Sepoct2008

AWARE

September/October 2008 Volume 2, Number 5

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‘Apostrophe’ hits newsstands

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Loreene Reid, left, helped her brother and sister-in-law, Lyle and Pam Whitmore, buy a home in Bozeman. Photo by Jim Tracy

‘Love and perseverance’ Bozeman couple beat tough odds, celebrate home-ownership, 15th wedding anniversary

By Michael O’Neil Pam Whitmore, when she was living at the State of Montana Developmental Center in Boulder, would tell her teachers that all she wanted when she grew up was to get married and to own a home.

After leaving the institution at Boulder and moving to Bozeman, she

Inside...

Note to staff and friends

— Page 2

met Lyle Whitmore. When she met Lyle more than 25 years ago, they began a love story that would result in both of her life dreams coming true.

Pam and Lyle’s story in many ways represents great strides American society has made in the last part of the 20th Century and the beginning of the See Housewarming on Page 18 Head Start partnership grows

— Page 4

Dr. Ira Lourie’s Shrink wRap — Page 8

an’t and shouldn’t. Those words too often turn into “could have” and “should have” – regrets about lost opportunities.

Apostrophe, a new magazine for, about and by people with developmental disabilities, intends to help turn “can’t” and “shouldn’t” into “can” and “should.”

The 48-page, full-color quarterly was mailed to more than 4,300 potential subscribers in August. The magazine also went on sale at Hastings stores and other outlets throughout Montana.

“We’ve learned a lot about developmental disabilities since we started putting the magazine together six months ago,” said editor Jim Tracy.

“Those words contain lots of syllables and carry loads of meaning. But one important lesson we’ve learned is that big words and labels can get in the way of understanding people.”

Apostrophe, a concept developed by AWARE CEO Larry Noonan, advocates for people with developmental See Apostrophe on Page 3 Tele-medicine network on line — Page 12

Center advocates for abused kids — Page 22

AWARE is connecting with communities Dear Staff and Friends, This summer has been one of serious progress in the ways that we communicate with the communities, people and families of Montana. Many of the things we have achieved have been in the works so long, and it’s been so exciting to watch us get into the fun part and hit the gas at the green light.

The open house for the Larry Noonan Candlelight program in June and the housewarming celebration for Lyle and Pam Whitmore in Bozeman in July were simply outstanding, and we were honored to have Senators Max Baucus and Jon Tester and Governor Brian Schweitzer present to say a few meaningful words.

We were happy to open the doors to the Candlelight program – giving all of those who took the initiative to fund this initiative the chance to see all the ways that their trust has benefited the lives of kids challenged by autism and other developmental delays. Exactly one week later, I was back in Bozeman at the housewarming party for the Whitmores.

Their story is nothing short of remarkable. Pam spent most of her life in an institution, while Lyle’s early education was relegated to the boiler room of an elementary school. Today, they are homeowners – whose party included almost 100 well-wishers from around the state and two U.S. senators.

Since 1984, I’ve been trying to visualize some form of communication for people with disabilities. Something that didn’t exist in the popular media.

Something of quality. Over the years I’ve read thousands of surveys of people with disabilities. “What would make your life easier?” The survey would ask.

“A new program?” “A new accounting policy?” “A bigger staff?” More often than not, though, the answer was clear.

“I just need a ride.”

So, in an answer to that, we’ve launched our first issue of Apostrophe, our quarterly magazine for, by, and about people with developmental disabilities in the state of Montana. This first issue has been received well thus far, and, most importantly, received well by the people we are seeking to address.

We wanted this magazine to stay away from the sorts of survey-style questions I mentioned earlier and really tackle the nuts and bolts of life. “Where can I find a job?” “Where are the most accessible hotels and motels in the state?” “What happens to my financial status if I choose to get married?” Apostrophe offers a mix of financial, legal, health and wellness, accessibility, home and garden, and feature material, as well as recipes, almanacs, and top of the line photo spreads throughout. The next issue is set to hit the stands in October, so be on the lookout for it, and if you know someone who might enjoy it, encourage them to check it out.

I’m also happy to announce that our Board of Directors has approved a corporate-wide increase in wages and benefits. The details of the increase can be found in this issue of Ink. One of the benefits of a non profit organization is that we are truly able to put our revenue right back into the services we provide and the staff that provides them.

Considering the economy we’re in, it’s comforting to know that we’re not beholden to shareholders or other corporate entities. One of the biggest projects that represents this reinvestment in the services we’re able to provide is that of the video network that we’ve launched.

AWARE’s virtual private network is in place, one of a select few video con-

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ferencing and telepsychiatry networks in the state. There are other networks around, and they are used by hospitals, mainly for physical medicine. In a rural state like ours, though, it is just as hard for a person to gain access to mental health professionals, and that’s something we think we can address, and are addressing. You’ll read about the network in this issue, but it’s so exciting to know that we can bring together doctor and patient, parent and child, trainer and trainee.

We expect this network to grow, and feel confident it will enhance the relationships we have with other community members, institutions and professionals. There is literally no telling what this could lead to, and I’m proud to say that we can offer this new way for people to connect.

So, while I can scarcely believe that summer has passed so quickly, I’m thoroughly impressed by the ways in which this whole organization has managed to push the boundaries of what can be accomplished by a nonprofit organization that has never lost sight of the people it is here to help.

Thank you.

Lawrence P. Noonan, CEO Geri L. Wyant, CFO Jeffrey Folsom, COO Mike Schulte, CHO Board of Directors John Haffey, President John O’Donnell, Vice President Al Smith Teresa Marshall Cheryl Zobenica Keith Colbo Editing and layout: Jim Tracy Staff writer: Tim Pray AWARE Ink is published bimonthly by AWARE, Inc., a 501(c)3 non-profit organization at 205 E. Park Ave., Anaconda, MT 59711. Copyright ©2008, 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: askaware@aware-inc.org.

Apostrophe...

the subject of the cover story. Veverka excels in disabilities and gives long-distance running, them another way to cross-country skiing advocate for themand basketball. Runselves. ning and skiing and Among the articles playing hoops make up in the first issue is an a big part of Anton’s editorial by People life, but you’ll read in First of Montana PresiApostrophe how he has dent Rocky Hughes of succeeded – sometimes Kalispell. against the odds – to Hughes writes about become successful in the goals of People the other parts of his First members, includlife. ing learning to speak In a section called for themselves. Lately “Three Months in People First has been Montana,” you can find speaking out about the out about fun things to “marriage penalty” – do and places to visit punitive regulations during the summer. that make it nearly We’ll publish seasonal impossible for some versions of the guide people to enjoy the in the fall, winter and basic right and simple spring. human desire to marry In other departments the person they love. you can learn: “It’s just a stupid how to get a job rule,” Hughes says. through the Job Service Apostrophe also Navigator program; took a cue from People how to make mariFirst in speaking up nara sauce; about other issues. how to re-pot a Disability Rights house plant.

Kerry Sheets and Jenna Whisenhunt of Billings Adults competed in the Special Montana lawyer Tom Olympics Summer Games in Great Falls. The first issue of Apostrophe featured Future issues will Dooling writes in photos, like this one, by Special Olypics photographer Gregg Edelen of Butte. include fashion tips and the first issue about how-to’s on keeping fit, saving and investing and buying a the Olmstead Act, a court decision that requires states to home. administer their services, programs and activities “in the Oh, about the name of the magazine. most integrated setting appropriate to the needs of qualiApostrophe means more than just punctuation. The title fied individuals with disabilities.” The decision was a comes from a song by the late rocker Frank Zappa. In 1974, promise made to people with disabilities, but that promise Zappa wrote and performed a tune about a man talking hasn’t always been kept, according to Dooling. to his dog, Fido. We all can relate to that. But in the song, Tim Plaska, Community Services Bureau Chief for the Fido talks back.

Montana Department of Public Health & Human Services “You can’t say that!” the man tells the dog in disbelief.

Developmental Disability Program, talks about disabilities “I do it all the time,” Fido replies. He talks, he says, even from the supply side with a column about services and supwith all the apostrophes thrown his way: can’t, won’t, don’t, ports people need to live as independently as possible in the hasn’t, isn’t, shouldn’t and couldn’t. community.

People with disabilities face the same apostrophes. Too Those are weighty matters. But not everything in the often they’re told what they can’t do. Apostrophe emphaApostrophe is serious. sizes what they can do.

You can read about the Special Olympics Montana 2008 To learn more, contact Jim Tracy or Tim Pray at State Summer Games in this issue and check out photos 406/563-8117. Or visit Apostrophe’s web site: www.apostrotaken by Gregg Edelen of Butte. phemagazine.com.

Special Olympics athlete Anton Veverka of Richey is 3

Rocky Mountain Development Center Head Start office in Helena. Photo by Kenton Rowe

Head Start partnership expands to Helena

By Jim Tracy

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hildren enrolled in Head Start in Lewis & Clark, Broadwater, and Jefferson counties will have access to AWARE services this fall.

Rocky Mountain Development Council Head Start, based in Helena with satellite classrooms in East Helena, Townsend and Whitehall, has partnered with AWARE to screen children and provide mental health services to them and their families.

The Helena partnership is AWARE’s second such collaboration with Head Start. When school starts this month, AWARE will begin its third year of working directly with Billings Head Start.

Mike Kelly, who directs AWARE’s family support services and set up the joint program in Billings, also negotiated the Helena agreement. He wants to apply the Billings model in Helena.

“We know there are parts of the Billings program that will definitely work in Helena,” Kelly said. “We want to replicate what we’ve done in Billings to the extent that it makes sense.

We want to see what we can copy, but we also plan to create a program that fits Helena’s unique needs.”

As in Billings, Kelly said AWARE’s job will be to develop relationships with the Head Start staff “and support them in meaningful ways.”

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e want our services to help them do the best they can at their jobs as teachers and paraprofessionals — Mike Kelly, family support services director 4

“We want our services to help them do the best they can at their jobs as teachers and paraprofessionals,” he said.

Services AWARE provides at Head Start include outpatient therapy, evaluation and assessment, therapeutic family care and community-based rehabilitation and support.

A Head Start class can have as many as 18 children, each taught by a degreed or credentialed teacher.

AWARE staff, indistinguishable from Head Start staff in the classroom, provide one-on-one support for kids who are struggling, freeing teachers to devote their time and attention to other kids without distraction.

To help prepare the RMDC program, Head Start staff from Billings, along with AWARE staff dedicated to Head Start there, met several times Continued on next page

with Rocky Mountain Development Center staff over the past 12 months.

While the Billings program is centralized, the Rocky Mountain Development Council operates classrooms at six sites in the Helena/East Helena Valley with satellite operations in Whitehall and Townsend.

“The challenge is that there are so many sites as opposed to one or two sites in Billings,” Kelly said AWARE staff in Helena will include recently hired service administrator Kenton Rowe and lead clinician Angelo Spado. AWARE also plans to hire as many as a half dozen paraprofessionals for the classroom.

Patty Dahl, director of RMDC Head Start, says her program staff, Policy Council and Board of Directors “are very excited about the partnership with AWARE.” “For a very long time we’ve been concerned with the increasing number of children in our program with social and emotional issues,” Dahl said.

“While we’ve offered different types of intervention over the course of the years, we are thrilled to begin a partnership with AWARE. We feel services will be more immediate and more timely and, as we all know, early intervention is such a key to making positive changes.”

Dahl commended the program’s Early Childhood Advisory team “for their work in bringing mental health services to children and families at RMDC Head Start.”

“I’ve been so pleased with the ground work done by our staff as well as the Head Start and AWARE staff from the Billings program,” she said.

“And I want to add how much I appreciate the work and attention given

by Mike Kelly to get this partnership up and running. We look forward to working with all our new partners from AWARE.” Lynn Guay, Early Childhood Development and Health Services manager for RMDC’s Head Start Program, also praised the Early Childhood Advisory Team, which she oversees.

The team worked “to see that mental health services would be available for children in the Program this year,” Guay said.

“Mental health services in the Head Start classrooms needed to be expanded to meet the needs of our children. We are very excited to have had the opportunity to work with AWARE these past months and look at a variety of services that can be available to our children and their parents.”

One of AWARE’s first tasks before school starts on Sept. 17 will be to train RMDC staff.

“We’ve collaborated with Head Start and they have incorporated us into their initial pre-service training for their staff,” Kelly said.

Once school begins, AWARE will provide social and emotional screening for all 248 children. Based on that screening, children will be identified as likely to benefit from mental health support services.

Screening, which could last through October, must be completed within 45 days of the first day of school.

Continued on Page 25

A place where kids can flourish Head Start prides itself on being a place where kids and families can flourish.

The program emphasizes development of social skills, early literacy, language and other kindergarten readiness skills. Parent involvement as partners is a key to the success of Head Start.

Head Start provides nutritious meals and snacks for kids and information for parents on healthful eating and meal planning on a budget; provides hearing, vision, and growth assessment screenings as well as a developmental screening; helps families in establishing medical and dental homes so that physical and dental well-child exams can be completed; and provides assistance with transportation to ensure families access services. Rocky Mountain Development Council’s Head Start sites are mostly parent-transport sites; only three of their eight sites offer transportation.

For children with special needs, Head Start works with local education associations to provide speech and language therapy and individual help with delayed development in any area, including social, motor and thinking skills.

While the program helps kids and their parents, it also provides benefits to the wider culture.

Society receives nearly $9 in benefits for every $1 invested in Head Start children. Those benefits include increased earnings, employment, family stability, and decreased welfare dependency, crime costs, grade repetition and special education.

A recent study funded by the U.S. Department of Health and Human Services, showed that Head Start children performed better on cognitive, language, and health measures than counterparts in a comparison group.

Head Start children at age 5 had larger vocabularies than a study control group had. They also demonstrated a higher level of social-emotional development than did the control group.

Head Start has served low-income children and their families since 1965. It actually consists of two programs: Head Start and Early Head Start. Funding goes directly from the federal government to local grantees.

The federal government provides 80 percent of the yearly cost to operate a Head Start program. The remaining 20 percent must come from a local match or in-kind contributions, which may be in the form of money, donations of goods or services, or volunteer hours.

Head Start and Early Head Start programs serve children in families earning income at or below the federal poverty level, which for a family of four in the 48 contiguous states and the District of Columbia is $21,200 for 2008.

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Timothy’s Neighborhood Watch

“Yeah, like a Neighborhood Watch,” someone added.

All of the team members thought it was a great idea, which helped Mom to accept it. Timothy didn’t quite know what to think about it; part of him didn’t want his freedom impinged on, but the other part was not happy about being the bad guy all the time.

Mom was included in the planning, and they created a list of neighbors who might be called upon to report sightings of Timothy. Once they had the list, Mom, the AWARE case manager and the staff of the therapeutic family care provider set out to explain the problem to the neighbors and how they could be of help by calling her when they saw him. It was amazing how many people were willing to step in and help Mom corral Timothy.

Some of them did it because they were justifiably worried about their kittens, mail and campers, but others were just happy to help.

One of the immediate benefits of this program was that Mom began to feel energized by finally being able to do something that could help. She had been terribly discouraged about her inability to deal with Timothy, but suddenly she was involved in a positive effort. She learned how to explain Timothy’s behavior to others and to work with the neighbors.

Or Lessons Learned from Tootle the Engine

By Dr. Ira Lourie

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imothy is a wiley 7-year-old and has — as the Germans would say — a wanderlust. He likes to take off from his home, go places and do things.

While at times this might seem like a good thing for you and me — and better than being a couch potato — for Timothy and his mom it was getting to be a problem.

For a 7-year-old to wander the neighborhood alone can be a dangerous thing, but in his neighborhood it was even less safe. Then there were his behaviors; the things he did while he as wandering. While he was wandering, he was also curious. He rifled through mail boxes, broke into the school and neighbors’ campers. The police were called and they tried to intervene by talking with him about the problem, but this did nothing to slow down his behaviors.

When he killed two kittens and Dr. Ira Lourie ­— on another occasion — drove off in his mother’s car, people felt he had gone too far and he ended up in an acute hospitalization at Shodair. (How a 7-year-old steals a car is beyond me, but I guess it is some indication of how much talent he has. At the same time, I need you to notice my re-framing of Timothy’s running away and behaviors in a positive light, i.e., “wanderlust” and “curious.”)

Improved self-esteem It became clear that even though she seemed helpless to give her son the containment that he needed, she was able to do this other task. This began a process by which she improved her self-esteem and began to understand that she indeed could be a more effective person than she imagined. Neighbors and team members began to see Mom as an effective individual rather than dysfunctional.

The more effective Mom felt in working with her community, the more effective she felt in general, including dealing with Timothy. At the same time, Timothy began to see his Mom as playing a more active part of his life.

In the words of Mom’s AWARE case manager, Flannery Harpole, “The most beneficial part of the [neighborhood watch] process is that his Mom feels more confident asking for help from her neighbors. [Recently] Timothy ran off and she found him at a neighbor’s house.

As she was leaving she reminded the neighbor, in front of Timothy, to please call her if he comes over to make

Psychiatric opinions sought The team was not exactly sure what to do. They had the police talk to him, they worked with mother to find better ways of keeping him at home and out of trouble, but none of this had proven effective. They suggested therapy and got psychiatric opinions. But Timothy could still not be contained, and his behavior had not gotten any better.

Then one of the team members had an idea: “Let’s get the neighbors involved in helping keep track of Timothy, so when he wanders he can easily be found and his negative behaviors stopped before he starts them.”

Continued Continuedon onnext nextpage page 6

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tle got off the track one of the neighbors would stand up with a red flag and Tootle felt he had to obey. After a while, Tootle figured it was more productive to stay on the track and ultimately grew up to be a “Two-mile a minute Flyer.”

The same thing happened with Timothy. He learned that the neighbors were watching him and that there wasn’t any sense in wandering. He was learning with his neighbors’ help how to stay on track. And after a while the same thing happened with Timothy that had happened with his Mom; he began to get a feeling of strength and competence which he himself could build on.

sure that he has permission to be there. This is a much more active role for her to play and I think that it has empowered her to be more assertive and confident in her parental role. She reported that she was surprised at how supportive people were with her request to contact her.”

The idea of a “Neighborhood Watch” to get a child back on track was not entirely a new one. I first came across it when I was a child and my parents read to me what was then a new children’s book that has become a classic, Tootle. As some of you might remember, Tootle was a little engine who was going to School for Engines.

There he learned many rules of which the two most important were to “Stay on the tracks no matter what” and “Always stop at a red flag.”

A curve in the track Well, Tootle was practicing one day and ended up racing a horse. All of a sudden when there was a curve in the track, Tootle figured that if he had to turn and horse could go straight, the horse would win. So he jumped off the track. He discovered how wonderful it was off the track and continued to do it many times so that he could chase butterflies and pick flowers.

When his wandering was discovered and persisted no matter what he was told, the instructors and townspeople came up with their own “Neighborhood Watch” plan.

They hid in the field with red flags and every time Too-

Dr. Ira Lourie, AWARE’s former medical director, is the author of Everything is Normal Until Proven Otherwise. He lives in Hagerstown, Maryland.

Sweet treats Kristie Connolly, project supervisor, pours syrup on a sundae for one of the hundreds of people in Anaconda who turned out for an AWARE ice cream social in conjunction with ­Marcus Daly Days Aug. 7-9. Dishing out ice cream behind Connolly is Janis Zeier, project manager in accounts payable. Photo by Jim Tracy

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Helena psychiatrist named medical director

By Tim Pray

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policy and AWARE’s unconditional care philosophy by providing direct psychiatric services, serving as a liaison between community physicians, hospital staff, and other professionals and agencies with regard to psychiatric services, reviewing and approving AWARE mental health center policies and procedures on an annual basis, providing input into AWARE training systems and programs, collaborating with CEO Larry Noonan and chief of operations Jeff Folsom in strategic planning, and acting upon the administrative decision making which impacts clinical care.

While it’s the sort of position that involves the continuation of past efforts, it also welcomes new ideas and strategies that address the fluctuating needs of an always-changing field of practice.

Take for instance Dr. Lantz’s strategy to address the mental health-care professional shortage while increasing the mental health knowledge base

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’ll admit that I felt somewhat intimidated about accepting the position. I have tremendous respect for Dr. Lourie who is a nationally recognized expert in mental and public health fields. — Dr. Len Lantz

or 10 years, Dr. Ira Lourie has served as AWARE’s medical director. In that time, he has helped to initiate a focus on unconditional care, been a strong advocate on behalf of family involvement with Corporate Congress, vocalized AWARE’s consistent emphasis on serving children in their home state, and brought the concepts and philosophies of wraparound services to not only AWARE staff but Montana’s greater mental health community. There have been countless other throughout the state of Montana. achievements, perhaps the grandest “Montana has a workforce shortage being the fact that – had he not served regarding psychiatry, however every as medical director – AWARE’s state in the nation will say that they mental health landscape would look have a shortage … we will be involvdramatically different. ing our psychiatric and other clinical In the beginning of August, Dr. staff in partnering with pediatricians, Len Lantz, a fifth-generation South family practice physicians, and other Dakotan, was named as AWARE’s primary care providers.” new medical director, stepping into He continues, “we may also collabthe position with a humble eagerness orate with local chapters of the Amerito complement and continue the work can Academy of accomplished by Pediatrics which Dr. Lourie. has been devel“I’ll admit oping forums that I felt somefor opening up what intimidated dialogue between about accepting pediatricians and the position. I child psychiahave tremendous trists, providing respect for Dr. educational opLourie who is a portunities, and nationally recogallowing greater nized expert in access for formal mental and public and informal health fields.” consultation.”

The medical Lantz received director’s posihis undergradution is one that ate degree in mixes developbiology from ment, supervision, Dartmouth Coladministration lege in Hanover, and direct care.

New Hampshire.

Some examples He received his of the position’s doctorate from duties include esthe University tablishing medical Dr. Ira Lourie in a familiar pose at Corporate Congress 2007. Photo by Jim Tracy of South Dakota 8

in Vermillion. Dr. Lantz performed his residency at the University of Wisconsin Hospital and Clinics in Madison in 2005. It was during a psychiatric training opportunity in Montana that same year that Lantz met Folsom.

After talking for some time about the problems facing a rural state’s mental health needs and the philosophies and treatment Dr. Len Lantz, at right, confers with a woman in his office in Helena. AWARE photo approaches of AWARE, Lantz came to the conclucommunity in training opportunities embrace of family-driven care, and the sion that the organization was one such as learning about more proven, fact that the ideas for the future direcpoised to make a real difference. evidence-based therapies for children tion of AWARE often come from staff He was hired as a board certiand families such as Applied Behavior representatives and the people who use fied general and child and adolescent Analysis, “a proven treatment model the services at Corporate Congress. psychiatrist, and has been based in for people with autism,” said Lantz.

Lantz was the winner of the 2007 AWARE’s Butte office, serving the “It’s important to note that AWARE Corporate Congress Unconditional southwestern portion of the state and currently serves more people in their Care Employee of the Year Award, traveling over 95,000 miles to provide hometown than any other mental demonstrating his understanding of psychiatric care to children and fami- health provider in the state, and we’ll AWARE’s systems of care and respect lies in their own communities. continue to strive to have the highest for the foundation that has been laid.

Lantz is excited to bring his enthu- quality mental health care available to “I believe my own training, backsiasm towards the community concept every corner of Montana.” ground and experience coupled with to his position as medical director. my passion for helping individuals and In addition to his role as a provider In serving individuals and families families with mental health concerns of care, Lantz also feels as though in so many communities across the will allow me to complement and conhe can make contributions to the state – and considering the differences state through informed advocacy. He tinue what Dr. Lourie started.” between those communities – Lantz Dr. Len Lantz’ office is now located anticipates addressing the diagnoses feels as though what could be viewed in Helena where he lives with his wife, left uncovered by Montana’s Medicaid as a challenge could also be seen as system and hopes to have the opportu- Dr. Krista David, also an AWARE one of AWARE’s greatest strengths. psychiatrist, and his daughter. nity to “work with the state on ensur“The significant geographic dising that mental health treatment is tance between the towns we serve offered to Montanans based on need, creates challenges in ensuring that all not on diagnosis.”

When a friend is in trouble, don’t annoy communities are able to benefit from It is in that regard that Lantz feels him by asking if there is anything you can do. new services and programs.”

AWARE is in a position to lead the Think up something appropriate and do it. — In addressing this challenge, one of state in mental health practice because Edgar Watson Howe (1853 - 1937) his goals as medical director will be of its unconditional care approach, to ensure greater involvement for each 9

Telemedicine brings new meaning to office visit Psychiatrists embrace video-conferencing

By Jim Tracy Office visit has taken on new meaning for AWARE Inc. psychiatrists who are using a new video network to treat patients.

“I use video-conferencing almost daily for direct patient care,” says Dr. Alan Reyes, who confers with clients on air and on line from his office in Missoula.

“Video-conferencing works very well with both clients and their representatives. I have found everyone so far accepts it readily and easily,” Dr. Reyes said. “I have met no objections.

I find people are net-savvy and comfortable with electronic interaction.”

Through video clinics, Reyes interacts with patients in Kalispell, Hamilton, Anaconda, Dillon, Billings and Miles City.

AWARE’s virtual private network, installed by Spokane-based Cerium Networks, Inc. with local engineers in Missoula and Billings, includes eight other sites.

Dr. Reyes’ office is one of six locations that feature stand-alone video cameras with flat-screen, high-defini-

tion, liquid crystal display monitors.

The other eight have a computer fitted with a ball camera.

“Telemedicine allows very good provider-client interaction,” Dr. Reyes said. “As tele-med technology has improved, the picture and sound have become better and better, allowing nuances of expression and emotion to be readily appreciated.”

This latest leap forward builds on AWARE’s already substantial use of telecommunications technology.

“AWARE has been using videoconferencing technology to provide psychiatric services on a limited basis for nearly 15 years,” said Chief Operations Officer Jeff Folsom, “As video quality and cost effectiveness have improved, AWARE has been able to expand our tele-psychiatry capacity to become an integral part of our service delivery system.

“The need for increasing the availability of psychiatric services in Montana is well documented; our effort to recruit and expand our psychiatric services goes hand in hand with our effort to make those services available to all of our clients in all areas of the state. With 14 sites up and running and eight psychiatrists currently employed or contracted across the state,

we are able to make the vision of telepsychiatry a reality. With our current efforts for recruitment and expansion well under way, we believe we will be able to provide psychiatry when and where it is needed statewide.”

While Dr. Reyes and other psychiatrists have embraced telemedicine applications for the network, other staff also are finding unique uses for it.

A recent meeting of Apostrophe magazine’s editorial board, for example, brought together more than a dozen people in a virtual meeting that included participants in Helena and Billings, joined by another 12 people at a table in a conference room at AWARE’s main office in Anaconda.

The network is also being used routinely for virtual meetings of management and leadership teams.

Still, its main purpose is to bring doctors and patients together without either having to travel long distances, which wastes time and money.

Throughout health-care, tele-medicine is being used to allow specialists to serve clients in areas that otherwise would not be served without either the client or provider making long trips.

“In a state the size of Montana, with six or more months of dangerous Continued on next page Adult Case Manager Sharon Dallalio, left, and Vivian Reynolds confer with AWARE psychiatrist Dr. Alan Reyes during a recent teleconference. Dr. Reyes, sitting in his office in Missoula, was joined by Dallalio and Reynolds in a conference room at AWARE’s main office in Anaconda. Photo

by Jim Tracy

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driving weather, telemedicine allows more practical and safe interaction,” Dr. Reyes said. “Also, appointments can be more flexible and frequent than would be possible if the provider had to stick to a rigid travel schedule.

Drive enough miles and hours and statistics show an accident will happen.”

While the system has been tested and proven, AWARE’s information technology team continues to iron out wrinkles.

“It’s still in the testing stages now, but it has been up and running since the end of July,” said Wendall Smith, Internet database administrator.

For the immediate future, video participation is limited to six sites at a time “just like a telephone conferencing line,” Smith said.

The system will also accommodate outside agencies.

“If an outside agency has a video camera and the right software they can come into our network,” Smith said.

He expects all AWARE main offices to be active by the end of October.

“When the system is all done, it will allow us to network all computers together to share resources,” he said.

“It will allow us, for example, to push out software, such as virus scan updates, to networked computers versus having to download those updates via the Internet.”

“There are countless ways that using the video-conferencing equipment can improve what we are able to provide to our clients,” said Folsom “Not only will we be able to increase access to much needed psychiatric services in all areas of the state, we are also excited about opportunities for family and other team members to stay connected with

one another when service location has separated folks we are serving from those who provide support in their lives.

“The video network creates numerous opportunities for training and support of our workforce in all areas of the state. AWARE has always promoted increasing the capacity of local communities as the critical component to helping folks live in the community of their choice. Providing day-to-day clinical support may in some instances be the difference for some to stay near family and loved ones.”

AWARE is sure to find other uses for the network as staff become more familiar with it.

In the meantime psychiatrists are finding it offers one big advantage.

“Telemedicine time,” Dr. Reyes said, “is 100 percent time spent for and with clients.”

‘A little loving care’

The Anaconda Kiwanis Club replaced a few parts and added a little loving care to 25 bicycles they donated to AWARE’s Galen School in late July. The used bicycles ­— including mountain bikes and 10-speeds — were donated to the Kiwanis by people in Anaconda. Standing behind the bikes, left to right, are Terry Galle, AWARE service administrator at Galen, Matt McGinnis, Austin LeDeau, Al Messer (Anaconda Kiwanis), Jacob Sherman, Lauren Damschen (Kiwanis), Michael Gage and Mike Hogart, AWARE program manager. The Anaconda Kiwanis have repaired and given away more than 110 bicycles this summer. Photo by Jim Tracy

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Who are the homeless?

Researcher helps reshape thinking on housing

By Michael O’Neil

and other young children, as well as young adults leaving foster care or other state care upon turning 18. Montana data show a similar trend with homeless individuals living in families making up the largest percentage of homeless.

Dr. Culhane has been able to show over time an interesting demographic bubble of single male homeless who make up a large part of the chronic homeless today — essentially these are individuals of the later baby boom generation who lacked job, education, training, and social service he chronic support opportunities when homeless eat they came of age in the early up the majority of 1980s. In not connecting as young adults, this demothe primarily emergraphic co-hort has remained gency homeless on the margins throughout resources despite their adulthood, and largely constitute America’s current being a smaller chronic homeless population. percentage of the Major cities, including comoverall homeless munities across Montana, population. had areas that fit the “Skid Row” pattern. Eventually age and the devastating health effects of being homeless and related premature death led to the extinction of the “Skid Row” type of homelessness.

A similar trend shows up in the current chronic homeless demographic bubble of the late baby boom generation.

These individuals also are dying off due to age and years of life on the streets.

D

ennis Culhane, Ph.D.,a leading researcher on homelessness in the United States, brought his ground-breaking research findings regarding the demographics of homelessness and the relative effectiveness of various strategies to addressing homelessness to Montana this summer for a three-day speaking/working tour.

Dr. Culhane’s presentations on his research riveted his audiences with a fresh perspective overturning common misperceptions of who the homeless are and what strategies are most effective in eliminating homelessness. Culhanes’s research was done in major U.S. cities but dovetails with the collected homeless information and data here in Montana, along with the experience of Montana homeless service providers.

Culhane is a professor at the University of Pennsylvania School of Social Policy & Practice. His primary areas of research are homelessness, housing policy, and policy analysis research methods. His current work Dr. Dennis includes studies of the impact of Culhane homelessness on the utilization of public health, corrections and social services in New York City and Philadelphia.

He is currently co-leading an effort to produce an annual report for the U.S. Congress on the prevalence and dynamics of homelessness based on analyses of automated shelter records in a nationally representative sample of U.S. cities.

He is also working with several jurisdictions to develop a typology of homelessness among families, and to test various interventions to prevent or reduce homeless spells among families.

Dr. Culhane’s research has been a major influence on current national, state and local efforts to eliminate chronic homelessness in America. To access a selection of Culhane’s research go to: http://works.bepress.com/dennis_culhane/.

Dr. Culhane’s ground-breaking research measures the actual prevalence and dynamics of homelessness. Many people carry around an inaccurate picture in their mind of who the homeless are. His research revealed the shocking pattern that children under age 1 constitute the largest single age of persons who are homeless. Other large homeless demographic patterns include the mothers of these infants

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Public sector costs His research also documents the significant public sector costs associated with varying patterns of homelessness. His research points to new more effective policy and program solutions to eliminate homelessness that are nearly cost neutral when considered in light of existing homelessness patterns, traditional program responses and significant public and private costs.

Dr. Culhane has shown that the results of not dealing with the direct causes of homelessness are societal costs like emergency room, ambulance, police, health care, emergency shelter (normally not accounted for in a systematic way) that are the same or greater than the costs of providing permanent housing and the necessary services to directly eliminate homelessness for an individual.

Further, Culhane’s research demonstrates that in any homeless population through careful analysis you can betContinued on next page 12

ter meet everyone’s needs. The chronic homeless eat up the majority of the primarily emergency homeless resources despite being a smaller percentage of the overall homeless population. Better direct intervention to the chronic homeless population will improve their lives but also result in a more effective use of resources for all. Only a small percentage of the homeless will need on-going support if they are given a rapid path back to permanent housing and to mainstream opportunities. A failure to provide these low cost interventions and opportunities can contribute to longterm homelessness.

At present, homelessness in the United States is primarily addressed by providing emergency and transitional shelter facilities. These programs do not directly address the causes of homelessness, and residents are exposed to victimization and trauma during stays. Dr. Culhane asserts that better alternative strategies are needed that are more humane as well as more efficient and effective at achieving desirable outcomes. He identifies barriers and potential opportunities for “ending homelessness” based on various systems and program reform strategies.

careful assessment of individual needs so that people receive just what they need to get back on their feet again in a relatively quick turnaround for many, and to give access to those with intense needs to the supports and permanent housing that will help them be successful longterm. He encourages communities and states to engage in careful evaluation of their homeless strategies and to recognize and change what simply is not working and adopt more effective responses to eliminating — not perpetuating — homelessness.

To read Dr. Culhane’s research paper on this subject, “Rearranging the Deck Chairs or Reallocating the Lifeboats? Homelessness Assistance and Its Alternatives,” go to: http://works.bepress.com/dennis_culhane/51/.

All of Culhane’s research recognizes that in communities and states across the country the nation faces a dire shortage of affordable permanent housing resources for Americans with low incomes — increasing the supply of permanent affordable housing is critical if the nation is going to eradicate homelessness. The lack of appropriate permanent affordable housing is the primary cause of homelessness in America and Montana.

The AWARE Montana Home Choice Coalition, as part of its efforts to promote effective strategies, approaches and policies to eliminte homelessness in Montana, hosted Dr. Culhane. While visiting Montana, Dennis was able to present his research to the Biannual Montana Statewide Housing Partnerships Affordable Housing Conference as well as meet with a working group of the Montana Homeless Continuum of Care.

His visit was made possible through the financial support of the Housing Partnership conference and the Montana Department of Public Health and Human Services Continuum of Care funding support. It is expected that Dr. Culhane’s visit will have a long-term impact on Montana’s response to homelessness.

Lack of low-cost interventions He suggests that we can better allocate existing resources. Too often the only solutions are high-cost solutions when it comes to homelessness, especially for those with greater needs. Generally, lower-cost preventive measures or interventions, such as eviction prevention, housing search/ find services, and short-term housing assistance, are not available in communities, resulting in people ending up in high-cost program responses due solely to the lack of low-cost interventions. Adopting rapid re-housing strategies like Housing First (see story below) can help assure that any experience of homelessness is a short one. Culhane strongly advocates that we need to reallocate our resources so that we prevent and shorten experiences of homelessness, and reserve high cost interventions for those with the most intensive needs. He is a strong proponent of the

What is the Housing First approach to eliminating homelessness? alcohol and substance use, so that “relapse” will not result in the client losing housing.

The continued effort to provide case management and to hold housing for clients, even if they leave their program housing for short periods.

Housing and treatment services are separated.

The Housing First approach responds effectively to the needs of homeless people with serious mental illness, successfully influencing housing tenure, stability and other positive outcomes for people.

Some of the most creative and effective adaptations of the original Housing First model involve permanent supported housing for families and individuals without disabilities.

Housing First continued on Page 16

Housing First programs may be constructed in a number of ways but share the following features: The direct, or nearly direct, placement of targeted homeless people into permanent housing. Even though the initial housing placement may be transitional in nature, the program commits to ensuring that the client is housed permanently.

While supportive services are offered and made readily available, the program does not require participation in these services to remain in the housing.

The use of assertive outreach to engage and offer housing to homeless people with mental illness who are reluctant to enter shelters or engage in services. Once in housing, a low demand approach accommodates client 13

Tourney champs Dan Guiberson, left, Dan Bowen and Amy Keele.

‘HOOPING’ it up

Mike Schaff of Helena defends the basket against Aimee Roberson of Anaconda.

Referee Russ Carstens, far left, and hoopsters Brandie Wilson, Heather Arnaud, Dan Ramsey, Troy Miller, Judy Armbruster, Candi Morrison, all of Anaconda, and Shawn Blessinger of Helena.

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Judy Armbruster, foreground with the pencil, organizes a game at a People First basketball tournament in Anaconda. Players, in the circle starting from her left, are Kelly Murray, Troy Miller, Mike Schaff, John Micheletti (referee), Dan Guiberson, Dan Bowen, and Amy Keele.

Anaconda and Helena chapters of People First tested their basketball skills at a round-robin tournament August 23 at the Church of Jesus Christ of Latter-day Saints court in Anaconda. The team of Dan Guiberson, an AWARE group home manager, Dan Bowen of Anaconda and Amy Keele of Helena, took first place in the tournament. More than two dozen players participated. The Anaconda and Helena People First chapters are planning a basketball tourney next year in Helena. Photos

by Michael Anne Tracy

Referees John Micheletti, left, and Russell Carstens made all the right calls.

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Housing First...

Once again, shelters and hotels are used only as a placement between the time a family or individual names the desire to move off the streets and the time that it takes the program to prepare an apartment.

Housing First/Housing Plus, or Rapid Re-Housing with support services, has been documented as highly effective in stabilizing chronically homeless persons with mental illness in a cost-effective manner, resulting in the end of homelessness for those individuals.

As a point of clarification — this research has not shown that housing alone makes the difference, but it clearly demonstrates that housing with support services is effective and efficient. Likewise, we are learning that services without permanent housing have a limited impact on the lives of many homeless persons. The combination of permanent housing and appropriate services is ending homelessness.

Housing First refers to a strategy that includes moving homeless people with mental illness and other disabilities off the streets and placing them directly into permanent housing, linked with comprehensive services.

Individuals are engaged by Assertive Community Treatment Teams programs that provide a continuity of services, beginning while the individual is on the street or in shelter and continuing after placement into permanent housing.

The Housing First strategy makes minimal use of shelters and hotels, using them only as a placement between the time that an individual names a desire to move off the streets and the time that it takes for the program to prepare an apartment.

Ongoing rental assistance A significant difference, however, may be found in the type and length of services that are provided. In a household that does not have any members with chronic disabilities, there is great likelihood there will be no need for permanent services, with the possible exception of ongoing rental assistance.

Instead, the program commits to providing whatever services are needed for as long as the services are needed, whether for two months, two years or 10 years. Yet, once services are no longer needed, the family or individual may continue to live in the same permanent housing. Therefore, stabilization is not threatened by a physical move at the same time that services are being discontinued.

For more information on the Housing First model, go to: “HUD Study: The Applicability of Housing First Models to Homeless Persons with Serious Mental Illness”: http://www.huduser.org/Publications/pdf/hsgfirst.pdf “Beyond Shelter — Housing First Methodology to Prevent Family Homelessness”: http://www.beyondshelter.org/ aaa_initiatives/ending_homelessness.shtml.

Successful treatment plan Individualized, client-centered services are provided as long as they are needed by the person. Yet, participation in a treatment plan is not a requirement for remaining in housing as housing itself is deemed a critical component of a successful treatment plan.

Tenants must comply with landlord tenant law and may be evicted for the same reasons as other tenants, but they are not evicted for compliance issues beyond what is expected of any other tenant in any other apartment.

A crucial programmatic feature is the awareness that the greatest stability is reached when all services that an individual requires and benefits from are provided in the context of permanent housing. Individuals who do not need hospitalization are served best in a permanent setting, and necessary services must be provided in that setting.

Most homeless service providers are aware that a large percentage of people who experience homelessness do not meet the definition of an individual with disabilities who is experiencing long-term homelessness.

The basic principles of the model remain in place – that homeless families and individuals are moved into permanent housing as quickly as possible rather than placed in shelters and transitional housing.

Furthermore, the service providers who engage the family or individual while they are homeless continue to work with that household after placement in permanent housing.

Corporate Congress set for Dec. 3-5 at Fairmont Corporate Congress 2008 is coming up and will be held again at the Fairmont Hotsprings Resort on Dec. 3, 4 and 5.

There are a number of delegate positions open for this year’s session. AWARE staff are able to represent their service or service area, depending on the positions open.

Corporate Congress is a good opportunity for staff to make their constituencies’ voices heard and have a real stake in the organization’s direction.

In order to be an eligible representative, staff must be non-managerial and must have been with AWARE for more than one year. Interested staff are encouraged to talk to their supervisors.

For more information, contact Tim Pray at tpray@aware-inc.org; or call 406/563-8117 ext.

15.

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AWARE announces wage, benefit increase Positions not specified – clinicians, service administrators or directors, core administrative, transportation and maintenance staff, nurses, etc. – will receive a 3 percent increase at their anniversary hire date.

The 3 percent increase will be in effect from July 1, 2008 – June 30, 2009. AWARE’s Payroll Department will process retroactive pay for any current employee whose anniversary date is in July.

“I would like to take this opportunity to thank you for your excellent work,” Noonan said in a staff memo. “I can speak for myself, the Board of Directors, as well as the management team, that we are all very proud of the work you do and the services you deliver.”

For answers to questions about the benefit and wage increases, call Leighanne Fogerty, director of staff management, at 406-563-8117, extension 19.

By Jim Tracy

AWARE announced a corporate-wide increase in benefits and wages at the end of July.

The Board of Directors and management team boosted the corporate contribution to the medical insurance benefit plan by 26 percent and refined benefit packages to allow more choice in plan coverage, which means employees can decide how best to meet the health care needs of themselves and their families.

In addition to the benefit package, AWARE adjusted the base wage to $25,500 a year from $23,660 a year for treatment service specialists, youth and adult case managers and residential coordinators. Base wages for the program manager II position increased to $25,500 a year from $24,960. All of those increases went into effect Aug. 1.

Staff and supervisors who earn a salary equal to or greater than $25,500 a year will receive a 3 percent wage increase at their anniversary date of hire.

Wages for direct-care staff, including treatment service technicians, habilitation technicians and night watch, also went up. Because of economic, competitive and overall labor market forces, however, hourly rates will differ from community to community.

“While this pay differential is being used in an attempt to meet corporate wide needs, it is my hope to align wages with individual community and service needs on a continuing basis,” said AWARE CEO Larry Noonan.

With that in mind, he and the board adjusted the wage for direct-care staff according to the following schedule:

Festival City

Location Base Rate Adjusted Rate Effective Date Butte $9.07/hour $9.50/Hour Aug. 1, 2008 Anaconda $9.07/hour $9.50/Hour Aug. 1, 2008 Deer Lodge $9.07/hour $9.50/Hour Aug. 1, 2008 Dillon $9.07/hour $9.50/Hour Aug. 1, 2008 Glendive $9.07/hour $9.50/Hour Aug. 1, 2008 Miles City $9.07/hour $9.50/Hour Aug. 1, 2008 Helena $9.07/hour $9.75/Hour Aug. 1, 2008 Missoula $9.07/hour $9.75/Hour Aug. 1, 2008 Great Falls $9.07/hour $9.75/Hour Aug. 1, 2008 Billings $9.07/hour $10.25/Hour Aug. 1, 2008 Bozeman $9.07/hour $10.25/Hour Aug. 1, 2008 Galen $9.07/hour $10.25/Hour Aug. 1, 2008 Kalispell $9.07/hour $10.25/Hour Aug. 1, 2008

Current direct care workers earning a salary equal to or greater than those wages will receive a 3 percent pay increase at the anniversary date of hire.

The Original Mine gallows frame in Uptown Butte served as one of the main stages for the National Folk Festival July 11-13 in the Mining City. AWARE is a sponsor of the festival, which will be held in Butte for the next two years. Photo courtesy of George Everett

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Housewarming...

21st opening up community life for persons with disabilities.

It represents a move from institutions to community life, from a life of routines prescribed by others to a life of making your own life choices.

They have been a couple now for over 25 years, but when Pam and Lyle decided years ago to marry, they met resistance. People told them it was not realistic — that they simply could not get married. They decided 15 years ago in July that after 10 years together they knew what they wanted, and they went ahead and made the big commitment. They exchanged wedding vows on July 25, 1993.

‘Caring for each other’ Still, they faced real challenges, losing critical income and support resources they needed, but they persevered together. They viewed their primary purpose in life as caring for each other, and though they struggled, they had each other, which made all the difference. Through the support of Lyle’s sister, Loreene Reid, other family, and their own tremendous care network of Bozeman community folks, they got by. Because of limited incomes, they had difficulty finding a decent affordable place to live. For that reason, they lived in a substandard, unsafe, unhealthy trailer, with exorbitant energy costs. At times, they were afraid of the loud parties and comings and goings of their neighbors at all hours within the trailer park where they lived.

Part of their struggles was the result of their limited incomes, which made it especially hard to make ends meet for their basic living needs. In the fall of 2007, it was discovered that Lyle had been underpaid his disability income going back many years.

Although the years of struggling to live on their meager incomes had been incredibly hard, this underpayment was now made up with a substantial one-time back payment. They saw that as a stroke of good luck and a chance, perhaps, to achieve their now shared

Sen. Max Baucus hugs an appreciative Pam Whitmore at her housewarming in Bozeman in July.

Baucus helped Pam and her husband, Lyle, navigate federal regulations to buy their own home.

Photos by Jim Tracy

dream of owning their own home.

About the time they received this one-time windfall, they got bad news.

Lyle had cancer that required surgery.

Lyle’s illness made it even more important for them to finally get a good, decent home of their own.

On Feb. 1, Pam and Lyle, with the help of Loreene, met for the first time with the AWARE Montana Home Choice Coalition at the AWARE of18

fices in Bozeman. Pam and Lyle knew exactly what they wanted: nothing fancy, just clean and safe, in a good welcoming neighborhood near downtown within walking distance, on a single level.

The Montana Home Choice Coalition listened and asked questions, gathered their financial info and examined what might be possible given mortgage rates, available home buyer

assistance funds, and the Whitmores’ own down-payment funds.

They explained that if they were unable to find a house to purchase by the end of May, they would lose their down-payment funds. It was a going to be a difficult homeownership dream to achieve, but it seemed it might be possible to find a home that met their approval at a price at or below $125,000 — pretty rare anywhere near Bozeman but particularly difficult with their needs.

Home-buyer assistance Right away, Pam and Lyle’s friend Marty Bakken of Remax Realty of Bozeman got in on this difficult task, and to everyone’s pleasant surprise, found the perfect home at 1120 W. Babcock, No. 7, in the charming Chequamegon Village neighborhood right off downtown Bozeman.

Pam and Lyle were approved for additional assistance through an innovative home-buyer assistance loan program provided by a Montana Home Choice Coalition partnership with the Montana DPHHS Developmental Disabilities Program.

Pam and Lyle were able connected with the Bozeman Human Resources Development Council Home Buyer

Sen. Jon Tester congratulates Lyle Whitmore on becoming a homeowner at a housewarming last July in Bozeman. Tester answered the call when Lyle and his wife, Pam, needed help securing a HUD waiver to buy the home.

program, “The Road to Home,” and got started on their home-buyer education requirement. They worked with loan officers at First Interstate Bank and applied for a mortgage — the lowinterest 2.75 percent Montana Board of Housing (MBOH) Disabled Accessible Mortgage. Loreene, continued her pivotal role coordinating and support-

Bozeman musicians, Ian Fleming, left, James Schlender, and Doug Schlender, also known as The String Jumpers, provided music at the housewarming/15th wedding anniversary party for Lyle and Pam Whitmore last July. About 200 people attended.

ing Lyle and Pam in the process. The pieces of their homeownership puzzle were coming together.

February turned into March, and things turned tough. Lyle’s surgery for his cancer kept him in the hospital for an extended period, making it difficult to work on the home-ownership goal.

The doctors would not release him to the trailer since they felt living conditions there would hinder his recovery.

Tracy Menuez, program director at “The Road to Home,” stepped up to face this challenge, offering to meet with Pam and Lyle one-on oneeven in the hospital if needed. With Tracy’s efforts, Pam and Lyle’s homeownership dream was back on track for a closing in April.

Housewarming continued on Page 24

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AWARE CEO Larry Noonan, left, addresses a crowd gathered at the Candlelight Home in Bozeman last June. Also speaking at the event were Bozeman Mayor Kaaren Jacobson, seated at left, who welcomed AWARE’s Community Living Initiative, and Gov. Brian Schweitzer, who repeated his pledge to serve the “last and least” throughout Montana. Photos by Tim Pray

Serving the ‘Last and least’

Bozeman Candlelight Home fits in with governor’s pledge

By Tim Pray

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here aren’t too many places but Montana in which you can walk into a backyard and find the staff of a newly opened residential program, the neighbors of that house, the staff of the Department of Public Health and Human Services, the mayor of the city, and the governor of the state talking with their mouths full and licking barbecue sauce from their fingers.

On June 26 at the open house for the Candlelight Community Living Initiative, it was very clear that what was occurring was a Montana event.

It was fitting that the open house felt so distinctly Montana. The program – which serves youth from around the state with autism spectrum disorders – is the first and only of its kind in the state, and serves as a clear message that AWARE is prepared and capable of serving youth as closely as possible to the support of their families and communities.

The event included a walk-through by DPHHS director Joan Miles, Disability Services Division Administrator Joe Mathews, Developmental Disabilities Program director Jeff Sturm, and Gov. Brian Schweitzer. The walk-through

presented an opportunity for those responsible for funding the program to see it realized.

Guests of the event were seated in no particular order and at each table that was set up in the large backyard was a mix of curious neighbors, parents, AWARE staff, and upper level state government officials.

As the meal began to wind down, attention was turned to the deck where Bozeman mayor Kaaren Jacobson, Governor Schweitzer, and AWARE CEO Larry Noonan were seated and prepared to make their remarks to the crowd.

Key to the city Mayor Jacobson introduced Noonan, and in doing so presented him – and AWARE – a key to the city. She remarked how proud she was that Bozeman was chosen to be the location for the program, and that she was confident in the city’s ability to be a welcoming place for children and families.

Noonan spoke briefly on the importance of serving youth within their home state. “We’re as equipped as anyone – better equipped, actually – to serve these kids.

This is their home, not some facility in Texas.” He told the crowd that AWARE plans to have another similar program

Dozens of well-wishers gathered June 26 at AWARE’s Candlelight Home for children with autism. Gov. Brian Schweitzer, speaking to the crowd in this shot, received a cherry tree that was planted at the home in his honor.

running in Gallatin County by the same time next year, and that he is eager to show the communities across the state just how much of an impact a nonprofit can have on the communities, families and economies of the state.

Gov. Schweitzer was presented with a gift by Noonan on behalf of AWARE – a young cherry tree in appreciation of the state’s support. He told the governor that it would be planted at the home and that it would always be “his tree.”

Appreciatively, Gov. Schweitzer accepted the tree calling it a “really great gift” and thanked Noonan.

The governor spoke of the importance of programs like Candlelight, and that he agreed with Noonan in respect to the need to address the growing numbers of children with autism.

Candlelight continued on Page 28

Residential Service Specialist Renae Jones goes on camera with Kathleen de Onis, a reporter from CBS affiliate KBZK in Bozeman, to answer questions about the Candlelight Home.

A monthly case review meeting at the Lewis and Clark Children’s Advocacy Center of AWARE. At the head of the table, Dana Toole, director.

Counterclockwise from Toole, Don Ferriter, Child Protective Services Supervisor for Lewis and Clark County, Investigator Cory Olson, Lewis and Clark County Sheriff’s Office, Kathy Shea, AWARE lead clinian, Darcy Komejan, National Children’s Alliance (with necklace), Dennis Nyland, Investigator, Lewis and Clark county Sheriff’s Office, Vickie Henderson, National Children’s Alliance. With Backs to camera, left to right; Macri

Buckles, forensic interviewer, Lewis and Clark County Health Department, Tanya Murgel (pony tail), Juvenile Probation, Dr. Michelle Danielson, Partners in Pediatrics, Detective Bryan Fischer, Helena Police Department ICAC Unit (Internet Crimes Against Children). Not pictured: Carolyn Clemens, Lewis and Clark County Attorney’s Office, Tara Harris, Lewis and Clark County Attorney’s Office, and Dr. Erin Keefe, Helena Pediatric Clinic. Photo by Tim Pray

Center advocates for sexually abused children

By Tim Pray

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t a monthly meeting of the Lewis and Clark County Children’s Advocacy Center of AWARE, the multidisciplinary team that operates the center gathers around the conference table at AWARE’s Helena offices to conduct case reviews, resolve issues or concerns, and celebrate successful teamwork.

The Advocacy Center, which has been in operation since March 2006, reorganizes the way in which a sexual abuse offender is prosecuted and, perhaps more importantly, brings necessary therapy and support closer to the child and his or her non-offending caregiver. It is the only advocacy center operated by a community mental health center in the state.

Traditionally, a child victim is brought from agency to agency during the course of the investigative process, forcing him or her to repeatedly relive the experience by being interviewed by police, doctors, and attorneys. The logistics of that process are felt by many in the field to inhibit the child’s healing, and perhaps even to re-traumatize the child with each re-telling of the abuse. It is also felt that the

environments the child is escorted to throughout the traditional process are intimidating to the point at which his or her statements regarding the case vary across the different locations.

No single agency or investigator has all the resources necessary to respond to child sexual abuse, so the advocacy center brings the professional team to the child, who – in the midst of a kid-friendly environment – may be accompanied by a non-offending caregiver. When a child is interviewed by a person trained in the forensic interviewing of children, the multidisciplinary team made up of law enforcement, legal, therapeutic, medical, and advocate representatives gathers in a separate room with a live video feed from a subtly placed camera in the interview room, avoiding the intimidation of an overwhelming presence.

On the day of the appointment, the multidisciplinary team for the case meets at the advocacy center about 15 minutes before the child and caregiver arrive to have a preinterview meeting. The team also meets after the interview for a post-interview meeting, and advocacy center staff supervise the child while the investigators have time with the Continued on next page 22

parent(s) or caregivers to explain the investigative process.

While the child is being interviewed, the caregivers receive support, information, and referrals from the child advocate on the team. The advocacy center has a full array of printed resources and each advocate is well trained in providing information to family members about how to care for their victimized child. The advocacy center staff also provides follow-up resources to children and families after the investigator’s work is completed.

Full knowledge of the case In a children’s advocacy center, much attention is paid to the sorts of details that matter to a child who has been traumatized. The rooms are comfortably lit, and there are books, toys, and art project materials available and within reach. Perhaps more importantly, though, is the manner in which the members of the multidisciplinary team interact with the children. When a police officer meets with a child, no uniform or weapons are worn. When a pediatrician meets with a child, he or she does so with full knowledge of the case at hand, having spoken with the rest of the team prior to the examination, and the scenarios or triggers that may traumatize the child are well understood and avoided if possible.

Finally, the non-offending caregiver or parent is made to be an integral part of the investigation and treatment of the child, which greatly increases his or her comfort level throughout the process.

According to Lewis and Clark County Children’s Advocacy Center of AWARE director Dana Toole, there are several ways that a child arrives at the center for services. The multidisciplinary team takes referrals from law enforcement and from child protective services, and there must be an open investigation of abuse or crime against a child in order to obtain services.

Either of those entities may refer a child at any time, and usually do so by sending a referral form to either Toole or Kathy Shea, AWARE’s lead clinician in Helena and also a therapist for the center. Those referrals arrive by fax or confidential email.

The advocacy center staff works with the investigators to schedule a forensic interview, an advocacy appointment for the child’s caregivers, and a forensic medical exam with one of the trained pediatricians if necessary. The advocacy center is open about eight hours a week for interviews, but will also schedule an interview in a crisis as needed for child protection issues.

The Lewis and Clark Children’s Advocacy Center of AWARE is currently undergoing a review that would gain the organization accreditation within the National Children’s Alliance, the nation’s largest collection of children’s advocacy centers. The National Children’s Alliance is “a nationwide not-for-profit membership organization whose mission is to promote and support communities in providing a coordinated investigation and comprehensive re-

sponse to victims of severe child abuse.”

In order to gain accreditation, the Lewis and Clark Children’s Advocacy Center of AWARE was visited by two representatives of the NCA, Darcy Komejan of the Holland, Michigan Children’s Advocacy Center and Vickie Henderson of the Bellevue, Kentucky Children’s Advocacy Center.

The two were on site to evaluate the ways in which – both in environment and practice – the Helena advocacy center adheres to the National Children’s Alliance’s 10 guiding principles, which also serve as their accreditation standards.

Ten program components According to the NCA, the purpose of children’s advocacy centers is to “provide a comprehensive, culturally competent, multidisciplinary team response to allegations of child abuse in a dedicated, child-friendly setting.” In meeting that purpose, the NCA establishes the 10 program components necessary for accreditation: 1. Child-Appropriate/Child-Friendly Facility: A children’s advocacy center provides a comfortable, private, child-friendly setting that is both physically and psychologically safe for clients.

2. Multidisciplinary Team: A multidisciplinary team for response to child abuse allegations includes representation from law enforcement, child protective services, prosecution, mental health, medical, victim advocacy, and children’s advocacy center.

3. Organizational Capacity: A designated legal entity responsible for program and fiscal operations has been established and implements basic sound administrative practices.

4. Cultural Competency and Diversity: The advocacy center promotes policies, practices and procedures that are culturally competent. Cultural competency is defined as the capacity to function in more than one culture, requiring the ability to appreciate, understand, and interact with members of diverse populations within the local community.

5. Forensic Interviews: Forensic interviews are conducted in a manner which is of a neutral, fact-finding nature, and coordinated to avoid duplicative interviewing.

6. Medical Evaluation: Specialized medical evaluation and treatment are to be made available to advocacy center clients as part of the team response, either at the advocacy center or through coordination and referral with other specialized medical providers.

7. Therapeutic Intervention: Specialized mental health services are to be made available as part of the team response, either at the advocacy center or through coordination and referral with other appropriate treatment providers.

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Advocacy Center...

nity of other centers through a National Children’s Alliance list-serve membership.”

Komejan and Henderson spent the day of the site review 8. Victim Support/Advocacy: Victim support and advotouring the facility and meeting with each contributing cacy are to be made available as part of the team response, agency of the multidisciplinary team for approximately 20 either at the advocacy center or through coordination with minutes each. To begin with, they met with AWARE staff other providers, throughout the investigation and subseto gain an understanding of the organizational capacity, quent legal proceedings.

9. Case Review: Team discussion and information shar- then on to discussions with the prosecutorial, mental health services, law enforcement, Child Protective Services, ing regarding the investigation, case status and services medical provider, victim advocacy and forensic interview needed by the child and family are to occur on a routine segments of the team. For two hours after those meetbasis. ings, Komejan and Henderson sat silently in the office’s 10. Case Tracking: Advocacy centers must develop and implement a system for monitoring case progress and track- conference room and observed the monthly meeting and case reviews of the advocacy center’s multidisciplinary ing case outcomes for team components. team. One by one, each member of the team spoke to their Since 2006, the Lewis and Clark Children’s Advocacy knowledge of each case, providing updates, concerns, and Center of AWARE has been an associate member of the expressing frustrations. At times during the meeting, tenNational Children’s Alliance, and director Dana Toole sions would be broken with a joke or with teasing. “They’re hopes to be fully accredited by November of 2008. just like most teams we’ve seen,” said Komejan. “They The benefits of this full accreditation are important for joke and tease, but they remain a committed and passionate the validity of the center’s work, said Toole.

“As an accredited children’s advocacy center, the Nation- multidisciplinary team with strong leadership.”

For more information on the Lewis and Clark Children’s al Children’s Alliance will list our center on their national Advocacy Center of AWARE, call 406/449-3120. For inWeb site, and we are able to access current child abuse research, multidisciplinary team members can attend online formation on the National Children’s Alliance, visit www. nca-online.org. trainings, and we have the resources of a national commu-

Housewarming...

In examining the covenants associated with their new home, the underwriters discovered that there was a restriction on renting to others – it could only be owner occupied.

Under HUD FHA rules, this was a problem, and the FHA declined to grant the Whitmores access to FHA insurance required. The FHA insurance was an absolute requirement in order to use the low-interest MBOH financing the Whitmores needed in order to afford their monthly mortgage payment.

Asking for a waiver The Montana Home Choice Coalition arranged all the proper FHA paperwork to ask for a waiver of this regulatory barrier to Pam and Lyle’s buying their home, and they submitted it to the Denver FHA office. They waited. And waited.

The Whitmores got one last extension of their buy/sell agreement. They needed an answer from the faceless FHA Bureaucracy in Denver. The Home Choice Coalition sought the help of the Montana Congressional Delegation to get an answer. The answer came back no – with no inquiry into the situation, and no real explanation.

Then the next shoe dropped. If the Whitmores could not close in 24 hours, the house would be sold to someone else.

Realtor Marty Bakken then took the extraordinary step of buying the house himself for the sole purpose of holding it

until Pam and Lyle’s financing could be worked out.

It had felt like the end of the road, that everything would be lost, but with Marty’s generous effort, they had hope – and 30 days.

Then the combined Montana U.S. Senate team swung into action. Jon Tester’s Pam Haxby-Cote and Max Baucus’ Kim Krueger said it was not over and they got the senators involved. Max Baucus had his chief housing person bring the Whitmores’ case to the attention of HUD at a high level meeting. Jon Tester’s reaction was to get on the phone and bring his Montana personal touch to bear contacting the FHA Commissioner himself to ask for approval of the waiver.

With the combined efforts of our U.S. Senators, the waiver was approved and the final piece of the home-ownership purchase was in place.

Pam and Lyle closed on their home May 28, 2008, signing a mountain of paperwork at American Land Title Company.

They were homeowners. The dream long held was now real.

Michael O’Neil is director of the Montana Home Choice Coalition.

Language exerts hidden power, like a moon on the tides.

— Rita Mae Brown, Starting From Scratch, 1988

24

Head Start...

school through June, July and August, learning new skills and reinforcing others.

“Even though Head Start closes its doors in May in Helena,” Kelly said, “we will continue to work with these children throughout the spring and summer so there is no lapse in services”.

The extra support has allowed kids to return to Head Start in the fall with greater success to the same learning environment, he said. The summer program also benefits children who are transitioning to kindergarten in the public school.

AWARE’s involvement in Head Start emphasizes the importance of early intervention, Kelly said.

“Early intervention makes a huge difference,” he said.

“If we wait until second or third grade, problems are amplified and take more time to solve. Because we intervene early, we need to continue to support very few children longer than a year.”

Even though they meet federal poverty guidelines, 37 children in Helena are on a waiting list because there isn’t enough money available to enroll them in Head Start.

Kelly expects about 40 of the 248 children enrolled in Head Start to take advantage of AWARE services. Historically about 15 percent of children in Head Start require mental health services either on site or in the community.

The program accepts children 3 to 5 years old.

In Billings, AWARE staff has integrated so naturally into the Head Start program that they are seen as other teachers or staff persons.

Billings Head Start officials have said AWARE’s presence is a blessing to children with special needs who otherwise might not be able to take advantage of the boost the pre-school program provides to needy kids.

AWARE has dedicated staff specifically to Head Start, offering clinical, therapeutic and support service in the classroom to kids while they are in the classroom and services to families in their own homes outside of school.

As it does in Billings, AWARE will provide a summer program in Helena. While most Head Start kids take the summer off, many children AWARE serves continue pre-

Before and after

Wally New Robe, photo at left, plants a squash last spring at the Sharon Court group home in Anaconda with the help of Linda Weer who’s standing behind him. In the photo at right, residents of the home gather in their garden at the end of August. From left, they are Denny Bowen, Linda Weer, Michael McCoy, Wally New Robe and Keith Dawson. Photo by Jim Tracy

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“It is time to respect and value people with intellectual disabilities.” That’s the key message of a new web site — r-word.org — published by Special Olympics.

NEWS BRIEFS Special Olympics takes aim at “r” word Visitors to the Special Olympics Montana web site can help take a stand against a word that has gained popularity in American culture, but is offensive to many people.

The “R-word,” or “retard,” has found a place in common language and seems to be accepted by many. In fact, it is said 16 times in one scene in the film “Tropic Thunder,” which recently opened in Montana theaters.

“The word hurts, even if it is not directed at a person with intellectual disabilities,” says Bob Norbie, Special Olympics Montana director. “For too long, people with intellectual disabilities have had to overcome the challenges society has put forth through stereotypes. It is time for a change and you can help.

“Help make much needed change which will bring acceptance and inclusion to our community – don’t say the R-word. When you hear that word, think about Anton Veverka from tiny Richey, Montana, who is currently Special Olympics Montana’s Athlete of the Year. Mr. Veverka is a distance runner who shatters stereotypes with his personal best as a miler at 5:06. Most of us can only dream of such success.”

“Help make change for Anton Veverka and others with intellectual disabilities by boycotting ‘Tropic Thunder.’

Help show Hollywood that it is time they understand the impact of their actions.”

To learn more about how you can be a fan of dignity, visit www.r-word.org.

Independent Living group touring state Living Independent for Today and Tomorrow (LIFTT) reports that Montana’s four Independent Living Centers are off to tour the state to talk with people with disabilities about employment.

They are encouraging all disabled workers and those seeking work to come to meetings and discuss experiences, goals, and primary barriers of employment.

In order to reach the goal of developing a Medicaid infrastructure that supports competitive employment and self-sufficiency for people with disabilities, they will be holding consumer focus groups throughout the state.

The only requirements to participate are that you must have a disability that affects your ability to live independently and you must be employed or be seeking employment.

For more information, contact LIFTT at 406/259-5181 or call toll free at 800/669-6319.

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Service dogs aiding people with autism The Joliet (Illinois) Herald News reports that service dogs can be a great partner for people with autism. Autism is not a condition that affects only children. The Autism Society of America estimates that 600,000 adults in the United States alone are living with autism.

Using service dogs for people with autism is a relatively new concept, first tried in 1998. It has proven successful in some cases.

“Jenni Amick, a 28-year-old woman living with autism, had problems with crowds and social interactions. This all changed when a furry friend named Jazzie came into her life,” according to the Herald.

Jazzie is a black Labrador trained to help Jenni with her day-to-day activities. In receiving the dog, Jenni found more than a helper.

She found a lifelong friend, a being with loyalty and unconditional love that relies on her, just as she does on it.

“Jazzie helps me to be more sociable, like going to the theater and restaurant,” Jenni said. “Once Jazzie came into her life she and her family have been very happy. The dog takes the pressure off of meeting new people. Jenni, who had problems making eye contact with new friends, worries less about that now that Jazzie is there to divert some attention.”

Home choice an option in other states Montana is not the only place helping people with developmental disabilities overcome obstacles to buying their own homes.

In Port Jervis, N.Y., a mother and her 12-year-old daughter closed recently on a house with the help of the Home of Your Own (HOYO) program.

HOYO assists people with developmental disabilities find low-interest mortgages and other services to get the buyer prepared to purchase a home. This program has proved to be effective. The New York family joined 200 other people with disabilities who got help purchasing their own homes through the program.

cally highlighted in this state by a string of high-profile slayings by people who had severe mental illness but could not be treated despite signs that they needed help.”

The story is among the news items at Patriciabaue.com — news and commentary about disability issues drawn from news organizations around the United States and elsewhere.

Patricia E. Bauer is a journalist who has served as senior editor of the Los Angeles Times Sunday Magazine; special assistant to the publisher of the Washington Post; reporter and bureau chief at the Washington Post, and pundit on public affairs television in Los Angeles. Her articles have appeared in the Washington Post, the New York Times and many other publications.

Bauer is a former member of an Institutional Review Board (IRB) at UCLA, where she participated in the ethical review of federally funded medical research on human subjects, and has addressed national and regional conferences on the rights of patients and people with disabilities. During the Carter years, she worked in the White House press office as editor of the White House News Summary.

She is a member of the President’s Leadership Council at Dartmouth College, the Pacific Council on International Policy, and the board of trustees of the Riverview School in East Sandwich, Mass.

Bauer and her husband are among the founders of the Pathway Program at UCLA, a post-secondary program for young adults with intellectual disabilities. They are the parents of two young adults, one of whom has Down syndrome and is a survivor of leukemia.

“As a journalist and the mother of a young adult with disabilities, I have often wondered why I was not able to find an online source for media coverage of issues relating to disability,” she says. “Ultimately, I concluded that I needed to create such a resource myself.”

Calendar of coming events Sept. 22-24 — Montana Nonprofit Association 7th Annual Conference in Helena. Visit www.mtnonprofit.org for more information

Washington state mental health care ‘gravely disabled’: Seattle newspaper

Sept. 25 — 6:30-8:30 p.m.: Montana Community Autism and Asperger’s Network Autism Group meets at the Missoula Public Library.

The Seattle Post-Intelligencer reports that an investigation has found serious problems with Washington state’s troubled $1.8 billion mental health care system.

The paper writes that the state leaves thousands of families …“snared in a Kafkaesque system that won’t help people with serious symptoms until they are in imminent danger of harming themselves or others, or gravely disabled — standards so high they exclude many who desperately need help.

“But this strategy ends up costing the public more money, and puts citizens at greater risk, a scenario tragi-

Oct. 1-2 — 7:30 a.m. to 1 p.m, SEEDS- Community Services Bureau Conference at the Holiday Inn in Billings Oct. 16-17 — Montana Council on Developmental Disabilities FFY meeting starts at 1 p.m. at the Wingate Inn, Helena.

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Montana Shares accepting pledges AWARE staff will notice a Montana Shares pledge form in their September 30 payroll envelopes.

Montana Shares is a collection of nonprofit organizations from around the state who work on a wide variety of issues.

The groups range from Montana 4H to the Montana Meth Project. On the pledge form, staff will see a complete listing of the groups.

Should an AWARE staff member choose to donate, designate the organization(s) on the form and send it to Tim Pray in the Anaconda office at 205 East Park Ave., Anaconda, MT 59711.

For more information on Montana Shares, visit www.montanashares.org or call Tim Pray at 406.563.8117 extension 15.

Fine art

Candlelight...

Throughout his administration, Gov. Schweitzer has made a pledge to address the “last and the least” throughout the state, and that – through the Medicaid waiver program he supported – programs such as the Candlelight Community Living Initiative were a representation of that.

Long after the talks had ended, the guests of the event lingered. The governor went down the usual line of press, people went back to the serving area for more barbecue and neighbors who began the day uninformed or uneasy about a new program unflinchingly welcomed the local staff and the residents of the home to the neighborhood.

For more information on the Candlelight Community Living Initiative in Bozeman or to see the press release regarding the program, visit www.aware-inc.org.

Lou and Irene Marchello of Crow’s Nest Gallery in Missoula were among the artists and art dealers who used the lobby at AWARE’s main office in Anaconda as a gallery during the annual Anaconda Wildlife Expo last September. AWARE was a venue for the Expo again this year. Photo by Jim Tracy

AWARE, Incorporated 205 East Park Avenue Anaconda, Montana 59711 1-800-432-6145 www.aware-inc.org

Printed on recycled paper

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