My Do-dad would not exist without Rachel.
- Document Rachel’s support needs accurately.
- A tailored system that flexed to
accommodate Rachel’s unique independence goals (instead of the other way around).
- Ensure that Rachel was involved in directing her documentation process with the same success with which she directed her care staff.
For a while, they tried enrolling Rachel in various development centers, but found they did not understand her complex behavioral and mental health needs. Unfortunately Mental Health Services in Idaho will not admit people with cognitive impairment.
The Challenge of Living more Independently
However, they were left with a significant set of challenges:
- Rachel needed additional staff who were properly trained regarding Rachel’s unique challenges. This would allow Mary to recuperate from burnout and find some life outside of her caregiving work. Rachel needed to be able to have her life outside of Mary because as much as they got along, there are many things Rachel likes that Mary doesn’t and she deserved a chance to explore those things with other people. This is core to Supported Independence.
- Rachel’s current evaluation of supports didn’t include enough financing to hire additional staff.
- Rachel’s size and condition meant that any care workers needed to be highly skilled, and the standard pay rates for support workers were inadequate.
- The state was unwilling to allocate additional funding without proof that the initial evaluation was inadequate, and Mary’s testimony (which included hundreds of pages of Provider and circle-of-support documentation) was not enough.
Why did we need to build MyDoDAD?
And thus the search for a person-centered documentation process began.
The Birth of Person-Centered Documentation
- The evaluator assumed a lower level of support frequency than what was being delivered. (ie – they automatically assigned Mary’s wound care supports as weekly instead of daily activities or only counting a cue once per goal when it could take up to 10).
- The evaluator underestimated the duration of events and their corresponding supports; meaning that Mary’s daily activities were given a default time allotment that was less than what was required in real life.
- The evaluator did not have the ability to understand Rachel’s unique condition, and as a result underestimated the intensity of her episodes. (Keeping a 300lb 5’11 woman in a psychotic state from running into traffic is harder than it sounds).
- It was determined that Rachel’s supports funding was too low. They established a new base funding level (prorated through the end of the plan year) more than 80% higher than what she had been approved for only 6 months earlier.
- Although previously denied, it was agreed that Rachel met the criteria for Intense Behavioral Support which allowed community support workers to be paid above the current wage cap and Intense Medical Support which allowed her to hire staff sufficient to cover 1:1 support, 24/7.
- By the end of her plan year, Rachel had shown such engagement with MyDoDad that her planwriter created MyDoDad specific goals so Rachel could use the system to better self-direct her care. The state agreed with these goals and also agreed to pay for MyDoDad out of Rachel’s annual adaptive equipment budget.