Deciding on the Best Way to Allocate Funds

Twice a year I have to think hard about this issue. Once, as the deadline approaches for the final budget modification, which must be submitted to DDA by the end of the 3rd quarter of the fiscal year, which is the end of March. The second time is when the annual update to the plan of care and budget has to be written.
I review how much of the budget has been spent for each item in the plan and how each of the items in the plan are benefiting V overall, compared the the time spent and the cost.
This year I am struggling with the issue of communication needs vs. physical needs. V is really making excellent progress with the speech therapy, which she receives one hour a week, and recently twice a week. The allocations for expenditures to meet her physical needs are not working out as well. The therapeutic riding lessons keep getting canceled because of various issues, and she is not receiving the benefit of nearly as many lessons in a year as I anticipated she would. So, I need to re-allocate that money to something else. In addition, the difficulties I have had finding and keeping someone to be an adapted aquatics instructor means that those funds have not been benefiting V either, and I need to get the position filled, or change the plan to re-allocate those funds as well. So, I am trying to decide if I should redirect the money to more speech therapy, since it is working so well, or to try to find another way to meet the need she has for improved balance, posture, and gross motor skills. The DDA restrictions on expenditures related to physical fitness make it more difficult to find alternatives to meet those needs for V. I have to make some decisions, justify those decisions in writing, work the numbers out, and do it soon. I shouldn't feel so much pressure to get it exactly right, as I can always submit a plan or budget modification later if I want to change things. Still, I take my responsibility to get this plan as close to meeting all of V's needs as I can very seriously. I should have a talk with the therapists and get some informed input to help me make my decision.

Services Not Covered Under New Directions

I attended a meeting for Support Brokers earlier this week to be fully informed as we approach the deadline for Annual Plan and Budget Updates for the new fiscal year.
Support Brokers were informed that DDA will be strictly enforcing the rules regarding services and supports that are not typically allowable under New Directions.
Some of the items on that list puzzle me.
Admission cost for staff to attend activities in the community with the disabled individual that they support is on the list. When a disabled individual has a monthly income of less than $700.00 from SSI, and no other source of financial support, it doesn't seem reasonable to expect that they can pay the admission cost for support staff to accompany them to the places that they want or need to go. Yet, without the support staff, V can not go anywhere. The staff transport her, speak for her, guide her and keep her safe. The community would be out of reach for V without the support of her staff. Some places allow support staff to enter for free, while charging admission only for V (which we pay for her). Other places, like the small private zoos that she enjoys walking in, will not allow free admission for support staff, so we buy season passes to keep the cost down, covering the cost for V, but receiving reimbursement for the cost of staff passes.
Included on the list of services not allowed are memberships to fitness centers, personal trainers, and nutritionists. All of these support the health of disabled people in a proactive way and prevent the health problems associated with obesity and inactivity. Cognitive and physical disabilities require specialized guidance to maintain a healthy level of physical activity. We do not use a nutritionist, but have used a fitness center to provide access to a pool year round for adapted aquatics, and V does require someone with certain expertise to support her physical fitness needs. Again, when a disabled individual receives only about $8,000 a year in income from SSI, and their family is already picking up the cost of housing, utilities, clothing, entertainment, medical copays, and food that the income can not possibly cover, how can they afford to pay for these services that support good health. If there are sufficient funds in the budget, why are these kind of supports not allowed?
Staff recruitment is now on the list of items not allowed. Since a Craigslist advertisement is $25.00, and a newspaper ad is $100.00 or more, if support staff are necessary, why could this necessary action to find staff not be covered? Agencies run advertisements in the local Gazette. I have seen the ads. I am sure that they pay for these ads from the state funds that they receive.
Maid service is not covered. I know for a fact that at least some group homes are professionally cleaned. Parents don't typically clean the living space of their adult children, and someone with a severe physical or cognitive impairment can not necessarily be expected to be able to do this for themselves. We have never used this service, but I still don't understand why it would be disallowed.
The last two examples seem to set a different standard for agencies vs those participants in New Directions, unless agencies are using funds that are not received from the state to pay for advertising and cleaning services for their offices and group homes. Do they pay for these things out of private donations? New Directions participants don't have the means to have fund-raising events the way agencies do. Whatever New Directions disallows for participants must come out of the pockets of family members.
To be fair, the list does state that consideration will be given on an individual basis if the service or support is justified as relating to the individual's disability and is habilitative in nature.

Aromatherapy to Treat Behavioral Issues?

Recently, I came across an article suggesting that certain essential oils may have an impact on certain behavioral issues that are commonly associated with ASD's. This is an excerpt from that article:

" Essential Oils and Autism

Essential oils can be effective in reducing some of the emotional and behavioral aspects of autism. Make essential oils a part of the daily routine to help keep everything balanced, calm and happy. Here are some examples:

* Peppermint essential oil is a neuro-stimulator, and helps with concentration. Use it in an aromatherapy diffuser or on cotton pads around the room.
* Neroli essential oil is known to be a very calming oil and is recommended for obsessive behaviors. Neroli is distilled from the flowers of the bitter orange tree and has a wonder full aroma. It can be added to a cream as a moisturizer, or as a perfume, but having it around will help with the obsessions.
* Roman chamomile essential oil has a calming effect and works well with hypersensitivity and aggression. It is particularly useful with in preventing tantrums and in easing transitions. Use in the bath or shower, inhale on a cotton ball or add to an aromatherapy diffuser.
* Sandalwood essential oil is another oil that can be used for obsessive and aggressive behaviors but it is also known for helping with emotional traumas. Use in an aromatherapy diffuser, bath or shower, or in a massage if tolerated. For people who are tactile defensive, add the essential oil to a cream and suggest they massage it into their own hands.


Read more at Suite101: Aromatherapy and Autism: Using Essential Oils to Reduce Symptoms of Autism http://autism-therapy.suite101.com/article.cfm/aromatherapy-and-autism#ixzz0iM4uSzoJ "

Has anyone tried this strategy and had any success with it? It seems harmless enough to try, and relatively inexpensive. I am thinking of giving it a shot and will write about any outcomes later.

No End to Learning

This morning was thrilling. Our speech therapist, Lauren, has been working each week on teaching V to use the Tech Speak voice output device to communicate by touching the pictures symbols on the device. A year ago, V thought the device was a toy and would touch random pictures to hear the words, but did not understand that it represented a way for her to talk. During speech therapy this week, she pressed the picture for "I want" and then the picture for "stickers" to form a complete sentence. Why is this a big deal? It is a big deal because, until now, V only used one word utterances,like a series of clues. She could not put two words together. Okay, it was in a speech therapy session, and that is great, by itself. But then, today, she did it again without prompting when the device was presented to her. So, she is transferring the skill of putting two words together to ask for something she wants as part of her day, instead of in a structured therapy session. For V, this is huge progress toward communicating more like the rest of us. She will be 23 years old next month. I remember, years ago, that professionals were trying to teach her this very same skill, and it didn't take. At that time, and in that situation, she was not receptive.
I look forward to continued progress and acquisition of skills for V over the many years ahead. The end of formal education for disabled individuals is an artificial boundary, just as it is for the rest of us. I believe it is important to continue to address areas of need with therapy after formal schooling ends and to make it part of any adult program. There is no deadline for learning and no point that it is too late to try for progress toward a better quality of life.