Since its founding in 1963, the School of Social Work’s Developmental Disabilities Training Institute (DDTI) has worked to ensure the well-being and inclusion of people with intellectual, developmental, and co-occurring disabilities.
Much of the institute’s focus has centered on providing training and technical assistance to the professionals and paraprofessionals serving the state’s I/DD population. The mission: To help foster and support the transition of individuals from institutions back into their own communities. While the agency’s efforts have impacted thousands of North Carolinians over the last 50 years, including in securing employment and in accessing daily personal care services, a lot of work remains, reflected Chris Egan, DDTI clinical program director.
“I think where we still see a gap is in people with developmental disabilities having recognized value,” Egan said. “That they’re earning social capital and that they’re seen as capable and are being welcomed into communities. I think that’s where we still find a great need.”
DDTI continues to address this issue by strengthening the state’s training around person-centered support options, Egan said. That means, among other things, teaching service providers the importance of giving individuals and families the chance to identify their own “hopes, goals and aspirations,” for creating success in their own lives, he said. For people with I/DD, such a focus also involves respecting their wishes around where they want to live and work and with whom they want to form friendships and relationships, Egan said.
“Right now, we are in the early stages of managed care in North Carolina, and we want to make sure that our people still have a voice,” he said. “For example, I was with a gentleman the other day, and he goes with his paid support provider to church and turns out, it’s not even his faith. No one has asked him where would you want to go to church. How do you want to practice your faith? Do you even want to go?”
Such scenarios illustrate the important role that DDTI plays in bridging the gap between communities and individuals in need of services, Egan said. Based on recent changes in the managed care system, that role will continue to intensify, especially around the Medicaid waiver program, which aims to provide needed support to keep people within their communities.
In North Carolina, nearly 11,000 residents currently receive services through the home and community waiver, which on average, offers individuals about $45,000 to $50,000 worth of services annually. This money pays for a variety of resources based on severity of need, including for certain types of equipment such as wheelchairs or communication devices, for periodic staff support to help individuals at home, or for respite support for caregivers.
But for all the waivers offered, at least 10,000 people remain on a waiting list for assistance. Moreover, agencies are being encouraged to be more efficient with waiver funding and to regularly assess clients to ensure that resources are properly tailored, Egan said. DDTI has helped with some of those assessments.
Most recently, staff worked closely with the state Division of Medical Assistance to roll out an assessment that examined residents’ activities in the home, community, and at work. For example, individuals were evaluated on their ability to: Prepare food, participate in recreational activities, work, avoid health and safety hazards, and advocate for themselves.
“The goal was to figure out how much support these individuals needed to be successful and how often did they need it,” Egan explained.
Over the next few years, DDTI likely will play a more significant role in among other things, helping young people with developmental disabilities go to college and ensuring that employees with I/DD earn a fair and living wage.
Fifty years later, the mission remains essentially the same, Egan noted.
“Ultimately, I think our work has been driven by a need to look at people with disabilities who have been marginalized and to figure out how to continue to chip away that,” he said. “That became the core of our efforts, and it’s work that we’re still committed to.”