DIVISION OF DEVELOPMENTAL DISABILITIES

FAMILY SUPPORT ANNUAL REPORT

July 1, 2014 – June 30, 2015

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 MEMBERS

Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2014 – June 30, 2015

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 or DDD) 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:
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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 within the Arizona Department of Economic
Security provides services and programs to 35,378 people with developmental disabilities as of
June 30, 2015. 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.
Division Eligibility Criteria: To qualify for supports and services through the Division, an
individual must:
1. Voluntarily apply;
2. Be an Arizona resident and lawfully in the United States;
3. Have been diagnosed with autism, cerebral palsy, epilepsy, or a cognitive/intellectual
disability which was manifested before the age of eighteen and is likely to continue
indefinitely; and
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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2014 – June 30, 2015

4. Have substantial function limitations in three or more of the following life areas that are
directly attributable to the qualifying diagnosis:
a.
b.
c.
d.

Self-care: Needing help with eating, hygiene, dressing, using the bathroom, etc.
Receptive and expressive language: Communicating with others.
Learning: Acquiring and processing new information.
Mobility: The skill necessary to move safely and efficiently from one location to
another within the person’s home, neighborhood, and community.
e. Self-direction: Managing personal finances, protecting self-interest or making
independent decisions which may affect your well-being.
f. Capacity for independent living: Needing supervision or assistance on a daily
basis.
g. Economic self-sufficiency: Being financially independent.
Children under the age of six may be eligible for services when they are determined to be at risk
for a developmental disability if services and supports are not provided.
The following chart shows the breakdown of eligible individuals by primary disability as of June
30, 2015:

The Division supports people of all ages. The following chart shows the breakdown of eligible
individuals by age as of June 30, 2015:
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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2014 – June 30, 2015

Ages of People Served
55+, 1,926 , 5%
0 - 5, 6,819 , 19%

22 - 54, 11,141 ,
32%

6 - 17, 13,146 , 37%
18 - 21, 2,346 , 7%

The Division provides services through two primary funding sources: state general fund and
Medicaid.
The Division provides services to three eligibility categories or populations: (1) state-only
funded members, (2) Arizona Long Term Care System (ALTCS) members, and (3) Targeted
Support Coordination (TSC) members.
Individuals who meet the Division’s eligibility criteria described above receive state-funded
services not to exceed the Division’s legislative budget appropriation. Children under the age of
three receive state-funded services in accordance with the Individuals with Disabilities Education
Act (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 care services,
behavioral health services, 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 ALTCS through a review of the person’s functional
needs and 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
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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2014 – June 30, 2015

care approach are more cost effective than institutionalization. Long-term care, 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, 2015:

People Eligible by Funding Source
TSC, 4,286 , 12%

NON-ALTCS, 2,885 ,
8%

ALTCS, 28,207 , 80%

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.
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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2014 – June 30, 2015

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:
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

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.

ALTCS provides funding for many services based on assessed need. Based on the availability of
State funding, the Division’s State-only funded program offers essentially the same services as
does ALTCS except for acute and behavioral health services. An asterisk (*) indicates services
that are available for ALTCS members only.
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

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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
in-patient 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).*
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).
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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2014 – June 30, 2015


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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,
non-licensed 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

Assisted Living Facilities (ALFs) – For ALTCS-eligible members who are physically or
functionally unable to live in their own home, but do not need the care intensity of a nursing
facility. The ALTCS member is usually 60 years old or older. The Assisted Living services
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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2014 – June 30, 2015

are classified according to the number of residents allowed to reside in the facility.
Classifications are as follows:
o Assisted Living Center (ALC) – The facility provides resident rooms or residential
units and services to 11 or more residents. Members residing in an ALC must be
provided the choice of single occupancy.
o Assisted Living Home (ALH) – The facility provides resident rooms and services to
ten or fewer residents.



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, 2015:

People Served by Residence

INSTITUTION
0.5%
GROUP HOME
7.7%
ADULT DEV HOME
3.2%
CHILD DEV HOME
0.6%
HOME
88.0%

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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2014 – June 30, 2015

V.

Employment Options

The Division offers a variety of employment services. The Division works in coordination with
the Rehabilitation Services Administration/Vocational Rehabilitation (VR) Program to obtain
appropriate services and supports, and where necessary, provides supports beyond those
available through VR. Based on a person’s needs and interests, the following options are
available:


Individual Supported Employment – This service provides Job Coaching and/or Job
Search for Division members. Job Coaching is a time-limited service that provides
regular contacts with the employed person and/or with their employer. This service is
intended to help the person develop the specific on-the-job skills necessary for successful
employment. Job search may be provided when it is not available through VR. Job
Search includes job development and assistance in matching the individual with a
community integrated competitive job.



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 with little or no interaction with the general community. 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 employmentrelated skill development, the service may also assist a member in obtaining unpaid work
exploration such as a volunteer job and job shadowing experiences.

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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2014 – June 30, 2015

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.
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 Partnership Limited (PPL).
Home and Community-Based Providers
Agencies (Qualified Vendors)
Individual Providers

# of Contracts
564
1,687

VII. Services for Children
Children from birth to three 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 ALTCS. The Division works with AzEIP, which is the lead agency for IDEA Part C, to
provide services designed to support parents and other caregivers to increase their child’s
engagement and participation in everyday routines and activities. An Individualized Family
Service Plan (IFSP) is developed to enhance the child’s development and the capacity of the
family. AzEIP providers utilize teaming, coaching and natural learning opportunities to support
families. Division funded services may include special instruction, therapies, service
coordination, health services, or assistive technology devices. As of June 30, 2015, 2,637 DDD
children are currently eligible for services through AzEIP.
VIII. Acute Care Health Plan Services
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 ALTCS 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:
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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2014 – June 30, 2015


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United Health Care Community Plan
Care 1st
Mercy Care

The Division also collaborates with the American Indian Health Program (AIHP) for children
and adults who are tribal members.
Other Division Activities that Support Arizona’s Families

IX.

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 contracts with Arizona Bridge to Independent Living
(ABIL) and DIRECT provide curriculum development and training to assist individuals
in learning self-determination and self-advocacy principles. Self-determination promotes
learning all types of decision-making skills to apply in everyday life. Project objectives
included focusing on abilities, developing a self-determination community, membercontrolled 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 (MMIC) began serving Division
members as the Regional Behavioral Health Authority (RBHA) for Maricopa County.
The new RBHA replaced Magellan Health Services who had served in that capacity for
several years. MMIC 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 MMIC
contractor.



In an ongoing effort to streamline efforts for addressing member complaints, the
Division’s Behavioral Health Unit obtained permission for the Division’s District
Behavioral Health Specialists to have access to the Division’s Resolution System. This
access allows the District Behavioral Health Specialists to address behavioral health
related complaints or those involving behavioral aspects which might warrant their
expertise. Maintaining resolution at the district level where personnel know the member
and family best allows the Division’s District Behavioral Health Specialists to apply their
knowledge of the behavioral health system and lend their technical assistance to Support
Coordination staff in resolving these complaints in a timely manner.
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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2014 – June 30, 2015



The Division hired its first Board Certified Behavior Analyst (BCBA) as part of its
Behavioral Health Unit. The addition of a BCBA will provide the Division with the
ability to provide technical assistance to Division personnel, Qualified Vendors and
members/families who receive home and community-based services in the areas of best
practices which may include behavior treatment modalities specific in the treatment of
persons with developmental disabilities and behavioral health conditions.



Cenpatico’s LifeShare Pathways Initiative has been a partnership between the Division
and the RBHA in which case file reviews are being conducted for 500 mutually-served
members affected by a developmental disability and a serious mental illness or general
mental health condition. Education and outreach to stakeholders has outlined “a whole
person approach to long-term care” in which “LifeShare’s Integrated Care Model is
designed to eliminate the silos that exist within the service delivery system through the
bridging of network providers, defining quality outcome measures, and maximizing
technology to reduce costs and improve communication.” As of the end of June 2015,
388 member files have been reviewed and data noted for planning purposes.



“Agency with Choice” is a 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
this 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-today managing employer of the direct care worker.



The Division supports councils and family groups. Some of these include the
Developmental Disabilities Advisory Council or DDAC (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 DDAC.



The Division provides updates to policy via an Opt In list. Families, members 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 100 hours of initial training upon hire that
teaches them the philosophy of the Division and provides the foundation for further onthe-job training.
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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2014 – June 30, 2015



The Division’s Office of Family and Community Resources provides support to Human
Rights Committees (HRCs) 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:
o Review any incidents that may have involved neglect, abuse or denial of rights of
members receiving services.
o Review behavior programs which involve the use of behavior modifying
medications or aversive techniques.
o Review any proposed research involving members receiving services.
o Make recommendations to DDD about changes needed to protect the rights of
members receiving services.



The Division provides support to Program Review Committees (PRCs) 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
(IMS) 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
approximately 900 group homes each 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 578
complaints.



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.
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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2014 – June 30, 2015

X.



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 AzEIP, uses a Team-Based approach to support
families receiving Early Intervention services for their children. In Team-Based Early
Intervention, every family has a team that works together to enhance children’s learning
and development within everyday activities. Early Intervention teams were selected to
attend a two-day Master Teams Institute in September and October 2014. This institute
provided teams the opportunity to build relationships and focus on evidence-based
practices. Teams also gained a deeper understanding of natural learning environments,
coaching and teaming practices. In addition to the two-day Master Teams Institute, the
first Master Coach Institute was held in October 2015. For individuals that completed the
Master Teams Institute, this one-day Master Coach Institute provided them the
opportunity to shine as leaders and further infuse the Team-Based Early Intervention
Services approach into every aspect of the program.
A Snapshot of 2015 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 “The Case for Inclusion 2015”, 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 seven
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.
 The Arizona Department of Housing (ADOH) announced that their joint competitive
application for the Section 811 Project Rental Assistance program (PRA) was approved and
will be operated by the Division. The Section 811 PRA program enables persons with
disabilities who are income-eligible to live in integrated, affordable housing.
The U.S. Department of Housing and Urban Development awarded over $150,000,000 in
rental assistance to 25 State Housing Agencies. Arizona received $2,950,000 of those funds
for the Section 811 PRA program.
The ADOH and DDD will provide permanent affordable rental housing and needed support
services to 54 households. The ADOH will identify the apartment complexes which will be
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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2014 – June 30, 2015

approximately four or five. There will be a limit to the number of eligible members in a
complex and they must be dispersed, not segregated, in one area. No more that 25 percent of
the total available units in any given complex may be used for this program.
The Division is establishing a team that will work collaboratively with the ADOH to
implement all of the details, requirements, timeframes, etc. It is anticipated that referrals will
begin to be accepted in the next one to two years.
 The Division completed a pilot study of the Supports Intensity Scale (SIS) utilizing a sample
of 500 individuals living in group homes or individually designed living arrangements
(IDLA). Assessments were started in late September 2014 and were concluded by March
2015. The Division is reviewing the results to determine the next steps.
 Arizona has participated for over a decade in the Residential Information Systems Project
(RISP) and the Supporting Individuals and Families Information Systems Project (FISP).
This is done in collaboration with the University of Minnesota’s Institute on Community
Integration and the National Association of State Directors of Developmental Disabilities
Services (NASDDDS). Arizona has 86 percent of persons with intellectual/developmental
disabilities living in their family home. The next closest state was South Carolina which has
71 percent living in their family home. The national aim is 90 percent and the Division is
committed to assisting our members in exceeding this goal
 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. The goal of the project is
to prepare those youth 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, selfdetermination 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 developmental disabilities 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 continues to participate in the National Core Indicators Project, a project that
has outlined approximately 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 offered 1,084 training class sessions to its employees. There were over 7,800
combined attendees who participated in these trainings.
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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2014 – June 30, 2015

 The Division offers free statewide Article 9: “Managing Inappropriate Behaviors” Instructor
Clinics throughout the year. 142 instructors from the provider community completed the
Instructor Certification process for Article 9.
 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.
 The DES commissioned the Arizona Sustainability and Innovation Workgroup a few years
ago to analyze reliable sources of information to determine how Arizona compared with
other states on key measures. The Workgroup 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 hold a leadership role as Chairperson of the broadly-based
statewide partnership working on a statewide “Employment First” Strategic Plan to
improve integrated and competitive outcomes for all individuals with a disability.
The Planning Committee has met regularly since January 2014 and has completed a
final draft of its statewide Plan. A webinar introducing the Plan’s key directions and
actions was held in April, 2015 and final stakeholder comments are being
incorporated for publication as final in August 2015. The Division was selected to
present an overview of its Employment First initiative at the 2015 National APSE
(Association of People Supporting Employment First) Conference in June 2014. 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 has continued its membership in the national State Employment
Leadership Network (SELN). The SELN is a network of State Developmental
Disability Agencies committed to improving integrated employment outcomes for
their program members. The Division participates in monthly webinars held with all
state members on a variety of issues that impact the ongoing work of state agencies
on behalf of their membership. Just a few of the issues addressed include national
Employment First initiatives, recent Department of Justice enforcement and related
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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2014 – June 30, 2015

settlement actions related to integration of services, CMS rules affecting waiver
services for eligible Medicaid service recipients, the new Workforce Innovation and
Opportunity Act (WIOA) requirements impacting state DDD agencies and other
stakeholders with reciprocal responsibilities and services, and family involvement
that is so critical in supporting their family members’ successful employment
outcomes. The Division is a standing member of the SELN Data Committee
benefitting from best and promising practice of other states as it considers
enhancements to its own processes.


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 14th Arizona Transition Conference, drawing over 800 participants.
The Division regularly presents at the Conference and has been consistently asked to
present a session that features Division members telling their own stories of
successful employment.



The Division’s nine 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. Division leadership likewise collaborated with the
Arizona Department of Education/Exceptional Student Services program in the
development of key goals and actions for their annual state plan. This collaboration is
intended to likewise enhance students’ successful transition from school to
employment.



A new Transition to Employment Qualified Vendor service was 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 VR. 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 14 to better ensure their successful transition to meaningful
and sustained employment, education and community living.



Additionally, the Division is broadening internal 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 VR in the
provision of employment services. In addition to this full day training, a new
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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2014 – June 30, 2015

computer based training curriculum is being finalized. It will be available for new
support coordination staff, including supervisors. It will be available for Support
Coordination staff, including supervisors, to take soon after hire and provide a short
overview of the Division’s employment services as a precursor to the day-long
training.


The Division implemented 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. These events,
held throughout the state, bring 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 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-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 plans 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,
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.

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Department of Economic Security, Division of Developmental Disabilities
Family Support Annual Report, July 1, 2014 – June 30, 2015

 The Division’s Office of Family and Community Resources delivered 33 presentations
during this fiscal year providing outreach to 2,140 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 Eleventh Annual Direct
Support Professionals Recognition event on Friday, September 26, 2014 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 Direct Support Professionals and two Direct Care Supervisors.
XI.

Conclusion

The Division is honored by its continued ranking as the best performing state in the U.S. for
individuals with intellectual and developmental disabilities as ranked by the UCP’s Case for
Inclusion 2015. The Division is committed to ensuring that those served can fully realize the
desired opportunities, quality of life and community participation they desire.
The Division recognizes that work remains to be done and is actively engaged in employment
efforts to promote productivity and employment opportunities. The Division is a partner and a
leader in those efforts.
Strategic Planning efforts are underway to produce goals and objectives that will guide the
Division’s work over the next five years. With the Developmental Disabilities Advisory Council,
the Division continues to explore new ways to receive input from people with developmental
disabilities and their families and staff on how to improve and enhance the service delivery
system.
The Division looks forward to continuing collaboration with the entire developmental disability
community and all stakeholders to provide quality supports and services in the most inclusive
ways and settings.

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