History: The Prince George's Provider Council
It was in the early 1980s that a small group of providers serving people with disabilities and their families first began coming together for support and advocacy in Prince George’s County. The founding members of the group included The Arc Prince George’s County, Melwood, Ardmore Enterprises, VSI (now New Horizons Supported Services), Family Services Foundation, CHI Centers, SMVI (now EPIC), CALMRA, and the Hope Center (which later merged with Melwood). The group met regularly at The Arc Prince George’s County. The focus of their work was primarily on expanding the services available to county residents, advocating for community opportunities for those who resided at Great Oaks (then the state institution for those from the Southern Region), educating the community regarding the needs of people with developmental disabilities, and working with the Prince George’s County Public Schools to promote more inclusive educational opportunities for students with developmental disabilities.
In these early years, services for people, as well as the number of providers, expanded as the group’s advocacy for additional state funding to serve county residents increased. The provider group remained active, meeting regularly as an informal group without a great deal of structure. Dues were collected and used for training and outreach purposes.
Through the 80s and early 90s, Maryland continued its efforts to decrease the number of people supported in institutional settings. In 1994, Great Oaks was the first state institution to close. While the number of people remaining at Great Oaks had decreased considerably, many of those remaining were from Prince George’s County. The transition of these people into the community required increased community services and supports. The provider community stepped up to the plate.
Service coordination, or case management services, were provided by one county agency during this period, first, the Prince George’s Health Department, later through the Commission for Persons with Disabilities, and finally through the Prince George’s County Department of Family Services. Service coordination facilitated the funding and placement of people working with the various provider agencies. It was also during the period, from the mid-1980s until 2002, that the Prince George’s County Government provided a small supplement to assist those providers who were serving county residents in day programs and/or residential services. This funding supplement was later terminated during the economic downturn.
In 2000, Prince George’s County notified the state that it would no longer provide service coordination. Shortly thereafter, the State of Maryland issued a request for proposals for the development of these services. At this point, the Prince George’s Provider Council had become considerably more active and decided, as a group, to respond to the RFP in an effort to assure that the service coordination agency would be locally-based and operated. The provider group’s proposal was selected, and the group began developing a brand new service coordination agency. This work included recruiting the organization’s first board members, composing Articles of Incorporation, and other critical tasks. Resource Connections, Inc., as this new case management agency was named, was officially funded to operate as of July 1, 2003. Incorporated as an independent nonprofit, Resource Connections, Inc. assumed staff from the county and approximately 950 people with intellectual and developmental disabilities. The provider group remained supportive of the new agency.
Several significant actions took place during the late 1990s and 2000s through the efforts of the Provider Council. One new function was to provide behavior plan oversight and technical assistance for many county DD and some mental health agencies. The second was a major accomplishment of the council, the collaborative effort with Prince George’s Community College to offer DDA mandated trainings for Direct Support staff. This effort assisted a number of providers in assuring that the required trainings were available at a reasonable cost, especially if providers did not have in-house training capacity. This effort continued for a number of years.
In 2015, the Provider Council, now comprised of 24 member agencies, embarked on its First Annual Employment Awards Breakfast which was held on October 9, 2015, as part of National Disabilities Employment Awareness month. Nominations were made to recognize excellence among employees, direct support professionals/job coaches, and employers. The goal was to highlight nominees by shining a light on their employment accomplishments and contributions. Over 100 were in attendance including a number of County Council members and/or their staff.
In its meetings, the Provider Council identified focus areas for its work going forward:
- Advocacy to ensure that people with intellectual and developmental disabilities residing and working in Prince George’s County have the support they need to be successful and live a life of their own choosing;
- Greater visibility of the county-wide provider community and efforts to strengthen the infrastructure of the Prince George’s systems of support;
- Enhanced collaboration to increase communication, and sharing of best practices in a wide range of areas; and
- Promoting community inclusion while increasing opportunities for people supported by member agencies.
The successful transition of young adults from high-school to adult services has always been a high priority for the Provider Council. That is why the council co-sponsors two Transitioning Youth (TY) Fairs to educate students and their families about options for adult services. Signification contributions to this effort were the development of a guide entitled Life After High School which summarized in clear, concise language, steps students and families can take to prepare for the future. The guide includes sample questions students and families can use in their explorations with providers, as well as information about accessing the DDA system. Included also is a universal application which council agencies agreed to utilize as a step toward streamlining the application processes. At this time, member agencies employed more than 1,500 staff who provided the direct day-to-day support for over 2,000 county residents. June of 2016 saw an increased demand for services, and many providers found it difficult to expand sufficiently to the need.
The Provider Council hosted its Second Annual Employment Awards Breakfast on October 6, 2016, with approximately 150 in attendance. The event was judged to be highly successful with increases across the board—in the number of award nominees, in the number of attendees, and in the financial support received through sponsorships. The council’s presenting sponsor was Giant Food, which provides employment opportunities throughout their sites in all parts of the county. Keynote speaker, David Harrington, CEO of the Prince George’s Chamber of Commerce, gave an excellent overview of the economic trends in the county and challenged all to take advantage of new and emerging employment opportunities for those we support.
A member-strong and well-organized body, the Provider Council took on major advocacy initiatives that year in areas critical to the disabilities community. Prince George’s County had legislated an increase in the minimum wage. The Provider Council worked to educate elected officials about the negative impacts and unintended consequences of this legislation, which would place an undue burden on providers to meet the new wage without additional funds to do so. The Provider Council made a request for the county to allocate a supplement to assist the provider community in complying with the new wage mandate. Representatives of member agencies met with the County Executive, County Council members, and their staff. In addition, testimony was presented at both the Executive and County Council budget hearings. The Provider Council waged a vigorous campaign to inform and educate elected officials at the state and county levels. Advocacy initiatives included rallying more than 200 people to a County Legislative hearing on a proposed bill which would have mandated the much-needed county supplement. Providers also organized a presence and testimony at numerous legislative and budget hearings; they attended personal meetings with all County Council members and the County Executive; they wrote hundreds of letters and emails, and placed as many phone calls in the effort to secure county funding.
The Provider Council collaborated to secure consultation from lobbyists through The Maryland Association of Community Services (MACS) who assisted throughout the campaign. In addition, the council developed a media campaign, which included a white paper articulating the impact of the mandated wage increases on quality supports, retention of staff and the ability to expand services to meet ever-increasing needs. Although the Provider Council received much positive feedback on this urgent campaign, no funding was allocated in the FY17 budget. Nevertheless, the Provider Council persevered. Members met with DDA to convey the effects of the county’s wage issue. They developed financial projections and visuals to help communicate the short- and long-term impact of decreasing fiscal resources. The message was clear as member agencies sought to demonstrate the need for state and county support.
In 2015-2016, the Provider Council also turned focused attention toward successful transition to comply with the Centers for Medicare & Medicaid Services (CMS) Final Rule and its outcome of full community inclusion. One of the council’s sub-groups on community living, for example, developed a Model Lease Agreement for use by providers and people transitioning from residential group homes, as well as a draft to use as a guide for restructuring residential programs in preparation for the final rule. These were distributed to all member agencies and are still available to be accessed.
Fiscal year 2017 was a very good year for the Prince George’s Provider Council and its members’ initiatives. Of specific significance was the active involvement and advocacy of members in the ongoing effort to secure supplemental funding from the County Council, which gained momentum as the new fiscal year began. Meetings with various elected officials were again initiated. The Provider Council’s consistent message was that adequate support for people with intellectual and developmental disabilities, as well as the Direct Support Staff who are the backbone of the provider system, was not only necessary but critical. At the same time, the Providers Council joined colleagues across the State of Maryland, faced with the task of advocating to secure restoration of the full annual 3.5% increase to DD Community Services funding, which had been mandated in state minimum wage legislation passed in 2014, but was threatened in the draft FY18 state budget. Providers rallied in Annapolis and advocated with the DD delegation for the 3.5% rate increase. Collectively, the Prince George’s Providers Council and its fellow organizations and affiliates across the state were successful in this initiative, thanks to State Legislature. At the same time and continuing throughout the spring, council members persisted in their advocacy at the county level for a DD supplement to offset the increased minimum wage. In the process, the council also rallied to defeat a well-intended but unhelpful county legislation which would have allowed any provider to request a one-year waiver exemption from compliance with the county minimum wage increase.
2017 saw the development of a brochure ( PGPC Brochure) which described the work of the Provider Council and identified member agencies and collective goals. This document is available for members to utilize and is also helpful for new member recruitment as well as distribution at community fairs and information sessions. The Provider Council continued its partnership with other colleagues in offering two Transitioning Youth Fairs to provide information to families and individuals.
October 12, 2017, was the date of the council’s Third Annual Employment Awards Breakfast, the most successful yet, with approximately 250 in attendance. Once again, this employment event drew an increased number of nominees, great financial sponsorships and a highly energized keynote speaker in Jim Coleman, Executive Director of the Prince George’s County Economic Development Corporation. Coleman rallied everyone in attendance to do more, be involved, and take advantage of the resources in the county. Post-event feedback indicated that it was our best awards breakfast yet, and members expect this event to grow and improve in the years to come.
Of significant interest to councilmembers during this fiscal year was the work of the consulting group hired by DDA to complete a reimbursement rate study for the DDA system. This study took place among other transition and restructuring of the entire state-wide system. It will be crucial to keep a pulse on the rate study, as well as the multiple system changes occurring within DDA. As the Provider Council continues its efforts of advocacy with county elected officials, it has become clear that whatever success the council might have, the results of the rate study, and the implementation of any recommendations on a statewide level, will have considerable impact on the county’s response to providers’ need for financial support.
As fiscal year 2017 came to an end, members of the Prince George’s Provider Council began to work on the development of a website with the hope of a launch in FY18. Another important activity was research on the formation of a 501(c) (3) organization. However, the most positive and exciting event which occurred in late spring 2017 was passage of the Prince George’s County FY18 budget which included an allocation of $3.5M to offset effects of the county minimum wage on the DD industry! As one might imagine, this news was greeted with much happiness. Provider Council members looked forward to a very full FY18 with negotiations starting anew, and with many changes on the horizon in the healthcare field and in our own service system. Council members did, however, take the time to celebrate the very successful year as they looked to the future.