Meghan Smallwood: 0:00

Welcome. This is the Postsecondary Transition conversation. We focus on the ins and outs and everything in between of the transition process for families of students with disabilities, I am one of the hosts. My name is Meghan Smallwood, and I am a public school transition coordinator. As always, I have a co host.

Patrick Cadigan: 0:18

My name is Patrick Cadigan. I am also a public school transition coordinator. So recently, we had a chance to catch up with friend of the pod and support broker Jamie Broadnax, who came to talk with us about some of the discussion and proposed budget cuts around self-direction. So we want to keep that discussion going, there is a bit of an update, but we're going to save that until the end of the discussion. So stay tuned. But without further ado, let's get to our discussion with Jamie.

Jamie Brodnax: 0:56

So DDA did justify kind of the minimization of the day to day Administrator role by saying that the service grew much faster than they expected it to, and the funding that they had initially set aside to support the service didn't even come close to covering the costs associated with it because of how quickly the service grew, which in some ways understandable. It did. It was a role that not many people heard of, and then once they did, I mean, it was kind of a dream come true for some who were looking for a solution to this problem. So it's been a difficult conversation to have with families to explain to them that this fantastic position that once answered so many potential concerns is now nearly unattainable, and on top of that, all of those tasks that the day to day administrator was once doing now we have to Talk as a team to figure out who is going to take on those roles.

Meghan Smallwood: 2:06

Most of the families that I've supported were barely aware of what a support broker was, let alone this assistant position. Yeah, that was, you know, after many conversations about the benefits of support broker, so I think it's just hard to know, like, this position that took off like, and has been doing a great job for so many it's just yeah...

Patrick Cadigan: 2:30

And again, it's wild to think about that like you were saying it like that was a position that, like, exploded

Meghan Smallwood: 2:36

Yeah.

Patrick Cadigan: 2:36

...very quickly, and it's like, Well, do you think that maybe because it was filling a need, as you were talking about it, like, I'm thinking project management, you are effectively, like, you know, offering project services to help someone plan this stuff out. Because, I mean, filling in that day to day stuff, man, that could get tough.

Meghan Smallwood: 2:57

Yeah, that's a good point. There's a need for it. So let's, let's cut the budget? Like...

Jamie Brodnax: 3:02

Yeah, pretty much.

Meghan Smallwood: 3:04

In terms of the supports of, like, staffing, one question, and I was bringing this up to Patrick before, like, I've heard a lot of back and forth about family of staffing. Has that changed?

Jamie Brodnax: 3:16

So there's been some changes to it, and there is a lot of speculation about future changes. Of course, we could go on forever about the potential future changes, but the thing that's been occurring right now is that they did update the family as staff policy and the family as staff document, which is a document that's completed every year during the annual PCP period, and they expanded it to include not just your immediate family. So now family and staff pretty much includes everyone except for your cousin, which is an unusual thing to have left off, but aunts, uncles, grandparents, step grandparents, adopted parents, siblings, spouses and children, all of those fall under the family of staff, where before your extended family was not included in that description. The proposed changes beyond what has already happened in the last couple years, which was primarily just limiting it that family of staff cannot work over time. The proposed changes have been that potentially, family of staff will not be a thing in the future. We do see that in other services, like Community First Choice, it's been discussed...

Meghan Smallwood: 4:47

Proposed, not set.

Jamie Brodnax: 4:49

I don't even know if it has been officially proposed...

Meghan Smallwood: 4:52

Ok.

Jamie Brodnax: 4:53

...has been discussed.

Meghan Smallwood: 4:54

Discussed okay, because I heard that and I'm like, I don't know if that's accurate, like and if it was, there's a lot of people that need to be aware of that.

Jamie Brodnax: 5:04

Yes, as of right now, to my knowledge, that is not a proposal, but I could see it being one at some point in the future.

Patrick Cadigan: 5:14

It's almost like they're talking about it out loud, because they want to see how people are going to respond to it...

Meghan Smallwood: 5:18

Respond, yeah.

Patrick Cadigan: 5:19

...to it figure out. Because I do, I feel like it's one of those things where you'd have to to me, like all of this, like you have to hear both sides of the story. You know, a lot of this discussion revolves around people with the most significant needs. And so again, we're talking about people that really need support and services, and they're going to be the ones that lose it, like,...

Meghan Smallwood: 5:46

Yeah, and Patrick, like you're saying the people with the most needs are the ones that this. Yeah, that will impact but I think of those families, the parents who have those children or young adults with the most needs, and I heard so many of them say, I couldn't possibly send them to an agency, because they're not going to know the kind of care they need. I know it in and out, and I need to be one of their staff members. And as I you know, we discuss it. I tell them you can't be the sole one, but I get, you know, the fact that you've been doing this your whole life. You know them best, and you worry about the care of your child, you want to still be involved as a staff member. And it's not even about the money for most of them, it's just about the fact that they want to be the person who's there, overseeing their their daily needs. And if that's taken away, it's just, yeah, that's going to be a hard one to swallow.

Jamie Brodnax: 6:34

It absolutely is. And even to speak to that point, I cannot tell you how many of the families I support who through these discussions of potential budget changes and pay rate cuts, have said, Do you think that DDA would be open to the idea of cutting our pay but allowing us to still pay our staff what they're making? Right? And unfortunately, I don't think that that is going to be an option, I think that the logistics of doing that would be beyond what DDA has the ability to control. But yeah, for a lot of our families, it is not about the money. The majority of them, it is not about the money. It is about making sure that their loved one is safe and receives the care that they need. And although there are some great provider agency options out there for the majority of people that I support, they've been turned down by provider agencies, either because the the agencies do not have the ability to provide the one to one support that somebody needs for behavior or medical reasons with transportation. It was shocking to me to learn how many of the traditional providers do not have the ability to provide accessible transportation. If you're an individual who happens to need a wheelchair or who happens to have a high health or high behavioral need. Chances are, your options, traditional wise, are very, very limited, and a lot of those traditional providers who do offer that level of support or that transportation don't have the ability to take on more people, right? That's what I was thinking. If self directed is no longer a viable option. Where do they go? What do they do? That's a question that I've been having with quite a few families, and sadly, some of them are in a position where they feel like they have to give up.

Patrick Cadigan: 8:34

As you were explaining that, how often are we hearing in the discussion about a lot of things, is staffing issues. You know, there's not enough people. Like, it's weird. Like, I keep hearing that there are people who are looking for work, but then consequently, I hear that there's no one to hire for these jobs. So I just, you know, it's weird. I don't know where the disconnect is. I don't understand it. But when, when Meghan and I have talked about this offline, it's always one of the reasons that I for myself brought up saying, like, I'm really nervous to talk about this, because I I don't understand it. Like, I can't pretend that, you know, this makes sense to me well.

Meghan Smallwood: 9:19

And then you have staff. I mean, turnover can be great in this field. We know that. But there's families who have had staff that have been with them for years, and they become like family. And you think about the impact on them, where they they have to walk away for their own their own family and their needs, and they have to pay bills, you know, and all of a sudden their jobs pay has changed for something that's out of anyone's control. But again, then you add that family to the list of people who need more support to, you know, a waiting list of ones that don't exist. And it's just, it just frustrates me so much.

Jamie Brodnax: 9:58

So it's a very difficult time for families, I will say just of the individuals that I support, almost every single one of them has at least one open position now and as we've been having these conversations, because we do believe in being very clear on what's going on and not keeping this information until the last minute and dropping a potential pay rate cut on their employees. As they're learning about this, some of them are openly having to say they would not be able to stay, they cannot continue to live their life as they typically are, at a pay rate that's so much less than what they're used to receiving, and then on top of that, if they do stay I feel like that's putting our individuals in danger, because those staff are going to have to work second jobs. They're going to have to have another way to make money, making them exhausted. I mean, it's just not a reasonable way to expect somebody to live.

Meghan Smallwood: 11:04

Yeah, and you can't blame them. I mean, it's just unfortunate.

Patrick Cadigan: 11:09

Well, one other question that I have, and this is kind of changing lanes a little bit, but then not really, because it's still in line with the discussion along with these proposed changes, is there any clarification? Is there any discussion around increased oversight or expected documentation requirements, like, are they going to be adding more to that as well?

Jamie Brodnax: 11:31

So they are not specifically related to the pay cuts, but more so to services getting a little bit stricter, in some cases getting a lot stricter. Specifically, again, those individuals that need that higher level of support, which are the individuals who are requesting specifically one to one support, a lot of times, that also coincides with the need for overnight support. And what DDA has already put in place with the policy changes that happened early last month is that now requesting those services requires a person to have a nursing care plan or a behavior support plan that specifically states the need that this person has to justify them being able to request that service, where previously, those things did help in justifying but it was the PCP that had the majority of the information that supported that need that is no longer the case. It is now a requirement that the person have, like I said, a behavior plan or a nursing care plan that specifically states the need for one to one support. Why that need for one to one support exists? What the one to one staff is going to be doing, and is there an opportunity for decreasing that support level in the future, what those strategies would look like. That is a big change, and unfortunately, we've seen plans get denied more frequently than I have ever seen since working with DDA services over the last few months, specifically for that reason.

Patrick Cadigan: 13:22

If that plan is denied, then whose responsibility is it? Okay? Because I can't my brain, I'm going back to Okay. First, how do we figure out what's wrong with it? The the person centered plan, then who's going to help make those changes? And then, like, what do we need to do to get to get to the yellow road? Yeah, yeah. Like, what, what is it does a team then have to come. Like, how does that work? But God, I have so many questions.

Jamie Brodnax: 13:50

So I will say, typically, before denial, you're going to get a clarification request, which is when DDA comes back, gives you information on basically asking for more clarification about something specific related to the plan. It could be that they are very specific in saying you need to do this or that, or it could be more vague, which unfortunately is what we see more often, where they just copy and paste a policy into the response, and it leaves us the job to guess exactly what they're looking for. Usually, the standard is about three clarification requests and then you get a denial if you don't get it right after those three times, however, I have seen one clarification request and then a denial. Just recently, had a plan denied with zero clarification requests. So there is a, I would say it's up to the discretion of the DDA reviewer on how that process goes. There is a general idea, but it does. And always follow those rules. Then if you do receive a denial, it's up to the participant and their immediate team, which could be their guardian, could be their CCS, to decide, are they going to accept the denial or appeal it? If they appeal the denial, and this is specific to self-direction. If they appeal the denial, their plan will go into what's called an auto extend, which is basically where your plan is locked in, as it is that day, and you wait for the courts and DDA to contact you with steps. Sometimes it's the ability to have a mediation and come to an agreement. If that doesn't happen, it would eventually be a court date where you have the opportunity to go in front of a judge explain why you think DDA made the wrong decision, and the judge will make a decision on should, does DDA approve that plan and provide you those services, or is it not approved? And we're basically back at the starting point, if you don't want to go through the appeal process, which, right now, it's taking 12 to 16 months to get a court date. So during that during that time, you are not able to make any changes to your plan. You cannot change pay rates, you cannot move funding, you cannot add or remove services. Your plan is locked in, as is the only thing you can do is hire new staff. If you do not elect to go through that process, then your option is to accept the denial immediately, get together with your team and develop and submit a new plan. It kind of puts you back at square one, where you are again guessing on what DDA wants to see or wants you to change from the previous submission in order to get this new plan approved. It is it's quite the process, and it's different for every person. There are things that we will see get approved on one team that we then see get denied on another team, and it's, it's a very confusing process where there's a lot of us just saying, I no longer know for sure what's allowed and what's not, because it seems, again, like it's up to the discretion of the reviewer, yeah, and you just don't know who you're going to get, and that makes a difference which it shouldn't right. If there's policies in place, we should all be following those policies. There should be no discretion involved. It should be way more black and white than it actually is.

Meghan Smallwood: 17:59

But it reminds me of just the same with SSI or, I mean, when you do a DDA initial application and they're reviewing things, it's just there's a lot of bias. And that's unfortunate.

Jamie Brodnax: 18:14

It is.

Patrick Cadigan: 18:16

Jamie, you are currently, you're a support broker. So then, how does this affect the job that you are doing for the families that you work with?

Jamie Brodnax: 18:27

In a couple ways? One is that it's part of my role to make sure that families know of all these changes and are able to stay up to date on things and not just know them, but understand them. So my job has really shifted from being kind of a reactive role where I'm solving problems, helping people manage different day to day things, to now I feel like I'm spending quite a lot of time of predicting problems and looking at these changes, and then having to go back and apply them to each of my specific teams, and try to guess on what how this could potentially impact them, and what we could potentially do if it does, and that is a new place for me to find myself. You know, I feel that the support broker role is a very solution focused role where there are certain sets of problems that happen on every team and we know how to fix them. It no longer feels that way. It now feels much more individualized, where every person is dealing with something a little bit different, and there's not one clear path anymore.

Meghan Smallwood: 19:51

That's a lot more on your shoulders too, to be the problem solver ahead of the problem...

Jamie Brodnax: 19:58

It is.

Meghan Smallwood: 19:58

...for people who don't even know. Know what's coming.

Jamie Brodnax: 20:01

It is, and it's also, I mean, it's, it's been tough to be the constant bearer of bad news.

Meghan Smallwood: 20:09

True.

Jamie Brodnax: 20:10

Where I feel like it's been a very long time since I've been able to say, like, something great is coming your way, or, like, look at the this is a new service or something to help.

Meghan Smallwood: 20:22

Yeah.

Jamie Brodnax: 20:23

It's been like, I'm sorry that I have to share this, but this is what's happening, and this is what we can do. And I try to follow it up with that with here are our options. Sadly, those options are not always positive. Sometimes it's picking the least, worst option.

Meghan Smallwood: 20:45

Yeah.

Patrick Cadigan: 20:45

Again, it kind of goes in line with having those hard discussions. Yes, yeah. And then is there, is there a timeline that families can expect like, which is to say that, do we know when this legislation is going to go through?

Jamie Brodnax: 21:00

So to my knowledge, and again, I'm not going to pretend to have a great understanding of how all of our government things work, because I don't. But to my knowledge, the last day that our legislator is able to vote on the budget is April 6. However, with the hearings taking place last week. I feel that that vote may come earlier than that, and this would be the vote on the state budget that would then impact the DDA budget. So once we have that decision from the state, I would expect within a few weeks of that, that we would have the final decision from DDA regarding what the overall budget cut is going to be, and then how each of those areas we discussed earlier are going to be impacted. As far as implementation of those things go, my expectation, looking back to how things occurred last year would be that any pay cuts would most likely take effect on July 1, and then the overall budget cap is going to be the thing that takes the longest, because that is the one area that DDA cannot just simply implement. It has to be added to the waiver. So that takes a waiver change process, and that plan has to be submitted by September 15. And then there's a 45 day review. And then, but after that 45 day review, there's additional time that is required before we they can actually implement a change if it's approved. So I would think end of this year, beginning of next year, potentially another New Year's Day change, which we experience quite often, but that one would be taking longer than the pay rate cuts or the changes to the wage exceptions, and I will say also, DDA did share in an email almost a month ago that there are three rounds of things coming to help decrease their spending. So this is just round one. Oh boy, yes. So in their email, they talked about the geographic differential was one of the things, which, if you're not familiar with that, it basically just means that people who live in areas where the cost of living is higher have the ability to use a higher pay rate for their staff and their vendors. It's just a few dollars an hour more. However, it has been proposed to get rid of that where the entire state follows the same pay rates, the same pay limitations across the board. Another thing that is specific to self-direction is something called the live in caregiver exemption. And this is just something very simple that DDA allows for parents or caregivers living in the same home as the person receiving services. It gives them the ability to choose between using the app to record their time live or using the website to enter their time, you know, once a week, once every two weeks, when it's convenient for them, DDA does seem to have some reason to believe that it would help decrease cost if those caregivers were forced to use the app because. Record their time live all the time, removing their the option for them to use the website to record their time. So that is something that has been proposed for future. I don't want to say cuts, but maybe future consideration for changes.

Meghan Smallwood: 25:19

It's very particular.

Jamie Brodnax: 25:21

It is very particular. A lot of these things seem to be very specific to targeting, self-direction, and yeah, there's, there's a few different thoughts on why that may be. I will say the biggest thought seems to be that it could be related to the money that the state is making off of self-direction compared to the money that the state is making off of traditional services, which, again, makes sense, but it's still sad to see that this very small specific group of people is being targeted to answer for such a large amount of funding deficit, and it doesn't really seem that their thoughts or how it's going to impact them really matters in these discussions when it should, because these are people's lives.

Patrick Cadigan: 26:19

How is it that families can stay up to date on this? Like, what can they do? Like, outside of someone who has a support broker, like, and I'm the now as we're having this conversation, like, I'm thinking of this for myself as well.

Jamie Brodnax: 26:32

So I would say the first thing that I suggest anyone who has any connection to DDA do is go to the DDA website and sign up for the DDA newsletters. I believe they have five different ones. I would say, sign up for all of them. And there are some that are specific to anyone related to DDA. There are some that are specific to families or provider agencies. Sign up for them all so that you can make sure that you are getting all the information that everyone else is getting, and then read them because there is a lot of information. They are long sometimes the information is not obvious. For example, the DDA updated every single policy related to every single service last month. The majority of people are not aware of that because the way that they shared it was they sent out a late afternoon email that almost seemed celebratory about all of the great things happening in DDA. And in the middle of that email was a tiny little paragraph that said, federal program updates. And it was basically saying, every single policy has changed. Here's a link, and if you didn't think to click on that, which admittedly I did not when I first read it, you would have no idea that all of these things have happened. So you really have to pay attention. It also matters who's on your team. Have a support broker who is willing to attend the meetings and read all of the things and keep you informed and talk with your CCS, although I have personally been informed that a lot of the CCSS are not able to attend the webinars anymore or receive that direct DDA information, they're having to wait and get that information At a agency wide meeting. So it's going to force fall on a lot of families to be proactive and find their own information, which is hard to find something if you don't even know that it exists.

Meghan Smallwood: 28:53

And that's a very unwelcome surprise, when you think you've got to figure it out, and then things have changed and you didn't know? Oh...

Unknown: 29:03

Yes, it's it's a tricky time.

Meghan Smallwood: 29:08

And I know I get the emails from DDA, and same thing, I read them, but a lot of times you have to go back and read them very closely to fully understand what they're trying to relay to you.

Jamie Brodnax: 29:20

Yes.

Meghan Smallwood: 29:22

Sorry to be the bear of bad news.

Jamie Brodnax: 29:25

Sorry once again to come to you with all of this.

Meghan Smallwood: 29:29

I guess once like, things are finally approved, maybe we can have Jamie come back and kind of review that all with us, just so...

Patrick Cadigan: 29:40

You had said it before. Jamie, like, I mean, obviously a lot of this stuff does sound pretty gloom and doom. However, it may just then, like, not have much of an impact at all, which is to say that they, like you said, they may find the funding that they need...

Jamie Brodnax: 29:57

Right.

Patrick Cadigan: 29:57

...and there won't be that many changes. So again, it's. Just, we're it's like we're in this constant state...

Jamie Brodnax: 30:02

Yeah.

Patrick Cadigan: 30:02

Families are in this...

Meghan Smallwood: 30:03

Yeah.

Patrick Cadigan: 30:03

...constant state of limbo.

Meghan Smallwood: 30:04

And it's like, if it doesn't happen this year, could it happen next year? So I think there's always that fear, and it is good to have, like, a Plan B, but again, also frustrating when that Plan B includes losing good staff, or losing, you know, having pay cuts, or whatever else it may be, so...

Jamie Brodnax: 30:22

Yeah, I will say, I feel pretty confident that there are going to be some pay cuts this year. I obviously can say what they're going to be. What DDA is, is relating to a lot, is the Bureau of Labor Statistics. And if you follow the service rates and the Bureau of Labor Statistics and then apply those to the DDA rate, it's looking at like $21 an hour for personal supports, which is significant. But then I heard that it was discussed off record at the hearings this week, $23 an hour. So even though not as significant, still, if you're going from $32 an hour to 23, that's huge.

Meghan Smallwood: 31:13

A big adjustment. Yeah.

Jamie Brodnax: 31:14

And last year, the pay cuts were not nearly as significant. They were a couple dollars here and there, and people quit over that.

Patrick Cadigan: 31:23

Yeah, because at the end of the day, I mean, yes, that's still less money that you're being paid. You you had, you know...

Meghan Smallwood: 31:30

And your work hasn't changed,

Patrick Cadigan: 31:31

Right.

Jamie Brodnax: 31:31

No, so imagine having to tell someone like, sorry, you're fantastic, and we love you, and you've done nothing wrong, but we're gonna cut your pay by $10 an hour overnight, and there's nothing we can do about it.

Patrick Cadigan: 31:48

And so again, I mean, it sounds like that, what families can be should be doing is, you know, contingency planning. Like, think you know Plan B, like thinking about that.

Jamie Brodnax: 32:02

Which, unfortunately, there's not a whole lot of Plan B's out there.

Meghan Smallwood: 32:08

Right.

Jamie Brodnax: 32:09

This is this really, is it for quite a few, I mean, and some of our previous students are in that exact position...

Meghan Smallwood: 32:18

Yep.

Jamie Brodnax: 32:18

...where they have exhausted their options. This is it.

Meghan Smallwood: 32:21

Yep.

Jamie Brodnax: 32:21

And it, and we don't know what to do next.

Patrick Cadigan: 32:28

All right. Well, just sounds like we, we, we need to be paying attention. We need to be paying attention again, willing to have hard conversations. Plan B planning, even though there may not be a Plan B.

Jamie Brodnax: 32:43

Absolutely.

Meghan Smallwood: 32:44

Yeah.

Jamie Brodnax: 32:44

Yeah, and then just paying attention, following along with what is going on. If you're on social media, there are some great advocacy groups that we all know of that you can pay attention to, but also take what you're learning on social media with a grade of salt and understand that some of that information has been their interpretation of what they've learned. You know, all of the bills and policy changes are viewable online. You can see when things are being approved by our legislator. So just yeah, stay informed and understand for yourself what is happening, and then talk to your team to help with understanding how that impacts each person on an individual level.

Meghan Smallwood: 33:34

Yeah, that's great advice.

Patrick Cadigan: 33:37

Well, once again, Jamie, we really appreciate you taking the time to come and talk with us about this, and we'll we'll keep track. We'll keep track.

Jamie Brodnax: 33:47

Sounds good.

Meghan Smallwood: 33:48

Thank you.

Jamie Brodnax: 33:49

Absolutely. And I'll definitely let you guys know as things come out and as I hopefully learn soon what to expect. But yeah, once that information comes out, that's when the serious conversations need to start happening.

Meghan Smallwood: 34:04

Right.

Patrick Cadigan: 34:06

All right, so there is an update on this discussion. This comes to us as of Friday, March 13, and there will be a link in the show notes to the article that I used to update this information. The budget that was unveiled on Friday by the Senate, the State Senate, includes a $126 million cut from the DDA budget, which, of course, is down from the initial 150 million proposed by our State Governor. One of the bright spots is that this version of the bill rejected the proposal that set that $500,000 cap on how much state funding a person with a DDA waiver can receive. So as of right now, that budget cap is currently off the table. Another provision that Jamie talked about that is still on the table is dropping the family employee wages closer to what they see from the Bureau of Labor Statistics wages. So the caveat to that is there is a provision in that proposal that non family employees would receive a slightly higher wage. But again, that whole piece is still getting worked out. This version of the budget proposal also adds restrictions on how many hours the family members can operate as support staff before looping in an outside provider, saying that a single family member can only receive payment for 40 hours of service a week, capping out all hours of any family member as a provider to 60 hours each week. So again, there is a link in the show notes to the article that I used to reference this update. Again, this is an ongoing discussion, so once this has all been ironed out, we will bring Jamie back, and we will give a full update. Our discussions are everywhere; Apple, Spotify, YouTube Music and others. So hit that follow button and you won't miss out. Please help us spread the word about our discussions by leaving us a review. Links to the information from our conversations are always in our show notes. Surf to our sister website, www.postsecondarytransition.com, full of information and links to more resources. Our YouTube channel contains curated videos that revolve around transition, including playlists for guardianship, alternatives to guardianship ABLE accounts and more to come. Thanks so much for your time spent with us, and we look forward to talking again soon.