Achiezer SpecialCare: Atara Sternman

my name is Atara sternman I'm a support broker for the LD um welcome my information is over here um it's best to reach me by email I get a lot of phone calls I'm a teenager I text but I do respond uh better with emails um I'd like to dedicate the speech uh to my father Al har prman who empowered me to advocate for what I believe in when baby mosha was floating down the river parro's daughter baa reached out and pulled him from the water kazal explained that mosha was floating a great distance away be Beyond B's reach however as she stuck out her hand to try to grab him Hashem miraculously caused her hand to stretch far enough so she could retrieve the floating mosha if indeed mosha was beyond B's grassp why then did even think of reaching for him the lesson here is that no matter how impossible a task may seem it's up to us to try to do whatever we can we try to give it our best shot and Hashem can make the unreachable reachable self-direction I tend to use a lot of acronyms and I always assume people know what I'm talking about I've been told that many times so decided to have the first slide list all the acronyms I'm going to use this evening I understand a lot of them appear in your booklets the resource guides but I thought it best to present them here first opwdd and again a lot of you are familiar with them so bear with me the office for people with developmental disabilities ddro the developmental disabilities regional office there are different Regional Offices we I happen to deal primarily with the Li ddro the Long Island ddro I'm also contracted with other DD's Queens in Manhattan but my primary focus is in Long Island okay hbcs I'm sure Mark spoke about this at Great length Home and Community Based waiver Services nothing happens without waiver nothing okay MSC Medicaid service coordinator I call the MSC the Maestro the person who assists the participant with sec uring services and supports that be best meet their needs self-direction is a partnership you need a good broker you need a good msse if you don't have that good relationship it's really not going to work well what is [Music] self-direction self-direction begins with the person the guiding principle behind self-direction is that the individual with developmental disabilities should have the right to run their own life and control their money Services supports with the right assistance neurotypical children a typ a neurotypical 18-year-old getting a car running his own life we want to empower our special needs children within reason to have a sense that they can control their own lives with the right supports that's really what self-direction is about okay self-direction provides the individual and family with budgetary authority the right to controlled funding and employer Authority the ability to hire schedule train and fire people who work with them so as you can see there's a lot of control that the family has here with self-direction with control comes responsibility and I tell this to all my families self-direction is not for everybody under self-direction the individual parent is are seeking a more individualized approach to Services there's a lot of paperwork there's a lot of responsibility involved the traditional agency no longer plays a central role for example if families choose to completely self-direct and a staff member doesn't show up you don't call the agency and say send me somebody else it's your responsibility to get a backup plan how does it all begin in order pursue self-direction the following must occur choose and contact a voluntary agency to complete the intake process for eligibility for opwdd I'm sure some of you attended Mark's presentation I understand he discussed that the next step is a front door training session the front door is opwdd eligibility for services through hbcs Medicaid waiver you will get an authorization letter in the mail called the nood the notice of a decision it will have the date the effective date of services and then we can begin after that you are eligible to choose a startup broker to begin writing your plan an exception to this is people who have been who are already in the system who already are receiving waver Services they do not need to go through the front door so if your child has waiver then you approach your MSC to do a Sam a service Amendment and then you can begin the process so you're one step ahead okay how do you find a broker it's almost like looking for a sh your msse recommendation your rub contact the L ddro this is a very very important frustrating number that I suggest you all write down um or obtain a referral from a friend who has self-directed plan some of the best are when friends set each other up right so personal recommendation is usually the best way to go um there is a woman in the ddro her name is Jessica Hansen if you cannot find a broker um she an MSE she will provide you with a list the ddro the LI ddro has a complete list of every broker some Brokers are contracted in Nassau some in suffk some in Queens some in Nassau and suffk it's a very very big list they will not vouch for any Brokers they will just give you a list and it's up to you to do your due diligence okay two types of Brokers startup broker support broker very often your startup broker morphs into your support broker the startup broker is the is the person who first meets with the family gets to know them and gains an understanding of the child of the vision for the future of the supports that are needed really it's a meet and greet we start with when I go in when I meet with a family I introduce myself I get to know the child I get to know the parents I like to know what the child does on a day-to-day basis what does he do on weekends what does he he what does she do in the summer um are there other children what is the family Dynamics it's a it's a it's a meeting to sort of get your feet wet and get to know the whole family situation okay um nothing happens unless there's a lot of what's called person- centered planning and I'll go into that in the next slide not yet not yet uh person- centered planning is at the Cornerstone of self-direction getting to know the person getting to know the family some broker ERS work with families and do one or two meetings I'm a schoer and I have great families so when I meet with my clients I find it so enjoyable so I tend to do 49 meetings or a crazy amount of meetings but there are families that want one or two meetings and correspond by email if that works for you that's great there's no limit to the amount of meetings you can have with a family as a startup broker there's no requirement it's really the family has to get to know the broker has to assess if the broker gets them it's it's it there is a lot of work involved but it's it's a it's an enjoyable experience for the broker and for the family okay the support broker is the is the person that that takes over once the budget is approved so the startup broker has done his person his or her uh person entered planning has drafted the plan has written all all the supports into the plan and submits the budget to the ddro and we all join hands in prayer and we hope that it will not be rejected we hope that you know what we what we want to fund will be approved okay assuming all that works okay and this is a process and we tend to be very impatient so when I'm using the word process what I'm really trying to tell you is it takes time it's not the broker's fault I want things I have a list on my refrigerator and I love using my Sharpie and going okay this family this you know I want to get things done right now as of 10:00 a.m. this morning the ddro has told me there are 140 startup budgets that they're working on and there are two people in Albany that are hired to approve them and one of them is going on vacation next week what am I going to do that's that's how we work it's very frustrating as a broker when you have a family that you really really feel needs those services and I I try to walk a very delicate line I don't want to be too much of a nudge so I always start out with a joke and then I kind of sneak in the name of a family so how's the cone budget doing that sort of thing but the people in the ddro in in the Long Island D they want to approve it they want to get the system going but we're dealing with central office which is greatly understaffed so it is a process we as Brokers we do try the best we can now you're now your budget is approved the confetti comes down from shamayim everybody's thrilled okay what happens next the startup broker usually turns into the support broker there are individuals that I've met that only want to do the the startup part and they don't want to do the support I I like to do both to me it's almost like I want to have the whole pregnancy and get the baby at the end I don't want to just do the first part okay okay so the support broker takes over once the budget is approved and the support broker has to make sure that the family is compliant with paperwork um and the support broker has to monitor the budget to ensure it meets guidelines and the support broker has to also see if the funding is really working so when I when I get a budget approved I tell the family you know what we have money in this category money in that c category let's roll with it let's see how it works for you if you feel I underfunded a category I overfunded a category and we have money to move around I'll say Let's do an amendment I don't like to do a lot of amendments the ddro hates when you do multiple amendments because basically they the they they want to see that the family is trying to access the services and the reports that were the result of that person- centered planning that you spend a lot of time doing okay next what do you look for in a broker this is what I always tell people a creative thinker a good listener someone who is accessible very very important someone who communicates clearly and effectively and someone who is up to date with all the trainings and all current information what I should really say is everything I'm telling you is accurate as of what time is it now whatever time is now it's accurate it could change in the next 15 minutes brokerage and the stock market share a lot in common there was a lot of ups and downs and there's a lot of changes what what was approved yesterday today I got a call at 5:00 of another change that it was very very upsetting to me so I'm just going to pretend it's not going to happen um things are changing categories are changing funding limits are increased and decreased it really evolves and there's trainings as Brokers were required to attend uh I encourage you to select a broker that's really really up to to date because you don't want your broker to advocate for something put it in the budget and then the budget is rejected because well the training in February they took that category out so very very very important to have a broker that's up to dat we spoke about person- centered planning ongoing discussions with the participant the msse and others to just to get to know the person to validate the needs to actualize the vision for the future uh the group of people that come together in this meeting they're known as the circle of support these are sample topics that we discuss at meetings what makes the individual unique all of us have something unique all of us have something to contribute what are the person's likes and dislikes what's important to them what does the person do on a day-to-day basis what supports are in place are there therapists are there is there a behaviorist is there com Community habilitation through through an a traditional agency what is going on in this person's life what how do they Envision their future we we often get frustrated and as parents we worry I don't know what's going to be what's going to happen in the future start with a small Vision narrow it down it doesn't have to be a very very big Vision break it up into small chewable pieces I want my son to be able to go to sh on chabis and say say hello to someone that's my vision will it change it may it may not but that's a goal so I always encourage participants and their families to just try to think is this something that I always wanted my son or my daughter to be able to do doesn't have to be big but we as a broker I like to get a sense of where are you headed what's on your mind and very often I I was at a meeting and the father ran the meeting the son did not speak and I'm looking at this son and he has this twinkle in his eye and he's verbal but he was kind of intimidated by his father and um I'm about to get up and he says to me Rolling Stones now uh I know who the Rolling Stones are and I looked at him and I said why are you talking about the Rolling Stones and he said I want a bang so he was trying to tell me he wants to be a drummer it was such a beautiful moment the father kept saying to the son I'll talk to her I'll talk to her he said two words and out of those two words came a conversation so I did find a drumming class in Hicksville and you probably can hear the noise now cuz he's hitting and hitting he goes you know once a week to a drum class and that's his vision and the father's overjoyed and the father never even knew that that's what his son was enjoying you never know how a conversation starts but every everybody I don't care if you're completely non-verbal I have been able to look at participants they'll lnk there's all sorts of communication it doesn't have to be verbal every single individual has a vision okay circle of support a group of people who know the individual and feel they have something valuable to contribute they can be family members they can be neighbors friends I have a participant who whose school crossing guard is part of his circle of support the child likes him says hello Smiles the crossing guard is a lovely woman she comes to the meetings wonderful okay think out of the box our children affect a lot of people it doesn't have to be your rub your therapist your friend your teacher your cleaning lady your Gardener it can be anybody anybody body who has who your son or daughter has any kind of relationship with it could be the most insignificant relationship but that person may have something to share about your child that you never thought of okay circle of support meeting uh members should be invited to as many person- centered meetings as possible they may not always be able to attend some meetings I have four members attend my own selfir I self-direct my daughter's plan my circle of support is me and when my husband's not working as a physician in the hospital so I'm the circle of support sometimes my kids will be part of it sometimes my daughter's support person will be part of it not we're all busy people we can't all send out invitations I have a family she does um evites to her circle of support meetings you know no one sends invitations anymore it's always evites that's her way of doing it what whatever works for the family nothing is set in stone that's what's great about self-direction what factors determine the budget okay so I'm sure everybody's wondering how much money am I really going to get okay number one is the participant less than age 22 living at home and accessing Services through the school district remember we can never have duplication of services so a child in school think of his or her budget as starting when the day in school ends okay as such the budget for a child in school will be less than the child that is out of school okay second Factor what are the participants ddp2 scores these scores are generally done by the ddro front door liaison when assessing the needs at the time of Eligibility sometimes the scores are accurate sometimes there is a lifechanging event in the in the participants life the MSE can redo the scores and the lower the scores would signify there is greater impairment and therefore the budget will increase I'm not advocating for anything bad to happen to our children but once the scores I I had a clients who developed uh an eating disorder and the MSC redid the scores and the budget was changed okay um the MSE generally does red will redo the scores prior to requesting the Sam the service Amendment for self-direction or at any time there is a need okay fiscal intermediary the FI the fiscal intermediary is the employer of record they process the payroll they conduct criminal background checks on staff they collect time sheet and they process reimbursements for Approved individual expenses I want to stress that under self-direction all reimbursements have to meet valued outcomes you're getting 40,000 50,000 whatever the amount is with that kind of money comes responsibility people have asked me to fund creative items shall we say if it doesn't meet a goal and it doesn't empower the person and it's not in the H plan or the ISP it's going to be very very very difficult to get that item reimbursed with that said we like to keep our goals very very broad occupy free time appropriately is my favorite goal in the world I love that goal because I can get almost anything approved under that goal okay promote independent promote socialization lead a healthy lifestyle we don't want to have a goal where you know he will exercise on the second Tuesday of every month when it is sunny outside we want everything to be General we want to get a lot of things funded and the only way to get things funded is by by linking the funding to the valued outcomes and we want those valued outcomes to be very very broad okay now the FI who will send your money once you submit your sheets the FI pays your staff they do collect a fee they get a fee a monthly fee for managing the the plan they append a percentage called a fringe rate on top of the staff rate so when people are doing the math they they say well I'm supposed to have this amount of money why am I only getting you know x minus one it's because there is a cost to this and the fiscal intermediary is entitled as the employer record to collect the cost what is funded through the budget okay Staffing number one number one we all want staff without staff we want good staff self-direction doesn't work you can choose to self-direct staff or you can continue to work with your agency to maintain and secure staff you can mix and match so let's say you're with an a traditional agency and they have found you the most amazing staff and you want to keep that staff you can still work with that agency and keep your staff the alternative is to completely self-direct which means you're responsible for hiring you're responsible for training you're responsible for looking for staff staff is the most the hardest part of self-direction people ask me where do you find staff I go to weddings uh that my daughter gets invited to more weddings than I do okay I'm always put at the single girls table it's I'm very flattered um but I'm put there because of my daughter so when I'm at a table and I'm looking at the single girls I've been known to say so what are you looking for I'm not exactly always looking for a sh for them I'm looking to poach them as staff I have found staff in the in the strangest places my daughter is solving the sh crisis everyone the last five staff persons female staff have become kalas so I use that you want to get engaged come work with user guarantee two sisters just got engaged I told the mother I know the older one got engaged second I don't promise the order that I I can't promise but I can tell you it's going to happen so barem I'm losing I don't want to say losing staff and trans staff are leaving Esther to transition to another stage it's great but I'm stuck without staff problem right I work with an MSE that goes to different libraries and watches huet High School young people study and she's been known to go over to them and say so what are you studying how serious are you do you want to be staff you know we you got to segue into it kind of you know I'm not going to pretend to have a magic formula staff is very very very difficult I'm constantly constantly looking for myself for my clients but it is hard agencies very sometimes not always have a better track record with securing staff I'm the kind of person where I'm a control freak I like to be on top of everything so I want to interview I want to train I want to figure out if it's if it's a sh a lot of it you know when you hire staff it's like you're on your first date you're getting to know the person will they work and if they don't work for me you know what I know someone else you'd be great for okay I've always um hadasa Bergman my very very close friend and cooworker always says we need to have a staff fair and I really think it's great one of my ideas not only a staff fair I want local businesses to come here and I want to show them how our population has so much to contribute the whole Silicon Valley I'm convinced as autistic are on the Spectrum I'm so convinced of that okay our our kids have a lot to offer and it is so hard you feel like um you know do you want to hire my my child um he's great at stuffing envelopes he's very presentable I I'm very very proud of my daughter her name is Esther braa and I always say she is a true blessing it's how you present it but it is difficult it's difficult to find staff it's difficult to find things to do it's difficult and yet there is still a lot to benefit from self-direction another thing that's funded through the budget is support of employment I'm not going to go too much into supportive employment it's job developers job coaches as of the most recent training the ddro has revamped the whole concept of supportive employment they want you to ACC to access access VR and other supports Pathways to employment um driving classes driving lessons can be funded through the budget if you've been denied through access VR but they want you to use another program and use the budget as the pair of Last Resort for for this category for number two Iggs individual goods and services this is a federally funded category I call it the category of goodies $4,000 of camp Camp has to be in New York I want everybody to hear that loud and clear because everybody says oh but I found a camp you know it's in Pennsylvan it's in New Jersey and New Jersey is kind of a first cousin to New York so it's really in no it's not it's not in New York we'll talk about out ofate camp on in another minute or so but Camp is allowed to be a camp for special needs and I'm stressing that because with Community classes there are different rules $44,000 can buy a couple of weeks of Cam Kay it it does buy you some Camp okay it doesn't have to be you know special need it doesn't have to be a mainstream Camp it can be a special needs Camp okay camps need approval c a lot of the camps are already pre-approved um you can tell me I I will tell you that Mora Gold's backyard Camp uh you know is not approved okay Camp has to has to be Camp the ddro doesn't do Hamish there's no Hamish camps has to be a real Camp you know I've been asked about people that you know put together no no it has to be a real camp but there are plenty of camps I I know a lot of the non-jewish ones I could rattle off I know kayle's been approved I'll talk about yahad in a second do you have a specific camp in mind M are they billing as uh respit programs or as Camp don't know okay so that's something we have to find out and I'll address that there's a reason because things are funded differently okay the next category is Community classes they're non-credit bearing and they have to meet specific guidelines so it can't be matriculated a class can be a class of one we need a flyer a W9 published rates it can't be dancing with dossi on Tuesday doesn't work I need um an address I need for you know $50 a session um meets on Mondays and Tuesday days I need information and a W9 to attest to the legitimacy of the class classes have to be open to the public that's why I want to distinguish between Camp they are getting increasingly more strict with reimbursing classes my daughter goes to chocolate making CLE making soap making glass fusing art class I mean you name it I have created a whole collection of classes but I know how to do a flyer I'm on a first name basis with Staples Copy and Print okay I do yes I don't do okay that's not going to be on a slide but I think people understand I can't create something that is really going to be subject to an audit but you'd be amazed what we we've been able to get approved as classes you really would be amazed I have a young man who has a Kusa and and the family was paying a lot of money for the you know for the young man to learn I said let's do a class there's no issue of Separation at CH and state so we could do so I did Jeremy's tomur Jeremy's uh Bible study they probably thought I'm some Evangelical who cares you know and we got it fund it it's an approved class I put Jeremy's cell number I put Jeremy's address I got the W9 I wrote $50 a class meets Monday through Friday at your convenience and I got it funded and it's great the parents don't have to incur the expense and my client loves to learn on and on his level so it was a creative way to secure funding for something that was very valuable that came out of person centered planning okay it all goes back to that okay other things that come out of Iggs staff mileage the current rate is 54 cents per mile that's a ferally funded rate ferally determined rate when the individual is in the car not when your worker comes from farak to sedah Hurst I don't get paid to travel our workers should not expect to get paid for travel when your worker is physically driving the individual to a class to the gym to a personal Trader anything that meets a valued outcome his or her gu ass is reimbursed at a rate of 54 now again um I don't want to go into too many details to confuse you but if you're using agency directed if you like your agency and you don't want to leave your agency you would not be eligible for some of the things I'm talking about one of them is Staff mileage okay Staffing support somebody to help do your paperwork we could fund that at a rate of $20 an hour that's the maximum the maximum alley rate but there's no maximum to how many hours we could secure for that clinical therapies massage music art hippotherapy aquatherapy Police Athletic League love them they have recreational riding and hypnotherapy pamine these are all sorts of places horseability they do two kinds of horseback riding they do the therapy kind and the recreational kind both are funded again funded if it is in the plan if it meets valued outcomes it massage therapy it can't be written because I'm under stress no because my mother wants to kill me so I need a massage no massage therapy music therapy has to be linked to a valued outcome decreases anxiety um promotes you know social social skills link it to anything you want we can link just about anything can be linked but you can't just fund things without linking them to a valued outcome okay behaviorists that's also in a plan um for those not living in a family home because I'm focusing on young children those children that are older household items and services you get snow removal cleaning services small appliances are covered again these are not for people living in the home these are most but they're not all of what's funded through itgs okay that's again a federally funded category because the budget has from the state the budget has money from federal federal is generous state is cheap think of it that way yes is there an age that's too old to self Direction no there's no the self-direction you can start whenever you want whenever you want no uh you're not late for no one is too late for self-direction okay otps other than personal services this is a state funded category cap to $3,000 a year no amendment in the world can increase the $3,000 okay um for those under the age of 18 cell phone only the participants portion um I'm financing my daughter's Verizon uh iPhone 6 or 6s I don't know whatever so the insurance is not covered that's $11 a month and the physical phone is not covered the usage is covered if you're on a family shared plan that's in the family's name it is fine just highlight your daughter's or your son's uh phone number and that portion can be reimbursed okay so that's very very good um clothing cap to $250 a year a PES suit yff dress not much but something okay cannot again anything that I'm talking about here I cannot do an amendment for I cannot read I cannot increase the category in other words it's 3,00 and that's it I have families that we go to the launch they say here's my receipt for $250 they say okay you you just launched your plan you used it up that's how it is okay personal use Transportation anytime a family member drives the participant anywhere difference between personal use Transportation which is a state funded category as opposed to staff Transportation federal what's the difference St uh under otps transportation does not have to meet a goal went to Grandma grandma lives in Bayside 54 cents times whatever the mileage is we all use ways we all use Google Maps you don't need a receipt just a statement this is what I did end of story pretty easy to get back okay um all right staff activity fees okay I want to be talk about this and be careful about this category when uh Michelle Juliano who runs the ddro totally love her but she says to me all the time Atara I don't fund fun okay so in other words you're going to a concert going to awy concert tickets aren't so cheap okay $36 a ticket your staff person's ticket is covered your son or daughter's ticket is not so let's picture a day the worker comes to your house his hourly rate gets covered the time he drives to Brooklyn to the concert is is covered 54 cents a mile and his ticket and they want to go out to uh I don't know to get to get a bite to eat his meal meaning the staff person's meal would be covered not your child's the reason I'm stressing this is because this should also be used as a marketing tool when you are looking for staff okay but by the way you know occasionally I want I may want you to take my son out to eat I may want you to take my child to a concert you know what's covered a b c d it it's not a bad idea to kind of throw it in there okay I don't encourage my families to put a lot of money in there okay I always tell my staff please Channel your inner peanut butter and jelly don't use this at you know go out to eat with out of my daughter's budget it's expensive the the ddro has told me staff has the audacity to submit Dunkin Donuts breakfast lunch and dinner and they always bring up at the training and don't ask me why they hate reimbursing Sushi and I tell them in the five towns it's it's almost like the 11th dibra here Thou shalt have sushi every time I they bring it up they say and someone always submits receipts for sushi and I kind of cringe because my daughter loves sushi so they they're looking at this category our goal is to be way under the radar okay I my budgets fully Glock kosher mahadin whatever hasaka but I don't like to put too much money things to raise you know a red flag and I also don't want my staff to get used to just you know well your daughter said she just had to go to chosen she just needed Chinese and she needed you know the the peing duck at$ 39.95 it wasn't my fa no no doesn't work so I don't put too much money I put a reasonable amount of money $350 $400 in there again $3,000 okay so the more money I put in there the less I have for other things okay you can also get money for staff recruitment costs if you want to put in that an ad in the newspaper an ad online a lot of uh advertising is free so I don't like to put too much money if any in this category okay okay for those over AG 18 even if you live at home you can get money for utilities the bill does not have to be in your child's names how many of our kids pay the utility bills you submit the bill if you're over 18 and again sticking within that that $3,000 category you can get your water bill your electric bill National Grid PNG it is quite valuable you can get the internet the landline phone these are only again covered for those over 18 even if they live at home again keep in mind the category maxes out $3,000 the whole year okay so um a state funded category additional items funded under a self-direction budget family reimburse respit I one of my favorites one of my favorites okay for some reason the state likes the number 3,000 I don't know why family reimburse respit is a category that is capped at $3,000 where a family member can hire anyone over the age of 18 to provide respit services to their child an adult child who let's say you have an older son without special needs who's living at home that person can be considered a respit worker not a staff member staff members cannot live at home they go through a fingerprinting process I'm sure you know about this the difference between a respit work you know a neighbor you have a friend they don't have to go through any fingerprinting they're not considered staff you you and your husband want to go out you know a neighbor that has a free evening you determine the rate I need a W9 form filled out and you can get reimbursed very very valuable the latest way to use this category and this is awesome and they the DAR darl asked me tonight not to discuss it so I'm dka going to discuss it okay out ofate camp y I'm bringing up these camps because they're out of state you can now use your $33,000 to fund an outof state camp through family reimbursed resit this is unbelievable because as the kids get older the camps are not in New York even when they're younger they're not in New York and there camps are expensive and let's face it when I was growing up camp was considered a luxury it's really a necessity today what are kids going to do at home so the new way to use this money is toward the respit money is to an outof state camp there are requirements an out of you have to secure an out of state approval anytime you kind of shake things up there's more forms I love paper I love paperwork I always view it as a challenge I have gotten out of state camps approved through this process Yak has L has Nikki what is it what else only no this is for all of them anybody a five-year-old a fetus anybody anybody can do this they don't want I I have been pushing this and pushing this because I can't stand you know somebody that's deciding you know what they're saying is tar I go straight to the to the law and I'm reading this and I'm saying where does it say that it can't be done out of state and they said please please don't don't tell families don't tell so of course you know they're going to tell me not to what's the first thing I'm going to do I'm going to tell everybody because I think this is amazing it's $3,000 yahad has two week programs that are 20 what Nikki like in the mid 20 like 2500 would you say okay so you got two weeks that's unbelievable think of how as parents we we don't get a break we're we're driving our kids we're we're thinking about them we're worrying about them we're entertaining them this is this can buy you two weeks of and this you can also use for your backyard camp and this you can use for your backyard Camp correct respit money is not and thank you hadasa that respit money is not scrutinized as much because there's no Staffing you're not going through the staff process you just you know just be careful because some FIS rcil is one of them they're in udica they're a new fi to Nassau they're saying we don't like that families are using $3,000 for a summer respit program so what I do is the program that I'm thinking of starts July 29th so I submit expenses for July and then I submit the rest for August so they're not paying out the full 3,000 at once so they feel a little better but it is 100% a legal use of this money fiscal intermediaries are new to this so they're getting nervous but I have an email from central office in Albany and I shared it with you um from a woman named Megan Blitz and right away she said it's it's 100% kosher so that's that's a really really powerful uh uh new uh way to use family reimburse respit Okay so direct provider purchase Services you can buy units of dayhab for example if you want to attend two weeks of dayhab and self-direct the rest of the week you can buy some dayhab if your child is in a dayhab program and you like the dayhab program that's great if you want to mix and match and have two days of dayhab and then self-direct the rest of the week that's fine too um direct provider purchase respit units use Medicaid units to fund respit programs such as the ohhl end of summer I don't know if anyone's familiar with that the um it's a one-week program the towards the end of August um if the broker puts the units in and obviously the child has to be accepted you can um get that program you may think of it as a camp but under the budget it's not considered a camp it's considered a direct provider respit program um Camp Loyalton um is an amazing amazing program for 2 weeks it's 5,800 bucks um it's not you don't use your Camp line which is great so I have clients that are sending their kids using $4,000 to a special needs camp and then to add bang to their Buck they're using their direct provider purchase units to get another two weeks so that's several weeks of Camp one is build on one side of the budget and one is buil under another category so this is another very valuable category and again when the broker determines the budget the family has to sit down it's like families are in a candy store oh my God I want this I want that but we have to set realistic expectations and we have to itemize what is most important here because we can't go over budget we're operating with a certain amounts of money and there's a lot of great stuff here we try to get it right we try to get funded what what's most important brokerage fees are come out of the plan the support brokerage fees do the startup don't all the person centered planning before the budget is approved those aren't counting against your budget so you can have as many meetings as you want before your budget is approved it doesn't it's not taking away money from your budget a seasoned broker an experienced broker gets $40 an hour this is set by the government we don't control our rates their families I don't budget the same number of hours for every family some families just need a lot of support so I'll put in more hours some families they're paperwork junkies they say you know what I'll see you you know four times a year the broker has to conduct four person centered for a circle of support meetings excuse me per year two of them are with for the ISP ISP ISP review thank you haasa and we meet we discuss the budget we talk about staff I'm doing a circle of support meeting for one family this woman is amazing she has four staff members they always come to the meetings they'll say the child um needs more behavior therapy or you know what the community class the Ceramics class well she's kind of throwing it at the teacher so maybe we shouldn't fund that class anymore you know we meet we talk it's it it I learn a lot more it helps me do my job better and I am able to direct funding appropriately because sometimes you know you you're going out on a date and the date's going well and you got two times three times I'm married 30 years why am I talking about dating I don't know but um maybe because some of my kids are in the para um sometimes you think it's going well and it isn't going so well so we we develop a budget and the good thing about self-direction is you know we can amend we can change we can direct nothing is said in stone okay is The Bu H is the budget set in stone self der the budget is not set in stone okay so just like our neurotypical kids go through changes in their lives our our non stereotypical children do as well so there are housing subsidies for one when one moves out of the family home uh some people need uh supports a paid neighbor with a monthly support if needed a paid neighbor is someone that kind of looks in and make sure everything's okay on the person that's living outside of the home it's it's generally funded for someone that's higher functioning that doesn't need intensive support you have clients that live outside of the home that need more intensive support they um are entitled to a liveing caregiver if needed uh there's a transition stiens of $3,000 to purchase pots pans Linens nothing disposable stay away from Amazing Savings um when one sets up a new home T another um new um directive that just came down in the last training as of a week ago taxes are now reimbursed okay and that's huge sorry Nikki sorry Nikki taxes on goods and services taxes when your staff goes out to eat is um the fiscal intermediary was paying you know the meal is $20 and there's tax they were denying the tax pay the tax on the transition also yes that's this is hot off the press this is huge because $3,000 think of what you know first they were saying we'll tell your families to get tax exempt forms and I was saying my families have better things to do than run around get you know Bob's furniture and Target I know were two stores that were not charging tax but now it's across the board it's a new thing now whether or not the fiscal intermediary adopts to that I don't know I find that I I'm the kind of person that is in the first seat of the training and I'm like don't talk don't talk I want to listen so I'm always listening I'm always Jing down notes and then I go bring things up to the FI and they say to me what are you talking about just today I had an argument with an fi and I and I said to her hm no you're wrong cuz I know I know what was what just came down at the last training and she wasn't there but had she been there she would know taxes are now reimbursable and you know what why weren't they why should why were wasn't tax reimbursable another thing that one of the FIS announced we are now going to let adult children uh be resit workers in the home providing they're o over 18 but if you go to the letter of the law that was always allowed so you know the eskimos chew their food for the young right I can't stand when somebody decides to make what they perceive as torami we have to go to the letter of the law and we are very fortunate um with the Li ddro and I'm not going to speak about other DD because that's a whole other conversation they're very open and they're very accessible and they're willing to hear different perspectives and they will they you know you can submit an inquiry and you do get a response within 3 days um it's not always easy to be patient how was Queens Queens Queens will be in my next lecture okay Queens is new Long Island is at the Forefront of self-direction we have 1,400 cases which is amazing queens has about 300 queens has one person uh one person in involved in it um Long Island has six seven and they're hiring Queens is a little bit behind the aall Brooklyn Brooklyn I don't deal with I can't speak about Brooklyn is it's not worth pursuing it as much I didn't say that I didn't say it's not worth pursuing each case is it's it's very worth pursuing it just will it could even take a little bit longer because you are your broker or you or your MSC will be teaching Queens how to do it right that's that's what happened so I used to work I used to work in Manhattan and I felt like I was teaching them how to ride a bike I finally said you know what it you know it's it's hard because they don't know and some people don't want to know and the process is delayed and it's not to the fault of your broker um they have to come up to speed I have one or two cases in Queens I'm kind of microwaving them a little bit to try to speed things up but it's it's a process it's a process and farak is considered Queens you had a question if you live in Queens you can't go through the Long Island you no and if you try to claim a Long Island address you'll get in a lot of trouble yes can you self-direct be the broker for young child I you cannot you can self-direct your your child's plan you can't get paid for it huh you want reg huh absolutely it's a okay I've been told to say it's a process I love that you use the hate that word I know and now I use it what did I used to say I used to tell them I make the process do you remember okay um it's I could direct you to websites it's it's not the the focus of my discussion unfortunately okay um all right so from start to finish it takes a couple of months to secure a budget the startup budget has to First first be approved by the fiscal intermediary then it goes to the LD and then it goes to Albany it takes a lot of time but it is well worth it okay that's the last one okay I just want to say one give me some lines I have one other thing to say we are very fortunate in New York to have many options I sometimes think we don't even appreciate how lucky we are I have friends with with children with special needs in other states and there's a dir of services with options comes power um so we have to be we have to be cognizant of that we're also fortunate and I I I do believe very much in giving hakara sat to I I really feel the LI ddro Liaisons are amazing I enjoy an incredible relationship with them um built on respect humor frustration but they partner with Brokers they really want this to work so I think it's very very important to realize that in Long Island we have an incredible uh group of people that are really working hard with families to make this happen Okay um we may we always have the strength the energy and the guidance from Hashem to continue to advocate for our special Treasures thank you very much okay you some