the macdonald training center residential services model october 15, 2009
TRANSCRIPT
The MacDonald Training CenterThe MacDonald Training CenterResidential Services ModelResidential Services Model
October 15, 2009October 15, 2009
We currently serve a total of 65 people in our residential services
Live-In IHS = 38 33 = 3 to 1 (11 settings) 4 = 2 to 1 ( 2 settings) 1 = 1 to 1 ( 1 setting)
Non Live-In IHS = 7 4 = 2 to 1 ( 2 settings) 3 = 1 to 1 ( 3 settings)
Supported Living Coaching only = 20
Current Service ConfigurationCurrent Service Configuration
Adults with a wide variety of needs including:•Walkers•Wheelchairs•Expressive communication challenges•Receptive communication challenges•Incontinence•Behavioral challenges – typically interpersonal in nature
The range of services & supports is determined by the individual with help from family and friends
Service Needs AddressedService Needs Addressed
Live-in HIS
Weekend & vacation relief
Non live-in HIS
Supported Living Coaches
Team leaders
Staff CoverageStaff Coverage
No campus setting
Highly flexible
Highly mobile
Focused & responsive to personal choice
We perceive our community as the entire Hillsborough County / Tampa Bay area
Outstanding CharacteristicsOutstanding Characteristics
A lot of socializing between and among homes and individuals
Significant interaction with families, including the live-in companion
More one-on-one contact with neighbors
Less restrictive than a group home
More restrictive than a person living alone
Community & Natural SupportsCommunity & Natural Supports
Eating out a lot …Hyatt at Disney
Theme parks – Busch Gardens, Adventure Island, Disney, etc.
Day cruises
A lot of drive-in movies
Beaches
Camping
Social Life & EventsSocial Life & Events
Spontaneous nights out•See it on TV and go…follow the coupons
Moving closer to friends•Bay Waters apartments…1-2-2•Country Wood apartments…1-1-1-2
Social Life & EventsSocial Life & Events
Day services - Live skills• Meals on Wheals• Food Bank• Humane Society• other volunteer opportunities
Day Services – Job skills•Job club•Job searches & related activities
Day Services – Art•Museums•Exhibitions
Meaningful Days & Meaningful Days & Community ContributionsCommunity Contributions
Year-by-year leases allow mobility annually
Always asking or listening to what we are being told
Decisions in the homes made individually or by consensus
If new residence is needed, the residents make the choice
(Example: did not close home when only one person was in residence)
Individual ChoiceIndividual Choice
We adjust our residential services model based on the needs and choices of the people we serve
We modify homes as needed…sometimes at our own cost
We are working on serving individuals with complex challenges•Currently limited by APD’s refusal to fund
Addressing Change in the Lives Addressing Change in the Lives of the People We Serveof the People We Serve
Waiver Support Coordinators
Supported Living Coaches
Family members
Day services team members
Team leader visits
Regular medical visits
OversightOversight
Intensive training by RN
Fire drills
Disaster drills
Teaching individual survival skills
Working in teams with 24/7 back-up
Safety as a FactorSafety as a Factor
Low turnover means the companions know the individuals (non-verbal communication)
Individuals look out for each other
Risk management assessments
Safety as a FactorSafety as a Factor
All staffed trained by RN
RN on call 24/7
RN & SLC’s coordinate with doctors•SLC’s take the lead
Access to Medical & Access to Medical & Mental Health ServiceMental Health Service
No zoning issues
Any and all residential areas are an option
Shop the market
Negotiate rents (MTC underwrites so rents are secure)
High mobility & year-to-year leases maximize options
Housing & AffordabilityHousing & Affordability
For MTC
Flexibility in creating new living situation• No zoning issues
Very little turnover•Experienced, stable staff that communicate effectively
Conducive to the use of self-directed teams
Advantages & StrengthsAdvantages & Strengths
For the people we serve
Mobility in housing
Greater mobility & exposure in the community…or not•Ex: Plant City…we never see your vans anymore
Stability•Typically only 2 or 3 companions a year so relationships are personal in nature
Advantages & StrengthsAdvantages & Strengths
For the people we serve
More contact with neighbors resulting in natural supports
Privacy •Private rooms
Near total reduction in attention seeking behaviors
Advantages & StrengthsAdvantages & Strengths
Finding quality live-in staff can be a challenge and can take time
APD has repeatedly refused to fund additional 1/4hrs of IHS services for people with extra ordinary needs•We are currently funding 3•We have lost others to nursing homes prematurely•No aging in place with dignity
Currently looking at technology as a way for addressing future service needs in a hostile funding environment
Disadvantages & WeaknessesDisadvantages & Weaknesses