THE ARC OF TENNESSEE POSITION PAPER ON SUPPORT COORDINATION

In 1996 the State of Tennessee began a system of independent support coordination (ISC) for people participating in the Medicaid Home and Community-Based Waiver. The system came about largely as a result of collaborative efforts by enlightened state officials, families and advocates. The Arc of Tennessee played a key role in promoting the concept of a system of support that worked with and on behalf of people receiving supports and their families. Indeed, several local chapters of The Arc became involved in the provision of independent support coordination because it appeared to mesh so well with their primary mission of advocacy. As the state looks to significantly revise the ISC system in 2002-2003, it is important that The Arc again take a position on what a system of support coordination should include and what principles need to be an integral part of that system.

DEFINITIONS
Support coordination consists of three basic functions:

• Planning - The coordinator gets to know the person and significant others in his/her life, finds out what the person wants and needs, gathers necessary information, and develops a plan of support. The plan specifies the type and frequency of services and supports that the person needs to achieve his/her personal goals and aspirations. The planning process addresses both short-term and long-range goals.
  
  
• Referral and Linkage - The coordinator helps locate and link the person to providers of the services and supports, including those identified in the plan and others that are necessary for the person to achieve his/her goals.
  
  
• Monitoring - The coordinator monitors the delivery of services and supports to ensure that the plan is effectively implemented and continues to adequately address the preferences and needs of the person.

PRINCIPLES
The Arc believes that any system of support coordination must embody the following principles:

• Coordinators must be advocates for the people that they support.
  
  
• Support coordination must be independent from the providers of services. There is an inherent conflict of interest when one entity plans, delivers, and monitors supports.
  
  
• Support coordination must be independent from the government agencies that pay for and oversee the provision of services. There is a serious conflict of interest when one entity plans, pays for, and directs services. Meaningful advocacy cannot exist within such a structure.
  
  
• Coordinators must get to know and develop relationships with the people that they support and the families of those people.
  
  
• Coordinators must be assigned caseloads that are small enough to allow them to effectively accomplish their job duties.
  
  
• Coordinators must be appropriately educated and trained prior to beginning their work and should receive continuing training and development during their employment.
  
• Support coordination must focus on planning, linking, and monitoring supports, not on paying for supports. Payment for supports should be negotiated between the funders and the providers of services.
  
  
• Coordinators must develop plans that address both the preferences and the needs of the people they support.
  
  
• The plans developed by coordinators must be concise, readable, usable and accessible to persons supported, their families and representatives, and support providers.
  
  
• The paperwork requirements of support coordination must be minimized in order for coordinators to spend time with and on behalf of persons supported.
  
  
• Support coordination must encourage people to make decisions and support self-directed and family-directed control of services and supports.
  
  
• Support coordination must be incorporated into the overall system efforts directed toward protecting people from harm.
  
  
• Support coordination must be available for all persons receiving long-term services and supports, regardless of type or source of funding.