Monday, September 24, 2007

Julia's Musings: The Lin Report

The Joint Legislative Oversight Committee for MH/DD/SA Reform will hold its first meeting since session adjournment tomorrow. On the agenda is an update on the Divisions LME Implementation Study. One of the presenters of this update is Dr. Alice Lin. Dr. Lin just completed a study of the LME’s for the Legislative Oversight Committee. Lin was also staff at the General Assembly during the passage of HB 381.

As I started reading the eighty-six page report, I kept a sharp eye on how issues facing persons with developmental disability would be addressed or, more importantly, if they would be addressed. Developmental disability issues have been having a difficult time rising to the attention of the media, let alone the legislative agenda. Thankfully, this was not the case in Dr. Lin’s work. The first mention of problems faced by people with developmental disabilities was on page five of the report. Lin states that there is an urgent need to address developmental disability issues. She acknowledges in her report the difficulties of trying to cover MH/DD/SA System Reform in one a single sweeping legislation, and she recognizes the differences between DD policy and MH policy.

A significant problem for the DD population is that most policy is written with a “recovery/rehabilitation” focus specifically aimed at the needs of persons trying to manage mental health issues. Persons with developmental disabilities require person centered, best practices, which look at the overall life development of the individual. People who have developmental or cognitive disabilities are not going to recover from them. Policy initiatives must address both the needs of the person with the disability and their family members. Legislators need to look at investing in supported employment, respite services, accessible transportation and transitional services. There needs to be a strong focus on creating community based services that permit a person with a developmental disability to live an independent, full life. MH/DD/SA service reform took the difficult step of trying to reform three different groups at the same time. We not only set out to close our state mental hospitals but we also set out to close our developmental disability centers. The transition to community based services has caused many to fall through the gaps. We need to look at a more effective ways for LME’s to handle the diverse population that they manage through provider networks. All of these issues were discussed in the Lin report. What policy will be created from this report remains to be seen.

The Arc of North Carolina, in the coming weeks, will be releasing its recommendations for positive policy initiatives that address the real needs of people with cognitive and developmental disabilities in our state.

Want more information on Lin’s recommendations for DD policy continue reading:

Here are some of the recommendations put forth by this study to address developmental disabilities issues:

-Status of Targeted Case Management
“The DD system has to comply with behavior health system in terms of units of service, and short time span for authorization and reauthorization all contribute to provider cost and paper work burden, not to mention a lack of “goodness of fit” with the tenets of DD system”.

-Status of DD Waiver
“North Carolina is under a CAP/DD waiver that probably can benefit from a reexamination. There was serious consideration for an Independence Plus waiver a few years ago, but not enough attention has been dedicated to this”.

-Interaction between state DD Centers and Community Services
“The same fragmentation experienced n the MH and SA side is also being felt on the DD side. There has not been an equal attention given to this unresolved concern”.

Edited: Changed Ms. Lin to Dr. Lin to reflect her professional title.

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