Last week on January 22nd, the Alabama Department of Mental Health Associate Commissioner for Developmental Disabilities Courtney Tarver visited Colin’s Castle. This was significant since the folks in Montgomery had been all but ignoring me for going on two years now. Mr. Tarver is new in the job, and I really appreciate the fact that early on in his tenure he decided to visit. It was significant because at least he had an open mind about the concept of Microboards, and how a Microboard operates. I appreciate his visit even though I don’t expect any sudden changes in the way we are funded. I do think, though, that something is likely to change within the next six to nine months in the way the ALDMH allows people to self-direct their services. This is essentially what we are doing now. What happens now is that all public funds which are allocated for the care of Colin are funneled through a third party provider of services which in turn pays our employees. Only problem is, they skim 37% off the top. That is a hefty profit for an organization that does no more than payroll management since we do everything else. We find our employees, we train our employees, we comply with the Nurse Delegation Program to include training, we maintain all records on site, and manage schedules. We do everything except cut the checks. What we need is to minimize the $$ that are skimmed off the top so that we can pay our employees better. All of these point I made with Mr. Tarver. I think that he listened and I am hopeful.
Going from the allocation of 31 hours of personal care to 113 hours of personal care hours takes a lot of planning. First, obtaining commitment from Perry to switch jobs and come work for us full time took a few days, then settling on the schedule for the 3 aides took some time. Then planning for contingencies and already scheduled time commitments elsewhere took time, delaying the start of Colin’s occupancy. Colin will spend about 70% of his week at Colin’s Castle, Monday through Friday. He will be picked up at our house on Monday mornings and return to our house Friday afternoon. Of course we will spend a lot of time during the day visiting him to help with his transition.
I think that we are finally good to go, and the transition will take place as of next week. We still have some loose ends to tie up like Colin’s Medication Administration Record and Plan, completion of necessary training, obtaining necessary records, compensation for the employees for expenses and transportation (which of course will not be covered by Colin’s Personal Care allocation), and how we are going to keep track of everything.
Thus far over the last three weeks Colin has stayed overnight at Colin’s Castle at least a couple of nights a week, and has seemed to do OK. The real test will be when he has to stay without Pat or I there with him. We should find out Tuesday AM how he does.
Paul has shipped Colin’s bed from Connecticut, and it should arrive mid-week. I can’t wait to see it and set it up. After it is set up I will take some photos and post on the Colin’s Castle facebook page. Paul instructs me that if it doesn’t work out to burn it (made of old barn board), but I think that it will be just fine and a unique addition to Colin’s home.
As of right now we still have to utilize the third party Oxford Health, but we will continue to push for at least self-direction of services. We have found our own staff and handle the schedule and deal with staff absences, so we are managing everything, not Oxford Health. When will Alabama Department of Mental Health come around to our way of thinking? Typical government bureaucracy.
We have cobbled Colin’s Castle’s funding together and will make it work until a better arrangement is realized.
Wish us luck!