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Virginia's Cross-Governmental Srategic Plan

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Virginia's Cross-Governmental Srategic Plan Powered By Docstoc
					Final Draft—6/20/06




                          VIRGINIA’S
                        COMPREHENSIVE
                      CROSS-GOVERNMENTAL
                        STRATEGIC PLAN

     TO ASSURE CONTINUED COMMUNITY INTEGRATION
           OF VIRGINIANS WITH DISABILITIES




                           Adopted June 20, 2006
                        Pursuant to Executive Order 2

        By the Community Integration Implementation Team and the
         Olmstead Community Integration Oversight Advisory Board
Final Draft—6/20/06


                                Table of Contents

                                                                                 Page
I.     Introduction                                                              1
       A. The Mission                                                            2
       B. The Vision                                                             2
       C. The Goals                                                              2
       D. Critical Success Factors for Goals #1 and #2                           3
       E. Critical Success Factors for Goal #3                                   5

II.    Goals #1 and #2: Action Plans That Apply to
       All Four Types of Facilities                                              6
       A. Critical Success Factor #1: Plan, Understand, Choose and
          Consumer-Direct Services and Supports                                  6
       B. Critical Success Factor #2: Choose Among Quality Community
          Providers and Direct Support Professionals                             8
       C. Critical Success Factor #3: Obtain Housing                             10
       D. Critical Success Factor #4: Locate and Obtain a Job                    12
       E. Critical Success Factor #5: Access Transportation                      14
       F. Critical Success Factor #6: Surrogate Decision-Making                  16
       G. Critical Success Factor #7: Access Ongoing Supports                    17

III.   Goals #1 and #2: Action Plans That Apply to a Specific Type of Facility   22
       A. Critical Success Factor #7: Access Ongoing Supports                    22


IV.    Goal #3: Action Plans for Team Critical Success Factors                   23



APPENDICES:

Appendix I:           Definitions
Appendix II:          A Guide to Acronyms Used in this Plan

                                            i.
Final Draft—6/20/06

           VIRGINIA’S COMPREHENSIVE, CROSS-GOVERNMENTAL
     STRATEGIC PLAN TO ASSURE CONTINUED COMMUNITY INTEGRATION
                   OF VIRGINIANS WITH DISABILITIES

I.     INTRODUCTION

This Plan was developed pursuant to Executive Order (EO) 2 by the following members
of the Community Integration Implementation Team, working in conjunction with the
four Secretariats and 21 Executive Branch entities represented on the Team, agency
staff, and the Olmstead Community Integration Oversight Advisory Board.

Julie Stanley, Chair, Director              Gary Krapf, SCHEV
Bill Fuller, Vice Chair, VHDA               Heidi Lawyer, VBPD
Ralph Davis, OST                            Theresa Preda, DRS
Heidi Dix for Secretary Tavenner, OSHHR     E. Janet Riddick, VDA
Vivek Kundra for David Smith, OSCT          Alan Saunders, OCS
   and for Daniel LeBlanc, Senior Advisor   Neil Sherman, DRPT
   to the Governor for Workforce            Teja Stokes, DMAS
Dietra Trent, OSEd                          David Suttle, VDH
Steven Combs, DVS                           Susan Payne, DBVI
Barbara Cotter, DSS                         Frank Tetrick, DMHMRSAS
Basil Gooden, DHCD                          Alexis Thornton-Crump, VDOT
Lisa Grubb, SILC                            Karen Trump, VDOE
Liz Hayes, DPOR                             Gloria Westerman, VCCS
Leslie Hutcheson-Prince, VDDHH


The Team gratefully acknowledges the contributions of the following individuals to the
preparation of this Plan:

Jenifer Urff,                               Brandon Leonard, Policy and
  Advocates for Human Potential              Planning Specialist
Marilyn Batan, OSHHR                        Lee Price, DMHMRSAS
Gail Braham, VHDA                           Susan Prokop, SILC
Tim Catherman, VDA                          Deborah Sawyer, VDOT
Mike Curseen, DMHMRSAS                      Michael Shank, DMHMRSAS
Tom Driscoll, VBPD                          Liz Smith, DRS
Ernie Forrest, DGS                          Jim Taylor, DBVI
Doug Garcia, OSEd                           Karen Tefelski, vaACCSES
Nancy Haynes, VDOE                          John Toscano, CAS
Herb Hill, VHDA                             Dawn Waters, DPOR
Steve Lambert, DSS                          Felicia Woodruff, DRPT
Karen Lawson, DMAS                          Bill Zieser, DMAS


The Plan was adopted June 20, 2006.
Final Draft—6/20/06

A. The Mission

The Implementation Team (IT) shall [d]evelop and annually update a comprehensive,
cross-governmental strategic plan, the purpose of which is to assure continued
community integration of Virginians with disabilities (and) seek advice and input from
the Governor’s Olmstead Community Integration Oversight Advisory Board as the
strategic plan is developed. . . .
Executive Order 2 (2006)

B. The Vision

We envision Virginia as ―one community‖ for all citizens—one that welcomes individuals
with disabilities and supports them as active members of their own communities. By
―own community,‖ we mean any location an individual with a disability chooses that
affords the individual the opportunity for maximum possible autonomy over his or her
daily life.

We believe that individuals, of all ages and with any disabilities, have the right to decide
where to live, and live as independently as possible, in the most integrated setting. This
is the same right--no more and no less—enjoyed by individuals who do not have
disabilities.
--One Community: Final Report of the Task Force to Develop an Olmstead Plan for Virginia (August 28,
2003), as adopted in 2004 and 2005 by the EO 61 and EO 84 Oversight Advisory Committee and in 2006
by the EO 2 Oversight Advisory Board.


C. The Goals

Goal #1: Virginians with disabilities who currently reside in a state mental health,
mental retardation, nursing or assisted living facility will have the opportunity to choose
to move from these facilities to an appropriate, more integrated setting and stay there.

Goal #2: Virginians with disabilities who are at risk of unwanted admission to a state
mental health, mental retardation, nursing or assisted living facility, will have the
opportunity to receive services and supports that prevent admission.

Goal #3: The Commonwealth will be successful in creating opportunities that
implement the Goals #1 and #2 action plans.




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D. Critical Success Factors for Goals #1 and #2

1. Virginians with disabilities plan, fully understand and choose among services and
supports they need, self-directing them to the extent possible.
Choices must be meaningful and driven, not by disability ―labels,‖ but by the unique
needs and preferences of individuals with disabilities. We believe that, in order to
assure meaningful choices, the Commonwealth must:
   Provide services and supports that are appropriate to and respectful of the
    individual, affordable, accessible, available, diverse, reliable, safe and accountable;
   Allow self-determination and consumer direction of services and supports to the
    extent possible;
   Provide maximum opportunities for individuals with disabilities and their families to
    participate in planning and developing services and supports as well as policy planning;
   Assure that individuals with disabilities and their families know about these services
    and supports and the choices that are available to them; and
   Address the institutional bias in the State Medicaid Plan by balancing community and
    institutional services.
2. Virginians with disabilities choose among individuals and agencies qualified to
provide the services and supports they select.
In order that individuals with disabilities have the opportunity to live, work, and
participate in activities in the community of their choosing, needed services and
supports must be available from qualified providers. Qualified providers can be
individuals or organizations that have a variety of backgrounds, professional expertise
and skills that maximize the ability and capacity of individuals with disabilities to live
independently in the community of their choosing, with a quality of life that empowers
them to fully participate in society. To increase the availability of qualified providers,
Virginia should embrace creative solutions, including public/private partnerships, and
ensure that adequate compensation is provided for services rendered.
3. Virginians with disabilities locate and obtain housing appropriate to their needs
and preferences.
Services and supports mean little unless Virginians with disabilities have access to
housing that enables them to live as independently as possible according to their
individual needs and preferences. A full array of permanent and transitional housing
options must, therefore, be available. Transitional and permanent housing for people
with disabilities must be affordable and accessible to all individuals who are: 1)
institutionalized; 2) living in a setting they consider to be restrictive; 3) at risk of
institutionalization; 4) on residential services waiting lists; and 5) homeless. Housing


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should be separate from supportive services and not be contingent on the receipt of
services; however, supportive services must be available, accessible if needed and
desired, flexible and individualized.
4. Virginians with disabilities locate and obtain a job if appropriate.
A true measure of integration into the community, for every individual who is able and
wants to do so, is the individual’s opportunity to work. The dignity, responsibility, and
economic independence resulting from gainful employment is the most effective way of
reducing dependence on public benefits, enhancing self-reliance, changing attitudes, and
promoting full community integration of individuals with disabilities.
5. Virginians with disabilities access transportation appropriate to their needs.
Transportation is basic in the integration into and survival in community living for
individuals with disabilities; it is what allows all citizens to work, go to the doctor, visit
friends, shop, and participate in activities in the manner they choose. Transportation of
all kinds must be consistently available, affordable, accessible, reliable, safe and meet
the needs of individuals with disabilities throughout the Commonwealth, in both rural
and metropolitan areas.
6. Virginians with disabilities--if they lack capacity to make decisions--have the
same choices, options and benefits as other Virginians with disabilities through a
surrogate decision-maker qualified to act on their behalf.
Most individuals with disabilities are fully capable of making choices and decisions for
themselves, just as individuals without disabilities are. We acknowledge that some
individuals with disabilities lack the capacity to make some or all decisions and choices
for themselves. Every such individual should have a means by which decisions and
choices may be made on his or her behalf. Among many other examples, some individuals
may have an advance directive, and others may need a surrogate decision-maker
appointed and available to act on their behalf. The surrogate decision-maker could be a
family member chosen in the order set forth in the Health Care Decisions Act, § 54.1-
2986 of the Code of Virginia, a guardian, or other legally authorized representative.
Unless the context indicates otherwise, wherever reference is made to a decision or
choice by an individual with a disability in the report that follows, the decision or choice
may be made by an appropriate surrogate decision-maker if the individual cannot make
the decision or choice independently.
7. Virginians with disabilities access ongoing supports in order to stay in the most
integrated setting of choice, self-directing them to the extent possible.
In order to assure choices to individuals with disabilities, ongoing community support
and services must be available and reflect the importance of Virginia's full continuum of
care, from self-care through institutional care.

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E. Critical Success Factors for Goal #3

Services and supports must be accountable to individuals with disabilities, their families,
the general public and decision-makers and be based on:
   Fairness and equity for all persons covered by the Olmstead decision;
   A clear connection between system goals and actual system outcomes;
   A philosophical and budgetary commitment to the requirements set forth in the
    Olmstead decision; and
   Clear criteria for current and new funding to insure that such funds are spent and
    distributed in a manner that supports the rights of individuals with disabilities to
    make choices from appropriate options within available resources.

1. Every state agency identified in EO 2 is actively involved in the Team’s work.
2. Every Team member has the agency head’s authority to represent the agency in
   the Team’s work.
3. Each Team member understands the EO 2 strategic planning directive, the
   critical success factors approach to developing the strategic plan, and their
   agency’s role in the process.
4. The Team’s work on critical success factors for Virginians with disabilities is
   incorporated into agency strategic planning, and every Team member supports
   every other Team member in achieving this.
5. The Team agrees on methods of measuring the Commonwealth’s progress in
   implementing an action plan for each critical success factor for Virginians with
   disabilities and takes whatever steps are needed, both as a Team and within
   their agencies, to enable regular and accurate measurements.
6. The Team works to secure a long-term commitment by the Executive and
    Legislative branches of government to community integration for Virginians with
    disabilities.




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                    II. GOALS #1 AND #2: ACTION PLANS THAT APPLY TO ALL FOUR TYPES OF FACILITIES

                   Critical Success Factor #1: Plan, Understand, Choose and Consumer-Direct Services and Supports
       Action Plan #1.1

Expectation Individuals with disabilities will plan, fully understand, choose and direct their own services.
Strategy      Identify people with disabilities or their families who have successful experiences with directing their services and supports
              and include them in state and local initiatives (e.g., training and mentor programs) to assure that service providers and
              disability communities share a commitment to maximize the principles of consumer-direction and choice.
Measurable    1) The number of people with disabilities who plan, fully understand, choose and direct their own services as measured by
outcome/s     service data indicators, self-report surveys and a variety of evaluation indicators (to be identified) will increase.
              2) The number of people with disabilities living in the most integrated setting will increase.
              3) Education/training of community service providers, consumers and families is well coordinated and consistently provided.
              4) The media is educated.
                                Implementation Actions                                        Date/s      Responsible agency/cies     Cost/s
1. Develop a baseline.                                                                       2006       IT
2. Identify best practice or promising practice models in other states that support          2007       DMAS, DMHMRSAS, VDOE,
consumer direction.                                                                                     DSS, DRS, IHEs
3. Ensure that policies and documents of state and local agencies, including training        2007       IT
materials, incorporate consumer direction language.
4. Develop strategies to identify and address the disparity among communities with           2008       DMAS, DMHMRSAS, VDOE,
regard to knowledge about consumer direction and person centered planning.                              DSS, DRS
5. Identify responsible entities to coordinate statewide education and training efforts.     2008       Office of Community
                                                                                                        Integration (OCI)
6. Encourage Institutions of Higher Education (IHEs) to include a curriculum that            2010       SCHEV
places priority on concepts of consumer direction and person centered planning in all
appropriate fields.




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       Action Plan #1.2

Expectation                  Individuals with disabilities will have a variety of choices to support their selected community integration option.
Strategy #1.2.1              Expand consumer-directed options in all service environments.
Measurable outcome/s         The number of people having consumer-directed options will increase.
                                  Implementation Actions                                     Date/s         Responsible agency/cies        Cost/s
1. Develop a baseline.                                                                       2006      IT
2. Identify best practice or promising practice models in other states that maximize         2007      DMAS, DMHMRSAS, VDOE,
consumer-directed choices and options.                                                                 DSS, DRS, IHE, VDH, VDA
3. Develop new consumer-directed community integration options for Virginians,               2008      DMAS, DMHMRSAS,
including adding consumer direction to all the waivers.                                                VDH, VDA
4. Involve the Centers for Independent Living (CILs), Area Agencies on Aging (AAAs), 2008              DMAS, DMHMRSAS, VBPD,
Community Services Boards (CSBs), and private case management organizations in                         DRS; SILC
identifying funding possibilities for new targeted community integration options
including transitional start-up costs.
5. Assure that Virginia policy reflects the expanded options and funding mechanisms          2010      IT
identified above.
Strategy #1.2.2              Develop an infrastructure to support people with disabilities to choose how their allocated funding is spent, with
                             appropriate accountability.
Measurable outcome/s         The number of people for whom money follows the person will increase.
                                  Implementation Actions                                     Date/s         Responsible agency/cies        Cost/s
1. Develop a baseline.                                                                       2006      IT
2. Adopt money follows the person initiatives.                                               2007      DMAS, DMHMRSAS, VBPD,
                                                                                                       DRS; SILC




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               Critical Success Factor #2: Choose Among Quality Community Providers and Direct Support Professionals
       Action Plan #2.1

Expectation                  An environment conducive to attracting and maintaining a network of quality community providers and direct
                             support professionals (DSPs) will be created.
Strategy #2.1.1              Evaluate standards of occupational licensing, certification, endorsement, approval, and registration in Virginia as
                             compared with other states and, if necessary, enhance Virginia’s standards to ensure that appropriately qualified
                             providers from other states can easily qualify to provide services in Virginia.
Measurable outcome/s         The number of quality community providers and DSPs in Virginia will increase.
                                 Implementation Actions                                        Date/s        Responsible agency/cies     Cost/s
1. Develop a baseline.                                                                     2006              IT
2. Review model programs from across the country and incorporate appropriate best          2006-2007         DHP, OCI, DPOR
practices into the development of best practice standards and certifications for a
continuum of providers of care for people with disabilities in Virginia.
3. Develop standards for best practices and certifications for a continuum of              July 2007 –       DHP, OCI, DPOR
providers of care for people with disabilities.                                            June 2008
4. Publish and communicate a complete career ladder of certifications and licensure        July 2008 –       IT, VCCS, OCI, VEC
for individuals serving people with disabilities.                                          October 2008
Strategy #2.1.2              Adequately reimburse quality community providers and DSPs so that they can afford to do business.
Measurable outcome/s         The number of quality community providers and DSPs in Virginia will increase.
                                 Implementation Actions                                        Date/s        Responsible agency/cies     Cost/s
1. Develop a baseline.                                                                     2006              IT
2. With the Community Integration Advisory Commission, review institutional and            2007              IT, DMAS
community-based rate structures from other states, the JLARC 2005 report on
reimbursement rates, and other applicable studies and research to identify best
practices.
3. Issue a report to the Governor.                                                         2007              Commission
4. Advocate, and educate the GO and the GA, about the need.                                Ongoing           OCI, IT                     0

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Strategy #2.1.3              Develop a curriculum and training programs to increase the employee pipeline (i.e., a pool of employees at various
                             stages of preparedness with access to necessary training and support to become fully qualified), and a full
                             spectrum of quality community providers and DSPs.
Measurable outcome/s         The number of quality community providers and DSPs in Virginia will increase.
                                     Implementation Actions                                        Date/s    Responsible agency/cies     Cost/s
1. Develop a baseline.                                                                             2006      IT
2. Conduct a thorough needs assessment that includes an analysis of current educational            2007      VDOE, VCCS, SCHEV,
programs and licensing available across public and private sectors in the Commonwealth, and                  VEC
that projects potential employment, types of professionals and DSPs needed, and geographic
distribution.
3. Incorporate needs assessment outcomes into existing public and private educational              2008      OSEd
programs.
Strategy #2.1.4              Professionalize the full continuum of quality community providers and DSPs.
Measurable outcome/s         The number of quality community providers and DSPs in Virginia will increase.
                                     Implementation Actions                                        Date/s    Responsible agency/cies     Cost/s
1. Develop a baseline.                                                                             2006      IT
2. Identify and develop career pathways ranging from basic orientation to full certification       2007      OSEd
and licensure programs.
3. Work with GA to provide tax incentives for private care providers for the training and          2008      Department of Taxation
certification of employees.




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                                                Critical Success Factor #3: Obtain Housing
       Action Plan #3.1

Expectation     Housing will be accessible.
Strategy        Eliminate physical, social and other barriers that impede a person’s ability to live in the most integrated environment
                possible. (Accessibility means different things for different people. For a person with a mobility limitation the elimination
                of structural barriers might result in accessibility. For a person with a developmental disability, accessibility might be a
                system of supports that mitigate limitations and perhaps include a congregate living model.)
Measurable      The number of people getting accessible housing will increase.
outcome/s       The number of people in supportive housing will increase.
                         Implementation Actions                               Date/s            Responsible agency/cies              Cost/s
1. Develop a baseline.                                                      2006        IT
2. Identify the barriers to accessible housing and how to address them.     July 2006 DMHMRSAS, VHDA, DRS, VBPD, DHCD              $32,000
3. Working with local housing authorities, develop a plan to inventory      January     DMHMRSAS, DRS, VBPD                        $40,000
those needing accessible housing and the housing available.                 2007
4. Working with local housing authorities, develop a method to              January     DMHMRSAS, DRS, VBPD, DHCD                  $40,000
determine those obtaining accessible and affordable housing.*               2007
5. Evaluate the need for additional program resources to assist the         May 2007    VHDA, DHCD, DMHMRSAS, DRS, VBPD            $35,000
development of accessible units in appropriate locations, and recommend
the allocation of additional resources as needed.
6. Develop plans for targeting more funding for independent housing.        May 2007    VHDA, DHCD, DMHMRSAS, DRS, VBPD            $35,000




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        Action Plan #3.2

Expectation Housing will be affordable.
Strategy       Produce more units for people above 60% of the average monthly income (AMI) that can be occupied using no more than 30%
3.2.1          of their available income.
Strategy       Provide income supplements to people below 60% of the AMI such that no more than 30% of their available income is spent
3.2.2          for housing.
Measurable     1) The number of units to house people at or below 80% of the AMI will increase.
outcome/s      2) The number of people receiving subsidies sufficient to meet their housing needs will increase.
                               Implementation Actions                                     Date/s       Responsible agency/cies   Cost/s
1. Develop a baseline.                                                                  2006          IT
2. Develop a plan to determine the number of people currently in facilities and those   January       DMHMRSAS                   $13,000
at risk of admission to these facilities needing affordable housing units.*             2007
3. Develop a plan to identify the type of disability housing needed, targeted income    March         DMHMRSAS                   $13,000
level, and geographic region.*                                                          2007
4. Working with local housing authorities, develop a plan to determine the number of    May 2006      DHCD, VHDA                 $25,500
affordable housing units.
5. Evaluate the need for additional program subsidies to increase affordability.        May 2007      VHDA, DHCD, VBPD           $35,000
                                                                                                      DMHMRSAS, DRS,
6. Preserve affordable, accessible housing where it exists.                             May 2007      VHDA, DHCD, VBPD
                                                                                                      DMHMRSAS, DRS,
7. Develop affordable, accessible housing where it does not exist.




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       Action Plan #3.3

Expectation        Housing will be available and appropriately located.
Strategy 3.3.1     Make specific financing resources available.
Strategy 3.3.2     Increase local capacity to undertake development.
Strategy 3.3.3     Insure appropriate enforcement of laws and regulations.
Measurable         1) The number of new units will increase.
outcome/s          2) The number of developers capable of building new units in appropriate regions will increase.
                   3) The number of complaints (Building Code violations and Fair Housing Complaints, including failure to make reasonable
                   modifications) will decrease.
                   4) Local communities’ comprehensive plans will reflect the needs of people with disabilities and address issues of
                   accessibility, affordability and availability.
                             Implementation Actions                                         Date/s         Responsible agency/cies       Cost/s
1. Develop a baseline.                                                                2006                 IT
2. Convene CSBs, CILs, AAAs and Disability Services Boards (DSBs), to                 July 2006            VHDA, DHCD, SILC              $14,000
determine local capacity needs and determine methods of addressing those needs
(programs and delivery models). Include public housing authorities (PHAs).**
3. Develop a plan to expand outreach and promote awareness of the existing            September 2007       VHDA, DHCD                    $7,000
resources available.
4. Develop a method of tracking building code and fair housing complaints.            January 2007         DHCD, DPOR                    $14,000
5. Develop methods of enhancing enforcement of laws and regulations.                  May 2007             DHCD, DPOR
       *These initiatives (3.1.4, 3.2.2, and 3.2.3) are recommended steps in each of the accessibility and affordability action plans.
       **Initiative 3.3.2 is a recommended step in the accessibility, affordability, and availability action plans.




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                                             Critical Success Factor #4: Locate and Obtain a Job
       Action Plan #4.1

Expectation                  People with significant disabilities will become employed.
Strategy                     Educate individuals with a disability, advocates, service providers, employers, family and the community that a
                             person with a significant disability needs to and can work.
Measurable outcome/s         The number of referrals to organizations that provide services to assist people with disabilities to become
                             employed will increase.
                                  Implementation Actions                                     Date/s          Responsible agency/cies       Cost/s
1. Develop a baseline.                                                                       2006       IT
2. Conduct training sessions regarding availability of services, especially for job          2007       DRS, DBVI, DVS, Virginia
readiness, to assist people with significant disabilities in becoming employed.                         Workforce System Partners
3. Incorporate employment information into the VBPD nursing home outreach grant.             2006       VBPD and grantees
4. With involvement of stakeholders, incorporate information regarding work and              2007       DMHMRSAS, DMAS, DVS
possible referral sources into institutional discharge plans.
5. Include people who are already successful in using personal assistants (PAs) in the       2007       DRS, DMAS, DBVI, DSS
workplace in the education process to educate consumers on the use of PAs in an
employment setting.

       Action Plan #4.2

Expectation                  People with disabilities will have informed choice in their employment options, including self-employment.
Strategy                     Develop knowledge of available employment options and the means to attain them.
Measurable outcome/s         At least 100 people in nursing homes, 100 people in institutions, and 100 people in the community will receive
                             employment options packages and will understand the various options.
                                  Implementation Actions                                     Date/s           Responsible agency/cies     Cost/s
1. Develop a baseline.                                                                       2006            IT


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2. Develop a cross-disability workgroup comprised of customers, advocates, and state        September      DRS, DBVI
agencies to develop an employment options package that includes information on how          2006
earned income affects benefits as well as available work incentives.
3. Working with advocates, disseminate the employment options package to                    July 2007      DRS, DBVI
appropriate bodies, in hard copy and through websites.
4. Working with CILs and employment services organizations (ESOs), train staff on                          DRS, DBVI
employment options and informed choice so that they can support persons with
disabilities to obtain desired employment.
5. Incorporate information regarding work and possible referral sources into                January        DMHMRSAS, DSS,
institutional discharge plans.                                                              2008           DMAS, DVS

       Action Plan #4.3

Expectation                  Opportunities for employment will exist.
Strategy                     Increase job opportunities and the capacity of employment support services.
Measurable outcome/s         The unemployment of people with disabilities will decrease.
                                    Implementation Actions                                       Date/s     Responsible agency/cies    Cost/s
1. Develop a baseline.                                                                          2006       IT
2. Working with ESOs, outreach to employers and educate the workforce development               On-        DRS, DBVI, Workforce
system on hiring people with disabilities. Include best practices from public and private       Going      Investment Advisory
sector employers of all sizes.                                                                             (WIA) Board
3. Implement the Medicaid Buy-In Program.                                                       2007       DMAS
4. Working with providers, people with disabilities, advocates and the GA, remove financial                DMAS, DSS, DRS,
disincentives for people with disabilities to become employed.                                             Department of Taxation
5. Expand Personal Assistance Services (PAS) by increasing allocations for the DRS              2008       DRS, DMAS
program and by increasing rates for both the DRS program and DMAS providers.
6. Make supported employment, assistive technology, and home modifications as applicable,       2007       DMAS
an option in all Medicaid waivers; fund supported employment consistently with DRS rates.
7. Continue an effective referral system to public and private VR agencies.                     2006       DRS, DBVI

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8. Expand funding and capacity of long-term employment supports.                                    2007      DRS
9. Working with Workforce Investment Boards (WIBs), increase outreach to Chambers of                2008      DRS, DBVI, VBPD
Commerce, industry associations, and other public and private employer organizations.


                                               Critical Success Factor #5: Access Transportation
       Action Plan #5.1

Expectation                  People with disabilities will be aware of available transportation options.
Strategy                     Educate and publicize available transportation options to people with disabilities.
Measurable outcome/s         The number of people aware of transportation services will increase.
                                     Implementation Actions                                          Date/s   Responsible agency/cies    Cost/s
1. Develop a baseline.                                                                              2006      IT
2. Identify transportation options for people with disabilities, using other studies like                     DRPT
Project Links.
3. Educate people with disabilities and other stakeholders.                                                   All state agencies
4. Provide transportation opportunities updates as needed.                                                    DRPT
5. Explore the use of vouchers and other consumer incentives for transportation.                              DRS, DRPT, Virginia
                                                                                                              Workforce Council,
                                                                                                              Senior Advisor to the
                                                                                                              Governor on Workforce
6. Educate people with disabilities on the process to redress Americans With Disabilities                     IT
Act (ADA) complaints.




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       Action Plan #5.2

Expectation                  People with disabilities will know how to take advantage of available transportation services.
Strategy                     Train key personnel, including CILs, CSBs, AAAs, ESOs and others, to identify and train end users.
Measurable outcome/s         The number of people trained to take advantage of their transportation choices will increase.
                               Implementation Actions                                     Date/s           Responsible agency/cies       Cost/s
1. Develop a baseline.                                                                  2006          IT
2. Identify training needs.                                                                           DRPT
3. Develop training tools.                                                                            DRPT
4. Identify key audiences.                                                                            DRPT
5. Provide training.                                                                                  DRPT

       Action Plan #5.3

Expectation                  The State will leverage funding to support current and increased transportation services.
Strategy                     Coordinate transportation services to maximize efficiencies to support additional transportation services
                             (United We Ride).
Measurable outcome/s         A plan will be submitted to the Governor by October 2007.
                                 Implementation Actions                                      Date/s        Responsible agency/cies   Cost/s
1. Develop a baseline.                                                                     2006         IT
2. Create a cross agency team to develop an integrated Human Services                      July 2006 DRPT
Transportation Plan that includes public transportation.
3. Identify transportation needs and barriers. Provide incentives to coordinate            January      DRPT
transportation services, and include disincentives for those who do not.                   2007
4. Identify coordination and improved efficiency opportunities, including                  July 2007 DRPT, VHDA, DHCD, VEC,
coordination with housing and medical and employment transportation.                                 Senior Advisor to the
                                                                                                     Governor on Workforce




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5. Develop a State Human Services Transportation Plan.                                      October     DRPT                           $75,000
                                                                                            2007
6. Consider transportation needs for people with disabilities in the Commonwealth’s         Ongoing     VDOT, DBVI
Transportation Planning Process (VTRANS).
7. Develop a strategy so that transportation services will be made liable for the cost                  VOPA
to consumers for failure to provide agreed services.
8. Consider incentives for transportation providers to provide services.                                DRPT


                                          Critical Success Factor #6: Surrogate Decision-Making
       Action Plan #6.1

Expectation                  A qualified surrogate will be available to each individual statewide who needs one, and if an individual cannot
                             afford one, one will be provided.
Strategy                     Identify the appropriate human and financial resources needed and develop mechanisms to make the resources
                             accessible.
Measurable outcome/s         There will be no unmet surrogate decision-making needs.
                                Implementation Actions                                     Date/s           Responsible agency/cies        Cost/s
1. Develop a baseline.                                                                    2006         IT
2. Conduct a statewide assessment of individuals who have unmet surrogate                 May 2007     DMHMRSAS, DSS, DRS, DMAS
service needs.
3. Determine the cost for the appropriate level of service to meet the unmet need.        August       DMHMRSAS, DSS, DRS, DMAS
                                                                                          2007
4. Develop a budget amendment to implement the action steps.                              Fall 2007    DMHMRSAS, DSS, DRS, DMAS




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       Action Plan #6.2

Expectation                  For those who have a surrogate decision-maker, the surrogate will represent the best interests of the individual
                             without exceeding the level of services required in accordance with applicable law and regulations.
Strategy                     Provide training for surrogate decision-makers on respect for individual values, person-centered planning and,
                             consumer direction, appropriate standards, and consistency with the needs of the individual.
Measurable outcome/s         All surrogate decision makers will receive training prior to serving as surrogates.
                                   Implementation Actions                                           Date/s       Responsible agency/cies     Cost/s
1. Develop a baseline.                                                                           2006           IT
2. Determine cost.                                                                               June 2007      OCI
3. Develop a budget amendment to implement the action steps.                                     Fall 2007      OCI
4. Contract for curriculum development.                                                          Fall 2008      OCI
5. Provide training for all surrogate decision-makers throughout the state, no less than         Spring         IT
twice per year.                                                                                  2009
6. Train lawyers to make sure guardianship decrees are written to retain rights to the                          OCI
maximum extent possible and reference person centered planning as decision-making
support tools.


                                           Critical Success Factor #7: Access Ongoing Supports
       Action Plan #7.1

Expectation                  All people with disabilities will have accessible, quality medical, dental, vision and hearing care in their
                             communities.
Strategy                     Increase the number of accessible medical, dental, vision and hearing providers in communities that offer
                             services to people with disabilities.
Measurable outcome/s         The number of accessible medical, dental, vision and hearing providers offering services to people with
                             disabilities will increase by 20%.




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        Final Draft—6/20/06



                               Implementation Actions                                        Date/s         Responsible agency/cies    Cost/s
1. Establish a base line of the number of providers offering specialized care            December       DMAS, VDH, DSS, VDDHH
currently in the community.                                                              2006
2. Collect needs data by locality
  Develop an assessment tool                                                              June 2007    DMHMRSAS, DSS, VDH,
  Collect data                                                                            June 2008    VDOE, DMAS, VDA
3. Provide data to the economic development community and enlist its support to
attract service providers.
4. Increase incentives for service providers to locate in under-served areas.
5. Add dental care as a covered service by Medicaid.
6. Review and modify medical care rates to make them competitive.
7. Ask professional and trade associations to be partners.
8. Advertise to health care providers. Offer rate flexibility for more challenging
situations.

        Action Plan #7.2

Expectation                    Services will be flexible and targeted to all Olmstead populations.
Strategy                       Pursue Medicaid options under the 2005 Deficit Reduction Act.
Measurable outcome/s
                              Implementation Actions                                      Date/s        Responsible agency/cies        Cost/s
1. Develop a baseline.                                                                2006             IT
2. Identify new state plan option services to maximize benefits to all citizens.      July 2006        DMAS, DMHMRSAS
3. Apply for Center for Medicare and Medicaid Services (CMS) grant funds for          June 2006        DMAS, DMHMRSAS
demonstration projects.
4. Obtain allocation from the GA for project(s) sustainability.                       January 2009     OSHHR, DMAS, DMHMRSAS
5. Change all applicable policies and regulations.                                    July 2010        OSHHR, DMAS, DMHMRSAS

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       Action Plan #7.3

Expectation                    Waiver services will be available for all who want them.
Strategy                       Expand existing waivers.
Measurable outcome/s           100% of people eligible for existing waivers will receive desired waiver services.
                             Implementation Actions                                    Date/s          Responsible agency/cies        Cost/s
1. Develop a baseline.                                                               2006         IT
2. Appropriate slots for waivers every year based on waiting list phase out.         2007 on      DMAS, DMHMRSAS, OSHHR
3. Identify additional needed services.                                              2007         DMAS, DMHMRSAS, OSHHR
4. Obtain appropriation for additional services.                                     2008         DMAS, DMHMRSAS, OSHHR
5. Amend waivers.                                                                    2008         DMAS, DMHMRSAS, OSHHR

       Action Plan #7.4

Expectation                       Medicaid will cover all needed services for people with mental illness.
Strategy                          Create Medicaid-reimbursable wellness management, peer supports, and supported employment services.
Measurable outcome/s              At least three new services will be established.
                                 Implementation Actions                                         Date/s      Responsible agency/cies       Cost/s
1. Develop a baseline.                                                                          2006      IT
2. Collaboratively provide written guidelines to community mental health (MH) service           2006      DMHMRSAS, DMAS              0
providers, including consumer-provider organizations, in identifying and delineating
opportunities for implementing and financing recovery support services under the
existing Medicaid State Plan.
3. Collaborate with consumers, peer providers and community MH services staff to                2006      DMHMRSAS, DMAS,             0
design and implement peer specialist/provider training programs to expand the number                      DRS
and type of trained, reimbursable peer providers within Virginia’s MH services system.
4. Collaboratively provide clear interpretive guidance to providers on how existing             2006      DMHMRSAS, DMAS              0
Medicaid reimbursable Community MH Rehabilitative Services may be provided to MH
consumers in and around employment settings.

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       Final Draft—6/20/06

5. Promote DRS vendor relationships to support the integration of vocational and MH       2006   DMHMRSAS, DRS    0
services staff as outlined in the evidence-based Individual Placement and Supports
model of Supported Employment.
6. Collaborate to encourage the creation of more effective partnerships among MH, VR,     2006   DMHMRSAS, DRS,   0
and benefits planning and assistance providers.                                                  DMAS
7. In conjunction with CSBs, pilot Supported Employment practices.                        2007   DMHMRSAS         $230,000
8. In conjunction with CSBs, pilot Peer Support practices.                                2007   DMHMRSAS         $1,658,000
9. In conjunction with CSBs, pilot Wellness Management practices.                         2007   DMHMRSAS         $377,000
10. Seek additional State General Funds (SGF) to help underwrite start-up and             2007   DMHMRSAS         $1,000,000
transition costs associated with transforming the MH system towards a more recovery-
oriented focus on employment.
11. Seek additional SGF to develop programs to train CSB staff in the importance of       2007   DMHMRSAS         $250,000
employment in the process of recovery and in utilizing the most effective technologies
to help MH consumers get and keep competitive employment.
12. Seek additional SGF to develop, plan, and deliver regional training on trauma-        2007   DMHMRSAS         $250,000
informed Wellness Management practices to MH provider staff and peer providers.
13. Seek additional SGF to promote the implementation of both the evidence-based          2007   DMHMRSAS         $75,000
Illness Management and Recovery and Illness Self-Management programs in all state
psychiatric facilities and local MH programs.
14. Seek additional SGF to collaborate with statewide partners and consumers to           2007   DMHMRSAS         $700,000
design, create and support a Virginia MH Recovery Institute to provide comprehensive
training, recovery education and ongoing consultation to state and local MH agencies in
the transformation of the MH system to one that truly embraces a culture of recovery.




                                                                                                                      21
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       Action Plan #7.5

Expectation        Specialized services and supports will be available to permit individuals to continue to live in their homes, through such
                   supports as the Older Blind Program, the Companion Program, and the Caregivers Grant.
Strategy 7.5.1     Provide increased community-based adjustment to blindness training and specialized adaptive equipment distribution to
                   older people experiencing vision loss.
Strategy 7.5.2     Provide increases to the companion program.

Strategy 7.5.3     Provide grants to caregivers of older individuals.
Measurable         1) The frequency of rehabilitation teacher contacts with older blind customers will increase.
outcome/s          2) The percentage of eligible individuals receiving services will increase.
                   3) Caregiver grants will be available statewide.
                               Implementation Actions                                     Date/s    Responsible agency/cies         Cost/s
1. Establish baselines.                                                                    2006     DBVI, DSS
2. Request a budget increase for the Older Blind Program to restore, and close a           2006     DBVI                         $200,000
current service gap created (primarily) by, 2003 SGF reductions.
3. Request a budget increases to make sufficient older blind services available to all     2007     DBVI
eligible individuals.
4. Request a budget increase for the Caregivers Grant to close the current service         2007     DSS                          $500,000
gap.
5. Request a budget increase for home-based services for elders and adults with            2007     DSS                          $2.0M
disabilities who are on the waiting list.




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       Final Draft—6/20/06

                    III. GOALS #1 AND #2: ACTION PLANS THAT APPLY TO A SPECIFIC TYPE OF FACILITY

                                              Critical Success Factor #7: Access Ongoing Supports
       Action Plan #7.1-F: Assisted Living Facilities (ALFs)

Expectation                  Information about community-based options will be readily available.
Strategy                     Provide information on all community living opportunities to people with disabilities who receive auxiliary grants.
Measurable outcome/s         100% of individuals of AG grant recipients living in ALFs will receive community-based options information.
                               Implementation Actions                                          Date/s          Responsible agency/cies     Cost/s
1. Develop a baseline.                                                                  2006                  IT
2. Educate and train appropriate staff on available resources and service options.      December 2008         DMHMRSAS, DSS
3. Expand VACIL’s nursing home transition grant to ALFs.                                July 2008             VBPD
4. Mandate communication of options to all people covered by this Plan.                 July 2009             DSS

       Action Plan #7.2-F: Assisted Living Facilities

Expectation                   Money will follow the person.
Strategy                      Use AGs for other community living options.
Measurable outcome/s          The AG will fund 250 people living in other community options.
                             Implementation Actions                                       Date/s          Responsible agency/cies        Cost/s
1. Develop a baseline.                                                               2006               IT
2. Explore a portable AG option; identify requirements for implementing pilot.       August 2006        DSS, DMHMRSAS
3. Submit to GA for approval and administrative funding of the pilot.                November 2006      DSS
4. Implement the pilot for two years to test a portable AG option.                   December 2007      DSS, DMHMRSAS                  $160,000
5. Evaluate for program outcomes and costs; identify needed policy changes.          September 2009     OSHHR, DSS, DMHMRSAS
6. Seek approval and appropriation for statewide implementation and, if              May 2010           OSHHR, DSS, DMHMRSAS
necessary, authority for regulatory changes effective July 2010.
7. Revise regulations.                                                               July 2010          OSHHR, DSS, DMHMRSAS

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       Final Draft—6/20/06

                                  IV. GOAL #3: ACTION PLANS FOR TEAM CRITICAL SUCCESS FACTORS

       1. Every state agency identified in EO 2 is actively involved in the Team’s work.

Expectation              All EO 2 state agencies will understand that people with disabilities are a part of their customer base.
Strategy #1              Keep the Secretariats informed.
Measurable outcomes      The number of agencies that include, in their own strategic plans, strategies within this Plan will increase.
                                  Implementation Actions                                          Date/s       Responsible agency/cies    Cost/s
1. Identify a designee to the IT from each Secretariat via memorandum from the                 5/15/06         OCI, IT                    0
Secretaries or Chief of Staff. Brief Secretaries. Establish communication protocols.
2. Set expectations via a directive from the Secretaries for agencies to incorporate           Beginning       OSCT, OSEd, OSHHR,
community integration goals against which they will be measured into agency strategic          with 2007       OST
plans. Explore feasibility of a dashboard, so that an independent body can ―grade‖             strategic
each agency on such measures as: Did the agency address the needs of people with               planning
disabilities in its strategic plan? Did the agency involve stakeholders in planning?           schedule
3. Keep the Secretary of Finance informed about relevant information.                          Ongoing         OCI
Strategy #2                  Reinforce that this is a Governor’s Initiative, not a Secretariat or agency initiative.
Measurable outcomes          Agency strategic plans and this strategic plan will reflect similar goals and critical success factors.
                   Implementation Actions                                            Date/s                    Responsible agency/cies    Cost/s
1. Conduct IT meetings to update this strategic plan.                Annually prior to April                   IT


       2.Every Team member has the agency head’s authority to represent the agency in the Team’s work.

Expectation                  All EO 2 state agencies will understand that people with disabilities are a part of their customer base.
Strategy                     Ensure that agency heads are familiar with Olmstead and understand its importance to their agency’s mission.
Measurable outcomes
                   Implementation Actions                                            Date/s                    Responsible agency/cies    Cost/s
1. Brief agency heads.                                               Beginning September 2006                  IT, OCI


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       Final Draft—6/20/06

       3.Each Team member understands the EO 2 strategic planning directive, the critical success factors approach to
       developing the strategic plan, and their agency’s role in the process.

Expectation                  All EO 2 state agencies will understand that people with disabilities are a part of their customer base.
Strategy                     Continue the comprehensive cross-governmental strategic planning process.
Measurable outcomes          Annual reports updating this strategic plan will be available.
                   Implementation Actions                                            Date/s                   Responsible agency/cies    Cost/s
1. Conduct meetings to update strategic plan.                        Annually by June                         IT


       4.The Team’s work on critical success factors for Virginians with disabilities is incorporated into agency strategic
       planning, and every Team member supports every other Team member in achieving this.

Expectation              All EO 2 state agencies will understand that people with disabilities are a part of their customer base.
Strategy                 Measure strategic plans annually.
Measurable outcomes      The number of agencies that include strategies, contained in this Plan, in their own strategic plans will increase.
                              Implementation Actions                                          Date/s       Responsible agency/cies       Cost/s
1. Review agency strategic plans to develop a baseline regarding what                   August 2006      OCI
objectives related to people with disabilities are included.
2. Use the strategic plan to identify agency responsibilities; brief agency             Late summer      Secretary’s designee, OCI,
heads.                                                                                  2006             IT
3. Time strategic plan updates with agency strategic planning time lines; give          Annually         IT
information and guidance to agencies when the process occurs.

       5.The Team agrees on methods of measuring the Commonwealth’s progress in implementing an action plan for each critical
       success factor for Virginians with disabilities and takes whatever steps are needed, both as a Team and within their
       agencies, to enable regular and accurate measurements.

Expectation              All EO 2 state agencies will understand that people with disabilities are a part of their customer base.
Strategy 5.1             Review outcome measures from strategic planning.


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        Final Draft—6/20/06

Strategy 5.1              Ask the Chief of Staff to have agencies incorporate measures into their strategic plans.
Measurable outcomes       The number of agencies that include measurable outcomes within this Plan in their own strategic plans will increase.
                                  Implementation Actions                                          Date/s    Responsible agency/cies    Cost/s
1. Tie measurable outcomes into the Council on Virginia’s Future objectives.                   May 2006    OCI
2. Identify how people with disabilities fit into core measurements. Study the
feasibility of developing a ―disability index‖ for major societal indices (e.g., dropout,
housing and unemployment).
3. Identify performance measures against which agencies can be held accountable.

        6.The Team works to secure a long-term commitment by the Executive and Legislative branches of government to
        community integration for Virginians with disabilities.

Expectation               All EO 2 state agencies will understand that people with disabilities are a part of their customer base.
Strategy                  Demonstrate results and successes early on to keep momentum.
Measurable outcomes       Budget and legislative initiatives will support implementation of this Plan.
                                 Implementation Actions                                          Date/s     Responsible agency/cies    Cost/s
1. Tie measurable outcomes into the goals of the Council on Virginia’s Future.               May 2006      OCI
2. Hold a reception with the Governor, Secretaries, agency heads, IT members, and            June 2006     GO, OCI
Board/Commission members in conjunction with a Memorandum of Understanding
(MOU) and/or a press release, possibly involving legislators.
3. Work with the GO Legislative Director to identify and brief legislators on HHR and        Summer        GO, OCI
other committees who could champion community integration and introduce legislation.         2006
4. Educate the media.




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Final Draft—6/20/06



                                                                               Appendix I


                                       Definitions

Action plan: A brief outline of expectations, strategies, measurable outcomes,
implementation actions, dates, responsible agency/cies, and cost/s that would result in
success for the applicable critical success factor.

Cost/s: If known, the cost of implementing each action.

Critical success factor: A key area in which the Commonwealth’s satisfactory
performance is required in order for Virginians with disabilities who currently reside in,
or are at risk of unwanted admission to, a state mental health, mental retardation,
nursing or assisted living facility to achieve their goal of community integration.

Date/s: For each implementation action, the date by which implementation should begin.

Expectation: A sentence that describes what Virginians with disabilities expect.

Implementation Actions: Action statements that describe sequentially how each
strategy would be implemented.

Measurable outcome/s: For each strategy, a sentence that describes how success would
be measured if the strategy were implemented.

Responsible agency/cies: For each implementation action, the agency or agencies that
would actually implement the action.

Strategy: A phrase that describes what is needed to meet the expectations. There can
be more than one strategy for an expectation.
Final Draft—6/20/06



                                                                        Appendix II
                          A Guide to Acronyms Used in this Plan

AAAs           Area Agencies on Aging
ADA            Americans With Disabilities Act
AG             Auxiliary Grant
ALF            Assisted Living Facility
AMI            Average Monthly Income
CAS            Commonwealth Autism Services
CILs           Centers for Independent Living
CMS            Center for Medicare and Medicaid Services
CSBs           Community Services Boards
DBVI           Department for the Blind and Vision Impaired
DGS            Department of General Services
DHCD           Department of Housing and Community Development
DHP            Department of Health Professions
DMAS           Department of Medical Assistance Services
DMHMRAS Department of Mental Health, Mental Retardation and
               Substance Abuse Services
DPOR           Department of Professional and Occupational Regulation
DRPT           Department of Rail and Public Transportation
DRS            Department of Rehabilitative Services
DSB            Disability Services Board
DSP            Direct Support Professional
DSS            Department of Social Services
DVS            Department of Veterans’ Services
EO             Executive Order
ESO            Employment Services Organization
GA             General Assembly
GO             Governor’s Office
HHR            Health and Human Resources
IHE            Institutions of Higher Education
IT             Implementation Team
Final Draft—6/20/06



JLARC          Joint Legislative Audit and Review Commission
MH             Mental Health
MHPC           Mental Health Planning Council
MOU            Memorandum of Understanding
OCI            Office of Community Integration
OCS            Office of Comprehensive Services for At-Risk Youth and Families
OSCT           Office of the Secretary of Commerce and Trade
OSEd           Office of the Secretary of Education
OSHHR          Office of the Secretary of Health and Human Resources
OST            Office of the Secretary of Transportation
PA             Personal Assistant
PAS            Personal Assistance Services
PHA            Public Housing Authority
SCHEV          State Council of Higher Education for Virginia
SGF            State General Funds
SILC           Statewide Independent Living Council
VACIL          Virginia Association of Centers for Independent Living
VBPD           Virginia Board for People with Disabilities
VCCS           Virginia Community Colleges System
VDA            Virginia Department for the Aging
VDDHH          Virginia Department for the Deaf and Hard of Hearing
VDH            Virginia Department of Health
VDOE           Virginia Department of Education
VDOT           Virginia Department of Transportation
VEC            Virginia Employment Commission
VHDA           Virginia Housing Development Authority
VOPA           Virginia Office for Protection and Advocacy
VR             Vocational Rehabilitation
WIA            Workforce Investment Advisory
WIB            Workforce Investment Board




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