C&C States
Self-Direction Handbook
Data &Jan Dressman
This Success Story appears in full on Iowa's website: http://www.dhs.state.ia.us
Dealing with a disability is tough enough; it’s the loss of autonomy that is so devastating. Ask Jan Dreesman, 49, whose mobility is severely limited by cervical spina bifida, a congenital condition that causes partial paralysis and interrupted motor functions. “Isolation is a big factor for anybody who is disabled, and especially for me since I have to constantly live with the fear of falling. It’s huge. It affects my outlook and my ability to deal with the physical challenges that most people don’t give a second thought about,” she said. “That’s why I can say, emphatically, that Iowa’s Consumer Choices Option program has saved my life,” she said. Not in a physical sense, she explained. Instead, the plan gives her an elevated quality of life.
The regular program for people like her – called the Ill and Handicapped Medicaid Waiver –provides the physical services needed to stay independent and to avoid more costly institutional care. The Consumer Choices Option program, which costs no more and often less than regular waiver services, allows recipients to direct and tailor their own services, and to hire the people who deliver them. Several safeguards are in place to help with planning and to make payments. Dreesman said she directs her waiver money to her exact specifications. “You should see what I can do now,” she said. “Consumer Choices Option pays for most of my personal trainer, a specialized physical chiropractor, and regular water exercises. It even helped pay for these special shoes” that are built to accommodate her gait. There is assistance with meal preparation and housekeeping, and a savings account within the CCO budget allowing her to save for special equipment. “There’s even money for horses,” she laughed. Her budget provides $180 three times a year for One Heart Equestrian Therapy, a central Iowa program that provides horseback therapy for people with disabilities.
With aggressive personal training, overlaid by fierce determination, Dreesman has learned to walk in many situations without the help of a rolling walker. “I’d like to be a little more fluid, to walk without swaying so much,” she said. She has progressed so well that specialists have asked to study her case and see if there might be lessons learned for others. It’s the CCO program, she said, that provides the support she needs to keep her job as an education assistant at an elementary school not far from her home in Ames. Using her degree in elementary education from the University of Northern Iowa, Dreesman’s specialty is to provide small-group academic services for kindergarteners and first graders, but she’s also keen to teach tolerance. “I have watched children develop empathy and compassion toward people like me who don’t walk the same as they do, or who don’t walk at all, or who are different in some other way,” she said. Consumer Choices Option is available only to the 24,000 disabled or senior Iowans who are eligible for Medicaid and choose to receive “waiver” services—such as meals, transportation, or help with toileting or bathing—designed to “waive” regular Medicaid and to keep them independent and in their own homes.