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Microboards Accessing Self Determination Under Existing Waivers

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Microboards: Accessing Self-Determination Under Existing Waivers

By Ruthie-Marie Beckwith, Ph.D.

A Microboard is formed when a small group (micro) of committed family and

friends join together with a person with challenges to create a non-profit

society (board). Together this small group of people address the person's

planning and support needs in an empowering and customized fashion.

-Vela Microboard Association

Tired of waiting for systems change to catch up with you? Wishing for a

circle of support that you can count on long term? Wanting to see families

and individuals self-direct services NOW? If you answered 'yes' to any of

these questions, you may want to explore how microboards can be used as a

tool to provide customized services and supports while dramatically

increasing individuals' quality of life.

First developed in British Columbia in the late 1980s, the use of

microboards has been expanding across the United States as way to plan for

inevitable changes in primary caregivers, as well as greater

self-determination in day-to-day life events. Ordinary citizens and families

have formed nonprofit organizations to meet the needs and desires of just

one person. Microboards, with names like " Pink Coyote " , " Joyful Care " ,

" 's Yacht Club " and " Hot Rod , " abound. As these small

non-profits take hold, board members have also mastered the necessary red

tape to become highly rated certified Medicaid waiver providers. As such,

the microboard serves as the fiscal intermediary for the same amount of

service dollars the focus person was allocated before the microboard was

created.

With on-going support from friends and families, the focus person's needs

and desires, which the government doesn't cover, are met the old fashioned

way: through the loving support of family and friends. Examples of these

efforts are plentiful and include:

* Jill produces highly coveted jams and vegetables made from produce

she grew in her garden and handpicked at the orchard.

* Bob works at the zoo in a job he sought out and secured for himself.

* has learned to ride horses and is planning to compete in

Special Olympics.

* Joe lost 65 pounds by working out at the YMCA every morning at 6

a.m. and by eating a carefully planned nutritious diet.

All of these examples and many more were made possible through the efforts

of the Tennessee Association of Microboards and atives, Inc. (TAMC)

with funding provided by the Tennessee Council on Developmental

Disabilities. Founded and established in 2001, The TAMC has developed a

successful and replicable model for the empowerment of ordinary citizens to

actively engage in the development of alternative futures for individuals

with disabilities.

Beginning with the development of a person centered plan using the PATH

<http://www.communityworks.info/articles/path.htm> [1] <> process, each

microboard demonstrates their commitment to the focus person through the

sharing of their personal networks and by problem-solving critical issues.

After the person centered planning session, potential board members receive

training in the development and governance of non-profit organizations. This

training assures that board members understand both their personal

commitment to the individual as well as their legal and fiduciary

responsibilities as board members. Board training culminates in the filing

of incorporation documents and the adoption of by-laws. As time passes,

individual board members may rotate off the board and be replaced by new

members who have new ideas or expertise that may be useful in helping the

focus person reach important personal goals.

In some cases, expertise may be recruited, for example, when the microboard

decides to apply to be approved as a Medicaid Home and Community Based

Waiver <http://aspe.hhs.gov/daltcp/reports/primer.htm> [2] <> provider in

their state. This decision is typically made when there is no other funding

mechanism that makes it possible for the focus person to self-direct their

service dollars. Microboards follow the same process that is required of

any potential waiver vendor and are subject to the same rules and

regulations. Although daunting in the degree of paperwork required,

microboards across the country have demonstrated that they can meet the

requirements and be good stewards of the individual's funding.

Board empowerment is a key function of the microboard development process

that TAMC utilizes. Empowerment of the board is essential to promoting the

microboard's independence and long-term success. Outcomes of this process

include:

* Expanded personal and family networks with greater ties to the

community

* Greater understanding of the focus person's vision and goals and how

day-to-day supports are carried out

* Increased participation and expanded advocacy voices in support of

the person's needs and desires

* Security and assurances that a group of caring people will be

available to the focus person for as long as he or she needs and wants their

support

Individuals and families continue to create microboards for two primary

reasons: 1) to self-direct services and supports in ways that will enhance

the individual's quality of life and 2) to secure the individual's future

through the use of a non-profit governing structure that has the flexibility

to change and grow throughout the individual's lifetime. The most important

outcome of the work of TAMC is that individuals who want self-determination

in their lives have not had to wait for their state to retool their home and

community based service systems. Instead, the microboards they have created

now serve as positive examples of how everyone benefits when

self-determination is at the heart of their work.

Over the past ten years, the TAMC has engaged over 500 ordinary citizens in

the work of creating and sustaining microboards in Tennessee. Other

microboard associations have emerged in Texas, Illinois, Iowa, Pennsylvania,

Wisconsin, and Georgia. For more information on microboards and the impact

they can have on someone's life, go to www.tnmicroboards.org

<http://www.tnmicroboards.org/> .

Ruthie-Marie Beckwith, Ph.D. is the founder and Executive Director of the

Tennessee Association of Microboards and atives Inc., a statewide

non-governmental organization dedicated to helping people with disabilities

self-manage their services and supports. Prior to developing her work with

microboards, Dr. Beckwith served as a volunteer, founder and subsequent

executive director of People First of Tennessee, Tennessee's self-advocacy

organization run by individuals with disabilities. She is also the author of

Seven Days at Oak Valley, a murder mystery featuring a sleuth with

intellectual disabilities.

_____

[1]Planning Alternative Tomorrows with Hope, (PATH) is a person centered

planning process developed by Jack Pierpoint, Marsha Forest, and

O'Brien. See also http://www.communityworks.info/articles/path.htm for more

information

[2] <> For more information about Medicaid waiver programs see:

http://aspe.hhs.gov/daltcp/reports/primer.htm

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