April-June 2013 Volume 7, No. 2
“The Right Services...To the Right People...At the Right Time!”
Brandy Wilson is one of two fulltime employees who also receive services from AWARE. They rotate between various duties at KANA Radio and receptionist duties at AWARE’s corporate office. They are treated as equal members of the team, receiving the same orientation as other employees, and like all employees, they are expected to meet job training requirements. Photo by Bryon Higgins
AWARE pioneers employment model By Bryon Higgins
Business Network, a collection of self-sustaining businesses operated as traditional, for-profit establishnew employment model at AWARE provides ments. The ultimate goal of the new model is to have community-based employment to people with people with disabilities fully integrated into the workdisabilities. Craig Keller and Brandy Wilson are the force. This means jobs at radio stations, retail stores, first to test out this new model with assistance from magazines and anywhere else high-level jobs are job coaches, Desarae Kulaski and Trista Lipscomb. available. For years, the employment norm for people For now, the model is being unveiled at KANA – with disabilities has included a sheltered workshop “The Mighty 580,” AWARE’s recently acquired AM setting and a piece rate wage. These jobs were simple, radio station, and the Anaconda corporate office. In See Employment model on page 6 the future, the model will be spread across the AWARE
DPHHS rule changes line up with AWARE care principles By Jim Tracy
AWARE has embraced recent changes by the state Children’s Mental Health Bureau in the way providers deliver services to families and how they measure outcomes.
Note to staff and friends
— Page 2
AWARE School Art & Science Fair — Page 5
The overhaul of family services, which has touched employees from Successful Starts to payroll, has allowed AWARE to stay true to its principles of unconditional care and faithful to family driven, strengthbased, individualized solutions for families. See Rule changes on page 8 Lead clinicians emphasize coaching — Page 11
Training determines caregiver success — Page 14
AWARE celebrates homeownership — Page 16
As usual, AWARE staff are busy. What else is new? Dear staff and friends,
Nothing makes me more proud than shattering myths about people and disabilities.
There are so many things going on right now that I scarcely know where to begin.
As some of you may know, we have assumed ownership of Cold Mountain Pottery in Billings. This company produces handmade mugs and ships them all over the world. If you’ve ever found yourself in a gift shop in Yellowstone Park, you’ve seen the mugs. This operation will eventually move into the Billings offices once construction for the kilns and other equipment is finished. However, we’re already employing people with disabilities, which, as you know, is one of our primary initiatives at AWARE—providing people Larry Noonan with opportunities. Those we’re employing are handling the shipping and receiving elements of the production, and as time goes on and we get more familiar with the intricacies of the business, we’ll be able to offer even more jobs.
Candlelight Home in Bozeman, it was the first home of its kind in Montana. Now there are six homes throughout the state, all of them operated with a wealth of experience and knowledge. Our continued relationship with the Kennedy Krieger Institute has been of critical importance and has affirmed our belief that what we’re offering is truly state of the art and outcomes based. Soon we’ll undergo our CARF review (for those who don’t know, CARF stands for ‘Commission on the Accreditation of Rehabilitation Facilities’—an international agency with thorough auditing process in which no stone is left unturned). The last time we were reviewed was three years ago, and we received exemplary marks in virtually all categories of services, administrative practices and ancillary services such as Apostrophe. I’m eager for them to witness all that has developed in that time: work opportunities for people with disabilities, more services for people with autism, the development of the Big Sky Psychiatry Conference into a leading event in the
While I’m talking about our recent endeavors that present a number of intricacies, we’re ramping up for the summer at Anaconda’s KANA radio station. We’re in the process of replacing and upgrading some equipment at the station. Besides strengthening our signal and enhancing the quality of the broadcasts, it allows staff at the station time to sell advertising, which, as you can imagine, is crucial to the success of any media.
Lawrence P. Noonan, CEO Geri L. Wyant, CFO Jeffrey Folsom, COO Mike Schulte, CHO
We continue to be the go-to agency in Montana for children with autism and their families who are desperately seeking real world strategies and opportunities. As time has passed, the services have become more dynamic. Providing comprehensive services to a population of well-informed families and their children who have struggled with their services in school, the community, and at home is a challenge. Five years ago, when we opened the
Board of Directors John Haffey, President Al Smith Cheryl Zobenica Ed Amberg Marlene Holayter Russell Carstens Stephen Addington Barbara Andreozzi Jesse Laslovich Editor: Jim Tracy Staff writers: Tim Pray Jacquie Peterson
AWARE Ink is published bimonthly by AWARE, Inc., a 501(c)3 nonprofit organization at 205 E. Park Ave., Anaconda, MT 59711. Copyright ©2013, AWARE Inc. All rights reserved. No part of this newsletter may be used or reproduced in any form or by any means without prior written permission of the publisher. Please send correspondence to: firstname.lastname@example.org
field, the Center for Excellence, Growth Thru Art… it’s really astounding to list all that’s been accomplished in three years, and even more astounding to consider the directions we’ll be going in another three. There have been, and there will continue to be, changes in the ways our services our provided. As many of you know, the intricacies of both youth case management and what was therapeutic family care have become much more intertwined, complete with changes in roles and responsibilities. The sudden transition into a new division of labor has been handled beautifully
by staff who never lost sight of the fact that, despite any difficulty on our end, the families we serve must not be a part of that difficulty. As the year continues to roll on, we’ll continue to look at the ways we do things and ask ourselves if we can be doing it better. If we can, we’ll figure out a way to do it. Sometimes those changes are daunting, changes like our conversion to electronic medical records that will begin in the next year. But I’m particularly proud of the small changes that occur over time, too. At more and more of our reception desks across the state, we have people with
disabilities answering the phones and doing other administrative tasks. It seems simple, but you’d be surprised at the number of people who have told me that it completely shattered their notion that people with developmental disabilities could not or would not work. Nothing makes me more proud than shattering myths about people and disabilities. So, again, thank you all for your support, hard work, attention to detail, and for putting the needs of those you’re serving first. With best regards,
AWARE volunteers chat with Drew Jenkins of Montana PBS during a break at the telephone banks March 4. The volunteers participated in a pledge night that featured the station’s Celebrate America Across Montana show. Left to right, they are Autumn Kirby, Jaci Noonan and Jennifer Leverett. Also volunteering as part of AWARE’s Apostrophe magazine team were Jacquie Peterson, Bryon Higgins, Tim Pray and Jim Tracy. PBS runs on-air ads for Apostrophe in exchange for PBS ads in the magazine. Photo by Jim Tracy
Art and Science Fair
Students at AWAREâ€™s school in Anaconda exhibited their projects at the annual Art and Science Fair May 17 in the gymnasium at the Anaconda High School vocational education center. At left, Anthony Runfola explains his project on motors and race cars. Below, Silas Baker (left) and Ethan Miller built a hovercraft using a leaf blower and then demonstrated how it works. Photos by Jim Tracy
Continued from page 1 requiring little to no skill, and wages were based on the number of “pieces” completed. With AWARE’s new model, the main emphasis is placed on individualized career placement. While the sheland receptionist duties at AWARE’s tered workshop model provides an corporate office, this means being approach for some people, it often treated as an equal member of the limits people with disabilities who team. They receive the same orienhave a wide spectrum of talents to tation as other employees, and they offer in the workforce. are expected to maintain their job AWARE’s new employment training requirements like everyone model is designed to help people else. with disabilities become indepen“I am really glad to be out in the dent, develop innate talents and community doing a real job that integrate into the community. It allows me to help others out,” says consists of two separate elements – Brandy about the model. “Learning a supported employment program new things and getting to help out and job placement based on interare my favorite parts.” est and skill level. An emphasis is At the radio station, Craig’s and placed on the separation of program and employment elements I am really glad to be because businesses lose their primary focus when they become out in the community responsible for programmatic details like transportation, docdoing a real job that tor’s appointments or behavioral issues. In some cases, these things can reduce business productivity allows me to help othby as much as 40 percent. In addition, maintaining this separation ers out. Learning new provides clarity for people as they make the psychological shift from things and getting to program to job placement and ultimately functioning as a reliable help out are my employee. For Craig and Brandy, both favorite parts. full-time employees rotating between various duties at KANA — Brandy Wilson
Craig Keller’s duties include answering the phones, greeting guests, responding to email and other office tasks. The highlight of the radio station, though, is operating the board during live play-by-play broadcasts of Anaconda Copperhead Sports. Photo by Bryon Higgins
Brandy’s duties include answering the phones, greeting guests, responding to email and other office tasks. The highlight of the radio station, though, is operating the board during live play-by-play broadcasts of Anaconda Copperhead Sports with announcer Blake Hempstead. Duties during the live events include using radio traffic software to initiate the broadcast, loading and playing commercials during timeouts and counting Blake back onto the air by telephone as commercial breaks end. “You’ve got 30 seconds Blake,” the excitement in the studio builds, “and 5…4…3…,” as the volume of Craig’s voice increases with the final countdown. He motions with hand signals while he talks into the phone, making sure Blake is ready to come back onto air at just the right moment. It is obvious that this is Craig’s favorite part of the job. Communication between the announcer and the board operator is critical because the duties are performed in separate locations. While Blake is on the field watching and announcing
the game, he is relying on Craig or Brandy in the studio for timing cues and volume levels. Without this information, it would be difficult, if not impossible, to air the live events. At the corporate office, receptionist duties primarily include answering the phones and transferring calls to the appropriate people. In many instances, Craig and Brandy have each answered the phone over 100 times in a four-hour period. Other duties include making public office announcements over the intercom, paging employees and handling incoming/outgoing mail. Job coaches, Desarae and Trista, help Craig and Brandy with their duties, but on a minimal level and only when necessary. The main goal for Desarae and Trista is to have Craig and Brandy work independently without assistance. The amount of assistance provided will decrease over time until it is no longer required. The new employment model is among the first of its kind, and AWARE is excited to see it take shape. As the model is incorporated across AWARE’s growing Business Network, people with disabilities will have an increasing number of opportunities for employment. The model will become an essential piece of AWARE’s work with young people who have disabilities as they make the transition from adolescents to young adults and active members of the community. It is yet another example of AWARE’s promise to provide the right services, to the right people, at the right time. I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel. — Maya Angelou
AWARE Special Olympians
Jay Arensmeyer Judy Armbruster
Billy Plummer — Shot put Jacob Sherman — Team bocce and bowling Russ Carstens — Coaching Assistant Judy Armbruster — Bowling Aimee Roberson — Team bocce and bowling Jay Arensmeyer — Team bocce and bowling Dan Bowen — Team bocce and bowling Casey Fisk — Cheerleader Dan Ramsey — Cheerleader Coaches: Deon Brown (head coach), Bill Tiskus and Katie Huot 7
from page 1 Jaci Noonan, director of case management and home support services, said the changes AWARE has made bring together services and the people who administer them in ways that didn’t always occur before. And the beneficiaries, she said, are the children and families who receive services. “That was one of the reasons we wrapped our arms around this rule change,” Noonan said, adding, “I think there is nothing but excitement about the reorganization. Certainly there are tweaks that still need to be done, but we have accomplished most of what we set out to do.” “It gets down to the whole premise of engaging families,” said Mike Kelly, whose new title under the reorganization is director of psychiatry and clinical services. “Once you have a family engaged and you have a relationship with them and your staff, it’s blue sky.” AWARE already was looking at better ways to deliver family services when the state Department of Public Health and Human Services changed its focus … and changed the rules. UCC principles “A group of us were looking at our principles of unconditional care and how we could better provide quality services for the families and kids we were serving,” Kelly said. “While that was happening, the state began meeting with providers and looking at changing the rules to improve the quality of services. So, it was very timely. It was parallel with our discussions at AWARE about improving the quality of our services.” Besides Noonan and Kelly, the
leadership group included Jeff Folsom, chief operating officer; Melinda Edwards, director of early childhood services; and Pandi Highland, quality management director. Frequent meetings They began meeting weekly by phone in January to formulate a plan to comply with the state’s rule changes. The plan required a lot of give and take and willingness to listen to other points of view, Noonan said. After about four months, they finished the reorganization plan, presented it to AWARE’s management and began making administrative adjustments to make it happen about May 1. That included allowing current employees to move into new jobs with new titles and hiring new employees from outside. It also included training staff at all levels. “We moved ahead,” Kelly said. “And we’re not looking back.” While AWARE has welcomed the state rule changes, other providers of the same services apparently are not as keen about them. “We are the only provider I’m aware of that has embraced these new rules,” Kelly said. “The rule changes are not what drove our reorganization, but they were absolutely a significant part of it.” Along with other providers, AWARE attended a meeting at the Children’s Mental Health Bureau in May. But unlike many other providers, AWARE has already implemented the department’s recommendations. According to Dan Ladd, program planning supervisor in the Children’s Mental Health Bureau, about half of the youth mental health providers across the state have participated in the changes. 8
Ladd said the changes were prompted by communities and providers “asking for more/better options to support keeping youth in their homes and communities while reducing the use of group home and residential settings.” Wraparound services, he said, provide a more coordinated effort to support the success of youth and families. He hopes the result will be an increase in the number of children being served in their home communities. Ladd offered no deadline for when he expects the changes to be fully implemented. Instead, he said, putting the changes in place “will be an ongoing challenge for the bureau and providers.” “As we continue to develop healthy partnerships with providers, the effectiveness of these programs should continue to increase over time,” he said. With the changes, Kelly said DPHHS hopes to develop and promote wrap-around services, a philosophy AWARE adopted more than 15 years ago. Wrap-around services are “individualized,” which means every family gets a unique plan that fits them and their beliefs and values, not the cookie cutter plan that everybody else gets. Greater flexibility “The program that has been developed in light of the rule changes will have greater flexibility in individualizing services provided to families and children,” said Jacob Henderson, one of eight community service administrators. AWARE also has two early childhood service administrators. “If I had to sum up the philosophy of wrap-around in one word or two words, I would say it means
individualized services. The new program will provide strong facilitators to work with kids and families with a focus on individualizing our services to meet a family’s needs.” AWARE prides itself on providing strength-based services. That means the wrap-around plans help individuals build on what is working in their lives instead of focusing exclusively on what isn’t working. A key part is the emphasis on family-driven services, which means plans are centered on the whole family and its choices. Noonan noted that proving outcomes may be easier for AWARE than for other providers because the company already tracks the progress of children and their families with several assessment tools and data collection. Staff already use the Wraparound Fidelity Assessment System. AWARE is considering adding CANS to its toolbox. CANS, or Child & Adolescent Needs and Strengths methodology, guides service delivery for children with mental health needs, developmental disabilities, issues of sexual development, juvenile justice involvement and child welfare involvement. Quality assurance CANS “provides information regarding the child and family’s service needs for use during system planning and/or quality assurance monitoring,” according to the description of the tool on the Maryland government website. The Wraparound Fidelity Assessment System, or WFAS, has been described as “a multi-method approach to assessing the quality of individualized care planning
and management for children and youth with complex needs and their families.” “We collect data on everything that has to do with child outcomes,” said Edwards. “We use standardized instruments that help us measure how much progress a child has made. We can measure pre- and post-intervention.” She said AWARE also uses data from Head Start for comparisons to gauge the success of its services. Edwards believes the new approach will be especially effective for families who are receiving services for their children in preschool and lower grades. ‘A logical focus’ “It’s a logical focus for those of us in early childhood,” she said. “One of our foundation pieces is to work primarily with families. If we are going to make changes with a child, we need to be working with a family.” The new approach, Edwards said, “is completely aligned with our early childhood philosophy at AWARE.” That philosophy emphasizes the value of working with children and families in a natural environment — in this case the home rather than, say, a therapist’s office. AWARE works with families with children in Head Start and Early Head Start programs in Billings, Miles City, Butte, Ronan, Lewistown, Great Falls, Bozeman and Helena. “Because we are housed in Head Start programs, we get referrals from a screening or parent request or teacher observing in the classroom,” Edwards said. She noted that most referrals involve children exhibiting aggressive behavior, although occasional9
ly other behaviors, such as extreme shyness, can draw the attention of teachers. “We don’t want to lose sight of the kids who tend to be wallflowers,” Edwards said. Once AWARE professionals begin working with a child and his or her family, they stay with them even after the Head Start connection ends. AWARE’s “wrap-around” support often involves home visits that focus on skill building and helping parents support and nurture their child’s social and emotional development. “When they don’t get that, it’s often a big void in their lives,” Edwards said. “Once children leave Head Start, AWARE is the consistent link in that family’s life, and that is what helps increase the child’s chances of success in school.” Edwards noted that 6 percent to 8 percent of all children of preschool age need support. “However, when we look at the Head Start population — those children living in poverty — that number jumps to about 30 to 35 percent, which in and of itself brings significant risk,” she said. Kids at risk Because AWARE has contracts with Head Start programs around the state, the majority of AWARE Successful Starts services are with Head Start children and families. Hence at-risk children in the community who are not in Head Start programs probably aren’t getting all of the help they need to succeed in school. “If the professional is not there (in the classroom), they can’t see the need,” Edwards said. “Because Continued on next page
A snapshot of AWARE Community Services AWARE promotes a “wraparound” philosophy so that services are strength-based, family focused, individualized, and comprehensive. Children’s Mental Health Youth Case Management YCM - The primary functions of Youth Case Management include walking families through various application processes, helping coordinate services and advocating for the needs of children and their families Home Support Services HSS- Home Support Services is a family-centered program designed to keep kids who have been identified as high-risk with their families; workers in this program are called Child and Family Specialist or CFS.
Continued from page 9 we are present on site, we can identify children’s needs at an early stage.” At Bozeman’s Head Start, for example, only one child was referred for social service support before AWARE became involved with the program. “This year alone we’ve had 20 referrals in Bozeman, and we’ll probably have more next year,” Edwards said. “Early childhood intervention works,” she added. “If they don’t get intervention early, we or another mental health agency will see these kids later.” While the change affects people
Community Based Psychiatric Rehabilitation and Support CBPR&S – Behavior Support Coordinators (BSCs) helps kids and families meet basic needs related to living in the community including housing, transportation, education, employment, social skill building, and any other areas that need attention as identified in a strength-based plan. Early Head Start/ Head Start and Successful Starts Successful Starts: AWARE’s collaboration with Head Start programs throughout the state provides mental health services and supports directly to Head Start students and their families. Comprehensive School and Community Based-Treatment CSCT- AWARE’s Comprehensive School and Community-based Treatment Services make addireceiving services, it also impacts AWARE administration. New position added Noonan noted that the change has meant increased midlevel supervision. And with new positions and new titles (AWARE has even created a new position, the child and family specialist) staff in the business office, especially payroll, have been redoubling efforts to ensure a smooth transition. Staff who work on the front lines with families have welcomed the changes, Noonan said. “They are mostly excited about it. They are talking about it with families. It’s a more focused team approach with more cohesiveness.” 10
tional supports available for young people who are struggling with behavioral and emotional issues in school. Psychiatry and Outpatient Services Psychiatry and Outpatient therapy is provided to youth, adults, and their families. Qualified professionals develop treatment plans suited to the individual or family, depending on their needs. Services are provided in a center (such as a clinic), at an AWARE office or at an appropriate and confidential community site of the customer’s choice. Adult Mental Health Adult Mental Health Case Management The primary functions of Adult Case Management include walking individuals through various appliContinued on next page “Change can always bring strong emotions,” said Henderson. “We have seen a lot of excitement from crew members in regards to the opportunities with the new program, along with some anxiety. Overall I have been pleased to see from my crew that their focus has been on the kids and families we serve.” “Philosophically,” added Kelly, “it’s one of the best things AWARE has done.” Data is not information, information is not knowledge, knowledge is not understanding, understanding is not wisdom. — Clifford Stoll (American astronomer and author) Give me six hours to chop down a tree and I will spend the first four sharpening the axe. — Abraham Lincoln
cation processes, helping coordinate services and advocating for the needs of the individual in services. Community Based Rehab and Support The CBPR&S program is paired with the ACM program and provides one-on-one assistance to individuals to meet goals outlined in the plan of care. Developmental Disability Services Adult Targeted Case Management AWARE’s DD Targeted Case Management provides case management services to adults with a developmental disability, the TCM’s assist individuals with accessing community services and developing a plan of care to meet the individuals needs. Children’s Waiver Services — Family Support Specialist (FSS) AWARE’s services for children with developmental disabilities (Children’s Waiver Services) provide every family with the individualized supports they need to keep their child in the home, while supporting their child to reach his/ her highest potential in living a fulfilling life. Community Service Administrators Jake Henderson — Kalispell and Missoula Suzanne Morgan — Helena Autumn Kirby — Bozeman Dawn Ann Peterson — Butte Katie Noctor — Anaconda, Deer Lodge and Dillon Kim Lewis — Billings Keith Polesky — Eastern Montana (Glasgow, Glendive, Miles City and Red Lodge)
Lead clinicians emphasizing coaching By Jim Tracy Besides reorganizing community services, AWARE has increased its emphasis in training clinicians. “We want our clinicians to understand completely what’s expected of them, and we want to develop our own internal experts in specialized content,” said Mike Kelly, whose new title is director of psychiatry and clinical service. “In conjunction with the reorganization, for the past nine Engaging families means months, we’ve been looking at developing trusting our lead clinicians to do three things: develop their leadership relationship that allow skills so they can coach front-line staff; coach early career therafamilies to better express pists who are working toward themselves and identify licensure; and develop their own professional skills.” their strengths, areas To help make that happen, six they want to improve, priorities for clinical services were identified and developed: skills they want to 1. Provide quality assessment services as a foundation to the develop and goals they development and implementation want to reach. of all services provided. — Mike Kelly 2. Act as engaged treatment team members who provide leadership, direction and coaching consistent with AWARE’s unconditional care principles. 3. Provide clinical coaching of mental health center services staff, including review and oversight of implementation of strength-based service plans. 4. Provide outpatient therapies through the use of evidence-based practice skills. 5. Accurately and consistently provide required documentation, including billing, prior authorization and documentation of client progress and outcomes. 6. Participate actively in the crisis response system, including primary attention to crisis planning and responsiveness to crisis calls. Lead clinician staff are Cindy Tadday, Kalispell; Carol Chisholm, Helena; Mindy Hayes, Great Falls; Jenn Leverett, Bozeman; Janelle Van Steeland, Billings; Anna Rapson, Miles City; and Laurie Helmer, Butte and Dillon. Lead clinician staff for AWARE’s Successful Starts pre-school program are Andrea Savage, Great Falls; Danielle Eldridge, Billings; and Jamie Knott, Butte.
Continued on next page 11
Kelly said the goal for clinisays. “Theraplay interactions What I do is help the cians is be to become leaders in focus on four essential qualities clinical services and build knowl- young professional with found in parent-child relationedge and skills in specific areas. ships: structure, engagement, skill sets, like crisis man“They would bring that infornurture and challenge.” mation to other clinicians and Children, specifically adolesagement, how to de-esca- cents, front-line staff and train them who are suffering severe to develop their own level of late crisis situations, how emotional repercussions due to expertise,” he said. “AWARE trauma respond extremely well to staff are working on strategies to to engage families. You trauma-focused cognitive behavengage families. Engaging famitherapy, Kelly said. build a sense of trust with iorThe lies means developing trusting therapy helps children relationships that allow families a person while at the same who have experienced repeated to better express themselves and episodes of trauma, as in abuse or identify their strengths, areas they time you’re helping this neglect, or those who have sufwant to improve, skills they want one occurrence of sudden person get involved in their fered to develop and goals they want trauma in their lives. to reach. It definitely takes skill It can also be used to treat own treatment. to engage families. Staff across children who are learning to cope — Carol Chisholm the state also are working closely with the death of a loved one. with Mary Grealish in developing skills that engage Family therapy is based on the belief that the famfamilies.” ily is a unique social system with its own structure and Grealish, who works for AWARE, is a pioneer in patterns of communication. The patterns are deterimplementing person- and family-centered practice, mined by factors that include the parents’ beliefs and the wrap-around process, therapeutic foster care, com- values, the personalities of family members and the munity assessment, system design and strengths-based influence of the extended family (grandparents, aunts behavior interventions. and uncles). As a result of these variables, each family develops its own unique personality, which is power‘Work from their strengths’ ful and affects all of its members. A mother of two, including a young adult who Health professionals who use the family systems has serious and persistent mental illnesses, Grealish model in caring for people always consider the whole is known for her simple and seemingly obvious apfamily. They view any problem in one member as a proach: “Tailor the necessary services to suit each symptom of change or conflict in the group. consumer, each child, and each family, and work from “So we’re using different techniques,” Kelly said. their strengths.” “We want to use an array of therapies because we indiUnder Grealish’s tutelage, AWARE staff are learnvidualize our services.” ing how to complete functional assessments. Formal clinical coaching “From that, they are being coached in implementing lesson plans that help families gain abilities and Kelly said the lead clinicians coach less experienced insights to accomplish goals they have identified,” therapists to provide evidence-based treatment Kelly said. “It’s formal clinical coaching of staff who are workThey are also becoming experts in specialized ing toward licensure,” Kelly said. content such as Theraplay, trauma-focused cognitive “The word ‘coaching’ can be interchanged with behavior therapy and family therapy. clinical supervision,” he added. “They give them feedTheraplay is a child and family therapy for building back on their technique. We use coaching because it and enhancing attachment, self-esteem, trust in others better describes what they are doing.” and “joyful engagement,” according to the Theraplay Lead clinician Carol Chisholm of Helena likens Institute. what she does to a basketball coach who teaches play“It is based on the natural patterns of playful, ers mechanics, conditioning and strategy. healthy interaction between parent and child and is “A good teacher knows how to break fundamentals personal, physical and fun,” the institute’s website into skill sets,” Chisholm said.
Skills could involve something as seemingly simple as learning to make eye contact with a client. “The way someone gets good at those is they practice and they practice and they practice,” she said. “What I do is help the young professional with skill sets, like crisis management, how to de-escalate crisis situations, how to engage families. You build a sense of trust with a person while at the same time you’re helping this person get involved in their own treatment.” Most of her coaching and mentoring involves home service specialists, a new position created as part of AWARE’s reorganization. “A lot of them are bachelor level professionals who have an eye to becoming licensed therapists,” Chisholm said. “I’m providing support that will give those folks a boost up.” She encourages them and helps channel their enthusiasm. “I work with the eager and young potential social worker and therapist who wants to work within family structures and family systems and bring those families to their full potential,” she said. Chisholm supervises five children and family specialists who work in the community, what she calls “the trenches.” Each specialist gets an hour a week alone with her.
behaviors, or meaning systems, include ingrained behaviors like incest, physical abuse and drug and alcohol abuse. “We work with families that really don’t see the problem,” Chisholm said. “We work on those larger meaning systems that really affect their lives.” At the same time, she said, therapists can sometimes get ahead of the family in an effort to change behavior. Anger management may sound like a good strategy, for example, but forcing someone to “manage” their emotions may produce the opposite result, she said.
Resisting change “Anytime someone hears that they have to change, there’s resistance,” she said. “Engagement really means a conversation, a collaborative conversation that gets behind people and helps them get involved in their own rescue.” Lead clinician Danielle Eldridge of Billings believes the changes have helped her become more connected. “For new clinicians, I think it increases connections and helps foster a sense of support and community within AWARE,” Eldridge said. “I also feel AWARE’s emphasis on coaching has increased the quality of service delivery and ensures a sense of consistency in expectations. It has also helped me to be more connected with other communities.” ‘We practice over and over’ She supervises clinicians in Billings, Bozeman and “I give them tips, then I do group supervision,” she in Helena. said. “We practice general skills. We might role-play a “As each program, runs things a little differently,” family who is having a tough time or a defiant teenshe said. “I am challenged to find ways to accept ager so we can figure out how to get some leverage in differences and also strive for consistency in service opening the person up. That’s what we practice over delivery.” and over and over.” She also feels challenged to keep abreast of new A specialist in family systems therapy, Chisholm is developments in her field and to understand rules, trained to know and understand relationships among policies and AWARE’s expectations. family members. She passes on that understanding to “I have become more self-reflective of how I can staff in her charge. encourage and teach others and more aware that other “So much is embodied in relapeople have different learnI have become more self- ing styles,” she said. “It has tionships with families,” she said. “I really work at larger meaning also helped increase the qualreflective of how I can systems and helping people hold ity of my own work as I spend on to what’s good and wonderful encourage and teach oth- so much time reflecting and about their families and traditions thinking about things like asthat have been passed on. We want ers and more aware that sessments and how therapy to keep those traditions and move should be written as well other people have different notes away from other behaviors that as recognizing how families haven’t been so helpful.” are responding and what might learning styles. Examples of other “unhelpful” See Lead Clinicians on page 24 — Danielle Eldridge
Training determines caregiver success By Chad Bushman AWARE Training Coordinator To succeed, the professional caregiver must be able to successfully navigate the treacherous administrative waters. This includes understanding regulations to ensure clients receive proper care, successfully completing employee performance evaluations, correctly documenting account expenditures and accurately billing for AWARE services. Supervisors, system administrators and service directors are expected to remain Chad Bushman knowledgeable of the ever-changing administrative policies and procedures. Additionally, it is implied they will also mentor and guide those under their charge on how to interpret, handle and manage administrative issues. To facilitate their endeavor, AWARE offers recurring administrative training opportunities. The latest information Administrative training is held once a quarter at the Corporate Office in Anaconda. The one-anda-half-day class is geared toward supervisors with the intention of helping them assume their new role armed with the latest information. Attendees are briefed by personnel from the different corporate departments, such as human resources,
accounts payable, accounts receivable, transportation, information technology and payroll. The benefit of this interaction is two-fold. First, attendees receive instruction directly from subject matter experts equipped with the most upto-date material. As such, attendees are able (and encouraged) to seek answers to their toughest questions, which helps separate fact from rumor. Put a face to a name Additionally, attendees and presenters get the opportunity to meet and put a face to name, which is the second benefit of this training. Face-to-face interactions allow frontline caregivers and corporate staff the opportunity to reduce the communication gap as well as to bring to light differences in their professional perspectives. This interaction is an AWAREwide benefit because corporate staff gets the chance to communicate the importance of administrative issues, such as the reason behind required deadlines. On the flip side, frontline caregivers are able to relate real-time challenges they face on a daily basis. Understanding and appreciating these differences has not only helped identify and select which topics are presented during the training event, but also helps corporate staff improve service to their customer (the frontline caregiver). In turn, it helps frontline caregivers enhance their care and customer service to their clients. Administrative Training covers a wide variety of information. A few examples of the specific briefing topics include: completing an 14
intake and discharge form, identifying Medicaid eligibility, petty cash actions, sub-account allocations, hiring methods, employee disciplinary process, NOVAtime, 401k, workerâ€™s compensation and purchase order procedures. This is just a smattering of the material presented. Inviting supervisors to Anaconda for the one and a half day event allows department personnel to brief attendees en masse, allowing for maximum interaction. Many attendees take advantage of the opportunity to visit one-onone with corporate personnel to address more specific or unique issues they are handling. Offered quarterly While the course was designed for the newly appointed supervisor, it is also a great refresher training opportunity for those who feel the knife edge on their administrative knowledge has dulled. As stated earlier, administrative training is offered quarterly with the next two sessions being held Aug. 26-27 and Oct. 28-29. Supervisors can register employees for this training by using the training signup email: email@example.com. In the email, please provide the following: participantsâ€™ name; desired training; date; and training location. Take advantage of this training opportunity. It is geared to help supervisors successfully navigate the treacherous administrative waters.
Do what you can, with what you have, where you are. â€” Theodore Roosevelt
Governor agrees to 4 percent increase
Pull, aim squeeze, sweep
Sharati Pia, an associate in accounts payable, demonstrates the proper use of a fire extinguisher as part of AWARE’s ongoing training. Use “PASS” to remember the technique: Pull the pin, Aim at the base of the fire, Squeeze the lever slowly and Sweep from side to side. Photo by Chad Bushman
Anaconda Work And Residential Enterprises 15
AWARE and other nonprofits that provide services to people with developmental disabilities across Montana will receive a 4 percent increase in state payments starting in July, according to a news report from the Lee State Bureau. The 2013 Legislature approved the 4 percent increase, but the administration of Gov. Steve Bullock last month proposed granting only a 2 percent rate increase this year and possibly basing the additional 2 percent on “performance outcome measures” for groups getting the money, the Lee Bureau reports. After provider groups protested, the state relented and agreed to pay the full 4 percent. There are 70 private, nonprofit companies that run group homes or provide day services for adults and children with developmental disabilities across the state. Richard Opper, director of the Department of Public Health and Human Services, told the Lee Bureau his agency still wants to explore the possibility of outcome measures next year, so the best providers might get more than a 4 percent raise in state payments. “I don’t know if we can get there or not. … But I’d sure like to have that conversation with them,” Opper was quoted as saying. Providers argued that the 2013 Legislature approved the 4 percent annual increase for each of the next two years, without any performance measures. The nonprofit companies are funded almost entirely by Medicaid, the state-federal program that pays medical costs for poor people and people with disabllities. The state, through the Legislature, sets the rates for these providers.
Sheila Rice, director of NeighborWorks in Great Falls (holding the AWARE banner) and Michael O’Neil, a program officer for AWARE (with the folder under his arm) spoke at a housewarming June 3 for Sierra Lode of Helena. Lode and Michael Kornec of East Helena are the latest Montanans to get a boost from organizations like NeighborWorks and AWARE that help people with disabilities buy their own homes. Photo by Jim Tracy
NeighborWorks, AWARE celebrate homeownership By Jim Tracy
“We can’t express the appreciation we have for all of you to help With the help of NeighborWorks, this dream come true,” Carol Lode, AWARE, other groups and famSierra’s mother, told the assembled ily and friends, Sierra Lode and crowd. Michael Kornec are living in their “Michael has been able to find own homes. a home that is way nicer than Lode moved into a two-bedroom, one-bath home in a quiet northcentral Helena neighborNeighborWorks has hood in early May. The home is fully accessible, a primary helped more than 5,000 consideration since she uses a wheelchair. Montanans statewide with Kornec’s three-bedroom, twobath home is on Main Street in financing the purchase of East Helena. The two young adults celtheir homes, and AWARE ebrated their recent participation Inc. has helped more than in the American dream with more than two dozen family 130 people with disabilities members, friends and supporters at a housewarming at Lode’s achieve homeownership. home on June 3. 16
anything he could rent,” Kornec’s mother, Shawn Brandt, said. “He wanted a house with a fenced yard so he could own a dog. Without you all it would not have been possible.” Well-wishers included Darren Larson, an independent living specialist at Summit Independent Living Center in Missoula and a member of the Montana Independent Living Centers Housing Task Force. “All people are deserving and need a place to call home,” Larson said. “Sierra Lode and I go way back. I am excited to see her beautiful new, accessible home. If Sierra’s home is the 130th home purchase assisted by AWARE, then I want to own the 131st.” Also attending was Montana
Lt. Gov. John Walsh. “I know how truly important it is to be a homeowner,” Walsh told the group. “We know as a team we can make things happen.” Sheila Rice, executive director of NeighborWorks in Great Falls, noted that homeownership gives people independence and confidence. “Owning a home is the most important goal anyone has,” she said. “Home matters. Home is where it all begins.” “Everyone should have the opportunity to own a home,” she added. “Sierra and Mike’s accomplishments took the dedication of the homeowners and their families along with the collaborative efforts of many organizations and individuals who believe that Home Matters especially for people with disabilities,” said Michael O’Neil, an AWARE program officer. 5,000 homeowners NeighborWorks has helped more than 5,000 Montanans statewide with financing the purchase of their homes, and AWARE Inc. has helped more than 130 people with disabilities achieve homeownership. The housewarming guest list included Gail Mann of American Federal Savings Bank; Mary Caferro, coordinator for The Arc of Montana; Darren Larson of Montana Independent Living Centers Housing Task Force; Leslie Torgerson and Josh Lafromboise of Helena Housing Authority; realtors Rita Williams and Kyle Courchane; Richard Opper, director of the Montana Department of Public Health and Human Services; Erik Amundson, field office director for the U.S. Department of Housing
Sierra Lode, foreground, has purchased her own home in a quiet northcentral Helena nighborhood with the help of NeighborWorks, AWARE and numerous other private and public organizations. Standing behind Sierra are her father, Fred, housemate, Beth Rolfe, and mother, Carol. Photo by Jim Tracy
and Urban Development; Debbie Morrison of Montana Department of Commerce HOME and Housing Choice Voucher programs; Bruce Brensdal, executive director of the Montana Board of Housing; Rebecca deCamara, administrator of Montana’s Developmental Services Division; Robin Homan, program 17
manager in the Community Services Bureau of the Senior and LongTerm Care Division; and representatives of the Montana Board of Housing, Rocky Mountain Development Council and USDA Rural Development.
Waiter sticks up for child with special needs [blog.sfgate.com] uk.reuters.com.
Compiled by Jacquie Peterson
Michigan teen with cerebral palsy completes triathlon JUSTINE McGUIRE [NECN.com]
The triathlon finish line represents a sense of accomplishment and often produces a surge of emotions. High school sophomore Bradley Langemaat, who has cerebral palsy, recently created plenty of each when he crossed the finish line of the Seahorse Challenge triathlon, according to a June 1 article at NECN.com. Along with his triathlon helpers, Langemaat produced an inspirational moment for his family, classmates and teachers — many of whom were on hand to witness the occasion, according to the Muskegon Chronicle. Langemaat received assistance from three teachers en route to completing the three legs of the race — a 500-meter swim, a 12.4-mile bike ride and a 3.1-mile run. The event also featured 70 other Grand Haven High School students who all completed the event. Derek Warner, who teaches the high school’s triathlon class, pulled Langemaat in a boat during the swim portion of the event. Tom Foley, an English teacher at the high school, pulled Langemaat in a bike trailer during the biking portion of the race, while Melissa Richardson, Langemaat’s main teacher, pushed him in a large stroller during the 3.1-mile run. Find the complete story at necn.com/06/09/13/ Grand-Haven-sophomore-with-cerebral-pals/landing_nation.html?&apID=b75f9c196472451db88b1cfc 3cf6bca4.
Boy with disability receives renovated home [PRWeb.com]
As part of a continued effort to support and give back to the local community, commercial painting company ProGroup Network and its employees recently took on yet another community service project, this time helping to renovate the home of Jeremiah, Aiden and Cindy Jeffers reports PRrweb.com. Called “Jeremiah’s Project,” more than 60 volunteers helped to completely renovate the home, gutting interior and exterior walls to create a more livable and moveable space for Jeremiah and his family.
Compiled by Jacquie Peterson Jeremiah is a 12-year-old boy with cerebral palsy. Both he and Aiden, his younger brother, are under the care of their grandmother, Cindy Jeffers. On April 26th, the family got the surprise of their life. Jeremiah, his brother and Cindy were picked up from their home in Wareham, Mass., and sent on vacation for a week, under the impression that small renovations would be done to their home. Little did they know that the small renovations were actually a complete gut and renovation of their entire home to make it handicap accessible. More than 60 volunteers, including those from ProGroup Network, worked around the clock to install new electric and plumbing, install a new exterior roof, build and install a new ramp to the property, and make improvements to enhance Jeremiah’s quality of life within the home. ProGroup Network also painted the entire interior and exterior of the home. Find the complete story at prweb.com/releases/commerical_painting/volunteer/prweb10807257.htm.
Students take ballroom dancing classes CHRISTIN LOVVOM [AL.com]
Tuesday evenings members of the Down Syndrome Society of Mobile County, Mobile, Ala., put on their dancing shoes to learn ballroom dancing at the Azalea City Center for the Arts. The class is taught by Ann Druhan as part an etiquette class, reports AL.com. “We wanted to teach traditional ballroom dancing and etiquette skills to young adults with Down syndrome to help them gain poise and confidence when in social situations,” said Lisa Gibert whose daughter, Britt, is a member of the Icebreakers. “Our etiquette class covers the basics of a traditional etiquette class and provides extra time to learn and practice the skills being taught,” Gibert said. According to the June 3 article by AL.com, the classes that average about 18 students 18-30 years old, were part of a pilot program funded by grants provided by the Down Syndrome Society of Mobile County and the Global Down Syndrome Foundation. To learn more about the class go to blog.al.com/prcommunity-news/2013/06/etiquette_and_dance_classes_fo.html. 20
A ride that changes lives
More than 3,500 units have been sold around the world, the company said. That robot has now been customized to help children who are autistic. The new model is dubbed ASK NAO — ASK stands for Autism Solution for Kids. Find the complete story at boston.com/businessupdates/2013/06/03/aldebaran-markets-robot-designedhelp-children-with-autism/QqMCjZGkLCNZGvg0hBTzxN/story.html.
SUE DeWERFF [FloridaToday.com]
Extremely emotional, sometimes tearful and truly awesome are just a few of the words Tracy Bastante has used to describe past Surfing for Autism events, which she and her 11-year-old son, Damian Richter, have attended, according to a June 1 FloridaToday. com article. Bastante of Florida says her decision to take her son who has special needs to the beach in 2008 for the inaugural Surfers for Autism event was one of the best she has ever made. “When they put Damian on the surfboard and he rode his first wave in on his knees (he was just 5-years-old then) — with the biggest smile on his face — I warned the volunteers who asked him if he wanted to do it again that he was going to say yes, again and again,” she said. FloridayToday.com reports that Surfing for Autism events spans throughout more than a dozen counties in Florida and was spearheaded by former lifeguard and long-time surfer, Don Ryan. “It has been a marvelous way to bring autism awareness to the forefront, not only throughout the state, but nationwide.” Read the complete story at floridatoday.com/article/20130602/SPORTS05/306020028/Surfers-Autismride-changes-lives?nclick_check=1.
Facebook hate speech problematic, advocates say
MICHELLE DIAMENT [DisabilityScoop.com] Under pressure, Facebook recently said it will improve its efforts to weed out hate speech on the social network. Disability advocates say the move is long overdue, according to DisabilityScoop.com article by Michelle Diament. The June 11 article reports that late last month Facebook acknowledged that it needs to do more to monitor and remove postings and pages featuring hate speech. The announcement came after a coalition of women’s rights groups successfully urged major companies to pull their advertisements from Facebook, accusing the social network of including content promoting violence against women. Many in the disability community have complained about Facebook pages featuring questionable content and misappropriated photos of those with disabilities. Diament talked to Hannah Jacobs, a New York City mother of a teen with an intellectual disability, who has spent years actively working to report offensive Facebook pages. Jacobs said she continues to find content on the social network each day that she considers to be problematic. She’s flagged pages with names like “I Am Retarded,” “I Hate Fat People in Wheelchairs” and one called “Retards in Cages.” “It’s a little like playing Whac-A-Mole. One group down, two more pop up,” said Jacobs who runs Family Member, a nonprofit dedicated to promoting fair representations of people with disabilities in the media. Jacobs’ efforts have won her meetings with Facebook officials in recent years. When she first spoke with the company, Jacobs said that disability wasn’t even an option on the drop-down menu to report problematic content. Find the complete article online at disabilityscoop. com/2013/06/11/facebook-problematic/18131/.
French company markets robot that helps children with autism CHRIS REIDY [Boston.com]
Aldebaran, a French robotics company that recently opened an office in Boston, is now marketing a humanoid robot specifically programmed as a teaching tool for children who are autistic, according to Boston Globe reporter Chris Reidy. Reidy reports that the company’s autism team was created in Boston in February mainly because the U.S. is a front runner in the search to improve the lives of those with special needs. The June 3 article says the new office includes 15 employees while the company employs about 300 people worldwide. For several years, Aldebaran has marketed a robot called NAO, which is described as a “programmable, autonomous humanoid robot able to run educational, entertaining and daily life assistance applications.” 21
Enterprise Learning Center celebrates first graduates
ELC graduate Zach Miller (center) poses with his parents on graduation day. At left is Zach’s mother, Liz Miller, and at right is father Norm.
By Tim Pray our years ago, in close collaboration with Billings’ School District 2, AWARE developed Montana’s first and only school for youth with autism. And now, after massive amounts of hard work, four students have graduated the Enterprise Learning Center and are beginning, like everyone their age, their transition into adulthood. For many of the youth in the Learning Center, their Individualized Education Plans (IEPs) went beyond what the resources of a school district’s special education staff were able to provide in a traditional classroom setting, and
talks between AWARE and school district staff began. What resulted was a classroom that could provide the one-on-one attention and functional academics that, with further support from the Kennedy Krieger Institute at Johns Hopkins University in Baltimore, Md,, began producing positive outcomes with time, hard work, and patience. While each student’s educational plan is unique, the ELC mixes academic, pre-vocational, and daily living skills management. The environment in the school allows students to form relationships at their own pace as opposed to faster-paced traditional venues. Further, significant time is spent allowing for trust to build between the students and the staff. 22
Each of the families with children attending the ELC have been intricately involved in both programmatic and social elements, working with staff and their children on bridging the gap between graduation and adult life. The prevocational aspects of the education are steeped in involvement at home and throughout the community, and regardless of each specific plan of action after high school, each are entering a significantly less restrictive environment than they knew prior to their time at the ELC. After four years of hard work, we are proud to introduce and congratulate the inaugural 2013 graduating class of the Enterprise Learning Center.
From left to right, mother Dianne Booth, ELC graduate Logan Booth, and father Jim Booth
Enterprise Learning Center 2013 Graduates Photos by Stacey Casterline ELC graduate Ryan King, at right, with his father Greg King.
ELC graduate Spencer Cooper (holding his diploma) and his family, from left, brother Harrison, mother Carina and, to the right of Spencer, father Mark.
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Continued from page 13 be more effective ways to engage them.” “I think this new role has pulled me out of my own little world more and caused me to seek others out to clarify and make sure I understand things clearly so that I can feel I am guiding new clinicians in a consistent and effective manner.” Therapists who are receiving coaching from Chisholm and other lead clinicians have a contract that is required by AWARE. The contract spells out the role of the lead clinician and therapist and requires specific outcomes. Generally it takes two years for an unlicensed therapist to acquire 3,000 hours of clinical supervision to become licensed.
“AWARE is making a big investment in the unlicensed therapists,” Kelly said. “It’s a positive investment. We want to make sure the clinical supervision — the coaching — that the unlicensed therapist is receiving is of high quality.” At the same time, he said, AWARE doesn’t want all clinicians to have expertise in all areas. All kinds of expertise “We don’t want everyone to know how to do Theraplay, for example,” he said. “We want to have all kinds of expertise across our clinical team.” Kelly’s new role will be to supervise all clinical leadership, including lead clinicians and psychiatrists. “One of my roles — and I work really closely with AWARE Medi24
cal Director Dr. Len Lantz — is to continue to develop the leadership of these two teams,” he said. “We’re trying to bring these teams together to work more closely with other staff.” Kelly said AWARE is also cultivating specific areas of expertise among its doctors, which now number 14, including full-time and contract psychiatrists. “This is all in the pursuit of excellence,” he said. “We’re taking from what others know and from the professional literature and we’re creating our own model.” If you have an apple and I have an apple and we exchange these apples then you and I will still each have one apple. But if you have an idea and I have an idea and we exchange these ideas, then each of us will have two ideas. — George Bernard Shaw (Irish literary Critic, Playwright and Essayist. 1925 Nobel Prize for Literature, 1856-1950)