Department of Economic Security
Division of Developmental Disabilities

FAMILY SUPPORT ANNUAL REPORT
July 1, 2013 – June 30, 2014

DIVISION OF DEVELOPMENTAL DISABILITIES
CREDO
To support the choices of individuals with disabilities and their families by promoting and
providing within communities flexible, quality, consumer-driven services and supports.
Individuals with developmental disabilities are valued members of their communities and are
involved and participating based on their own choices.

VALUES
We Value:
1.
2.
3.
4.

Healthy relationships with people;
Individual and family priorities and choices;
Equal access to quality services and supports for all individuals and families;
Partnerships and ongoing communication with individuals, family members,
advocates, providers and community members;
5. Developmental approaches – changing conditions that affect people rather than
changing people who are affected by conditions;
6. Individual freedom from abuse, neglect and exploitation with a balance between the
right to make choices and experience life and individual safety;
7. A diverse workforce that is motivated, skilled and knowledgeable of and uses the
most effective practices known;
8. An environment rich in diversity in which each person is respected and has the
opportunity to reach their optimal potential;
9. An individual’s right to choose to participate in and contribute to all aspects of
home and community life; and
10. A system of services and supports which are:
 Responsive – timely and flexible responses to internal and external customers;
 Strength-based – recognizing people’s strengths, promoting self-reliance,
enhancing confidence and building on community assets;
 Effective – ongoing identification of effective methods and practices and
incorporation of those practices into operations; and
 Accountable – to our customers and to the taxpayers.

THE KEY TO OUR SUCCESS:
EXCEEDING THE EXPECTATIONS OF OUR CUSTOMERS

Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2013 – June 30, 2014

I.

Introduction

In 1993, Family Support Legislation was passed that defined a family support program for
people with developmental disabilities and their families, subject to funding appropriations. This
legislation was a result of collaboration with families, advocacy organizations, providers of
services and the Division of Developmental Disabilities (Division) in recognition of the
significance of family support as a national initiative. While there is no appropriated funding for
a family support program in Arizona, the Division integrates the philosophy of the legislation
into its activities as indicated in its Credo and Values. This Annual Report highlights initiatives
and systems successfully implemented, and describes the ways in which individuals and families
are supported through the Division and its many collaborators.
Family support is defined as services, supports and other assistance provided to families with
members who have a developmental disability and that are designed to:






II.

Strengthen the family’s role as a primary caregiver;
Prevent inappropriate out-of-home placement;
Maintain family unity;
Reunite families with members who have been placed out of home; and
Include respite care, assistive technology, appropriate personal assistance services, parent
training and counseling, home modifications and assistance with extraordinary expenses
associated with the needs of a person with a developmental disability.
Overview of the Division of Developmental Disabilities

The Division of Developmental Disabilities (DDD) within the Arizona Department of Economic
Security provides services and programs to 33,933 people with developmental disabilities as of
June 30, 2014. The Division believes that people can best be supported in integrated community
settings and the majority of the Division’s programs and services are tailored to meet the needs
of individuals and their families at home and in community-based settings.
The Division coordinates services and resources through central administrative offices, district
offices and local offices located in communities throughout Arizona. There are five (5) districts
statewide. They include: District Central, District East, District North, District South and District
West. These district and local offices promote the use of existing community resources and
program flexibility to meet the needs of individuals with developmental disabilities and their
families. While a few services are delivered directly by the state, most services and supports are
delivered through a network of individual and agency providers throughout Arizona.

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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2013 – June 30, 2014

Division Eligibility Criteria: To be eligible for Division services a person must have a
developmental disability that is manifested before the age of 18 and is attributable to a
cognitive/intellectual disability, cerebral palsy, epilepsy or autism. The disability must also
result in substantial functional limitations in three or more of the following areas of major life
activities:








Self-care: needing help with eating, hygiene, etc.;
Receptive and expressive language: needing help with communicating with others;
Learning: needing help with acquiring and processing new information;
Mobility: needing help with moving from place to place;
Self-direction: needing help with managing personal finances or making decisions;
Capacity for independent living: needing supervision or assistance on a daily basis; and/or
Economic self-sufficiency: not being financially independent.

Infants and toddlers under the age of three years may be eligible for services if they exhibit a
significant delay in one or more areas of development or, for children under the age of six, are
determined to be at risk of having a developmental disability without services. The following
chart shows the breakdown of eligible individuals by primary disability as of June 30, 2014:

People Served by Primary Disability
AUTISM, 6,900 , 20%

AT RISK, 7,465 , 22%

CEREBRAL PALSY,
3,186 , 9%

EPILEPSY, 1,501 , 5%

COGNITIVE
DISABILITY, 14,881 ,
44%

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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2013 – June 30, 2014

The Division supports people of all ages. The following chart shows the breakdown of eligible
individuals by age as of June 30, 2014:

Ages of People Served
55+, 1,811 , 5%
0 - 5, 6,774 , 20%

22 - 54, 10,636 ,
31%

18 - 21, 2,245 , 7%

6 - 17, 12,467 , 37%

The Division provides services through two primary funding sources: state general fund and
Medicaid.
The Division provides services to three eligibility categories or populations: DDD state funded
(DD only) members, Arizona Long Term Care System (ALTCS) members, and Targeted
Support Coordination (TSC) members.
Individuals who meet the Division’s eligibility criteria described above receive state funded
services (DD only) not to exceed the Division’s legislative budget appropriation. Children under
the age of three receive state funded services in accordance with IDEA Part C requirements. The
types of state funded services provided are listed in Section III of this report.
Individuals with developmental disabilities who qualify for services through the Division may
also be eligible for services through ALTCS. ALTCS provides long term, behavioral health, and
acute care services to individuals with developmental disabilities who are at risk of
institutionalization. Arizona Health Care Cost Containment System (AHCCCS) staff determines
eligibility for Long Term Care Services through a review of the person’s functional needs and
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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2013 – June 30, 2014

financial eligibility. AHCCCS is the Arizona Single State Medicaid Agency and oversees the
Medicaid program. In Arizona, the Medicaid program is a research and demonstration waiver
approved through the Federal Centers for Medicare and Medicaid Services (CMS), and is
intended to demonstrate that home and community-based services and a managed care approach
are more cost effective than institutionalization. Long term, behavioral health, and acute care
services are bundled to improve coordination and enhance service delivery under a single system
of support managed by the Division.
Targeted Support Coordination (TSC) is an option for people who qualify for services through
the Division and are also eligible for Medicaid acute care through AHCCCS, but are not eligible
for ALTCS. AHCCCS determines if an individual is eligible for the TSC program. This option
allows the individual/responsible person to determine the frequency and type of contact he/she
wants from the Support Coordinator. TSC provides support to the individual by assisting in
identifying community resources and helping to coordinate acute care services provided by
Medicaid. These individuals may also receive state funded services not to exceed the Division’s
legislative budget appropriation.
The following chart shows the breakdown of eligible individuals by funding source as of
June 30, 2014:

People Eligible by Funding Source
TSC, 4,207 , 13%

DD Only, 2,822 , 8%

ALTCS, 26,904 , 79%

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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2013 – June 30, 2014

The Division provides most of its services through a statewide network of profit and non-profit
agencies (Qualified Vendors) and independent providers. Services are provided based on the
person’s identified needs, state and/or federal guidelines and, when applicable, the availability of
funds. See Section VI for the number of providers.
III. Services and Supports
People receive assistance from a support coordinator (case manager) in determining eligibility,
assessing needs, and obtaining services and supports. Support coordinators:
 Gather information to help determine eligibility;
 Develop, with ideas and suggestions from the person and his/her family, an Individual
Service/Support Plan that identifies the supports and services needed;
 Assist the person and family in obtaining the needed services and supports;
 Monitor the provision and effectiveness of services; and
 Provide information about services available from other state and community agencies as
well as from private organizations.
The Arizona Long Term Care System provides funding for many services based on assessed
need. Based on the availability of state funding, the Developmental Disabilities (DD) state
funded program (DD only) offers essentially the same services as does the Arizona Long Term
Care Services program except for acute and behavioral health services. An asterisk (*) indicates
services that are available for Arizona Long Term Care members only.
 Augmentative Communication Devices (devices that help a person communicate, such as a
notebook, communication board or computer system. Each device is individualized to a
person’s specific needs and strengths).*
 Attendant Care (help with personal care and housekeeping).
 Behavioral Health (care and treatment for people with behavioral health needs such as crisis
services, evaluation and diagnosis, counseling, behavioral health rehabilitation,
transportation, respite, medication, psychiatric medication adjustment and monitoring or inpatient hospital services).*
 Day Treatment and Training (training, supervision, therapeutic activities, and support to
promote skill development in independent living, self-care, communication, and social
relationships. Services can be provided in both congregate and individual community
settings).
 Early Periodic Screening, Diagnosis and Treatment Services (EPSDT).*
 Employment Services (transition to employment, center based employment, group supported
employment and individual supported employment).
 Environmental modifications (building modifications to allow an individual to function as
independently as possible in their own home). *
 Habilitation (interventions such as habilitative therapies, special developmental skills,
behavioral intervention and sensory-motor development designed to increase the person’s
skills and functioning).
 Health Plan Services (acute care).*
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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2013 – June 30, 2014

 Homemaker (help with housekeeping).
 Home Health Aide (health maintenance, continued treatment or monitoring of a health
condition and supportive care with activities of daily living).*
 Home Health Nurse (skilled nursing services).*
 Hospice (care for individuals who are terminally ill).*
 Residential Services (see Section IV).
 Therapies (Occupational, Physical and Speech).*
 Transportation (to ALTCS covered services).*
 Respite Care (short term care and supervision to provide relief to the caregiver).*
Information about children’s services can be found in Section VII.
IV.

Residential Options

The Division provides services in a variety of living environments, the vast majority of which are
community-based. Most services are provided in the family or person’s home. Opportunities are
provided for people to choose a place to live, with necessary supports, within their communities,
such as receiving supports to live within the family home; living in one’s own home or
apartment; living in an adult developmental or child developmental home; or residing in a small
group home. When residential services are needed, the following options are available:
Individually Designed Living Arrangement – This service provides for an alternative, nonlicensed living situation for individuals to choose where and with whom he/she will live and
assume all responsibility for his/her residence. Generally, one or more individuals reside
together in a private residence that is leased or owned by the individual(s) and/or the
individual(s) representative(s). The focus of this service is to provide teaching supports
(habilitation) to individuals based on the collective need for support to eligible individuals
who have chosen to reside together and share their resources.
Adult Developmental Home – A licensed, private home contracted to provide room and
board, supervision, and teaching (habilitation) for a group of siblings or up to three adults
with developmental disabilities.
Child Developmental Home – A licensed, private home contracted to provide supervision,
teaching (habilitation) and room and board for a group of siblings or up to three children with
developmental disabilities. This includes children who have been determined (adjudicated)
dependent by the court as well as children who can benefit from temporarily living away
from home.
Group Home – A residential setting in the community for up to six people with
developmental disabilities that provides supervision, habilitation, and room and board. The
group home provides a safe and homelike atmosphere, which meets the needs of individuals
who cannot physically or functionally live independently in the community.
Rarely does a person need a more intensive residential setting.
following facilities may be accessed:

For those individuals, the

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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2013 – June 30, 2014

Nursing Facility – A Medicaid certified facility which provides residential care, supervision,
and skilled nursing services to individuals who need them on a continuous basis but who do
not require hospital care or direct daily care from a physician.
Intermediate Care Facility for Persons with Intellectual Disabilities – A facility whose
primary purpose is to provide health, habilitative and rehabilitative services to people who
require them on a continuous basis.
The following chart shows the breakdown of eligible individuals by residence as of
June 30, 2014:

People Served by Residence

INSTITUTION
0.5%
GROUP HOME
7.7%
ADULT DEV HOME
3.3%
CHILD DEV HOME
0.6%
HOME
87.8%

V.

Employment Options

The Division offers a variety of employment services. The Division works in coordination with
the Rehabilitation Services Administration/Vocational Rehabilitation Program to obtain
appropriate services and supports, and where necessary, provides supports beyond those
available through the Vocational Rehabilitation program. Based on a person’s needs and
interests, the following options are available:
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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2013 – June 30, 2014

Individual Supported Employment – This service provides job development, assistance in
matching the individual with an integrated competitive job and intensive time-limited
supports to an employed individual once placed. This time-limited service provides regular
contacts at an individual job site with the employed person and/or with the employer.
This service is intended to help the person develop the specific on-the-job skills necessary for
successful employment and may also include job search when such services are not available
through the Rehabilitation Services Administration/Vocational Rehabilitation Program.
Employment Support Aide – This service provides people with the one-to-one supports
needed for the person to remain in his/her employment. These supports could include one or
more of the following three options: personal care services, behavioral supports and/or
follow-along supports needed to maintain stable employment. The actual supports provided
will depend upon the person’s need; however, it is the Division’s expectation that this service
will primarily be used to provide on-the-job follow-along supports for people in competitive
employment.
Group Supported Employment – This group service provides people with an on-site
supervised work environment in an integrated community employment setting. People are
provided the opportunity to work in an environment that allows for maximum interaction
with other members of the workforce. People are paid in accordance with state and federal
laws by a Qualified Vendor for work performed.
Center-Based Employment – This service is provided in a Qualified Vendor owned or
operated setting where participants are to be engaged in paid work and work-related
activities. People are supported in developing the skills, abilities and behaviors that will
enable them to realize their vocational goals, including transition to a more integrated setting.
The Qualified Vendor pays people in accordance with state and federal laws for the work the
person performs.
Transition to Employment – This service is a curriculum-based service that provides a
Division member with individualized instruction, training and supports to promote skill
development for integrated and competitive employment. In addition to employment-related
skill development, the service may also assist a member in obtaining unpaid work
exploration and job shadowing experiences.

VI.

Provider Network

The Division provides most of its services through a statewide network of for-profit and nonprofit agencies (Qualified Vendors) and individual providers.
The Division contracts with agencies and professional providers through the Qualified Vendor
Application process. This is an electronic process that is open and continuous. This means the
Division accepts applications at any time.

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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2013 – June 30, 2014

In order to support choice, individuals/families have a variety of providers from which to choose.
Individuals/families can recruit someone through the local school, neighborhood, spiritual
community, family, etc. These potential providers can either work for an agency or be an
individual provider.
Individual providers receive training and must be certified prior to service provision. These
individual providers are employees of the person or family and are paid through a fiscal
intermediary. The fiscal intermediary for the Division is Public Partners Limited.
Home and Community-Based Providers
Agencies (Qualified Vendors)
Individual Providers

# of Contracts
615
1,536

VII. Services for Children
Children from birth to three (3) years of age who have a developmental delay and who are
eligible for services though Arizona Early Intervention Program (AzEIP), may also be eligible
for services through the Division and/or the Arizona Schools for the Deaf and the Blind (ASBD),
and the Arizona Long Term Care System (ALTCS). The Division works with AzEIP, which is
the lead agency for Part C of the Individuals with Disabilities Education Act, to provide services
designed to support growth and development for infants and toddlers and their families. An
Individualized Family Service Plan is developed to enhance the child’s development and the
capacity of the family. Division funded services may include special instruction, therapies,
service coordination, health services, or assistive technology devices. As of June 30, 2014, 2,651
DDD children are currently eligible for services through the Arizona Early Intervention Program.
VIII. Acute Care Health Plan Services
The Arizona Long Term Care System (ALTCS) is unique in the nation in that it has always
followed a managed care model. A managed care approach has proved cost effective over many
years in Arizona. It is also the first program of its kind to bundle acute and long term care
services under a single program contractor.
The Division currently holds contracts with three health plans to provide acute medical care
services to Arizona Long Term Care System members served by the Division residing in every
Arizona county. The health plans allow each person who is enrolled a choice of a primary care
provider. The Division’s contracted health plans are:
 United Health Care/Independent Physician Association (UHC/IPA)
 Care First
 Mercy Care
The Division also coordinates the American Indian Health Program for children and adults who
are tribal members.

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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2013 – June 30, 2014

IX.

Other Division Activities that Support Arizona’s Families

In addition to the supports and services noted above, the Division strives to provide other
supports to individuals and families. Some of these include:
 The Division’s This Is MY Life contract provides curriculum development and training to
assist individuals in learning self-determination and self-advocacy principles. Selfdetermination promotes learning all types of decision-making skills to apply in everyday life.
Project objectives included focusing on abilities, developing a self-determination community,
member-controlled provider contracts, member budget control, promoting programs that
support inclusion, and improving operating efficiencies within DDD.
 The Division’s website provides information about the Qualified Vendor program (how the
Division contracts for services), the Fiscal Intermediary program (the network of individual
providers) and how to work with providers. It includes links to Division laws, rules, policies,
and forms; and links to many of the Division’s publications such as “Navigating the System”
(a handbook for people with developmental disabilities and families), the ALTCS “Member
Handbook”, DDD “Working with You” and others. The website also has a referral feature
for people to make a referral for an eligibility determination.
 On April 1, 2014, Mercy Maricopa Integrated Care began serving Division members as the
Regional Behavioral Health Authority (RBHA) for Maricopa County. The new RBHA is
replacing Magellan Health Services who had served in that capacity for several years. Mercy
Maricopa is piloting a new service model, integrating physical and behavioral health care
under one entity; however, the DD-ALTCS members will retain their DDD contracted health
plan and receive behavioral health care from a Mercy Maricopa contractor.
 “Agency with Choice” is a new member-directed option available to ALTCS members who
reside in their own home and receive attendant care, housekeeping, and/or habilitation
(hourly). “Agency with Choice” offers members or the member’s Individual Representative
the ability to play a more active role in directing their own care. Under the new model, the
member will enter into a partnership with the provider agency where the provider will serve
as the legal employer of record and the member will act as the day-to-day managing
employer of the direct care worker. Implementation is currently underway.
 The Division supports councils and family groups. Some of these include the Developmental
Disabilities Advisory Council (a Governor appointed council that is advisory to the Assistant
Director); FACT groups (Families Actively Communicating Together – a parent-driven
group that provides support and learning opportunities); and specialized groups for Autism,
Down Syndrome and groups for families who speak Spanish. These groups are located
throughout the state.
 The Division has a Policy Review Team (PRT) that meets monthly. The PRT is responsible
for the annual policy review, policy approvals and policy clarifications. New policies or
major policy revisions are shared with the Developmental Disabilities Advisory Council.

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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2013 – June 30, 2014

 The Division provides updates to policy via an Opt In list. Families, people with disabilities
and community stakeholders submit their contact information to the DDD Policy Unit so that
they can receive email updates when there are changes to policy. There are currently over
100 individuals on the Opt In list.
 All new support coordinators complete over one hundred (100) hours of initial training upon
hire that teaches them the philosophy of the Division and provides the foundation for further
on-the-job training.
 In cooperation with the Arizona Department of Administration, leadership staff within the
Division were provided with the opportunity to complete four different leadership courses:
Real Colors, Crucial Conversations, RAPID Innovations and Project Management.
 The Division’s Office of Family and Community Resources provides support to Human
Rights Committees organized within each District across the state. These committees are
comprised of local volunteers who provide independent oversight in matters related to the
rights of people with developmental disabilities such as incidents of abuse, neglect, or
exploitation. Committees usually meet one time a month to:
 Review any incidents that may have involved neglect, abuse or denial of rights of
members receiving services.
 Review behavior programs which involve the use of behavior modifying
medications or aversive techniques.
 Review any proposed research involving members receiving services.
 Make recommendations to DDD about changes needed to protect the rights of
members receiving services.
 The Division provides support to Program Review Committees across the state. These
volunteer committees review every proposed behavior plan to make sure the plan is properly
written, includes positive strategies and does not violate people’s rights.
 The Division’s Quality Management System includes the Incident Management System
which is the automated system for incident reporting. The purpose of incident management
is to assist in promoting the health, safety and welfare of people with developmental
disabilities through active reporting, investigating, tracking and trending of incidents and the
implementation of both individual-specific and systemic corrective actions and prevention
strategies.
 The Division’s Quality Management Staff also conducts residential monitoring of roughly
900 group homes once or twice a year for compliance with programmatic standards.
 The Division’s Resolution System is an automated system used to track member, provider,
and community concerns and complaints, and to describe the resolution of the issue. This
allows for the ability to identify patterns of concern to ensure systemic identification and
resolution. During this time period, the Division responded to 821 complaints.

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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2013 – June 30, 2014

 Activities of the Office of Compliance and Review, which include Notice of Action appeals
and hearings, are also reviewed for trends and areas for improvement.
 Quality Management staff gathers information to support the Division’s credentialing process
of Qualified Vendors. Staff also coordinates the gathering of data, analysis and responses to
Quality of Care concerns. The Division holds monthly meetings to analyze a variety of data
to use in its performance improvement plan. This plan includes a description of all planned
activities/tasks for both clinical care and other covered services; targeted implementation and
completion dates for measurable objectives and activities; methodologies to accomplish goals
and objectives; and identifies staff responsible and accountable for meeting established goals
and objectives.
 The statewide Quality Management Committee prioritizes, monitors and coordinates all
organization wide quality/performance improvement activities in accordance with the quality
management plan. Its monitoring activities include utilization review data analysis, member
and provider satisfaction survey data review, quality of care concerns, performance
improvement plans, corrective action plans, etc.
 The Division, in partnership with the Early Intervention Program (AzEIP), implemented
Team-Based Early Intervention to improve service delivery for infants and toddlers. In
Team-based Early Intervention, every family has a team that works together to enhance
children’s learning and development within everyday activities. New changes that have
occurred are a centralized referral process through Raising Special Kids along with a new
data system (I-TEAMS). Early Intervention teams were selected to attend a 2-day Master
Teams Institute in July and August 2013. This institute provided teams the opportunity to
build relationships and focus on evidence- based practices. In addition, teams gained a deeper
understanding of natural learning environments, coaching and teaming practices. Statewide
training/workshops were provided throughout the year through various modalities on topics
such as referrals, eligibility, assessment and IFSP development.
X.

A Snapshot of 2014 Accomplishments

In partnership with members, families, and community stakeholders, the Division continues to
support innovations and improvements. Some achievements are as follows:
 In the annual report “Case for Inclusion 2014”, compiled by United Cerebral Palsy (UCP),
Arizona ranked first as the nation’s “Best Performing” state when it comes to key outcomes
for citizens with developmental disabilities. Arizona has been ranked first six times since the
annual survey started in 2006. The report tracks how well state Medicaid programs serve
Americans with intellectual and developmental disabilities (ID/DD).
The UCP report also recognizes Arizona as ranking number one for being a family-focused
state, where support services are provided to families who are caring for children with
disabilities in the home, which keeps families together and people with a disability living in
their communities.

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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2013 – June 30, 2014

 Creating a “Picture of Life”, a key collaboration with the Division, the University of Arizona
Sonoran Center for Excellence in Developmental Disabilities (UCEDD), and the Arizona
Developmental Disabilities Planning Council, was launched in 2012 as a statewide project to
improve outcomes for foster youth with developmental disabilities (DD). The goal of the
project is to prepare youth with DD who are about to exit foster care to exercise choice,
promote the use of informal and community supports and to make knowledgeable decisions
on community living and work. In doing so, the project intends to improve transition
outcomes for these youth, which include the following desired outcomes: a safe and stable
home, self-determination and self-advocacy, framing a vision for their future, a support
system to help with decision making, an ongoing circle of natural/informal support, and
employment exploration and opportunities. Ultimately, this model project will help to
improve services for individuals with DD exiting foster care in Arizona by offering a
mechanism for youth to exercise meaningful choice about their living arrangements, work
life, social networks and services.
 The Division is a partner in Arizona’s Aging and Disability Resource Center whose goal is to
create a coordinated system of information, assistance and access for all people seeking long
term care services. This system, known as AzLinks, includes a web site (www.azlinks.gov)
that provides links to federal, state, and other agencies, integrating resources on a variety of
relevant topics. AzLinks also has a reference manual for people who do not have access to
the internet.
 The Division continues to participate in the National Core Indicators Project, a project that
has outlined approximately one-hundred (100) individual, family, systemic, cost, and health
and safety outcomes. Surveys measure areas such as the satisfaction with supports and
services provided to people with developmental disabilities and their families. The Division
continues to show areas of strength and areas where improvement is needed. Following each
survey completion, the Division identifies strategies to improve priority areas.
 The Division participates in the Department’s Faith Based Initiative. This initiative seeks to
form cohesive partnerships with other government entities and faith based organizations to
improve access to community and government services and supports.
 The Division offered 1,039 training class sessions to its employees. There were over 7,500
combined attendees who participated in these trainings.
 The Division is in its second year of implementing Prevention and Support Training. This
course is designed for direct support providers and trains them to identify and prevent
behavioral emergencies. In situations that involve a behavioral emergency, participants are
trained in the least-restrictive responses, including emergency physical intervention
techniques. The Division offers free instructor clinics throughout the state during the year.
Last year, 48 employees from the provider community began the process to become
instructors, and 58 instructors from the previous year completed the renewal process to
continue as instructors.

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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2013 – June 30, 2014

 The Division offers free statewide Article 9: “Managing Inappropriate Behaviors” Instructor
Clinics throughout the year. Approximately 80 instructors from the provider community
completed the Instructor Certification process for Article 9.
 The Division trained over 110 participants from the provider community in the area of
behavior plan development. This training provides an overview of the components of a
behavior plan.
 With significant public and stakeholder feedback the Division amended its Qualified Vendor
Agreement (QVA), the primary method to contract for Home and Community-Based
Services. This amendment, which is effective September 1st, 2014, includes three new
services developed to meet the changing needs of our members. These services include:


Transition to Employment- A service that provides individualized instruction,
training and supports to promote skill development for integrated and competitive
employment.



Early Childhood Autism Specialized, Habilitation- A service that provides both
consultative and direct services to pre-school aged children with autism or at risk
of autism and their families; through the development, training, and
implementation of an intervention plan targeted to address the core symptoms of
autism.



Habilitation, Consultation- A service that provides for an assessment and the
development of an intervention plan designed to provide strategies for caregivers
to teach alterative behavior to improve the integration and success of members in
their homes and communities.

 Over the past year, the Division has developed and implemented a new rate setting tool for
members who reside in Independent Developmental Homes. This tool has enhanced the
Division’s ability to assess the strengths and needs of each member and provides for rates
which support members who live in these settings.
 Over the past year, DDD Business Operations worked with two consulting firms to review
and update the rates that are paid to Qualified Vendors for Home and Community-Based
Services. This process is called a “rate rebase”. The Division pays providers an adopted rate
based on the availability of funds. The rebased benchmark and adopted rates were published
in the July 1, 2014 rate book and are available on the Division’s Help for Providers Page:
https://www.azdes.gov/uploadedFiles/Developmental_Disabilities/ddd_ratebook_2014.pdf
 The Department of Economic Security commissioned the Arizona Sustainability and
Innovation Work Group, which was formed in response to the economic downturn the
country has been experiencing over the last several years. This workgroup was diverse and
composed of contracted agency providers, AHCCCS representatives, family members,
individual providers, state staff, self-advocates and others. The work group analyzed reliable
sources of information to determine how Arizona compared with other states on key
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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2013 – June 30, 2014

measures then issued a report making recommendations in a variety of areas such as home
based and residential services, employment, therapies, case management and other ideas to
explore for potential changes and innovations. The Division is working to implement some
of the recommendations from the group. Subgroups continue to meet to address ongoing
sustainability concerns.
 Over the past year, the Division has continued its efforts to prioritize integrated employment
as the primary consideration for adults of working age.


The Division continues to participate in a broadly-based statewide partnership
working toward a consistent “Employment First” approach for all individuals with
a disability. A webinar introducing the initiative was held in April, 2014 and six
(6) community forums were conducted around the state to engage stakeholders in
the discussion. To further support the effort, the Division has also partnered with
other state agencies and stakeholders who are developing the state’s first business
leadership network. “Untapped Arizona” supports businesses by connecting them
with qualified job candidates that meet their workforce needs and providing
technical assistance to support them in hiring and retaining workers with
disabilities. An Executive Director has been hired and is in the process of creating
a non-profit organization and identifying a Board of Directors that is
representative of Arizona business leaders committed to workplace diversity.



The Division continues to prioritize efforts directed toward enhancing the
successful transition of young adults with intellectual disabilities from school to
work. There is an active state level Community of Practice on Transition (CoPT)
that meets monthly and is supporting local CoPTs with training and technical
assistance. The Division co-sponsored the 13th Arizona Transition Conference,
drawing over 800 participants. The Division’s nine (9) District Employment
Specialists regularly participate in local high school transition fairs, job fairs, and
other events highlighting employment. All Division Employment staff are
members of the Arizona Department of Education’s Secondary Transition
Mentoring Project, working with local school districts on collaborative transition
planning. A new Transition to Employment qualified vendor service was recently
introduced with a focus toward teaching the “soft skills” needed by all employees
to be successful on the job.



Related to successful transition to adult life, the Division has continued its joint
project with the state’s Rehabilitation Services Administration/Vocational
Rehabilitation (VR) Program. Through a Memorandum of Understanding, the
Division provides matching funds to allow the VR program to obtain additional
federal monies and hire dedicated staff to work with Division eligible youth in the
foster care system. The project established a system of coordinated planning and
service provision for youth beginning at age fourteen (14) to better ensure their
successful transition to meaningful and sustained employment, education and
community living.

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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2013 – June 30, 2014



Additionally, the Division is broadening both internal and external awareness of
the value of employment for individuals with intellectual disabilities. The
Division began providing a new mandatory Support Coordination training
curriculum on the full array of employment services and supports available to
members through the Division. The training also outlines the Division’s
relationship with the Rehabilitation Services Administration’s Vocational
Rehabilitation Program in the provision of employment services.



The Division has generated several success stories highlighting Division members
on the job that have been featured by local newspapers and TV news and has
made employment stories a standing feature on the Division’s website and
member newsletter.



The Division revised employment service rate-setting with a goal toward
building rates that will encourage the provision of integrated, supported and
competitive employment services and supports. The Division is a co-sponsor of
the DREAM Job Fairs held in October across the state to celebrate National
Disability Employment Awareness Month. This year there will be eight (8) job
fairs throughout the state bringing together employers ready to hire and
Arizonans with disabilities ready to go to work.

 The Division is a member of the Arizona Leadership Team implementing the newly awarded
federal PROMISE (Promoting Readiness of Minors in Supplemental Security Income) grant.
Arizona, as part of a six state consortium that includes Colorado, Montana, North Dakota,
South Dakota and Utah, received one of the five (5) year federal study grants designed to fill
gaps in services, remove barriers to successful transition from high school to adult life for
young adults on SSI, and increase the self-sufficiency of these young adults. Youth 14-16
years of age who are receiving SSI benefits, and their families, will be eligible to participate
in this study. The project Arizona is part of has been titled ASPIRE (Achieving Success by
Promoting Readiness for Education and Employment) and hopes to engage over 1,000
teenagers and their families over the course of the study.
 The Division partners with Pilot Parents of Southern Arizona to provide Partners in
Policymaking. Partners in Policymaking is an innovative leadership training program that
teaches people to be community leaders, and to affect systems and policy change at the local,
state and national levels. The program is designed for individuals who have a disability and
for parents raising children with a disability. Partners provides the most current information
and education about disability policy, the legislative process, and local, state and national
issues that affect individuals with disabilities. Partners’ participants are people who are
ready to work for long term systems change and for change in public policy. The overall goal
of the program is to foster a partnership between people who need and use services for
disabilities, and those who determine public policy. Partners’ graduates gain the abilities to
teach policymakers a new way of thinking about people with disabilities.
 The Division contracts with Raising Special Kids and Pilot Parents of Southern Arizona to
provide peer counseling which provides self-help opportunities through education, training,
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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2013 – June 30, 2014

information, encouragement and support to individuals, families and other caregivers. This
service also communicates with professionals in fields such as education, healthcare, child
protection and law enforcement to increase awareness and understanding of developmental
disabilities.
 The Division’s Office of Family and Community Resources delivered 45 presentations
during this fiscal year providing outreach to 2,800 people. Attendees included stakeholders,
community partners, emergency management teams, school districts, family groups, Division
staff, various community fair attendees and health and wellness event attendees.
 The Division, along with its community partners, sponsored the Ninth Annual Direct Support
Professionals Recognition event on Friday, September 27, 2013 at the Disability
Empowerment Center. These outstanding individuals were honored for their superior service
in working with individuals with developmental disabilities. There were 12 awardees which
included ten (10) Direct Support Professionals and two (2) Direct Care Supervisors.
XI.

Conclusion

The Division is proud to be a leader in its support of individuals and families and continuously
seeks to improve its system of family and individual supports. Staff is updating the Qualified
Vendor System, including revising the service descriptions and expectations for the services.
The Division continues to engage consumers and families to provide valuable ideas on how
services should be provided. With the Developmental Disabilities Advisory Council, the
Division continues to explore new ways to receive input from people with developmental
disabilities and their families on how to improve the service delivery system. The Division
actively pursues additional employment opportunities for people with developmental disabilities.
The Division looks forward to continuing collaboration with the community, stakeholders and
other entities to provide quality supports and services in the most inclusive ways and settings.

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