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Maryland offers "The New Directions Waiver" as a means of self-directing state and federal Medicaid dollars for individuals who qualify for supports due to their disability.

This offers the disabled individual the opportunity to use those dollars to best meet their own unique needs. However, it comes with the responsibility to create a plan, a budget, and find your own resources to make the plan a reality.

No centralized source of resources exists. The purpose of this blog is to direct others to resources in our communities and to provide one example of a self-directed plan. (*Caution: The self-directed plan described at the beginning of this blog is for an individual with a 5/5 needs rating, the highest possible rating in Maryland, and therefore the highest budget possible. Most will have a lower rating and a lower budget to work with.) It is also to share firsthand knowledge of experiences that may assist others who self-direct services.

Comments are welcome. Please share your knowledge with others.

Friday, April 17, 2009

The Second Challenge: Safety

V's petit mal seizures and her tantrums began at the age of 3, but there were earlier physical expressions of her frustrations. As a toddler, I remember how she would try to bite the carpet or the arm of a chair. Unfortunately, she soon learned that her hand was a more convenient target for her little teeth when she was overwhelmed. Hand-biting became her go-to release, and although she didn't break the skin, she bit her hand so often that the skin on her hand became calloused from the bites. Other physical expressions of her frustration followed in later years, from scratching, pinching, biting others, hair pulling, kicking, droppping to the ground and screaming, throwing or knocking over any available item, or tearing off her own clothing. Naturally these behaviors garnered V quite a bit of attention, as they were nearly impossible to ignore. School put in place behavior management plans, with little impact.
Transportation Safety
Since tantrums could occur in moving vehicles as easily as anywhere, the school bus staff provided a safety vest for V to wear on the bus to keep her in her seat for her own safety and the safety of others. I eventually purchased one of these harnesses for use in my personal vehicle, but as long as she was sitting in the seat behind me, she could still reach me while I drove if she became agitated. I feared that one day she would cause me to have an accident while driving, and eventually this fear was addressed by the purchase of a vehicle with a 3rd passenger row where she could be safely restrained with her harness. A seat belt is not sufficient restraint because she can unhook it and doesn't know how to put it back on. It is not safe to have to keep pulling off on the side of the road to rehook the safety belt, so the type of vest that was used on the bus is much more secure. I have created a link at the top of the page to the company that makes these vests and they can be purchased by private individuals and shipped. Now that we have the 3rd passenger row of seats and use the safety vest, I feel that everyone on the road is safer when V is riding. As you can imagine, public transportation presents a challenge on many levels. First, waiting is a skill that V is still learning, and patience is not her middle name. I have not attempted to fly anywhere with V since she was 9 years old and we took our last flight.
Like other people, I purchased 2 tickets on AirTran from Dulles International to Fort Lauderdale, Florida to visit V's paternal grandparents. At the gate, she wanted to board the flight but they were not quite ready to board and she dropped to the floor and had a tantrum more typical of what you would expect of a two year old. She calmed down, but as we walked down the jetway to board the flight, the pilot came out of the plane and pulled us out of line. He proceeded to survey the other passengers in line, asking them, "Do you think these people should be allowed to fly on this plane?" One of the passengers whispered to me,"I would sue this company!"
I explained to the pilot that my daughter could not understand why she couldn't board the plane, but was perfectly happy now that she could and that we had flown many times without any danger to anyone. I also told him that we had purchased valid tickets to travel, just like everyone else in line, and that he would expose his company to a discrimination law suit if we were denied boarding. The pilot backed down and allowed us to travel, but placed us in the last row of the plane, blocking off the rows beside and in front of us, as if we were contagious. V was perfectly behaved during the entire flight, because she loves to fly and one her few words is "plane". I dreaded the return trip but called AirTran to report what had happened to get an assurance that we would not be treated the same way on our return flight. The supervisor arranged an escort for us through the airport and to our seats, and we had an uneventful return trip. However, that experience left such a bad taste in my mouth that I have never attempted to travel by air again with V since then. To say that the experience was humiliating would be an understatement. It is sad because we had traveled on standby with my former employer, Delta Air Lines, many times before and been treated very well. The only difficulty I had was that V was very sensitive to the sound of voices over an intercom, and every time the pilot or flight attendant spoke over the intercom, V would become agitated and grab on to me in a panic. But this behavior only impacted my comfort and V's, not the safety of anyone else.
...safety to be continued...