WEBVTT

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>>  Hello everybody.

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We're going to wait one minute until everybody gets on and we will get started in just a minute.

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>> Okay.

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We will go ahead and get started.

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There around few more people jumping in.

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Hello everyone.

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I'm Sierra Roy suffer I'm director of innovation at APRIL which is association of programs for rural independent living.

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Thank you for joining us for this webinar.

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Scary or not Scary considering it is Halloween.

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Understanding the HCBS settings rule.

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So a couple of housekeeping things before we get started.

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We do have a webinar platform today.

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So when you scroll over that bar depending on what device you are on that bar can at the top or bottom of your screen.

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That where you will find the kwloefd captioning for today's session.

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You can view captioning by selecting the CC tab on that tool bar.

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You also have assign language interpreter that can found just directly on scene.

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You like to change the size of the screen once the slides are shown you can do that by selecting the line in the middle of the screen that will slide to the right or left to make the slides or the interpreter large other or smaller.

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If you have any technical issues please use the chat feature for that today.

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You can use the word bubble and same menu bar.

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If you would like to turn chat feature off if you are using screen reader reader you can do that by press's Alt H or please use ininfor oh help section on APRIL website for more information if you need it.

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I will also drop my email into that chat as well if you would like to contact me in the chat's with a technical issue.

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We will have a question and answer time at the end of today.

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Please note the question ask answer box is on the menu bar.

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And so if you have something that you want to make sure gets asked in there, go ahead and drop that throughout the time we will review those at the end.

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We will have during that same question and answer time you will have option to raise hands.

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And so I can unmute you at that point.

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And then you can press star 9 or Alt Y on your key pad to raise hand and then star 6 to unmute or Alt A using key strokes.

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Once you join to keep the conversation background noise down so we can hear you as clearly as possible.

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Okay.

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So thank you.

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That's all the housekeeping items.

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But please let me know if you need anything throughout.

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I am going to go ahead and start the screen sharing so you can see our slides for today.

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Okay.

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So first off we have several of us talking today.

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We thank you for joining us.

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I'm again Sierra Royster and we will have kaed Brady and Amber OHaver and a Jay Harner and Erica McFadden.

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So thank you so much for all of them for joining as well.

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A couple of objectives we hope you leave with today, who are the stakeholders and important partners in your area.

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So start to understand the role of the HCBS settings rule.

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In case you do not understand that we hope you leave with a little bit better understanding of that today.

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Hen how does this apply to your work?

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How does this apply to your center or CIL and what can you do with it after?

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And where do you find information on this rule?

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So there probably be lots you still need to learn if this is new for you.

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We hope to give you some places that you can go that you can access some of this information.

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And then, once you have this information, what do you do next to promote those rules and find information about it?

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We hope that will a little bit that you will come away with today.

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Also have to for giverme I'm having bit of a cough this weekend and only likes only makes me cough when I have to talk.

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So this is fun.

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But, how did APRIL get involved with this?

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This is a partnership that NASILC or working with HSIR on.

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Ask this is something that we are hoping that we can encourage the work that centers and SILCKs have been done in independent living and transition work for a very long time.

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But to understand there's a setting rule that has been in place for a while but some of that work and how that looks in your state may look very different.

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But that also can enforce kind of what we have been saying a community choice for so long, and then consumer control as well within that choice.

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So some of these rules are kind reinforced with what we've trying to do and independent living for a very long time.

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So just seems natural to giver those resources and help get you connected with those partners in the community.

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Some of our role we will bring awareness to the membership and IL partners on this role.

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This one way we're doing this is today.

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We'll have couple different things we will be doing with this work.

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But in order to know about it you have have to be aware of it.

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A lot centers probably are not aware how this rule As them.

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We hope through these situations, excuse me, you will be able to do that.

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Okay.

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Okay.

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>> Kate I'm going to ask you to go ahead

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>> I'm happy to do that, I'm so sorry you are with us while you have a cough.

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.

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His the season.

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Go back a slide and I'm happy to cover -- yeah.

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So my name is kaelt Brady.

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I'm a project manager at the human service research institute.

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And we host the national center on advancing person centered practices and systems.

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And it's through that center that the administration of disabilities and administration from community living is funding this home and community based services partnership that we're so thrilled APRIL and NASILC are a part of.

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So APRIL's role since Sierra able to get through, APRIL's role is to bring awareness to your membership.

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To independent living partners on the HCBS settings rule.

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Which couldn't I couldn't agree more.

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Aligns completely with IL philosophy.

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So we're hoping that we can equip CILs ask SILCKs with the information will allow auto increase your efficacy around transition and diversion from institutional settings where we can provide you with resources so that the you'll better able to educate the people that you're interfacing with in the community.

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And that we can identify those of you that are already doing this work and position you as within the network.

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So that is kind of the aims of the partnership.

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Next slide.

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Okay.

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So quick visual description.

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Kathy I'm comically in my witch I committed to my children I would dress up this year I use home and community based services to get ready for my day.

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You just have one opportunity to get ready.

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So it was an all or nothing proposition.

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So so I'm here with you in my costume.

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Comical as that is.

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And I guess other thank you for the support and the chat there.

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Other visual descriptions middle aged white woman with short brown curly hair.

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And my background is a kind of blue green human service research institute background.

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Next slide, please.

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And just to plug there's an interpreter who needs will need access to using her camera online.

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Just a plug for, Sierra, so that she can promoted to a panelist.

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Her name is Amanda.

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All right.

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So the who and what of home and community based services or HCBS.

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What are home and community based services?

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These are the services that are funded to support things like supported employment, finding a job, keeping a job, getting accommodations on that job, transportation, very often people are using Medicaid waivers for activities of daily living support such as bathing, dressing, toileting, cooking.

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Perhaps like housekeeping, in-home services like PT, OT, speech therapy, medications finances as well as assistive tech in home modification.

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So you can see that home and community based services are really underpinning our access to really critical daily supports for live an independent life.

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In 2018 more than 4.7 million people received these Medicaid funded services.

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And each state its own system for administering Medicaid waiver HCBS.

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They decide which populations they will offer these waivers to.

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So the home and community based settings rule is a federal rule, there's tremendous variation in the states which is why your expertise and knowledge advocacy or going to be so important.

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Because we have to be working on the ground locally in states to advance these changes.

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Next slide.

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Thank you.

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So a little background.

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Where did this role come from?

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Why why are we doing this?

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Well we knew that people Lovieing in community based settings were still living in a life that was closer to an institutional experience be that in group homes, so in 2014 the home and community based final rule was the very first attempt to really define when we say community based, what do we mean?

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What meets that has threshold?

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?

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Since 27th 14 we have been in what we call a transition period.

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In March 17th of 2023, that will be the end of the home and community based services transition period.

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Meaning that those services that don't align with the requirement have to come into compliance.

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So the time is now for advocacy.

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We will talk a little bit more about particular opportunities for advocacy.

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So thankful ACL and CMS are being very steadfast in ensuring that our services adhere to tenants of the rule regulatory criteria.

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Though these provide the framework for ensuring that services are to be person-centered.

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And that settings within which those services are provided facilitate autonomy.

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And independence.

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You can see another alignment the with IL facility.

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Next slide, please.

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Thank you.

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So what does this rule require of service ask supports?

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It requires they are integrated and support full access to the greater community.

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It requires that the person receives services in the community with the same degree of access as people not receiving federal Medicaid funding.

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So that's the box.

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Any person not receiving services that level of access should not be different or diminished by fact they are receiving services.

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And it requires that service and supports provide opportunities to seek employment, working competitive integrated settings, engage in community life and control your own resources.

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Next slide, please.

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So what exactly makes a setting home and community based?

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It is in the community.

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It should provide that full access.

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As we said t should provide opportunities to seek employment at an integrated settings at competitive wages.

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Allow participation in community life and control resources.

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It howls also always be selected by the person from options that include nondisability specific settings.

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So really important.

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So in menu of options there should always be options of nondisability specific setting.

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The rule ensures right to privacy and freedom of respect and freedom of coercion and restraint and facilitates individual initiative autonomy and independence in making life choices.

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So that's a very specific requirement, right is this so when we evaluate these services and when you're in conversations with people about their life and the supports that they are receiving, you can be listening for violations of people's freedoms or situations in which they've been coerced or maybe their independence in making choices has not be upheld.

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Those indicate violations of HCBS settings.

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Next slide, please.

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All right.

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The requirements at the state level are that the state has to ensure that all of the services meet the minimum sfdz standards integration access to community life, choice autonomy and other protections.

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It also require that is every person's service are driven by person-centered plan.

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They have to receive final stayed-wide approval.

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So we will look at which states have already submitted their transition plan and had it approved ask which states have yet to accomplish that and you can get involved.

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Next slide, please.

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So thankfully there are some additional requirements when the setting of the services is provider owned or controlled.

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And those are requirements are here.

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The unit has to be owned or rented occupied under a legally enforceable agreement.

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It has to it allow for privacy meetings people can lock their bed courtroom doors.

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People have to have choice roommates and freedom to deck rate the space as they choose.

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One should have control over one's own schedule.

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So that means not only what services one gets, but when they have them.

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Right?

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Access to food at any time.

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So that means unless there's something in the person-centered plan that says I really want to change the way I eat, I really want to make sure I don't eat after 11 at night, there should no limitations on access to food.

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And any person living in a provider-owned or controlled setting should have choice, should have access to visitors at any time.

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Next slide, please.

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All right.

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I put it in here twice.

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Because it is that important.

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And you would think that these are kind of basic rights that we would assume that any adult living on their own would have, right and we shouldn't have the to stipulate.

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But unfortunately, we know that there are many -- people all over country that a disabilities of variety kinds where Medicaid is funding service and they do not have access to food or they are told we can only have visitors on Saturday afternoon.

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So it's really important that we have these things in mind.

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Control of schedule and activities.

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Of course physical accessibility.

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And key to note here that as I mentioned, any deviation these has to be supported by a specifically assessed need in the person dash centered plan or individualized service plan.

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When a plan to reevaluate and return those freedoms, right.

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So not indefinitely that I can't eat my cheese puffs after 11 p.m.

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It is once I have accomplish ad change in my habits or once I've accomplished the change in my weight and what supports am I going to receive to regain access so that I have autonomy to make decisions.

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Next slide, please.

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All right.

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So this person-centered plan that drives all services has some requirements thankfully in the HCBS settings law.

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That us it should always identify strengths, preferences, needs, both clinical and support needs.

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And any desired outcomes that the individual has.

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It should include very individually identified goals and preferences.

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And these goals and preferences should speak to relationships, community participation, employment, income, savings, healthcare and wellness, education, anything else that is both important to and important for the person.

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And it should reflect what is important to the individual and speak to the manner they want services delivered so that that is ensured.

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It may identify any risk factors so that supports can engage to minimize those.

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And the plan should be understood by the individual, that means it should be free of jargon and they should have a primary voice in the development of that plan.

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And of course it should reflect any cultural considerations.

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Next slide, please.

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All right.

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So why are we talking to you about this?

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Why are we so concerned about public engagement?

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Well the administration and community living works closely with CMS to implement the settings rule.

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The rule is key to engaging community members in the development provision and the oversight of HCBS programs.

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We're so grateful that for the very first time ACL specifically is funding public engagement efforts.

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So next slide, please.

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So what do we mean by public engagement?

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Is well there are a number of opportunities to engage and a number of methods that you can take.

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And we'll go over some of those.

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In short-term I will put link in this chat after I'm done going through the slides, every state has a state-wide transition plan.

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Meaning what are their plans for ensuring all the places that deliver services are in #k078 appliance?

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And they have to release that rule for public comment, consider those comments, revise it and finalize it.

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So there are opportunities during that process for people with disabilities, their families or the organizations to look at that plan, see what they think and provide comments.

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There's also heightened scrutiny package.

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Heightened scrutiny very simply means that a state agency has identified as not likely in compliance now.

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And states have to make plans for how they expect additional federal oversight to review those sites and how they will in the future come into compliance.

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So they produce what's called a height scrutiny package.

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CMS, centers for Medicaid, will identify some states around the country each year to do site visits.

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They go and look at those sites so that they can provide monitoring and feedback about the experiences of the people in those services.

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And they are always, to opportunities to engage.

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There are also corrective action plans.

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So CMS put forth the opportunity for states to show that their policy and procedures reflected setting criteria that they are making attempts to implement the criteria to fullest extent possible.

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But that they are going to make corrective action plans to allow for more time and more actions to bring those systems into full compliance.

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And then I put in bold here waiver amendments and renewals.

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Because when we are all said and done with the transition period all states still deliver home and community based services through waivers, Medicaid waivers.

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And you are probably serving tons of folks who come into CILs and probably SILCK and about their experience on waiting list.

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It is waiver document and any times in which state proposes amendments that there are always opportunities for advocates to engage.

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So that really important one to keep an eye on.

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Next slide, please.

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So here's just the restate, I think we've covered those opportunities for engagement.

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Next slide, please.

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So when we say stakeholders who do we mean?

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We really mean everyone.

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We mean individual people with disabilities and their families, advocacy groups, every kind of advocacy group.

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Self advocacy groups.

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Parent groups.

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Sibling groups.

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We also mean the P & A protecting and advocacy organization in your state, ombudsman office.

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Adult protective services.

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Today most importantly Centers For Independent Living and State Wide Independent Living Councils.

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Next slide, please.

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So as I mentioned there are a myriad of ways that you can get involved.

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When a state posts a period of comment you can show up in person and give a public comment.

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That can just comments on your experience or something in particular you're concerned about regarding the state system.

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You can submit those same comments in writing.

00:27:21.000 --> 00:27:25.000
You can also coordinate templates for others to use in submitting their comments to support people and knowing what to say.

00:27:25.000 --> 00:27:30.000
You can consult a partners in your state.

00:27:30.000 --> 00:27:49.000
ACL is currently funding the national network.

00:27:49.000 --> 00:27:58.000
So not only at APRIL and NASILC are involved this this work but the national association of DD councils, the national disability rights network and ACB, the association for university centers on disability as well as ASAN are all involved.

00:27:58.000 --> 00:28:03.000
So any given state you probably have partners that you can working with to submit comments.

00:28:03.000 --> 00:28:27.000
Always you have the opportunity to call your elected officials.

00:28:27.000 --> 00:28:28.000
And I think for your day-to-day work, the opportunity that we really want to support you in is to help someone who receiving services be aware of their rights and be able to decipher when those rights have been violated and how that applies to the home and community based settings rule.

00:28:28.000 --> 00:28:30.000
Next slide.

00:28:30.000 --> 00:28:32.000
So quick review.

00:28:32.000 --> 00:28:39.000
Settings ought to be integrated.

00:28:39.000 --> 00:28:44.000
They have to ensure right to a privacy and respect autonomy and a freedom from coercion and restraint.

00:28:44.000 --> 00:28:48.000
And provider settings have additional requirements.

00:28:48.000 --> 00:28:52.000
And all services should facilitate choice.

00:28:52.000 --> 00:28:59.000
Next slide.

00:28:59.000 --> 00:29:02.000
So when we're thinking about the state system I want you to be aware of these deadlines.

00:29:02.000 --> 00:29:10.000
March 17th, 2023, that's the deadline for state compliance.

00:29:10.000 --> 00:29:15.000
You can look at this link here and that's how you'll know whether your state has already attained final approval.

00:29:15.000 --> 00:29:28.000
KAPS or corrective action plans are do you January 1st, 2023.

00:29:28.000 --> 00:29:31.000
States are not required to release their corrective action plans for public comment that does not mean you cannot call and say we would like to understand if you're thinking about submitting a corrective action plan.

00:29:31.000 --> 00:29:33.000
We would like to have a chance to talk through that with you.

00:29:33.000 --> 00:29:45.000
You can always make those requests.

00:29:45.000 --> 00:30:01.000
And then we anticipate continued CMS heightened scrutiny reviews for any settings that are considered presumptively eligible.

00:30:01.000 --> 00:30:04.000
And we have seen, it's really important for you all to know, we have seen already when advocates identify sites that are of concern to them and communicate that those sites go on the heightened scrutiny list.

00:30:04.000 --> 00:30:07.000
It really does matter.

00:30:07.000 --> 00:30:12.000
And all of this stuff is super complex.

00:30:12.000 --> 00:30:17.000
And the most successful states are working in coalition with other organizations.

00:30:17.000 --> 00:30:18.000
Next slide, please.

00:30:18.000 --> 00:30:21.000
All right.

00:30:21.000 --> 00:30:25.000
I think we covered this.

00:30:25.000 --> 00:30:26.000
I'm going to keep going in interest of time.

00:30:26.000 --> 00:30:27.000
Thank you.

00:30:27.000 --> 00:30:33.000
All right.

00:30:33.000 --> 00:30:34.000
So yeah we should skip this one too.

00:30:34.000 --> 00:30:35.000
Yeah.

00:30:35.000 --> 00:30:52.000
All right.

00:30:52.000 --> 00:31:00.000
So by January 1st states have to have told CMS what is their oversight system, licensure, certification, prior manuals, person-centered plan monitor thing.

00:31:00.000 --> 00:31:13.000
They also have to tell them what assessment process that they will be using for initial compliance and ongoing compliance of settings.

00:31:13.000 --> 00:31:15.000
And they have to describe what is the beneficiaries, resource what is your option if you notice a provider is not in compliance.

00:31:15.000 --> 00:31:18.000
They will call this grievance process.

00:31:18.000 --> 00:31:20.000
Might be notification of the case manager.

00:31:20.000 --> 00:31:28.000
It will be different in every state.

00:31:28.000 --> 00:31:32.000
So it's very critical for when you know what the grievance process of beneficiary recourse is in your state.

00:31:32.000 --> 00:31:33.000
And the state has to say how they are going to respond.

00:31:33.000 --> 00:31:39.000
Right?

00:31:39.000 --> 00:31:40.000
So not a one way, it should be closely watched.

00:31:40.000 --> 00:31:41.000
Next slide, please.

00:31:41.000 --> 00:31:56.000
All right.

00:31:56.000 --> 00:32:00.000
Here's a map that I won't go over because you can access it on the link that we will put in chat, but it just shows you states that have pending state wide transition plans and initial approval or final approval.

00:32:00.000 --> 00:32:01.000
Next slide, please.

00:32:01.000 --> 00:32:29.000
All right.

00:32:29.000 --> 00:32:42.000
As a reminder, corrective action plans can include, this is important, they can include modifications to the state's compliance plan ensuring all services provide access to the broader community, opportunities for employment, private unit and/or choice of roommate and choice of nondisability specific settings.

00:32:42.000 --> 00:32:47.000
In other words a corrective action plan may delineate how a certain part of the home and community based service system in the state is not yet compliant with those requirements.

00:32:47.000 --> 00:33:05.000
They have to be concrete and time limited.

00:33:05.000 --> 00:33:11.000
And they have to, they have to address how the state will in the future ensure that access, opportunities for employment choice of private unit or roommates and choice of nondisability disability settings will in the future be made available.

00:33:11.000 --> 00:33:27.000
Next slide.

00:33:27.000 --> 00:33:31.000
So they have to be able to show that they have a plan and that they have done everything they can to adhere to these requirements and they are not falling short and their plans is how they will get there.

00:33:31.000 --> 00:33:36.000
They are encouraged to seek public input.

00:33:36.000 --> 00:33:40.000
So I'm encouraging you to initiate that conversation with your agency.

00:33:40.000 --> 00:33:42.000
Next slide, please.

00:33:42.000 --> 00:33:47.000
And then there we are.

00:33:47.000 --> 00:33:52.000
We'll go to the State Wide Independent Living Council.

00:33:52.000 --> 00:34:05.000
I'm thrilled to pass it over to Amber.

00:34:05.000 --> 00:34:07.000
Executive director of NASILC.

00:34:07.000 --> 00:34:09.000
>> This is Amber speaking.

00:34:09.000 --> 00:34:11.000
Thank you, Kate, I appreciate that.

00:34:11.000 --> 00:34:15.000
A lot of really, really great information.

00:34:15.000 --> 00:34:16.000
I even learned several things that were new to me too.

00:34:16.000 --> 00:34:21.000
I appreciate that.

00:34:21.000 --> 00:34:30.000
So good afternoon everybody my name Amber OHaver.

00:34:30.000 --> 00:34:49.000
I'm vice chair of NASILC and current executive director of end state wide living council.

00:34:49.000 --> 00:34:51.000
I will address thee intimidating or scary related components of the rule and how the SILCK play as role or can play a role in advocating to ensure compliance in our peers' rights when it comes to HCBS setting role.

00:34:51.000 --> 00:34:54.000
Let me give a visual description.

00:34:54.000 --> 00:34:58.000
A middle age wide woman.

00:34:58.000 --> 00:35:01.000
Very long blond hair pulled back with blood head band.

00:35:01.000 --> 00:35:06.000
I'm black and white V next sweaters.

00:35:06.000 --> 00:35:10.000
I have silver little ball earrings and silver necklace on.

00:35:10.000 --> 00:35:12.000
My background is blurred but I'm at home in my office today.

00:35:12.000 --> 00:35:17.000
And again, happy to be here with everyone.

00:35:17.000 --> 00:35:27.000
Go to the next slide, please, that would be great.

00:35:27.000 --> 00:35:39.000
So before I dig into start going through this I want to say I'm really thrilled to be working with various national partners.

00:35:39.000 --> 00:35:51.000
And I so appreciate APL really providing NASILC and APRIL and MDRN and all the other national groups the opportunity to receive some funding to do work in some space.

00:35:51.000 --> 00:36:05.000
Particularly NASILC because it just the HCBS setting rule really presents a great opportunities for SILCKs to really dig into their duties and exercise their thortd.

00:36:05.000 --> 00:36:07.000
Which again I think is exceptional and this thing that quite frankly the independent living network across the country and our state has not had the opportunity to do a lot of work around when it comes to specifically identifying advocacy opportunities when it comes to HCBS settings rule.

00:36:07.000 --> 00:36:14.000
So here we are.

00:36:14.000 --> 00:36:17.000
So I want to start with just identifying talking a little bit about building and bridging partnerships or collaborations in your state a SILCK.

00:36:17.000 --> 00:36:42.000
And the role of the SILCK when it comes to it.

00:36:42.000 --> 00:36:57.000
So what I'm talking about building and bridging partnerships and collaborations, the importance of those is essentially how can you come together with those various agencies entities, consumer directed groups in your state and work together or leverage your different strengths and knowledge, right to advocate to ensure the rights of disabilities when it comes to the HCBS settings rule.

00:36:57.000 --> 00:37:06.000
So when I'm talking about state agencies I'm essentially talking about entities that have oversight sort of control overseeing development and implementation and compliance when it comes to the state transition plans.

00:37:06.000 --> 00:37:13.000
And then when I'm talking about state advocacy entities I'm really talking about all various advocacy in your state like protection advocacy system.

00:37:13.000 --> 00:37:20.000
The DD council, even ACLU state chapter.

00:37:20.000 --> 00:37:32.000
AARP state chappers ombudsman when it comes long-term care, the list goes on and on and on.

00:37:32.000 --> 00:37:47.000
Essentially anyone that fingers or you know, advocacy efforts engagement when it comes to home and community based services or just community living in general.

00:37:47.000 --> 00:38:08.000
So it another role or another piece of the work that SILCK can get engaged in and that really can play I think a very strong role when it comes to the HCBS settings rule is around information dissemination and educational awareness.

00:38:08.000 --> 00:38:20.000
So what I mean by this is the SILCK can arrange and schedule and set up some training to educate the CILs and their consumers or board members about HCBS settings rule to better understand what that looks like what it andwhat purpose is, and how it directly tied to independent living philosophy which is great.

00:38:20.000 --> 00:38:38.000
And then also disseminating information and doing some educational awareness efforts and activities when it comes to consumers and peers with disabilities.

00:38:38.000 --> 00:38:49.000
So one of the ways I think that really gets back to why it important to have strong partnerships and collaborations in your state with various partners is because when it comes to information dissemination and an educational awareness it really important to tap those partners to help you disseminate the information.

00:38:49.000 --> 00:39:03.000
So for example, you know your P&As are ones that access in terms monitoring visits to lot of spaces and places and facilities where our peers are.

00:39:03.000 --> 00:39:16.000
And very easily share and provide information about the rule and what their rights are in language and ways that is easy to wrap their heads around and understand.

00:39:16.000 --> 00:39:33.000
That is something you can work with parters in on to develop one really great resources I would say again and express to everyone here is the u ad ASAN is phenomenal.

00:39:33.000 --> 00:39:39.000
They have a phenomenal resources in plain language and lots of other templates and lots of other tool kits that that are really great and really helpful and can also be tapped and tweaked to your needs or your state to share and disseminate and push out through those various partners you have.

00:39:39.000 --> 00:39:53.000
Your AAA is another great one to also tap to help you disseminate information about the settings rule.

00:39:53.000 --> 00:39:58.000
So I would also advise developing partnership and collaborations with them to sort of link up together and start working together ensure rights of people with disabilities in your state when it comes to the HCBS settings rule.

00:39:58.000 --> 00:40:09.000
Next slide, please.

00:40:09.000 --> 00:40:21.000
So this really gets more into the systems advocacy piece which is really an example of how a SILCK can dig into its authorities.

00:40:21.000 --> 00:40:29.000
So systems systems advocacy when I'm talking about that when I'm talking about a settings rule what is already happening in your state when it comes to systemic activities that you can engage in?

00:40:29.000 --> 00:40:38.000
Recreating wheel or starting something over again or something that is already occurring can you get in work groups that are already taking place?

00:40:38.000 --> 00:40:40.000
Can you get involved in tag teaming on training opportunities to educate our peer with disabilities andwhat their rights are when it comes to the rule.

00:40:40.000 --> 00:40:43.000
What is already taking place?

00:40:43.000 --> 00:41:10.000
What is happening in your state really to dig into.

00:41:10.000 --> 00:41:15.000
And if there isn't a lot happening in your state or anything or there antiopportunities necessarily that you think are a good fit for the SILCK at that time you could also then as a SILCK really start to develop or implement or create and lead and direct your own advocacy opportunities and pull those partners I talked about a minute ago into fold in work you're doing a SILCK.

00:41:15.000 --> 00:41:23.000
The so SILCK can engage through work that already occurring and become a part of that work.

00:41:23.000 --> 00:41:28.000
It also can lead and direct some varus out type advocacy opportunities to help ensure compliance with the rule.

00:41:28.000 --> 00:41:31.000
And then also, again, to ensure the rights of our peers with disabilities.

00:41:31.000 --> 00:41:32.000
The next thing is around con you remember engagement.

00:41:32.000 --> 00:41:59.000
This piece I think is really important.

00:41:59.000 --> 00:42:26.000
When we talk about the SILCK there isn't always necessarily a lot of thought around consumer engagement to be quite honest or Centers For Independent Living ones that do a really great job providing direct services and day-to-day services and engaged with consumers on the ground every day doing work around diversion transition and home and community based services related advocacy supports.

00:42:26.000 --> 00:42:32.000
So I would say the for the SILCK one of the ways you can help address this advocacy needs when it comes to the rule is really looking how having a SILCK helped resxrut bring in people into about fold doing this work learning about it, gaining knowledge which then helps to empower them which next one I have on our slide.

00:42:32.000 --> 00:42:41.000
For example Indiana one.  Ways we have done that work a SILCK really utilizing our existing leadership programs.

00:42:41.000 --> 00:42:48.000
So a lot of SILCKs across country or.youth leadership forum or youth are leadership programs ask us in action.

00:42:48.000 --> 00:43:00.000
We just did another one this past summer, a virtual all virtual event or programming that was shifting the narrative.

00:43:00.000 --> 00:43:13.000
And built in a lot lot of this type of education and training and awareness when it came to rule and other HCBS-type issues that are experienced here in Indiana.

00:43:13.000 --> 00:43:15.000
But not only talked about them and educated them on the issues, work together as a peer to peer network and group to really get into the space of brainstorming around action.

00:43:15.000 --> 00:43:20.000
Like what do activities look like?

00:43:20.000 --> 00:43:24.000
What do next steps look like in terms of consumers do we work together?

00:43:24.000 --> 00:43:37.000
Do we work with SILCK and other partners to bring them in.

00:43:37.000 --> 00:44:02.000
Really just about thinking more broadly in terms of consumer engagement when it comes to recruitment and empowerment and utilizing what you're already doing a SILCK if you're doing any of those type of programming.

00:44:02.000 --> 00:44:14.000
Other thing I would say when it comes to con you remember engagement I think is honest WIA SILCKs don't do enough of because we're so engaged engulfed in doing the work sometimes we forget, it's a privilege to be in spaces where there is some pretty heavy gatekeeping that often happens for us as people with disabilities.

00:44:14.000 --> 00:44:42.000
And so we have this unsaid responsibility quite frankly to leverage that privilege in that space and who is not here at the table that my peer that needs to be here.

00:44:42.000 --> 00:44:47.000
Who else can I help get here in this space to learn about the advocacy or the information that is being shared when it comes to the HCBS settings rule or are there advocacy efforts taking place that our peers with disabilities can engaged in and then how can WIA SILCK make sure we get them pulled into the fold and working together and collaborating with the existing group to conduct those advocacy opportunities.

00:44:47.000 --> 00:45:14.000
Next slide, please.

00:45:14.000 --> 00:45:24.000
So this is sort of where I -- when we were forming and putting this presentation together we talked a lot about you know, what can a SILCK currently do where should SILCK currently focus energy and time and following this our final slide which I'll talking about in future opportunities and ways SILCK can focus energy and time when it comes to advocacy efforts around the HCBS settings rule.

00:45:24.000 --> 00:45:27.000
So I would first say one of the things really pofrnt for SILCKs to do is find out if your state has final approved state transition plan.

00:45:27.000 --> 00:45:42.000
If it doesn't, find out why.

00:45:42.000 --> 00:45:51.000
I think if you're wanting to know how to navigate that and Kate touched on this a little bit but you can ask your your DSE will know actually where to point you to get access to the state transition plan.

00:45:51.000 --> 00:45:58.000
Or if you have a relationship with other state leaderships or agency folks you can also tap them and ask them about and request a copy of the state plan.

00:45:58.000 --> 00:46:04.000
So in Indiana, for example, one of the things that we are going to working with our state on to ensure greater access to the plan.

00:46:04.000 --> 00:46:13.000
And Indiana's plan was approved in June they didn't push out that information until September.

00:46:13.000 --> 00:46:14.000
When they pushed out that information they pushed own announcement if you would like like a copy plan you need to email us to request it.

00:46:14.000 --> 00:46:15.000
Okay.

00:46:15.000 --> 00:46:33.000
So I did that.

00:46:33.000 --> 00:46:43.000
Well wouldn't much easier and much less restrictive if we could just click on a link and up would pop the plan and we would access to it right there instead of having to ask for permission to get access to copy of plan?

00:46:43.000 --> 00:46:48.000
Those little things are ways we can talk with our state agency folks to ensure greater access to information we need to to be their advocate to do this work.

00:46:48.000 --> 00:46:53.000
So the other thing I would encourage you to do is review the plan.

00:46:53.000 --> 00:46:56.000
I will say, Indiana's plan 167 pages long.

00:46:56.000 --> 00:46:58.000
These plans are not easy to read.

00:46:58.000 --> 00:47:01.000
They are not necessarily easy to follow.

00:47:01.000 --> 00:47:24.000
And they are extremely long.

00:47:24.000 --> 00:47:29.000
So one of the ways that I think you could also leverage or tap some of those partnerships that you have with other entities in your state is to contact your P & A or DD council or youth center, who every you're working with or you know and are a relationship with in your when it comes to disability related advocacy or services and say hey, do you know much about this plan.

00:47:29.000 --> 00:47:34.000
And if you do, do you have anyway you can help me break this down and understand this?

00:47:34.000 --> 00:47:44.000
Or I have these questions, can you walk me through this.

00:47:44.000 --> 00:47:58.000
I know in Indiana that is something I do a lot with our P & A because they tend to have a much deeper level of knowledge and experience when it comes to these plans.

00:47:58.000 --> 00:48:05.000
Because they've been involved in from most of them from the beginning in their state around provide around written comment and being involved in development work groups when it comes to work plan and all of that.

00:48:05.000 --> 00:48:07.000
So they have a little bit of a deeper insight a lot of times and better equipped sometimes to answering questions you may have about the plan.

00:48:07.000 --> 00:48:09.000
So they are a great resource.

00:48:09.000 --> 00:48:13.000
Your partners utilize them.

00:48:13.000 --> 00:48:17.000
Leverage them, don't be afraid to reach out even to your state agency folks.

00:48:17.000 --> 00:48:22.000
We have an excellent relationship with our Indiana Medicaid director here.

00:48:22.000 --> 00:48:26.000
And I tap her for information questions all the time.

00:48:26.000 --> 00:48:28.000
Which she appreciates because some goods are not on her radar.

00:48:28.000 --> 00:48:39.000
Some things she's not aware of.

00:48:39.000 --> 00:48:46.000
And when I reach out and ask questions or pose inquiries to her, it helps raise her awareness of things they need to get better in doing, right?

00:48:46.000 --> 00:48:48.000
In the state agency where these kind of issues are occurring or these plans exist.

00:48:48.000 --> 00:48:58.000
And need to be implemented appropriately.

00:48:58.000 --> 00:48:59.000
So also Kate touched on this, but, how essentially is your state planning to provide a grievance process?

00:48:59.000 --> 00:49:01.000
What is that?

00:49:01.000 --> 00:49:02.000
What does that look like?

00:49:02.000 --> 00:49:09.000
Is it clear?

00:49:09.000 --> 00:49:14.000
Is it transparent is this is it something you thing you and your peers our peers would able to easily navigate?

00:49:14.000 --> 00:49:23.000
Think about that from a lot of different types of disabilities when you're considering that.

00:49:23.000 --> 00:49:34.000
Some other questions are around how does your state plan or transition plan depress need of consumer transition.

00:49:34.000 --> 00:49:36.000
So if there's a site that says you know what, we're not going to get to be in compliance have to transition folks out of here we can't continue to serve them.

00:49:36.000 --> 00:49:38.000
Oh crap, what what happens then?

00:49:38.000 --> 00:49:39.000
How is that being addressed in plan?

00:49:39.000 --> 00:49:42.000
Do you think it appropriate or not?

00:49:42.000 --> 00:49:51.000
You know, dig into that and look for that kind of information.

00:49:51.000 --> 00:50:06.000
The other key piece I think often gets missed is how is your state transition plan addressing issues of equity?

00:50:06.000 --> 00:50:15.000
How are they addressing specific needs or prioritizing folks who are multiply marginalized and are people of color who with disabilities who are individuals who are part of other marginalized groups and communities.

00:50:15.000 --> 00:50:17.000
So I know it may seem kind of Audrey to think well we're talking about home and community based service what to ensure equity.

00:50:17.000 --> 00:50:24.000
I will tell you a lot.

00:50:24.000 --> 00:50:31.000
So, I would not be surprised if there isn't much when it comes to addressing these kinds of issues of equity in these plans.

00:50:31.000 --> 00:50:40.000
So it's an opportunity for you to dig into that with your state if that is something that you think is important which I think it is.

00:50:40.000 --> 00:51:04.000
So next slide, please.

00:51:04.000 --> 00:51:08.000
This one I won't go into de-A. Lot detail but one ways to dig into and find out your state is doing Weavering webbing a lot of these advocacy efforts or implementation or state wide transition plan when come it is to the settings rule is looking at other plans of your state.

00:51:08.000 --> 00:51:12.000
Do we this our state have anything in a setting rule?

00:51:12.000 --> 00:51:13.000
If we don't, why not?

00:51:13.000 --> 00:51:20.000
Let's dig into that.

00:51:20.000 --> 00:51:30.000
Same thing with DD council five-year strategic plan wee state plan through voc rehab.

00:51:30.000 --> 00:51:36.000
State P & As are required to do priorities and object uives on regular basis.

00:51:36.000 --> 00:51:49.000
How is the HCBS setting rule being addressed through priorities and objectives of your P & A.

00:51:49.000 --> 00:52:05.000
In Indiana we're develop a state plan on aging you bet your butt I'm going make sure as a SILCK there are issues addressed in there when it comes to the HCBS settings rule.

00:52:05.000 --> 00:52:09.000
And are there other plans in your state that maybe aren't federal related plans you need to have but are really important and key to addressing this from a more comprehensive level when it comes to compliance with the rule.

00:52:09.000 --> 00:52:12.000
Next slide, please.

00:52:12.000 --> 00:52:15.000
This will be my last slide.

00:52:15.000 --> 00:52:19.000
I will turn it over to Kathy to facilitate our panel.

00:52:19.000 --> 00:52:24.000
But what is the future for SILCK involvement or sick focus look like?

00:52:24.000 --> 00:52:30.000
What can it look like?

00:52:30.000 --> 00:52:44.000
I know right now our SILCKs are looking at amending our current plan to do 1-year extension.

00:52:44.000 --> 00:52:46.000
Is it a possibility that you might want to build into that some education and awareness training and activities or efforts as a SILCK to address this HCBS settings rule?

00:52:46.000 --> 00:53:12.000
So think about that.

00:53:12.000 --> 00:53:14.000
Another thing to do you do decide to do that, you could then get everyone prepared in your network be educated and up to speed on the rule and then be able to build out and dig into the rule a little bit more in the development of the CIL and use it a really great, the CIL is a really great tool or mechanism to address advocacy related efforts and issues when it comes to a rule from IL network perspective.

00:53:14.000 --> 00:53:19.000
Not just the SILCK, not just the CIL.

00:53:19.000 --> 00:53:23.000
It really all encompassing.

00:53:23.000 --> 00:53:39.000
A lot of SILCKs have states on state commission on rehabilitation.

00:53:39.000 --> 00:53:54.000
How can you leverage that is this how can you ensure that you as a SILCK in that seat, whoever that might be, SILCK staff, SILCK member, how are you asking questions about the rule and how that commission is addressing compliance with that.

00:53:54.000 --> 00:54:01.000
So other thing is I mentioned partnering with different various groups in your state to conduct education and straining events for peers with disabilities on their rights and in accordance with the rule.

00:54:01.000 --> 00:54:05.000
I think it would kwufrl to tag team P&A.

00:54:05.000 --> 00:54:11.000
And doing some train thing for folks in these settings.

00:54:11.000 --> 00:54:14.000
And then also, you know talking to more doing, talking to them about doing, you know, what is the rule?

00:54:14.000 --> 00:54:15.000
What is the purpose?

00:54:15.000 --> 00:54:19.000
Why is it needed?

00:54:19.000 --> 00:54:24.000
How does it apply to me as consumer and my peers with disabilities?

00:54:24.000 --> 00:54:29.000
And then, provide some examples of what violation of that rule would look like for folks.

00:54:29.000 --> 00:54:30.000
And then talk to them about, what do I do if my rights are violated?

00:54:30.000 --> 00:54:31.000
Who doi contact?

00:54:31.000 --> 00:54:32.000
Who do I notify?

00:54:32.000 --> 00:54:33.000
How does this work?

00:54:33.000 --> 00:54:44.000
Has how does this happen?

00:54:44.000 --> 00:54:52.000
It and again, hopefully, you've working and engaging with your state on allowing or providing for very clear and transparent grievance complaint process.

00:54:52.000 --> 00:54:55.000
Again the last thing, what does engagement of consumers or people with disabilities look like when it comes to ensure compliance with the rule?

00:54:55.000 --> 00:55:01.000
Site visits a really great one.

00:55:01.000 --> 00:55:02.000
In tandem with CMS, op they pull advocates in to help.

00:55:02.000 --> 00:55:06.000
That's good one.

00:55:06.000 --> 00:55:08.000
Another unis pushing out advocacy alerts.

00:55:08.000 --> 00:55:12.000
We do that lot here.

00:55:12.000 --> 00:55:28.000
Our peer latch on to those and we provide action alerts.

00:55:28.000 --> 00:55:38.000
Not just the opportunity, but templates and actions that folks can take to help make it a little GIT easier for our peers to engage and continuing leverage like leadership programming and training you do as SILCK.

00:55:38.000 --> 00:55:48.000
And we host a lot of times these disability community conversations that are just spaces for people with disabilities, no one else.

00:55:48.000 --> 00:55:53.000
We talk about services and then typically we end those and wrap those up with some calls to action and what that looks like.

00:55:53.000 --> 00:56:04.000
That is a group developed and decided decision.

00:56:04.000 --> 00:56:11.000
Just really reinforces consumer direction and the peer to peer support model of independent living is beautiful in providing to our disability community.

00:56:11.000 --> 00:56:22.000
With that I will end and wrap things up and Kathy, I think you're up.

00:56:22.000 --> 00:56:29.000
>> Hello everybody this is Kathy Cooper I'm going to step in and help Sierra of verbal description of myself I am a white woman in my early 50s.

00:56:29.000 --> 00:56:35.000
I have brown brond hair it pulled up in a messy bun on my head with a pink and mauve shirt.

00:56:35.000 --> 00:56:40.000
The background is a white wall with a red white and blue picture.

00:56:40.000 --> 00:56:45.000
I am the chair of the national association of State Wide Independent Living Councils.

00:56:45.000 --> 00:56:48.000
And I'm also the executive director of the SILCK in Kansas.

00:56:48.000 --> 00:57:01.000
I'm going to have a few questions for our panelists.

00:57:01.000 --> 00:57:12.000
And we're going to have Jay Harner and Jodie from a roads to freedom Independent Living Center join us along with Amber OHaver you just heard from.

00:57:12.000 --> 00:57:14.000
We're going to ask them some questions about the work they are doing in this area and how it strengthened advocacy in this work.

00:57:14.000 --> 00:57:15.000
Kate will help me with this too.

00:57:15.000 --> 00:57:23.000
So we will get started.

00:57:23.000 --> 00:57:44.000
I'll go ahead and turn on my screen so you can see panelists and interpreters a little better.

00:57:44.000 --> 00:57:46.000
What are some activities that your CIL ask SILCK is doing now around HCBS and what is worked for you to get stakeholders engaged?

00:57:46.000 --> 00:57:47.000
Feel free to jump in Jodie, Jay or Amber.

00:57:47.000 --> 00:57:48.000
>> This Amber.

00:57:48.000 --> 00:58:00.000
I can jump in.

00:58:00.000 --> 00:58:02.000
One of the things I know we do, so we are stwod pretty heavily.

00:58:02.000 --> 00:58:12.000
We do a lot of work around that.

00:58:12.000 --> 00:58:21.000
Obviously an HCBS piece to doing you know ensuring community living and a being says to community sports.

00:58:21.000 --> 00:58:23.000
We do lot of work around that Indiana our self direction planning is like bottom of the pack in terms of entire country.

00:58:23.000 --> 00:58:37.000
So there's a lot work that needs to be done.

00:58:37.000 --> 00:58:47.000
The other thing we do our sick hosts ask conducts a monthly long-term advocate coalition meeting that. Coalition meeting is essentially consist majority 80, 85 percent of people with disabilities.

00:58:47.000 --> 00:59:06.000
And they essentially determine and figure out how to get involved in when can comes around community can integration and HCBS.

00:59:06.000 --> 00:59:09.000
It doesn't thourt compensate our peers when you have ability to do that for their time and experience and because their lived experience our lived experience is just valuable as professional experience that folks have that we work with on a day-to-day basis.

00:59:09.000 --> 00:59:13.000
>> Hi this is Jay.

00:59:13.000 --> 00:59:24.000
Unthing we do we work on advocating on consumers' behalf.

00:59:24.000 --> 00:59:44.000
We get lots of calls calls on regular basis for individuals working forward and unaware are what services are out there for them, how they qualify what financial restrictionses are.

00:59:44.000 --> 01:00:08.000
And we've advocating throughout state to expand services and working with our state budget to expand pay and add again fits overtime.

01:00:08.000 --> 01:00:12.000
They have experience since COVID, unable to find direct care workers because of rate of pay has not gone up substantially in comparison to many of the different sectors of employment that is possible within our area.

01:00:12.000 --> 01:00:20.000
We are in center part of state which a little bit more rural.

01:00:20.000 --> 01:00:26.000
We have issues with transportation not only for consumers but for direct care workers.

01:00:26.000 --> 01:00:29.000
So getting people to get to their homes to remain independent the in community and safe has challenge right now.

01:00:29.000 --> 01:00:32.000
We're working on the state to expand that.

01:00:32.000 --> 01:00:40.000
We did receive an 8 percent budget increase several months ago.

01:00:40.000 --> 01:00:44.000
But inflation and price of gas it hasn't really touch ad lot of things for some.

01:00:44.000 --> 01:00:47.000
I take a lot of calls just how the process can started.

01:00:47.000 --> 01:00:52.000
What they need to do.

01:00:52.000 --> 01:00:55.000
Everybody else myself I'm quadriplegic I'm paralyzed from neck down.

01:00:55.000 --> 01:01:02.000
I combroek my neck when he was 18 years old.

01:01:02.000 --> 01:01:14.000
I've used HCBS since January '98 not only do I live it but my profession I promote it.

01:01:14.000 --> 01:01:18.000
And advocate to remove barriers for anyone that wants to live independently on their own and stay out nursing homes which are like prisons.

01:01:18.000 --> 01:01:36.000
Once people are subjected to go into facilities, we will get them out.

01:01:36.000 --> 01:01:37.000
Anything we can do to keep them it thriving in their own personal comfortable environment what is we do on a daily basis.

01:01:37.000 --> 01:01:38.000
>> Okay.

01:01:38.000 --> 01:01:39.000
Thank you guys.

01:01:39.000 --> 01:01:44.000
We will go on told next question.

01:01:44.000 --> 01:02:02.000
>> How do you see advocating for this rule as being important to IL?

01:02:02.000 --> 01:02:03.000
And how do you think we can spread the message of its importance?

01:02:03.000 --> 01:02:07.000
>> This is Jay again.

01:02:07.000 --> 01:02:17.000
IL without these services I would in nursing home.

01:02:17.000 --> 01:02:23.000
Many other individuals need, you know, as we learn about the services I need assistance with showering bathing and getting dressed and food preparation, temperatures.

01:02:23.000 --> 01:02:34.000
All of the things that you know daily activities that allow me to remain independent.

01:02:34.000 --> 01:02:36.000
So for us to promote those services for individuals that are out there that there know this, I get calls everyday again people I heard about this transition program or what is independent living?

01:02:36.000 --> 01:02:50.000
What can I do?

01:02:50.000 --> 01:02:58.000
For somebody that is you know adult child living with their parents and 35 years old doesn't know what to do as they get older and never heard of independent living because all they've told is live on their own do anything.

01:02:58.000 --> 01:03:13.000
And they become almost, you know, recluses in their own home because they this know what is available out there.

01:03:13.000 --> 01:03:15.000
The more we know and remind people what is available, better off we will be as a whole.

01:03:15.000 --> 01:03:17.000
Jodie, this is Amber.

01:03:17.000 --> 01:03:18.000
I don't want to take from you

01:03:18.000 --> 01:03:21.000
>> I with us

01:03:21.000 --> 01:03:25.000
>> JESSICA:  Going to support Jay.

01:03:25.000 --> 01:03:32.000
Continuing advocate for supports and services that are already out there.

01:03:32.000 --> 01:03:38.000
We always say that specifically centers for independent living sometimes are the best kept secret.

01:03:38.000 --> 01:03:47.000
Oftentimes people this know what we do or you know, what services and supports it that we can connect individuals to.

01:03:47.000 --> 01:03:54.000
So education is always at the front of our game plan, you know, how are we going to continue to push it out?

01:03:54.000 --> 01:04:04.000
Is I can say that you know, at our center, one of the things that we use the most is social media.

01:04:04.000 --> 01:04:09.000
There are so many different forums of social media out there and opportunity to educate others by doing so.

01:04:09.000 --> 01:04:11.000
>> I'll follow up on that.

01:04:11.000 --> 01:04:14.000
Again, she said we are a secret.

01:04:14.000 --> 01:04:17.000
We tend to be especially in our area.

01:04:17.000 --> 01:04:31.000
We will get our name is center for independent living.

01:04:31.000 --> 01:04:39.000
People will call and all time ask ask if we have any rooms available because they, they hear the name and that's first things do you have rooms available kind live there.

01:04:39.000 --> 01:04:54.000
So by just promoting being interactive in your community a lot of outreach and try to attend as many events as we can.

01:04:54.000 --> 01:04:58.000
We have open door policy here bringing in more groups all the time but show them what we do, we're not just -- we provide employment services.

01:04:58.000 --> 01:05:02.000
Peer mentoring, I mean I can go on and on.

01:05:02.000 --> 01:05:05.000
And people would call and si say I have no idea.

01:05:05.000 --> 01:05:31.000
Give me a call just asking for information.

01:05:31.000 --> 01:05:39.000
You know I had someone call looking for a lock because we ended up talking about the waiver services how they can get because she was paying, she literally paying somebody ten ten hours a month living in her apartment area to help her go shopping, you know personal needs and she's and probably getting one shower a week.

01:05:39.000 --> 01:05:49.000
And she is crying to me on the phone that she wants to do more but she can't take care of herself.

01:05:49.000 --> 01:05:52.000
So, you know that one call about turned into the program, assistive technology.

01:05:52.000 --> 01:05:54.000
She doesn't have cell phone or tablet.

01:05:54.000 --> 01:06:02.000
She's by herself.

01:06:02.000 --> 01:06:04.000
Here we have a through the university we can an assist her with providing free cell phone.

01:06:04.000 --> 01:06:10.000
Demos how to use it.

01:06:10.000 --> 01:06:12.000
She's eligible for snap benefits which food stamps here in a Pennsylvania.

01:06:12.000 --> 01:06:25.000
She's on free phone service.

01:06:25.000 --> 01:06:27.000
So a two minute phone call she thought she was going to get no information from turned into 45 minutes of her being overwhelmed with what we can provide and how we can help her.

01:06:27.000 --> 01:06:35.000
>> This is Jodie again.

01:06:35.000 --> 01:06:48.000
I just wand to add that a lot of our work is not only based in our county, but state-wide and federally as well.

01:06:48.000 --> 01:06:50.000
We're always looking at all aspects, you know and how can we people with disabilities to table so their voices are heard.

01:06:50.000 --> 01:06:52.000
>> Getting to sum up this question.

01:06:52.000 --> 01:07:00.000
This rule is an independent living.

01:07:00.000 --> 01:07:08.000
I mean, it is a very heart and core of what we do and our philosophy.

01:07:08.000 --> 01:07:20.000
The CILs are just phenomenal resource to tap and refer folks to when their rights are being violated.

01:07:20.000 --> 01:07:33.000
They don't know what their rights are when it comes to setting rule and making sure we leverage our partners and collaborators to share that information with folks in these types of settings where the rule is applicable.

01:07:33.000 --> 01:07:44.000
And ensuring that they have information to access the CIL in their area so they can get access to all of the phenomenal services that Jay and Jodie have just talked and shared today.

01:07:44.000 --> 01:07:47.000
And then can also ensure that if someone's rights are being violated after they've educated them on what rights are based on the rule they can help them address that and walk through navigate that process.

01:07:47.000 --> 01:07:58.000
Because it can extremely intimidating.

01:07:58.000 --> 01:08:00.000
A lot of folks are very scared to address and hold folks accountable in these facilities or societyings if they are violating the rule.

01:08:00.000 --> 01:08:03.000
So tie it back to the rule there.

01:08:03.000 --> 01:08:10.000
>> I'll follow-up on one other thing.

01:08:10.000 --> 01:08:17.000
Recently in the past, especially since COVID we've come across guardian ships.

01:08:17.000 --> 01:08:19.000
We've run into many who get locked into a guardian ship.

01:08:19.000 --> 01:08:37.000
Not even to their knowledge.

01:08:37.000 --> 01:09:07.000
And these tend to overtake an individual's life with no rhyme or reason, just because they went into into hospital for a simple a simple, sickness or injury.

01:09:07.000 --> 01:09:13.000
Next thing you know they have some complications and before they know it, and a state AAA so we start vigorously working with the state and lawmaker and Congressmen to educate individuals and how guardianships are being used to almost prison these individuals.

01:09:13.000 --> 01:09:20.000
I don't want to go too far but they get locked into a guardian ship they have no say in their life.

01:09:20.000 --> 01:09:28.000
They have nothing, no finances their care where they want to live, how they want to live how to be treated.

01:09:28.000 --> 01:09:40.000
They are told really they are in print, when to sleep, what they are going eat, when they are going to eat, how they are going eat and so on.

01:09:40.000 --> 01:09:41.000
We've which across that working with the state to educations and try try to peel back.

01:09:41.000 --> 01:09:51.000
>> All right.

01:09:51.000 --> 01:09:57.000
>> Guys, I thiet cut it short I'm so sorry, Amber, we are running quite a bit behind I do have to go ahead cut this a little bit short.

01:09:57.000 --> 01:10:05.000
We do have commissioner Jill Jacobs from the office of independent living programs with us.

01:10:05.000 --> 01:10:07.000
And I know she has some things that she would like to say so we will go ahead and cut away to Jill.

01:10:07.000 --> 01:10:09.000
Go ahead, Jill.

01:10:09.000 --> 01:10:10.000
>> Hi, everyone.

01:10:10.000 --> 01:10:14.000
I'm Jill.

01:10:14.000 --> 01:10:16.000
I am the commissioner of administration on disabilities.

01:10:16.000 --> 01:10:25.000
I'm very happy to be here.

01:10:25.000 --> 01:10:34.000
So I want to talk a little bit about the settings rule and why it is so important.

01:10:34.000 --> 01:10:41.000
When we talk about settings rule I though that this is something that the centers for independent living, I was an executive director of CIL.

01:10:41.000 --> 01:10:43.000
I wasn't really familiar in my role about what this meant, what does this mean to as Centers For Independent Living?

01:10:43.000 --> 01:10:49.000
How does that affect people with disabilities?

01:10:49.000 --> 01:10:56.000
And so I want to be clear what settings rule really means.

01:10:56.000 --> 01:10:59.000
The settings rule lay things out some very basic rights for people with disabilities.

01:10:59.000 --> 01:11:17.000
Things you wouldn't need to Ian be laid out.

01:11:17.000 --> 01:11:20.000
Things like for people who often live and people who live in setting like group homes often, people who are living in environment things maybe, you know groups of people living together than their own place in HCBS.

01:11:20.000 --> 01:11:25.000
Maybe people who receive day services.

01:11:25.000 --> 01:11:33.000
People who live in what is considered an assisted living or Independent Living Center.

01:11:33.000 --> 01:11:37.000
But it's really just right here next to nursing home and one other hallway in a nursing home.

01:11:37.000 --> 01:11:44.000
But those services are being covered under home and community based services.

01:11:44.000 --> 01:12:05.000
So these are the torts of things that we are looking at, that we are looking at states and providers how are these services being provided?

01:12:05.000 --> 01:12:06.000
We're looking a basic, bafb civil rights that many of us can't even fathom because we're part of independent living movement, we are IL and we don't even think about reality that there are people out there that live in HCBS settings and they have never experienced these most basic rights.

01:12:06.000 --> 01:12:10.000
Okay?

01:12:10.000 --> 01:12:15.000
So these are things like I can have a lock on my door.

01:12:15.000 --> 01:12:16.000
If I'm hungry I should have access to food when ever I want it.

01:12:16.000 --> 01:12:25.000
My food shouldn't locked up.

01:12:25.000 --> 01:12:32.000
Nobody should taking my snap card for me and buying food for whole community and using sliding my card.

01:12:32.000 --> 01:12:37.000
These are I mean, they are really, I should have an opportunity to choose when I shower and bathe.

01:12:37.000 --> 01:12:40.000
You know, who I hang out withif I want a beer on a Friday night.

01:12:40.000 --> 01:12:45.000
If I have intimate relationships.

01:12:45.000 --> 01:12:52.000
Can someone come over is visit me where I live or are there rules around visiting hours?

01:12:52.000 --> 01:13:03.000
Those are really basic things that lot of us in the independent living community have not ever experienced.

01:13:03.000 --> 01:13:04.000
We're so used to directing our own care and yes, I know we often feel in IL movement numbered listens to us we don't have our own voice.

01:13:04.000 --> 01:13:07.000
And that's true.

01:13:07.000 --> 01:13:10.000
But y'all I'm talking about whole other level as they say.

01:13:10.000 --> 01:13:12.000
And so that's what we're really working on here.

01:13:12.000 --> 01:13:18.000
That's what we're really focused on here.

01:13:18.000 --> 01:13:21.000
When we are looking at this we are looking at this key tenant of nothing about us without us.

01:13:21.000 --> 01:13:22.000
That's a big part of who we are, right?

01:13:22.000 --> 01:13:35.000
In the IL movement.

01:13:35.000 --> 01:13:43.000
So when it comes to the HCBS settings rule we are really wanting to make sure to a big push for us not just something I've saying.

01:13:43.000 --> 01:13:52.000
I'm going to put funds towards moving this advocacy ball down the road to making sure people know this exists.

01:13:52.000 --> 01:13:59.000
You know, in this particular situation, HCBS settings rule it's a requirement that people with disabilities are at the table.

01:13:59.000 --> 01:14:00.000
They are being heard their voices are getting heard at the state level that there are, there's a public comment opportunities.

01:14:00.000 --> 01:14:07.000
Okay.

01:14:07.000 --> 01:14:16.000
But we at ACL know even when is no the a requirement according to some rule it should always be the reality.

01:14:16.000 --> 01:14:31.000
So for us the HCBS settings rule I view it at first step in big process around advocacy.

01:14:31.000 --> 01:14:38.000
You know we want to make sure that we are participating in the process and making sure that we are informing and engaging and a we're giving people the tools that are needed to really and truly be part of the process.

01:14:38.000 --> 01:14:43.000
So we want to see a cadre of knowledge filled advocates engage fully in making that change happen.

01:14:43.000 --> 01:14:46.000
And I see HCBS settings rule as a first step in it.

01:14:46.000 --> 01:14:56.000
I want to see us being successful.

01:14:56.000 --> 01:14:59.000
I want to see us engage in a way that we can see CMS listening to us, that we can see change happening at the state level and at the provider level.

01:14:59.000 --> 01:15:02.000
Because we are being heard.

01:15:02.000 --> 01:15:05.000
And with that success I want us to continue to build on that.

01:15:05.000 --> 01:15:09.000
I want us to continue to coalition build.

01:15:09.000 --> 01:15:15.000
I want to see our numbers and our interactions grow and grow.

01:15:15.000 --> 01:15:20.000
I want to make sure we're including all sorts of people with disabilities and people ageing in that process.

01:15:20.000 --> 01:15:26.000
IL world we sometimes leave out people who are aging.

01:15:26.000 --> 01:15:30.000
We sometimes leave out people with intellectual and developmental disabilities.

01:15:30.000 --> 01:15:34.000
People who may be don't actually hear, get their voices heard.

01:15:34.000 --> 01:15:35.000
People who have had guardians since the minute they turned 18.

01:15:35.000 --> 01:15:39.000
Okay?

01:15:39.000 --> 01:15:43.000
People who have never had a chance to speak their voice.

01:15:43.000 --> 01:15:51.000
And that's why I want Centers For Independent Living involved in this.

01:15:51.000 --> 01:16:04.000
I need why I all to reach out people we have left behind in the past and setting rule is a huge part of that.

01:16:04.000 --> 01:16:06.000
So I want to also let you know that the work we've done so far on this, when we came on board and started it there was this feeling of can we even be hopeful that anyone is going listen to us?

01:16:06.000 --> 01:16:09.000
What's the point?

01:16:09.000 --> 01:16:12.000
But I want to tell you what the point is.

01:16:12.000 --> 01:16:27.000
We have seen things happen.

01:16:27.000 --> 01:16:29.000
When we very first started working on this our meetings with CMS, they weren't all, you know the way they viewed things may have not been the way we in IL movement would want them to view us.

01:16:29.000 --> 01:16:34.000
Maybe we weren't really been heard.

01:16:34.000 --> 01:16:37.000
We were at the table or in the room, but we were kind of like a check box.

01:16:37.000 --> 01:16:42.000
That ain't the case any more my friends.

01:16:42.000 --> 01:17:00.000
We now are really engaged in the whole process with C MS.

01:17:00.000 --> 01:17:05.000
What is going out to states and will be getting you will be able to see at the state level some of these letters that are coming from CMS and some of these action plans that CMS is KAPS as they are called corrective action plans that CMS is issuing to states.

01:17:05.000 --> 01:17:09.000
You're going to see, you're going toe see advocates' voice in those.

01:17:09.000 --> 01:17:14.000
You will read them and know wait a second somebody was at the table who really got us heard.

01:17:14.000 --> 01:17:18.000
And that somebody is y'all.

01:17:18.000 --> 01:17:24.000
Advocates, that is who at the table and getting these things heard.

01:17:24.000 --> 01:17:31.000
We need you CIL's to be reaching out to communities that have never been heard before.

01:17:31.000 --> 01:17:32.000
People with intellectual ask developmental disabilities and group homes or day programs whose parents always speak for them.

01:17:32.000 --> 01:17:33.000
That's where we need you.

01:17:33.000 --> 01:17:46.000
Okay?

01:17:46.000 --> 01:17:52.000
I will tell you that we also, ACL, me personally, Jill, I am going to every state that is getting a review by CMS I'm going with CMS team.

01:17:52.000 --> 01:17:59.000
I'm looking at every single provider that comes that that is put forward that needs a review.

01:17:59.000 --> 01:18:01.000
And when we see that provider haves issues across the board we're identifying that there are a systemic issues in that state.

01:18:01.000 --> 01:18:02.000
We are being heard.

01:18:02.000 --> 01:18:03.000
We are going out there.

01:18:03.000 --> 01:18:05.000
We are making a change.

01:18:05.000 --> 01:18:15.000
I need you all to participate in this.

01:18:15.000 --> 01:18:17.000
And when I see this change making happening I see you all putting in your time I see this happening in a whole new way, real, you know, old school coalition building.

01:18:17.000 --> 01:18:19.000
You know take it back to the 60s and 70s.

01:18:19.000 --> 01:18:21.000
I see that happening.

01:18:21.000 --> 01:18:28.000
We see these changes happening.

01:18:28.000 --> 01:18:31.000
I'm going to tell you, we have meeting now with CMS where advocates from state get together and they identify all of these issues.

01:18:31.000 --> 01:18:34.000
They meet with CMS with us.

01:18:34.000 --> 01:18:41.000
This real grassroots work.

01:18:41.000 --> 01:18:46.000
They come forward lots of times the advocates do and they say hmm, you know I saw the list on providers that need to be looked at.

01:18:46.000 --> 01:18:47.000
You know, we need these, here's a couple more providers that need to be looked at.

01:18:47.000 --> 01:18:48.000
Heir ours back up.

01:18:48.000 --> 01:18:55.000
Here's our reason.

01:18:55.000 --> 01:18:57.000
Here's some systemic issues we see in the state where we feel the settings rule is being violated.

01:18:57.000 --> 01:18:59.000
I'm telling you we go out to those places then.

01:18:59.000 --> 01:19:03.000
We add them to our list.

01:19:03.000 --> 01:19:06.000
I, me, I put my eyes on those places.

01:19:06.000 --> 01:19:10.000
I come back, we write solid reports.

01:19:10.000 --> 01:19:16.000
And the staters that information.

01:19:16.000 --> 01:19:18.000
Didn't even used to be the states were going to have a public any kind of public documents around it.

01:19:18.000 --> 01:19:22.000
Yes.

01:19:22.000 --> 01:19:24.000
Send letters to states about it, yes we're going to say here's the concerns we have.

01:19:24.000 --> 01:19:27.000
Now, those are going to be public.

01:19:27.000 --> 01:19:30.000
Y'all can look and see what you've done.

01:19:30.000 --> 01:19:33.000
How your difference is what the work has made a difference.

01:19:33.000 --> 01:19:36.000
How states are going to have to respond to that.

01:19:36.000 --> 01:19:37.000
I appreciate your time, your interest.

01:19:37.000 --> 01:19:39.000
I'm really glad you're here.

01:19:39.000 --> 01:19:42.000
I want to see us go places.

01:19:42.000 --> 01:19:43.000
I want us to go there together.

01:19:43.000 --> 01:19:48.000
Go far beyond this.

01:19:48.000 --> 01:19:51.000
Thanks.

01:19:51.000 --> 01:19:56.000
>> Thank you so much commissioner this Abbey from APRIL.

01:19:56.000 --> 01:19:58.000
We've had a few question and answers come through.

01:19:58.000 --> 01:20:09.000
This question was for Amber.

01:20:09.000 --> 01:20:13.000
The question is are your services available in ASL either that you an interpret or advocate who deaf or hard of hearing?

01:20:13.000 --> 01:20:15.000
>> Hi.

01:20:15.000 --> 01:20:20.000
This is Amber.

01:20:20.000 --> 01:20:23.000
So we don't u just to be clear, we don't provide direct services.

01:20:23.000 --> 01:20:43.000
We're not a center for independent living.

01:20:43.000 --> 01:20:46.000
But when we engage in activities with our pierce with disabilities when comes to a system change work oh disability listening session or community conversations, we always as best practice ASL and live captioning and always always, always.

01:20:46.000 --> 01:20:53.000
We also provide whatever accommodation are need are necessary.

01:20:53.000 --> 01:20:58.000
Also to be clear, the past two and a half maybe three years now we've doing everything virtually.

01:20:58.000 --> 01:21:16.000
There's not a lot we've gone back to in terms of on site or in person.

01:21:16.000 --> 01:21:21.000
But in and when we do when we did before this they were any related accommodations we were hosting or conducting we also provided any on site or in person related accommodations which includes ASL interpreter and even live captioning Alt those efrptsz.

01:21:21.000 --> 01:21:25.000
at those live events.

01:21:25.000 --> 01:21:31.000
We have a policy around this that those are always provided.

01:21:31.000 --> 01:21:38.000
>> We also doubled up our budgets for accommodation and supports because we wanted to engage consumers more.

01:21:38.000 --> 01:21:47.000
We knew in order to do that successfully our peers were going to need accommodations to participate and engage.

01:21:47.000 --> 01:21:49.000
So it's a really key piece I think to doing this work when it comes to advocacy around the HCBS seatings rule.

01:21:49.000 --> 01:21:52.000
>> Thank you so much, Amber.

01:21:52.000 --> 01:21:57.000
Jodie, I see that you are typing an answer to this question.

01:21:57.000 --> 01:21:58.000
But I didn't know if you wanted the opportunity to answer it out loud?

01:21:58.000 --> 01:22:07.000
Either way is fine.

01:22:07.000 --> 01:22:12.000
The question is, how do you maintain or enhance communication equity for thoses with diverse needs to help them advocate for themselves?

01:22:12.000 --> 01:22:32.000
>> I was, sorry my computer was freezing not allowing me to answer the question.

01:22:32.000 --> 01:22:33.000
But as a center for independent living we have multiple assistive technology programs that allow us access to communication devices and whatever a participants needs to be able to ensure that their voice is heard.

01:22:33.000 --> 01:22:34.000
>> Excellent.

01:22:34.000 --> 01:22:40.000
Thank you so much.

01:22:40.000 --> 01:22:42.000
As a reminder, folks are welcome to put questions into the Q&A.

01:22:42.000 --> 01:22:47.000
We do still have few minutes.

01:22:47.000 --> 01:22:56.000
We would love to hear what folks want to know more about.

01:22:56.000 --> 01:23:16.000
In the meantime, the recording and PowerPoints for this webinar will be added to the APRIL website under the advocacy tab.

01:23:16.000 --> 01:23:19.000
So you can visit WW with W.APRIL-rural.org and select advocacy and you will see the information there.

01:23:19.000 --> 01:23:22.000
.

01:23:22.000 --> 01:23:25.000
>> We have rah raised handed from Todd.

01:23:25.000 --> 01:23:26.000
One second, Todd.

01:23:26.000 --> 01:23:28.000
There you go.

01:23:28.000 --> 01:23:30.000
You now have the ability to unmute.

01:23:30.000 --> 01:23:33.000
>> Thank you so much.

01:23:33.000 --> 01:23:56.000
Jill, it's Todd Holloway.

01:23:56.000 --> 01:24:11.000
I'm curious have we considered any of these new HCBS rules when it comes to something you and I are very familiar with and that is people getting relocated due to disasters and ending up having troubles with Medicaid and other issues where they end up out of state?

01:24:11.000 --> 01:24:12.000
>> Todd can you repeat that question I didn't get all of it were you asking about what happens in disaster when people end up out of state?

01:24:12.000 --> 01:24:17.000
>> Yes.

01:24:17.000 --> 01:24:41.000
In relation to HCBS, the new rules.

01:24:41.000 --> 01:24:47.000
Do you see any caveats that would strengthen our position about, you know Medicaid being able to even transfer across state lines where we worked with the today's Medicaid recovery act and looking at these new rules and how that would play out for somebody who has had to be relocated into another state?

01:24:47.000 --> 01:25:02.000
>> So these settings rules are, they don't have any specific elements that would impact disaster at all.

01:25:02.000 --> 01:25:04.000
I mean what impacts disaster and HCBS and how people can move across states has lot to do with reciprocity between states, about how, you know, HCBS is fund between state and federal funds and kind of prevents movement in that way.

01:25:04.000 --> 01:25:07.000
There are some potential solutions around that.

01:25:07.000 --> 01:25:24.000
But it's not related to the settings.

01:25:24.000 --> 01:25:53.000
The settings rule is specific to inwho receivers home and community based services and what those settings how those settings are meeting the rule, making sure that people have the most basic rights in place.

01:25:53.000 --> 01:26:04.000
So person has to move in a disaster from Mississippi to you know, Idaho to be with family, and they can access HCBS in that move, if that something that happens for them, then, you know the same ideas around settings and how people are able to get into the community how their civil rights are not impacted or impacted as the case may be would be the same.

01:26:04.000 --> 01:26:06.000
It doesn't really relevant to the specifics of the settings rule.

01:26:06.000 --> 01:26:08.000
>> Thank you commissioner Jacobs.

01:26:08.000 --> 01:26:10.000
.

01:26:10.000 --> 01:26:17.000
Sorry, excuse me.

01:26:17.000 --> 01:26:21.000
Another question from anonymous attendee which says I worked for a shady care provider a couple years ago.

01:26:21.000 --> 01:26:29.000
There is anyway to anonymously turn them in forbad practices?

01:26:29.000 --> 01:26:32.000
I believe this is directed towards anybody.

01:26:32.000 --> 01:26:45.000
>> Well I'll go ahead and answer that.

01:26:45.000 --> 01:26:49.000
If you feel like a provider that you worked for is shady and you you are familiar with settings rule you go read about settings rule, wow they are violating this, then I would say reach out to your center for independent living.

01:26:49.000 --> 01:26:51.000
Reach out to your, you know, your SILCK, reach out to APRIL.

01:26:51.000 --> 01:26:55.000
And say, this is I'm concerned about this.

01:26:55.000 --> 01:27:00.000
I've looked at at the settings rule can you help me look at this.

01:27:00.000 --> 01:27:06.000
And then it something that could be made known, you know about that provider.

01:27:06.000 --> 01:27:21.000
I don't want to get into a ticks of shady, not shady what that actually means.

01:27:21.000 --> 01:27:40.000
We're talking about if you are concerns that entities violating the settings rule than this process that we're talking about advocacy to bring it forward this exactly the way you would do it.

01:27:40.000 --> 01:27:48.000
>> Another question came in from misty, with regards to the HCBS settings rule and guardian ship interference with real consumer input and their person-centered plan and consumer choice where they prefer to live not in headquarters nursing home or assisted living but a community setting.

01:27:48.000 --> 01:27:56.000
How can CILs assure enconsumer hat input fullest extent possible?

01:27:56.000 --> 01:27:57.000
>> So part of settings rule, one of the elements is did this individual actually have choice in where they live.

01:27:57.000 --> 01:28:04.000
Okay.

01:28:04.000 --> 01:28:06.000
So if they are in an HCBS environment and they are in an assisted living did they really have choice in this?

01:28:06.000 --> 01:28:08.000
Were they given all the information they need?

01:28:08.000 --> 01:28:16.000
Did they get informed choice?

01:28:16.000 --> 01:28:21.000
If a person is living in a group home, how did this person choose this home?

01:28:21.000 --> 01:28:26.000
What sort of process is in involved around creating person-centered plans?

01:28:26.000 --> 01:28:29.000
And how does informed choice play a role in that is this so that is settings rule, yes.

01:28:29.000 --> 01:28:35.000
Looks at those things.

01:28:35.000 --> 01:28:40.000
We, we when we gout we take look and look at person-centered plans.

01:28:40.000 --> 01:28:48.000
Biggest way people are getting informed choice are solid person center planning process.

01:28:48.000 --> 01:28:52.000
And having, information that comes to them through advocates, in particular people with intellectual and developmental disabilities.

01:28:52.000 --> 01:28:53.000
People who are ageing that may be never been involved in this, they just got older.

01:28:53.000 --> 01:28:58.000
Now they need support.

01:28:58.000 --> 01:29:10.000
Those are the areas where it noornt CIL's, you all get involved.

01:29:10.000 --> 01:29:32.000
And you make sure that the informed part of informed choice comes from you.

01:29:32.000 --> 01:29:40.000
>> Before we close out any other questions is this I did want to read out, we had a great chat from Erica McFadden that says moving forward as you think about spaces your organization is in and what commissioner has said, what more can done to advocate for independent living in HCBS?

01:29:40.000 --> 01:29:46.000
Starting HCBS settings rule and even beyond with your statings transition plans are there specific actions your organization can take?

01:29:46.000 --> 01:29:55.000
Who else needs to be at the table in your state when it comes to HCBS advocacy and enforcing the settings rule?

01:29:55.000 --> 01:30:01.000
Who do you they had to to make stronger connections with to ensure that IL is represented in every space involving disability as it applies to HCBS?

01:30:01.000 --> 01:30:03.000
Have you met with your area agency on aging for example where a number of older adults are not aware of their rights?

01:30:03.000 --> 01:30:14.000
How can you start with your own consumers?

01:30:14.000 --> 01:30:17.000
If any are receiving HCBS services from provider for example, day programs, residential programs, job sites, have you talked to them about where their lives are like in these settings?

01:30:17.000 --> 01:30:19.000
Are they aware of what their rights are?

01:30:19.000 --> 01:30:23.000
Are their families, friends and allies aware?

01:30:23.000 --> 01:30:30.000
Just wanted to make sure that got read out.

01:30:30.000 --> 01:30:38.000
As we're getting ready to close, I also want to the ask that everybody here take the evaluation.

01:30:38.000 --> 01:30:43.000
It will be a link as you close out of the webinar today, you will see a link to the evaluation for today's webinar.

01:30:43.000 --> 01:30:46.000
We really love to hear your feedback on what we shared here today.

01:30:46.000 --> 01:30:52.000
And also, this is just the first part of this work.

01:30:52.000 --> 01:30:59.000
We will have a part 2 of this session and a couple further conversations around this work.

01:30:59.000 --> 01:31:12.000
So make sure to keep an eye out for that going forward.

01:31:12.000 --> 01:31:13.000
Any last things anybody wants to share or say before we close out for today?

01:31:13.000 --> 01:31:14.000
All right.

01:31:14.000 --> 01:31:21.000
Thank you all so much.