Wednesday, July 15, 2020

Happy Developmental Disabilities Professional Day

Logo for Developmental Disabilities Professionals Day
Today is July 15th and besides being the last day for 2020 to file your federal income taxes, today is also Developmental Disabilities Professional Day.  Bet you did not know that, did you?  Started by the NAQ (National Association of QIDP), the day is meant to recognize professionals working in the field and making a difference in the lives of people with developmental disabilities. 

The day is more than just a "QIDP" day though.  This day is meant to recognize all professionals in the field.  We are talking about the psychologist, psychiatrist, nurses, directors, case managers, social workers, service coordinators, surveyors, and so many more.  There are titles from QDDP to QIDP to Medicaid Worker to Service workers all given to people working with people.   The impact these professionals make is extraordinary. 

Let's face it, we each have responsibilities.  Often the direct care staff implements the plans written by the professionals.  It may be a behavior plan to help improve social skills, or it could be a medication plan to maintain health and well being, or any other dozens of plans.  These plans come from professionals.  Though planning, observations, input from individuals, family, friends, and others, the Developmental Disabilities Professional from the Medical Doctor to the Case Manager develop plans with profound impacts on the lives of people.  The responsibility is great.  A medical procedure or medication today could extend a person's life for years.  A plan today to teach someone how to hold a job, move into the community, and even manage money could one day made the difference between dependence and independence. 

Developmental Disability Professionals put in long hours and years of work.  They often give up family time, stop eating at restaurants, leave a movie,  ballgame, or concert early all because the call comes to rise to a professional level, and serve.  Sadly, some of those professionals will never see the impact their work has accomplished.  Through changing jobs, moving people, changing programs, and simply years, what is taught or worked toward today, may not be realized until long after the professional has left the scene. 

Maybe you will never know the change you have affected, or maybe you will.  Maybe one day after your time here is finished, you will arrive in the next world.  You may be greeted by a long line of people you do not recognize, but yet something is familiar about them.  They will no longer have developmental disabilities.  They will no longer be confined to wheelchairs, braces, or other supports.  They will no longer have a diagnosis, a condition, or a problem of some other kind.   Maybe you will meet these people in that next life, and they will tell you the stories of how your work changed their lives in this world.  These will be the people free of disabilities because God will have finished the work you started here.  You are important and there can be no higher calling than to serve people. 

Wednesday, July 8, 2020

Behind the Scenes at Texas HHSC Surrogate Program

In the 1990s, Texas implemented a program to assist in decision making for individuals with intellectual disabilities known as the Surrogate Decision Making Program.   Whether you have liked the system, disliked it, or had little to do with it, the fact is the program has helped thousands of people make decisions with support for health, medical procedures, and psychotropic medications.

Over the years, the staff has come and gone in the Austin office for the Surrogate Program.  The program is currently overseen by two individuals.  Dennis Tomlinson and Marti Granger receive the request for Surrogate service from the entire state of Texas.

Dennis and Marti are responsible for the implementation of the program, according to Texas law.  This means they must gather the initial information, which includes paperwork like Certifications of Need, Data forms, notification forms, etc.  In addition to a list of standard forms from Texas, the two must also gather information about specific procedures or medications.  The information needed can include medical histories, family histories, social and psychological histories, nursing notes, psychiatric notes, or dental and medical notes.  It ultimately depends on what procedure or request is being made to the program as to what documentation will be required.

The program currently only addresses needs in an ICF/IID setting.  The areas covered are major medical treatment, major dental treatment, administration of psychoactive medications,  and the use of highly restrictive behavior procedures.  Also, the program may include the release of records to assist in obtaining consent and decisions the IDT indicates may pose a risk to individual protection and rights.

Outside of Dennis and Marti, the program depends entirely on a network of volunteers.  Volunteers attend a training - usually with Dennis or Marti - and learn the limitations under the law, the rules, and how to conduct hearings for a person from an ICF/IID program.

Perhaps the most crucial aspect of the entire program is the gathering and reviewing of the information for each person served.  Dennis and Marti must ensure that all information possible is gathered, reviewed, compiled, and distributed for a hearing.  The information, should it ever be needed, must show that the program administrators gathered all possible answers, avenues, and potential outcomes for the volunteer to use in making a decision.   The process and responsibility fall entirely to Marti and Dennis in the background.

Often providers and volunteers alike forget there is a considerable amount of work that goes on before a hearing.  Some hearings can last forty-five minutes or an hour or so, but the work that has gone into the preparation sometimes takes weeks and months to come together.  In the diligence required to ensure all aspects of a case are presented for review, Dennis and Marti have the sole responsibility.  It should be remembered that the work they do impacts the ability to make informed decisions for people.  In the area of making informed decisions, there can be no higher calling that requires so much care as ensuring the people we serve have a fair and knowledgeable hearing.  In the shadows of each hearing held, two people can be seen.  From time-to-time, those two people deserve a spotlight, and a thank you for the service they provide to the people living in ICF/IID programs.