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This document explores advocacy for systems change in the context of supporting families in the community. It discusses levels of change, advocacy over the lifespan, and the federal and local environments. It also provides an overview of the political landscape and the branches of government in the District of Columbia. Furthermore, it examines the role of the executive and legislative branches in the decision-making process, and highlights the importance of coalition building and partnership in advocacy efforts. The document concludes with key points to remember in advocacy and public policy considerations for the IDD community, including education, employment, and healthcare.
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Supporting Families Community of Practice Advocacy – Systems Change ALTA Consulting Group, Inc. Diane Lewis September 2014
Advocacy – Systems Change • “Levels of Change 3: Any change in practice, structure and rules made at the system level. These changes have an effect on many organizations, and therefore many peoples’ lives.”
Advocacy over the Life Span • Prenatal/Infancy • Early Childhood • School Age • Transition • Adulthood • Aging
The Environment – Federal • Federal • Olmstead – Discrimination under ADA • CMS – HCBS Waiver • Rules – Expansion service options • New definition – “community” settings • Ensures the person receives services in the community to the same degree of access as persons not receiving HCBS services • Person-centered service plans document the options based on a person’s need, preferences.
Environment – Local • Local • Evans – Exit – no longer defines IDD issues • DDS – Lead agency for Medicaid budget for waiver services, starting FY 2015 • Individual & Family Support Service Waiver
Environment – political landscape • DC political landscape – elections • Mayor • Council At-Large (2) • Wards – 1, 3, 5 & 6
Environment – Local-Dynamic • Political Environment is Dynamic • What interests change? • What priorities change as a result? • Political Transition = Opportunity
The District of Columbia Home Rule Act of 1973 - Charter • Executive Branch – The executive power of the District is vested in the Mayor • Legislative Branch – The legislative power granted to the District is vested in the Council (13 members). • Judicial branch – The judicial power of the District is vested in DC Court of Appeals and the Superior Court.
Executive Branch • Executive Branch – Governed by an elected Mayor who serves a 4-year term. City Administrator is appointed by the Mayor. Current structure includes Deputy Mayors who report to the City Administrator and are responsible for a defined cluster of agencies. Also, other agencies report directly to the Mayor and others are independent.
Office of Chief Financial Officer • Chief Financial Officer manages the District financial operations, including its approximately $10 Billion in annual operating and capital funds. OCFO is an independent agency.
Deputy Mayor – Health & Human Services • DDS • DHCF/DHS (eligibility – Medicaid, TANF, Food Stamps, etc.) • DBH • DOH • CFSA – Transition (exit foster care) • Office on Aging
Deputy Mayors (con’t.) • Deputy Mayor-Planning & Economic Development • DOES • DHCD/DCHA • Deputy Mayor – Education • OSSE • DCPS • DDOT
Legislative Branch-Process – DC Council-Committees • Committee of the Whole • Committee on Health • DHCF • DOH • Committee on Human Services • DDS • CFSA
Legislative Process - Committees • Committee on Education • OSSE • DCPS • Committee on Transportation and the Environment • DDOT
Legislative Process - Committees • Committee on Economic Development • DHCD • DCHA • Committee on Business, Consumer, and Regulatory Affairs • DOES
Advocacy – Level 3 • “Level 3: Any change in practice, structure and rules made at the system level. These changes have an effect on many organizations, and therefore many peoples’ lives.”
Where Does Advocacy Fit? • Budget – Establishes funding and priorities • Oversight Hearings – Agency Performance • Legislation – Establishes Framework/Mandates • Rulemaking – Implementation • Boards & Commissions
Advocacy – Systems Change • What do we want? (The Ask) • Why do we want it? • Who wants what we want? • Who is the decision-maker?
Advocacy – Systems Change • How do we reach the decision-maker? • What is the solution? • How will it be funded
How do we get to the Decision-maker? • Phone call • Letters • E-mail • Face-to-Face meeting • Don’t forget the ask?
Public Policy - Funding • Funding = Priorities • Follow the Money/Funding/Budget • If it is not funded – there is no policy
Advocacy – Coalition Building & Partnership • Who cares about your issue(s)? • Do they have a similar point of view? • What do they bring that enhances your advocacy campaign? • “No permanent friends, no permanent enemies -- only permanent issues”
Advocacy – Things to Remember • Stay the course • Focus • Do your homework • Provide decision-makers with solutions • Become a resource for decision-makers • This a Marathon not a Sprint!
Public Policy-IDD Community • Education • Early intervention • Transition • Employment – “Employment First” State • Work readiness • Work adaptation • Employer education
Public Policy- IDD, con’t. • Health • Medicaid Expansion • ACA – Private Insurance • Mental Health Parity • Support Services • HCBS – Waiver -“Community” Setting
Public Policy – con’t. • Housing • Affordable • Accessible • Workforce – Who are the caregivers? • Language Access - services/programs
Case #1: Service Eligibility • Should DDS eligibility expand/include others? • Who should be included? What impact for those not included? • How will services to “expanded population” be paid for?
Case #2: Commitment • Should commitment end? • What, if anything, should take its place? • What protections should be provided?