Monday, April 22, 2013

Transition and employment - notes from a Minnesota presentation

The special needs roller coaster starts to speed up again in 10th grade.

Tenth grade is when #1 is no longer encouraged to join mainstream sports teams, perhaps because the coaches are no longer educators. They are competitors. Tenth grade is when the gulf between him and mainstream students he admires becomes too big for him to ignore, and there's sorrow in his heart he does not understand and cannot express. It's when the focus changes from an educational track to an employment track.

Employment was the focus of a meeting I attended today. I won't try to summarize what I heard, instead I'll summarize what I think is happening in Minnesota and probably nationally. My summary has only a passing resemblance to anything I heard today, it's my own personal impression for which nobody bears responsibility.

To keep this short, so I can get to sleep, I'll do this in a series of bullet points.

How things used to work in the 70s-00s.

  • After deinstitutionalization in the 1970s money was made available for community care of disabled persons in the form of waivers:
    • DD: Developmental disorders
    • CADI: Mental health (schizophrenia mostly)
    • CAC: Severe medical (vent dependency now, once might have been more)
    • BI: Traumatic brain injur (this may be more recent)
  • The waivers were used to pay for various forms of what was once called Supported Employment for developmentally disabled adults whose primary income came from Social Security Disability.  Supported employment and related activities included:
    • DTNH employment: piece rate and workshop activities that paid less than minimum wage. Aka "Sheltered workshops" or "Work Centers"
    • Pre-Voc programs: ?
    • Day Programs
    • Adult day care
    • Regular employment with funded supports and supervisors (and perhaps subsidies to employers?)
  • Schools provided work experience programs and work rotation during transition (typically 19-21)
  • These programs were administered by agencies (non-profit usually) sometimes known as "Employment and Alternative Service providers" and "Supported Employment Service (SES)" providers and typically organized by County though some provide services in multiple counties. (See 2009 Access Press directory and the Minnesota Habilitation MSP index)
How things work in the 10s.
  • There is much less money available to support employment. In particular, waiver lists are growing. To receive waiver support now may require homelessness. [1]
  • With "Reform 2020" services will be less county specific and more state delivered
  • Instead of "Supported Employment" we have "Customized Employment". This is employment that is in some way adapted to the special needs population though it is now used for any adjusted employment including part-time work. It is typically but not necessarily minimum wage employment and it is often part-time.
    • There does not appear to be any direct financial or tax benefit to employers who do this, though adults on social security disability may quality for vocational programs like "ticket to work" and there are some SSI incentives that provide support.
    • There may or may not be some form of external work support for non-waiver disabled (this is fuzzy)
    • We have about 1-2 years of early experience in MN with Customized Employment and no data at all on how well it is working particularly in the new post-waiver era.
  • There appear to be two paths to Customized Employment which roughly follow the adaptation vs. modification educational tracks.
    • More disabled (educational modification, non-diploma track, social security disability): This tracks makes use of services like Kaposia to assist with finding job opportunities. These services are not available privately, they still rely on funding sources but seem to be able to find money from vocational rehab or county funds even when waivers are not available - at least at this time. At least some of one of these services claim good placement records "0 reject model" and they can be impressively creative.
    • Less disabled (IEP, educational adaptation, diploma but not college): This track does not use "Supported Employment Services". This depends entirely on parents to arrange for networking, "informational interviews", employment training, work experience training and so on.
  • IEP work experiences provided by school districts post-graduation (19-21) are being reworked and are less encouraged. It's not clear how well current grade 11/12 programs work.
  • Employment opportunities do seem to rely on the kindness of local small businesses and a few large employers. Workers in the system prefer not to share employer information, perhaps for fear of overloading them.
It reminded me of a presentation I attended some months ago on housing services for the Minnesota special needs population. We learned that the old system was gone, the money was missing, and it was all up to parents now.
[1] Parenthetically, the prison-industrial complex is thriving, so we may have outsourced care of the mentally ill and developmentally disabled to the prison system. 

See also

Saturday, April 20, 2013

Minnesotans with developmental disabilities can get a lifetime free fishing license and a fifty cent Minnesota ID card

Exemptions and fishing licenses issued without a fee: Minnesota DNR: "Permanent angling license issued to any Minnesota resident over age 16 who is developmentally disabled ... Available only from the DNR License Center."

I paid $6 for my 16yo to get his teen license, but we'll probably do this when he's 18. 

When I picked up this year's license I realized it's time for #1 to start carrying a wallet with at least his school ID. He's not keen on this; I suspect he won't like the sensation. A think sports wallet, or even a clip, is probably our best bet. That wallet can include a reduced-fee Minnesota ID card ...

A reduced-fee Minnesota Identification Card (similar in appearance to a driver's license) can be obtained through the Department of Public Services, Driver's Vehicle Services, with a form signed by a doctor or social worker. The cost is only fifty cents.

I wonder if that cost was set in the 1950s.

The physician form is available here. The rules for getting a Minnesota ID card are here, sounds like #1 needs his passport, a school photo ID, and a parent.

Connect WC: a superb MN resource for children and adults with developmental disabilities

Washington County is a predominantly exurban and suburban region west of the Twin Cities. I didn't expect it to be the home of well done website on Developmental Disabilities Resources and Information funded by the CCP Foundation [1]. Some of the material is Minnesota specific, but much of it applies anywhere in the US. Only a few topics are truly specific to Washington County.

I learned a few things about developmental disability options in our region -- and that doesn't happen too often. Some the pages to check out include:

Despite the web site description, they mix physical and cognitive disability resources. They could perhaps do a better job separating those, but many people with cognitive disability also have physical disabilities.
This may be the best web site on special needs services I've seen anywhere - certainly the best in Minnesota. I've added this domain to the Google Custom Search for special needs services in Minneapolis and St Paul.
[1] Alas, its grant program just ended.

Sunday, April 14, 2013

Transferring 529 assets to siblings

Long ago we created 529 plans for our children; including #1. Even then we knew #1 wouldn't likely go to college, but we also knew that when the time came we could switch beneficiaries to #2 and/or #3.

That time has come. #1 is approaching an age where we will assume guardianship. At that time he will become officially disabled and receive state financial support. The assets we can provide will be channeled through a protected trust.

I have the beneficiary reassignment form; I have only to complete it and put it in the mail.

This is not an easy thing to do.

Tuesday, April 09, 2013

Reminder: keep psych meds locked up

We've always locked up medications for basic safety reasons, but we've friends who've learned the hard way that this is a good idea.

There are two reasons to keep meds locked up. One is accidental or misguided misuse by a young or judgment impaired child. I've read stories of high functioning ASD adolescents overdosing on sedating medications to help them sleep.

The other reason, of course, is that many behavioral meds have street value and are widely abused. They can be a powerful temptation for teenagers.

So lock 'em up.