Building An Accessible Transportation Network, A Public-Private Partnership

1. Building An Accessible Transportation Network, A Public-Private Partnership Jim Wilkie – Link Associates Jon Davis – Polk County Emergency Management

2. Community-based non-profit organization • Founded in 1953 • Provides services for children & adults with intellectual disabilities. • Link Serves over 1,200 unduplicated individuals yearly • Services Provided • Supported Employment • Worksite program (mobile crew) • Developmental Center for Adults (Day Habilitation Services) • Residential (RCF-MR/HCBS/SCL) • Representative Payee Services • Respite Services • Transportation • Case Management & Service Coordination • Leisure Services

3. Mission: Providing People with Intellectual Disabilities opportunities to achieve their personal goals Vision: Consumers in the community reaching their chosen goals Values: • Dignity & Respect • We respect the dignity of each person & the person’s right to direct their life. • Quality Services • We work together as a team, consumers & staff, to provide services that support consumers in defining and achieving their needs & desires. • Caring and Supportive Environments • We provide people with living & working environments that offer consumers opportunities to work, learn, & socialize through supports provided by caring, skilled, & knowledgeable staff. • Personal Choices • We provide services reflecting individual needs and desire, recognizing the consumer’s right to risk failure in striving to achieve their personal goals.

4. Sample of Consumers served Through Second Quarter For Fiscal Year 2010 -2011 • Leisure – 272 • Respite - 63 • Residential (HCBS/SCL/RCF) – 100 • Day Habilitation – 59 • Pre Vocational – 91 • Supported Employment – 62 • Transportation (trips provided) – 44,716

5. State System • Targeted Case Management • Eligibility: Under the state Medicaid plan, case management services are available to persons with chronic mental illness, mental retardation, or a developmental disability, who are not in a Medicaid-funded institution. Children must be receiving services through the Home and Community-Based Services Waiver for Persons with Mental Retardation to be eligible. Case management services may be provided to persons with brain injuries occurring after the age of 22 only through the Brain Injury Waiver. Some agencies may serve individuals with other disabilities, but the consumer must pay the full cost of the service. • Funding:The state and the county of legal settlement share equally the non-federal share of the cost of service to adults whose case management service is not covered by the Iowa Plan for Behavioral Health (administered by Merit Behavioral Care of Iowa). In addition, Polk County may pay for case management services to individuals who are temporarily ineligible for Medicaid and for those transitioning into or out of the case management system. • Service description: Generally, all case management services include the following: Assessing service needs, including assurance that a diagnosis and evaluation is obtained for each consumer Developing, with an interdisciplinary team, an appropriate individual program plan for each consumer. Assisting the consumer in obtaining needed services. Monitoring the provision of services and the consumer’s progress. Advocating on behalf of the consumer • Specific provider agencies: Each county in Iowa directly provides or designates one or more agencies to provide case management services. Polk County has designated six different agencies as case management providers. Consumers may apply to any of the designated providers. The following chart shows the population groups each agency serves, and a description of each program follows the chart

6. PolkCounty Provider Network • Polk County service contracts require that all providers meet all applicable licensure, accreditation or certification standards; however Polk County makes serious efforts to stimulate access to more natural supports in its service provider network. Successful attainment of positive outcomes, consumer and family satisfaction, and cost effectiveness measures are the most important factors in continued network participation. PCHS has identified access points within the provider network to assist individuals or their representatives to apply • Targeted Case Management Agencies contracted by Polk County Health Services (CPC) • Link Associates • Easter Seals • Child Serve • Golden Circle • Community Support Advocates • Broadlawns Cap • Consumers may have CM outside of where they live • Funding would be approved by a different Central Point of Communication (CPC) for each county

7. Programs in Polk County fund by PCHS • Behavioral Health Resources (BHR) • Behavioral Technologies • Broadlawns Medical Center • Candeo • Child Guidance Center, a division of Orchard Place • Children & Families of Iowa • ChildServe • Christian Opportunity Center (COC) • Community Support Advocates (CSA) • Counseling & Assessment Services, P.C. • Crest • DART (Des Moines Area Regional Transit) • Easter Seal Society • Generations Inc. • Golden Circle Behavioral Health • Goodwill Industries of Central Iowa • Homestead • H.O.P.E. • Iowa foundation for Medical Care • Link Associates • Lutheran Services in Iowa • Mainstream Living • Mosaic • Primary Health Care Inc. • Progress Industries • Passageway • ResCare • Strawhacker & associates • Trans Iowa, L.C.

8. How Link Transportation Began • Needed a way to get Consumers to and from work/day programs • Contracted with Dart until 2004 • Waiver funding rules changed and Link began its own routes in 2004 • DART assisted Link in identifying and establishing the routes • Work with Polk County Health Services to gain approval and set reimbursement rate • Started with Link’s Day Hab/Pre Voc consumers first

9. Link’s Transportation Department • Link Employees 300 full and Part time staff • Transportation Department has 3 full time staff • Fleet & Facilities Director - Jim Wilkie • Fleet & Facilities Administrator – Scott Hennings • Fleet & Facilities Administrator – Linda Knapp • Drivers • 14 Drivers Permanent/Part Time (30 hours less/wk) • Work split shifts • Operate 13 Wheelchair Accessible Bus Routes • Buses hold 10-14 consumers • 13 Residential routes • Utilize Residential vehicles & staff to assist with transportation • Transport 6 consumers per vehicle Provide over 86,000 trips on a yearly basis

10. Staff Training & Qualifications • Bus drivers required to have Class “C” CDL • Background Checks • Employees Receive the following Training Classes • Agency Orientation • Rights, Responsibility & Confidentiality • Life Plans/Incident Reporting • Mandatory Reporter • CPR/First Aid • Introduction to MR/DD • Positive Behavioral Support • Universal Precautions • Respect • Transportation & Safety Training • Defensive Driving • Fish Training

11. Businesses & Providers Served • Behavioral Technologies • Candeo • ChildServe • Christian Opportunity Center (COC) • Community Support Advocates (CSA) • Crest • DART (Des Moines Area Regional Transit) • Easter Seal Society • Golden Circle Behavioral Health • Goodwill Industries of Central Iowa • Homestead • Lutheran Services in Iowa • Mainstream Living • Mosaic • Progress Industries • ResCare

12. Transportation Coordination • Case Manager issue NOD’s (notice of Decisions) after consumers & their teams choose the providers they would like to access • Fleet & Facilities Administrator looks at: • Where consumer lives • Where consumer will be going to work • Do they need to transfer to another route at Link to reach final stop • Time consumer needs to be at work & picked up • Can we meet the consumers needs • Where does the consumer fit on the existing routes • Ensure they will be on the route less than 1 ½ hours • Place on appropriate route • Do consumers on different routes need to be moved around • Contacts CM & residential provider to inform them of drivers name, cell phone number and pick up times or informs them that we can’t meet their needs at this time • Start date determined, changes made to route, drivers informed • Transportation Services Begin

13. Links Routes

14. Sampling of Link’s Fleet

15. Benefits of Link Transportation • Human Service Provider who understand the needs of the consumers served • Link’s Transportation saves the county over $900,000.00 a year • Specialized service with trained staff to work with people with Intellectual Disabilities • Reduced ride time for consumers • Reduces the carbon foot print with condensed routes • Works with consumers team to help them achieve their personal goals. Benefits consumers and Link • Service is designed as an income source/self sustaining program • Program provides reliable transportation with staff that are trained to work with people with disabilities

16. Link & Polk County EMA • How Link and Polk County EMA started • Link contacted Polk County EMA for assistance in planning and preparing for Emergencies/Disasters • Polk County EMA reviewed plans & offered suggestions • Also contacted DM Police Dept for assistance with Bomb Threats • DMPD and Polk Co. EMA invited Link to join the Polk county Multidisciplinary team • Growing the relationship • Remained in contact with AJ Mumm • Expresses Link’s desire/ability to give back as best we could as a non profit • Assisted Polk Co EMA in Vigilant Guard Exercises • Asked to attend pre planning meetings during 08’ Floods • Assisted in emergency evacuation during 2008 Floods • Finalizing Cooperative Agreement

17. Providers in Iowa • Iowa Association of Community Providers (IACP) • State association of community providers • IACP State office located at • 7025 Hickman Road; Suite 5Urbandale, IA 50322Phone: (515) 270-9495Fax: (515) 270-1035 ACP www.iowaproviders.org

18. IACP Website Home Page

19. Select More IACP link

20. Select Providers by Counties Link

21. IACP Providers by County

22. In partnership with private sector and nonprofit organizations, coordinate and promote a comprehensive, risk-based program of local emergency management activities in order to establish a disaster resilient community in Polk County. Mission Statement

23. Mission = Comprehensive

24. Emergency Management Commission

25. Response Transition Recovery • Incidents should be managed at the lowest jurisdictional level possible

26. Core Duties and Responsibilities • Administration and finance • Hazard identification, risk and capability assessments • Resource management • Planning • Direction, control, and coordination • Damage assessment • Communications and warning • Operations and procedures • Training • Exercises • Public education and information • Homeland Security* (informal) Iowa Code & Iowa Administrative Code

27. Hazard Analysis, Risk Assessment • Historical Occurrence • Probability • Vulnerability • Geographic Scope • Severity of Impact • Speed of Onset • Cascading Potential

28. Planning • PRODUCTS • Comprehensive Emergency Plan • Response/Operations • Mitigation • Recovery • Pre-Disaster Mitigation • COOP/COG • Strategic Plan • PROCESS • Agreed upon courses of action among parties with shared responsibilities. • Prevent misunderstandings • Fulfill community expectations • Satisfy legal requirements • Reduce liability • Identify shortfalls • Basis for training and exercises “In preparing for battle I have always found that plans are useless, but planning is indispensable.” – Dwight D. Eisenhower “Men often oppose a thing merely because they have had no agency in planning it, or because it may have been planned by those whom they dislike.” - Alexander Hamilton

29. Resource Management • Functions • Identify/Type • Build • Implement • Maintain • Categories/Types • Services • Equipment • Supplies • Facilities • Methods • Own • Contract • Mutual aid • EMAC/IMAC

30. Flooding Example • Planning: • No notice incident • Planned event • Evacuation Rally Point: • 3rd Ave/University • Public Health • EMS • Accessible Transportation • Law Enforcement • Shelters: • Location/identification

31. Public • CodeRED • NOAA Weather Radio • Media • Door to door Notification Response Partners EOC activation Call lists CodeRED

32. Triage Assess medical needs - Pre-incident - Due to incident Basic First Aid or transport to hospital Determine sheltering needs - Medical Shelter for acute medical conditions - Residential Care - Accessible General Population Shelters - Self sufficient

33. Transportation From Evacuation Rally Point to shelters From residence to Evacuation Rally Point or shelter Other missions ex. Showers, Disaster Recovery Center

34. Why it works… Natural partner Utilizes the ‘experts’ in the field Common goals Established trust with public

35. How to build partnership in your community Identify resources for accessible transportation Identify support staff/private partners Include them in the planning process