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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.

Tuesday, July 24, 2012

Assembling a Team

Yesterday a new tutor had her first session with V. I was hopeful. For the first time I did not feel that I had to  hire anyone who would take the job and I did not feel that I had to rush the decision to hire. I had many qualified applicants and I had learned from past experience with other tutors and therapists what qualities made a tutor successful or unsuccessful with V. I slowed the hiring process down this time. After reviewing the online resumes, I had a face to face meeting and had a prepared list of questions that had not been addressed in the resume. After that, I still did not make a job offer, but instead I asked the applicant to return to meet V and observe a speech therapy session to see how a successful therapist works with V, to see her capabilities and to ask questions. Only after that second meeting did I ask the applicant if she felt that the job was a good match, knowing that she now understood what to expect from V and what my expectations of her would be.

 I had learned that it is important for anyone who comes to our home to work with V to be well prepared with a variety of activities. Sometimes V will reject an activity that does not interest her, other times she will complete an activity more quickly than anticipated. It can cause an episode of agitation if a therapist or tutor continues to offer a rejected activity because they have nothing else to offer or because they want to force the issue. Knowing this from prior experience allowed me to share this knowledge with the new tutor.

I had learned that if V becomes tense, it is important to offer her a break and to give her some physical
space until she is ready to resume work. It is important to read her body language and verbal cues and respond to them to avoid triggering an episode of agitation. Again, I was able to communicate this to the new tutor.

V likes to work with someone who is cheerful, relaxed, low-key, confident and who goes with the flow. She does not like someone who talks too much, too fast or nervously. She does not like someone who is inflexible, unresponsive to her communication and body language, or someone who is unprepared. Knowing the her personality and behavioral preferences makes it easier for me to look for someone with the right personality who can connect well with her. Credentials don't matter if the specialist doesn't relate well with V, or if they just get on her nerves.

All of these things seemed to make a difference. For the first time in 4 years of self directed services, V worked a full hour, cooperatively and with no behavior incidents, in her very first session with the new tutor. This has already become the norm for her time with her speech therapist and her occupational therapist. She has learned to give an hour of her attention and energy to a specialist almost every weekday afternoon, and I have learned better hiring skills. This time I used Craigslist and I used the the local teacher's chat room on the county's school system website. I had to have a local teacher put my advertisement there for me, but it got a lot of responses.

I am thrilled with the team of specialists who are working with V now. With her cooperation, they are all able to help her make progress.