Department of Mental Retardation
Chapter 171 Plan

Department of Mental Retardation
Annual Family Support Plan State
Fiscal Year 2004
(July 2003 – June 2004)


Since 1995 the Department of Mental Retardation (DMR)
has been providing flexible family support services. In July 2002,
Chapter 171 of the Acts of 2002, “An Act Providing Support to Individuals
with Disabilities and Their Families,” was signed into law. This legislation
specifies that all named state agencies, with substantial consultation
from individuals with disabilities and their families, need to prepare
and submit on an annual basis an individual and family support plan
that explains how the department intends to provide flexible supports
to families and individuals. This is the Department of Mental Retardation’s
first Annual Family Support Plan.

Overview of Family Support

Definition of family support:

Family support strives to achieve the goal of helping
families stay together through:

• Developing the family’s natural capacity to meet
the needs of family members;

• Offering additional supports such as staff resources,
goods and services, and financial assistance; and

• Enhancing the capacity of communities to value
and support people with disabilities and their families.

Array of family support services and how funding
will be wed to deliver these services through network of family support

Approximately $37 million dollars was spent on
a range of family support services in Fiscal Year 2003, (July 1,2002
through June 30, 2003). Approximately $28.8 million dollars
of this total amount provides funding for general family support services,
which includes the required Core Service Elements and flexible funding
allocations. The rest of this funding is used to fund a variety of
enhanced and specialty family support services. Every DMR region funds
Enhanced Family Support services including Intensive Family Support
and Medically Fragile Projects. In addition, each DMR region
has funding for an Autism Support Center. Also, there is funding
for a variety of specialty family support projects that vary from
region to region, such as after-school programs, social/recreational
activities, camps, and planned facility-based respite services. Some
of these services are designed to provide services for children only.

The Department of Education & Department of Mental
Retardation Community Residential Education Project is a collaborative
initiative that had an allocation of $7.5 million dollars in fiscal
year 2003. During fiscal year 2003, 288 children participated in this
project. This included 29 students who were assisted to return from
residential school placements to their home communities. In addition,
259 students utilized project resources to obtain a diversity of supports
as an alternative to an initial residential special education school

It is estimated that approximately 10,000 to 13,000
across the lifespan are receiving some type of family
support service at any given time. These services are delivered through
contracts developed with about 74 family support provider agencies
across the state. All Family Support Provider Agencies are required
to complete and evaluated on Performance Outcome Measures that
are designed around the key principles and core service elements for
family support.

In July 2002, the Department issued the New Family
Support Guidelines and

Procedures. This is a document that describes
the goals and principles of family support, the core service elements
to be offered and other supports available, and all of the operational
requirements. This document was first published in 1995 and most recently
revised in July 2002.

DMR internal family support network:

Presently DMR is organized into five regions with Regional
Directors, and 24 Area Offices with Area Directors, all under the
umbrella of Central Office. By the middle of this fiscal year the
Department will be reorganized into 4 regions with 23 Area Offices.
Each DMR region has a Director of Family Support Services. In each
Area Office there is a Children’s Coordinator who generally works
with children under the age of 18 years and their families, and a
Transition Coordinator who works with individuals generally between
the ages of 18 and 22. Adults over the age of 22 who have met the
eligibility criteria for DMR services are assigned a Service Coordinator
and participate in an Individual Service Planning process.

Process for obtaining “substantial” input from families
regarding current family support services:

The Department used several approaches to get input
from family members to help assess the Department’s current system
of family support and to help craft this Annual Family Support Plan.
One approach involved hosting forums with family members that were
held across the five regions of the state in December 2002 – January
2003 in partnership with Massachusetts Families Organizing for Change
(MFOFC). These forums provided the opportunity to get direct, face-to-face
input from families about the strengths and gaps in our current system
of family support. The results of these forums are described in a
separate report and were used in the development of this plan. A second
approach involved the administration of a mail survey to family members
regarding their opinions of the services and supports for children
with disabilities and their families. We have also conducted a parallel
survey with families of adults who reside in the family home. Both
of these activities are part of the “National Core Indicator Project”
that DMR participates in along with twenty-two other states. The survey
for families of children with disabilities was sent to approximately
1500 randomly selected families from across the state, who have a
child under the age of 18 and who are receiving family support services.
These results will also be used to guide priorities for the annual
family support plan.

Focus Areas

I. Family Empowerment: Opportunities for
families and individuals to be involved in the development of
agency policies and procedures, program development, and evaluation
of services.

 Current Activities:

1. The Department, in partnership with MFOFC,
hosted five regional forums for family members in December
2002 – January 2003 to gather assessment information on current
strengths of the agency’s family support system and to identify
gaps and concerns. This information helped inform the development
of this Plan.

2. The Department has initiated family-governed
and family-directed projects across the state to enable families
to exercise increasing control and influence over the direction
and operation of these family support services. Information
about these initiatives is included in the Department’s “Family
Support Guidelines and Procedures.”

3. Through goal setting and monitoring, Department staff
will work with Family Support Provider Agencies to improve their performance
in meeting contractual requirements and Performance Outcome Measures,
with a particular emphasis on the following expectations: to provide
opportunities for the establishment of family councils; to get family
member input on policies and program development; and to at least
annually conduct satisfaction surveys with families to get information
about supports provided and ways to enhance services for families.

4. The Department has convened ad-hoc groups
of family members at different times to get specific feedback and
input on program development and policy changes and initiatives;
Examples include: revisions to the Family Support Guidelines and
Procedures, the development of the Family Support Request for Response,
and planning activities regarding the Home and Community Based Waiver
for Children.

New Initiatives:

1. The Department will establish a Statewide Family
Support Council

representative of the geographic, cultural, ethnic,
and linguistic diversity of families in Massachusetts. Its primary
purposes will be to advise the Department on issues that affect
the well-being of families with family members who are either living
at home or have recently transitioned from their home, and to be
an important vehicle to receive “substantial consultation” from
families in Grafting and implementing the Department’s Annual Family
Support Plan. It will be important for representatives on the Statewide
Council to be in touch with the “grassroots” so that it maintains
it independence and integrity. The Department will set aside some
funding to pay for some of the costs necessary for family participation,
such as respite, transportation, translation, etc.

2. The Department will host a variety of regular and
well-publicized local and regional forums for feedback on service
delivery and program development needs, including but not limited
to town meetings, small focus groups, information-sharing sessions,
etc. These forums will provide input to be used in the development
of the Annual Family Support Plan and to also determine satisfaction
with activities outlined in the Plan.

II. Family Leadership

Current Activities:

1. The Department provides support for family-directed
groups to provide educational and leadership opportunities for families,
such as the Family Leadership Series sponsored by MFOFC.

2. As part of the Core Service Elements, Family Support
Provider Agencies are expected to provide and offer varied educational
and learning opportunities for families and individuals that are
responsive to their specific interests and needs.

3. In partnership between the Department and the Arc,
fifteen Family-to Family Support Centers provide a range of educational
and training opportunities on a range of topics, as well as mentoring
and clinical support services to families covered under the Boulet
Settlement Agreement, to help them develop more independent living
options for their family member. These services also help develop
a network among families for ongoing support and assistance. New

1. The Department will provide funding for leadership
development opportunities for families in all of the DMR regions.

2. Department staff will explore with family members
the types of support and assistance that may be helpful to them as
they plan for and encourage more “dependent hfestyles with their adult
son or daughter, including moving out of the family home. One avenue
of exploration will involve the resources of the existing Family to
Family Centers mentioned above.

HI. Family Support Resources and Funding

Current Activities:

1. The Department will continue flexibility
in funding options to support individuals and families.

2. The Department will continue funding for
enhanced and specialized services in order to respond
to the specific needs of individuals and families, e.g. the

Medically Fragile Projects, the Intensive Flexible
Family Support Services New Initiatives:

1. The “Family Support Guidelines and Procedures”
will be updated to ensure that departmental funding mechanisms
and policies and procedures support flexibility in services
to eligible individuals and their families. When finalized,
Department staff will implement a variety of ways to disseminate
these and offer training on the key changes to both DMR staff
and provider agencies, creating an opportunity to also address
improved consistency in how services are provided across the

2. The Department will pursue federal reimbursement
for family support services through the development and approval
of a Home and Community Based Waiver for Children.

3. The Department will develop a variety of
ways to share information and support families and their adult
family member in exploring and pursuing more flexible, consumer
and family driven approaches in the design and purchasing
of support services. Some of these approaches include, but
are not limited to, funding partnerships between families
and DMR, self-determination initiatives, and expanded utilization
of an Intermediary Service Organization (ISO). This information
may be most applicable to individuals in the process oftransitioning
from school to adult life and their families, and outreach
efforts will initially be focused on reaching this group.

IV. Accessing Services and Supports

Current Activities:

1. The Department has developed a website for the
agency and will work to enhance the family support information
on the website to be more helpful to families.

2. The Department, in partnership with other
groups, offers a variety of ways for families to access information
about services and resources, such as, New England Index, MassCares,
First Call (United Way), etc. The Department will work to improve
publicity and information about these resources to help make sure
families are aware of and can access them. New Initiatives:

1. Each DMR region will develop and make available
Family Support resource information that provides both a comprehensive
listing of the Family Support Provider Agencies in their region,
and contact information for other family support organizations
and resources both in their region and statewide. This information
will be developed to be responsive to the primary cultural,
ethnic and linguistic backgrounds of families in each region.

2. The Department will develop a “Family Support Handbook”
that will be an

abridged version of key sections of the Family
Support Guidelines and Procedures that is of greatest importance
and relevance to families in using family support services.

V. Culturally Competent Outreach and Support

Current Activities:

1. The Department will continue to support a number
of existing cultural intiatives in western Massachusetts and with
the Family Governing Boards in Boston representing different cultural
and linguistic communities, as well as focused outreach and family
support initiatives in many other areas and regions.

2. The Department has established a Diversity Council
and has a Diversity Plan that includes a focus on staff training
on diversity and more culturally competent service delivery. New

1. The Department will develop a comprehensive
and streamlined system for the translation ofDMR information
and materials and the provision of interpretation services,
in order to promote the delivery of culturally competent family
support services.

2. As part of the Core Service Elements, Family
Support Provider Agencies are expected to respond to the specific
ethnic, cultural and linguistic needs of families in the geographic
area that they serve. DMR staff will utilize the performance
outcome monitoring process to evaluate progress in this area
and work with provider agencies to improve their cultural

3. The Department will explore different grant
opportunities and outreach initiatives to build upon and expand
multi-cultural efforts and services, e.g. funding through
the Administration on Developmental Disabilities, the Capacity
Interchange Project at the Institute for Community Inclusion,

VI. Interagency Collaboration

Current Activities:

1. The Department of Education and Department
of Mental Retardation Community Residential/Education Project
has been in operation since 1995. It is designed to assist individuals
who are returning from residential school placements to their
home communities, as well as provide supports that enable individuals
to remain in their home communities to prevent residential school
placement. During Fiscal year 2003 this project provided services
to 282 individuals and their families with a funding level of
7.5 million dollars.

2. The Department is involved in a number of inter-agency
activities with other EOHHS agencies as well as other state
agencies to enhance service delivery to families and individuals
served by both agencies. Examples include the Elder Caregiver
Project, the Interim Policy with the Department of Social Services,
etc.. New Initiatives:

1. DMR will take the lead role in convening
on a regular basis all the other state agencies named in
this legislation to discuss progress on family support initiatives
and to work collaboratively on improving and expanding family
support services. In addition, all of these state agencies
will participate in jointly sponsored, cross-agency forums
for family members in the Spring of 2004 in order to get
broader input about the needs and concerns of family

members, strengths of current family support services,
and ideas on ways to respond to the gaps that exist.

2. The Department has received a one year federal grant
from the

Administration on Developmental Disabilities for the
planning and design of a One Stop Family Center in the city of Springfield.
This proposal includes a Memorandum of Understanding signed by all
the disability agencies in addition to the Departments of Education
and Department of Social Services, to work collaboratively in this
planning effort and to identify ways to better coordinate and integrate
information and services for families from diverse ethnic, racial
and linguistic backgrounds who have a child or adult family member
with a developmental disability.

3. In the Executive Office of Health and Human Services
an Inter-Agency Group, the Transition Team, has been developed
to establish a more streamlined approach for assigning state agency
responsibility for service planning for individuals in the “Turning
22” process who “fall between the eligibility cracks.” The Transition
includes representatives of the Departments of Mental Health,
Mental Retardation and Social Services, and the Massachusetts Rehabilitation
Commission, Massachusetts Commission for the Deaf and Hard of Hearing,
and the Massachusetts Commission for the Blind.

4. Within EOHHS a number of specific committees and
work groups are being established to identify ways to better serve
families at risk.