ARRM News and Public Relations

Commentary: Focus greater attention on structural barriers to inclusion for people with disabilities

By Sue Schettle

Published by the Minneapolis Star Tribune on 12/14/2019 (original publication here)

The latest article in the Chaotic Care series (Disabled Minnesotans Often Live in Costly Isolation, 12/08/2019) had the opportunity to continue the series’ constructive look into the current challenges Minnesotans with disabilities face in having the opportunity to live their best lives. Unfortunately, several core issues were glazed over, and some ignored, in exchange for painting a negative picture of group homes where hundreds of Minnesotans in fact do receive the support and services they need for a high quality of life.

Minnesota’s relatively large number of group homes is a manifestation of being one of the first states to close all state institutions housing people with disabilities. Beginning as early as the late 60’s and early 70’s, Minnesota led the nation in a commitment to the community integration of people with intellectual and developmental disabilities. Minnesota closed its institutions, establishing the alternative of group homes as the most individualized and community-based support setting conceived at the time. To this day, Minnesota is one of only 17 states with no state institutions.

However, this history is just for context, because progress never stops. Fifty years ago, the list of options for community-based services was short. Today, group homes are part of a spectrum of residence and support options for people with disabilities. This is a great advancement that offers the potential for people to customize the support they need with the independence they want.

I say potential because as the article calls out, too many still lack access to those opportunities. Yet centralizing group homes as the problem is a disservice to addressing the true factors preventing more people from living their best lives. 

The article failed to address the lack of affordable housing or discriminatory zoning ordinances and tenant policies which limit options even in the most progressive of counties.

It failed to discuss that direct support staff shortages covered in the article affect people in ALL housing situations, not just group homes. Access to stable staff is a key factor in whether a person can have the confidence to live in a more individualized setting.

The article glazed over the central role of counties and case managers in supporting transitions to more individualized homes. As the ultimate administrators of waiver funding, they are not being held accountable for their responsibilities to ensure people can access the most independent setting possible.

In the overwhelming majority of cases, structural barriers like these take the choice and opportunity out of the hands of people with disabilities. 

Finally, the article misleadingly states group homes are more costly than individualized services. Yet the scope of services being provided is drastically different in a group home setting. The majority of people living in group homes require some level of 24-hour support, while people living on their own are utilizing a fraction of that. Making this comparison is like suggesting that the retail store minute clinic is a better health care investment because getting a flu shot there costs less than a hospital stay for pneumonia.

This all boils down to two main points which the article had the chance to make, but instead, overly focused on a handful of negative group home experiences.

First, group homes do not deserve the overall negativity portrayed by this article. While they are not the right home and support setting for some, they are extremely positive options for others and exist on a spectrum of services designed to maximize a person’s independence and avoid more expensive and restrictive care settings.

Second, lack of public awareness, or will, to take action on systemic issues is the root cause of the fact that many who want to live in a different setting and have greater access to their community are not currently receiving that choice. It must be addressed. The services sector is shifting, with significant and growing numbers of programs supporting a variety of living situations for people, from organizations using a combination of innovative tools, above-and-beyond resourcefulness, and in some cases, pure grit. Yet, they are capped in their growth not because there are too many group homes, but by inconsistent county administration and case management, lack of affordable housing stock, and the demographics of those needing support outstripping those providing support by a factor of five to one.

We in the disability service sector have openly and deliberately communicated these concerns to both state officials and the media. Opportunities for Minnesotans with disabilities to live lives based on their abilities will continue to be limited until we as a state stop looking for where we can place the easy blame and start taking responsibility for addressing the real barriers.

Sue Schettle is the CEO of the Association of Residential Resources in Minnesota (ARRM), an association of more than 200 organizations representing the Home and Community-Based Services industry, from intermediate care facilities to individual home support.

ARRM CEO Selected For Gov. Blue Ribbon Commission on Health and Human Services

Sue Schettle will represent service providers and vulnerable adults in spending reduction talks

PRESS RELEASE

SAINT PAUL, MINN. – ARRM, an association representing more than 200 direct care providers and supporting service providers for people with disabilities in Minnesota, announced today its CEO Sue Schettle has been appointed to the newly formed Gov.’s Blue Ribbon Commission on Health and Human Services.

The commission was created out of the 2019 State Legislative Session with the task of increasing accountability in the administration of services and aid to the state’s vulnerable populations of impoverished families, seniors and people with disabilities. Part of that accountability is identifying $100 million in savings for the state budget.

“As the second largest portion of the state budget, directly serving the largest number of Minnesotans, the state government has an obligation to taxpayers to ensure there is a high degree of accountability in the administration of these dollars,” said Schettle. “But more importantly, we have an obligation to the tens of thousands of Minnesotans who fully rely on these services for critical health and quality of life outcomes to ensure there are enough resources to support their needs and that it is being directed to the right places.”

Schettle currently represents organizations which provide approximately half of the state’s home and community-based support services for Minnesotans with disabilities. These services assist people in living more independently in community settings who otherwise would qualify for more expensive and restrictive nursing facility care. Previously, she served as the CEO of the Twin Cities Medical Society, representing more than 4,000 physicians from the 7-County Metropolitan Area.

Duluth-Area Respite DSP Wins 2019 ARRM Cares Award, DSP Week Celebrated

Mayor Emily Larson proclaims Direct Support Professional Week in Duluth, recognizes caregiver of the year.

DULUTH, MINN. – ARRM, a statewide association representing more than 200 direct care providers and supporting service providers for people with disabilities in Minnesota, joined with Duluth Mayor Emily Larson in a ceremony today proclaiming Direct Support Professional (DSP) Recognition Week in Duluth, and celebrating more than a dozen DSPs nominated for their outstanding service, including one of six statewide caregivers of the year.

DSPs are professional staff that support people with disabilities to live as independently as possible in the community, helping individuals with critical care and achieving their goals and passions for a greater quality of life. Performing regular duties such as medication management, hygiene care, independent living skill building, and employment support, DSPs support more than 35,000 Minnesotans across the state, including several hundred in Duluth and the surrounding communities. The week of recognition is a national initiative to bring greater awareness to the profession, which struggles from a growing workforce shortage.

“DSPs provide support to individuals with disabilities to stay connected to family, friends, coworkers and the community, helping them to define and live a quality of life,” said Mayor Larson at a city hall ceremony this morning. “Therefore, I do officially proclaim September 8-14 as Direct Support Professionals Appreciation Week in the City of Duluth.”

Also recognized at today’s ceremony were more than a dozen area-DSPs identified for outstanding performance and achievement in the field, including Sharon Johnston who was selected by ARRM to receive its ARRM Cares Award, given annually to six of the top DSPs in the state out of a field of more than 20,000 eligible professionals. Sharon is an employee of Tender Loving Care of Duluth and provides respite support to children and families. Respite care is a critical area of support as it allows those families serving as primary caregivers a brief reprieve and can help extend the period where families are able to provide care and support.

“Because of the population they work with and the intensity of their responsibilities, a DSP requires a high level of professionalism, skill, training, and compassion,” said Sue Schettle, CEO of ARRM. “The care and support they provide is a critical public service for meeting the state’s obligation to ensure people with disabilities have the opportunities to lead self-directed lives as part of their communities. We’re honored to recognize Sharon for her tremendous talent, dedication and impact.”

Johnston has worked in the field for three years, supporting many families during that time. While respite care often comes in short 24-48 hour increments, she ensures that time continues to be filled with individualized support and care, including enriching community engagement and social activity to fit the child’s personality for whom she is supporting, sometimes above and beyond what they are able to access at home. This type of support is essential for achieving one of the primary goals for DSPs: to strengthen community inclusion.

“Sharon has an outsized impact on the individuals and the families she supports for the time she has with them,” said Keven Johnson, Chief Administrative Officer for Tender Loving Care. “She makes the most of every minute she has with the people she supports, and as a result she is strengthening the overall level of care and support they receive. She is most deserving of this recognition.”

ARRM is touring the state recognizing each of the six ARRM Cares Award winners during Direct Support Professional Recognition Week. Learn more about the ARRM Cares Award and current winners at www.ARRM.org/ARRM-Cares. 

DSP to Wounded Warriors Wins ARRM Cares Award

Matt Tebbutt works with veterans across the state who live with disabilities from injuries while serving in the armed forces

MENDOTA HEIGHTS, MINN. – ARRM, a statewide association representing more than 200 direct care providers and supporting service providers for people with disabilities in Minnesota, announced today that Matt Tebbutt has been chosen for the ARRM Cares Award, given to the top six direct support professionals (DSPs) in the state each year.

Tebbutt is employed with Dungarvin Minnesota, LLC, specifically working in the organization’s partnership with the Wounded Warrior Project to support veterans with significant intellectual and physical disabilities stemming from their injuries, particularly traumatic brain injury. Specializing in helping people live successfully in the community while requiring varying degrees of critical care and support, Tebbutt works with veterans across the state to rebuild and continue their lives which have been dramatically altered by their service and injuries.

“In addition to being a tremendous advocate and working with people to find and live out new goals and passions, Matt provides a foundation of support to individuals and families whose lives have been changed forever,” said Maria Hawes, Program Director for Dungarvin Minnesota. “We always say that life can change in an instant and for the people Matt works with, it has. He ensures there is a fulfilling life looking forward.”

More than 20,000 DSPs across Minnesota are eligible to be nominated for the ARRM Cares Award, given to individuals who demonstrate outstanding talent and success in supporting people with disabilities to choose and achieve their life goals and be included in their community. Less than 100 are selected for nomination and Tebbutt was ultimately selected by a review panel of leaders from more than 50 provider organizations.

“Because of the population they work with and the intensity of their responsibilities, a DSP requires a high level of professionalism, skill, training, and compassion,” said Sue Schettle, CEO of ARRM. “The care and support they provide is a critical public service for meeting the state’s obligation to ensure people with disabilities have the opportunities to lead self-directed lives as part of their communities. We’re honored to recognize Matt for his tremendous talent, dedication and impact.”

Tebbutt’s work varies widely depending on the individual he’s working with. In some cases, it’s helping people access former passions in new ways, or finding ways to explore new passions and life goals. In other cases, it’s assisting people with relearning many key life skills for independent living which after their injuries have become a challenge, particularly important for those suffering symptoms from traumatic brain injuries. For some, it’s providing companionship for an individual who has lost touch with their friends struggling to adapt to someone who’s been changed by injury.

“Matt has made an impact on dozens of lives,” said Hawes. “He is very deserving of this award.”

ARRM is touring the state recognizing each of the six ARRM Cares Award winners during Direct Support Professional Recognition Week. Learn more about the ARRM Cares Award and other winners at www.ARRM.org/ARRM-Cares.

Moorhead DSPs Receive ARRM Cares Award

To celebrate national Direct Support Professional Recognition Week, ARRM is excited to announce the winners of the 2019 ARRM Cares Award all throughout this week! We are presenting awards at different times throughout the week, and are announcing winners as we go.

Today, we are honored to share that Amber Lobdell and Madie Uglem of CCRI, Inc. are two of the six winners of the 2019 ARRM Cares Award. Congratulations to you both!

Amber and Madie have incredible stories, which you can check out in full on the ARRM Cares webpage. Below is the press release announcing their selection.

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ARRM, a statewide association representing more than 200 direct care providers and supporting service providers for people with disabilities in Minnesota, announced today that two Moorhead Direct Support Professionals (DSPs) have been chosen for the ARRM Cares Award, given to the top six DSPs in the state each year.

Amber Lobdell and Madison Uglem, both employees of CCRI (Creative Care for Reaching Independence, Inc.), were identified for the exemplary care and support they provide to local Moorhead residents living with intellectual and developmental disabilities. Through their work, many individuals are leading higher quality lives because they have more opportunities to live and participate in their community based on their personal interests and passions.

“This is such a well-deserved honor for Amber and Madie,” said Shannon Bock, Executive Director of CCRI. “The skill and passion with which they approach their work has changed the lives of many, but I think also contributed to a stronger community here in Moorhead overall.”

More than 20,000 DSPs across Minnesota are eligible to be nominated for the ARRM Cares Award, given to individuals who demonstrate outstanding talent and success in supporting people with disabilities to choose and achieve their life goals and be included in their community. Less than 100 are selected for nomination and Lobdell and Uglem were ultimately selected by a review panel of leaders from more than 50 provider organizations.

“Because of the population they work with and the intensity of their responsibilities, a DSP requires a high level of professionalism, skill, training, and compassion,” said Sue Schettle, CEO of ARRM. “The care and support they provide is a critical public service for meeting the state’s obligation to ensure people with disabilities have the opportunities to lead self-directed lives as part of their communities. We’re honored to recognize Amber and Madie for their tremendous talent, dedication and impact.”

Lobdell has worked as a DSP for nearly seven years and has spent much of the last few years supporting a group of men the Moorhead community has come to know as “The Guys.” These four gentlemen, who are unrelated but have formed a strong brotherhood, were living in a home that could not meet their needs or desired quality of life. They were at risk of being separated, but Amber played a leading role in giving their story a voice, helping to introduce them to the broader community and advocate for the importance and impact of creating a new home that would support their family. The effort was successful, garnering strong community support and fundraising dollars to build their new home.

Uglem has a strong bond with a young woman she supports who loves getting out and experiencing the world but at times experiences extreme anxiety which can lead to outbursts, making public activities a challenge. However, Uglem developed such a close relationship with this individual that she not only has devised several strategies for assisting her to calm down, but Uglem can also identify when anxiety attacks are coming on and act so subtly that no one around them would know something out of the ordinary was happening. This preserves this young woman’s safety and dignity while ensuring she is able to participate in the things she loves.

“There’s so much more you could say about these two outstanding professionals, so many other ways they support people to live their best lives,” said Bock. “We’re so proud to have them on our team.”

ARRM is touring the state recognizing each of the six ARRM Cares Award winners during Direct Support Professional Recognition Week. Learn more about the ARRM Cares Award and past winners at www.ARRM.org/ARRM-Cares.

LSS-MN CEO Jodi Harpstead Selected To Lead DHS

SAINT PAUL, MINN. – ARRM, an association representing more than 200 direct support providers and associated service providers for people with disabilities in Minnesota, today released this statement from CEO Sue Schettle regarding the selection by Gov. Walz of Lutheran Social Services of Minnesota CEO and ARRM Board Member Jodi Harpstead to be the next commissioner of the Minnesota Department of Human Services:

"I want to congratulate Gov. Walz on such a strong choice to lead the Department of Human Services in Jodi Harpstead. As a leader of one of the largest private-sector human services organizations in Minnesota, Jodi has the breadth of experience to not only return stability to the department, but effectively manage the complex and critical agency. She has the credibility of a leader who has worked with, and improved the lives of, the people she will ultimately serve as commissioner.

"Moreover, Jodi is well positioned to take on the significant challenges which now face Minnesota’s human services systems, with her track record of driving innovative thinking to efficiently allocate resources and achieve the outcomes which matter most to vulnerable populations. Our association looks forward to working with her and her team to address issues like the critical shortage of disability support professionals and continue supporting greater inclusiveness and independence for Minnesotans with disabilities."

East Metro Legislators Share Coffee, Ideas With Local Disability Service Advocates

Representatives from East Metro area disability service providers thanked legislators for investing in the direct support workforce

STILLWATER, MINN. – Representatives from several organizations which provide supportive services to people with disabilities in Minnesota’s East Metro area met with local legislators to express the importance of recent investments in their workforce by the State Legislature, and to discuss future ideas for meeting the support and care goals for people seeking greater independence and community inclusion.

Sen. Karin Housley (R-Stillwater), Rep. Linda Runbeck (R-Circle Pines), and Rep. Ami Wazlawik (DFL-White Bear Lake) discuss disability services with provider representatives in Stillwater.

Sen. Karin Housley (R-Stillwater), Rep. Linda Runbeck (R-Circle Pines), and Rep. Ami Wazlawik (DFL-White Bear Lake) sat down Wednesday for coffee with more than a dozen representatives from area service providers at Joseph’s Family Restaurant. They discussed issues ranging from the 17 percent wage gap for Direct Support Professionals (DSPs) to the overall difficulties families face in finding services for their loved ones.

Bill Tiedemann from Hope House of the St. Croix Valley said, “There just aren’t enough services available for those who need it.” Jon Poulson of The Phoenix Residence echoed that statement: “We have over 100 people on a waiting list. And we aren’t the only provider in that situation.”

The discussion made clear the wage gap is just the tip of the iceberg for providers in Minnesota. Although the state passed legislation this year which will invest more in DSP wages, providers will still have trouble recruiting and retaining staff. There are over 75,000 DSPs in Minnesota and the average wage is roughly $13 per hour. “Something needs to change,” said Senator Housley (R-Stillwater).

This coffee event was organized by ARRM, a trade association representing organizations in the home and community-based services industry, as part of an ongoing effort to strengthen communication and effectiveness of the public-private sector relationship which defines services for people with disabilities in Minnesota.

“These critical supports are almost entirely funded through public spending, and yet delivered predominantly by private non-profit and for-profit organizations,” said Sue Schettle, ARRM CEO. “Minnesota has historically been a national leader in the standard of care and supporting greater independence for people with disabilities and regular conversations like this are essential to continuing that leadership.”

Home and community-based service organizations began as an alternative to large, state-run institutions and helped launch a dramatic expansion of the care, support, residential and community engagement opportunities for people with intellectual and developmental disabilities over the last 50 years. Hundreds of organizations operate these programs across the metro Minnesota, supporting several thousand people with disabilities and employing more than 10,000 direct support staff.

ARRM Statement on DHS Resignations

Essential to restore institutional knowledge of services for people with disabilities in department leadership

SAINT PAUL, MINN. – ARRM, an association representing more than 200 direct support providers and associated service providers for people with disabilities in Minnesota, released this statement from CEO Sue Schettle regarding the recent resignations of top leaders at the Minnesota Department of Human Services:

“Today’s news regarding Minnesota Department of Human Services (DHS) Commissioner Tony Lourey’s resignation is unsettling and leaves serious questions for our field which works so closely with the department for technical assistance and as the primary regulatory body for Home and Community-Based Services supporting Minnesotans with disabilities.

“This, on top of news last week of the resignations of Deputy Commissioners Wilson and Johnson, raises concerns about a loss in the department’s leadership of formidable institutional knowledge around supportive services for people with disabilities. As several past examples have demonstrated, familiarity and experience with this large and complex sector of publicly funded services for vulnerable adults is a critical asset for successful oversight and policy development.

“As we learn more about the situation at DHS and the future of its leadership, we strongly urge Gov. Walz to ensure the new leadership team has strong credentials in the areas of Home and Community-Based Services for people with disabilities. They will be charged with developing and implementing significant initiatives to address major public policy priorities, from ensuring Minnesota meets its mandated goals under its Olmstead Plan, to addressing challenges in meeting the growing demand for services with a shrinking pool of workers.”

NEWS ALERT: Protected Status for Liberians in Minnesota Extended

By ARRM

The White House announced today it will extend the protected status another 12 months for people living in the U.S. under temporary protected status or deferred enforced departure status who originally came from Liberia. 

A large portion of the Liberian immigrants in the United States call Minnesota home and make up an important segment of the direct support workforce here, along with other African immigrant populations. This is an important and positive announcement for those dedicated staff who are right now providing supports towards more independent and inclusive lives for Minnesotans with disabilities. 

However, the new deadline of March 31, 2020 for the end of this protected status creates a new limbo point. We will continue to follow and support efforts to provide stability and a home into the future for these individuals and their families who are currently working hard to ensure the same for the people our members support.

Read more about today's announcement.

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Judge Dismisses Suit Challenging 7 Percent Cuts

Judge Wilhelmina Wright cites lack of standing in ruling

SAINT PAUL, MINN. – Yesterday, plaintiffs in the case ARRM, MOHR, et al. v. Commissioner Emily Johnson Piper received notification of United States District Court Judge Wilhelmina Wright’s dismissal without prejudice of the challenge brought by ARRM, MOHR and four individual waiver recipients to a decision by the Commissioner of the Minnesota Department of Human Services (DHS) to impose a 7 percent cut to DWRS provider payment rates (ARRM, MOHR, et al. v. Commissioner Emily Johnson Piper, Case No. 18-cv-01627-WMW-BRT).

The suit alleged that, without state or federal authority, DHS imposed a 7 percent cut by eliminating three provider workforce rate increases conferred by Minnesota laws enacted in 2013 and 2014. The plaintiffs contend the cuts will harm, and already are harming, waiver recipients, in addition to violating the federal Rehabilitation Act and the Americans with Disabilities Act (“ADA”).

In a 22 page Order, Judge Wright concluded the harm to waiver recipients resulting from the 7 percent cuts was not imminent and was too speculative to support a claim in federal court. Noting the elimination of the 7 percent “will occur in multiple stages” from July 1, 2018 through December 31, 2019, the Court held that any injuries are speculative given that one or more events could occur in the next nine months which might prevent the alleged injuries from ever arising.

The Judge also stated that providers do not have constitutionally protected interests in this case. Citing with approval a 1979 Eighth Circuit decision that rejected a constitutional challenge to the sufficiency of Minnesota nursing home rates, the Court noted that if providers are “dissatisfied with the reimbursement rates, they can either operate more efficiently or terminate their relationship with Medicaid and no longer accept Medicaid recipients as residents.”

“Home and community-based providers are already operating well beyond any rational concept of efficiency, and to terminate their relationship with Medicaid waiver service recipients would be akin to closing, as more than 95 percent of all clients of home and community-based service providers are funded entirely by Medicaid waivers,” said Sam Orbovich, attorney with the law firm Fredrikson & Byron who represented the plaintiffs in this case. “Unlike disability service providers, nursing facilities serve a mix of residents who either pay privately, or are covered by Medicaid, Medicare or other payers. If ARRM’s members were to terminate their relationships with Medicaid waiver recipients, Minnesota would lose the majority of its capacity to provide federally mandated supports to people with disabilities to access independent and inclusive lives in their communities.”

In other notes, in her ruling Judge Wright did not rule whether the overall action by DHS ultimately overstepped its authority or Minnesota law, leaving the possibility open for future litigation in either state or federal court. The plaintiffs are carefully considering all their options moving forward.

About ARRM (The Association of Residential Resources of Minnesota)
ARRM is a nonprofit association of more than 200 Minnesotan providers, businesses and advocates dedicated to leading the advancement of community-based services that support people living with disabilities in their pursuit of meaningful lives. ARRM members support people with developmental, intellectual and physical disabilities including autism, brain injury and mental health needs. People served live in their own homes, adult foster care settings, and other community settings. Founded in 1970, ARRM continues to lead positive industry reforms that support Minnesotans with disabilities.

About MOHR (The Minnesota Organization for Habilitation and Rehabilitation)
The Minnesota Organization for Habilitation and Rehabilitation (MOHR) is comprised of more than 100 Adult Day, Day Training & Habilitation, Extended Employment, and Supported Employment Service provider members serving in excess of 26,000 Minnesotans with disabilities. Members proudly offer a broad array of quality options to realize the work and life enrichment goals of the people who have chosen these services. MOHR has a mission to advocate and support its nonprofit members in providing meaningful services to persons with disabilities and communities served. Members are committed to respect for each individual, a person-centered approach and expanding work opportunities.