Freedom. Plain and Simple.
Sandra is living her best life by partnering with others to live a self-determined life. Self-Determination is a theory of motivation which focuses on individuals having control over their lives and exercising the basic rights of citizenship, freedom, liberty, and the pursuit of happiness.
A Self-Determined life encourages choice, risk, and responsibility, and is associated with greater independence and improved quality of life.
With Sandra taking the lead, she and her Interdisciplinary Team work together to explore and achieve what’s possible. They proactively partner to develop a plan that encourages dignity, choice and connections, focusing on Sandra’s independence and community involvement.
Sandra uses Self-Directed Supports (SDS) as one option to support living a self-determined life, where:
- Sandra decides who she wants to provide her services and supports.
- Sandra controls how her budget is used for services.
- Sandra is the boss of her caregivers and services; she hires, trains, supervises, and fires
her direct care workers.
What does this look like?
What better way, than to hear from the people living it?
(Sandra) “I do self-directed supports because I’ve had agencies before and they just don’t really fit with what you need. […] So, when they started the self-directed supports program I tried it, and I’ve never gone back.
“My sister who had helped me for several years was burnt out and she just couldn’t [anymore]. She said, “I just can’t. I’m sorry.” and I came home and I was really struggling […].”
(Sandra’s Self-Directed Support Employee) “When Sandra and I were introduced the [Community Resource Coordinator] called me and asked me if I would be willing to interview with [Sandra] and told me what some of her needs were and I said yes. And so, we set up a time, and we interviewed each other; so she asks me questions and then I ask her questions. And then we you know, I’ll tell her what I will and what I do and what I don’t want to do and she’s talking about what her needs are and we you know, decide on how many hours with the [Interdisciplinary Team] what the salary is going to be and you come to all the terms and agreements and then you get hired on. You get to really be part of these peoples’ lives and touch them not just in the medical area but in their personal, psychological and their well-being.”
“Even though some things Sandra can’t do totally, she can still do part of it. And like I said earlier, I’m kind of like her extended hands and feet. So, when we make a meal for her and her husband, she does as much prep as she possibly can and then I do the parts that she can’t do. So, she still has a big role to play in what we do. Not just in the kitchen, but when we do wound care, she tells me you know, if she’s got something new or if she has questions, I can answer. So, she is totally involved in her care and we discuss how she wants things done in every aspect. What shampoo she wants, what ointments she wants, what medications she wants to use – so she runs the show! She gets to decide how she wants to be taken care of, what she wants done and how she wants it done.”
So how does this really all happen?
Well, with the assistance of fiscal agencies. Fiscal agencies help members to easily hire, and employ, caregivers legally by handling the required employer and employee paperwork. This may include time tracking, payroll, tax filing, and insurance concerns. Payments to caregivers are made through the fiscal agency.
(Sandra’s Self-Directed Support Employee) “We submit a timesheet and they send back a paycheck. The fiscal agency takes care of the timecards, writing out the checks, taking out the proper taxes, and I do believe that since there’s so many of us now, I do believe that there’s workers comp available […]. I know a lot of people think we work for the [fiscal agent] but it’s totally separate so they just, they do the checking part and the taxes, which is really nice.”
(Sandra) “Yes, they have been very helpful that way. And they always send me an email telling me, because I email that time sheet to them and they always send me an email making sure I know that they got it. If you have a question, they’re right there. They’re answering and helping.”
*Names are changed to protect identity.
If you are interested in learning more about Self-Directed Supports within Inclusa or becoming a self-directed employee, please contact us to learn more.
Inclusa Received the following message and is sharing, on behalf of DHS:
Attn: Nurse Aide Training Programs
Update for Emergency Nurse Aide Training Programs Due to End of Public Health Emergency
As of May 11, 2020, the public health emergency ended and Emergency Order #21 is no longer in effect; therefore, the Department has established a waiver request process to allow entities and facilities to continue to hire and train caregivers through the Emergency Nurse Aide Training Programs.
DHS is actively working to promulgate an emergency rule. Until the emergency rule is promulgated, both approved and temporary Emergency Nurse Aide Training Programs may request a waiver to allow the provider to continue to hire and train nurse aides to work in their facility.
- The request should include the name of the facility and a request for a waiver of “all applicable regulations to allow for the continuation of the Emergency Nurse Aide Training Program.” It is not necessary to include specific regulatory references in your request.
- Please send your waiver request via email to Nurse Aide Training and Testing.
We are able to accept students via the survey who were hired and started training while the emergency order was in effect. Therefore, currently approved Emergency Nurse Aide Training Programs may continue to train students who began their training on or before May 18, 2020, without a waiver. Temporary nurse aides who have completed an Emergency Nurse Aide Training Program may also continue to work at this time.
The Division of Quality Assurance (DQA) will schedule a webinar to provide additional information as needed. The date and time of the webinar will be communicated via this listserv messaging. Thank you for your continued efforts to train much-needed nurse aides during this time.
If you have any questions about this information, please email Nurse Aide Training and Testing
Internet and Communications Resources Available to Support Increased Needs during Safer at Home and COVID-19
DHS has provided Inclusa with the following guidance around internet and communication resources available during the COVID19 Public Health Emergency. This includes information on obtaining and replacing phones for members and cellphone minutes.
If you require assistance to follow up with any of these directions, please contact your Inclusa Community Resource Coordinator or Health and Wellness Coordinator – they will be glad to help! If you don’t have their phone number, please call Inclusa’s toll free number at 1-877-622-6700 or TTY 711 for assistance. You can also contact us on via our website here: https://www.inclusa.org/about/contact-us/
Question: Are resources available to help get telephone service?
Answer: The Lifeline program offers discounts on phone service, including no-cost cell phone plans. The Wisconsin Public Service Commission (PSC) administers the program in Wisconsin. Information about Lifeline is available at: https://psc.wi.gov/Pages/Programs/LifeLineLinkup.aspx.
Residents are directed to contact a telephone service provider to apply. The list of providers that offer lifeline service can be found at https://psc.wi.gov/Documents/USF/lifelineContacts.pdf.
Question: I had a Lifeline phone at one time, but it has been lost/stolen/damaged. How do I report this and get a new phone?
Answer: The federal rules require the providers of the “free phone” (prepaid, wireless Lifeline) to de-enroll a customer if they have not used their phone for 30 days or more. Contact the Commission’s Consumer Affairs line. They can check on enrollment and contact the carrier on your behalf.
- The Commission Consumer Affairs phone number is (800) 225-7729 or (608) 266-2001. The line is open Monday through Friday, from 7:45 a.m. and 4:30 p.m.
- The Consumer Affairs team will call an interpreter if a customer needs assistance in a different language.
Question: How many free minutes a month should Lifeline customers receive?
Answer: As of December 2019, Lifeline phone carriers were required to provide a minimum of 1000 free minutes per month to Lifeline customers.
If the you do not receive 1000 minutes, let your CRC or HWC know right away and they will assist you.
Inclusa continues to follow the guidance of the federal Centers for Disease Control and Prevention (CDC) and the Wisconsin Department of Health Services (DHS), alongside local public health agencies across Wisconsin. Providers licensed by the State of Wisconsin should continue to watch for operations guidance in relation to COVID-19 from the Wisconsin Department of Health Services (DHS) Division of Quality Assurance (DQA).
The DHS and CDC websites are updated regularly as circumstances are changing and evolving. Also be sure to connect with your local health department, the first line of contact for situations that impact your community’s health.
In addition, the following are the most recent memos issued by DHS:
- Department of Health Services (DHS) | REVISED Recommendations for Long-Term Care and Assisted Living Facilities
- Department of Health Services (DHS) | AFH Guidelines – Letter
- Department of Health Services (DHS) | Adult Day Services Guidelines – Letter