faculty has learned so much from this very politically astute and professional state leader Before the state was aware of its challenges emerging from children with autism and their families Mr Nicholson quietly accepted the mantle of addressing what we have come to know are unbelievable challenges presented by the impact of autism Seven years ago he convened a multishyagency multishydisciplinary task force that included parents of individuals with autism to develop the Oklahoma State Plan for Autism and the Oklahoma Autism Network We are honored by him placing the OAN within the structure of the College
ldquoMr Nicholson has stimulated us to mature as educators researchers and service providers to more effectively address many of Oklahomarsquos needs in the field of
developmental disabilitiesrdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 7 Developmental Disabilities Services Division
Nickrsquos Law
I N T E R F A C E
Insurance Mandates for autism treatments fail once again to pass Oklahoma legislature
For the second consecutive year bills that would have mandated insurance companies to cover
treatments for autism failed to pass through the Republicanshycontrolled legislatureIn February the House Economic Development and
Financial Services Committee voted down House Bill 1312 also known as ldquoNickrsquos Lawrdquo which would have required insurance providers to cover autism treatment The only autismshyrelated bills that did receive enough
support to pass were House Bill 2027 and its companion Senate Bill 135 The Senate version made it through the legislative process and will enact a licensing process for national board certified behavior analysts and enhance existing state programs that would train doctors to diagnose and treat autism Critics of this bill question whether it will actually produce
significant new services if insurance doesnrsquot cover the cost of treatment and parents canrsquot afford to pay the bill
ldquoSadly this bill will do nothing to relieve the pressure on families struggling to care for children with autismrdquo said Sen Jay Paul Gumm author of lsquoNickrsquos Lawrsquo legislation ldquoThis measure was designed to relieve political pressure on legislators who refuse to even consider Nickrsquos Lawrdquo
When Governor Henry signed Senate Bill 135 he said the measure was just a small step in the effort to help affected Oklahoma families He urged lawmakers to pass legislation to mandate insurance coverage for the treatment of autism
ldquoThere is nothing wrong with this bill just like there is nothing wrong with a pack of shingles at a construction siterdquo said Sen Gumm ldquoIf you try to put the shingles on before you pour the foundation you are doomed to failure As Governor Henry wisely noted when he signed the bill the foundation is insurance coverage of autism Absent that Senate Bill 135 is doomed to failurerdquo
Republican legislative leaders oppose insurance mandates saying they drive up the cost of health insurance despite reports from states with similar insurance mandates that show no significant increase in the cost of premiums
Republicans attempted to pass House Bill 1975 which would only allow insurance legislation to be introduced in oddshynumbered years and approved in evenshynumbered years The bill would have also required a 75 percent supershymajority vote to do away with the mandate in the case of an emergency
Henry vetoed that bill and said it would have unreasonably ldquotied the hands of state policy makers on a very important issuerdquo
ldquoThis would empower a small minority of legislators to thwart legitimate state efforts to address a pressing public policy issue and ensure that the restriction would rarely if ever be liftedrdquo Henry said
Henry also questioned why HB 1975 restrictions were only applied to a single issue area saying it raised legitimate concerns regarding why only one subject would be singled out for special treatment
Autism cont on page 9
Oklahoma Department of Human Services 8 Developmental Disabilities Services Division
SUMMER 2009
Autism cont from page 8
ldquoOklahoma and its citizens are better served when policy makers are allowed the freedom to address any pressing issue in the Legislature without the hindrance of arbitrary restrictionsrdquo Henry said Democrats offered a compromise mdash to put autism coverage in highshy
risk insurance pools as a last resort for families who canrsquot afford the coverage elsewhere Republicans again declined and instead went forward with SB 135 This year three more states enacted Autism Mandate legislation bringing
the total to 11 states that now require insurance companies to cover treatment for autism InterFace NEWSLETTER
Proudly displaying their CPR (Cardio Pulmonary Resuscitation) certificates are (From Left) Guy Bivens Allen Larimore Steve Sposato Andy Edwards Joshua Johnson and Tino Hensley residents of the Independence House
Residents of the Independence House at the Home of Hope in Vinita recently became CPR certified after a fellow resident had a heart attack A staff member used CPR to save Allen Larimorersquos life and he has since received a pacemaker Although staff members must be CPR certified this event inspired Larimorersquos housemates to take the class so they could also be prepared ndash just in case Donna Marlow a CPR trainer from the OKDHS Developmental Disabilities Services Division held the class free of charge at the agency and was proud that all the men passed their tests with flying colors
11th Circuit Rules Doctors donrsquot trump state on Medicaid care for children with disabilities by Alyson M Palmer
A federal appeals panel has declared that treating doctors donrsquot have the final say in how much nursing care the state must provide
children with disabilities under MedicaidOn April 24 the 11th US Circuit Court of Appeals reversed a district
judgersquos decision that had said the state must provide the amount of nursing care that a North Georgia girlrsquos doctor said she needs
Despite a slew of amicus briefs by state governments and Medicaid plan administrators the panel dispatched the case in a twoshypage unpublished unsigned opinion that came out a month after oral argument
Holland amp Knight partner Robert S Highsmith Jr who represented a proshystate friend of the court that provides managed care services for Medicaid programs said his client WellCare of Georgia had been concerned about language in US District Judge Thomas W Thrash Jrrsquos ruling that suggested anything ordered by a treating physician is medically necessary under the law ldquoThat one sentence just had to get reversedrdquo said Highsmith ldquoWe are very excited that they saw and reversed that clear errorrdquo
But an advocate for the teenage girl at the center of the case Atlanta Legal Aid Society General Counsel David A Webster said Monday that the decision ldquodoesnrsquot mean muchrdquo and says little about the relationship between the state and the treating physician ldquoThatrsquos going to be open for future litigationrdquo said Webster Webster said the case of his client Anna C Moore will go back to Thrash for the judge to consider the
11th Circuit Rules cont on page 15
Oklahoma Department of Human Services 9 Developmental Disabilities Services Division
I N TERFACE
ImaginingEverest The Story of LaelBy Adrienne Benz
ldquoI prayed for God to open the eyes of my understanding and the pieces began to fall into place Mollyrsquos future had been planned since she was a young girl she would marry andhave a bright healthy family known for their intelligence andkindness However the birth of her first born quickly dispelled the myth of the stereotypically perfect family as Molly learns her son Lael has Down syndrome Struggling to accept the disconcerting news and understand Godrsquos perfect plan Molly faces a challenge no more daunting than the climbing of the greatMt Everest she often dreamed of as a child Guilt hope grief and happiness take Molly and Lael across rocky terrain and risky edges but faith and the resonant voice of God bring mother and son up the emotional mountain 30 years in the making ndash a mountain that revealed the aptitude of Mollyrsquos beloved son and the kindness of others By Imagining Everest Molly and Lael forge a unique and amazing relationship which allows them to overcome even the most intimidating ascension into the unknownrdquo
Molly Mathewrsquos son Lael currently receives services through the OKDHSDDSD community waiver program
264 pages shy $1499 (paperback) This book is available online through Tate Publishing wwwtatepublishingcombookstore
Health and Human Services rescinds Medicaid regulations affecting case management
Department of Health and Human Services (HHS) Secretary
Kathleen Sebelius announed June 29 that the administration will rescind all or part of three Medicaid regulations that were previously
issued and delay the enforcement of a fourth regulation Each of these
rules in whole or in part had been subject to Congressional moratoria
set to expire on July 1 2009ldquoThese regulations if left in place would have potentially adverse
consequences for Medicaid beneficiaries some of our nationrsquos most vulnerable peoplerdquo said Secretary Sebelius ldquoBy rescinding
these rules we can expect that children will continue receiving
services through their schools beneficiaries will be able to
access all available case management resources to help them
better manage their health care and outpatient hospital and
clinic services can continue to be covered in the most efficient mannerrdquo
This ruling was crucial to Oklahomarsquos Developmental Disabilities Services as the state could have lost the ability
to bill Medicaid for 100 percent of the cost of providing
case management services to waiver service recipients which totals approximately $22 million per year
ldquoThe actions we are taking today are necessary to
ensure that the states have the flexibility they need to
fully serve Medicaidshyeligible individualsrdquo said
Secretary Sebelius
The Centers for Medicare amp Medicaid
Services (CMS) and HHS arebull Rescinding provisions of an interim final rule
published Dec 4 2007 which would have restricted beneficiary access to case management services These provisions appeared to in practice restrict beneficiary access to needed covered case management services and limit state flexibility in determining efficient and effective delivery systems for case management services
Regulations Expiring cont on page 11
Oklahoma Department of Human Services 10 Developmental Disabilities Services Division
SUMMER 2 0 0 9
Regulations Expiring cont from page 10
bull Rescinding a final rule published Dec 28 2007 that would have eliminated reimbursement for schoolshybased administrative costs and costs of transportation to and from schools The rescission reflects concern that the rule could limit the Medicaid administrative outreach activities of schools and that the overall budgetary impact on schools could potentially impact their ability to offer Medicaid services to students
bull Rescinding a rule published Nov 7 2008 that would have limited the outpatient hospital and clinic service benefit for Medicaid beneficiaries to the scope of services recognized as an outpatient hospital service under Medicare This rule was rescinded because CMS became aware that coverage beyond that scope could not be easily moved to other benefit categories resulting in great impact than previously anticipated
bull Delaying until June 30 2010 the enforcement of portions of a regulation that clarified limitations on health care related tax programs so that CMS could determine whether states need additional clarification or guidance CMS may also further review the potential impact of the regulation and give additional consideration to alternative approaches InterFace NEWSLETTER
Waiting and HopingBy Adrienne Benz
Sad is like sitting here when I donrsquot have a home to run away to
So there on the street just waiting for something to eat somewhere to stay and a bed to sleep on and someone to hold
And hoping Irsquom still there the next day
They have to get up from the street in the park sitting on a cold chair in the dark
Just waiting for someone to take them in their home Waiting to open up and talk about their hidden feelings
like they canrsquot wait any longer
Adrienne Benz was a child in state custody when she wrote this poem She is now an adult reunited with her family
Oklahoma Department of Human Services 11 Developmental Disabilities Services Division
I N T E R FA C E
DDSD Fiscal Year 2010 Budget Outlook OKDHS Director Howard Hendrick
presented the agencyrsquos Fiscal Year 2010 budget to the Commission for Human Services on June 16 Hendrick emphasized that even with the additional federal stimulus money and other oneshytime funds the agencyrsquos overall funding will be approximately $50 million short of anticipated spending levels To achieve a balanced budget cuts would have to be made within each division The Developmental Disabilities Services Divisionrsquos
share of the cuts amount to approximately 3 percent of the divisionrsquos operating budget ($17 million) Another $200000 had to be identified to fund the new initiative for Applied Behavior Analysis mandated by Senate Bill 135 this legislative sessionDDSD was able to accomplish the budget cuts without
impact to any programs or services through reductionsat the Northern and Southern Oklahoma ResourceCenters The rest of the savings came from reductions in training and professional contracts the divisions holds with various entitiesOver the next year DDSD will be under a selfshyimposed hiring
freeze for all positions except for case management direct care professionals and registered nursesIf monthly state revenue collections continue to fall below
expected levels additional reductions may be required of all stateagenciesrsquo operating budgets
Interim StudiesThere will be two interim legislative studies conducted this summer that could impact DDSD and service recipients
One of these studies will investigate a possible provider feetax on agencies providing waiver community services If the provider feetax is found to be within federal Medicaid guidelines it could possibly be used to fund rate increases in waiver services
The other legislative study will look into the pros and cons of online training versus classroom training specifically for providers of DDSD community services
Money Follows the PersonAs of this date DDSD has transitioned eight people from Northern Oklahoma Resource Center of Enid and Southern Oklahoma Resource Center into community homes using the federal Money Follows the Person grant Utilizing these federal funds DDSD has been able to save approximately $21000 in the community services provided to those individuals
Oklahoma documentary on developmental disabilities history to air on OETA
an
Oklahoma
document
ary
Adocumentary showing Oklahomarsquos history serving people with intellectual and developmental disabilities is
scheduled to begin airing on OETA (Oklahomarsquos Education Television Authority) in October during national Disabilities Awareness Month
The video ldquoWagons to Waivers A Century of Changerdquo narrated by Oklahomarsquos own country music star Reba McEntire will be broadcast on the OETAshyOklahoma channel starting on Oct 24th at 5 pm and on Nov 5th at 830 pm The program will be
aired a couple times a month
The documentary takes viewers on an emotional journey from the days of the Dust Bowl and covered wagons and shows the statersquos progression from institutional services to full community inclusion for persons with intellectual disabilities Oklahomarsquos story begins in 1909
with the creation of the Institute for the Feeble Minded in Enid and includes the
tears and efforts of parents the stories ofpeople who grew up in institutions the legal struggles and the triumph of selfshyadvocacy The video was produced by the Oklahoma Department of Human Services Developmental Disabilities Services Division
OETAshyOKLA is Cox Cable channel 112 but other television carriers as well as satellite users can access the channel which is devoted to Oklahomashyspecific programming Check your local television lis tings for specific programming dates and times
Oklahoma Department of Human Services 12 Developmental Disabilities Services Division
SUMMER 2009Compassion friendship and longevity A good measure of success
The day had finally come and Danny waited anxiously on the sofa He watched quietly as the
nursing staff set up the hospital bed and made his friend Carl comfortable The minute all was clear Danny went to Carl and told him how much he had missed him and that he needed him to get better Dannyrsquos longshytime friend had just undergone surgery
to remove a malignant brain tumor Danny didnrsquot understand the procedure or Carlrsquos prognosis ndash all that mattered was that his best friend was home It just wasnrsquot home without CarlCarl is considered the head of the household that he shares
with Danny and his other friend Hershel Carl was always the one who planned their meals said the prayers at the diningroom table and got them involved in Special Olympics events When Carl became ill and went to the hospital it was Danny
who stepped up and tried to fill in ndash just until Carl came home ldquoThe Three Musketeersrdquo (thatrsquos what their staff call them) have
been friends and have lived together for more than 30 years
Danny (lef
t) spends
hours by
Carlrsquos sid
e
encourag
ing him in his
recovery
They met as boys at The Hissom Memorial Center the nowshyclosed institution in Sand Springs for persons with developmental disabilities When they aged out of Hissom the three moved about the same time to a private facility where they lived for many years
In 1993 The Musketeers were given the opportunity to move together once again into a house in their community supported through the DDSD Medicaid Community Waiver program Since
that time they have lived in the house withsome of the same staffmembers who havecared for them for morethan 20 years
The Three Musketeers Danny (left) shows his excitement over his friend Carlrsquos (right) return from the hospital after brain surgery Shy Hershel (center) wipes tears from his eyes
Carl is recoveringfrom his surgery andworking on his abilityto speak and onregaining the use of theleft side of his bodyThe staff in the home
often has to make Danny go to bed at 1 am when hersquos still sitting beside Carl encouraging him to get better so he can go back to work
All three men have jobs and love their work ndash Carlmost of all Danny somehow knows that if Carl canjust get back to work life will continue as they onceknew it
ldquoTheyrsquore like a wellshysettled familyrdquo said Gretchen Moser their DDSD case manager ldquoEven their families consider these guys a family and respect their wishesrdquo
These days there are many opinions about what constitutes a family or even success But there are stories that transcend those discussions Stories like these that remind us success can also be measured by the love and longevity of a friend InterFace NEWSLETTER
Relations
hips
Oklahoma Department of Human Services 13 Developmental Disabilities Services Division
I N T E R F A C E
StateLegislativeNews
Of the thousand or more bills filed at the beginning of the 2009 legislative session only a few made it through the entire process that will have an impact on persons with developmental disabilities families and professionals in the field They are
HB 1007 mdash Wesselhoft Leftwich Signed by the Governor Requires specific Physically Disabled person signage to be posted as a reserved area for the parking of a vehicle displaying a valid permit
HB 1019 mdash WrightSigned by the Governor Recreates the Group Homes for Persons with Developmental or Physical Disabilities Advisory Board
HB 1048 mdash Banz AldridgeSigned by the Governor Relates to the collection of delinquent real property taxes removes physically disabled from ldquoincapacitatedrdquo persons granted additional time to redeem personal items reduces time to collect excess sale proceeds by half
HB 1065 mdash Faught Crain Signed by the Governor Relates to the Continuum of Care and Assisted Living Act adds definition and requires inspection results to be posted on website
HB 1424 mdash Protor Signed by the Governor Requires treatment facilities transitional living facilities halfway houses and any house or facility that may be used for medical or nonmedical detoxification to mail notification to property owners within a quarter mile radius if zoning changes are proposed
HB 1461 mdash Sears Ford Signed by the Governor A school that does not make adequate yearly progress for two straight years shall utilize the assistance of a school support team formed by the State Department of Education EMERGENCY
HB 1581 mdash Coody Jolley Signed by the Governor School teacher candidates that wish to teach elementary early childhood education or special education programs must study the five elements of reading instruction EMERGENCY
HB 1763 mdash Enns Reynolds Signed by the Governor Requires the state Department of Education to provide special education training for process hearing officers to ensure adequate knowledge in special education laws and proceduresEMERGENCY
HB 1893 mdash Peterson Anderson Signed by the Governor Creates the Aging and Disability Resource Consortium to work with other agencies in developing and implementing a singleshypointshyofshyentry concept for aging and disability groups in Oklahoma
SB 135 mdash Johnson Mike Signed by the Governor Provides for the licensing of certain persons to practice as a licensed behavior analyst or a licensed assistant behavior analyst and to study children with autism and their behaviors directs funds to be used by the Department of Human Services Developmental Disabilities Services division for training SoonerStart providers to treat children with autism spectrum disorders provides for a behavorial analysis research pilot project provides legislative intent
SB 518 mdash Justice Osborn Signed by the Governor Adds grandparents as members of immediate family
SB 871 mdash Anderson Signed by the Governor Modifies membership of the Electronic and Information Technology Accessibility Advisory Council
Oklahoma Department of Human Services 14 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
11th Circuit Rules cont from page 9
matter again Moore a teenager living in North Georgia who goes by ldquoCallierdquo has been receiving inshyhome nursing care paid for by Medicaid for about a decade The state has been trying to cut the number of hours of care she receives each week
The 11th Circuit interpreted a federal law that says states participating in the Medicaid program must provide ldquoearly and periodic screening diagnostic and treatment servicesrdquo that are necessary to ldquocorrect or ameliorate defects and physical and mental illnessesrdquo in Medicaidshyeligible children The primary ways children become eligible for Medicaid are that they come from a lowshyincome family or have a disability according to Joshua H Norris another one of Calliersquos lawyers
Georgiarsquos Department of Community Health operates a program to administer Medicaidshyfunded nursing services for several hundred children who need nursing care It delegates the decisions about approval of such services to an organization called the Georgia Medical Care Foundation
According to Thrashrsquos order Callie is disabled because of a stroke she experienced in utero and suffers from various chronic conditions including mental retardation and cerebral palsy She lives at home and according to the statersquos brief attends an elementary school in Athens Ga three days a week Her lawyers have said she requires constant care
The statersquos lawyers have said that nursing hours can be reduced when the patientrsquos medical condition stabilizes positing that a goal of the program is to teach parents and other caregivers to take care of their children on their own The Mooresrsquo lawyers have contended that the statersquos system of ldquoweaningrdquo patients off their nursing services as long as theyrsquore staying out of the hospitaland not getting worse follows a different standard than that set by federal law
In 2006 the state informed Calliersquos mother that it was reducing Calliersquos nursing hours from 94 hours a week to 84 contrary to the recommendation of Calliersquos primary care physician Calliersquos mother filed suit
The Mooresrsquo lawyers convinced Thrash that the reduction was improper Afterissuing multiple injunctions in Calliersquos favor he denied the statersquos motion for summary judgment and granted the Mooresrsquo motion in part concluding the state must provide for the amount of skilled nursing care that Calliersquos treating physician deems necessary The panel that ruled in favor of the state in its appeal was comprised of Senior 11th Circuit Judge R Lanier Anderson III 11th Circuit Judge Gerald B Tjoflat and US District Judge Lisa Godbey Wood visiting from the Southern District of Georgia
The panel said both the state and Calliersquos physician have roles in determining whatrsquos medically necessary to correct or ameliorate Calliersquos medical conditions It cited a federal regulation that says a Medicaid agency ldquomay place appropriate limits on a service based on such criteria as medical necessity or utilization control proceduresrdquo
ldquoA private physicianrsquos word on medical necessity is not dispositiverdquo the panel concluded
Assistant Attorney General Virginia B Fuller made the successful oral argument for the state last month Attorney General Thurbert E Bakerrsquos spokesman Russ Willard said in an eshymail that the state ldquois appreciative of the Court of Appeals decision recognizing the role of the Medicaid program in providing for this treatmentrdquo
Norris who also is director of legal advocacy for a nonprofit that advocates for people with disabilities said the 11th Circuit gave Thrash
an opportunity to say more about the roles of treating doctors and the state in deciding what care the state needs to provide Norris noted that Thrash wrote on the subject last year in another nursing care case about a Savannah Ga boy who nearly drowned when he was 2Thrash barred the state from enforcing a policy of not providing nursing care for patients requiring 16
to 24 hours per day for more than one week he said that criteria isnrsquot based on whatrsquos medically necessary under federal Medicaid law
On the other handThrash denied the plaintiff rsquos request based on the
treating physicianrsquos recommendation for 24shyhourshyashyday private nursing services for an
indefinite period of time Thrash deemed such a prescription ldquoan abuse of the Medicaid systemrdquo
The state has limited discretion to deny a providerrsquos request for care under the ldquoearly and periodic
screening diagnostic and treatment servicesrdquo portion of the Medicaid Act said Thrash He added that ldquo[t]he statersquos discretion is limited to a review of the request for fraud abuse of the Medicaid system and whether the service is within the reasonable
standards of medical carerdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 15 Developmental Disabilities Services Division
klahoma Department of Human Services
I N T E R F A C E
DDSD Area II Project Elves get together to wrap all the presents and make sure they are delivered to the individuals before Christmas Elves work year round
to make Christmas special for DDSD clients For the past eight years individuals with
developmental disabilities who donrsquot have families or who would otherwise not receive gifts have had their Christmas wishes come true thanks to caring DDSD ldquoelvesrdquo in Area II Project Elf is the brainchild of ldquoThe Men in Recrdquo namely
Steve Pitts and Roger McDaniel DDSD Area II recreational therapists and Joe Stie DDSD case manager ldquoDDSD serves a lot of people with developmental
disabilities who donrsquot have families to celebrate the holidays withrdquo said Pitts ldquoAlthough our services meet their basic needs therersquos still a gap when it comes to those special things that families do for one anotherrdquoThat gap has been filled by The Men in Rec who work all year
long coordinating various events to raise money to buy Christmas presents for individuals ldquoWe raise all of the funds and no OKDHS money is usedrdquo said
Pitts ldquoThis year we are selling Blue and Gold sausage and Amish jams We also have an annual Christmas Carol fundraising performance which is donated to Project Elf by the American Theater Company We are given 300 tickets that we can sell and last year we sold 225rdquoDDSD coshyworkers got together and purchased 44 of those theater
tickets last year for the children who happened to be in the Laura Dester Center Shelter around the holidays ldquoWe have also set up a sponsorship program where people can purchase
the gift and return it wrapped and ready for the elf (aka case manager) to deliver This last Christmas we had 108 sponsors 30 of whom were the case managers themselvesrdquo
The Men in Rec also recruit fellow DDSD workers to help shop for the gifts and wrap themldquoWe could not accomplish this awesome Project Elf without the assistance of so many of our coshyworkers and our community volunteersrdquo he said ldquoItrsquos such a pleasure to share these gifts at Christmas time and let our customers know that they have a family through our good service to themrdquoThe Men in Rec are currently working to raise money for this yearrsquos Christmas gifts If you would like to join the rank of DDSD Elves by donating funds or becoming a sponsor please contact Steve Pitts at stevepittsokdhsorg or call918shy794shy7625 InterFace NEWSLETTER
Steve Pitts (right) DDSD Area II recreational therapist gives a donated WalshyMart gift card to case manager Roy Willett to purchase a Christmas gift for one of the people on his caseload
Oklahoma Department of Human Services 16 Developmental Disabilities Services Division
shy shyshy shy
shy shy
shy shy
shy shy
shy shy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
Developmental Disabilities Services Area Offices and Resource Centers
CUSTER
ELLIS
BECKHAM WASHITA CADDO
McCLAIN
SEM
INO
LE HUGHES HASKELL
LE FLORELATIMER PITTSBURG
COAL
ATOKA
PONTOTOC
JOHNSTON
GARVIN
MURRAY
CARTER
LOVE
BRYAN CHOCTAW
PUSHMATAHA McCURTAIN
GRADY
KIOWA
TILLMAN
JACKSON HA
RM
ON
GREER
COTTON
JEFFERSON
STEPHENS
COMANCHE
McINTOSH
CLEVELAND
POTT
AWAT
OM
IE
DEWEY BLAINE
CANADIAN
MAJOR
GRANT KAY OSAGE
WA
SHIN
GTO
N CRAIG
ROGERS
CH
ERO
KEE
ADAIR TULSA
WAGONER
MAYES
OKMULGEE
CREEK
LINCOLN
LOGAN
PAYNE
KINGFISHER
OKLAHOMA OKFUSKEE
MUSKOGEE SEQUOYAH
DEL
AWA
RE
OTTAWA NOATTA
GARFIELD NOBLE
PAWNEE
WOODS ALFALFA HARPER BEAVER TEXASCIMARRON
WOODWARD
ROGER MILLS
MARSH
Oklahoma CityOklahoma City
Tulsa
Area II
Area III
Area I
Pauls Valley
Enid
wwwokdhsorg
State Officetoll free 1shy866shy521shy3571
AREA Itoll free 1shy800shy522shy1064
AREA IItoll free 1shy800shy522shy1075
AREA IIItoll free 1shy800shy522shy1086
Greer Center (Enid)2501 NE Delaware Enid OK 73701
580 237 10272599 FAX 580 213 2799
Northwest Oklahoma Resource Center at Enid (NORCE)2600 E Willow
Enid OK 73701
580 237 1027
FAX 580 548 2600
Southern Oklahoma Resource Center at Pauls Valley (SORC)3210 Chickasaw St
Pauls Valley OK 73075 6822
405 238 6401
FAX 405 238 8261
DDSD Area I Office (Enid)729 Overland Trail Enid OK 73703
580 548 8900 FAX 580 548 8964
DDSD Area I Office (Oklahoma City)4545 N Lincoln Blvd
Oklahoma City OK 73105 405 522 6925
FAX 405 522 6995
DDSD Area II Office (Tulsa)Laura Dester Center 1427 E 8th Tulsa OK 74120
918 560 4848 FAX 918 560 4898
DDSD Area III Office (Pauls Valley)301 S Indian Meridian Rd Pauls Valley OK 73075
405 238 4700 FAX 405 238 4740
If you would like to find out what the DevelopmentalDisabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
If you would like to find out what the Developmental Disabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
This will take you to the main Oklahoma Department of Human Services Web page From there just click on Divisions and Offices and the Developmental Disabilities Services Division On our Web site you will find information about services the division offers how to apply for services eligibility policies contract provider agencies and much more
Come visit us today You may be surprised at what you will learn
OKLAHOMA DEPARTMENT OF HUMAN SERVICES Developmental Disabilities Services DivisionPO Box 25352 Oklahoma City OK 73125
Nickrsquos Law
I N T E R F A C E
Insurance Mandates for autism treatments fail once again to pass Oklahoma legislature
For the second consecutive year bills that would have mandated insurance companies to cover
treatments for autism failed to pass through the Republicanshycontrolled legislatureIn February the House Economic Development and
Financial Services Committee voted down House Bill 1312 also known as ldquoNickrsquos Lawrdquo which would have required insurance providers to cover autism treatment The only autismshyrelated bills that did receive enough
support to pass were House Bill 2027 and its companion Senate Bill 135 The Senate version made it through the legislative process and will enact a licensing process for national board certified behavior analysts and enhance existing state programs that would train doctors to diagnose and treat autism Critics of this bill question whether it will actually produce
significant new services if insurance doesnrsquot cover the cost of treatment and parents canrsquot afford to pay the bill
ldquoSadly this bill will do nothing to relieve the pressure on families struggling to care for children with autismrdquo said Sen Jay Paul Gumm author of lsquoNickrsquos Lawrsquo legislation ldquoThis measure was designed to relieve political pressure on legislators who refuse to even consider Nickrsquos Lawrdquo
When Governor Henry signed Senate Bill 135 he said the measure was just a small step in the effort to help affected Oklahoma families He urged lawmakers to pass legislation to mandate insurance coverage for the treatment of autism
ldquoThere is nothing wrong with this bill just like there is nothing wrong with a pack of shingles at a construction siterdquo said Sen Gumm ldquoIf you try to put the shingles on before you pour the foundation you are doomed to failure As Governor Henry wisely noted when he signed the bill the foundation is insurance coverage of autism Absent that Senate Bill 135 is doomed to failurerdquo
Republican legislative leaders oppose insurance mandates saying they drive up the cost of health insurance despite reports from states with similar insurance mandates that show no significant increase in the cost of premiums
Republicans attempted to pass House Bill 1975 which would only allow insurance legislation to be introduced in oddshynumbered years and approved in evenshynumbered years The bill would have also required a 75 percent supershymajority vote to do away with the mandate in the case of an emergency
Henry vetoed that bill and said it would have unreasonably ldquotied the hands of state policy makers on a very important issuerdquo
ldquoThis would empower a small minority of legislators to thwart legitimate state efforts to address a pressing public policy issue and ensure that the restriction would rarely if ever be liftedrdquo Henry said
Henry also questioned why HB 1975 restrictions were only applied to a single issue area saying it raised legitimate concerns regarding why only one subject would be singled out for special treatment
Autism cont on page 9
Oklahoma Department of Human Services 8 Developmental Disabilities Services Division
SUMMER 2009
Autism cont from page 8
ldquoOklahoma and its citizens are better served when policy makers are allowed the freedom to address any pressing issue in the Legislature without the hindrance of arbitrary restrictionsrdquo Henry said Democrats offered a compromise mdash to put autism coverage in highshy
risk insurance pools as a last resort for families who canrsquot afford the coverage elsewhere Republicans again declined and instead went forward with SB 135 This year three more states enacted Autism Mandate legislation bringing
the total to 11 states that now require insurance companies to cover treatment for autism InterFace NEWSLETTER
Proudly displaying their CPR (Cardio Pulmonary Resuscitation) certificates are (From Left) Guy Bivens Allen Larimore Steve Sposato Andy Edwards Joshua Johnson and Tino Hensley residents of the Independence House
Residents of the Independence House at the Home of Hope in Vinita recently became CPR certified after a fellow resident had a heart attack A staff member used CPR to save Allen Larimorersquos life and he has since received a pacemaker Although staff members must be CPR certified this event inspired Larimorersquos housemates to take the class so they could also be prepared ndash just in case Donna Marlow a CPR trainer from the OKDHS Developmental Disabilities Services Division held the class free of charge at the agency and was proud that all the men passed their tests with flying colors
11th Circuit Rules Doctors donrsquot trump state on Medicaid care for children with disabilities by Alyson M Palmer
A federal appeals panel has declared that treating doctors donrsquot have the final say in how much nursing care the state must provide
children with disabilities under MedicaidOn April 24 the 11th US Circuit Court of Appeals reversed a district
judgersquos decision that had said the state must provide the amount of nursing care that a North Georgia girlrsquos doctor said she needs
Despite a slew of amicus briefs by state governments and Medicaid plan administrators the panel dispatched the case in a twoshypage unpublished unsigned opinion that came out a month after oral argument
Holland amp Knight partner Robert S Highsmith Jr who represented a proshystate friend of the court that provides managed care services for Medicaid programs said his client WellCare of Georgia had been concerned about language in US District Judge Thomas W Thrash Jrrsquos ruling that suggested anything ordered by a treating physician is medically necessary under the law ldquoThat one sentence just had to get reversedrdquo said Highsmith ldquoWe are very excited that they saw and reversed that clear errorrdquo
But an advocate for the teenage girl at the center of the case Atlanta Legal Aid Society General Counsel David A Webster said Monday that the decision ldquodoesnrsquot mean muchrdquo and says little about the relationship between the state and the treating physician ldquoThatrsquos going to be open for future litigationrdquo said Webster Webster said the case of his client Anna C Moore will go back to Thrash for the judge to consider the
11th Circuit Rules cont on page 15
Oklahoma Department of Human Services 9 Developmental Disabilities Services Division
I N TERFACE
ImaginingEverest The Story of LaelBy Adrienne Benz
ldquoI prayed for God to open the eyes of my understanding and the pieces began to fall into place Mollyrsquos future had been planned since she was a young girl she would marry andhave a bright healthy family known for their intelligence andkindness However the birth of her first born quickly dispelled the myth of the stereotypically perfect family as Molly learns her son Lael has Down syndrome Struggling to accept the disconcerting news and understand Godrsquos perfect plan Molly faces a challenge no more daunting than the climbing of the greatMt Everest she often dreamed of as a child Guilt hope grief and happiness take Molly and Lael across rocky terrain and risky edges but faith and the resonant voice of God bring mother and son up the emotional mountain 30 years in the making ndash a mountain that revealed the aptitude of Mollyrsquos beloved son and the kindness of others By Imagining Everest Molly and Lael forge a unique and amazing relationship which allows them to overcome even the most intimidating ascension into the unknownrdquo
Molly Mathewrsquos son Lael currently receives services through the OKDHSDDSD community waiver program
264 pages shy $1499 (paperback) This book is available online through Tate Publishing wwwtatepublishingcombookstore
Health and Human Services rescinds Medicaid regulations affecting case management
Department of Health and Human Services (HHS) Secretary
Kathleen Sebelius announed June 29 that the administration will rescind all or part of three Medicaid regulations that were previously
issued and delay the enforcement of a fourth regulation Each of these
rules in whole or in part had been subject to Congressional moratoria
set to expire on July 1 2009ldquoThese regulations if left in place would have potentially adverse
consequences for Medicaid beneficiaries some of our nationrsquos most vulnerable peoplerdquo said Secretary Sebelius ldquoBy rescinding
these rules we can expect that children will continue receiving
services through their schools beneficiaries will be able to
access all available case management resources to help them
better manage their health care and outpatient hospital and
clinic services can continue to be covered in the most efficient mannerrdquo
This ruling was crucial to Oklahomarsquos Developmental Disabilities Services as the state could have lost the ability
to bill Medicaid for 100 percent of the cost of providing
case management services to waiver service recipients which totals approximately $22 million per year
ldquoThe actions we are taking today are necessary to
ensure that the states have the flexibility they need to
fully serve Medicaidshyeligible individualsrdquo said
Secretary Sebelius
The Centers for Medicare amp Medicaid
Services (CMS) and HHS arebull Rescinding provisions of an interim final rule
published Dec 4 2007 which would have restricted beneficiary access to case management services These provisions appeared to in practice restrict beneficiary access to needed covered case management services and limit state flexibility in determining efficient and effective delivery systems for case management services
Regulations Expiring cont on page 11
Oklahoma Department of Human Services 10 Developmental Disabilities Services Division
SUMMER 2 0 0 9
Regulations Expiring cont from page 10
bull Rescinding a final rule published Dec 28 2007 that would have eliminated reimbursement for schoolshybased administrative costs and costs of transportation to and from schools The rescission reflects concern that the rule could limit the Medicaid administrative outreach activities of schools and that the overall budgetary impact on schools could potentially impact their ability to offer Medicaid services to students
bull Rescinding a rule published Nov 7 2008 that would have limited the outpatient hospital and clinic service benefit for Medicaid beneficiaries to the scope of services recognized as an outpatient hospital service under Medicare This rule was rescinded because CMS became aware that coverage beyond that scope could not be easily moved to other benefit categories resulting in great impact than previously anticipated
bull Delaying until June 30 2010 the enforcement of portions of a regulation that clarified limitations on health care related tax programs so that CMS could determine whether states need additional clarification or guidance CMS may also further review the potential impact of the regulation and give additional consideration to alternative approaches InterFace NEWSLETTER
Waiting and HopingBy Adrienne Benz
Sad is like sitting here when I donrsquot have a home to run away to
So there on the street just waiting for something to eat somewhere to stay and a bed to sleep on and someone to hold
And hoping Irsquom still there the next day
They have to get up from the street in the park sitting on a cold chair in the dark
Just waiting for someone to take them in their home Waiting to open up and talk about their hidden feelings
like they canrsquot wait any longer
Adrienne Benz was a child in state custody when she wrote this poem She is now an adult reunited with her family
Oklahoma Department of Human Services 11 Developmental Disabilities Services Division
I N T E R FA C E
DDSD Fiscal Year 2010 Budget Outlook OKDHS Director Howard Hendrick
presented the agencyrsquos Fiscal Year 2010 budget to the Commission for Human Services on June 16 Hendrick emphasized that even with the additional federal stimulus money and other oneshytime funds the agencyrsquos overall funding will be approximately $50 million short of anticipated spending levels To achieve a balanced budget cuts would have to be made within each division The Developmental Disabilities Services Divisionrsquos
share of the cuts amount to approximately 3 percent of the divisionrsquos operating budget ($17 million) Another $200000 had to be identified to fund the new initiative for Applied Behavior Analysis mandated by Senate Bill 135 this legislative sessionDDSD was able to accomplish the budget cuts without
impact to any programs or services through reductionsat the Northern and Southern Oklahoma ResourceCenters The rest of the savings came from reductions in training and professional contracts the divisions holds with various entitiesOver the next year DDSD will be under a selfshyimposed hiring
freeze for all positions except for case management direct care professionals and registered nursesIf monthly state revenue collections continue to fall below
expected levels additional reductions may be required of all stateagenciesrsquo operating budgets
Interim StudiesThere will be two interim legislative studies conducted this summer that could impact DDSD and service recipients
One of these studies will investigate a possible provider feetax on agencies providing waiver community services If the provider feetax is found to be within federal Medicaid guidelines it could possibly be used to fund rate increases in waiver services
The other legislative study will look into the pros and cons of online training versus classroom training specifically for providers of DDSD community services
Money Follows the PersonAs of this date DDSD has transitioned eight people from Northern Oklahoma Resource Center of Enid and Southern Oklahoma Resource Center into community homes using the federal Money Follows the Person grant Utilizing these federal funds DDSD has been able to save approximately $21000 in the community services provided to those individuals
Oklahoma documentary on developmental disabilities history to air on OETA
an
Oklahoma
document
ary
Adocumentary showing Oklahomarsquos history serving people with intellectual and developmental disabilities is
scheduled to begin airing on OETA (Oklahomarsquos Education Television Authority) in October during national Disabilities Awareness Month
The video ldquoWagons to Waivers A Century of Changerdquo narrated by Oklahomarsquos own country music star Reba McEntire will be broadcast on the OETAshyOklahoma channel starting on Oct 24th at 5 pm and on Nov 5th at 830 pm The program will be
aired a couple times a month
The documentary takes viewers on an emotional journey from the days of the Dust Bowl and covered wagons and shows the statersquos progression from institutional services to full community inclusion for persons with intellectual disabilities Oklahomarsquos story begins in 1909
with the creation of the Institute for the Feeble Minded in Enid and includes the
tears and efforts of parents the stories ofpeople who grew up in institutions the legal struggles and the triumph of selfshyadvocacy The video was produced by the Oklahoma Department of Human Services Developmental Disabilities Services Division
OETAshyOKLA is Cox Cable channel 112 but other television carriers as well as satellite users can access the channel which is devoted to Oklahomashyspecific programming Check your local television lis tings for specific programming dates and times
Oklahoma Department of Human Services 12 Developmental Disabilities Services Division
SUMMER 2009Compassion friendship and longevity A good measure of success
The day had finally come and Danny waited anxiously on the sofa He watched quietly as the
nursing staff set up the hospital bed and made his friend Carl comfortable The minute all was clear Danny went to Carl and told him how much he had missed him and that he needed him to get better Dannyrsquos longshytime friend had just undergone surgery
to remove a malignant brain tumor Danny didnrsquot understand the procedure or Carlrsquos prognosis ndash all that mattered was that his best friend was home It just wasnrsquot home without CarlCarl is considered the head of the household that he shares
with Danny and his other friend Hershel Carl was always the one who planned their meals said the prayers at the diningroom table and got them involved in Special Olympics events When Carl became ill and went to the hospital it was Danny
who stepped up and tried to fill in ndash just until Carl came home ldquoThe Three Musketeersrdquo (thatrsquos what their staff call them) have
been friends and have lived together for more than 30 years
Danny (lef
t) spends
hours by
Carlrsquos sid
e
encourag
ing him in his
recovery
They met as boys at The Hissom Memorial Center the nowshyclosed institution in Sand Springs for persons with developmental disabilities When they aged out of Hissom the three moved about the same time to a private facility where they lived for many years
In 1993 The Musketeers were given the opportunity to move together once again into a house in their community supported through the DDSD Medicaid Community Waiver program Since
that time they have lived in the house withsome of the same staffmembers who havecared for them for morethan 20 years
The Three Musketeers Danny (left) shows his excitement over his friend Carlrsquos (right) return from the hospital after brain surgery Shy Hershel (center) wipes tears from his eyes
Carl is recoveringfrom his surgery andworking on his abilityto speak and onregaining the use of theleft side of his bodyThe staff in the home
often has to make Danny go to bed at 1 am when hersquos still sitting beside Carl encouraging him to get better so he can go back to work
All three men have jobs and love their work ndash Carlmost of all Danny somehow knows that if Carl canjust get back to work life will continue as they onceknew it
ldquoTheyrsquore like a wellshysettled familyrdquo said Gretchen Moser their DDSD case manager ldquoEven their families consider these guys a family and respect their wishesrdquo
These days there are many opinions about what constitutes a family or even success But there are stories that transcend those discussions Stories like these that remind us success can also be measured by the love and longevity of a friend InterFace NEWSLETTER
Relations
hips
Oklahoma Department of Human Services 13 Developmental Disabilities Services Division
I N T E R F A C E
StateLegislativeNews
Of the thousand or more bills filed at the beginning of the 2009 legislative session only a few made it through the entire process that will have an impact on persons with developmental disabilities families and professionals in the field They are
HB 1007 mdash Wesselhoft Leftwich Signed by the Governor Requires specific Physically Disabled person signage to be posted as a reserved area for the parking of a vehicle displaying a valid permit
HB 1019 mdash WrightSigned by the Governor Recreates the Group Homes for Persons with Developmental or Physical Disabilities Advisory Board
HB 1048 mdash Banz AldridgeSigned by the Governor Relates to the collection of delinquent real property taxes removes physically disabled from ldquoincapacitatedrdquo persons granted additional time to redeem personal items reduces time to collect excess sale proceeds by half
HB 1065 mdash Faught Crain Signed by the Governor Relates to the Continuum of Care and Assisted Living Act adds definition and requires inspection results to be posted on website
HB 1424 mdash Protor Signed by the Governor Requires treatment facilities transitional living facilities halfway houses and any house or facility that may be used for medical or nonmedical detoxification to mail notification to property owners within a quarter mile radius if zoning changes are proposed
HB 1461 mdash Sears Ford Signed by the Governor A school that does not make adequate yearly progress for two straight years shall utilize the assistance of a school support team formed by the State Department of Education EMERGENCY
HB 1581 mdash Coody Jolley Signed by the Governor School teacher candidates that wish to teach elementary early childhood education or special education programs must study the five elements of reading instruction EMERGENCY
HB 1763 mdash Enns Reynolds Signed by the Governor Requires the state Department of Education to provide special education training for process hearing officers to ensure adequate knowledge in special education laws and proceduresEMERGENCY
HB 1893 mdash Peterson Anderson Signed by the Governor Creates the Aging and Disability Resource Consortium to work with other agencies in developing and implementing a singleshypointshyofshyentry concept for aging and disability groups in Oklahoma
SB 135 mdash Johnson Mike Signed by the Governor Provides for the licensing of certain persons to practice as a licensed behavior analyst or a licensed assistant behavior analyst and to study children with autism and their behaviors directs funds to be used by the Department of Human Services Developmental Disabilities Services division for training SoonerStart providers to treat children with autism spectrum disorders provides for a behavorial analysis research pilot project provides legislative intent
SB 518 mdash Justice Osborn Signed by the Governor Adds grandparents as members of immediate family
SB 871 mdash Anderson Signed by the Governor Modifies membership of the Electronic and Information Technology Accessibility Advisory Council
Oklahoma Department of Human Services 14 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
11th Circuit Rules cont from page 9
matter again Moore a teenager living in North Georgia who goes by ldquoCallierdquo has been receiving inshyhome nursing care paid for by Medicaid for about a decade The state has been trying to cut the number of hours of care she receives each week
The 11th Circuit interpreted a federal law that says states participating in the Medicaid program must provide ldquoearly and periodic screening diagnostic and treatment servicesrdquo that are necessary to ldquocorrect or ameliorate defects and physical and mental illnessesrdquo in Medicaidshyeligible children The primary ways children become eligible for Medicaid are that they come from a lowshyincome family or have a disability according to Joshua H Norris another one of Calliersquos lawyers
Georgiarsquos Department of Community Health operates a program to administer Medicaidshyfunded nursing services for several hundred children who need nursing care It delegates the decisions about approval of such services to an organization called the Georgia Medical Care Foundation
According to Thrashrsquos order Callie is disabled because of a stroke she experienced in utero and suffers from various chronic conditions including mental retardation and cerebral palsy She lives at home and according to the statersquos brief attends an elementary school in Athens Ga three days a week Her lawyers have said she requires constant care
The statersquos lawyers have said that nursing hours can be reduced when the patientrsquos medical condition stabilizes positing that a goal of the program is to teach parents and other caregivers to take care of their children on their own The Mooresrsquo lawyers have contended that the statersquos system of ldquoweaningrdquo patients off their nursing services as long as theyrsquore staying out of the hospitaland not getting worse follows a different standard than that set by federal law
In 2006 the state informed Calliersquos mother that it was reducing Calliersquos nursing hours from 94 hours a week to 84 contrary to the recommendation of Calliersquos primary care physician Calliersquos mother filed suit
The Mooresrsquo lawyers convinced Thrash that the reduction was improper Afterissuing multiple injunctions in Calliersquos favor he denied the statersquos motion for summary judgment and granted the Mooresrsquo motion in part concluding the state must provide for the amount of skilled nursing care that Calliersquos treating physician deems necessary The panel that ruled in favor of the state in its appeal was comprised of Senior 11th Circuit Judge R Lanier Anderson III 11th Circuit Judge Gerald B Tjoflat and US District Judge Lisa Godbey Wood visiting from the Southern District of Georgia
The panel said both the state and Calliersquos physician have roles in determining whatrsquos medically necessary to correct or ameliorate Calliersquos medical conditions It cited a federal regulation that says a Medicaid agency ldquomay place appropriate limits on a service based on such criteria as medical necessity or utilization control proceduresrdquo
ldquoA private physicianrsquos word on medical necessity is not dispositiverdquo the panel concluded
Assistant Attorney General Virginia B Fuller made the successful oral argument for the state last month Attorney General Thurbert E Bakerrsquos spokesman Russ Willard said in an eshymail that the state ldquois appreciative of the Court of Appeals decision recognizing the role of the Medicaid program in providing for this treatmentrdquo
Norris who also is director of legal advocacy for a nonprofit that advocates for people with disabilities said the 11th Circuit gave Thrash
an opportunity to say more about the roles of treating doctors and the state in deciding what care the state needs to provide Norris noted that Thrash wrote on the subject last year in another nursing care case about a Savannah Ga boy who nearly drowned when he was 2Thrash barred the state from enforcing a policy of not providing nursing care for patients requiring 16
to 24 hours per day for more than one week he said that criteria isnrsquot based on whatrsquos medically necessary under federal Medicaid law
On the other handThrash denied the plaintiff rsquos request based on the
treating physicianrsquos recommendation for 24shyhourshyashyday private nursing services for an
indefinite period of time Thrash deemed such a prescription ldquoan abuse of the Medicaid systemrdquo
The state has limited discretion to deny a providerrsquos request for care under the ldquoearly and periodic
screening diagnostic and treatment servicesrdquo portion of the Medicaid Act said Thrash He added that ldquo[t]he statersquos discretion is limited to a review of the request for fraud abuse of the Medicaid system and whether the service is within the reasonable
standards of medical carerdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 15 Developmental Disabilities Services Division
klahoma Department of Human Services
I N T E R F A C E
DDSD Area II Project Elves get together to wrap all the presents and make sure they are delivered to the individuals before Christmas Elves work year round
to make Christmas special for DDSD clients For the past eight years individuals with
developmental disabilities who donrsquot have families or who would otherwise not receive gifts have had their Christmas wishes come true thanks to caring DDSD ldquoelvesrdquo in Area II Project Elf is the brainchild of ldquoThe Men in Recrdquo namely
Steve Pitts and Roger McDaniel DDSD Area II recreational therapists and Joe Stie DDSD case manager ldquoDDSD serves a lot of people with developmental
disabilities who donrsquot have families to celebrate the holidays withrdquo said Pitts ldquoAlthough our services meet their basic needs therersquos still a gap when it comes to those special things that families do for one anotherrdquoThat gap has been filled by The Men in Rec who work all year
long coordinating various events to raise money to buy Christmas presents for individuals ldquoWe raise all of the funds and no OKDHS money is usedrdquo said
Pitts ldquoThis year we are selling Blue and Gold sausage and Amish jams We also have an annual Christmas Carol fundraising performance which is donated to Project Elf by the American Theater Company We are given 300 tickets that we can sell and last year we sold 225rdquoDDSD coshyworkers got together and purchased 44 of those theater
tickets last year for the children who happened to be in the Laura Dester Center Shelter around the holidays ldquoWe have also set up a sponsorship program where people can purchase
the gift and return it wrapped and ready for the elf (aka case manager) to deliver This last Christmas we had 108 sponsors 30 of whom were the case managers themselvesrdquo
The Men in Rec also recruit fellow DDSD workers to help shop for the gifts and wrap themldquoWe could not accomplish this awesome Project Elf without the assistance of so many of our coshyworkers and our community volunteersrdquo he said ldquoItrsquos such a pleasure to share these gifts at Christmas time and let our customers know that they have a family through our good service to themrdquoThe Men in Rec are currently working to raise money for this yearrsquos Christmas gifts If you would like to join the rank of DDSD Elves by donating funds or becoming a sponsor please contact Steve Pitts at stevepittsokdhsorg or call918shy794shy7625 InterFace NEWSLETTER
Steve Pitts (right) DDSD Area II recreational therapist gives a donated WalshyMart gift card to case manager Roy Willett to purchase a Christmas gift for one of the people on his caseload
Oklahoma Department of Human Services 16 Developmental Disabilities Services Division
shy shyshy shy
shy shy
shy shy
shy shy
shy shy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
Developmental Disabilities Services Area Offices and Resource Centers
CUSTER
ELLIS
BECKHAM WASHITA CADDO
McCLAIN
SEM
INO
LE HUGHES HASKELL
LE FLORELATIMER PITTSBURG
COAL
ATOKA
PONTOTOC
JOHNSTON
GARVIN
MURRAY
CARTER
LOVE
BRYAN CHOCTAW
PUSHMATAHA McCURTAIN
GRADY
KIOWA
TILLMAN
JACKSON HA
RM
ON
GREER
COTTON
JEFFERSON
STEPHENS
COMANCHE
McINTOSH
CLEVELAND
POTT
AWAT
OM
IE
DEWEY BLAINE
CANADIAN
MAJOR
GRANT KAY OSAGE
WA
SHIN
GTO
N CRAIG
ROGERS
CH
ERO
KEE
ADAIR TULSA
WAGONER
MAYES
OKMULGEE
CREEK
LINCOLN
LOGAN
PAYNE
KINGFISHER
OKLAHOMA OKFUSKEE
MUSKOGEE SEQUOYAH
DEL
AWA
RE
OTTAWA NOATTA
GARFIELD NOBLE
PAWNEE
WOODS ALFALFA HARPER BEAVER TEXASCIMARRON
WOODWARD
ROGER MILLS
MARSH
Oklahoma CityOklahoma City
Tulsa
Area II
Area III
Area I
Pauls Valley
Enid
wwwokdhsorg
State Officetoll free 1shy866shy521shy3571
AREA Itoll free 1shy800shy522shy1064
AREA IItoll free 1shy800shy522shy1075
AREA IIItoll free 1shy800shy522shy1086
Greer Center (Enid)2501 NE Delaware Enid OK 73701
580 237 10272599 FAX 580 213 2799
Northwest Oklahoma Resource Center at Enid (NORCE)2600 E Willow
Enid OK 73701
580 237 1027
FAX 580 548 2600
Southern Oklahoma Resource Center at Pauls Valley (SORC)3210 Chickasaw St
Pauls Valley OK 73075 6822
405 238 6401
FAX 405 238 8261
DDSD Area I Office (Enid)729 Overland Trail Enid OK 73703
580 548 8900 FAX 580 548 8964
DDSD Area I Office (Oklahoma City)4545 N Lincoln Blvd
Oklahoma City OK 73105 405 522 6925
FAX 405 522 6995
DDSD Area II Office (Tulsa)Laura Dester Center 1427 E 8th Tulsa OK 74120
918 560 4848 FAX 918 560 4898
DDSD Area III Office (Pauls Valley)301 S Indian Meridian Rd Pauls Valley OK 73075
405 238 4700 FAX 405 238 4740
If you would like to find out what the DevelopmentalDisabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
If you would like to find out what the Developmental Disabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
This will take you to the main Oklahoma Department of Human Services Web page From there just click on Divisions and Offices and the Developmental Disabilities Services Division On our Web site you will find information about services the division offers how to apply for services eligibility policies contract provider agencies and much more
Come visit us today You may be surprised at what you will learn
OKLAHOMA DEPARTMENT OF HUMAN SERVICES Developmental Disabilities Services DivisionPO Box 25352 Oklahoma City OK 73125
SUMMER 2009
Autism cont from page 8
ldquoOklahoma and its citizens are better served when policy makers are allowed the freedom to address any pressing issue in the Legislature without the hindrance of arbitrary restrictionsrdquo Henry said Democrats offered a compromise mdash to put autism coverage in highshy
risk insurance pools as a last resort for families who canrsquot afford the coverage elsewhere Republicans again declined and instead went forward with SB 135 This year three more states enacted Autism Mandate legislation bringing
the total to 11 states that now require insurance companies to cover treatment for autism InterFace NEWSLETTER
Proudly displaying their CPR (Cardio Pulmonary Resuscitation) certificates are (From Left) Guy Bivens Allen Larimore Steve Sposato Andy Edwards Joshua Johnson and Tino Hensley residents of the Independence House
Residents of the Independence House at the Home of Hope in Vinita recently became CPR certified after a fellow resident had a heart attack A staff member used CPR to save Allen Larimorersquos life and he has since received a pacemaker Although staff members must be CPR certified this event inspired Larimorersquos housemates to take the class so they could also be prepared ndash just in case Donna Marlow a CPR trainer from the OKDHS Developmental Disabilities Services Division held the class free of charge at the agency and was proud that all the men passed their tests with flying colors
11th Circuit Rules Doctors donrsquot trump state on Medicaid care for children with disabilities by Alyson M Palmer
A federal appeals panel has declared that treating doctors donrsquot have the final say in how much nursing care the state must provide
children with disabilities under MedicaidOn April 24 the 11th US Circuit Court of Appeals reversed a district
judgersquos decision that had said the state must provide the amount of nursing care that a North Georgia girlrsquos doctor said she needs
Despite a slew of amicus briefs by state governments and Medicaid plan administrators the panel dispatched the case in a twoshypage unpublished unsigned opinion that came out a month after oral argument
Holland amp Knight partner Robert S Highsmith Jr who represented a proshystate friend of the court that provides managed care services for Medicaid programs said his client WellCare of Georgia had been concerned about language in US District Judge Thomas W Thrash Jrrsquos ruling that suggested anything ordered by a treating physician is medically necessary under the law ldquoThat one sentence just had to get reversedrdquo said Highsmith ldquoWe are very excited that they saw and reversed that clear errorrdquo
But an advocate for the teenage girl at the center of the case Atlanta Legal Aid Society General Counsel David A Webster said Monday that the decision ldquodoesnrsquot mean muchrdquo and says little about the relationship between the state and the treating physician ldquoThatrsquos going to be open for future litigationrdquo said Webster Webster said the case of his client Anna C Moore will go back to Thrash for the judge to consider the
11th Circuit Rules cont on page 15
Oklahoma Department of Human Services 9 Developmental Disabilities Services Division
I N TERFACE
ImaginingEverest The Story of LaelBy Adrienne Benz
ldquoI prayed for God to open the eyes of my understanding and the pieces began to fall into place Mollyrsquos future had been planned since she was a young girl she would marry andhave a bright healthy family known for their intelligence andkindness However the birth of her first born quickly dispelled the myth of the stereotypically perfect family as Molly learns her son Lael has Down syndrome Struggling to accept the disconcerting news and understand Godrsquos perfect plan Molly faces a challenge no more daunting than the climbing of the greatMt Everest she often dreamed of as a child Guilt hope grief and happiness take Molly and Lael across rocky terrain and risky edges but faith and the resonant voice of God bring mother and son up the emotional mountain 30 years in the making ndash a mountain that revealed the aptitude of Mollyrsquos beloved son and the kindness of others By Imagining Everest Molly and Lael forge a unique and amazing relationship which allows them to overcome even the most intimidating ascension into the unknownrdquo
Molly Mathewrsquos son Lael currently receives services through the OKDHSDDSD community waiver program
264 pages shy $1499 (paperback) This book is available online through Tate Publishing wwwtatepublishingcombookstore
Health and Human Services rescinds Medicaid regulations affecting case management
Department of Health and Human Services (HHS) Secretary
Kathleen Sebelius announed June 29 that the administration will rescind all or part of three Medicaid regulations that were previously
issued and delay the enforcement of a fourth regulation Each of these
rules in whole or in part had been subject to Congressional moratoria
set to expire on July 1 2009ldquoThese regulations if left in place would have potentially adverse
consequences for Medicaid beneficiaries some of our nationrsquos most vulnerable peoplerdquo said Secretary Sebelius ldquoBy rescinding
these rules we can expect that children will continue receiving
services through their schools beneficiaries will be able to
access all available case management resources to help them
better manage their health care and outpatient hospital and
clinic services can continue to be covered in the most efficient mannerrdquo
This ruling was crucial to Oklahomarsquos Developmental Disabilities Services as the state could have lost the ability
to bill Medicaid for 100 percent of the cost of providing
case management services to waiver service recipients which totals approximately $22 million per year
ldquoThe actions we are taking today are necessary to
ensure that the states have the flexibility they need to
fully serve Medicaidshyeligible individualsrdquo said
Secretary Sebelius
The Centers for Medicare amp Medicaid
Services (CMS) and HHS arebull Rescinding provisions of an interim final rule
published Dec 4 2007 which would have restricted beneficiary access to case management services These provisions appeared to in practice restrict beneficiary access to needed covered case management services and limit state flexibility in determining efficient and effective delivery systems for case management services
Regulations Expiring cont on page 11
Oklahoma Department of Human Services 10 Developmental Disabilities Services Division
SUMMER 2 0 0 9
Regulations Expiring cont from page 10
bull Rescinding a final rule published Dec 28 2007 that would have eliminated reimbursement for schoolshybased administrative costs and costs of transportation to and from schools The rescission reflects concern that the rule could limit the Medicaid administrative outreach activities of schools and that the overall budgetary impact on schools could potentially impact their ability to offer Medicaid services to students
bull Rescinding a rule published Nov 7 2008 that would have limited the outpatient hospital and clinic service benefit for Medicaid beneficiaries to the scope of services recognized as an outpatient hospital service under Medicare This rule was rescinded because CMS became aware that coverage beyond that scope could not be easily moved to other benefit categories resulting in great impact than previously anticipated
bull Delaying until June 30 2010 the enforcement of portions of a regulation that clarified limitations on health care related tax programs so that CMS could determine whether states need additional clarification or guidance CMS may also further review the potential impact of the regulation and give additional consideration to alternative approaches InterFace NEWSLETTER
Waiting and HopingBy Adrienne Benz
Sad is like sitting here when I donrsquot have a home to run away to
So there on the street just waiting for something to eat somewhere to stay and a bed to sleep on and someone to hold
And hoping Irsquom still there the next day
They have to get up from the street in the park sitting on a cold chair in the dark
Just waiting for someone to take them in their home Waiting to open up and talk about their hidden feelings
like they canrsquot wait any longer
Adrienne Benz was a child in state custody when she wrote this poem She is now an adult reunited with her family
Oklahoma Department of Human Services 11 Developmental Disabilities Services Division
I N T E R FA C E
DDSD Fiscal Year 2010 Budget Outlook OKDHS Director Howard Hendrick
presented the agencyrsquos Fiscal Year 2010 budget to the Commission for Human Services on June 16 Hendrick emphasized that even with the additional federal stimulus money and other oneshytime funds the agencyrsquos overall funding will be approximately $50 million short of anticipated spending levels To achieve a balanced budget cuts would have to be made within each division The Developmental Disabilities Services Divisionrsquos
share of the cuts amount to approximately 3 percent of the divisionrsquos operating budget ($17 million) Another $200000 had to be identified to fund the new initiative for Applied Behavior Analysis mandated by Senate Bill 135 this legislative sessionDDSD was able to accomplish the budget cuts without
impact to any programs or services through reductionsat the Northern and Southern Oklahoma ResourceCenters The rest of the savings came from reductions in training and professional contracts the divisions holds with various entitiesOver the next year DDSD will be under a selfshyimposed hiring
freeze for all positions except for case management direct care professionals and registered nursesIf monthly state revenue collections continue to fall below
expected levels additional reductions may be required of all stateagenciesrsquo operating budgets
Interim StudiesThere will be two interim legislative studies conducted this summer that could impact DDSD and service recipients
One of these studies will investigate a possible provider feetax on agencies providing waiver community services If the provider feetax is found to be within federal Medicaid guidelines it could possibly be used to fund rate increases in waiver services
The other legislative study will look into the pros and cons of online training versus classroom training specifically for providers of DDSD community services
Money Follows the PersonAs of this date DDSD has transitioned eight people from Northern Oklahoma Resource Center of Enid and Southern Oklahoma Resource Center into community homes using the federal Money Follows the Person grant Utilizing these federal funds DDSD has been able to save approximately $21000 in the community services provided to those individuals
Oklahoma documentary on developmental disabilities history to air on OETA
an
Oklahoma
document
ary
Adocumentary showing Oklahomarsquos history serving people with intellectual and developmental disabilities is
scheduled to begin airing on OETA (Oklahomarsquos Education Television Authority) in October during national Disabilities Awareness Month
The video ldquoWagons to Waivers A Century of Changerdquo narrated by Oklahomarsquos own country music star Reba McEntire will be broadcast on the OETAshyOklahoma channel starting on Oct 24th at 5 pm and on Nov 5th at 830 pm The program will be
aired a couple times a month
The documentary takes viewers on an emotional journey from the days of the Dust Bowl and covered wagons and shows the statersquos progression from institutional services to full community inclusion for persons with intellectual disabilities Oklahomarsquos story begins in 1909
with the creation of the Institute for the Feeble Minded in Enid and includes the
tears and efforts of parents the stories ofpeople who grew up in institutions the legal struggles and the triumph of selfshyadvocacy The video was produced by the Oklahoma Department of Human Services Developmental Disabilities Services Division
OETAshyOKLA is Cox Cable channel 112 but other television carriers as well as satellite users can access the channel which is devoted to Oklahomashyspecific programming Check your local television lis tings for specific programming dates and times
Oklahoma Department of Human Services 12 Developmental Disabilities Services Division
SUMMER 2009Compassion friendship and longevity A good measure of success
The day had finally come and Danny waited anxiously on the sofa He watched quietly as the
nursing staff set up the hospital bed and made his friend Carl comfortable The minute all was clear Danny went to Carl and told him how much he had missed him and that he needed him to get better Dannyrsquos longshytime friend had just undergone surgery
to remove a malignant brain tumor Danny didnrsquot understand the procedure or Carlrsquos prognosis ndash all that mattered was that his best friend was home It just wasnrsquot home without CarlCarl is considered the head of the household that he shares
with Danny and his other friend Hershel Carl was always the one who planned their meals said the prayers at the diningroom table and got them involved in Special Olympics events When Carl became ill and went to the hospital it was Danny
who stepped up and tried to fill in ndash just until Carl came home ldquoThe Three Musketeersrdquo (thatrsquos what their staff call them) have
been friends and have lived together for more than 30 years
Danny (lef
t) spends
hours by
Carlrsquos sid
e
encourag
ing him in his
recovery
They met as boys at The Hissom Memorial Center the nowshyclosed institution in Sand Springs for persons with developmental disabilities When they aged out of Hissom the three moved about the same time to a private facility where they lived for many years
In 1993 The Musketeers were given the opportunity to move together once again into a house in their community supported through the DDSD Medicaid Community Waiver program Since
that time they have lived in the house withsome of the same staffmembers who havecared for them for morethan 20 years
The Three Musketeers Danny (left) shows his excitement over his friend Carlrsquos (right) return from the hospital after brain surgery Shy Hershel (center) wipes tears from his eyes
Carl is recoveringfrom his surgery andworking on his abilityto speak and onregaining the use of theleft side of his bodyThe staff in the home
often has to make Danny go to bed at 1 am when hersquos still sitting beside Carl encouraging him to get better so he can go back to work
All three men have jobs and love their work ndash Carlmost of all Danny somehow knows that if Carl canjust get back to work life will continue as they onceknew it
ldquoTheyrsquore like a wellshysettled familyrdquo said Gretchen Moser their DDSD case manager ldquoEven their families consider these guys a family and respect their wishesrdquo
These days there are many opinions about what constitutes a family or even success But there are stories that transcend those discussions Stories like these that remind us success can also be measured by the love and longevity of a friend InterFace NEWSLETTER
Relations
hips
Oklahoma Department of Human Services 13 Developmental Disabilities Services Division
I N T E R F A C E
StateLegislativeNews
Of the thousand or more bills filed at the beginning of the 2009 legislative session only a few made it through the entire process that will have an impact on persons with developmental disabilities families and professionals in the field They are
HB 1007 mdash Wesselhoft Leftwich Signed by the Governor Requires specific Physically Disabled person signage to be posted as a reserved area for the parking of a vehicle displaying a valid permit
HB 1019 mdash WrightSigned by the Governor Recreates the Group Homes for Persons with Developmental or Physical Disabilities Advisory Board
HB 1048 mdash Banz AldridgeSigned by the Governor Relates to the collection of delinquent real property taxes removes physically disabled from ldquoincapacitatedrdquo persons granted additional time to redeem personal items reduces time to collect excess sale proceeds by half
HB 1065 mdash Faught Crain Signed by the Governor Relates to the Continuum of Care and Assisted Living Act adds definition and requires inspection results to be posted on website
HB 1424 mdash Protor Signed by the Governor Requires treatment facilities transitional living facilities halfway houses and any house or facility that may be used for medical or nonmedical detoxification to mail notification to property owners within a quarter mile radius if zoning changes are proposed
HB 1461 mdash Sears Ford Signed by the Governor A school that does not make adequate yearly progress for two straight years shall utilize the assistance of a school support team formed by the State Department of Education EMERGENCY
HB 1581 mdash Coody Jolley Signed by the Governor School teacher candidates that wish to teach elementary early childhood education or special education programs must study the five elements of reading instruction EMERGENCY
HB 1763 mdash Enns Reynolds Signed by the Governor Requires the state Department of Education to provide special education training for process hearing officers to ensure adequate knowledge in special education laws and proceduresEMERGENCY
HB 1893 mdash Peterson Anderson Signed by the Governor Creates the Aging and Disability Resource Consortium to work with other agencies in developing and implementing a singleshypointshyofshyentry concept for aging and disability groups in Oklahoma
SB 135 mdash Johnson Mike Signed by the Governor Provides for the licensing of certain persons to practice as a licensed behavior analyst or a licensed assistant behavior analyst and to study children with autism and their behaviors directs funds to be used by the Department of Human Services Developmental Disabilities Services division for training SoonerStart providers to treat children with autism spectrum disorders provides for a behavorial analysis research pilot project provides legislative intent
SB 518 mdash Justice Osborn Signed by the Governor Adds grandparents as members of immediate family
SB 871 mdash Anderson Signed by the Governor Modifies membership of the Electronic and Information Technology Accessibility Advisory Council
Oklahoma Department of Human Services 14 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
11th Circuit Rules cont from page 9
matter again Moore a teenager living in North Georgia who goes by ldquoCallierdquo has been receiving inshyhome nursing care paid for by Medicaid for about a decade The state has been trying to cut the number of hours of care she receives each week
The 11th Circuit interpreted a federal law that says states participating in the Medicaid program must provide ldquoearly and periodic screening diagnostic and treatment servicesrdquo that are necessary to ldquocorrect or ameliorate defects and physical and mental illnessesrdquo in Medicaidshyeligible children The primary ways children become eligible for Medicaid are that they come from a lowshyincome family or have a disability according to Joshua H Norris another one of Calliersquos lawyers
Georgiarsquos Department of Community Health operates a program to administer Medicaidshyfunded nursing services for several hundred children who need nursing care It delegates the decisions about approval of such services to an organization called the Georgia Medical Care Foundation
According to Thrashrsquos order Callie is disabled because of a stroke she experienced in utero and suffers from various chronic conditions including mental retardation and cerebral palsy She lives at home and according to the statersquos brief attends an elementary school in Athens Ga three days a week Her lawyers have said she requires constant care
The statersquos lawyers have said that nursing hours can be reduced when the patientrsquos medical condition stabilizes positing that a goal of the program is to teach parents and other caregivers to take care of their children on their own The Mooresrsquo lawyers have contended that the statersquos system of ldquoweaningrdquo patients off their nursing services as long as theyrsquore staying out of the hospitaland not getting worse follows a different standard than that set by federal law
In 2006 the state informed Calliersquos mother that it was reducing Calliersquos nursing hours from 94 hours a week to 84 contrary to the recommendation of Calliersquos primary care physician Calliersquos mother filed suit
The Mooresrsquo lawyers convinced Thrash that the reduction was improper Afterissuing multiple injunctions in Calliersquos favor he denied the statersquos motion for summary judgment and granted the Mooresrsquo motion in part concluding the state must provide for the amount of skilled nursing care that Calliersquos treating physician deems necessary The panel that ruled in favor of the state in its appeal was comprised of Senior 11th Circuit Judge R Lanier Anderson III 11th Circuit Judge Gerald B Tjoflat and US District Judge Lisa Godbey Wood visiting from the Southern District of Georgia
The panel said both the state and Calliersquos physician have roles in determining whatrsquos medically necessary to correct or ameliorate Calliersquos medical conditions It cited a federal regulation that says a Medicaid agency ldquomay place appropriate limits on a service based on such criteria as medical necessity or utilization control proceduresrdquo
ldquoA private physicianrsquos word on medical necessity is not dispositiverdquo the panel concluded
Assistant Attorney General Virginia B Fuller made the successful oral argument for the state last month Attorney General Thurbert E Bakerrsquos spokesman Russ Willard said in an eshymail that the state ldquois appreciative of the Court of Appeals decision recognizing the role of the Medicaid program in providing for this treatmentrdquo
Norris who also is director of legal advocacy for a nonprofit that advocates for people with disabilities said the 11th Circuit gave Thrash
an opportunity to say more about the roles of treating doctors and the state in deciding what care the state needs to provide Norris noted that Thrash wrote on the subject last year in another nursing care case about a Savannah Ga boy who nearly drowned when he was 2Thrash barred the state from enforcing a policy of not providing nursing care for patients requiring 16
to 24 hours per day for more than one week he said that criteria isnrsquot based on whatrsquos medically necessary under federal Medicaid law
On the other handThrash denied the plaintiff rsquos request based on the
treating physicianrsquos recommendation for 24shyhourshyashyday private nursing services for an
indefinite period of time Thrash deemed such a prescription ldquoan abuse of the Medicaid systemrdquo
The state has limited discretion to deny a providerrsquos request for care under the ldquoearly and periodic
screening diagnostic and treatment servicesrdquo portion of the Medicaid Act said Thrash He added that ldquo[t]he statersquos discretion is limited to a review of the request for fraud abuse of the Medicaid system and whether the service is within the reasonable
standards of medical carerdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 15 Developmental Disabilities Services Division
klahoma Department of Human Services
I N T E R F A C E
DDSD Area II Project Elves get together to wrap all the presents and make sure they are delivered to the individuals before Christmas Elves work year round
to make Christmas special for DDSD clients For the past eight years individuals with
developmental disabilities who donrsquot have families or who would otherwise not receive gifts have had their Christmas wishes come true thanks to caring DDSD ldquoelvesrdquo in Area II Project Elf is the brainchild of ldquoThe Men in Recrdquo namely
Steve Pitts and Roger McDaniel DDSD Area II recreational therapists and Joe Stie DDSD case manager ldquoDDSD serves a lot of people with developmental
disabilities who donrsquot have families to celebrate the holidays withrdquo said Pitts ldquoAlthough our services meet their basic needs therersquos still a gap when it comes to those special things that families do for one anotherrdquoThat gap has been filled by The Men in Rec who work all year
long coordinating various events to raise money to buy Christmas presents for individuals ldquoWe raise all of the funds and no OKDHS money is usedrdquo said
Pitts ldquoThis year we are selling Blue and Gold sausage and Amish jams We also have an annual Christmas Carol fundraising performance which is donated to Project Elf by the American Theater Company We are given 300 tickets that we can sell and last year we sold 225rdquoDDSD coshyworkers got together and purchased 44 of those theater
tickets last year for the children who happened to be in the Laura Dester Center Shelter around the holidays ldquoWe have also set up a sponsorship program where people can purchase
the gift and return it wrapped and ready for the elf (aka case manager) to deliver This last Christmas we had 108 sponsors 30 of whom were the case managers themselvesrdquo
The Men in Rec also recruit fellow DDSD workers to help shop for the gifts and wrap themldquoWe could not accomplish this awesome Project Elf without the assistance of so many of our coshyworkers and our community volunteersrdquo he said ldquoItrsquos such a pleasure to share these gifts at Christmas time and let our customers know that they have a family through our good service to themrdquoThe Men in Rec are currently working to raise money for this yearrsquos Christmas gifts If you would like to join the rank of DDSD Elves by donating funds or becoming a sponsor please contact Steve Pitts at stevepittsokdhsorg or call918shy794shy7625 InterFace NEWSLETTER
Steve Pitts (right) DDSD Area II recreational therapist gives a donated WalshyMart gift card to case manager Roy Willett to purchase a Christmas gift for one of the people on his caseload
Oklahoma Department of Human Services 16 Developmental Disabilities Services Division
shy shyshy shy
shy shy
shy shy
shy shy
shy shy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
Developmental Disabilities Services Area Offices and Resource Centers
CUSTER
ELLIS
BECKHAM WASHITA CADDO
McCLAIN
SEM
INO
LE HUGHES HASKELL
LE FLORELATIMER PITTSBURG
COAL
ATOKA
PONTOTOC
JOHNSTON
GARVIN
MURRAY
CARTER
LOVE
BRYAN CHOCTAW
PUSHMATAHA McCURTAIN
GRADY
KIOWA
TILLMAN
JACKSON HA
RM
ON
GREER
COTTON
JEFFERSON
STEPHENS
COMANCHE
McINTOSH
CLEVELAND
POTT
AWAT
OM
IE
DEWEY BLAINE
CANADIAN
MAJOR
GRANT KAY OSAGE
WA
SHIN
GTO
N CRAIG
ROGERS
CH
ERO
KEE
ADAIR TULSA
WAGONER
MAYES
OKMULGEE
CREEK
LINCOLN
LOGAN
PAYNE
KINGFISHER
OKLAHOMA OKFUSKEE
MUSKOGEE SEQUOYAH
DEL
AWA
RE
OTTAWA NOATTA
GARFIELD NOBLE
PAWNEE
WOODS ALFALFA HARPER BEAVER TEXASCIMARRON
WOODWARD
ROGER MILLS
MARSH
Oklahoma CityOklahoma City
Tulsa
Area II
Area III
Area I
Pauls Valley
Enid
wwwokdhsorg
State Officetoll free 1shy866shy521shy3571
AREA Itoll free 1shy800shy522shy1064
AREA IItoll free 1shy800shy522shy1075
AREA IIItoll free 1shy800shy522shy1086
Greer Center (Enid)2501 NE Delaware Enid OK 73701
580 237 10272599 FAX 580 213 2799
Northwest Oklahoma Resource Center at Enid (NORCE)2600 E Willow
Enid OK 73701
580 237 1027
FAX 580 548 2600
Southern Oklahoma Resource Center at Pauls Valley (SORC)3210 Chickasaw St
Pauls Valley OK 73075 6822
405 238 6401
FAX 405 238 8261
DDSD Area I Office (Enid)729 Overland Trail Enid OK 73703
580 548 8900 FAX 580 548 8964
DDSD Area I Office (Oklahoma City)4545 N Lincoln Blvd
Oklahoma City OK 73105 405 522 6925
FAX 405 522 6995
DDSD Area II Office (Tulsa)Laura Dester Center 1427 E 8th Tulsa OK 74120
918 560 4848 FAX 918 560 4898
DDSD Area III Office (Pauls Valley)301 S Indian Meridian Rd Pauls Valley OK 73075
405 238 4700 FAX 405 238 4740
If you would like to find out what the DevelopmentalDisabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
If you would like to find out what the Developmental Disabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
This will take you to the main Oklahoma Department of Human Services Web page From there just click on Divisions and Offices and the Developmental Disabilities Services Division On our Web site you will find information about services the division offers how to apply for services eligibility policies contract provider agencies and much more
Come visit us today You may be surprised at what you will learn
OKLAHOMA DEPARTMENT OF HUMAN SERVICES Developmental Disabilities Services DivisionPO Box 25352 Oklahoma City OK 73125
I N TERFACE
ImaginingEverest The Story of LaelBy Adrienne Benz
ldquoI prayed for God to open the eyes of my understanding and the pieces began to fall into place Mollyrsquos future had been planned since she was a young girl she would marry andhave a bright healthy family known for their intelligence andkindness However the birth of her first born quickly dispelled the myth of the stereotypically perfect family as Molly learns her son Lael has Down syndrome Struggling to accept the disconcerting news and understand Godrsquos perfect plan Molly faces a challenge no more daunting than the climbing of the greatMt Everest she often dreamed of as a child Guilt hope grief and happiness take Molly and Lael across rocky terrain and risky edges but faith and the resonant voice of God bring mother and son up the emotional mountain 30 years in the making ndash a mountain that revealed the aptitude of Mollyrsquos beloved son and the kindness of others By Imagining Everest Molly and Lael forge a unique and amazing relationship which allows them to overcome even the most intimidating ascension into the unknownrdquo
Molly Mathewrsquos son Lael currently receives services through the OKDHSDDSD community waiver program
264 pages shy $1499 (paperback) This book is available online through Tate Publishing wwwtatepublishingcombookstore
Health and Human Services rescinds Medicaid regulations affecting case management
Department of Health and Human Services (HHS) Secretary
Kathleen Sebelius announed June 29 that the administration will rescind all or part of three Medicaid regulations that were previously
issued and delay the enforcement of a fourth regulation Each of these
rules in whole or in part had been subject to Congressional moratoria
set to expire on July 1 2009ldquoThese regulations if left in place would have potentially adverse
consequences for Medicaid beneficiaries some of our nationrsquos most vulnerable peoplerdquo said Secretary Sebelius ldquoBy rescinding
these rules we can expect that children will continue receiving
services through their schools beneficiaries will be able to
access all available case management resources to help them
better manage their health care and outpatient hospital and
clinic services can continue to be covered in the most efficient mannerrdquo
This ruling was crucial to Oklahomarsquos Developmental Disabilities Services as the state could have lost the ability
to bill Medicaid for 100 percent of the cost of providing
case management services to waiver service recipients which totals approximately $22 million per year
ldquoThe actions we are taking today are necessary to
ensure that the states have the flexibility they need to
fully serve Medicaidshyeligible individualsrdquo said
Secretary Sebelius
The Centers for Medicare amp Medicaid
Services (CMS) and HHS arebull Rescinding provisions of an interim final rule
published Dec 4 2007 which would have restricted beneficiary access to case management services These provisions appeared to in practice restrict beneficiary access to needed covered case management services and limit state flexibility in determining efficient and effective delivery systems for case management services
Regulations Expiring cont on page 11
Oklahoma Department of Human Services 10 Developmental Disabilities Services Division
SUMMER 2 0 0 9
Regulations Expiring cont from page 10
bull Rescinding a final rule published Dec 28 2007 that would have eliminated reimbursement for schoolshybased administrative costs and costs of transportation to and from schools The rescission reflects concern that the rule could limit the Medicaid administrative outreach activities of schools and that the overall budgetary impact on schools could potentially impact their ability to offer Medicaid services to students
bull Rescinding a rule published Nov 7 2008 that would have limited the outpatient hospital and clinic service benefit for Medicaid beneficiaries to the scope of services recognized as an outpatient hospital service under Medicare This rule was rescinded because CMS became aware that coverage beyond that scope could not be easily moved to other benefit categories resulting in great impact than previously anticipated
bull Delaying until June 30 2010 the enforcement of portions of a regulation that clarified limitations on health care related tax programs so that CMS could determine whether states need additional clarification or guidance CMS may also further review the potential impact of the regulation and give additional consideration to alternative approaches InterFace NEWSLETTER
Waiting and HopingBy Adrienne Benz
Sad is like sitting here when I donrsquot have a home to run away to
So there on the street just waiting for something to eat somewhere to stay and a bed to sleep on and someone to hold
And hoping Irsquom still there the next day
They have to get up from the street in the park sitting on a cold chair in the dark
Just waiting for someone to take them in their home Waiting to open up and talk about their hidden feelings
like they canrsquot wait any longer
Adrienne Benz was a child in state custody when she wrote this poem She is now an adult reunited with her family
Oklahoma Department of Human Services 11 Developmental Disabilities Services Division
I N T E R FA C E
DDSD Fiscal Year 2010 Budget Outlook OKDHS Director Howard Hendrick
presented the agencyrsquos Fiscal Year 2010 budget to the Commission for Human Services on June 16 Hendrick emphasized that even with the additional federal stimulus money and other oneshytime funds the agencyrsquos overall funding will be approximately $50 million short of anticipated spending levels To achieve a balanced budget cuts would have to be made within each division The Developmental Disabilities Services Divisionrsquos
share of the cuts amount to approximately 3 percent of the divisionrsquos operating budget ($17 million) Another $200000 had to be identified to fund the new initiative for Applied Behavior Analysis mandated by Senate Bill 135 this legislative sessionDDSD was able to accomplish the budget cuts without
impact to any programs or services through reductionsat the Northern and Southern Oklahoma ResourceCenters The rest of the savings came from reductions in training and professional contracts the divisions holds with various entitiesOver the next year DDSD will be under a selfshyimposed hiring
freeze for all positions except for case management direct care professionals and registered nursesIf monthly state revenue collections continue to fall below
expected levels additional reductions may be required of all stateagenciesrsquo operating budgets
Interim StudiesThere will be two interim legislative studies conducted this summer that could impact DDSD and service recipients
One of these studies will investigate a possible provider feetax on agencies providing waiver community services If the provider feetax is found to be within federal Medicaid guidelines it could possibly be used to fund rate increases in waiver services
The other legislative study will look into the pros and cons of online training versus classroom training specifically for providers of DDSD community services
Money Follows the PersonAs of this date DDSD has transitioned eight people from Northern Oklahoma Resource Center of Enid and Southern Oklahoma Resource Center into community homes using the federal Money Follows the Person grant Utilizing these federal funds DDSD has been able to save approximately $21000 in the community services provided to those individuals
Oklahoma documentary on developmental disabilities history to air on OETA
an
Oklahoma
document
ary
Adocumentary showing Oklahomarsquos history serving people with intellectual and developmental disabilities is
scheduled to begin airing on OETA (Oklahomarsquos Education Television Authority) in October during national Disabilities Awareness Month
The video ldquoWagons to Waivers A Century of Changerdquo narrated by Oklahomarsquos own country music star Reba McEntire will be broadcast on the OETAshyOklahoma channel starting on Oct 24th at 5 pm and on Nov 5th at 830 pm The program will be
aired a couple times a month
The documentary takes viewers on an emotional journey from the days of the Dust Bowl and covered wagons and shows the statersquos progression from institutional services to full community inclusion for persons with intellectual disabilities Oklahomarsquos story begins in 1909
with the creation of the Institute for the Feeble Minded in Enid and includes the
tears and efforts of parents the stories ofpeople who grew up in institutions the legal struggles and the triumph of selfshyadvocacy The video was produced by the Oklahoma Department of Human Services Developmental Disabilities Services Division
OETAshyOKLA is Cox Cable channel 112 but other television carriers as well as satellite users can access the channel which is devoted to Oklahomashyspecific programming Check your local television lis tings for specific programming dates and times
Oklahoma Department of Human Services 12 Developmental Disabilities Services Division
SUMMER 2009Compassion friendship and longevity A good measure of success
The day had finally come and Danny waited anxiously on the sofa He watched quietly as the
nursing staff set up the hospital bed and made his friend Carl comfortable The minute all was clear Danny went to Carl and told him how much he had missed him and that he needed him to get better Dannyrsquos longshytime friend had just undergone surgery
to remove a malignant brain tumor Danny didnrsquot understand the procedure or Carlrsquos prognosis ndash all that mattered was that his best friend was home It just wasnrsquot home without CarlCarl is considered the head of the household that he shares
with Danny and his other friend Hershel Carl was always the one who planned their meals said the prayers at the diningroom table and got them involved in Special Olympics events When Carl became ill and went to the hospital it was Danny
who stepped up and tried to fill in ndash just until Carl came home ldquoThe Three Musketeersrdquo (thatrsquos what their staff call them) have
been friends and have lived together for more than 30 years
Danny (lef
t) spends
hours by
Carlrsquos sid
e
encourag
ing him in his
recovery
They met as boys at The Hissom Memorial Center the nowshyclosed institution in Sand Springs for persons with developmental disabilities When they aged out of Hissom the three moved about the same time to a private facility where they lived for many years
In 1993 The Musketeers were given the opportunity to move together once again into a house in their community supported through the DDSD Medicaid Community Waiver program Since
that time they have lived in the house withsome of the same staffmembers who havecared for them for morethan 20 years
The Three Musketeers Danny (left) shows his excitement over his friend Carlrsquos (right) return from the hospital after brain surgery Shy Hershel (center) wipes tears from his eyes
Carl is recoveringfrom his surgery andworking on his abilityto speak and onregaining the use of theleft side of his bodyThe staff in the home
often has to make Danny go to bed at 1 am when hersquos still sitting beside Carl encouraging him to get better so he can go back to work
All three men have jobs and love their work ndash Carlmost of all Danny somehow knows that if Carl canjust get back to work life will continue as they onceknew it
ldquoTheyrsquore like a wellshysettled familyrdquo said Gretchen Moser their DDSD case manager ldquoEven their families consider these guys a family and respect their wishesrdquo
These days there are many opinions about what constitutes a family or even success But there are stories that transcend those discussions Stories like these that remind us success can also be measured by the love and longevity of a friend InterFace NEWSLETTER
Relations
hips
Oklahoma Department of Human Services 13 Developmental Disabilities Services Division
I N T E R F A C E
StateLegislativeNews
Of the thousand or more bills filed at the beginning of the 2009 legislative session only a few made it through the entire process that will have an impact on persons with developmental disabilities families and professionals in the field They are
HB 1007 mdash Wesselhoft Leftwich Signed by the Governor Requires specific Physically Disabled person signage to be posted as a reserved area for the parking of a vehicle displaying a valid permit
HB 1019 mdash WrightSigned by the Governor Recreates the Group Homes for Persons with Developmental or Physical Disabilities Advisory Board
HB 1048 mdash Banz AldridgeSigned by the Governor Relates to the collection of delinquent real property taxes removes physically disabled from ldquoincapacitatedrdquo persons granted additional time to redeem personal items reduces time to collect excess sale proceeds by half
HB 1065 mdash Faught Crain Signed by the Governor Relates to the Continuum of Care and Assisted Living Act adds definition and requires inspection results to be posted on website
HB 1424 mdash Protor Signed by the Governor Requires treatment facilities transitional living facilities halfway houses and any house or facility that may be used for medical or nonmedical detoxification to mail notification to property owners within a quarter mile radius if zoning changes are proposed
HB 1461 mdash Sears Ford Signed by the Governor A school that does not make adequate yearly progress for two straight years shall utilize the assistance of a school support team formed by the State Department of Education EMERGENCY
HB 1581 mdash Coody Jolley Signed by the Governor School teacher candidates that wish to teach elementary early childhood education or special education programs must study the five elements of reading instruction EMERGENCY
HB 1763 mdash Enns Reynolds Signed by the Governor Requires the state Department of Education to provide special education training for process hearing officers to ensure adequate knowledge in special education laws and proceduresEMERGENCY
HB 1893 mdash Peterson Anderson Signed by the Governor Creates the Aging and Disability Resource Consortium to work with other agencies in developing and implementing a singleshypointshyofshyentry concept for aging and disability groups in Oklahoma
SB 135 mdash Johnson Mike Signed by the Governor Provides for the licensing of certain persons to practice as a licensed behavior analyst or a licensed assistant behavior analyst and to study children with autism and their behaviors directs funds to be used by the Department of Human Services Developmental Disabilities Services division for training SoonerStart providers to treat children with autism spectrum disorders provides for a behavorial analysis research pilot project provides legislative intent
SB 518 mdash Justice Osborn Signed by the Governor Adds grandparents as members of immediate family
SB 871 mdash Anderson Signed by the Governor Modifies membership of the Electronic and Information Technology Accessibility Advisory Council
Oklahoma Department of Human Services 14 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
11th Circuit Rules cont from page 9
matter again Moore a teenager living in North Georgia who goes by ldquoCallierdquo has been receiving inshyhome nursing care paid for by Medicaid for about a decade The state has been trying to cut the number of hours of care she receives each week
The 11th Circuit interpreted a federal law that says states participating in the Medicaid program must provide ldquoearly and periodic screening diagnostic and treatment servicesrdquo that are necessary to ldquocorrect or ameliorate defects and physical and mental illnessesrdquo in Medicaidshyeligible children The primary ways children become eligible for Medicaid are that they come from a lowshyincome family or have a disability according to Joshua H Norris another one of Calliersquos lawyers
Georgiarsquos Department of Community Health operates a program to administer Medicaidshyfunded nursing services for several hundred children who need nursing care It delegates the decisions about approval of such services to an organization called the Georgia Medical Care Foundation
According to Thrashrsquos order Callie is disabled because of a stroke she experienced in utero and suffers from various chronic conditions including mental retardation and cerebral palsy She lives at home and according to the statersquos brief attends an elementary school in Athens Ga three days a week Her lawyers have said she requires constant care
The statersquos lawyers have said that nursing hours can be reduced when the patientrsquos medical condition stabilizes positing that a goal of the program is to teach parents and other caregivers to take care of their children on their own The Mooresrsquo lawyers have contended that the statersquos system of ldquoweaningrdquo patients off their nursing services as long as theyrsquore staying out of the hospitaland not getting worse follows a different standard than that set by federal law
In 2006 the state informed Calliersquos mother that it was reducing Calliersquos nursing hours from 94 hours a week to 84 contrary to the recommendation of Calliersquos primary care physician Calliersquos mother filed suit
The Mooresrsquo lawyers convinced Thrash that the reduction was improper Afterissuing multiple injunctions in Calliersquos favor he denied the statersquos motion for summary judgment and granted the Mooresrsquo motion in part concluding the state must provide for the amount of skilled nursing care that Calliersquos treating physician deems necessary The panel that ruled in favor of the state in its appeal was comprised of Senior 11th Circuit Judge R Lanier Anderson III 11th Circuit Judge Gerald B Tjoflat and US District Judge Lisa Godbey Wood visiting from the Southern District of Georgia
The panel said both the state and Calliersquos physician have roles in determining whatrsquos medically necessary to correct or ameliorate Calliersquos medical conditions It cited a federal regulation that says a Medicaid agency ldquomay place appropriate limits on a service based on such criteria as medical necessity or utilization control proceduresrdquo
ldquoA private physicianrsquos word on medical necessity is not dispositiverdquo the panel concluded
Assistant Attorney General Virginia B Fuller made the successful oral argument for the state last month Attorney General Thurbert E Bakerrsquos spokesman Russ Willard said in an eshymail that the state ldquois appreciative of the Court of Appeals decision recognizing the role of the Medicaid program in providing for this treatmentrdquo
Norris who also is director of legal advocacy for a nonprofit that advocates for people with disabilities said the 11th Circuit gave Thrash
an opportunity to say more about the roles of treating doctors and the state in deciding what care the state needs to provide Norris noted that Thrash wrote on the subject last year in another nursing care case about a Savannah Ga boy who nearly drowned when he was 2Thrash barred the state from enforcing a policy of not providing nursing care for patients requiring 16
to 24 hours per day for more than one week he said that criteria isnrsquot based on whatrsquos medically necessary under federal Medicaid law
On the other handThrash denied the plaintiff rsquos request based on the
treating physicianrsquos recommendation for 24shyhourshyashyday private nursing services for an
indefinite period of time Thrash deemed such a prescription ldquoan abuse of the Medicaid systemrdquo
The state has limited discretion to deny a providerrsquos request for care under the ldquoearly and periodic
screening diagnostic and treatment servicesrdquo portion of the Medicaid Act said Thrash He added that ldquo[t]he statersquos discretion is limited to a review of the request for fraud abuse of the Medicaid system and whether the service is within the reasonable
standards of medical carerdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 15 Developmental Disabilities Services Division
klahoma Department of Human Services
I N T E R F A C E
DDSD Area II Project Elves get together to wrap all the presents and make sure they are delivered to the individuals before Christmas Elves work year round
to make Christmas special for DDSD clients For the past eight years individuals with
developmental disabilities who donrsquot have families or who would otherwise not receive gifts have had their Christmas wishes come true thanks to caring DDSD ldquoelvesrdquo in Area II Project Elf is the brainchild of ldquoThe Men in Recrdquo namely
Steve Pitts and Roger McDaniel DDSD Area II recreational therapists and Joe Stie DDSD case manager ldquoDDSD serves a lot of people with developmental
disabilities who donrsquot have families to celebrate the holidays withrdquo said Pitts ldquoAlthough our services meet their basic needs therersquos still a gap when it comes to those special things that families do for one anotherrdquoThat gap has been filled by The Men in Rec who work all year
long coordinating various events to raise money to buy Christmas presents for individuals ldquoWe raise all of the funds and no OKDHS money is usedrdquo said
Pitts ldquoThis year we are selling Blue and Gold sausage and Amish jams We also have an annual Christmas Carol fundraising performance which is donated to Project Elf by the American Theater Company We are given 300 tickets that we can sell and last year we sold 225rdquoDDSD coshyworkers got together and purchased 44 of those theater
tickets last year for the children who happened to be in the Laura Dester Center Shelter around the holidays ldquoWe have also set up a sponsorship program where people can purchase
the gift and return it wrapped and ready for the elf (aka case manager) to deliver This last Christmas we had 108 sponsors 30 of whom were the case managers themselvesrdquo
The Men in Rec also recruit fellow DDSD workers to help shop for the gifts and wrap themldquoWe could not accomplish this awesome Project Elf without the assistance of so many of our coshyworkers and our community volunteersrdquo he said ldquoItrsquos such a pleasure to share these gifts at Christmas time and let our customers know that they have a family through our good service to themrdquoThe Men in Rec are currently working to raise money for this yearrsquos Christmas gifts If you would like to join the rank of DDSD Elves by donating funds or becoming a sponsor please contact Steve Pitts at stevepittsokdhsorg or call918shy794shy7625 InterFace NEWSLETTER
Steve Pitts (right) DDSD Area II recreational therapist gives a donated WalshyMart gift card to case manager Roy Willett to purchase a Christmas gift for one of the people on his caseload
Oklahoma Department of Human Services 16 Developmental Disabilities Services Division
shy shyshy shy
shy shy
shy shy
shy shy
shy shy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
Developmental Disabilities Services Area Offices and Resource Centers
CUSTER
ELLIS
BECKHAM WASHITA CADDO
McCLAIN
SEM
INO
LE HUGHES HASKELL
LE FLORELATIMER PITTSBURG
COAL
ATOKA
PONTOTOC
JOHNSTON
GARVIN
MURRAY
CARTER
LOVE
BRYAN CHOCTAW
PUSHMATAHA McCURTAIN
GRADY
KIOWA
TILLMAN
JACKSON HA
RM
ON
GREER
COTTON
JEFFERSON
STEPHENS
COMANCHE
McINTOSH
CLEVELAND
POTT
AWAT
OM
IE
DEWEY BLAINE
CANADIAN
MAJOR
GRANT KAY OSAGE
WA
SHIN
GTO
N CRAIG
ROGERS
CH
ERO
KEE
ADAIR TULSA
WAGONER
MAYES
OKMULGEE
CREEK
LINCOLN
LOGAN
PAYNE
KINGFISHER
OKLAHOMA OKFUSKEE
MUSKOGEE SEQUOYAH
DEL
AWA
RE
OTTAWA NOATTA
GARFIELD NOBLE
PAWNEE
WOODS ALFALFA HARPER BEAVER TEXASCIMARRON
WOODWARD
ROGER MILLS
MARSH
Oklahoma CityOklahoma City
Tulsa
Area II
Area III
Area I
Pauls Valley
Enid
wwwokdhsorg
State Officetoll free 1shy866shy521shy3571
AREA Itoll free 1shy800shy522shy1064
AREA IItoll free 1shy800shy522shy1075
AREA IIItoll free 1shy800shy522shy1086
Greer Center (Enid)2501 NE Delaware Enid OK 73701
580 237 10272599 FAX 580 213 2799
Northwest Oklahoma Resource Center at Enid (NORCE)2600 E Willow
Enid OK 73701
580 237 1027
FAX 580 548 2600
Southern Oklahoma Resource Center at Pauls Valley (SORC)3210 Chickasaw St
Pauls Valley OK 73075 6822
405 238 6401
FAX 405 238 8261
DDSD Area I Office (Enid)729 Overland Trail Enid OK 73703
580 548 8900 FAX 580 548 8964
DDSD Area I Office (Oklahoma City)4545 N Lincoln Blvd
Oklahoma City OK 73105 405 522 6925
FAX 405 522 6995
DDSD Area II Office (Tulsa)Laura Dester Center 1427 E 8th Tulsa OK 74120
918 560 4848 FAX 918 560 4898
DDSD Area III Office (Pauls Valley)301 S Indian Meridian Rd Pauls Valley OK 73075
405 238 4700 FAX 405 238 4740
If you would like to find out what the DevelopmentalDisabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
If you would like to find out what the Developmental Disabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
This will take you to the main Oklahoma Department of Human Services Web page From there just click on Divisions and Offices and the Developmental Disabilities Services Division On our Web site you will find information about services the division offers how to apply for services eligibility policies contract provider agencies and much more
Come visit us today You may be surprised at what you will learn
OKLAHOMA DEPARTMENT OF HUMAN SERVICES Developmental Disabilities Services DivisionPO Box 25352 Oklahoma City OK 73125
SUMMER 2 0 0 9
Regulations Expiring cont from page 10
bull Rescinding a final rule published Dec 28 2007 that would have eliminated reimbursement for schoolshybased administrative costs and costs of transportation to and from schools The rescission reflects concern that the rule could limit the Medicaid administrative outreach activities of schools and that the overall budgetary impact on schools could potentially impact their ability to offer Medicaid services to students
bull Rescinding a rule published Nov 7 2008 that would have limited the outpatient hospital and clinic service benefit for Medicaid beneficiaries to the scope of services recognized as an outpatient hospital service under Medicare This rule was rescinded because CMS became aware that coverage beyond that scope could not be easily moved to other benefit categories resulting in great impact than previously anticipated
bull Delaying until June 30 2010 the enforcement of portions of a regulation that clarified limitations on health care related tax programs so that CMS could determine whether states need additional clarification or guidance CMS may also further review the potential impact of the regulation and give additional consideration to alternative approaches InterFace NEWSLETTER
Waiting and HopingBy Adrienne Benz
Sad is like sitting here when I donrsquot have a home to run away to
So there on the street just waiting for something to eat somewhere to stay and a bed to sleep on and someone to hold
And hoping Irsquom still there the next day
They have to get up from the street in the park sitting on a cold chair in the dark
Just waiting for someone to take them in their home Waiting to open up and talk about their hidden feelings
like they canrsquot wait any longer
Adrienne Benz was a child in state custody when she wrote this poem She is now an adult reunited with her family
Oklahoma Department of Human Services 11 Developmental Disabilities Services Division
I N T E R FA C E
DDSD Fiscal Year 2010 Budget Outlook OKDHS Director Howard Hendrick
presented the agencyrsquos Fiscal Year 2010 budget to the Commission for Human Services on June 16 Hendrick emphasized that even with the additional federal stimulus money and other oneshytime funds the agencyrsquos overall funding will be approximately $50 million short of anticipated spending levels To achieve a balanced budget cuts would have to be made within each division The Developmental Disabilities Services Divisionrsquos
share of the cuts amount to approximately 3 percent of the divisionrsquos operating budget ($17 million) Another $200000 had to be identified to fund the new initiative for Applied Behavior Analysis mandated by Senate Bill 135 this legislative sessionDDSD was able to accomplish the budget cuts without
impact to any programs or services through reductionsat the Northern and Southern Oklahoma ResourceCenters The rest of the savings came from reductions in training and professional contracts the divisions holds with various entitiesOver the next year DDSD will be under a selfshyimposed hiring
freeze for all positions except for case management direct care professionals and registered nursesIf monthly state revenue collections continue to fall below
expected levels additional reductions may be required of all stateagenciesrsquo operating budgets
Interim StudiesThere will be two interim legislative studies conducted this summer that could impact DDSD and service recipients
One of these studies will investigate a possible provider feetax on agencies providing waiver community services If the provider feetax is found to be within federal Medicaid guidelines it could possibly be used to fund rate increases in waiver services
The other legislative study will look into the pros and cons of online training versus classroom training specifically for providers of DDSD community services
Money Follows the PersonAs of this date DDSD has transitioned eight people from Northern Oklahoma Resource Center of Enid and Southern Oklahoma Resource Center into community homes using the federal Money Follows the Person grant Utilizing these federal funds DDSD has been able to save approximately $21000 in the community services provided to those individuals
Oklahoma documentary on developmental disabilities history to air on OETA
an
Oklahoma
document
ary
Adocumentary showing Oklahomarsquos history serving people with intellectual and developmental disabilities is
scheduled to begin airing on OETA (Oklahomarsquos Education Television Authority) in October during national Disabilities Awareness Month
The video ldquoWagons to Waivers A Century of Changerdquo narrated by Oklahomarsquos own country music star Reba McEntire will be broadcast on the OETAshyOklahoma channel starting on Oct 24th at 5 pm and on Nov 5th at 830 pm The program will be
aired a couple times a month
The documentary takes viewers on an emotional journey from the days of the Dust Bowl and covered wagons and shows the statersquos progression from institutional services to full community inclusion for persons with intellectual disabilities Oklahomarsquos story begins in 1909
with the creation of the Institute for the Feeble Minded in Enid and includes the
tears and efforts of parents the stories ofpeople who grew up in institutions the legal struggles and the triumph of selfshyadvocacy The video was produced by the Oklahoma Department of Human Services Developmental Disabilities Services Division
OETAshyOKLA is Cox Cable channel 112 but other television carriers as well as satellite users can access the channel which is devoted to Oklahomashyspecific programming Check your local television lis tings for specific programming dates and times
Oklahoma Department of Human Services 12 Developmental Disabilities Services Division
SUMMER 2009Compassion friendship and longevity A good measure of success
The day had finally come and Danny waited anxiously on the sofa He watched quietly as the
nursing staff set up the hospital bed and made his friend Carl comfortable The minute all was clear Danny went to Carl and told him how much he had missed him and that he needed him to get better Dannyrsquos longshytime friend had just undergone surgery
to remove a malignant brain tumor Danny didnrsquot understand the procedure or Carlrsquos prognosis ndash all that mattered was that his best friend was home It just wasnrsquot home without CarlCarl is considered the head of the household that he shares
with Danny and his other friend Hershel Carl was always the one who planned their meals said the prayers at the diningroom table and got them involved in Special Olympics events When Carl became ill and went to the hospital it was Danny
who stepped up and tried to fill in ndash just until Carl came home ldquoThe Three Musketeersrdquo (thatrsquos what their staff call them) have
been friends and have lived together for more than 30 years
Danny (lef
t) spends
hours by
Carlrsquos sid
e
encourag
ing him in his
recovery
They met as boys at The Hissom Memorial Center the nowshyclosed institution in Sand Springs for persons with developmental disabilities When they aged out of Hissom the three moved about the same time to a private facility where they lived for many years
In 1993 The Musketeers were given the opportunity to move together once again into a house in their community supported through the DDSD Medicaid Community Waiver program Since
that time they have lived in the house withsome of the same staffmembers who havecared for them for morethan 20 years
The Three Musketeers Danny (left) shows his excitement over his friend Carlrsquos (right) return from the hospital after brain surgery Shy Hershel (center) wipes tears from his eyes
Carl is recoveringfrom his surgery andworking on his abilityto speak and onregaining the use of theleft side of his bodyThe staff in the home
often has to make Danny go to bed at 1 am when hersquos still sitting beside Carl encouraging him to get better so he can go back to work
All three men have jobs and love their work ndash Carlmost of all Danny somehow knows that if Carl canjust get back to work life will continue as they onceknew it
ldquoTheyrsquore like a wellshysettled familyrdquo said Gretchen Moser their DDSD case manager ldquoEven their families consider these guys a family and respect their wishesrdquo
These days there are many opinions about what constitutes a family or even success But there are stories that transcend those discussions Stories like these that remind us success can also be measured by the love and longevity of a friend InterFace NEWSLETTER
Relations
hips
Oklahoma Department of Human Services 13 Developmental Disabilities Services Division
I N T E R F A C E
StateLegislativeNews
Of the thousand or more bills filed at the beginning of the 2009 legislative session only a few made it through the entire process that will have an impact on persons with developmental disabilities families and professionals in the field They are
HB 1007 mdash Wesselhoft Leftwich Signed by the Governor Requires specific Physically Disabled person signage to be posted as a reserved area for the parking of a vehicle displaying a valid permit
HB 1019 mdash WrightSigned by the Governor Recreates the Group Homes for Persons with Developmental or Physical Disabilities Advisory Board
HB 1048 mdash Banz AldridgeSigned by the Governor Relates to the collection of delinquent real property taxes removes physically disabled from ldquoincapacitatedrdquo persons granted additional time to redeem personal items reduces time to collect excess sale proceeds by half
HB 1065 mdash Faught Crain Signed by the Governor Relates to the Continuum of Care and Assisted Living Act adds definition and requires inspection results to be posted on website
HB 1424 mdash Protor Signed by the Governor Requires treatment facilities transitional living facilities halfway houses and any house or facility that may be used for medical or nonmedical detoxification to mail notification to property owners within a quarter mile radius if zoning changes are proposed
HB 1461 mdash Sears Ford Signed by the Governor A school that does not make adequate yearly progress for two straight years shall utilize the assistance of a school support team formed by the State Department of Education EMERGENCY
HB 1581 mdash Coody Jolley Signed by the Governor School teacher candidates that wish to teach elementary early childhood education or special education programs must study the five elements of reading instruction EMERGENCY
HB 1763 mdash Enns Reynolds Signed by the Governor Requires the state Department of Education to provide special education training for process hearing officers to ensure adequate knowledge in special education laws and proceduresEMERGENCY
HB 1893 mdash Peterson Anderson Signed by the Governor Creates the Aging and Disability Resource Consortium to work with other agencies in developing and implementing a singleshypointshyofshyentry concept for aging and disability groups in Oklahoma
SB 135 mdash Johnson Mike Signed by the Governor Provides for the licensing of certain persons to practice as a licensed behavior analyst or a licensed assistant behavior analyst and to study children with autism and their behaviors directs funds to be used by the Department of Human Services Developmental Disabilities Services division for training SoonerStart providers to treat children with autism spectrum disorders provides for a behavorial analysis research pilot project provides legislative intent
SB 518 mdash Justice Osborn Signed by the Governor Adds grandparents as members of immediate family
SB 871 mdash Anderson Signed by the Governor Modifies membership of the Electronic and Information Technology Accessibility Advisory Council
Oklahoma Department of Human Services 14 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
11th Circuit Rules cont from page 9
matter again Moore a teenager living in North Georgia who goes by ldquoCallierdquo has been receiving inshyhome nursing care paid for by Medicaid for about a decade The state has been trying to cut the number of hours of care she receives each week
The 11th Circuit interpreted a federal law that says states participating in the Medicaid program must provide ldquoearly and periodic screening diagnostic and treatment servicesrdquo that are necessary to ldquocorrect or ameliorate defects and physical and mental illnessesrdquo in Medicaidshyeligible children The primary ways children become eligible for Medicaid are that they come from a lowshyincome family or have a disability according to Joshua H Norris another one of Calliersquos lawyers
Georgiarsquos Department of Community Health operates a program to administer Medicaidshyfunded nursing services for several hundred children who need nursing care It delegates the decisions about approval of such services to an organization called the Georgia Medical Care Foundation
According to Thrashrsquos order Callie is disabled because of a stroke she experienced in utero and suffers from various chronic conditions including mental retardation and cerebral palsy She lives at home and according to the statersquos brief attends an elementary school in Athens Ga three days a week Her lawyers have said she requires constant care
The statersquos lawyers have said that nursing hours can be reduced when the patientrsquos medical condition stabilizes positing that a goal of the program is to teach parents and other caregivers to take care of their children on their own The Mooresrsquo lawyers have contended that the statersquos system of ldquoweaningrdquo patients off their nursing services as long as theyrsquore staying out of the hospitaland not getting worse follows a different standard than that set by federal law
In 2006 the state informed Calliersquos mother that it was reducing Calliersquos nursing hours from 94 hours a week to 84 contrary to the recommendation of Calliersquos primary care physician Calliersquos mother filed suit
The Mooresrsquo lawyers convinced Thrash that the reduction was improper Afterissuing multiple injunctions in Calliersquos favor he denied the statersquos motion for summary judgment and granted the Mooresrsquo motion in part concluding the state must provide for the amount of skilled nursing care that Calliersquos treating physician deems necessary The panel that ruled in favor of the state in its appeal was comprised of Senior 11th Circuit Judge R Lanier Anderson III 11th Circuit Judge Gerald B Tjoflat and US District Judge Lisa Godbey Wood visiting from the Southern District of Georgia
The panel said both the state and Calliersquos physician have roles in determining whatrsquos medically necessary to correct or ameliorate Calliersquos medical conditions It cited a federal regulation that says a Medicaid agency ldquomay place appropriate limits on a service based on such criteria as medical necessity or utilization control proceduresrdquo
ldquoA private physicianrsquos word on medical necessity is not dispositiverdquo the panel concluded
Assistant Attorney General Virginia B Fuller made the successful oral argument for the state last month Attorney General Thurbert E Bakerrsquos spokesman Russ Willard said in an eshymail that the state ldquois appreciative of the Court of Appeals decision recognizing the role of the Medicaid program in providing for this treatmentrdquo
Norris who also is director of legal advocacy for a nonprofit that advocates for people with disabilities said the 11th Circuit gave Thrash
an opportunity to say more about the roles of treating doctors and the state in deciding what care the state needs to provide Norris noted that Thrash wrote on the subject last year in another nursing care case about a Savannah Ga boy who nearly drowned when he was 2Thrash barred the state from enforcing a policy of not providing nursing care for patients requiring 16
to 24 hours per day for more than one week he said that criteria isnrsquot based on whatrsquos medically necessary under federal Medicaid law
On the other handThrash denied the plaintiff rsquos request based on the
treating physicianrsquos recommendation for 24shyhourshyashyday private nursing services for an
indefinite period of time Thrash deemed such a prescription ldquoan abuse of the Medicaid systemrdquo
The state has limited discretion to deny a providerrsquos request for care under the ldquoearly and periodic
screening diagnostic and treatment servicesrdquo portion of the Medicaid Act said Thrash He added that ldquo[t]he statersquos discretion is limited to a review of the request for fraud abuse of the Medicaid system and whether the service is within the reasonable
standards of medical carerdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 15 Developmental Disabilities Services Division
klahoma Department of Human Services
I N T E R F A C E
DDSD Area II Project Elves get together to wrap all the presents and make sure they are delivered to the individuals before Christmas Elves work year round
to make Christmas special for DDSD clients For the past eight years individuals with
developmental disabilities who donrsquot have families or who would otherwise not receive gifts have had their Christmas wishes come true thanks to caring DDSD ldquoelvesrdquo in Area II Project Elf is the brainchild of ldquoThe Men in Recrdquo namely
Steve Pitts and Roger McDaniel DDSD Area II recreational therapists and Joe Stie DDSD case manager ldquoDDSD serves a lot of people with developmental
disabilities who donrsquot have families to celebrate the holidays withrdquo said Pitts ldquoAlthough our services meet their basic needs therersquos still a gap when it comes to those special things that families do for one anotherrdquoThat gap has been filled by The Men in Rec who work all year
long coordinating various events to raise money to buy Christmas presents for individuals ldquoWe raise all of the funds and no OKDHS money is usedrdquo said
Pitts ldquoThis year we are selling Blue and Gold sausage and Amish jams We also have an annual Christmas Carol fundraising performance which is donated to Project Elf by the American Theater Company We are given 300 tickets that we can sell and last year we sold 225rdquoDDSD coshyworkers got together and purchased 44 of those theater
tickets last year for the children who happened to be in the Laura Dester Center Shelter around the holidays ldquoWe have also set up a sponsorship program where people can purchase
the gift and return it wrapped and ready for the elf (aka case manager) to deliver This last Christmas we had 108 sponsors 30 of whom were the case managers themselvesrdquo
The Men in Rec also recruit fellow DDSD workers to help shop for the gifts and wrap themldquoWe could not accomplish this awesome Project Elf without the assistance of so many of our coshyworkers and our community volunteersrdquo he said ldquoItrsquos such a pleasure to share these gifts at Christmas time and let our customers know that they have a family through our good service to themrdquoThe Men in Rec are currently working to raise money for this yearrsquos Christmas gifts If you would like to join the rank of DDSD Elves by donating funds or becoming a sponsor please contact Steve Pitts at stevepittsokdhsorg or call918shy794shy7625 InterFace NEWSLETTER
Steve Pitts (right) DDSD Area II recreational therapist gives a donated WalshyMart gift card to case manager Roy Willett to purchase a Christmas gift for one of the people on his caseload
Oklahoma Department of Human Services 16 Developmental Disabilities Services Division
shy shyshy shy
shy shy
shy shy
shy shy
shy shy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
Developmental Disabilities Services Area Offices and Resource Centers
CUSTER
ELLIS
BECKHAM WASHITA CADDO
McCLAIN
SEM
INO
LE HUGHES HASKELL
LE FLORELATIMER PITTSBURG
COAL
ATOKA
PONTOTOC
JOHNSTON
GARVIN
MURRAY
CARTER
LOVE
BRYAN CHOCTAW
PUSHMATAHA McCURTAIN
GRADY
KIOWA
TILLMAN
JACKSON HA
RM
ON
GREER
COTTON
JEFFERSON
STEPHENS
COMANCHE
McINTOSH
CLEVELAND
POTT
AWAT
OM
IE
DEWEY BLAINE
CANADIAN
MAJOR
GRANT KAY OSAGE
WA
SHIN
GTO
N CRAIG
ROGERS
CH
ERO
KEE
ADAIR TULSA
WAGONER
MAYES
OKMULGEE
CREEK
LINCOLN
LOGAN
PAYNE
KINGFISHER
OKLAHOMA OKFUSKEE
MUSKOGEE SEQUOYAH
DEL
AWA
RE
OTTAWA NOATTA
GARFIELD NOBLE
PAWNEE
WOODS ALFALFA HARPER BEAVER TEXASCIMARRON
WOODWARD
ROGER MILLS
MARSH
Oklahoma CityOklahoma City
Tulsa
Area II
Area III
Area I
Pauls Valley
Enid
wwwokdhsorg
State Officetoll free 1shy866shy521shy3571
AREA Itoll free 1shy800shy522shy1064
AREA IItoll free 1shy800shy522shy1075
AREA IIItoll free 1shy800shy522shy1086
Greer Center (Enid)2501 NE Delaware Enid OK 73701
580 237 10272599 FAX 580 213 2799
Northwest Oklahoma Resource Center at Enid (NORCE)2600 E Willow
Enid OK 73701
580 237 1027
FAX 580 548 2600
Southern Oklahoma Resource Center at Pauls Valley (SORC)3210 Chickasaw St
Pauls Valley OK 73075 6822
405 238 6401
FAX 405 238 8261
DDSD Area I Office (Enid)729 Overland Trail Enid OK 73703
580 548 8900 FAX 580 548 8964
DDSD Area I Office (Oklahoma City)4545 N Lincoln Blvd
Oklahoma City OK 73105 405 522 6925
FAX 405 522 6995
DDSD Area II Office (Tulsa)Laura Dester Center 1427 E 8th Tulsa OK 74120
918 560 4848 FAX 918 560 4898
DDSD Area III Office (Pauls Valley)301 S Indian Meridian Rd Pauls Valley OK 73075
405 238 4700 FAX 405 238 4740
If you would like to find out what the DevelopmentalDisabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
If you would like to find out what the Developmental Disabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
This will take you to the main Oklahoma Department of Human Services Web page From there just click on Divisions and Offices and the Developmental Disabilities Services Division On our Web site you will find information about services the division offers how to apply for services eligibility policies contract provider agencies and much more
Come visit us today You may be surprised at what you will learn
OKLAHOMA DEPARTMENT OF HUMAN SERVICES Developmental Disabilities Services DivisionPO Box 25352 Oklahoma City OK 73125
I N T E R FA C E
DDSD Fiscal Year 2010 Budget Outlook OKDHS Director Howard Hendrick
presented the agencyrsquos Fiscal Year 2010 budget to the Commission for Human Services on June 16 Hendrick emphasized that even with the additional federal stimulus money and other oneshytime funds the agencyrsquos overall funding will be approximately $50 million short of anticipated spending levels To achieve a balanced budget cuts would have to be made within each division The Developmental Disabilities Services Divisionrsquos
share of the cuts amount to approximately 3 percent of the divisionrsquos operating budget ($17 million) Another $200000 had to be identified to fund the new initiative for Applied Behavior Analysis mandated by Senate Bill 135 this legislative sessionDDSD was able to accomplish the budget cuts without
impact to any programs or services through reductionsat the Northern and Southern Oklahoma ResourceCenters The rest of the savings came from reductions in training and professional contracts the divisions holds with various entitiesOver the next year DDSD will be under a selfshyimposed hiring
freeze for all positions except for case management direct care professionals and registered nursesIf monthly state revenue collections continue to fall below
expected levels additional reductions may be required of all stateagenciesrsquo operating budgets
Interim StudiesThere will be two interim legislative studies conducted this summer that could impact DDSD and service recipients
One of these studies will investigate a possible provider feetax on agencies providing waiver community services If the provider feetax is found to be within federal Medicaid guidelines it could possibly be used to fund rate increases in waiver services
The other legislative study will look into the pros and cons of online training versus classroom training specifically for providers of DDSD community services
Money Follows the PersonAs of this date DDSD has transitioned eight people from Northern Oklahoma Resource Center of Enid and Southern Oklahoma Resource Center into community homes using the federal Money Follows the Person grant Utilizing these federal funds DDSD has been able to save approximately $21000 in the community services provided to those individuals
Oklahoma documentary on developmental disabilities history to air on OETA
an
Oklahoma
document
ary
Adocumentary showing Oklahomarsquos history serving people with intellectual and developmental disabilities is
scheduled to begin airing on OETA (Oklahomarsquos Education Television Authority) in October during national Disabilities Awareness Month
The video ldquoWagons to Waivers A Century of Changerdquo narrated by Oklahomarsquos own country music star Reba McEntire will be broadcast on the OETAshyOklahoma channel starting on Oct 24th at 5 pm and on Nov 5th at 830 pm The program will be
aired a couple times a month
The documentary takes viewers on an emotional journey from the days of the Dust Bowl and covered wagons and shows the statersquos progression from institutional services to full community inclusion for persons with intellectual disabilities Oklahomarsquos story begins in 1909
with the creation of the Institute for the Feeble Minded in Enid and includes the
tears and efforts of parents the stories ofpeople who grew up in institutions the legal struggles and the triumph of selfshyadvocacy The video was produced by the Oklahoma Department of Human Services Developmental Disabilities Services Division
OETAshyOKLA is Cox Cable channel 112 but other television carriers as well as satellite users can access the channel which is devoted to Oklahomashyspecific programming Check your local television lis tings for specific programming dates and times
Oklahoma Department of Human Services 12 Developmental Disabilities Services Division
SUMMER 2009Compassion friendship and longevity A good measure of success
The day had finally come and Danny waited anxiously on the sofa He watched quietly as the
nursing staff set up the hospital bed and made his friend Carl comfortable The minute all was clear Danny went to Carl and told him how much he had missed him and that he needed him to get better Dannyrsquos longshytime friend had just undergone surgery
to remove a malignant brain tumor Danny didnrsquot understand the procedure or Carlrsquos prognosis ndash all that mattered was that his best friend was home It just wasnrsquot home without CarlCarl is considered the head of the household that he shares
with Danny and his other friend Hershel Carl was always the one who planned their meals said the prayers at the diningroom table and got them involved in Special Olympics events When Carl became ill and went to the hospital it was Danny
who stepped up and tried to fill in ndash just until Carl came home ldquoThe Three Musketeersrdquo (thatrsquos what their staff call them) have
been friends and have lived together for more than 30 years
Danny (lef
t) spends
hours by
Carlrsquos sid
e
encourag
ing him in his
recovery
They met as boys at The Hissom Memorial Center the nowshyclosed institution in Sand Springs for persons with developmental disabilities When they aged out of Hissom the three moved about the same time to a private facility where they lived for many years
In 1993 The Musketeers were given the opportunity to move together once again into a house in their community supported through the DDSD Medicaid Community Waiver program Since
that time they have lived in the house withsome of the same staffmembers who havecared for them for morethan 20 years
The Three Musketeers Danny (left) shows his excitement over his friend Carlrsquos (right) return from the hospital after brain surgery Shy Hershel (center) wipes tears from his eyes
Carl is recoveringfrom his surgery andworking on his abilityto speak and onregaining the use of theleft side of his bodyThe staff in the home
often has to make Danny go to bed at 1 am when hersquos still sitting beside Carl encouraging him to get better so he can go back to work
All three men have jobs and love their work ndash Carlmost of all Danny somehow knows that if Carl canjust get back to work life will continue as they onceknew it
ldquoTheyrsquore like a wellshysettled familyrdquo said Gretchen Moser their DDSD case manager ldquoEven their families consider these guys a family and respect their wishesrdquo
These days there are many opinions about what constitutes a family or even success But there are stories that transcend those discussions Stories like these that remind us success can also be measured by the love and longevity of a friend InterFace NEWSLETTER
Relations
hips
Oklahoma Department of Human Services 13 Developmental Disabilities Services Division
I N T E R F A C E
StateLegislativeNews
Of the thousand or more bills filed at the beginning of the 2009 legislative session only a few made it through the entire process that will have an impact on persons with developmental disabilities families and professionals in the field They are
HB 1007 mdash Wesselhoft Leftwich Signed by the Governor Requires specific Physically Disabled person signage to be posted as a reserved area for the parking of a vehicle displaying a valid permit
HB 1019 mdash WrightSigned by the Governor Recreates the Group Homes for Persons with Developmental or Physical Disabilities Advisory Board
HB 1048 mdash Banz AldridgeSigned by the Governor Relates to the collection of delinquent real property taxes removes physically disabled from ldquoincapacitatedrdquo persons granted additional time to redeem personal items reduces time to collect excess sale proceeds by half
HB 1065 mdash Faught Crain Signed by the Governor Relates to the Continuum of Care and Assisted Living Act adds definition and requires inspection results to be posted on website
HB 1424 mdash Protor Signed by the Governor Requires treatment facilities transitional living facilities halfway houses and any house or facility that may be used for medical or nonmedical detoxification to mail notification to property owners within a quarter mile radius if zoning changes are proposed
HB 1461 mdash Sears Ford Signed by the Governor A school that does not make adequate yearly progress for two straight years shall utilize the assistance of a school support team formed by the State Department of Education EMERGENCY
HB 1581 mdash Coody Jolley Signed by the Governor School teacher candidates that wish to teach elementary early childhood education or special education programs must study the five elements of reading instruction EMERGENCY
HB 1763 mdash Enns Reynolds Signed by the Governor Requires the state Department of Education to provide special education training for process hearing officers to ensure adequate knowledge in special education laws and proceduresEMERGENCY
HB 1893 mdash Peterson Anderson Signed by the Governor Creates the Aging and Disability Resource Consortium to work with other agencies in developing and implementing a singleshypointshyofshyentry concept for aging and disability groups in Oklahoma
SB 135 mdash Johnson Mike Signed by the Governor Provides for the licensing of certain persons to practice as a licensed behavior analyst or a licensed assistant behavior analyst and to study children with autism and their behaviors directs funds to be used by the Department of Human Services Developmental Disabilities Services division for training SoonerStart providers to treat children with autism spectrum disorders provides for a behavorial analysis research pilot project provides legislative intent
SB 518 mdash Justice Osborn Signed by the Governor Adds grandparents as members of immediate family
SB 871 mdash Anderson Signed by the Governor Modifies membership of the Electronic and Information Technology Accessibility Advisory Council
Oklahoma Department of Human Services 14 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
11th Circuit Rules cont from page 9
matter again Moore a teenager living in North Georgia who goes by ldquoCallierdquo has been receiving inshyhome nursing care paid for by Medicaid for about a decade The state has been trying to cut the number of hours of care she receives each week
The 11th Circuit interpreted a federal law that says states participating in the Medicaid program must provide ldquoearly and periodic screening diagnostic and treatment servicesrdquo that are necessary to ldquocorrect or ameliorate defects and physical and mental illnessesrdquo in Medicaidshyeligible children The primary ways children become eligible for Medicaid are that they come from a lowshyincome family or have a disability according to Joshua H Norris another one of Calliersquos lawyers
Georgiarsquos Department of Community Health operates a program to administer Medicaidshyfunded nursing services for several hundred children who need nursing care It delegates the decisions about approval of such services to an organization called the Georgia Medical Care Foundation
According to Thrashrsquos order Callie is disabled because of a stroke she experienced in utero and suffers from various chronic conditions including mental retardation and cerebral palsy She lives at home and according to the statersquos brief attends an elementary school in Athens Ga three days a week Her lawyers have said she requires constant care
The statersquos lawyers have said that nursing hours can be reduced when the patientrsquos medical condition stabilizes positing that a goal of the program is to teach parents and other caregivers to take care of their children on their own The Mooresrsquo lawyers have contended that the statersquos system of ldquoweaningrdquo patients off their nursing services as long as theyrsquore staying out of the hospitaland not getting worse follows a different standard than that set by federal law
In 2006 the state informed Calliersquos mother that it was reducing Calliersquos nursing hours from 94 hours a week to 84 contrary to the recommendation of Calliersquos primary care physician Calliersquos mother filed suit
The Mooresrsquo lawyers convinced Thrash that the reduction was improper Afterissuing multiple injunctions in Calliersquos favor he denied the statersquos motion for summary judgment and granted the Mooresrsquo motion in part concluding the state must provide for the amount of skilled nursing care that Calliersquos treating physician deems necessary The panel that ruled in favor of the state in its appeal was comprised of Senior 11th Circuit Judge R Lanier Anderson III 11th Circuit Judge Gerald B Tjoflat and US District Judge Lisa Godbey Wood visiting from the Southern District of Georgia
The panel said both the state and Calliersquos physician have roles in determining whatrsquos medically necessary to correct or ameliorate Calliersquos medical conditions It cited a federal regulation that says a Medicaid agency ldquomay place appropriate limits on a service based on such criteria as medical necessity or utilization control proceduresrdquo
ldquoA private physicianrsquos word on medical necessity is not dispositiverdquo the panel concluded
Assistant Attorney General Virginia B Fuller made the successful oral argument for the state last month Attorney General Thurbert E Bakerrsquos spokesman Russ Willard said in an eshymail that the state ldquois appreciative of the Court of Appeals decision recognizing the role of the Medicaid program in providing for this treatmentrdquo
Norris who also is director of legal advocacy for a nonprofit that advocates for people with disabilities said the 11th Circuit gave Thrash
an opportunity to say more about the roles of treating doctors and the state in deciding what care the state needs to provide Norris noted that Thrash wrote on the subject last year in another nursing care case about a Savannah Ga boy who nearly drowned when he was 2Thrash barred the state from enforcing a policy of not providing nursing care for patients requiring 16
to 24 hours per day for more than one week he said that criteria isnrsquot based on whatrsquos medically necessary under federal Medicaid law
On the other handThrash denied the plaintiff rsquos request based on the
treating physicianrsquos recommendation for 24shyhourshyashyday private nursing services for an
indefinite period of time Thrash deemed such a prescription ldquoan abuse of the Medicaid systemrdquo
The state has limited discretion to deny a providerrsquos request for care under the ldquoearly and periodic
screening diagnostic and treatment servicesrdquo portion of the Medicaid Act said Thrash He added that ldquo[t]he statersquos discretion is limited to a review of the request for fraud abuse of the Medicaid system and whether the service is within the reasonable
standards of medical carerdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 15 Developmental Disabilities Services Division
klahoma Department of Human Services
I N T E R F A C E
DDSD Area II Project Elves get together to wrap all the presents and make sure they are delivered to the individuals before Christmas Elves work year round
to make Christmas special for DDSD clients For the past eight years individuals with
developmental disabilities who donrsquot have families or who would otherwise not receive gifts have had their Christmas wishes come true thanks to caring DDSD ldquoelvesrdquo in Area II Project Elf is the brainchild of ldquoThe Men in Recrdquo namely
Steve Pitts and Roger McDaniel DDSD Area II recreational therapists and Joe Stie DDSD case manager ldquoDDSD serves a lot of people with developmental
disabilities who donrsquot have families to celebrate the holidays withrdquo said Pitts ldquoAlthough our services meet their basic needs therersquos still a gap when it comes to those special things that families do for one anotherrdquoThat gap has been filled by The Men in Rec who work all year
long coordinating various events to raise money to buy Christmas presents for individuals ldquoWe raise all of the funds and no OKDHS money is usedrdquo said
Pitts ldquoThis year we are selling Blue and Gold sausage and Amish jams We also have an annual Christmas Carol fundraising performance which is donated to Project Elf by the American Theater Company We are given 300 tickets that we can sell and last year we sold 225rdquoDDSD coshyworkers got together and purchased 44 of those theater
tickets last year for the children who happened to be in the Laura Dester Center Shelter around the holidays ldquoWe have also set up a sponsorship program where people can purchase
the gift and return it wrapped and ready for the elf (aka case manager) to deliver This last Christmas we had 108 sponsors 30 of whom were the case managers themselvesrdquo
The Men in Rec also recruit fellow DDSD workers to help shop for the gifts and wrap themldquoWe could not accomplish this awesome Project Elf without the assistance of so many of our coshyworkers and our community volunteersrdquo he said ldquoItrsquos such a pleasure to share these gifts at Christmas time and let our customers know that they have a family through our good service to themrdquoThe Men in Rec are currently working to raise money for this yearrsquos Christmas gifts If you would like to join the rank of DDSD Elves by donating funds or becoming a sponsor please contact Steve Pitts at stevepittsokdhsorg or call918shy794shy7625 InterFace NEWSLETTER
Steve Pitts (right) DDSD Area II recreational therapist gives a donated WalshyMart gift card to case manager Roy Willett to purchase a Christmas gift for one of the people on his caseload
Oklahoma Department of Human Services 16 Developmental Disabilities Services Division
shy shyshy shy
shy shy
shy shy
shy shy
shy shy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
Developmental Disabilities Services Area Offices and Resource Centers
CUSTER
ELLIS
BECKHAM WASHITA CADDO
McCLAIN
SEM
INO
LE HUGHES HASKELL
LE FLORELATIMER PITTSBURG
COAL
ATOKA
PONTOTOC
JOHNSTON
GARVIN
MURRAY
CARTER
LOVE
BRYAN CHOCTAW
PUSHMATAHA McCURTAIN
GRADY
KIOWA
TILLMAN
JACKSON HA
RM
ON
GREER
COTTON
JEFFERSON
STEPHENS
COMANCHE
McINTOSH
CLEVELAND
POTT
AWAT
OM
IE
DEWEY BLAINE
CANADIAN
MAJOR
GRANT KAY OSAGE
WA
SHIN
GTO
N CRAIG
ROGERS
CH
ERO
KEE
ADAIR TULSA
WAGONER
MAYES
OKMULGEE
CREEK
LINCOLN
LOGAN
PAYNE
KINGFISHER
OKLAHOMA OKFUSKEE
MUSKOGEE SEQUOYAH
DEL
AWA
RE
OTTAWA NOATTA
GARFIELD NOBLE
PAWNEE
WOODS ALFALFA HARPER BEAVER TEXASCIMARRON
WOODWARD
ROGER MILLS
MARSH
Oklahoma CityOklahoma City
Tulsa
Area II
Area III
Area I
Pauls Valley
Enid
wwwokdhsorg
State Officetoll free 1shy866shy521shy3571
AREA Itoll free 1shy800shy522shy1064
AREA IItoll free 1shy800shy522shy1075
AREA IIItoll free 1shy800shy522shy1086
Greer Center (Enid)2501 NE Delaware Enid OK 73701
580 237 10272599 FAX 580 213 2799
Northwest Oklahoma Resource Center at Enid (NORCE)2600 E Willow
Enid OK 73701
580 237 1027
FAX 580 548 2600
Southern Oklahoma Resource Center at Pauls Valley (SORC)3210 Chickasaw St
Pauls Valley OK 73075 6822
405 238 6401
FAX 405 238 8261
DDSD Area I Office (Enid)729 Overland Trail Enid OK 73703
580 548 8900 FAX 580 548 8964
DDSD Area I Office (Oklahoma City)4545 N Lincoln Blvd
Oklahoma City OK 73105 405 522 6925
FAX 405 522 6995
DDSD Area II Office (Tulsa)Laura Dester Center 1427 E 8th Tulsa OK 74120
918 560 4848 FAX 918 560 4898
DDSD Area III Office (Pauls Valley)301 S Indian Meridian Rd Pauls Valley OK 73075
405 238 4700 FAX 405 238 4740
If you would like to find out what the DevelopmentalDisabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
If you would like to find out what the Developmental Disabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
This will take you to the main Oklahoma Department of Human Services Web page From there just click on Divisions and Offices and the Developmental Disabilities Services Division On our Web site you will find information about services the division offers how to apply for services eligibility policies contract provider agencies and much more
Come visit us today You may be surprised at what you will learn
OKLAHOMA DEPARTMENT OF HUMAN SERVICES Developmental Disabilities Services DivisionPO Box 25352 Oklahoma City OK 73125
SUMMER 2009Compassion friendship and longevity A good measure of success
The day had finally come and Danny waited anxiously on the sofa He watched quietly as the
nursing staff set up the hospital bed and made his friend Carl comfortable The minute all was clear Danny went to Carl and told him how much he had missed him and that he needed him to get better Dannyrsquos longshytime friend had just undergone surgery
to remove a malignant brain tumor Danny didnrsquot understand the procedure or Carlrsquos prognosis ndash all that mattered was that his best friend was home It just wasnrsquot home without CarlCarl is considered the head of the household that he shares
with Danny and his other friend Hershel Carl was always the one who planned their meals said the prayers at the diningroom table and got them involved in Special Olympics events When Carl became ill and went to the hospital it was Danny
who stepped up and tried to fill in ndash just until Carl came home ldquoThe Three Musketeersrdquo (thatrsquos what their staff call them) have
been friends and have lived together for more than 30 years
Danny (lef
t) spends
hours by
Carlrsquos sid
e
encourag
ing him in his
recovery
They met as boys at The Hissom Memorial Center the nowshyclosed institution in Sand Springs for persons with developmental disabilities When they aged out of Hissom the three moved about the same time to a private facility where they lived for many years
In 1993 The Musketeers were given the opportunity to move together once again into a house in their community supported through the DDSD Medicaid Community Waiver program Since
that time they have lived in the house withsome of the same staffmembers who havecared for them for morethan 20 years
The Three Musketeers Danny (left) shows his excitement over his friend Carlrsquos (right) return from the hospital after brain surgery Shy Hershel (center) wipes tears from his eyes
Carl is recoveringfrom his surgery andworking on his abilityto speak and onregaining the use of theleft side of his bodyThe staff in the home
often has to make Danny go to bed at 1 am when hersquos still sitting beside Carl encouraging him to get better so he can go back to work
All three men have jobs and love their work ndash Carlmost of all Danny somehow knows that if Carl canjust get back to work life will continue as they onceknew it
ldquoTheyrsquore like a wellshysettled familyrdquo said Gretchen Moser their DDSD case manager ldquoEven their families consider these guys a family and respect their wishesrdquo
These days there are many opinions about what constitutes a family or even success But there are stories that transcend those discussions Stories like these that remind us success can also be measured by the love and longevity of a friend InterFace NEWSLETTER
Relations
hips
Oklahoma Department of Human Services 13 Developmental Disabilities Services Division
I N T E R F A C E
StateLegislativeNews
Of the thousand or more bills filed at the beginning of the 2009 legislative session only a few made it through the entire process that will have an impact on persons with developmental disabilities families and professionals in the field They are
HB 1007 mdash Wesselhoft Leftwich Signed by the Governor Requires specific Physically Disabled person signage to be posted as a reserved area for the parking of a vehicle displaying a valid permit
HB 1019 mdash WrightSigned by the Governor Recreates the Group Homes for Persons with Developmental or Physical Disabilities Advisory Board
HB 1048 mdash Banz AldridgeSigned by the Governor Relates to the collection of delinquent real property taxes removes physically disabled from ldquoincapacitatedrdquo persons granted additional time to redeem personal items reduces time to collect excess sale proceeds by half
HB 1065 mdash Faught Crain Signed by the Governor Relates to the Continuum of Care and Assisted Living Act adds definition and requires inspection results to be posted on website
HB 1424 mdash Protor Signed by the Governor Requires treatment facilities transitional living facilities halfway houses and any house or facility that may be used for medical or nonmedical detoxification to mail notification to property owners within a quarter mile radius if zoning changes are proposed
HB 1461 mdash Sears Ford Signed by the Governor A school that does not make adequate yearly progress for two straight years shall utilize the assistance of a school support team formed by the State Department of Education EMERGENCY
HB 1581 mdash Coody Jolley Signed by the Governor School teacher candidates that wish to teach elementary early childhood education or special education programs must study the five elements of reading instruction EMERGENCY
HB 1763 mdash Enns Reynolds Signed by the Governor Requires the state Department of Education to provide special education training for process hearing officers to ensure adequate knowledge in special education laws and proceduresEMERGENCY
HB 1893 mdash Peterson Anderson Signed by the Governor Creates the Aging and Disability Resource Consortium to work with other agencies in developing and implementing a singleshypointshyofshyentry concept for aging and disability groups in Oklahoma
SB 135 mdash Johnson Mike Signed by the Governor Provides for the licensing of certain persons to practice as a licensed behavior analyst or a licensed assistant behavior analyst and to study children with autism and their behaviors directs funds to be used by the Department of Human Services Developmental Disabilities Services division for training SoonerStart providers to treat children with autism spectrum disorders provides for a behavorial analysis research pilot project provides legislative intent
SB 518 mdash Justice Osborn Signed by the Governor Adds grandparents as members of immediate family
SB 871 mdash Anderson Signed by the Governor Modifies membership of the Electronic and Information Technology Accessibility Advisory Council
Oklahoma Department of Human Services 14 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
11th Circuit Rules cont from page 9
matter again Moore a teenager living in North Georgia who goes by ldquoCallierdquo has been receiving inshyhome nursing care paid for by Medicaid for about a decade The state has been trying to cut the number of hours of care she receives each week
The 11th Circuit interpreted a federal law that says states participating in the Medicaid program must provide ldquoearly and periodic screening diagnostic and treatment servicesrdquo that are necessary to ldquocorrect or ameliorate defects and physical and mental illnessesrdquo in Medicaidshyeligible children The primary ways children become eligible for Medicaid are that they come from a lowshyincome family or have a disability according to Joshua H Norris another one of Calliersquos lawyers
Georgiarsquos Department of Community Health operates a program to administer Medicaidshyfunded nursing services for several hundred children who need nursing care It delegates the decisions about approval of such services to an organization called the Georgia Medical Care Foundation
According to Thrashrsquos order Callie is disabled because of a stroke she experienced in utero and suffers from various chronic conditions including mental retardation and cerebral palsy She lives at home and according to the statersquos brief attends an elementary school in Athens Ga three days a week Her lawyers have said she requires constant care
The statersquos lawyers have said that nursing hours can be reduced when the patientrsquos medical condition stabilizes positing that a goal of the program is to teach parents and other caregivers to take care of their children on their own The Mooresrsquo lawyers have contended that the statersquos system of ldquoweaningrdquo patients off their nursing services as long as theyrsquore staying out of the hospitaland not getting worse follows a different standard than that set by federal law
In 2006 the state informed Calliersquos mother that it was reducing Calliersquos nursing hours from 94 hours a week to 84 contrary to the recommendation of Calliersquos primary care physician Calliersquos mother filed suit
The Mooresrsquo lawyers convinced Thrash that the reduction was improper Afterissuing multiple injunctions in Calliersquos favor he denied the statersquos motion for summary judgment and granted the Mooresrsquo motion in part concluding the state must provide for the amount of skilled nursing care that Calliersquos treating physician deems necessary The panel that ruled in favor of the state in its appeal was comprised of Senior 11th Circuit Judge R Lanier Anderson III 11th Circuit Judge Gerald B Tjoflat and US District Judge Lisa Godbey Wood visiting from the Southern District of Georgia
The panel said both the state and Calliersquos physician have roles in determining whatrsquos medically necessary to correct or ameliorate Calliersquos medical conditions It cited a federal regulation that says a Medicaid agency ldquomay place appropriate limits on a service based on such criteria as medical necessity or utilization control proceduresrdquo
ldquoA private physicianrsquos word on medical necessity is not dispositiverdquo the panel concluded
Assistant Attorney General Virginia B Fuller made the successful oral argument for the state last month Attorney General Thurbert E Bakerrsquos spokesman Russ Willard said in an eshymail that the state ldquois appreciative of the Court of Appeals decision recognizing the role of the Medicaid program in providing for this treatmentrdquo
Norris who also is director of legal advocacy for a nonprofit that advocates for people with disabilities said the 11th Circuit gave Thrash
an opportunity to say more about the roles of treating doctors and the state in deciding what care the state needs to provide Norris noted that Thrash wrote on the subject last year in another nursing care case about a Savannah Ga boy who nearly drowned when he was 2Thrash barred the state from enforcing a policy of not providing nursing care for patients requiring 16
to 24 hours per day for more than one week he said that criteria isnrsquot based on whatrsquos medically necessary under federal Medicaid law
On the other handThrash denied the plaintiff rsquos request based on the
treating physicianrsquos recommendation for 24shyhourshyashyday private nursing services for an
indefinite period of time Thrash deemed such a prescription ldquoan abuse of the Medicaid systemrdquo
The state has limited discretion to deny a providerrsquos request for care under the ldquoearly and periodic
screening diagnostic and treatment servicesrdquo portion of the Medicaid Act said Thrash He added that ldquo[t]he statersquos discretion is limited to a review of the request for fraud abuse of the Medicaid system and whether the service is within the reasonable
standards of medical carerdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 15 Developmental Disabilities Services Division
klahoma Department of Human Services
I N T E R F A C E
DDSD Area II Project Elves get together to wrap all the presents and make sure they are delivered to the individuals before Christmas Elves work year round
to make Christmas special for DDSD clients For the past eight years individuals with
developmental disabilities who donrsquot have families or who would otherwise not receive gifts have had their Christmas wishes come true thanks to caring DDSD ldquoelvesrdquo in Area II Project Elf is the brainchild of ldquoThe Men in Recrdquo namely
Steve Pitts and Roger McDaniel DDSD Area II recreational therapists and Joe Stie DDSD case manager ldquoDDSD serves a lot of people with developmental
disabilities who donrsquot have families to celebrate the holidays withrdquo said Pitts ldquoAlthough our services meet their basic needs therersquos still a gap when it comes to those special things that families do for one anotherrdquoThat gap has been filled by The Men in Rec who work all year
long coordinating various events to raise money to buy Christmas presents for individuals ldquoWe raise all of the funds and no OKDHS money is usedrdquo said
Pitts ldquoThis year we are selling Blue and Gold sausage and Amish jams We also have an annual Christmas Carol fundraising performance which is donated to Project Elf by the American Theater Company We are given 300 tickets that we can sell and last year we sold 225rdquoDDSD coshyworkers got together and purchased 44 of those theater
tickets last year for the children who happened to be in the Laura Dester Center Shelter around the holidays ldquoWe have also set up a sponsorship program where people can purchase
the gift and return it wrapped and ready for the elf (aka case manager) to deliver This last Christmas we had 108 sponsors 30 of whom were the case managers themselvesrdquo
The Men in Rec also recruit fellow DDSD workers to help shop for the gifts and wrap themldquoWe could not accomplish this awesome Project Elf without the assistance of so many of our coshyworkers and our community volunteersrdquo he said ldquoItrsquos such a pleasure to share these gifts at Christmas time and let our customers know that they have a family through our good service to themrdquoThe Men in Rec are currently working to raise money for this yearrsquos Christmas gifts If you would like to join the rank of DDSD Elves by donating funds or becoming a sponsor please contact Steve Pitts at stevepittsokdhsorg or call918shy794shy7625 InterFace NEWSLETTER
Steve Pitts (right) DDSD Area II recreational therapist gives a donated WalshyMart gift card to case manager Roy Willett to purchase a Christmas gift for one of the people on his caseload
Oklahoma Department of Human Services 16 Developmental Disabilities Services Division
shy shyshy shy
shy shy
shy shy
shy shy
shy shy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
Developmental Disabilities Services Area Offices and Resource Centers
CUSTER
ELLIS
BECKHAM WASHITA CADDO
McCLAIN
SEM
INO
LE HUGHES HASKELL
LE FLORELATIMER PITTSBURG
COAL
ATOKA
PONTOTOC
JOHNSTON
GARVIN
MURRAY
CARTER
LOVE
BRYAN CHOCTAW
PUSHMATAHA McCURTAIN
GRADY
KIOWA
TILLMAN
JACKSON HA
RM
ON
GREER
COTTON
JEFFERSON
STEPHENS
COMANCHE
McINTOSH
CLEVELAND
POTT
AWAT
OM
IE
DEWEY BLAINE
CANADIAN
MAJOR
GRANT KAY OSAGE
WA
SHIN
GTO
N CRAIG
ROGERS
CH
ERO
KEE
ADAIR TULSA
WAGONER
MAYES
OKMULGEE
CREEK
LINCOLN
LOGAN
PAYNE
KINGFISHER
OKLAHOMA OKFUSKEE
MUSKOGEE SEQUOYAH
DEL
AWA
RE
OTTAWA NOATTA
GARFIELD NOBLE
PAWNEE
WOODS ALFALFA HARPER BEAVER TEXASCIMARRON
WOODWARD
ROGER MILLS
MARSH
Oklahoma CityOklahoma City
Tulsa
Area II
Area III
Area I
Pauls Valley
Enid
wwwokdhsorg
State Officetoll free 1shy866shy521shy3571
AREA Itoll free 1shy800shy522shy1064
AREA IItoll free 1shy800shy522shy1075
AREA IIItoll free 1shy800shy522shy1086
Greer Center (Enid)2501 NE Delaware Enid OK 73701
580 237 10272599 FAX 580 213 2799
Northwest Oklahoma Resource Center at Enid (NORCE)2600 E Willow
Enid OK 73701
580 237 1027
FAX 580 548 2600
Southern Oklahoma Resource Center at Pauls Valley (SORC)3210 Chickasaw St
Pauls Valley OK 73075 6822
405 238 6401
FAX 405 238 8261
DDSD Area I Office (Enid)729 Overland Trail Enid OK 73703
580 548 8900 FAX 580 548 8964
DDSD Area I Office (Oklahoma City)4545 N Lincoln Blvd
Oklahoma City OK 73105 405 522 6925
FAX 405 522 6995
DDSD Area II Office (Tulsa)Laura Dester Center 1427 E 8th Tulsa OK 74120
918 560 4848 FAX 918 560 4898
DDSD Area III Office (Pauls Valley)301 S Indian Meridian Rd Pauls Valley OK 73075
405 238 4700 FAX 405 238 4740
If you would like to find out what the DevelopmentalDisabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
If you would like to find out what the Developmental Disabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
This will take you to the main Oklahoma Department of Human Services Web page From there just click on Divisions and Offices and the Developmental Disabilities Services Division On our Web site you will find information about services the division offers how to apply for services eligibility policies contract provider agencies and much more
Come visit us today You may be surprised at what you will learn
OKLAHOMA DEPARTMENT OF HUMAN SERVICES Developmental Disabilities Services DivisionPO Box 25352 Oklahoma City OK 73125
I N T E R F A C E
StateLegislativeNews
Of the thousand or more bills filed at the beginning of the 2009 legislative session only a few made it through the entire process that will have an impact on persons with developmental disabilities families and professionals in the field They are
HB 1007 mdash Wesselhoft Leftwich Signed by the Governor Requires specific Physically Disabled person signage to be posted as a reserved area for the parking of a vehicle displaying a valid permit
HB 1019 mdash WrightSigned by the Governor Recreates the Group Homes for Persons with Developmental or Physical Disabilities Advisory Board
HB 1048 mdash Banz AldridgeSigned by the Governor Relates to the collection of delinquent real property taxes removes physically disabled from ldquoincapacitatedrdquo persons granted additional time to redeem personal items reduces time to collect excess sale proceeds by half
HB 1065 mdash Faught Crain Signed by the Governor Relates to the Continuum of Care and Assisted Living Act adds definition and requires inspection results to be posted on website
HB 1424 mdash Protor Signed by the Governor Requires treatment facilities transitional living facilities halfway houses and any house or facility that may be used for medical or nonmedical detoxification to mail notification to property owners within a quarter mile radius if zoning changes are proposed
HB 1461 mdash Sears Ford Signed by the Governor A school that does not make adequate yearly progress for two straight years shall utilize the assistance of a school support team formed by the State Department of Education EMERGENCY
HB 1581 mdash Coody Jolley Signed by the Governor School teacher candidates that wish to teach elementary early childhood education or special education programs must study the five elements of reading instruction EMERGENCY
HB 1763 mdash Enns Reynolds Signed by the Governor Requires the state Department of Education to provide special education training for process hearing officers to ensure adequate knowledge in special education laws and proceduresEMERGENCY
HB 1893 mdash Peterson Anderson Signed by the Governor Creates the Aging and Disability Resource Consortium to work with other agencies in developing and implementing a singleshypointshyofshyentry concept for aging and disability groups in Oklahoma
SB 135 mdash Johnson Mike Signed by the Governor Provides for the licensing of certain persons to practice as a licensed behavior analyst or a licensed assistant behavior analyst and to study children with autism and their behaviors directs funds to be used by the Department of Human Services Developmental Disabilities Services division for training SoonerStart providers to treat children with autism spectrum disorders provides for a behavorial analysis research pilot project provides legislative intent
SB 518 mdash Justice Osborn Signed by the Governor Adds grandparents as members of immediate family
SB 871 mdash Anderson Signed by the Governor Modifies membership of the Electronic and Information Technology Accessibility Advisory Council
Oklahoma Department of Human Services 14 Developmental Disabilities Services Division
S U M M E R 2 0 0 9
11th Circuit Rules cont from page 9
matter again Moore a teenager living in North Georgia who goes by ldquoCallierdquo has been receiving inshyhome nursing care paid for by Medicaid for about a decade The state has been trying to cut the number of hours of care she receives each week
The 11th Circuit interpreted a federal law that says states participating in the Medicaid program must provide ldquoearly and periodic screening diagnostic and treatment servicesrdquo that are necessary to ldquocorrect or ameliorate defects and physical and mental illnessesrdquo in Medicaidshyeligible children The primary ways children become eligible for Medicaid are that they come from a lowshyincome family or have a disability according to Joshua H Norris another one of Calliersquos lawyers
Georgiarsquos Department of Community Health operates a program to administer Medicaidshyfunded nursing services for several hundred children who need nursing care It delegates the decisions about approval of such services to an organization called the Georgia Medical Care Foundation
According to Thrashrsquos order Callie is disabled because of a stroke she experienced in utero and suffers from various chronic conditions including mental retardation and cerebral palsy She lives at home and according to the statersquos brief attends an elementary school in Athens Ga three days a week Her lawyers have said she requires constant care
The statersquos lawyers have said that nursing hours can be reduced when the patientrsquos medical condition stabilizes positing that a goal of the program is to teach parents and other caregivers to take care of their children on their own The Mooresrsquo lawyers have contended that the statersquos system of ldquoweaningrdquo patients off their nursing services as long as theyrsquore staying out of the hospitaland not getting worse follows a different standard than that set by federal law
In 2006 the state informed Calliersquos mother that it was reducing Calliersquos nursing hours from 94 hours a week to 84 contrary to the recommendation of Calliersquos primary care physician Calliersquos mother filed suit
The Mooresrsquo lawyers convinced Thrash that the reduction was improper Afterissuing multiple injunctions in Calliersquos favor he denied the statersquos motion for summary judgment and granted the Mooresrsquo motion in part concluding the state must provide for the amount of skilled nursing care that Calliersquos treating physician deems necessary The panel that ruled in favor of the state in its appeal was comprised of Senior 11th Circuit Judge R Lanier Anderson III 11th Circuit Judge Gerald B Tjoflat and US District Judge Lisa Godbey Wood visiting from the Southern District of Georgia
The panel said both the state and Calliersquos physician have roles in determining whatrsquos medically necessary to correct or ameliorate Calliersquos medical conditions It cited a federal regulation that says a Medicaid agency ldquomay place appropriate limits on a service based on such criteria as medical necessity or utilization control proceduresrdquo
ldquoA private physicianrsquos word on medical necessity is not dispositiverdquo the panel concluded
Assistant Attorney General Virginia B Fuller made the successful oral argument for the state last month Attorney General Thurbert E Bakerrsquos spokesman Russ Willard said in an eshymail that the state ldquois appreciative of the Court of Appeals decision recognizing the role of the Medicaid program in providing for this treatmentrdquo
Norris who also is director of legal advocacy for a nonprofit that advocates for people with disabilities said the 11th Circuit gave Thrash
an opportunity to say more about the roles of treating doctors and the state in deciding what care the state needs to provide Norris noted that Thrash wrote on the subject last year in another nursing care case about a Savannah Ga boy who nearly drowned when he was 2Thrash barred the state from enforcing a policy of not providing nursing care for patients requiring 16
to 24 hours per day for more than one week he said that criteria isnrsquot based on whatrsquos medically necessary under federal Medicaid law
On the other handThrash denied the plaintiff rsquos request based on the
treating physicianrsquos recommendation for 24shyhourshyashyday private nursing services for an
indefinite period of time Thrash deemed such a prescription ldquoan abuse of the Medicaid systemrdquo
The state has limited discretion to deny a providerrsquos request for care under the ldquoearly and periodic
screening diagnostic and treatment servicesrdquo portion of the Medicaid Act said Thrash He added that ldquo[t]he statersquos discretion is limited to a review of the request for fraud abuse of the Medicaid system and whether the service is within the reasonable
standards of medical carerdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 15 Developmental Disabilities Services Division
klahoma Department of Human Services
I N T E R F A C E
DDSD Area II Project Elves get together to wrap all the presents and make sure they are delivered to the individuals before Christmas Elves work year round
to make Christmas special for DDSD clients For the past eight years individuals with
developmental disabilities who donrsquot have families or who would otherwise not receive gifts have had their Christmas wishes come true thanks to caring DDSD ldquoelvesrdquo in Area II Project Elf is the brainchild of ldquoThe Men in Recrdquo namely
Steve Pitts and Roger McDaniel DDSD Area II recreational therapists and Joe Stie DDSD case manager ldquoDDSD serves a lot of people with developmental
disabilities who donrsquot have families to celebrate the holidays withrdquo said Pitts ldquoAlthough our services meet their basic needs therersquos still a gap when it comes to those special things that families do for one anotherrdquoThat gap has been filled by The Men in Rec who work all year
long coordinating various events to raise money to buy Christmas presents for individuals ldquoWe raise all of the funds and no OKDHS money is usedrdquo said
Pitts ldquoThis year we are selling Blue and Gold sausage and Amish jams We also have an annual Christmas Carol fundraising performance which is donated to Project Elf by the American Theater Company We are given 300 tickets that we can sell and last year we sold 225rdquoDDSD coshyworkers got together and purchased 44 of those theater
tickets last year for the children who happened to be in the Laura Dester Center Shelter around the holidays ldquoWe have also set up a sponsorship program where people can purchase
the gift and return it wrapped and ready for the elf (aka case manager) to deliver This last Christmas we had 108 sponsors 30 of whom were the case managers themselvesrdquo
The Men in Rec also recruit fellow DDSD workers to help shop for the gifts and wrap themldquoWe could not accomplish this awesome Project Elf without the assistance of so many of our coshyworkers and our community volunteersrdquo he said ldquoItrsquos such a pleasure to share these gifts at Christmas time and let our customers know that they have a family through our good service to themrdquoThe Men in Rec are currently working to raise money for this yearrsquos Christmas gifts If you would like to join the rank of DDSD Elves by donating funds or becoming a sponsor please contact Steve Pitts at stevepittsokdhsorg or call918shy794shy7625 InterFace NEWSLETTER
Steve Pitts (right) DDSD Area II recreational therapist gives a donated WalshyMart gift card to case manager Roy Willett to purchase a Christmas gift for one of the people on his caseload
Oklahoma Department of Human Services 16 Developmental Disabilities Services Division
shy shyshy shy
shy shy
shy shy
shy shy
shy shy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
Developmental Disabilities Services Area Offices and Resource Centers
CUSTER
ELLIS
BECKHAM WASHITA CADDO
McCLAIN
SEM
INO
LE HUGHES HASKELL
LE FLORELATIMER PITTSBURG
COAL
ATOKA
PONTOTOC
JOHNSTON
GARVIN
MURRAY
CARTER
LOVE
BRYAN CHOCTAW
PUSHMATAHA McCURTAIN
GRADY
KIOWA
TILLMAN
JACKSON HA
RM
ON
GREER
COTTON
JEFFERSON
STEPHENS
COMANCHE
McINTOSH
CLEVELAND
POTT
AWAT
OM
IE
DEWEY BLAINE
CANADIAN
MAJOR
GRANT KAY OSAGE
WA
SHIN
GTO
N CRAIG
ROGERS
CH
ERO
KEE
ADAIR TULSA
WAGONER
MAYES
OKMULGEE
CREEK
LINCOLN
LOGAN
PAYNE
KINGFISHER
OKLAHOMA OKFUSKEE
MUSKOGEE SEQUOYAH
DEL
AWA
RE
OTTAWA NOATTA
GARFIELD NOBLE
PAWNEE
WOODS ALFALFA HARPER BEAVER TEXASCIMARRON
WOODWARD
ROGER MILLS
MARSH
Oklahoma CityOklahoma City
Tulsa
Area II
Area III
Area I
Pauls Valley
Enid
wwwokdhsorg
State Officetoll free 1shy866shy521shy3571
AREA Itoll free 1shy800shy522shy1064
AREA IItoll free 1shy800shy522shy1075
AREA IIItoll free 1shy800shy522shy1086
Greer Center (Enid)2501 NE Delaware Enid OK 73701
580 237 10272599 FAX 580 213 2799
Northwest Oklahoma Resource Center at Enid (NORCE)2600 E Willow
Enid OK 73701
580 237 1027
FAX 580 548 2600
Southern Oklahoma Resource Center at Pauls Valley (SORC)3210 Chickasaw St
Pauls Valley OK 73075 6822
405 238 6401
FAX 405 238 8261
DDSD Area I Office (Enid)729 Overland Trail Enid OK 73703
580 548 8900 FAX 580 548 8964
DDSD Area I Office (Oklahoma City)4545 N Lincoln Blvd
Oklahoma City OK 73105 405 522 6925
FAX 405 522 6995
DDSD Area II Office (Tulsa)Laura Dester Center 1427 E 8th Tulsa OK 74120
918 560 4848 FAX 918 560 4898
DDSD Area III Office (Pauls Valley)301 S Indian Meridian Rd Pauls Valley OK 73075
405 238 4700 FAX 405 238 4740
If you would like to find out what the DevelopmentalDisabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
If you would like to find out what the Developmental Disabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
This will take you to the main Oklahoma Department of Human Services Web page From there just click on Divisions and Offices and the Developmental Disabilities Services Division On our Web site you will find information about services the division offers how to apply for services eligibility policies contract provider agencies and much more
Come visit us today You may be surprised at what you will learn
OKLAHOMA DEPARTMENT OF HUMAN SERVICES Developmental Disabilities Services DivisionPO Box 25352 Oklahoma City OK 73125
S U M M E R 2 0 0 9
11th Circuit Rules cont from page 9
matter again Moore a teenager living in North Georgia who goes by ldquoCallierdquo has been receiving inshyhome nursing care paid for by Medicaid for about a decade The state has been trying to cut the number of hours of care she receives each week
The 11th Circuit interpreted a federal law that says states participating in the Medicaid program must provide ldquoearly and periodic screening diagnostic and treatment servicesrdquo that are necessary to ldquocorrect or ameliorate defects and physical and mental illnessesrdquo in Medicaidshyeligible children The primary ways children become eligible for Medicaid are that they come from a lowshyincome family or have a disability according to Joshua H Norris another one of Calliersquos lawyers
Georgiarsquos Department of Community Health operates a program to administer Medicaidshyfunded nursing services for several hundred children who need nursing care It delegates the decisions about approval of such services to an organization called the Georgia Medical Care Foundation
According to Thrashrsquos order Callie is disabled because of a stroke she experienced in utero and suffers from various chronic conditions including mental retardation and cerebral palsy She lives at home and according to the statersquos brief attends an elementary school in Athens Ga three days a week Her lawyers have said she requires constant care
The statersquos lawyers have said that nursing hours can be reduced when the patientrsquos medical condition stabilizes positing that a goal of the program is to teach parents and other caregivers to take care of their children on their own The Mooresrsquo lawyers have contended that the statersquos system of ldquoweaningrdquo patients off their nursing services as long as theyrsquore staying out of the hospitaland not getting worse follows a different standard than that set by federal law
In 2006 the state informed Calliersquos mother that it was reducing Calliersquos nursing hours from 94 hours a week to 84 contrary to the recommendation of Calliersquos primary care physician Calliersquos mother filed suit
The Mooresrsquo lawyers convinced Thrash that the reduction was improper Afterissuing multiple injunctions in Calliersquos favor he denied the statersquos motion for summary judgment and granted the Mooresrsquo motion in part concluding the state must provide for the amount of skilled nursing care that Calliersquos treating physician deems necessary The panel that ruled in favor of the state in its appeal was comprised of Senior 11th Circuit Judge R Lanier Anderson III 11th Circuit Judge Gerald B Tjoflat and US District Judge Lisa Godbey Wood visiting from the Southern District of Georgia
The panel said both the state and Calliersquos physician have roles in determining whatrsquos medically necessary to correct or ameliorate Calliersquos medical conditions It cited a federal regulation that says a Medicaid agency ldquomay place appropriate limits on a service based on such criteria as medical necessity or utilization control proceduresrdquo
ldquoA private physicianrsquos word on medical necessity is not dispositiverdquo the panel concluded
Assistant Attorney General Virginia B Fuller made the successful oral argument for the state last month Attorney General Thurbert E Bakerrsquos spokesman Russ Willard said in an eshymail that the state ldquois appreciative of the Court of Appeals decision recognizing the role of the Medicaid program in providing for this treatmentrdquo
Norris who also is director of legal advocacy for a nonprofit that advocates for people with disabilities said the 11th Circuit gave Thrash
an opportunity to say more about the roles of treating doctors and the state in deciding what care the state needs to provide Norris noted that Thrash wrote on the subject last year in another nursing care case about a Savannah Ga boy who nearly drowned when he was 2Thrash barred the state from enforcing a policy of not providing nursing care for patients requiring 16
to 24 hours per day for more than one week he said that criteria isnrsquot based on whatrsquos medically necessary under federal Medicaid law
On the other handThrash denied the plaintiff rsquos request based on the
treating physicianrsquos recommendation for 24shyhourshyashyday private nursing services for an
indefinite period of time Thrash deemed such a prescription ldquoan abuse of the Medicaid systemrdquo
The state has limited discretion to deny a providerrsquos request for care under the ldquoearly and periodic
screening diagnostic and treatment servicesrdquo portion of the Medicaid Act said Thrash He added that ldquo[t]he statersquos discretion is limited to a review of the request for fraud abuse of the Medicaid system and whether the service is within the reasonable
standards of medical carerdquo InterFace NEWSLETTER
Oklahoma Department of Human Services 15 Developmental Disabilities Services Division
klahoma Department of Human Services
I N T E R F A C E
DDSD Area II Project Elves get together to wrap all the presents and make sure they are delivered to the individuals before Christmas Elves work year round
to make Christmas special for DDSD clients For the past eight years individuals with
developmental disabilities who donrsquot have families or who would otherwise not receive gifts have had their Christmas wishes come true thanks to caring DDSD ldquoelvesrdquo in Area II Project Elf is the brainchild of ldquoThe Men in Recrdquo namely
Steve Pitts and Roger McDaniel DDSD Area II recreational therapists and Joe Stie DDSD case manager ldquoDDSD serves a lot of people with developmental
disabilities who donrsquot have families to celebrate the holidays withrdquo said Pitts ldquoAlthough our services meet their basic needs therersquos still a gap when it comes to those special things that families do for one anotherrdquoThat gap has been filled by The Men in Rec who work all year
long coordinating various events to raise money to buy Christmas presents for individuals ldquoWe raise all of the funds and no OKDHS money is usedrdquo said
Pitts ldquoThis year we are selling Blue and Gold sausage and Amish jams We also have an annual Christmas Carol fundraising performance which is donated to Project Elf by the American Theater Company We are given 300 tickets that we can sell and last year we sold 225rdquoDDSD coshyworkers got together and purchased 44 of those theater
tickets last year for the children who happened to be in the Laura Dester Center Shelter around the holidays ldquoWe have also set up a sponsorship program where people can purchase
the gift and return it wrapped and ready for the elf (aka case manager) to deliver This last Christmas we had 108 sponsors 30 of whom were the case managers themselvesrdquo
The Men in Rec also recruit fellow DDSD workers to help shop for the gifts and wrap themldquoWe could not accomplish this awesome Project Elf without the assistance of so many of our coshyworkers and our community volunteersrdquo he said ldquoItrsquos such a pleasure to share these gifts at Christmas time and let our customers know that they have a family through our good service to themrdquoThe Men in Rec are currently working to raise money for this yearrsquos Christmas gifts If you would like to join the rank of DDSD Elves by donating funds or becoming a sponsor please contact Steve Pitts at stevepittsokdhsorg or call918shy794shy7625 InterFace NEWSLETTER
Steve Pitts (right) DDSD Area II recreational therapist gives a donated WalshyMart gift card to case manager Roy Willett to purchase a Christmas gift for one of the people on his caseload
Oklahoma Department of Human Services 16 Developmental Disabilities Services Division
shy shyshy shy
shy shy
shy shy
shy shy
shy shy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
Developmental Disabilities Services Area Offices and Resource Centers
CUSTER
ELLIS
BECKHAM WASHITA CADDO
McCLAIN
SEM
INO
LE HUGHES HASKELL
LE FLORELATIMER PITTSBURG
COAL
ATOKA
PONTOTOC
JOHNSTON
GARVIN
MURRAY
CARTER
LOVE
BRYAN CHOCTAW
PUSHMATAHA McCURTAIN
GRADY
KIOWA
TILLMAN
JACKSON HA
RM
ON
GREER
COTTON
JEFFERSON
STEPHENS
COMANCHE
McINTOSH
CLEVELAND
POTT
AWAT
OM
IE
DEWEY BLAINE
CANADIAN
MAJOR
GRANT KAY OSAGE
WA
SHIN
GTO
N CRAIG
ROGERS
CH
ERO
KEE
ADAIR TULSA
WAGONER
MAYES
OKMULGEE
CREEK
LINCOLN
LOGAN
PAYNE
KINGFISHER
OKLAHOMA OKFUSKEE
MUSKOGEE SEQUOYAH
DEL
AWA
RE
OTTAWA NOATTA
GARFIELD NOBLE
PAWNEE
WOODS ALFALFA HARPER BEAVER TEXASCIMARRON
WOODWARD
ROGER MILLS
MARSH
Oklahoma CityOklahoma City
Tulsa
Area II
Area III
Area I
Pauls Valley
Enid
wwwokdhsorg
State Officetoll free 1shy866shy521shy3571
AREA Itoll free 1shy800shy522shy1064
AREA IItoll free 1shy800shy522shy1075
AREA IIItoll free 1shy800shy522shy1086
Greer Center (Enid)2501 NE Delaware Enid OK 73701
580 237 10272599 FAX 580 213 2799
Northwest Oklahoma Resource Center at Enid (NORCE)2600 E Willow
Enid OK 73701
580 237 1027
FAX 580 548 2600
Southern Oklahoma Resource Center at Pauls Valley (SORC)3210 Chickasaw St
Pauls Valley OK 73075 6822
405 238 6401
FAX 405 238 8261
DDSD Area I Office (Enid)729 Overland Trail Enid OK 73703
580 548 8900 FAX 580 548 8964
DDSD Area I Office (Oklahoma City)4545 N Lincoln Blvd
Oklahoma City OK 73105 405 522 6925
FAX 405 522 6995
DDSD Area II Office (Tulsa)Laura Dester Center 1427 E 8th Tulsa OK 74120
918 560 4848 FAX 918 560 4898
DDSD Area III Office (Pauls Valley)301 S Indian Meridian Rd Pauls Valley OK 73075
405 238 4700 FAX 405 238 4740
If you would like to find out what the DevelopmentalDisabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
If you would like to find out what the Developmental Disabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
This will take you to the main Oklahoma Department of Human Services Web page From there just click on Divisions and Offices and the Developmental Disabilities Services Division On our Web site you will find information about services the division offers how to apply for services eligibility policies contract provider agencies and much more
Come visit us today You may be surprised at what you will learn
OKLAHOMA DEPARTMENT OF HUMAN SERVICES Developmental Disabilities Services DivisionPO Box 25352 Oklahoma City OK 73125
klahoma Department of Human Services
I N T E R F A C E
DDSD Area II Project Elves get together to wrap all the presents and make sure they are delivered to the individuals before Christmas Elves work year round
to make Christmas special for DDSD clients For the past eight years individuals with
developmental disabilities who donrsquot have families or who would otherwise not receive gifts have had their Christmas wishes come true thanks to caring DDSD ldquoelvesrdquo in Area II Project Elf is the brainchild of ldquoThe Men in Recrdquo namely
Steve Pitts and Roger McDaniel DDSD Area II recreational therapists and Joe Stie DDSD case manager ldquoDDSD serves a lot of people with developmental
disabilities who donrsquot have families to celebrate the holidays withrdquo said Pitts ldquoAlthough our services meet their basic needs therersquos still a gap when it comes to those special things that families do for one anotherrdquoThat gap has been filled by The Men in Rec who work all year
long coordinating various events to raise money to buy Christmas presents for individuals ldquoWe raise all of the funds and no OKDHS money is usedrdquo said
Pitts ldquoThis year we are selling Blue and Gold sausage and Amish jams We also have an annual Christmas Carol fundraising performance which is donated to Project Elf by the American Theater Company We are given 300 tickets that we can sell and last year we sold 225rdquoDDSD coshyworkers got together and purchased 44 of those theater
tickets last year for the children who happened to be in the Laura Dester Center Shelter around the holidays ldquoWe have also set up a sponsorship program where people can purchase
the gift and return it wrapped and ready for the elf (aka case manager) to deliver This last Christmas we had 108 sponsors 30 of whom were the case managers themselvesrdquo
The Men in Rec also recruit fellow DDSD workers to help shop for the gifts and wrap themldquoWe could not accomplish this awesome Project Elf without the assistance of so many of our coshyworkers and our community volunteersrdquo he said ldquoItrsquos such a pleasure to share these gifts at Christmas time and let our customers know that they have a family through our good service to themrdquoThe Men in Rec are currently working to raise money for this yearrsquos Christmas gifts If you would like to join the rank of DDSD Elves by donating funds or becoming a sponsor please contact Steve Pitts at stevepittsokdhsorg or call918shy794shy7625 InterFace NEWSLETTER
Steve Pitts (right) DDSD Area II recreational therapist gives a donated WalshyMart gift card to case manager Roy Willett to purchase a Christmas gift for one of the people on his caseload
Oklahoma Department of Human Services 16 Developmental Disabilities Services Division
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Developmental Disabilities Services Area Offices and Resource Centers
CUSTER
ELLIS
BECKHAM WASHITA CADDO
McCLAIN
SEM
INO
LE HUGHES HASKELL
LE FLORELATIMER PITTSBURG
COAL
ATOKA
PONTOTOC
JOHNSTON
GARVIN
MURRAY
CARTER
LOVE
BRYAN CHOCTAW
PUSHMATAHA McCURTAIN
GRADY
KIOWA
TILLMAN
JACKSON HA
RM
ON
GREER
COTTON
JEFFERSON
STEPHENS
COMANCHE
McINTOSH
CLEVELAND
POTT
AWAT
OM
IE
DEWEY BLAINE
CANADIAN
MAJOR
GRANT KAY OSAGE
WA
SHIN
GTO
N CRAIG
ROGERS
CH
ERO
KEE
ADAIR TULSA
WAGONER
MAYES
OKMULGEE
CREEK
LINCOLN
LOGAN
PAYNE
KINGFISHER
OKLAHOMA OKFUSKEE
MUSKOGEE SEQUOYAH
DEL
AWA
RE
OTTAWA NOATTA
GARFIELD NOBLE
PAWNEE
WOODS ALFALFA HARPER BEAVER TEXASCIMARRON
WOODWARD
ROGER MILLS
MARSH
Oklahoma CityOklahoma City
Tulsa
Area II
Area III
Area I
Pauls Valley
Enid
wwwokdhsorg
State Officetoll free 1shy866shy521shy3571
AREA Itoll free 1shy800shy522shy1064
AREA IItoll free 1shy800shy522shy1075
AREA IIItoll free 1shy800shy522shy1086
Greer Center (Enid)2501 NE Delaware Enid OK 73701
580 237 10272599 FAX 580 213 2799
Northwest Oklahoma Resource Center at Enid (NORCE)2600 E Willow
Enid OK 73701
580 237 1027
FAX 580 548 2600
Southern Oklahoma Resource Center at Pauls Valley (SORC)3210 Chickasaw St
Pauls Valley OK 73075 6822
405 238 6401
FAX 405 238 8261
DDSD Area I Office (Enid)729 Overland Trail Enid OK 73703
580 548 8900 FAX 580 548 8964
DDSD Area I Office (Oklahoma City)4545 N Lincoln Blvd
Oklahoma City OK 73105 405 522 6925
FAX 405 522 6995
DDSD Area II Office (Tulsa)Laura Dester Center 1427 E 8th Tulsa OK 74120
918 560 4848 FAX 918 560 4898
DDSD Area III Office (Pauls Valley)301 S Indian Meridian Rd Pauls Valley OK 73075
405 238 4700 FAX 405 238 4740
If you would like to find out what the DevelopmentalDisabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
If you would like to find out what the Developmental Disabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
This will take you to the main Oklahoma Department of Human Services Web page From there just click on Divisions and Offices and the Developmental Disabilities Services Division On our Web site you will find information about services the division offers how to apply for services eligibility policies contract provider agencies and much more
Come visit us today You may be surprised at what you will learn
OKLAHOMA DEPARTMENT OF HUMAN SERVICES Developmental Disabilities Services DivisionPO Box 25352 Oklahoma City OK 73125
shy shyshy shy
shy shy
shy shy
shy shy
shy shy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
shy shyshy shy
Developmental Disabilities Services Area Offices and Resource Centers
CUSTER
ELLIS
BECKHAM WASHITA CADDO
McCLAIN
SEM
INO
LE HUGHES HASKELL
LE FLORELATIMER PITTSBURG
COAL
ATOKA
PONTOTOC
JOHNSTON
GARVIN
MURRAY
CARTER
LOVE
BRYAN CHOCTAW
PUSHMATAHA McCURTAIN
GRADY
KIOWA
TILLMAN
JACKSON HA
RM
ON
GREER
COTTON
JEFFERSON
STEPHENS
COMANCHE
McINTOSH
CLEVELAND
POTT
AWAT
OM
IE
DEWEY BLAINE
CANADIAN
MAJOR
GRANT KAY OSAGE
WA
SHIN
GTO
N CRAIG
ROGERS
CH
ERO
KEE
ADAIR TULSA
WAGONER
MAYES
OKMULGEE
CREEK
LINCOLN
LOGAN
PAYNE
KINGFISHER
OKLAHOMA OKFUSKEE
MUSKOGEE SEQUOYAH
DEL
AWA
RE
OTTAWA NOATTA
GARFIELD NOBLE
PAWNEE
WOODS ALFALFA HARPER BEAVER TEXASCIMARRON
WOODWARD
ROGER MILLS
MARSH
Oklahoma CityOklahoma City
Tulsa
Area II
Area III
Area I
Pauls Valley
Enid
wwwokdhsorg
State Officetoll free 1shy866shy521shy3571
AREA Itoll free 1shy800shy522shy1064
AREA IItoll free 1shy800shy522shy1075
AREA IIItoll free 1shy800shy522shy1086
Greer Center (Enid)2501 NE Delaware Enid OK 73701
580 237 10272599 FAX 580 213 2799
Northwest Oklahoma Resource Center at Enid (NORCE)2600 E Willow
Enid OK 73701
580 237 1027
FAX 580 548 2600
Southern Oklahoma Resource Center at Pauls Valley (SORC)3210 Chickasaw St
Pauls Valley OK 73075 6822
405 238 6401
FAX 405 238 8261
DDSD Area I Office (Enid)729 Overland Trail Enid OK 73703
580 548 8900 FAX 580 548 8964
DDSD Area I Office (Oklahoma City)4545 N Lincoln Blvd
Oklahoma City OK 73105 405 522 6925
FAX 405 522 6995
DDSD Area II Office (Tulsa)Laura Dester Center 1427 E 8th Tulsa OK 74120
918 560 4848 FAX 918 560 4898
DDSD Area III Office (Pauls Valley)301 S Indian Meridian Rd Pauls Valley OK 73075
405 238 4700 FAX 405 238 4740
If you would like to find out what the DevelopmentalDisabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
If you would like to find out what the Developmental Disabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
This will take you to the main Oklahoma Department of Human Services Web page From there just click on Divisions and Offices and the Developmental Disabilities Services Division On our Web site you will find information about services the division offers how to apply for services eligibility policies contract provider agencies and much more
Come visit us today You may be surprised at what you will learn
OKLAHOMA DEPARTMENT OF HUMAN SERVICES Developmental Disabilities Services DivisionPO Box 25352 Oklahoma City OK 73125
If you would like to find out what the DevelopmentalDisabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
If you would like to find out what the Developmental Disabilities Services Division has to offer come and visit our Web site at
wwwokdhsorg
This will take you to the main Oklahoma Department of Human Services Web page From there just click on Divisions and Offices and the Developmental Disabilities Services Division On our Web site you will find information about services the division offers how to apply for services eligibility policies contract provider agencies and much more
Come visit us today You may be surprised at what you will learn
OKLAHOMA DEPARTMENT OF HUMAN SERVICES Developmental Disabilities Services DivisionPO Box 25352 Oklahoma City OK 73125