Author: Karen Herrera

WHY THE CHANGE-Newtrax Transforms Transportation

On November 7, 2011, Newtrax, Inc., will begin to transport over 500 clients of both Merrick, Inc., and Phoenix Alternatives, Inc., (PAI) between their homes and five program sites. This is a major change for Merrick in that an external, although related, company will be transporting clients and that a two-route system will replace the current single route model. This new system also means the current program hours of approximately 8:15 a.m.-1:45 p.m. will expand to approximately 8 a.m. – 3 p.m., requiring our staffing schedule to change from 7 a.m.-3 p.m. to 6:30 a.m.- 4:30 p.m.

We acknowledge that change is often difficult and, in this case, cannot be avoided because of the rate cuts. The majority of drivers for Newtrax will be our existing drivers who already have a relationship with clients of Merrick and PAI. We realize clients value the time they spend in transit between home and their program site, and will continue to strive to make it a positive experience. Ultimately we believe that clients and our employees will benefit from this change through new relationships, quality program services, and stable company finances.

In addition to the route changes, the schedule changes mean that the same number of clients will need the same support from the same number of staff over a longer period of time. This poses some significant challenges for our Program Division and is worth telling the story behind the change.

In January 2010, the Merrick, Inc., Board of Trustees held their annual strategic planning session, in part, to assess and establish the company’s three – five year goals and related key strategies. The Board had recognized for some time that the company could no longer depend on the current percentage of revenue from government sources and had to offset expected rate cuts by generating more revenue from the non-government sector. With that in mind, as Executive Director, one of my strategic initiatives became to acquire a related day service program. On July 15, 2010, Susan M. Warweg announced her retirement as the Executive Director of PAI at a quarterly Ramsey County provider meeting. Anticipating at least a three percent rate cut on July 1, 2011, and with the strategic initiative to acquire a related day service program, I approached Susan about the possibility of a merger as an alternative to hiring another Executive Director for PAI. After considering this option, PAI declined the offer, but stated their interest in working collaboratively with us in some manner. After some time to reflect, I offered another option that would preserve the unique mission, culture, and services of each non-profit (its “color”) by establishing a third non-profit that would exist to deliver “non-mission” services to Merrick and PAI. Susan and her Board were intrigued by this idea. Mike Greenbaum, Merrick’s Finance and Development Director, and Terry Higgs of PAI joined with Susan and I in exploring this third non-profit concept. After several months of discussion and planning, on January 7, 2011, Newtrax, Inc., was incorporated in the State of Minnesota with the objectives to:

(i) Ensure safe, accessible, and reliable transportation for clients of Merrick and PAI;

(ii) Maximize operational efficiencies to reduce expenses and stabilize services in anticipation of less government reimbursement;

(iii) Develop strategic collaborations that increase the potential of each organization to deliver services to their respective clients; and

(iv) Contribute to the overall health and well being of our communities by reducing the number of vehicles congesting roads and vehicle emissions.

Newtrax was incorporated with the ability to provide other services to its members and/or to add additional non-profits to its membership with the mission – To increase the potential of each member organization to advance their charitable mission more effectively and with greater efficiency.

Ultimately the State of Minnesota reduced our rates by 1% effective September 1, 2011, and it is nearly certain that another 1.67% reduction will be applied on July 1, 2012. The collective impact of those reductions on Merrick is approximately $160,000 annually in revenue that cannot be fully replaced from other sources and would seriously compromise our ability to provide the quality of services expected by clients, their families, regulatory agencies, and the community at large. Our three largest expenses, in rank order, are:

· Wages;

· Transportation; and

· Facility costs (i.e., mortgage/lease, operating, & maintenance).

Our services must comply with a host of licensing regulations, the most relevant of which is staff to client ratios, which limits our ability to reduce wage expenses. Because we own an energy-efficient building there is little savings to be found in the facility cost center. As a result, reducing transportation expenses through Newtrax offered the greatest opportunity for cost savings because each organization operates in that same service area, under the same regulations, with an extensive fleet of similar vehicles. In the first year of operations, it is projected that Newtrax will be able to provide transportation services to all 534 clients at an anticipated cost savings of $150,000 annually to both Merrick and PAI permitting each to maintain its services and supports despite the rate reductions. For more detail on the transition to Newtrax, visit www.merrickinc.org and click on “Transportation Updates”.

The consolidation of transportation routes among member organizations by Newtrax offers not only the potential for significant cost savings to the programs and clients served, but also a meaningful reduction in congestion, air pollution and carbon emissions contributing to the overall health of the local communities in which we operate. Using an estimate from the book “Cradle to the Grave”, (Umwetlund Prognose-Institut Heidelberg, 1993), the environmental cost of one car is as follows:

· 26.5 tons of waste and 32,560 cubic feet of polluted air to extract the raw materials to manufacture a car;

· 1.5 tons of waste and 2,613,285,326 cubic feet of polluted air to manufacture the car;

· 40 pounds of abrasive waste and 35,879,701 cubic feet of polluted air in driving the car; and

· 3,602,095,990 million cubic feet of polluted air to dispose of the car.

Newtrax will be able to transport all Merrick and PAI clients with 15 fewer vehicles than was required by Merrick and PAI separately. Not only will this reduce road congestion in our local communities, more importantly it will eliminate an estimated 420 tons of waste, 600 pounds of abrasive waste, and 93,769,463,655 cubic feet of polluted air which is the equivalent waste produced by 49,500 residential homes. Further, from the report “Benefits of Community Trees” (David J. Nowak, Brooklyn Trees, USDA Forest Service General Technical Report), a healthy tree stores about 13 pounds of carbon annually – or 2.6 tons per acre each year. An acre of trees absorbs enough carbon dioxide over one year to equal the amount produced by driving a car 26,000 miles. Based on our preliminary routing schedules, we expect to reduce the miles driven to transport all 534 clients by 300,000 miles per year, the equivalent of planting 11.5 acres of trees a year in our local communities.

We know this change might cause some issues for both clients and staff as they adjust to the new ride and schedule times. Still, it is our best option given current and projected rate cuts at the state level and continued funding uncertainties at the federal level. We believe that the development of Newtrax supports each non-profit’s mission and protects the quality of our core services in these economically uncertain times. Our dedicated staff will do all we can to ease this transition for our clients. If you have further questions on the transition, please contact me at either 651-789-6209 or JWB@MerrickInc.org

In future issues of Bark’s Bytes I will share some of the social enterprise ideas and other strategies we plan to implent to further reduce our dependence on state and federal funding.

Jeni is a young lady that enrolled at Merrick in 2007, just after graduating from a school transition program.  Currently, she does not work, which may seem odd for a person so young, and is very involved in the many therapeutic activities available here.  When Jeni first came to Merrick she was having difficulty going 100 feet in her gait trainer and, in less than six months, has now progressed to a distance of 1000 feet, three times a week.  Her body strength has improved dramatically and staff are in awe of her progress.  Always sassy and a social butterfly, Jeni is active in self-advocacy, which has helped her to meet new friends and learn the power of her voice.  As much as she loves to be social, Jeni is also very comfortable doing an activity alone or sitting next to someone listening to music.  It is not uncommon to see her doing something different every time you see her throughout the day.  She loves working in the greenhouse and helps with watering, cutting, and planting; and seems to have developed quite a green thumb.  We continue to support Jeni through the Alternative Services area in our DT&H program; and her charisma, independence, and perseverance, along with the love she has for people, makes others seek her out when they need a hug and smile to know everything is going to be okay.

Jerry is deaf and was referred to Merrick while still in school.  When our staff went to meet Jerry, school staff working with him wore metal-plated gloves because he had a history of biting and reportedly had severely injured someone’s hand.  We were also told of his severe aggression and property destruction that would prohibit him from working off-site.  Despite this history, we admitted Jerry and chose not to use the metal-plated gloves thinking that this may be a catalyst to the behavior and not the answer to the biting problem.  We quickly learned that much of Jerry’s behavior was due to his need to communicate with others, understand his environment, and know what was expected of him.  As it turned out, the biting was better addressed through sensory integration; that providing a highly structured environment nearly eliminated property destruction; and by establishing a strict schedule, most aggression was avoided.  Staff in his area have been trained in American Sign Language and are expected to give Jerry ongoing opportunities each day to discuss important topics and to engage in sensory activities.  We know that soda is something that Jerry obsesses over and that denying him access can lead to aggression and property destruction.  As an alternative, we have given Jerry controlled access by knowing exactly when and where he will receive soda and he trusts that this schedule will not vary.  We continue to support Jerry through the Enhanced Services area in our DT&H program and we have all been enriched by his presence.  He currently works five days per week with one staff and two other clients on an off-site recycling crew going in and out of grocery stores, interacting with the public, and amazingly walking right past cases of soda on a daily basis.  He has successfully held his job for several years without injuring himself or others, and as of this month, Jerry has not needed a Rule 40 program for 18 months.

When Brian came to Merrick in the summer of 2000, he immediately knew that he wanted to work outside doing landscaping.  Brian joined an off-site crew that worked at a college greenhouse; and after many different assignments due to facility improvements, curriculum changes, and budget revisions – a potential dream job began to emerge.  The college built a veterinary medical center (VMC) and Brian was hired to clean and disinfect animal stalls and clean the general area within the clinic and hospital.  Brian and his supervisor have a close relationship referring to each other as “big brother” and “right hand man” respectively.  Brian continues to love his job and is very happy with the salary he earns.  In October 2008, Brian, his supervisor, and the VMC were recognized by the Governor’s Council on Developmental Disabilities for being an innovative employer.  We continue to support Brian through the Individual Services area in our DT&H program.  In the future, Brian wants to get his driver’s license and buy a truck with a plow so he can run a side business in the winter, plowing parking lots.

Sovanny has had many dreams in her life.  In recent years, many of those dreams have come true.  Due to her severe hearing loss and brittle diabetes, few thought she would be able to be “independent.”  However, Sovanny has learned more about diabetes through the Diabetes Expo and the Diabetes Association Convention.  She has become empowered over the management of her own health by monitoring her insulin pump and sugar readings, and has continued to be in stable health by exercising and eating well.  Sovanny is also a strong advocate for disability rights and has received letters from President Bush, Governor Tim Pawlenty, Senator Norm Coleman, and the Diabetes Association, praising her support of bills to revise the ADA.  She also is in the process of setting up a meeting with Governor Pawlenty and is working on her “elevator speech” along with a longer written presentation.  Sovanny was excited to be a first-time voter in the 2008 general election.  Sovanny also recently became the President of one of Merrick’s self-advocacy groups with hopes to share her knowledge and grow as a leader.  In the professional world, Sovanny has always been interested in beauty and is a member of a crew placed in an upscale salon.  We continue to support Sovanny through the Off-Site Services area in our DT&H program; and she works twenty hours per week, with eight of these hours working independently from the crew, and hopes to work-up to a goal of four eight-hour days.  Sovanny has taught salon employees sign language and has mastered her SideKick to help her communicate.  Sovanny also assisted salon stylists during the Raffa show at the Myth and will begin classes at Century College in January 2009 to be a Nail Tech.  Personally, Sovanny recently returned from a vacation to Hawaii (it’s the Bahamas next year) and she’s looking forward to eventually getting her driver’s license.  Also, Sovanny says, “I am working out twice a day at home and am looking like a female wrestler!”  In addition, she would like to live in an apartment, get married, and have children.  Sovanny is proof that advocacy, hard work, persistence, creativity, and not settling for the answer “no” can get you a long way in life.

Katie McDermott had a bit of a rough childhood.  She has said, in part, that due to her disability she was often taken advantage of by others.  All that changed when she came to Merrick and began attending a self-advocacy group.  Soon she found herself running to be the President of one of the groups and was elected.  Katie has proven herself to be a natural leader with a very outspoken personality and was a member of the redesign team for the Metro Self Advocates of Minnesota (SAM).  Because of these traits, Katie was invited to make presentations to:  Partners in Policy Making, the Institute of Community Integration at the U of M, the Minnesota Day Activity Center Association, Advocating Change Together (ACT) and, perhaps most exciting, a SAM program in Baltimore, MD.  Just recently, Katie was asked to be a member of the ACT Board of Directors and was featured in two videos; Get Out the Vote and Offense Taken.  She is also looking to produce a program for Public Access channels talking about disability issues and self-advocacy.  We continue to support her through the Utility Services area in our DT&H program; and she works on-site which allows her to participate in many self-advocacy activities during the work day.  While her Presidency of one self-advocacy group was completed in 2008, she decided to run for the Presidency of another self-advocacy group and has been elected.

Jason has been a client at Merrick for several years and a vital part of the on-site cleaning crew.  Recently, Jason was hired by a local florist to work in their greenhouse and we now support Jason through our Supported Employment Services program.  In addition to work, Jason has been taking computer classes at Century College and attended a couple of micro-enterprise workshops with hopes to start his own computer business in the future.  Jason currently lives in his own apartment, recently got his driver’s license, and bought a car.  He is very involved in his community, particularly through his church, and also attends a weeklong religious retreat in Montana every year.  Jason is a member of the Metro Chapter of Self-Advocates of MN (SAM) and has been selected for the Partners in Policy Making leadership training program.  In the future, Jason would like to be more involved politically, get married and have kids, and travel throughout the United States.

For years Ann worked on-site at Merrick in the Utility Services area and specialized on the card contract.  Watching Ann do her work was truly amazing as it looked like she was in a fast-forward mode due to her astounding speed.  Ann wanted a job around children and this fall she accepted a position at the local YMCA where she hopes to extend her personal network of friends.  We continue to support Ann through a vendor contract in our DT&H program.  Outside of work, Ann’s real passion is fundraising for Amyotrophic Lateral Sclerosis (ALS) because she lost a dear friend to this horrible disease in 2007.  For the 2008 ALS walk, Ann raised over $500 through solicitations and organizing a bake sale.  Next year, she wants to double that amount and increase the number of walkers from five to ten.  She also would like to be on the ALS event planning committee or volunteer at next year’s walk.

When Nick came to Merrick in 2005, he began working in the afternoons with the It’s In the Bag plastic recycling crew.  It was there that he learned some important skills such as working with others, staying on task, and handling anger and frustration.  About two years later, Nick chose to pursue his interest in office work and began digital imaging documents for Merrick.  Through this experience he validated his interest in clerical tasks and acquired excellent computer skills.  In the fall of 2008, Nick was hired by the Social Security Administration to do administrative tasks.  We continue to support Nick through our Ticket To Work program; and he now takes Metro Transit to his job, works full time, earns a good salary, and has access to full benefits.  In addition to work, Nick has been certified as a Skywarn spotter and wants to be connected with his local police and fire stations to volunteer.  Nick is currently very happy with his support system of family and friends, but would like to have more acquaintances.  He also hopes to move to a safer neighborhood, own a townhouse, get his driver’s license and buy a car, join Merrick’s Safety Committee, and be more involved politically.

With resources from the Secretary of State’s Office and the MN Disability Law Center, self-advocates at Merrick have been busy all year in “get out the vote” activities.  Of the 176 clients that attended voter training programs, 127 voted (72%) and of those that voted, 48 (38%) were first-time voters.  One of the clients that voted was Scott.  At first, Scott had stated that he did not intend to vote.  Even so, he did attend an Arc Civic Engagement workshop, a MN Disability Law Center Voter Registration session, and internal self-advocacy meetings where the election was discussed.  The day after the election Scott told staff in a very deliberate and low voice, “I VOTED!”  In a subsequent conversation, Scott’s mother commented that Scott would come home and share what he was learning about the election process and decided two days before the election that he wanted to vote.  On Election Day, Scott and his mother went to the polling place together.  He enjoyed the excitement in the polling place and being able to cast his ballot for the very first time.  That evening, he watched the election results like most Americans knowing that he had cast a vote that was being tabulated to elect the next President of the United States.  Consistent with our core belief of “Civic Responsibility”, two employees of Merrick agreed to staff the central hub for “Metro Rides to the Polls” on Election Day.  This hub alone coordinated rides for 220 citizens to get to their polling place and vote.  A self-advocate also volunteered that day to be a rider.  Matt completed the training with 40 other volunteers and, for 5 hours on Election Day, rode with a driver as a rider writing down directions, assisting people at the polling place, and providing support during the transit.  At the end of the night, he commented, “I don’t want this day to end.  I am usually on the sidelines but today I made a difference in other people’s lives.  When can I do this again?”

In closing, I am pleased to be with an agency that has been part of these success stories and to know that if we listen to clients we can make a difference one person at a time and cumulatively reform the system.  I am satisfied to know that success is not singularly defined by where the client works (i.e. independent, work crew, on-site work, or on-site habilitation); it also matters that people listen to their preferences, respect their choices, and value their contributions.  Finally, I am encouraged by the remarkable supports and success stories of people with disabilities served by the many qualified providers in Minnesota.  However, mostly I am thankful that the words of our critics cannot diminish the success these individuals have achieved.

From everything I have heard and read, citizens of Minnesota are unhappy with the continuing degradation of the quality of life in our State.  Yet the Governor, and some legislators, seem intent on funding reductions to balance the State’s budget in spite of the negative consequences that most Minnesotans find objectionable.  It really is time for each of us to acknowledge that more funding cuts crosses the “line in the sand” and we need to send a message to the 2010 Legislature that enough-is-enough.  It is time to find more revenue and make funding reductions with a scalpel and not an axe; and to realize that spending on health and human services not only meets our social contract to care for our most vulnerable citizens – it is also a huge investment in our State’s economy.

The following is Merrick’s 2010 Legislative Agenda approved by our Board of Trustees on March 10, 2010, and some suggestions on how to take action.

No further reduction in Medicaid (MA) or Children’s and Community Service Act (CCSA) rates.  No further limits on waiver slots.  Restore or sustain services as much as possible.

The Governor’s supplemental budget recommendation proposes a 2.5% rate reduction for home and community based waiver programs, home care services such as personal care, nursing facilities, ICF/MR homes, and continuing care grants effective July 1, 2010 on top of the 2.58% enacted last year.  Make sure legislators understand what DT&H programs do and how additional cuts will negatively impact the people we serve.  Urge a balanced approach to balancing the state budget that includes fair and sensible cuts that requires all Minnesotans to share the burden.  Make sure that $81 million “claw back” from federal MA spending goes to support human service expenses and not other operating expenses.  Support increases in revenues that will allow us to continue to invest wisely in the future of Minnesota and to fund the priorities that have made Minnesota a strong and vibrant state and provides opportunity for all Minnesotans.  Oppose cuts that put our most vulnerable citizens at further risk or further erode their ability to live independently as valued members of the community.  Cuts in human service funding are a form of taxation that targets our most vulnerable citizens.  Instead we need innovation that will provide sustainable solutions that:

Expand systems and supports that give clients greater control over their funding, staffing, and living arrangements.
Focus on the participation and values of the person with a disability and work to ensure quality cost effective supports.
 

Use current regulatory reform agenda, prompted by federal oversight, to redesign state and local government agencies administering MA, waiver, and related programs; and redirect more resources directly to consumers.

In the face of continued fiscal constraints, encourage legislators to push the Department of Human Services (DHS) to press for comprehensive reorganization that will reduce administrative costs without jeopardizing appropriate oversight and free-up resources for direct service.  Where are the cuts in government overhead and administration?

Ramsey County must ensure an appropriate funding level for adequate day services chosen by the individual which meet their needs as stated in their individual service plan.  CCSA should be amended to require the county to fund day services unless it can show a compelling reason, other than the availability of CCSA funds, to deny the provision of these services.

Encourage more employment opportunities by state government

Our industry trade associations (MnDACA, MHC and MACRO) are pursuing legislation to require that the state award more contracts to people with disabilities for digital imaging and other services.  State government needs to walk its own talk and we need opportunities to generate non-government revenue.

Insurance reform for transport

Representative Gardner has authored H.F. 298 and Senator Dibble has authored the companion bill S.F. 2814 to encourage more efficient and environmentally responsible transportation.  Current insurance underwriting, policies, and practices create barriers for efficient transportation of persons with disabilities, particularly adults with developmental disabilities served by DT&H providers.  Support legislation that will remove those barriers.

Quality Assurance and other Statewide Reform Initiatives

Monitor closely to ensure that initiatives deliver desired results, are compliant, responsive to the needs of clients, and fair to providers.

Maintain/reinstate sunshine laws

Ensuring the quality of care and protecting the safety of individuals with disabilities can best be accomplished by limiting 24-hour control of an individual by government and other service providers.  The quality of life for individuals with disabilities is enhanced by having multiple individuals or entities involved in the life of the individual.  It is preferable that the individual leave their residential site for day services of their choice unless documented medical conditions preclude it, the individual has chosen to have a DT&H provider provide services in their own home or residence, or if the individual is retired from work.

Require consistent annual reporting of statewide goals and benchmarks for services and supports not just spending

DT&H statewide survey of wages and hours and other relevant planning information has not been conducted since 2005 and even that survey had inconsistencies in data reported.  More current reports (MN DHS CCA 2007 and Minnesota State Profile 2009 both of long term service system) focus on spending only, not other outcomes like employment, types of employment, hours worked, wages and income earned, and supports required for all of the above.  Create and support initiatives that will demand and ensure regular publication of good data to make good decisions.  Support legislation that requires establishing baselines, goals, outcomes, and measurable benchmarks, so we can determine the progress and impact of our investment in human services, as we work to ensure that people with disabilities have an opportunity to live, learn, and work as independently as possible in their communities.

How can I influence the public policy debate?

As a voter, taxpayer, and person directly impacted by these public policy decisions, your voice is very powerful and the one that has the most credibility with legislators.  Your voice becomes even more powerful when your legislator hears from multiple constituents, each with a unique story or personal touch, but all with a common theme that influences their vote on a matter.  Most people don’t take the time to share their concerns with their legislators, and those that do get heard, particularly when the stories are personal, to the point and heartfelt.

Who represents me and how do I locate my legislators?

Minnesota has great resources to help you identify your legislators.  Go on line and either click on the following link or copy it into your internet browser – http://www.gis.leg.mn/mapserver/districts/

This is the District Finder.  Enter your street address, city, state, and zip code and click search.  The search engine will identify your Minnesota State Representative and State Senator as well as your Federal Congressional Representative and both U.S. Senators for Minnesota.  Now you are ready to take action!

What are some of the key messages I might want to share with my legislators?

No more budget cuts.  Funding for day and employment services is an investment in our community – money well spent that pays the following dividends and must continue:

Meaningful employment, vocational support, and other life enrichment activities that increases independence and self sufficiency, provides an improved sense of self worth, allows persons to make choices about and improve their quality of life, and establishes an important link for a person’s social and support network.
Employing persons with developmental disabilities taps an underutilized labor pool and fosters employment among a segment of the population with the highest rate of unemployment and underemployment.  Our clients rely on our support to obtain and maintain employment.  These services promote diversity, inclusion, and social responsibility in the workplace.
We are an important link in the transportation network for the elderly and persons with disabilities.
These services have a positive ripple effect in the economy through employment of staff and clients alike and the resulting benefits to families and society of the money earned, saved and spent, taxes paid, and more costly welfare expenses avoided.
 

Other tips to get your message heard:

Pick your favorite method of communication – the one most comfortable for you.  Send a letter typed on the computer or handwritten (as long as legible) or send an email.  You can also make a phone call or schedule a personal visit.  Prepare a script to use and even leave behind.
Use your personal stationary or blank paper and include your name and home address (include your telephone number and email address if you want to be contacted that way).  Introduce yourself and why you are interested in the issue.  Only discuss one issue or bill (cite the bill number) per letter.
Use your own words.  The fact that you took the time to craft a personal message is what makes your communication so powerful.  Your tone should be sincere and polite.  Guard against being whiny or aggressive.  State how the issue will impact the clients and/or yourself personally.  Give a personal story about how the legislation will affect you.
Keep it brief and polite – one page if possible.  Identify why you are writing in the heading or first sentence.  Tell the legislator what specifically you want them to do.  Thank the legislator for considering your position, and if desired, request a reply.
Encourage your co workers, family, and friends to do the same.  We have a parent who shared his son’s story in a letter to his church.  Several members were so touched that they too wrote to their legislators protesting further budget cuts to human services.
 

If you care about the quality of life in Minnesota, or you are just simply tired of the political wrangling at the Legislature, it is time to let the politicians know that as a voter your heels are against the line in the sand and you are counting on them to do the right thing for our most vulnerable citizens.