Presentation to DDA Day & Employment Providers March 26, 2015

 Strongest focus ever on ensuring day and employment services for people with disabilities are delivered in the most integrated setting.  “Most integrated setting” is the setting that enables the person with a disability to interact with people without disabilities (who are not staff) to the greatest extent possible.

 Legal action in states focused exclusively on day and employment services

All settings where waiver-funded services are provided must:  Be integrated in the greater community  Support access to the greater community  Provide opportunities to engage in community life

 States aren’t just required to offer some settings that meet these standards  States must ensure all settings for all services meet these standards

 IDS and Supported Employment help DC to be in compliance BUT...  Meaningful changes must be implemented in Day Habilitation and Employment Readiness

Change within existing service models needs to begin now DDA wants to support providers in making the necessary changes

Art & Drama*Life Skill Center BridgewayMetro Day* BrooklandPhase Two Academy Choices Unlimited*Progressive Community Srvs Creative Options*Project Redirect* Head Start to LifeSt. Colletta PSIUCP* Helping Hands One and Two Capitol Hill Supportive Services* *Currently Approved IDS Provider

2015 Technical Assistance Effort  Goal is to assist each provider to: ◦Increase community integration (a/k/a community participation and community involvement) for participants; ◦Facilitate participants using mainstream community venues, services and resources rather than using separate, disability- specific venues, services and resources; ◦To the greatest extent possible, tailor integration opportunities to small groups of participants with similar interests and compatible personalities;

2015 Technical Assistance Effort (2)  Expectation that each provider will: ◦Provide meaningful activities for individuals to participate in - within the facility and in the community - which reflect individual preferences and goals, provide adult learning opportunities, and offer real opportunities for individuals to pursue interests and engage in community life; ◦Have a focus on career exploration and encouraging the choice to work for working-age participants not currently working; and ◦Have a focus on controlling personal resources for all service participants.

Technical Assistance to be provided  Help each provider assess their current situation and develop organizational action plan to expand traditional Day Hab and Employment Readiness service delivery in the community.  Assist the provider with identifying their staff’s training and professional development needs associated with making this change, and identifying ways to meet these needs.  Assist provider to revise internal quality assurance/quality improvement processes to reflect the organizational action plan and changes to service delivery philosophy, strategies and models.

How We Will Provide Support & TA  Each provider will be assisted by a team of three:  Lisa Mills  Quality Management Division representative (PRMU staff or QI unit staff)  Service Planning and Coordination representative

How We Will Provide Support & TA  Outreach to each provider during month of April (including one conference call) to accomplish three things: 1.Establish date/time for half-day on-site visit in May. [Date Options: May 4, 5, 12, 13, 19, 20, 28, 29] 2.Agree on the required members of the provider staff that will be present for the on-site visit in May. 3.Explain self-assessment the provider is being asked to complete in preparation for the on-site visit

How We Will Provide Support & TA  Half Day Training for Day Hab/Empl Readiness program directors (and any other staff interested) on May 6.  Half Day On-Site Visits [May 4, 5, 12, 13, 19, 20, 28, 29]  Lisa Mills to write up summary of action plan agreed at on- site visit and other recommendations for each provider (deliver to provider within 21 days of on-site visit)  Monthly follow-up TA Calls (60-90 minutes each) with each provider [June through September]

How We Will Provide Support & TA  Monthly discussions at DDA-sponsored leadership meeting of Day Hab and Employment Readiness providers [create Community of Practice feature in the May through September monthly meetings]  Other topic-specific trainings as needed for Day Hab/Empl Readiness program directors and staff. Peer training.  Final recommendations report for each provider. [September]

 Services should lead to outcomes for people receiving services  Outcome goals should be ◦ Individualized ◦ Meaningful ◦ Relevant to increasing each person’s level of community involvement

 Help the people you support to identify the activities in their neighborhoods and communities that they would want to participate in.  Seek and offer options based on Positive Personal Profile and understanding of each person’s unique interests, preferences, goals and conditions for success

 Engage in activities that help each person identify his/her interests, preferences and goals  Utilize community mapping to catalogue opportunities and find best matched opportunities for specific individuals  Find ways to bring community opportunities and connections to the people you serve

 Manage staffing resources to offer people some small group opportunities to explore and participate in the community  Recruit and/or redeploy volunteers to support community exploration and involvement

 Skill development efforts should be designed: “To equip people to successfully participate in personally chosen activities in their neighborhoods and local communities.” What kinds of changes might you make in your service delivery model?

Providers help people learn/gain skills by:  Giving them opportunities to participate (Learn by Doing)  Giving them specific instruction (Teaching)  Modeling and encouraging imitation  Connecting person to community members, organizations, places that teach/instruct

 Key to meaningful improvements in experience for the people you serve  Staff must understand reasons for making changes  Modeling, mentoring and coaching must be available in lieu of traditional supervision models (Implementation Science)

“Tell me and I forget... Teach me and I may remember... Involve me and I learn. -Ben Franklin

 Reasons for change must be discussed and understood from top down  Enthusiasm for making change must be evident among senior and middle management  Challenges and “bumps in the road” result in solution-building rather than retreat

All settings where waiver-funded services are provided must:  Be integrated in the greater community  Support access to the greater community  Provide opportunities to engage in community life

 Revise rules and policies to reflect new regulations  Revise provider qualifications and on-going monitoring/certification processes to reflect new regulations  Implement new quality assurance and quality improvement mechanisms to ensure service delivery consistent with new regulations

Lisa A. Mills, PhD