Section 1. General Funding Information

1.1 Sources and Amounts of Funds and Resources

1.1.4 Total Income

1.1.5 Pass Through Funds

1.1.6 Net Operating Resources

1.2 Resource Development Activities

Briefly describe the CIL's resource development activities conducted during the reporting year to expand funding from sources other than chapter 1 of Title VII of the Act. *

MCIL resource development encompassed not only fundraising events and letters etc. but developing new partners and staffing practices. Through trial and error MCIL has determined that 2 fundraising events stretch manpower as far as it can go. These events are; an annual Access Awards banquet and the Holiday Silent Auction and party. During the reporting year MCIL also wrote and were awarded 2 grants; Reeves Foundation to assist the Nursing Home Transition program, and a grant for a collaborative project with the College of Art. MCIL also renegotiated a local City grant for home modification. The MCIL Personal Assistant Services fee for service program had to be closed due to decreasing revenues, resulting in a decrease in workers comp insurance and an increase in unemployment. New connections and resources are always being explored and a new strategic plan is being prioritized for 2018. A new data system will make better use of staff time and allow easier reporting for a new State wide grant for nursing home transition.

The Memphis Center for Independent Living (MCIL) was one of seven Centers for Independent Living in the country to receive a grant of $40,000.00 from the Christopher and Dana Reeve Foundation Paralysis Resource Center. The Nursing Home Transition Grant Program is to transition people living with paralysis in nursing homes back into their homes or a community-based setting of their choice.

MCIL has a long history of working for choice in long-term care. Currently Tennessee has the CHOICES program that provides some assistance for individuals to move from expensive institutions. MCIL has worked on the “Money Follows the Person” legislation that still provides some federal funds to help people remain in the community and with their family. MCIL explored funding options under Medicaid waivers through Fee for service and MFP.

Section 2. Compliance Indicator 1: Philosophy

2.1 Board Member Composition

Section 3. Individuals Receiving Services

3.1 Number of Consumers Served During the Reporting Year

3.2 Independent Living Plans and Waivers

3.3 Number of Consumer Service Records Closed by September 30 of the Reporting Year

3.4 Age

3.5 Sex

3.6 Race and Ethnicity

3.7 Disability

3.8 Individuals Served by County During the Reporting Year

List each county within the CIL's service area, as indicated in the CIL's application for Part C funds and the approved SPIL. Add additional rows as necessary. For each county, indicate how many individuals residing in that county were served by the CIL during the reporting year.

3.8.1 Individuals Served by County During the Reporting Year

Section 4. Individual Services and Achievements

4.1 Individual Services

4.2 I&R Information

To inform RSA how many service providers engage in I&R follow-up contacts regarding access to transportation, health care services or assistive technology, please indicate the following:

The service provider did engage in follow-up contacts with I&R recipients to document access gained to previously unavailable transportation, health care or assistive technology

Yes No

Describe how information and referral services and the other IL core and other IL services are provided to those who request such services in formats accessible to the individual requesting the services. Describe any innovative practices (not mentioned elsewhere in this report) to enhance the availability and effectiveness of IL services. *

During this reporting period MCIL only reported Information and Referral services that we followed-up on. In the past we had reported all I&R contacts and followed-up on many, however, we have changed our reporting to only note those I&R contacts that we make and also followup on.

We are developing a new policy and procedure for all I&R calls and will note I&R's that are either achieved, in-progress or have no followup. All I&R will fall into these categories and MCIL will track these.

Additionally, MCIL maintains a referral resources database for Shelby County. MCIL believes that information is the most powerful tool that we can provide and MCIL staff work one-on-one with consumers who ask for those services. MCIL provides information in requested formats and we caption and describe videos that we use on our website and in social media.

4.3 Peer Relationships and Peer Role Models

Briefly describe how, during the reporting year, the CIL promoted the development of peer relationships and peer role models among individuals with significant disabilities. *

MCIL has always had a person with a significant disability as the Executive Director and nearly all members of the Independent Living team have a visible significant disability. MCIL consumers work with a peer on the Independent Living team and see the agency administered by people with disabilities. Each new consumer is shown a video by the current and former Executive Director with the message that people with disabilities are a powerful and significant part of our community.

MCIL has several peer groups that reinforce the peer relationships of our community in Memphis. The young adult group shares information on independence, employment and involvement. MCIL has developed a Peer Outreach Program, POP that works to match peer mentors and the Peer-To-Peer program that trains mentors to work with individuals making the transition from a Nursing Home into the community. This year the Grey Panthers Senior Support Group has grown and continues to provide support, training and information to people with disabilities over 55.

4.4 Increased Independence and Community Integration

4.5 Improved Access To Transportation, Health Care Services, and Assistive Technology

In column one, indicate the number of consumers who required access to previously unavailable transportation, health care services, or assistive technology during the reporting year. Of the consumers listed in column one, indicate in column two, the number of consumers who, as a result of the provision of IL services (including the four core services), achieved access to previously unavailable transportation, health care services, or assistive technology during the reporting year. In column three, list the number of consumers whose access to transportation, health care services or assistive technology is still in progress at the end of the reporting year.

Note: For most IL services, a consumer's access to previously unavailable transportation, health care and assistive technology is documented through his or her CSR. In some instances, consumers may achieve an outcome solely through information and referral (I&R) services. To document these instances as successful outcomes, providers are not required to create CSRs for these consumers but must be able to report that follow-up contacts with these consumers showed access to previously unavailable transportation, health care and assistive technology.

4.6 Self-Help and Self-Advocacy

Briefly describe how the CIL has promoted self-help and self-advocacy among individuals with significant disabilities during the reporting year. *

MCIL continues to use the “How to Be Your Own Best Advocate” training that was developed for the Peer-To-Peer Mentoring Project. The Independent Living Skills Training focuses on ways to be assertive without being aggressive and avoiding being too passive. The training includes several tasks each requiring a little more assertive behavior.

All MCIL consumers work with peer IL Team members who model self-advocacy and suggest and explain self-advocacy techniques to accomplish the consumer’s goal. The Center also uses peer outreach and peer mentors in combination with any events, workshops and training that we do. We added a document to the MCIL Independent Living toolbox on "Tips for Self-Advocacy" for staff to use to reinforce self-advocacy to consumers.

4.7 Additional Information Concerning Individual Services or Achievements

Please provide any additional description or explanation concerning individual services or achievements, including outstanding success stories and/or major obstacles encountered. *

The MCIL Community Organizer worked with a consumer this year who successfully developed her voice for self and system advocacy. The individual had a strong desire to speak out about the importance of Medicaid services to her and other people with disabilities who use home and community based services.

MCIL assisted her to work with others to write and call legislators. The consumer with MCIL’s assistance made a video message to her Senator. She is a regular participant in a peer group and activist group. She encourages people with her own experience and speaks up when she may be strategically effective.

The consumer has also developed her self-advocacy skills. She is working with an MCIL IL Specialist to become expert at directing her personal service professionals. The MCIL consumer continues to work on and practice what she learns from her experience and from peers.

Section 5. Provision of Services

5.1 Compliance Indicator 2: Provision of Services on a Cross-Disability Basis

Briefly describe how, during the reporting year, the CIL has ensured that IL services are provided to eligible individuals with a diversity of significant disabilities and individuals who are members of populations that are unserved or underserved, without restrictions based on the particular type or types of significant disability and in a manner that is neither targeted nor limited to a particular type of significant disability. *

Community groups representing marginalized populations are welcomed at MCIL. A transportation advocacy group meets monthly and homeless support group meets weekly to reinforce outreach to all people with disabilities. Likewise MCIL has regular meetings of a cross-disability youth group and a group of seniors with disabilities called the Grey Panthers. These groups welcome individuals with physical, sensory, psychiatric and cognitive disabilities.

Additionally, MCIL has been working to expand services to our diverse community. MCIL has sponsored integrated workshops on "couponing" and sex to reach as widely diverse audience as possible. Additionally, MCIL has worked to be more prominent at school and educational events that will include younger and transitional individuals.

5.2 Alternative Formats

Briefly describe how, during the reporting year, the CIL has ensured the availability in alternative formats of all of its written policies and materials and IL services, as appropriate. *

MCIL this reporting period has developed a new policy and procedure guide to assist in providing alternative formats and appropriate communication. The policy and procedure titled: AUXILIARY AIDS AND SERVICES FOR PERSONS WITH DISABILITIES, covers alternative formats and accommodations for:

• Persons Who Are Deaf or Hard of Hearing

• Persons Who are Blind or Who Have Low Vision

• Persons with Speech Impairments, and

• Persons with Manual Impairments

MCIL has a Braille embosser to ensure that we can produce materials for Braille users. All MCIL materials are produced so that they may be enlarged, embossed in Braille or provided digitally to individuals that wish alternative formats. MCIL also will provide extended documents in a Daisy Books format.

5.3 Equal Access

Briefly describe how, during the reporting year, the CIL has ensured equal access of individuals with significant disabilities, including communication and physical access, to the center's services, programs, activities, resources, and facilities, whether publicly or privately funded. Equal access, for the purposes of this indicator, means that the same access is provided to any individual with a significant disability regardless of the individual's type of significant disability. *

This reporting period MCIL produced an access awards lunch and workshop on transportation, both events were physically accessible with accessible communication and alternative formats. Weekly we have accessible exercise classes and meetings at the Center.

MCIL provides and promotes public events at MCIL and in community locations that include access to all, including communication.

The Center promotes equal access and equal communication in its informational and marketing materials. Everyone is welcome at MCIL and the staff makes effort to ensure that people with disabilities and marginalized populations feel welcome at the Center. During the reporting period, MCIL continues to use audio information about MCIL and the Center’s mission in a looped video that plays in our lobby. MCIL uses captioned, described videos about MCIL on our website.

Briefly describe how, during the reporting year, the CIL has advocated for and conducted activities that promote the equal access to all services, programs, activities, resources, and facilities in society, whether public or private, and regardless of funding source, for individuals with significant disabilities. Equal access, for the purposes of this indicator, means that the same access provided to individuals without disabilities is provided in the center's service area to individuals with significant disabilities. *

MCIL works to exemplify equal access at our public events. Several groups host meetings and events at MCIL we work so those events that are a model of equal access.

The Center takes action where we find failure of access in our community. MCIL continues to work with the city, county and state departments to build accessible sidewalks, construct and repair curb-ramps and other public access issues.

Vocational Rehabilitation Hearing at MCIL

On June 9, 2017 MCIL staff notified the Division of Vocational Rehabilitation about our concerns over the location of the public hearing in Memphis for Vocational Rehabilitation (VR) scheduled for June 27, 2017. VR changed the location of the public hearing because the original site was not accessible by public transportation. In fact, it is more than a mile from the closest bus stop.

Paratransit, the accessible service that runs alongside the Memphis public transit service, will only travel three-quarters of a mile from the current fixed-route system to provide additional accessibility. MATAplus would not serve the location that VR had selected for the hearing.

Additionally, the library site is more than a mile from the nearest bus stop on Germantown Parkway. If someone was to take public transit, not only would they have to walk more than a mile, but there are no sidewalks in sections along the route on Trinity Road.

MCIL offered our accessible location for the hearing and we provided essential proof-reading for the materials produced in Braille.

5.4 Consumer Information

Briefly describe how, during the reporting year, the CIL has ensured that consumers have the opportunity to develop and achieve their goals (either with or without an ILP) and that the consumer has the opportunity to express satisfaction with the center and such consumer satisfaction results are evaluated by the center. *

Most of the initial contact with MCIL is through the Information and Referral Specialist, who helps the individual decide if they may need Independent Living services. The Information and Referral Specialist and all members of the Independent Living Team help individuals to know what the Memphis Center for Independent Living does and does not do. MCIL has a complaint and grievance procedure that allows individuals to record their satisfaction and dissatisfaction with the Center.

The Independent Living Team works one-on-one with an individual that has a disability, requests an independent living service from us and will benefit from that service. For the past five years, MCIL has kept a steady percentage of consumers that request and develop an Independent Living Plan, while about 10 percent work with MCIL staff but waive the plan. This reporting year, 94% of consumers had a signed ILP that listed the goals that they were working toward and the goals that they achieved.

5.5 Consumer Service Record Requirements

Briefly describe how, during the reporting year, the CIL ensured that each consumer's CSR contains all of the required information *

The Consumer Record at MCIL includes a signed ILP or ILP Waiver. Only consumers with a goal are counted in the MCIL Program Performance Report. The Center does periodic checks to ensure that all consumer services are progressing. The Memphis Center for Independent Living uses a custom database that records all necessary PPR compliance issues. The database includes checks so that all required information is entered by the Independent Living Team. MCIL does not include in the reporting numbers those CSR that do not include all required information from our service area.

5.6 Community Activities

5.7 Description of Community Activities

For the community activities mentioned above, provide additional details such as the role of the CIL staff board members and/or consumers, names of any partner organizations and further descriptions of the specific activities, services and benefits. *

MCIL has offered technical assistance in assistive technology with our accessible tech lab at the center. In addition to unstructured time with accessible equipment for self-advocacy, MCIL staff also provides one-on-one training for a consumer's independent living plan.

MCIL also has one-on-one Braille training and unstructured use of Brailling equipment. In the summer we offer a camp for children with low-vision to begin to develop good mobility techniques and an introduction to Braille and use of a white-cane.

To expand affordable, accessible and integrated housing options for the Memphis Area MCIL helped produce the West Tennessee Fair Housing Celebration in April. The Center emphasized to local housing providers the overlooked segments of the 1988 Fair Housing Amendments Act. Much of our system advocacy is directed to assist and inform homeless people with disabilities in our community.

MCIL has a strong collaboration with the local grassroots advocacy group for homeless individuals. The group HOPE meets at MCIL every Wednesday and disability issues are a significant part of their goals. During this reporting period, HOPE has worked for more access at local shelters and has a goal for next year on working for accessible Women’s shelters.

During this reporting period, MCIL had to completely rewrite the policies and procedures for making minor home modifications for the City program. Because of City government troubles with contracting, the Center’s ambitious program was cut off and staff had to create and replace policy and procedures it was using for the program. The successful result was four homes modified in May, and the City requiring five months to pay for accessibility work done.

MCIL provided direct system advocacy in support of access to health care. Center staff traveled to Boston and Washington DC in this reporting period and consumers showed their support reasonable healthcare to federal, state and local lawmakers. MCIL helped organize the “Save My Care” bus tour through Memphis in February and we again supported the “Drive for Our Lives” event in August. MCIL was featured at the Memphis Rally for Health care in July.

MCIL has a long history of system advocacy in transportation and this reporting period the Center improved our transportation toolbox for consumers, brought back the route 31 and got changes in the paratransit recertification. MCIL collaborated with the Memphis Bus Riders Union to get the cancelled route 31 back as a demonstration route and the Center held a workshop to provide technical assistance and tips for using paratransit.

Section 6. Annual Program and Financial Objectives

6.1 Work Plan for the Reporting Year

6.1.1 Achievements

Discuss the work plan's proposed goals and objectives and the progress made in achieving them during the reporting year. *

The MCIL Work Plan for 2016 and 2017 included general system advocacy goals with various planned activities to determine outcomes. The general areas the plan covers are Housing, Transportation, Healthcare, Barriers to full integration, Assistive Technology and Resource Development.

In the general area of housing MCIL is working to increase affordable, accessible, integrated housing and expand the knowledge of access to housing and resources. During the reporting period MCIL two staff attended Fair Housing events. One on Affirmatively Furthering Fair Housing and the other MCIL staff was an invited presenter on the accessibility requirements of the Fair Housing Amendments Act. Each week, MCIL collaborates with a homeless advocacy group on accessible alternatives for homeless individuals in our area.

In this reporting period, MCIL completely rewrote the policies and procedures for the Minor Home Modification program to create accessible homes in the City of Memphis. The City of Memphis froze the program in April because of the City’s inability to approve projects. The City made a large request on our time and MCIL complied with all of the City of Memphis requests for changes to the program and use of Community Block Grant Development Funds. MCIL is continuing to offer Minor Home Modification and will get right back into the program once the city finalizes its funds allocation.

In the general goal of Transportation MCIL had the objective of increasing the availability of affordable, accessible and reliable transportation. The Center was successful in expanding the attendance, activities and support for the Memphis Bus Riders Union. In collaboration with MBRU, Memphis has brought back the 31 route on a limited basis. We hope that the demonstration route will justify the return of the full 31 bus route next year.

MCIL provided two workshops and one online training on transportation in the reporting period. The first was for paratransit riders and offered our consumers tips on using MATAplus and the reservation system. There was also a workshop on using the fixed route and online training on making effective complaints. The Center also participated in several MATA service hearings this reporting period and the “Dump the Pump” promotion of the transit system. MCIL also worked to improve our Transportation Toolbox to reflect additional transportation options for our consumers.

MCIL participated in two public events related to pedestrians and pedestrian safety. This is in combination with the Center’s ongoing work with the city on walkable communities and accessible crosswalks and curb ramps. This relates to the Center’s accessibility goal on mobility and transportation.

MCIL has worked with other organizations including Citizens for Better Service and the Memphis Advisory Council for Citizens with Disabilities for improved public transportation. With the MACCD transportation subcommittee, MCIL is working to improve called-stops on the fixed-route, recertification on the paratransit system and ending capacity constraints. MCIL staff have written sample recertification documents and we are proposing a recertification fair. MCIL provides direct information and support for people who apply for paratransit. The Center is working on the long range goal of developing tracking tools and indicators of effectiveness.

MCIL has an objective to assist people with disabilities to obtain or maintain healthcare and needed services for community living. MCIL is continuing to support efforts of the Tennessee Healthcare Campaign to expand Medicaid coverage in our state. This reporting period MCIL has hosted stops by the SAVE MY CARE and DRIVE FOR OUR LIVES buses. MCIL organized the local stops and had multiple speakers at each event.

Most critically, MCIL had staff travel to Washington DC to demonstrate against changes to the Affordable Care Act that would be harmful to people with disabilities in the Memphis area. Activists made trips in May, June and September to halt legislation. The action in Washington DC was supported locally by our Rally for Healthcare here in Memphis. Memphis consumers and staff also confronted Tennessee Senators Bob Corker and Lamar Alexander several times in the community about health care and the Disability Integration Act.

MCIL this reporting period has been working to inform consumers about TennCare (Medicaid) eligibility and ACA enrollment dates and assistance. The Center has been successful in finding and training peer mentors to assist people moving into the community and working to build a sustainable home. Our Peer mentorship program experienced a slow-down this reporting period as we worked with the SILC and other state partners to develop a statewide program.

Another MCIL goal is to expand our community’s knowledge and access to Assistive Technology. The Center has been successful in training seniors and other people with disabilities in basic computer and mobile device use, focusing on affordable appropriate Assistive Technology. MCIL is working to document using affordable Assistive Technology for use in the community. The Center has been successful in recruiting and training technology mentors and we find that this need is continuing.

Physical, attitudinal and barriers to socialization all isolate and segregate our community; MCIL worked on goals to eliminate these barriers. MCIL was successful in educating consumers and organizations of many barriers in the community. Most notably, MCIL complained that the Division of Vocational Rehabilitation had scheduled a public hearing about a mile from the nearest bus stop. Additionally, there was not an accessible route, the sidewalk ended between the bus stop and the planned hearing location. Likewise, paratransit would not provide service to the planned location because of the distance from the fixed-route. MCIL volunteered our accessible office location as an alternative and the Tennessee state agency held the hearing at our office.

MCIL’s objective to eliminate attitudinal barriers is to expand disability awareness and decrease stigma attached to disability. The Center published the narrative of a consumer who told about her difficulty voting privately and independently. A MCIL staff member told about the stigma of being labeled in a very personal blog post. Likewise, a MCIL staff member wrote to oppose a fundraising campaign that used pity of people who are blind.

“This campaign reinforced beliefs by many that being blind is something to fear,” the staff member wrote in the article, “that people who are blind have lives are full of misery, frustration and that individuals who are blind require assistance to perform menial everyday tasks like fixing meals.”

The Center had an integrated “game night” and a Super Bowl party to further our goal to eliminate isolation. MCIL offered an integrated training on “Couponing to Save Money” to bring people with and without disabilities into the Center for a common social event. “The LIFE group for youth meets weekly and the Grey Panthers for seniors meets monthly and they often include integrated social events. MCIL hosted a city-wide celebration of the ADA and the Deborah Cunningham Access Awards lunch. The Mayor and other local celebrities spoke and the Center recognized a consumer for winning an essay contest: The Accessible Memphis I Wish in My Future.

Finally the Center had planned activities for our work plan and a goal to strengthen our business and resource development. Our annual Holiday Open House and Silent Auction is the biggest event that we have at the Center. During this reporting period MCIL made a major contribution to develop a Peer Mentoring program that will fund each participating Center for Independent Living in Tennessee. The program will also benefit MCIL, however, not this reporting period where much of the development has been accomplished. MCIL was unsuccessful in updating the strategic plan.

6.1.2 Challenges

Describe any substantial challenges or problems encountered by the CIL, and the resolutions/attempted resolutions. *

This reporting period MCIL found our Personal Attendant Services (PAS) program to be unsustainable and we were forced to dissolve the program. The business plan for the PAS program needed to have a set number of billed hours to support the administration. The program was competing with over 100 Personal Attendant programs in the Memphis Area and rather than adding billable hours, cuts to the program reimbursement and the deaths of consumers made it necessary for MCIL to end the program in March of 2017.

Additionally, MCIL had hoped that the new Employment and Community First CHOICES program would add to our business model and underwrite some of the cost of the PAS program. From the beginning of the development of ECF CHOICES, MCIL was looking forward to being a part of this unique Tennessee program. However, MCIL did not receive a single appropriate referral and even after we dissolved the PAS program, ECF failed to be of any benefit to MCIL and we had to end our participation to prevent accumulating any more unreimbursed costs.

MCIL is pleased with the new statewide program in cooperation with the SILC and other CILs to provide peer mentoring. The program was developed by MCIL and the Executive Director worked to share our resources for the new program. The new program is scheduled to begin next spring, however, the MCIL program funding expired during this reporting period. MCIL could not carry the experienced staff without funding for over a year.

6.1.3 Comparison with Prior Reporting Year

As appropriate, compare the CIL's activities in the reporting year with its activities in prior years, e.g., recent trends. *

This reporting year the Memphis Center for Independent Living did not record each newsletter sent as an information and referral contact. While the Center did make bulk mailing with information, it was recorded as resource development rather than I&R.

Again this reporting period, MCIL worked to close records and attempted not to "carry over" records that were dormant or should have been closed. We used the end of the reporting period to schedule the beginning of our CIL using a new online database. We are daily training on proficient use of the new system and are working to use our experience to develop a clear set of Independent Living Policy and Procedures.

We are striving to correctly record and report consumer's race, ethnicity and disability. We have the same challenge with reporting multiple disabilities and multiple races. We are using a team approach to help one another to appropriately record information in the database.

6.2 Work Plan for the Year Following the Reporting Year

6.2.1 Annual Work Plan

List the CIL's annual work plan goals, objectives and action steps planned for the year following the reporting year. *

MCIL Work plan 2017 - 18

Systems Change Activities

Housing

Issue: lack of affordable, accessible, integrated housing

MCIL Objective: Increase access of people with disabilities to affordable, accessible, integrated housing. Inform the community on the protections of the Fair Housing Amendments Act.

Planned Activities:

• • MCIL will participate in the Area Fair Housing Assessment and will produce a survey of barriers to Fair Housing in our community.

  • Educate our community and legislators of the need for VISITABILITY with a general article of the need for visitability and a community forum in the spring 2018 about visibility in Memphis.

  • Educate consumers on Fair Housing rights with a workshop in April 2018. Reinforce Fair Housing rights for people with disabilities throughout the year with 4 original blog posts and supplemented with social media.

  • MCIL will continue providing home modifications as funding permits and develop materials for alternative resources to make accessible home modifications. Advocate for more local funding for Minor Home Modifications for critical accessibility.

  • MCIL will publicly support creating or making changes to local policies and ordinances to increase accessible, affordable and integrated housing. MCIL will monitor the Memphis City Council and the Shelby County Commission to report on issues relating to accessible, integrated and affordable housing.

  • Collaborate with funders and other partners to create and maintain a clearinghouse for current accessible housing information and referral and other issues.

  • Give in-kind support to the Memphis Homeless Organizing for Power and Equality (HOPE). Report on homeless issues that impact the disability community in The MCIL Journal with at least 6 original informational articles.

  • Improve the MCIL online Housing tool to provide consistent and quality information to individuals about housing in our community.

Transportation

Issue: need for reliable, affordable, accessible transportation

MCIL Objective: Increase awareness of accessible transportation options and improve public transit

Planned activities:

• • Provide in-kind support for the Memphis Bus Riders Union.

  • Inform consumers and the Memphis community about public transportation and accessible public transportation with a workshop in January and September 2018. MCIL will reinforce the workshop information with two complementary newsletter articles, original blog articles and social media.

  • MCIL will produce an original monthly informational article about paratransit in the area.

  • MCIL will promote and improve the “Transportation Toolbox” that will inform consumers on how to use accessible transportation resources.

  • Monitor, respond and collaborate with groups and other organizations working to increase availability of all forms of transportation. Including the Memphis Advisory Committee for Citizens with Disabilities and the MACCD transit subcommittee.

  • MCIL will create a user survey of MATAplus and report to MATA and the media the consumers’ findings.

  • MCIL will advocate with local and state partners for an increase in the state budget for transportation.

Healthcare

Issue: lack of adequate healthcare and long-term care

MCIL Objective: Assist people with disabilities in Shelby county or surrounding areas to obtain or maintain healthcare and needed services for community living

Planned Activities:

• • MCIL will inform consumers about the Disability Integration Act and will collaborate with ADAPT to end the institutional bias.

  • MCIL will collaborate, monitor, network and support efforts of Tennessee Healthcare Campaign to expand Medicaid coverage in Tennessee.

  • MCIL will provide peer mentors to individuals transitioning from nursing homes as requested to assist with maintaining successful community integration.

  • MCIL will inform consumers of healthcare with a workshop in March 2018 on managing attendants and will update consumers on state issues as needed through the year on the MCIL blog, newsletter and with social media.

  • MCIL will advocate with State and Federal legislators to maintain and expand long term care and home and community based services.

  • MCIL will collaborate, monitor and advocate with Tenncare, MCOs and other related agencies to ensure that all needed services are provided for people with disabilities.

  • MCIL will begin to advocate for consumers of Employment and Community First CHOICES. MCIL will advocate for the state ECF program to emphasise Independent Living.

  • MCIL will host accessible, free diabetes management classes for six weeks beginning in 2018.

Assistive Technology

Issue: lack of knowledge and access to Assistive Technology

MCIL Objective: Increase the use of appropriate affordable AT by people with disabilities

Planned Activities:

• • MCIL will produce an Assistive Technology Fair in June of 2018. The AT Fair will inform consumers and allow hands-on testing of AT equipment. MCIL will reinforce lessons learned about AT with two additional blog articles.

  • MCIL will create and produce a model and guide for use of selected AT in the community that MCIL will provide for free and promote on our website, in The MCIL Journal and through social media.

  • MCIL will collaborate with other agencies and organizations for people with disabilities to remain knowledgeable of current AT that will enhance independence.

  • Train Peer Mentors as Technical Mentors in appropriate affordable AT.

  • Promote use of the MCIL computer lab, accessible software and Internet connection for consumers.

Other – Barriers to full integration

Issue: Community Access barriers

MCIL Objective: Educate, advocate and participate in groups supporting a more accessible and livable community

Planned Activities:

• • MCIL will work with community partners to create a Memphis ADA plan.

  • MCIL will educate consumers, business owners and community partners in access requirements, regulations and laws. MCIL will work with consumers on self-advocacy for gaining ADA compliance and give information and referral to businesses that wish to comply with the ADA. MCIL will produce at least two MCIL Journal articles on the ADA, one in July of 2018.

  • MCIL will find, document and respond to problems related to public access and teach consumers to use system- and self-advocacy tools to remedy access issues in our community.

  • Work with the SILC and Tennessee Centers for Independent Living to ensure accessible elections and polling sites.

Other – Barriers to full integration

Issue: Attitudinal Barriers, segregation of people with disabilities and regressive language.

MCIL Objective: Expand disability awareness and decrease attitudinal barriers and social stigma

Planned activities:

• • MCIL will work with community partners to create at least one annual citywide summit or conference related to an identified issue or barrier to independence in the fall of 2018.

  • MCIL will expand disability awareness through group community activities. MCIL will produce an open house and resource development party December of 2017. MCIL will produce a celebration of the 27th Anniversary of the ADA in July 2018 and will produce the annual Access Awards event in honor of Deborah Cunningham.

  • MCIL will use language and etiquette awareness presentations, and will integrate language and etiquette training in all presentations, community forums, workshops and training when possible.

  • MCIL will produce one original blog article on language.

  • MCIL will produce a video blog that will discuss local accessibility issues.

Other – Barriers to full integration

Issue: Increase Socialization and decrease isolation

MCIL Objective; Increase opportunities for education, socialization and community inclusion

Planned activities:

• • MCIL will develop “Community Forums” on topics of general concern and invite community members, partners and consumers to discuss and share information.

  • MCIL will collaborate with the Federation of the Blind to hold a camp for youth with visual impairments in the summer of 2018. MCIL will promote with social media and newsletter and blog articles.

  • MCIL will provide in-kind support for a weekly inclusive exercise class.

  • MCIL staff, board and volunteers will be involved in community activities, governing boards, advisory committees and local government to ensure equal participation of people with disabilities.

  • MCIL will develop and promote an integrated accessible game night for general socialization at the MCIL

Business and Resource Development

Issue: Limited funding and local resources.

MCIL Objective: Expand general funding and unrestricted development funds. Have a strategic planning to prepare MCIL beyond the next fiscal year.

Planned Activities:

• • MCIL will have a strategic planning meeting with all staff and board in the summer of 2018. The strategic plan will provide new guidance, reporting and tracking for MCIL staff.

  • MCIL will continue and increase funding streams including fee for service programs, grant based projects and fundraising throughout the year.

  • MCIL will work to promote the Deborah Cunningham Access Awards and Silent Auction as separate fundraising and outreach events.

6.2.2 SPIL Consistency

Explain how these work plan goals, objectives and action steps are consistent with the approved SPIL. *

During this reporting period, the MCIL Executive Director was on the Statewide Independent Living Council of Tennessee state plan committee. She helped to craft the SPIL . MCIL has worked to keep the goals of the SPIL and is cooperating with the SILC and Tennessee CILs to improve service in our state. MCIL will contribute to the development of the new State Plan and work with the goals of the SPIL. The Center has a good relationship with the new SILC Coordinator.

Section 7. Other Accomplishments, Activities and Challenges

Describe any additional significant accomplishments, activities and/or challenges not included elsewhere in the report, e.g. brief summaries of innovative practices, improved service delivery to consumers, etc. *

During the reporting period MCIL was successful in getting the state to waive a requirement for a "Day Habitation License," for the CIL to offer Employment and Community First CHOICES services. The systemic advocacy, however, did not result in Tennessee CILs actually being able to participate in the ECF program.

The state of Tennessee developed a unique service with the new Employment and Community First initiative. Tennessee Amendment 27 was the first attempt in the U.S. to bring integration and independence to Americans that were often trapped on waiting lists for programs. All of the state’s six IL Centers were asked to be a part of providing the tools to help people with disabilities all over the state to live independently and to work for employment and self-sufficiency.

July 1, 2016 the program went live and MCIL had done the work to build our program and services from scratch. In the ECF program we offer: Peer-to-peer Self-Direction; Community support, development, organization and navigation; Health Insurance Counseling (Forms Assistance) and Independent Living Skills Training. At the time we were also offering Personal Attendant Services and Supportive Home Care through our existing PAS Services department.

MCIL desperately needed more service hours for our PAS program and those two ECF services seemed to be in demand. Increasing our capacity with ECF Personal Attendant Services and Supportive Home Care seemed just what the Center needed to continue consumer oriented home and community services. MCIL did not get any of the first ECF referrals and by October we had paid for all necessary training and background checks for our staff and we had been certified by both Managed Care Organizations.

MCIL never received a single appropriate referral. We have heard from five people and some “Support Coordinators” from the MCO’s, but none were looking for services that MCIL had agreed to provide. One referral may have included services we offer, but it was from a county outside our area.

MCIL did not end its ECF program. From the beginning, we had assumed the IL Skills would be our bread-and-butter. MCIL has more than 32 years of IL experience in the community and it is our calling-card, it is in our name.

The Memphis Center for Independent Living never removed the service “IL Skills Training” from our Policy and Procedure Manual but the Managed Care Organizations apparently could not approve us to provide IL Skills because, they claimed, an IL Skills provider must have be a “Licensed Day Habitation Provider” in order to be credentialed by the Managed Care Organizations.

From early on in this process, the Statewide Independent Living Council and other CILs in the state were advocating to get rid of the Day Services license. The other Tennessee CILs were working on developing ECF programs of their own and saw the license as a barrier. One-by-one the CILs dropped out of the ECF program for a variety of reasons, including the burden of the unnecessary license.

MCIL was approved by the two Managed Care Organizations to provide some ECF services, but the Center was informed that the Day Services License was essential to provide IL Skills Training. Since the ECF program began in July of 2016, no one was really clear on why the requirement existed. MCIL directly wrote the Tennessee Medicaid Director asking to change the policy and the current requirement of a Day Services License is not in keeping with the objective of the ECF program.

On April 21, 2017 the state responded to MCIL and essentially changed the requirement. In a letter to the Program Director of MCIL, Patti Killingsworth, the Assistant Commissioner and Chief of Long Term Services and Supports wrote that the provider qualifications would be adjusted.

“A Center for Independent Living,” said Ms. Killingsworth in the April 21st letter, “as defined in federal law, that is receiving federal funding from [the] federal Department of HHS to operate as a Center for Independent Living is qualified to provide services in the Employment and Community First CHOICES program that would otherwise require an Adult Habilitation Day Facilities license.”

The state carved out an exemption for CILs, they did not get rid of the unnecessary requirement.

Nearly a year after the program rolls out, MCIL may offer Independent Living Skills training. However, the Center and other CILs in Tennessee cannot have a good feeling about the long-term viability of the program. Most importantly is how long it took to have the state recognize the problem with the day services license. For a year MCO’s and TennCare recognized the problem; facility license for non-facility services, and failed to act.

The MCO reviewers listened politely to our case, but simply agreed that the requirement did not make sense. Reason did not climb the ladder to action. For most CILs and small providers in the state, the unreasonable requirement to have a Day Habitation license seems to be just another bureaucratic hurtle that made the overall program unfeasible.

After many hours and hurtles, MCIL joined the other Tennessee CILs in withdrawing as a provider to this waiver. The struggle of all the CILs, the SILC and small providers may say more about the future of the Employment and Community First Program.

Section 8. Training and Technical Assistance

8.1 Training and Technical Assistance Needs

8.2 Additional Information

Provide additional information, comments, explanations or suggestions not included elsewhere in the report *

This reporting period is highlighted by cuts to funding and the closing of the MCIL Personal Attendant Services program. The loss of experienced staff and revenue will be felt in our community. MCIL is responding to this loss by continuing to be advocates for HCBS in Tennessee and the Memphis area.

For over ten years, MCIL has had a data collection system developed and maintained internally. MCIL is now dedicated to using the tools of a new online commercial database to keep the fundamentals in focus for our reporting. MCIL believes that for this reporting period our old data system kept us from fulling reporting our individual services. MCIL priority in the following reporting period is fastidiously reporting our work in the database.

Section 9. Signatures

NAME OF EXECUTIVE DIRECTOR* Diane T (Sandi) Klink

I certify that the information provided in this report is true, complete and accurate to the best of my knowledge.

As the Executive Director, I certify that the Board has reviewed and given approval for submission of this report.