Task Force Minutes- Missouri SSP Program

July 10, 2024

 

Minutes prepared by: Stephie Birkhead

 

Attendance

Becky Davis-Director (in person)

Amber Carter- SSP Program Coordinator (in person)

Mary Hale- Task Force Member (in person)

Scott Dollar- Task Force Member (in person)

Amy Rowson- Task Force Member (remote)

Chip Hailey-Task Force Member (remote)

Beth Jordan- HK Representative (remote)

Stephie Birkhead- Task Force Member (remote)

Sarah Pretchel- Task Force Member, Deaf Inc. (remote)

 

Audience: Erica Walz, Kim Vaughn (consumers)

 

Meeting commencement: 11:00am

 

Becky Davis began the meeting by apologizing for not setting and sending an agenda and explaining her focus on reviewing the budget. Becky discussed that when Vancro resumed the program, there did not seem to be oversight from MCDHH. With new staff, there also did not seem to be training on how to use the data collected from invoices to provide oversight to the program. Without that direction, some practices were put into place that were not in compliance with the SSP Program as designed and established in the RFP. Becky will be working with the Business Operations Manager and Vancro to straighten out invoicing and tracking funds by region and function. In the September meeting she plans to report on how this is handled and addressed with the focus of making improvements to the program and preparing for FY2025 and FY2026 when we hope to address expansion of the program.

 

After Becky’s explanation, she opened the floor for questions from the committee.

 

Mary Hale queried about discussing salaries and budget content in closed session. Becky clarified that while she understood when talking about specific employees, close session is merited, she did not see the need for closed session when discussing about what grant money was being used for within the 15% set aside for Indirect Services.

 

Amy Rowson discussed Vancro’s budget transparency issues, highlighting discrepancies in reporting and suggesting clearer breakdowns aligning with their RFP commitments. Becky acknowledged these concerns and indicated further dialogue and structure is needed.

 

2. Background checks and fingerprinting:

 

Becky raised the topic of background checks and fingerprinting, outlining the coverage of FCSR checks. Mary questioned the adequacy of FCSR checks for detecting certain offenses and asked about costs. Amber Carter checked the website and stated that FCSR checks are free. Applicants are not fingerprinted but the FCSR does include any information on record from the MO State Highway Patrol. Fingerprinting through the MSHP costs approximately $40.00. A member of the Task Force shared that the screening fee for FCSR was $14.53 and we will need to verify with the company.

Concerns were raised about the coverage and comprehensiveness of FCSR checks, proposing annual requirements due to potential evolving histories of service providers. The practical differences between FCSR checks and highway patrol fingerprinting were discussed, with Becky supporting the idea of adopting annual FCSR checks. Staff will follow up on question regarding pricing.

 

3. Insurance issues:

 

The discussion revolved around the insurance concerns related to SSPs (Support Service Providers) transporting others. The main issues highlighted include:

Becky Davis had researched with the Missouri Department of Insurance seeking clarification regarding the SSP transporting DB consumers and coverage should an accident or incident occur. The Missouri Department of Insurance clarified that insurance underwriting is under each provider’s jurisdiction, not theirs.  

The group discussed the importance of creating clear guidelines and scripts for SSPs to use with their insurance agents to mitigate these risks and ensure proper handling of the situation. There’s a recognition that failure to inform insurance companies about changes in driving behavior could lead to significant financial and legal consequences for SSPs and potentially the organizations they work for.

 

Need for Clarity and Process: There’s a call for developing formal processes and scripts for SSPs to use when discussing insurance coverage with their agents. This is seen as crucial to ensure all parties understand the options and liabilities involved. Becky will meet with Vancro and discuss adding information in training to make SSPs aware.

 

Lunch: 12 noon till 12:40pm.

Resumed at 12:40pm.

 

Becky Davis raised a point that was brought to her attention by Scott Dollar during the break, noting the distinction between PCAs (Personal Care Assistants) and Consumer Directed Services (CDS). She emphasized the need to explore how CDS, unlike PCAs, are permitted to drive.

Amy raised a question about the disparity between Consumer Directed Services (CDS) and Personal Care Assistants (PCA) regarding driving privileges, noting that CDS drivers manage their Medicaid payments independently, whereas agency involvement differs for PCAs.

Scott Dollar mentioned his discussion with Becky, who plans to contact MCDHH commissioners and Clark Corogenes from TWP in KC for more insights, promising to share outcomes at the next meeting. Becky acknowledged the valuable information on Medicaid services and expressed appreciation for the feedback provided.

 

 

Budget

Discussion regarding the use of funds for things other than specified for in the grant or with different priorities than direct service. Examples were provided of such by taskforce members; training, direct service prioritization, more efficient outreach and SSP recruitment, inappropriate uses for hotel expenses, using funds for training not covered in the grant such as for haptics and protactile, etc. Appropriate use of scholarship funds was also brought up. Moving forward, the Task Force emphasized the need for stricter fiscal management.

 

Adding SSP Representation to the Task Force:

While the primary focus is the operation of the program, SSPs contribute much to that operation. Mary Hale suggested adding SSP Representation to the Task Force. She nominated Marsha Martin who has many years of experience as well as the understanding of how the program came about. Marsha would be helpful when it comes to training protocols of SSPs in the field. Mary believes Marsha would be a valuable addition. Discussion ensued regarding using the SSP survey gathered at the end of the year for the program. 

SSP program management: Amy has suggested exploring whether the MCDHH (Missouri Commission for the Deaf and Hard of Hearing) should directly manage the SSP program, similar to other states like Hawaii and Pennsylvania. This would involve amending legislation annually and ensuring adequate staffing. Mary Hale expressed concerns about potential turnover and the need for multiple staff members to understand and manage the program effectively, given past turnover issues at the commission. Becky acknowledged the valid concerns about turnover and staffing. She discussed the concept of reengineering and the current shared responsibilities among staff members. She emphasized the need for thorough research before making a decision. This would not be her preference for the upcoming contract.

Mary Hale mentioned for future thought, but especially if the SSP program was housed at the Commission that the Commission consider adding DeafBlind to the organization name.

Amy Rowson emphasized the program is laid out for the administering the grant. With a structured approach to managing the SSP program an organization could manage the program with stability and consistency, including detailed job descriptions and quarterly updates. They highlighted the importance of minimizing disruption for consumers due to staff changes.

 

Discussion and Action items:

 

Becky Davis noted the importance of gathering feedback from other commissions and reevaluating the RFP (Request for Proposal) based on the discussions.

–Beth offered and will provide a national listing of SSP programs managed by commissions for reference. Top of Form

 

SSP Directory: Scott Dollar addressed concerns about the accuracy of the SSP (Support Service Provider) directory. He noted instances where interpreters were listed in the directory intended for SSPs. This caused confusion among DeafBlind consumers trying to contact appropriate SSPs. Dollar clarified that interpreters, while essential, should not be listed or functioning as SSPs simultaneously due to conflict-of-interest concerns. There was consensus among the team to review and rectify discrepancies in the directory, ensuring interpreters are correctly categorized and separate from SSP roles. Mary Hale highlighted issues in the Eastern region where incorrect addresses and roles were listed, emphasizing Vancro’s failure to correct these errors. Amy Rowson expressed frustration with Vancro’s handling of the SSP directory in the Eastern region, suggesting laxity might extend to their training practices, prompting the need for a detailed discussion on training effectiveness.

–Commission will follow up with the provider regarding the directory.

 

Mary Hale also stressed concerns about deficiencies in training provided by Vancro. All agree that there needs to be more discussion in regard to training. DeLinda Brite was recommended as a resource for Vancro.

–Becky Davis would try and arrange that review.

 

Becky mentioned observations and discussions regarding the inclusion of Co-navigator role in the RFP related to working with DeafBlind signers, acknowledging the need for clarification to avoid confusion.

 

15-minute Break

 

The group addressed meeting minutes. Changes were discussed and made. The importance of providing minutes as soon after the meeting as possible was stated. Changes were discussed and made to previous meeting minutes.

One topic related to the minutes was having the names of SSPs and Interpreters as part of the minutes. Discussion ensued. Both sides of the matter were heard. Becky Davis will respond to the matter with the next meeting minutes after giving it some thought.

Another suggestion was that all minute-correcting business be handled via email prior to the meeting, thus being more efficient with meeting time.

–Commission will complete minutes and corrections via email. Corrected minutes will be sent out prior to upcoming meeting.

 

This meeting was the first that did not include the current provider in some way. Hale mentioned she thought it worked best. The commission can address any issues or ask any questions they wish to follow up on for the taskforce.

 

Beth Jordan emphasized the need to prepare a plan for increased funding and legislative action, stressing the urgency due to service hour cuts and waiting lists.

–Commission will work on a path towards legislation change since the dollar amount for the program is stated in legislation.

 

Beth Jordan outlined upcoming tasks, mentioned ensuring the appropriate tone in service minutes.

–Commission would discuss the development of script to be included in SSP training pertaining to insurance coverage.

–Budget data and projections for the next meeting are needed. Mary Hale stressed the importance of gathering budget data before fall.

 

Becky mentioned she had not received and reviewed the annual report from Vancro and discussed administrative procedures related to budget allocation and legislative initiatives.

 

–Scott Dollar requested assistance from Becky in reviewing the list of SSPs to ensure accuracy and proper categorization across regions. Dollar would provide Davis with an example of the SSP directory given to DB consumers. 

 

Action Plan

–Becky will prepare an action plan.

 

Meeting Adjourned at 3:52 PM. 

Top of Form

Bottom of Form

 

Service Providers:

Nicole Conrad

April Dunlap

Jeff Dunlap

Christina Godinez

Amy Sue Guinn (MCDHH)

Marsha Martin

Rebecca McSpadden

Heidi Rich

Jake Schraecke

Anna Sturgeon

Julia Wiggs 

Missouri Commission for the Deaf and Hard of Hearing (MCDHH)

 

Date: September 11, 2024

 

Commission: Becky Davis, Director; Amber Carter

 

Task Force Members in Attendance:

• Chip Hailey (in person)

• Mary Hale (in person)

• Stephanie Birkhead (virtual)

• Amy Rowson (virtual)

• Beth Jordan (virtual)

 

Absent:

• Scott Dollar, TF member.

 

Audience:

•    Erica Walz

•    Kim Vaughn

•    Lydia Olmsted

·    Andrea Silver

 

 

1. Call to Order

• The public meeting was called to order by Becky Davis at 11:26 a.m.

2. Approval of Previous Minutes

• The minutes from the previous meeting were approved. It was noted that MCDHH Commission minutes tended to be less detailed and a brief summary report can be given for those seeking more in-depth information and these records are held for public view. Taskforce minutes have been very detailed, but can be more direct to what is being discussed.

3. DEAF, Inc.

• Sarah Prechtel and Delinda Brite from DEAF, Inc. were absent. It was mentioned that Deaf Inc. might be interested in taking over the program, potentially starting in January 2025. They are aware of the involved parties and community members.

4. Task Force Updates

• Revisit Addition of SSP to Taskforce: Recommendations for SSP representation are to be submitted via email to Becky Davis by next week. Sarah Kurtz was recommended as a choice to consider. This could mean two SSP representatives chosen.

5. End of Year Survey

Vancro EOY report. Good information, but not sure if anyone here who has received training should be seeing that information.

6. Meeting Virtual Attendance of Public

A question was asked whether people who are interested in the audience can attend remotely, or is the TF only able to join?

It was felt that as those attending the meeting in the audience are there to observe primarily and that opening virtual platform to the public could cause disruption to the running of the meeting, even though it would be a great idea. This might be something available down the road.

7. Bid and RFP Updates:

• The need for a new public bid and potential changes to the current RFP were discussed. The authority to make changes within the existing budget constraints was confirmed. The current vendor will continue until December 31st.

• RFP Modifications:

Concerns were raised about the classification of services as direct or indirect. There was feedback indicating the need for clearer guidance on these classifications. Inconsistencies in categorizing scheduling and training were noted.

• Funding Allocation:

A discrepancy in the reported funding amount was identified. It was suggested to adjust the scholarship fund and reallocate resources to better support the program. History on the Scholarship funds was shared. Discussion regarding funds available to families of DB children ensued.

8. Consumer/Community Engagement:

Becky reported that she has been contacted by several community members interested in what is going on with the SSP program. Becky mentioned that Lydia Olmsted has set up a group for individuals, for information-sharing purposes. Lydia addressed the group briefly stating she is exploring some possibilities and have reached out to many DB and SSPs to gauge interest in advocating for more funding with the legislature, noting the election might pose challenges. Ideally, those interested would coordinate a time to meet at the Capitol to showcase the work SSPs do and its empowering impact.

If members know of anyone who should be involved, please email or text her. She is working on formally organizing something and have contacted Vancro to obtain specific data from previous agency records.”

 

Next Steps:

Additional funding options will be explored, and an email will be sent to initiate discussions with other projects.

 

The meeting reconvened at 1:15 p.m. after a lunch break.

 

9. Discussion Points

• Scholarship Funding and Staffing:

The team discussed reallocating scholarship funding to enhance direct services. It was suggested that a full-time program worker might be more effective than a part-time one due to the time required for scheduling.

• Concerns were raised about the adequacy of funding for staffing roles such as program management, training, and scheduling. The professional salary benchmark in Missouri is around $42,000, though actual pay may vary. The team will assess whether the current funding is sufficient and consider adjusting expectations or allocations.

• Training Specifics:

The team proposed setting a minimum of 8 hours for training, including at least 2 hours of hands-on training. Training should involve both blind and sighted co-trainers to ensure quality. One-on-one sessions should be emphasized, and online training should supplement, not replace, in-person training. Also, an exam be written for one-on-one candidates, must pass before certified.

• Professional Conduct and Reimbursement:

Concerns were raised about SSPs’ use of cell phones during assignments and the need for clearer language regarding professional conduct and background screenings. Transportation and mileage reimbursement were also discussed, focusing on fair compensation for travel expenses and incorporating these costs into the budget.

10. RFP and Funding Discussions

A revised RFP is planned to be ready by October 1st. The RFP will be split into sections with specific deadlines for feedback and revisions. Information provided by current vendor will be used to make changes for the program coverage for the remainder of the 2025 fiscal year.

• The need for updated data on consumer numbers and regional demand to make informed decisions about funding and program adjustments was acknowledged.

• The new RFP FY2026 is planned to start July 1, 2025. Discussions are ongoing about extending the program’s duration and revising language to clarify the program’s full length. Becky discussed potentially revising the RFP to cover the 2026 Fiscal Year.

11. Legislative Efforts and Funding

Becky is exploring legislative options for increasing the program’s budget beyond $300,000 and is seeking a legislator to sponsor an amendment. Concerns about the time required for new legislation or amendments and their impact on program funding and continuity were discussed. If approved for increase this year, expansion of funding would begin FY2027 (July 1, 2026).

12. Meeting Scheduling

• The next meeting is scheduled for November 13, 2024. It was agreed that regular meetings will be held on the 3rd Tuesday of each month starting in 2025.

13. Public Input and Testimonies

• The audience emphasized the importance of the SSP program and discussed alternative funding sources. It was suggested to gather testimonies to support legislative efforts. Amber Carter will assist in collecting testimonies for legislative support.

14. Additional Discussion and Public Comment

Concerns about the flexibility of SSP hours and the Use or Lose policy

Public comment included the option of funding to have a donation capacity so the SSP Program fund could receive donations. The SSP Program supports the basic functions of daily life. Idea of allowing use of Uber if an SSP could not drive.

 

15. Action Items

Invitations to future meetings in 2025 and 2026 (with Links)

Contact Jane Herder to discuss funding options.

Review and provide feedback on RFP modifications.

Confirm updated funding figures and correct any discrepancies.

Becky will send out the Vancro EOY report and other relevant documents.

Becky will inquire about detailed funding and expense information from Vancro.

Becky will update the RFP and communicate with DESE regarding the program’s future.

Amber Carter will assist in collecting testimonies for legislative support; development of form or input option or information

SSP Representation on the taskforce

 

Service Providers Present:

Sydney Johnson

Corinne Glaus

Randi Eisenhauer

Nicole Niles

Amy Sue Guinn

Christina Godinez

Aaron Smith

Christina Burns

 

The meeting was adjourned at 4:09 p.m.

Minutes of the Task Force Meeting

Date: November 13, 2024

Time: 11am

Location: MCDHH Office

Remote: Webex

Commission: Becky Davis, Director, Amber Carter.

Task Force members in attendance:

Chip Hailey, Stephie Birkhead, Scott Dollar, Mary Hale, Amy Rowson, Beth Jordan and Marsha Martin.

Task force members not in attendance: Sarah Kurtz

None in the audience.

1. Introductions and Agenda Overview

• Becky welcomed new Task Force (TF) members Marsha Martin and Sarah Kurtz. Sarah was unable to attend the meeting but will join the January meeting.

• Becky outlined the meeting agenda

• Approval of September minutes

• Review of the action plan

• Updates on Specialized Services Providers (SSP) and Request for Proposal (RFP)

• Discussion on SSP training, SSP FY2026 plan, and new action items.

2. Housekeeping

• Discussion on the accessibility of meeting minutes via the MCDHH website, with links to Google Drive for easy access.

• The format of minutes (suggested “Word”) was discussed to ensure compatibility with screen readers (JAWS, NVDA, Supernova/Dolphin, Voiceover).

3. Approval of September Minutes

• Corrections to the September minutes

• The training hours for SSPs should state a minimum of 8 hours, with at least 2 hours of hands-on, one-on-one training, not a maximum of 8 hours.

• Clarification that the 8 hours of training can include virtual sessions, but at least 2 hours must be in-person and hands-on.

• Corrections were made to the spelling of names.

• The minutes were approved unanimously with the stated corrections.

4. RFP Discussion

• The current RFP suggests a maximum of 8 hours of training, but the requirement is for a minimum of 8 hours, including at least 2 hours of hands-on training.

• Clarification that for one-on-one training, a minimum of 4 hours may be required.

• The RFP recommends role-play as part of training, with the flexibility to extend training hours as needed based on consumer needs.

• There were technical questions about the Webex meeting platform, how to use the raised hand function via phone.

• Members confirmed flexibility in the training duration for individuals needing additional support, reinforcing the term “minimum.”

5. Action Item Review

• Review of action items from the previous meeting:

• Sending out links for 2025 meetings.

• Contacting Jean Herder for family support.

• Follow-up on RFP.

• Clarification: Some members had not received the final version of the RFP, which will be resent.

6. RFP & Vendor Selection Process

• Discussion on the current process for selecting a vendor for services from January to June 2025. Several agencies and one individual expressed interest in the RFP.

• Concern raised about whether an individual without a business affiliation can handle the scope of the work. Members prefer that the agencies involved are based in Missouri.

• Historical challenges with vendors (such as Vancro’s non-compliance with the RFP) were discussed. Strict adherence to the RFP was emphasized.

• Members agreed to set up quarterly meetings between MCDHH and the selected vendor for program oversight.

• Concerns about the feasibility of agencies committing to a 6-month contract, given the scope of work. It was noted that the contract could potentially be extended beyond June.

7. Next Steps

• The group agreed to move forward with the RFP process, with the December 20th deadline in mind. Further discussion on the vendor selection process and ensuring proper oversight will follow.

8. Program History and Challenges

• The SSP program has experienced instability, with agencies entering and exiting the program, leaving consumers without consistent service. There is a need for long-term stability.

• Feedback from both SSPs and consumers is crucial. MCDHH will consider separate surveys for agencies and consumers to evaluate the program’s effectiveness and identify areas for improvement.

• Suggestions were made to improve communication between MCDHH, SSPs, and consumers, addressing feelings of disconnection. More transparency and improved training, especially for tactile communication, were identified as key areas for improvement.

9. Surveys and Metrics

• It was agreed that surveys should be conducted at the 6-month and end-of-year marks to assess the program’s success and identify issues in real-time.

• Increased oversight and the inclusion of metrics in the new RFP were seen as important steps for improving program structure and effectiveness.

10. Program Duration and Extensions

• The program operates on a 1-year contract, with the possibility of up to three 1-year continuances, allowing it to potentially extend for up to 4 years, contingent on successful execution.

11. Agency Selection

• A discussion took place regarding whether an individual or an agency would be more suitable to manage the program. Some members felt that an individual with the right qualifications could manage the program effectively, as long as they could lead a team and meet the program’s requirements.

12. RFP & FY 2026 Planning:

·       There is ongoing work to gather input on the upcoming RFP for FY 2026, with some previous discussions already taking place. One topic is reaching out to potential partners and legislators for funding and support, including discussions with the Missouri Federation for the Blind and possible contacts in the Northwest area.

·       Legislative Process and Budget Concerns: The focus is on navigating the process for securing funding, particularly through supplemental budgets. The team is exploring avenues to raise funds without needing a legislative change. This includes looking into supplemental budgets, the process with DESE, and whether the program could expand sooner rather than later. There’s also a question about whether the funding could be recurring annually or if it is a one-time grant.

·       Chip, who is well-connected in the legislative realm, offered to assist by providing services to help speak with legislators and advocate for the program. He knows quite a number of them.

·       Legislative Contacts: In addition to Representative Griffith from Coal County, there are ongoing efforts to connect with other legislators. The team also discussed the possibility of reaching out to other state agencies or legislative contacts for further support, especially if DESE is unresponsive or not providing the needed information.

·       Challenges with DESE: There’s frustration with the lack of responsiveness from DESE, despite repeated attempts to follow up. This has led to reaching out to other potential legislative contacts, including Representative Griffith, who may help facilitate communication with DESE.

·       Next Steps: The team is strategizing to get more responses and possibly leverage political support to get answers and move the process forward. They also discussed the need for a multi-faceted approach, ensuring that they are not solely reliant on one source or solution.

13.  Accessibility Concerns

• Discussion: It was highlighted that training materials, particularly PowerPoint slides, are not accessible for deaf-blind users who rely on braille readers. It was recommended that all materials be text-based to ensure full access.

·       Becky agreed to address this in future Requests for Proposals (RFPs) and training materials.

14. Program Structure and Budgeting:

·       Becky outlined the need to reassess program structures for fiscal year 2026, referencing a comparison with New Mexico’s SSP program, which divides its budget into six categories (administration, case management, services, outreach, customer satisfaction, and reporting).

·       Concerns were raised about high budget allocations (e.g., 13% for case management) and discrepancies in percentage totals.

·       Planning for Future RFPs: Discussions focused on refining program categories and ensuring clarity between direct and indirect services. Suggestions included incorporating regional reporting and reconsidering the program’s structural breakdown, potentially reducing regions from five to fewer.

·       Legislative and Collaborative Efforts: Becky mentioned ongoing efforts to engage with legislators and organizations like the Governor’s Council on Disability to secure support and improve program processes.

·       Recommendations and Follow-Up: The group plans to review previous recommendations, consider alternative program setups, and gather input from stakeholders for a more efficient and inclusive framework.

·       The discussion revolves around structuring and funding a service program, with a focus on clarifying how regions, budgets, and services should be managed.

·       Initial Regional Division: The program was initially split into regions to allow multiple vendors to manage services. However, a preference for statewide coverage emerged, though regional division remains an option.

·       Vendor Expectations: Potential vendors are expected to manage services statewide. The program’s growth, driven by word-of-mouth, has expanded its consumer base significantly, indicating a need for strategic planning.

·       Current Consumer Data: Approximately 75 people currently receive services, with some on a waiting list. Numbers are projected to grow, emphasizing the need for efficient program structuring.

·       Budgeting Concerns: Discussions focused on simplifying budget allocations, categorizing funds into “direct” and “indirect” services, and allowing vendors flexibility in detailed budget distribution. There is an emphasis on prioritizing direct services while minimizing unnecessary training expenses during the transition.

·       Medicaid Involvement: Medicaid funding was discussed as a potential supplementary source. Concerns were raised about equitable service distribution and legislative implications. Clarifications ensured Medicaid involvement would not disadvantage consumers without coverage and it’s not an issue in Missouri.

·       Guidance for New Vendors: Suggestions include providing vendors with insights based on past program operations to avoid inefficiencies, especially given limited funding. Recommendations highlight targeted recruiting and training, balanced against operational priorities.

·       Future Program Structuring: The task force intends to refine program guidelines, ensuring transparency in service allocation and supporting vendors with detailed expectations to streamline implementation.

·       The task force discussed various concerns and strategies related to SSP training and program management. Key points included:

o  Targeted Recruitment and Funding Guidance: There was a suggestion to focus on targeted recruitment and provide potential vendors with guidance on fund allocation, especially since the program has a limited budget. Task force members emphasized the need to assist vendors with clear breakdowns and suggestions based on the task force’s experience.

o  Legislative and Collaborative Efforts: Becky mentioned ongoing efforts to engage with legislators and organizations like the Governor’s Council on Disability to secure support and improve program processes.

o  Recommendations and Follow-Up: The group plans to review previous recommendations, consider alternative program setups, and gather input from stakeholders for a more efficient and inclusive framework.

15. Initial Regional Division:

·       The program was initially split into regions to allow multiple vendors to manage services. However, a preference for statewide coverage emerged, though regional division remains an option.

·       Vendor Expectations: Potential vendors are expected to manage services statewide. The program’s growth, driven by word-of-mouth, has expanded its consumer base significantly, indicating a need for strategic planning.

16. Guidance for New Vendors: Suggestions include providing vendors with insights based on past program operations to avoid inefficiencies, especially given limited funding. Recommendations highlight targeted recruiting and training, balanced against operational priorities.

·       Future Program Structuring: The task force intends to refine program guidelines, ensuring transparency in service allocation and supporting vendors with detailed expectations to streamline implementation.

·       State and Legislative Considerations: A consensus emphasized protecting the program’s independence from potential Medicaid funding consequences, ensuring consistent service quality and availability.

17. Various concerns and strategies related to SSP training and program management.

Key points included:

·       Targeted Recruitment and Funding Guidance: There was a suggestion to focus on targeted recruitment and provide potential vendors with guidance on fund allocation, especially since the program has a limited budget. Task force members emphasized the Need to assist vendors with clear breakdowns and based on the task force’s experience.

·       Training Concerns: Several participants highlighted issues with inconsistent or insufficient training for SSPs:

o  Some SSPs had only virtual training with no hands-on experience.

o   There was concern that newly recruited SSPs may lack critical skills due to inadequate or rushed training processes.

o  Recommendations included developing a checklist or refresher document to standardize what SSPs need to know, ensuring uniform training and covering any gaps.

 

·       Hands-On Training: Members underscored the importance of hands-on training to better prepare SSPs for real-world scenarios. They shared personal experiences highlighting the value of immersive learning, such as using blindfolds and earplugs to simulate consumer conditions. There was a call for both experienced SSPs and trainers to lead such sessions collaboratively.

18.  Program Oversight and Transition:

·       Concerns were raised about past management decisions, such as adding new SSPs without adequate training shortly before a program transition.

• The need for better communication with new vendors and clarity about training deficiencies among existing SSPs was emphasized.

 

19.  National Collaboration:

·       A national community of practice for SSP program coordinators was announced, with plans to share best practices and develop joint projects to improve services across the country. Beth is sending Becky this information.

20.  The meeting concluded with plans for follow-up discussions and ensuring alignment on training needs

Summary of Discussion on SSP Training and Support:

Participants raised concerns about inadequate training for Support Service Providers (SSPs) working with Deaf Blind individuals. It was noted that some SSPs begin working with clients after only online training and before in-person training, which many felt was inappropriate and unprofessional. Examples were shared where SSPs admitted feeling unprepared, leading to anxiety and suboptimal service.

Key points included:

·       Need for One-on-One Training: One-on-one training was emphasized as essential for effective learning and ensuring SSPs gain the skills and confidence required for the role. Group training with multiple SSPs to one consumer was deemed ineffective.

·        Participants stressed the importance of building trust and rapport between SSPs and consumers.

·       Periodic Refresher Training: SSPs expressed a desire for periodic refresher training to reinforce skills and address gaps, especially for those working part-time.

 

Communication Among SSPs:

·       A call was made for more opportunities for SSPs to communicate and share experiences, strategies, and best practices. Restrictions on SSPs collaborating were criticized as counterproductive.

 

Tailored Approaches:

• Acknowledging the diverse needs of Deaf Blind individuals, SSPs highlighted the need for adaptive approaches, as no two consumers have identical requirements.

Confidence Building:

• Participants noted that many new SSPs are nervous and need guidance on initiating interactions with consumers. Confidence-building measures were suggested as part of training.

 

Support and Resources:

• SSPs requested a clear point of contact for assistance in challenging situations, emphasizing the need for a structured support system.

The discussion concluded with an emphasis on the critical role of SSPs in ensuring the safety, independence, and dignity of Deaf Blind individuals. Participants advocated for improved training protocols and a stronger sense of community among SSPs to enhance the quality of service.

21.  Quality of training for SSPs and associated concerns:

·       Another participant emphasized the importance of one-on-one training, criticizing group training sessions where several SSPs work simultaneously with one consumer. This approach was seen as inefficient and overwhelming for both SSPs and consumers.

·       An SSP advocated for creating a support network among SSPs to share knowledge and best practices. They emphasized that every consumer has unique needs and SSPs should exchange strategies to handle varying situations effectively.

·       The discussion also touched on the vital role SSPs play in ensuring the safety and accessibility of deafblind individuals, highlighting examples of adapting to evolving needs like hearing changes or public safety scenarios.

·       Overall, the group agreed on the need for better training, more collaboration opportunities, and accessible resources to support both SSPs and the individuals they assist.

·       Training and consistency were recurring themes. Several speakers mentioned the need for standardized statewide training for SSPs, emphasizing that uniformity would build confidence and ensure all SSPs are equally equipped to assist, regardless of location. Suggestions included detailed training checklists, hands-on experience, and consistent communication between SSPs and their specialists.

·       Concerns were raised about gaps in communication and responsiveness from specialists, which hinder effective collaboration. Participants expressed hope that new approaches, including “train-the-trainer” programs, would improve the situation moving forward.

The discussion centered around improving the training and support systems for SSPs who assist individuals who are deafblind. Key points raised include:

·       Mentorship and Peer Support: Suggestions were made to implement mentorship programs, pairing seasoned SSPs or experienced deafblind consumers with new SSPs to guide them through real-world challenges. This idea came from the interpreters model.

·       Ongoing Resources: Participants recommended creating refresher videos, detailed training manuals, and accessible resources like video demonstrations of essential skills.

22.  Task Force and Future Goals: Optimism was expressed about the task force’s efforts to strengthen the program and implement necessary changes to enhance SSP training and support systems.

·       A discussion emphasized creating a library of video resources to provide training and refreshers on various tasks, such as handling a buffet or assisting at restaurants. These videos would help individuals unfamiliar with the scenarios or tools involved.

·       Suggestions included involving organizations in developing and sharing training materials, with some recalling videos illustrating correct and incorrect practices in specific situations, such as interpreting for deaf-blind individuals.

·       A participant highlighted the importance of technology devices for independence and suggested hosting regular virtual meetups (e.g., coffee chats) to share knowledge of these devices with service providers.

·       Concerns were raised about delays in scheduling one-on-one training sessions, suggesting that they be prioritized and accompanied by assessments to ensure trainees retain knowledge from virtual training.

·       The group discussed the value of real-life scenario videos in training, where participants could observe specialists and service providers in action. Scenarios like grocery shopping or navigating a stadium were proposed.

·       Issues of public misunderstanding and bias against blind or deaf-blind individuals were shared, with a suggestion to use such examples in training to promote awareness and better practices.

23.  Updates on the Request for Proposal (RFP) process indicated that a vendor for the program would be chosen within 10-15 days after the deadline.

• A draft training quiz was shared, with open-ended questions aimed at assessing candidates’ understanding of content. There was debate over whether multiple-choice questions would suffice, with some arguing that open-ended questions better gauge comprehension.

• The meeting concluded with an expression of gratitude for the collaborative effort and acknowledgment of the ongoing challenges. It was suggested that participants provide feedback on the draft quiz to refine the training process.

·       It was agreed that the quiz would be revised and sent out to members to be discussed at the next meeting.

·       A group discussed improving documents, testing formats, and training procedures. There was consensus on the need for clarity in question design and a preference for multiple-choice formats. Concerns about the suitability of automated marking software and manual grading were raised, highlighting the importance of thorough review and standardization.

·       A participant explained a system involving video training sessions with integrated quizzes, emphasizing the value of intermittent questions to ensure engagement and learning. Vocabulary reviews at the end of sessions were appreciated.

Action items included reviewing the questions and document formats, gathering feedback, and scheduling discussions for further refinement. Follow-ups with specific individuals on budgetary and legislative topics were planned. Participants expressed commitment to collaboration and appreciated ongoing efforts, with plans to finalize meeting minutes and distribute action items.

The meeting concluded with acknowledgment of contributions and agreement to follow up on unresolved issues.

Additional thoughts:

·       Customer Interaction and Accessibility: Scott recounts an incident at Costco where he and his deaf friend faced misunderstanding from a fellow customer. The situation highlights the challenges faced by individuals with disabilities, particularly in retail environments, and the importance of awareness and training for both staff and the public.

·       RFP Timelines: The team reviews deadlines and timelines for a Request for Proposal (RFP) process, noting changes from 30 days to 10-15 days for vendor selection. The importance of adherence to schedules and transparency is emphasized.

·       Internal Communication and Feedback: Marsha raises concerns about missing information, like coffee chats, stressing the need for better communication. There’s also a suggestion to centralize feedback on training materials for easier management and revisions.

Metting adjourned at 4:26 pm.

DeafBlind Taskforce Meeting

Meeting Minutes

February 18, 2025

Taskforce Members in Attendance:

Stephie Birkhead *Present at start of the meeting, then had access to part of the meeting via WhatsApp  

Mary Hale                              

Chip Hailey                             

Sarah Kurtz

Marsha Martin                                      

Amy Rowson                         

Beth Jordan

NOTE: Scott Dollar had access to transcription of meeting via WhatsApp, but was not able to participate.

MCDHH Staff in Attendance:

Amer Carter                                           Becky Davis                           Amy Sue Guinn

Interpreter Team: Access Sign Language, Nicole Niles

Captioner: Access Equality, Kendra

First matter of business was an update on HB1308 which was filed by Rep. Brenda Shields. Sheila Wright and Lydia Olmsted with the Missouri Chapter of the National Federation of the Blind and Becky Davis met with Shields. The purpose of the bill is to remove the cap on funding for the program as the legislation currently states “the program shall not exceed $300,000.00”. With that language our program cannot ask for supplemental funds or receive any other money from the legislature. 

At present time the bill has only been introduced and read. Davis refreshed briefly the steps that would come shortly if the bill progressed Hailey added to that. On March 6 ^th we are planning a workday at the capitol for our community and supporters to meet up with legislators and talk about the bill and the need for the SSP program. Details of that plan were shared. A template for a constituent letter would be sent to contacts on the DB consumer and SSP list if they wish to contact their congress representatives that way or use it however they wanted. The edited version is an updated version from the one shared previously. 

–Hailey continued regarding steps in the process, who to talk with at different times, the Legislature Spring Break. Hale and Davis discussed planning and possible appointments to be make with legislators. The question came up about the “best” way to contact folks, via phone calls or emails. Knowing you have someone’s ear when you call is an assurance they got your information and heard your opinion if you can contact them that way, but all communication is important. 

–Rowson also commented about video clips as an effective way and asked about meeting legislators while they are at home in one’s respective areas as an idea as well. Hailey, Hale and Martin commented on past methods of shooting videos and sharing them and the effectiveness since a legislator can view it at their convenience.

–The scholarship funds were also discussed not only regarding having possible people to speak for the bill, but also getting scholarship information out to school districts so more people can access the fund.

Issues to bring up with Legal Counsel:

Whether, in the way the RFP was written, if SSPs should be considered 1099 employees or W2 employees. Our program lists out job duties and our vendor determines the rate, which are 2 characteristics that are not compliant to 1099 status. This issue was brought up in our commission meeting as well as with DEAF, Inc. in a separate meeting.   

We also want him to look over the insurance issue again to see what he can advise regarding transportation and liability. This point was reviewed and clarified with the taskforce. Rowson suggested adding a language in the document that would outline the issue and suggest language to use when SSPs are talking to insurance agents. Making sure SSPs have discussed this with their agent maybe needs to be a requirement of the program. Martin inquired about seeing how programs like Consumer Direct Services handles this and Rowson informed Martin that she had contacted the program and they stated that they leave that responsibility up to the consumer since the consumer is given funds to hire out for services.

“Holding harmless” Davis explained that a concern was raised that the SSP agreement did not specifically state that MCDHH was to be held harmless. MCDHH had spoke to the issue with DEAF, Inc. MCDHH and legal counsel discussed it and did not feel this was necessary as the contract is between the SSP and DEAF, Inc., not MCDHH. Rowson explained her concerns and also added that protection for the DeafBlind consumer may also be needed.

Our legal counsel will look it over and advise accordingly.

Targeted Recruitment: Rowson summarized her document sent prior to the meeting. Per discussion, this will be added as an Appendix for Program managers and consumers to reference. She covered changes she made. Changes and suggestions were regarding mileage, pay information and consumer preferences for SSP. Rowson covered what was listed that could be included in an advertisement for recruiting an SSP. The intent is to that SSPs are aware of the work they are doing and what is expected of them when reading the ad.

SPIE, Scholarship funds, one concern discussed was that information regarding the funds was not being sent out to a broad scope of people, especially to families of DeafBlind children.  Rowson has listed areas, locations, where the SSP Program Manager can promote the use of the SPIE funds and reach more people who might utilize it as intended; related to independence or education.

Jordan inquired about the SPIE fund still being supported. Due to the tight budget, she has not advertised the fund to her consumers 16+. Davis answered that while it has been reduced from previous years, there is still a line item separate from the funds for each region.  If it is unused, it will be allocated to other regions needing funding to sustain services. Rowson added that the amount was $12,000 and Davis clarified that this means $3000 of that fund is to cover administrative services and $9000 is to be used for scholarship opportunities.

Rowson added information in the scholarship porting regarding the grantee knowing how many DB individuals are in the state and use that information to help establish scholarship amounts and opportunities.

Hale encouraged people to refer any DeafBlind child’s family to Jane Herder with the Deaf-Blind Technical Assistance Proram. They too have funds and services available to families. Hale added that whatever funding is available in the scholarship fund a minimum of 50% of it should be designated for children and families. Previous use of the scholarships at $750 and then $2000 per opportunity felt excessive as the scholarship is to assist, not pay for things in their entirety.

There was discussion regarding whether DeafBlind adults outside the program would be eligible for SPIE funds. Points for consideration: low funding, a DeafBlind consumers inability to receive SSP services through the program due to being on the waiting list, not being independent enough to be in the program, scope of the scholarship was supposed to be on children and families. Consensus was reached considering the limited funding that only eligible adults would be considered for scholarship opportunities, but overall, to reiterate that the main purpose for the SPIE opportunities was to assist DeafBlind children and their families.

Davis reported on meeting with DEAF, Inc.

Regarding the hourly rate ideas for SSPs. At this time, DEAF, Inc. will remain at $20/hour. They feel that decreasing the amount would have a negative impact on the number of SSPs willing to work. Due to the inconsistent nature of appointment-based work, the $20/hour rate provides incentive for SSPs to accept appointments.

Although, DEAF, Inc. will not be recruiting many new SSPs between January and June, but they do agree that any training provided will not be paid time for the SSP. Comment was added that the suggested rate for the new RFP was $18 and there it could be mentioned that Missouri Technology Assistance pays $15/hr to their drivers (knowing the responsibilities are different). An increase in the minimum wage was voted on and passed at $13.75

Break was taken at 2:40. For approximately 5 minutes.

There was discussion regarding the role of an SSP and the importance of an SSP regarding the safety of a DB consumer. Feedback given was that while the role is important, there was caution thrown out to about making it seem the DB consumer was over-reliant on the SSP.

For the document concerning “Considerations with a $300,00 budget”, Davis explained that if members needed more time to read and make suggestions, that was fine. They could discuss it at the next meeting.

Rowson had also shared an example of a press release the task force could read.

Rowson also shared a letter drafted by Lydia Olmsted. Davis let the group know that there is an updated version of the letter that would be shared and used on March 6 ^th.

Under Considerations for a $300K Budget, Rowson lead discussion regarding the amount of funds spent on mileage. There needs to be some way to better regulate how much and when mileage is paid. One suggestion was that a set amount could be set, like 70 miles per assignment. Anything over that, a consumer’s time can be used to cover those costs. For every 7 miles over, the consumer’s time could be reduced .25hrs (15 minutes). Rural consumers may have a different allowance if needed. She added that for travel time, the SSP earn half their rate. 

Discussion ensued regarding recruitment in rural areas. Birkhead explained her experiences with using SSPs during different times of the year and in different locations. She believes targeted recruitment strategies would improve her options with obtaining available SSPs. Martin shared her experience as an SSP of what occurred during the in-between times of training. Rowson followed up on comments regarding timing for recruitment ads happening closer to training events so individuals maintain interest.

Rowson discussed a possible 3-tier system. The first tier would be for a smaller percent of DB consumers  who are interested and able have more oversight responsibilities in their own arrangements and confirmations with SSPs. Post assignment, information can be provided to the scheduler and then the SSP can close the assignment. The second tier would be used for the majority of SSP assignments where the DB consumer schedule their own SSP and send in their request. The scheduler handles any change or cancelations prior to or after the assignment. The third tier is for individuals who send in a request and the scheduler arranges the SSP work and details included. A cancellation policy was also discussed. Jordan inquired as to the need for the Tier system, but this may be expanded on in the next meeting.

A recap of things needed for the March 6 ^th event and what would be included in that email to assist individuals in talking to their legislators.

Feedback provided may be added as appendices for the RFP.

Davis will try and have a draft of the new RFP out to TF members by the 10 ^th. TF members are encouraged to send in any other feedback between meetings.

DeafBlind Task force Meeting

September 16, 2025

12:30-4:30

Present: Amy Rowson, Mary Hale, Sarah Kurtz, Marsha Martin, Beth Jordan, Becky Davis, Amber Carter, Amy Sue Guinn

Not Present: Scott Dollar, Chip Hailey, Stephie Birkhead

Service Providers: Nicole Niles, Heidi Rich, Kendra with Access Equality

Davis reported that last month the task force asked MCDHH to address the need for training regarding the scheduling app Usked. It was recommended to have training videos for the use of the app on both computer and phone. Davis has met with DEAF, Inc. regarding other issues, but we have not discussed the training concerns. SSP representative, Sarah Kurtz mentioned that she just had her first experience with the app recently and it is transparent, not complicated at all. Davis will follow up as now DEAF, Inc. states training announcements should happen soon.

Davis made the point that DEAF, Inc. will accept appointment requests in all forms; through the app, through email and via phone calls.

The task force wanted to make sure information on the website was available to consumers. Task force names, regions, and email contact information is available.

Ms. Lydia Olmsted, author of two letters previously used while we were seeking legislation changes and an increased funding source. The draft had been shared, and comments were received which were aligned with discussion of the funding. The letter will be edited and reshared to incorporate changes and the consensus that our goal will be to go for the legislative language change, but not the funding increases due to program spending history of recent years and the current state legislative climate to decrease spending.

 The task force was very concerned about communication and training which would have direct impact on spending. DB consumers had not received the directory for SSPs available to them. Davis mentioned that when she brought this to DeLinda Brite, Ms. Brite was under the impression they had been shared and would look into this issue. The task force mentioned more people might use their hours if they knew who the SSPs were they could work with. Regarding training, Davis reported that DeLinda mentioned there have been obstacles in setting up the training and they would be making the announcement soon. The task force members voiced concerns not only about people being trained properly, but also having consumers and SSPs go through the training will effect the number of active consumers and SSPs. This, in turn, will allow for planning towards recruiting and for those on the waiting list. All affecting the spending of funds and the allocation of hours. The task force also mentioned that DEAF, Inc. might ask regarding people who consistently do not use their 40 hours, if they have any intention of doing so and maybe a more tailored approach would result in other consumers using that time.

Suggestions have been made regarding a way to cover the gap of services in June that occurs when the vendor must submit paperwork to MCDHH who has to prepare paperwork for the state. Previously a “round up” fundraiser was mentioned. Davis reported that Jordan had mentioned a lead regarding community foundations that would administer grants. This is something that would need to be handled by consumers and the vendor because when she investigated the opportunity, it was clear that counties wanted the impact to occur in their respective counties; it was unclear if they would send money out of the county even if it served individuals in the county. This may be too big of a feat to manage for a vendor.

Jordan mentioned that in the state of Ohio they received funds and one thing that heavily helped them accomplish this was including the wider disability community. Davis reported that she has a good relationship with the Governor’s Council on Disability and used to with the Developmental Disability group under Mental Health. We could certainly reach out again for their support.

Other suggestions discussed or offered by the task force was to amend the 40-hour per quarter use requirement to 80 hours per every 2 quarters. Hale feels this flexibility would result in more use of hours.

Rowson mentioned planning of funds so that if there were funds available at the end of the program, activity benefitting the next cycle could happen such as training or onboarding, etc.

Davis emphasized that the state expects the fund to be used up for activity in that fiscal year, or else we cannot justify asking for more funding.

Meeting minutes available to the public. Davis reported having worked on this and trying to find a work-around the state’s allowance to use Google Doc as a way to share minutes. The group clarified that PDF format is not always accessible to screen readers. Rowson will work with Davis when the minutes are posted to see if the format is appropriately accessible.

A recent question came up in program policy regarding ride-along passengers with DB consumers being transported by SSPs. Task force members mentioned to Davis that there were guidelines drawn up earlier in the program so that family members and guests might join the DB consumer as long as the SSP was in agreement. The task force is in agreement that extra mileage should not be incurred by the program or by the SSP and the DB consumer should always be the top priority of the SSP. Davis will look for the guidelines developed.

The group briefly touched on holding virtual meetings when addressing legislator interactions. This will be revisited.

CORRECTION:

Addition to include that the committee talked at length regarding the addition of co-navigation (CN) services. The supporting argument was that there are people within the DeafBlind community that have a preference for CN services and it is common with what is happening in the DB community. Discussion related to adding CN language was concern regarding funding being sufficient to provide that additional training as it is more extensive than our current SSP training. Changing legislative language could make our speaking points muddled to legislators. Davis recommended reviewing the language to make sure such training is not prohibited, but also not required. There was a comment to have the word “co-navigation or navigator” in the legislation, in some way. Davis will review and report back to the group.

Action Items:

____ MCDHH will clarify with Delinda about the following: the SSP directory and ensure it includes availability times, locations, communication modalities, and contact information; The closing of assignments via email by SSPs; and the announcement of who the Trainers are who were hired

_____MCDHH will send a separate email to all deaf-blind consumers and current SSPs promoting the task force members’ contact information and how to find it on the website.

_____MCDHH will explore alternative methods for uploading meeting minutes on the website that are accessible for all users, potentially using text-only formats and work with Amy Rowson

_____MCDHH will look for the Extra Passenger Guidelines mentioned by the task force

_____MCDHH will discuss with Deaf Inc their calculation process of how they determine how many people to let into the program.

_____MCDHH to consider sending an email to consumers with contact information and the targeted recruiting appendix as an attachment.

_____MCDHH will explore the possibility of creating a webpage section for deaf blind services that includes up-to-date data on program usage.

_____ MCDHH will investigate funding and steps for the SSP program especially that of grants and how they are handled.

_____ MCDHH will create a version of talking points for individuals to use when meeting with legislators including feedback and information provided by Amy Rowson.

_____MCDHH will look into adjusting the language of the bill, potentially changing it to “Deaf Blind Support Bill” and including wording that allows for both SSPs and co-navigators.

_____MCDHH will reach out to the Governor’s Council on Disability for collaboration on legislative planning.