AWARE
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September/October 2009 Volume 3, Number 5
“The Right Services...To the Right People...At the Right Time”
Alternative, complementary and conventional medicine
Helena naturopath joins AWARE medical team By Jim Tracy
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Dr. Jerry Taylor specializes in treating people with autism, ADHD/ ADD, Asperger’s, asthma, allergies and digestive health challenges.
r. Jerry Taylor, a licensed naturopathic medical doctor practicing in Helena, has joined AWARE as its biomedical physician. Dr. Taylor is a certified Defeat Autism Now! physician with a special interest in treating people with autism, ADHD/ADD (attention deficit hyperactivity disorder/attention deficit disorder, Asperger’s, asthma, allergies and digestive health challenges. “The goal of our practice is to provide solutions for individuals who struggle with a variety of health concerns,” Taylor says. “We can help with many degenerative and autoimmune disorders, and often times these issues can be resolved. We focus on the integration of alternative, complementary, and conventional medicine, in treating the individual, and not just the symptoms or the diagnosis. We also provide healthy lifestyle counseling for those who are interested in improving, optimizing and maintaining their quality of life.” “I am passionate about healthy living and disease prevention, and teaching anyone who is interested how to do the same,” he adds. “Healthy lifestyle counseling is one of the services I offer to anyone who is interested.” Dr. Taylor received his NMD from Southwest College of Naturopathic Medicine and Health Sciences located in Tempe, Ariz. He completed his undergraduate degree in nutrition science and dietetics from Central Washington University in Ellensburg, Wash. See Dr. Taylor Page 10
Flexible mental health supports
AWARE psychiatrists serve clients across Montana By Tim Pray
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welve years ago, AWARE made a commitment when it began providing psychiatry. That commitment was to make sure that psychiatry was available to every client who wanted or needed it. Working toward that goal has meant continuing collaboration with stakeholders and families in commu-
nities around the state, large and small. In providing access to psychiatry for AWARE clients, it became clear that many communities throughout the state have no access to mental health care at all. Since that time, AWARE has been working to provide flexible mental health supports to those who need them, and in a way that reflects the things that make their communities unique.
See Psychiatry on Page 13
Inside...
Note to staff and friends
— Page 2
Missoula housing group honored — Page 5
MSU-Billings hosts Autism Conference — Page 8
Corporate Congress set for Dec. 9-11 — Page 12
ShrinkWrap with Dr. Lourie — Page 18
If you’re looking for choice, AWARE has it autism spectrum disorders. Most importantly, I think this is of huge benefit to those kids and their families who deserve a relevant and worthwhile education, but it also represents a great collaboration with the Billings School District, which is a partner in the program.
Dear staff and friends, The word “choice” has been coming up a lot lately. Whether it’s in the context of the current healthcare debate or informed family members advocating for their sons, daughters, parents or siblings, it’s something that we pay attention to.
When we tell people that AWARE services are based in part on the strengths of any given community, we mean it, and the Enterprise Learning Center is evidence of that. There’s no way to start a school without the support of countless local stakeholders and entities, and there’s no way to operate one without respecting the traditions, practices and day-to-day operations of the existing structure. One of the AWARE staff’s strongest attributes is the ability to adapt quickly and respectfully in new situations.
From the beginning, AWARE’s philosophy has been based upon offering choice to people who may not have previously had it. Our beginning as an organization came about around a kitchen table where parents convened to find ways that their children with disabilities could be offered choice in the community. We haven’t forgotten that.
We continue to offer more choice to families across the state who are looking for solutions. Whether they’re trying to help their child with autism, their grandmother with mental health needs or an adult son with developmental disabilities, we’re continually adding options that may suit their service needs, or—at the very least—point them in the right direction.
Larry Noonan We’re working hard to provide a whole new level of choice in housing for people with disabilities. In talking with a number of people over the years, I’ve heard that living in a group home doesn’t always offer the independence that people may be looking for. Granted, we’re light years ahead of where we were 25 years ago, and it’s been an honor to be a part of a real, tangible shift to community living and involvement. But more can be done. What seemed dynamic and independent five years ago is not now, and that’s good.
One really positive trend we’ve been seeing is that of parents becoming increasingly educated on issues that affect their family, particularly in regards to autism. Last April, I attended a “Defeat Autism Now!” conference in Atlanta. Dozens of panels staffed by experts in their respective fields spoke and offered their insights into the causes and treatments of autism. Fact is, there’s so much that we don’t know. No one can tell you—with certainty—what the cause of autism is. But what was most interesting to me were the families attending the
For people who are unhappy with their current living situations in group homes, we’re going to start offering housing—four bedroom homes in the community—that doesn’t apply blanket policies and rules to the people who live there. If a person feels that he or she wants meals prepared and a medical professional to check in once a week, great, that’s what will happen. If someone wants to have much more attention during the course of a week, we can do that, too. Point is, a major part of being independent within the community is having the ability to choose what sort of supports you want, and there’s no reason we can’t be offering that.
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 Russell Carstens Stephen Addington
We’re more involved with education now. The 2009-2010 school year will be the first for our newest program, the Enterprise Learning Center in Billings. The school serves four students from the Billings area who have
Editor: Jim Tracy Staff writers: Tim Pray Bryan Noonan
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AWARE Ink is published bimonthly by AWARE, Inc., a 501(c)3 non-profit organization at 205 E. Park Ave., Anaconda, MT 59711. Copyright ©2009, 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.
conference. Many parents were the first to arrive and the last to leave. They took notes diligently and made sure to speak at length with the experts in attendance. It was clear that in the midst of an oft-misunderstood condition like autism, it is the parents who become the true experts. They are the ones who decide whether to try a strictly medical approach, an applied behavior analysis approach or a naturalistic approach. They want choice. We’ll never be able to guarantee that we can make a person’s condition go away. But we can—and are obliged to—offer as many options to families as possible. One of these options is the recent hiring of Dr. Jerry Taylor, N.M.D., who you’ll read about in this issue of Ink. Dr. Taylor offers a biomedical approach to those who are interested, and response has been very good thus far. Since we have been providing services for children with autism and other developmental disabilities, parents have been asking for approaches that include a focus on nutrition. That approach has received a great deal of national attention over the course of the last few years, and we’re happy to tell Montana families that it is available to them. In this issue you’ll also read about the progress and expansion of our psychiatric services. By now, you’ve surely heard of—and maybe used—the telepsychiatry/video network, and we’ve been pleased with the rate at which it’s made a difference in the way we approach mental health services on a statewide basis. Five years ago, AWARE employed just a few doctors who spent significant time driving from community to community for sessions. Now, we employ and contract with 12 doctors across the state and have recently hired a practice manager for telepsychiatry, Carrie Sayre in Helena, to manage the growing infrastructure. Revisions have been made or are underway for several of AWARE’s core curricula: the HELP manual, the Health and Safety Handbook and the Disaster and Emergency Preparedness Guide. A major reason that we’re able to expand the breadth of our services so confidently is because of the professionalism of the administrative personnel. As families are offered more choice, people are offered more and different ways to live within the community and those with mental health needs have access to help for the first time, there are people who ensure that AWARE services remain the standard for safety and forethought. Many more news items, events and ideas are covered in this issue, and I hope you enjoy seeing so many great efforts represented on paper, knowing that it’s but a fraction of all that is happening in living rooms, schools, offices, clinics and communities around the state. So as summer comes to a close, I again want to thank everyone for the work that continues to offer real solutions to people around the state. Best,
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Leadership group’s work leads to revised handbooks AWARE’s Leadership Committee and management staff have revised the “Employee Health & Safety Handbook” and “Disaster/ Emergency Planning Guide.” “Staff spent time over the past several months collecting information regarding the best possible way in which to create practices to provide a safe and healthy work environment,” said Leighanne Fogerty, director of Human Resources. The final revisions were published on Aug. 24 and went into effect Sept. 1. “The H&S and DES handbooks were updated and revised as the last time they were updated was in 2005,” Fogerty said. “Because of this, the handbooks did not reflect the changes to AWARE’s corporate structure or services. I believe they are a much better product as they reflect AWARE’s commitment to the health and safety of both clients and employees. Every AWARE employee should be familiar with this information in order to be prepared for all emergencies and health and safety concerns.” Employees can access the handbook and guide as pdf files through AWARE’s web site —www.awareinc.org. Employees are expected to carefully review the documents since policies and practices have been revised and new policies have been added. The Human Resources Department has contacted supervisors to make sure each employee has read this material and signed the Employee Acknowledgement Form, found at the beginning of each document.
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Located near the corner of Russell and Broadway at 1515 Liberty Lane in Missoula, Equinox features 35 sustainably built apartments for residents who are qualified because of their income. Photo courtesy of homeWORD.
Welcoming Communities Award
Coalition honors Missoula housing group
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that earn 30 percent to 50 percent of the area median income. Rents range from $223 to $558, depending on unit size and income. These rents are appropriate for people on fixed incomes, or typical hourly wages of $7 to $10 an hour. Most units have private outdoor spatios or decks, and all have access to common balconies and a community room overlooking the Clark Fork. “We’ve had incredible interest from the community,” said homeWord asset manager Jennifer Betz. “We have about 250 people on the waiting list. Something we’re very proud of is Equinox offers more fully accessible units than are required by code.” The entire building is “universally designed,” a term that refers to building flexible spaces to include people with all abilities. Accessibility features include 36-inch-wide doors, lever handles, higher electrical outlet heights and reinforcement for later installation of grab bars. Missoula, and Montana as a whole, are projected to have an increasingly aging population. Over the next 15-20 years, forecasters say Montana will be the state
quinox, a new affordable housing project operated by homeWORD in Missoula, opened its doors at a celebration on July 30. AWARE was there to present homeWORD its Welcoming Communities Award. “Equinox represents a true model of affordable and accessible rental housing in keeping with our housing goals,” says Michael O’Neil, executive director of AWARE’s Montana Home Choice Coalition. “In the development of the Equinox, homeWORD demonstrated a model process of inviting and involving the disability and senior communities in every step of the project from design to property rent-up resulting in the creation of the Equinox – a housing community truly welcoming to all.” Sustainably built Located near the corner of Russell and Broadway at 1515 Liberty Lane, Equinox features 35 sustainably built apartments for residents who are qualified because of their income. Starting in July, homeWORD began leasing 35 studio, one- and two-bedroom apartments to households
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ment along the West Broadway Corridor that incorporates a planned mixed use, mixed income development.
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with the fifth-oldest population. “From the beginning, we brought together professionals, clients, and experts in the field that really understand usability of spaces so we could plan for residential needs well into the future,” said homeWORD Executive Director Andrea Davis. “In fact, that’s the way homeWORD designs their buildings— by bringing together the community to help define needs, wants and dreams.” Equinox, homeWORD’s seventh multi-family property, is a blend of those ideas, resulting in a realistic but innovative project, according to Heather McMilin, homeWORD’s housing development director. McMilin said Equinox represents growth and understanding “of the appropriate use of sustainable building in affordable housing.” “We focused our limited funds where they matter the most,” she said. “We did what we could to ensure affordability for each resident, as well as for the long term of this facility.” The location provides easy access for future tenants to walking/biking trails, several mass transit routes, and is within easy biking and walking distance to many services and resources such as health care facilities, social service support offices, and grocery stores. The building was constructed on a former “gray field” site; the previous development (Liberty Lanes bowling alley) had paved approximately 90 percent of the parcel with asphalt paving, all of which was reclaimed for recycling during deconstruction. Equinox is the first phase of a model re-develop-
Riverbank restoration homeWORD intended Equinox to enhance the city’s designs for biking/walking trail improvements as it includes development of a 385-foot section of Missoula’s popular Clark Fork Trail that winds along the top of the bank on the north side of the Clark Fork, as well as restoration of the riverbank itself with removal of concrete riprap and landscaping with indigenous plants appropriate for the riparian environment. Some of the green building features include: High-efficiency heating and cooling Roof-top photovoltaic array for electrical power generation Use of recycled content in most interior finishes No- and low-VOC (volatile organic compound) paints and construction adhesives Use of “good wood,” a local sustainably harvested framing product. The project is also designed to incorporate a graywater system, harvesting waste water from lavatory sinks, tubs and showers for underground drip irrigation of the landscaped areas, and has been approved for permitting via a variance through the Missoula County Health Department. For information on how to get your name on the waiting list call homeWORD’s property management company, the Missoula Housing Authority, at (406) 549-4113.
Equinox housing project by the numbers Three stories, one basement Fully sprinklered Underground parking with 28 spaces; aboveground parking with 14 spaces. 1.2 spaces per unit 31.842 square-foot finished floor area. 10.661 sq. ft. basement — total: 42.503 square feet Cost per square foot, not including riverbank restoration or PV panels: $99/sq. ft. with riverbank and PV panels: $1 05/sq. ft. 35 dwelling units — five studios, 20 one-bedroom. and 10 two-bedroom Community room — 550 square-foot opening to patio, equipped with refrigerator, sink, cabinets, tables, chairs, microwave — for tenants only Elevator
64 PV panels providing 12.8 kW of electrical power Storage units on each floor — one storage area per dwelling unit Rents: Studios — $223 to $431, One-bedroom — $245 to $467. Two-bedroom — $291 to $558, electrical and gas utilities not included Sizes: Studios — 420 square feet to 510 square feet. One-bedrooms — 539 sq. ft. to 652 sq. ft. Two bedrooms — 702 square feet to 781 square feet Covered bicycle parking in basement and at three of four exterior entries Four “public” (tenant-use only) balconies, 31 private balconies/patios (all but four of 35 units have private outdoor space adjacent to unit) 6
Sixty-four photovoltaic panels provide 12.8 kilowatts of electrical power to the Equinox housing project in Missoula. Below left, kitchen features accessible counter tops. Double doors (below right) lead to a private balcony from a spacious dining/living room. Photos courtesy of homeWORD.
Equinox
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‘Don’t give up’
Parents meet experts at autism conference By Bryan Noonan
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arents, teachers, caregivers and concerned citizens gathered at MSU-Billings for the sixth annual At-Risk conference for autism Aug. 3 and 4. The conference drew about 160 people. Doctors and pharmacists reported new information about children with autism and what is being done to treat it, as well as what parents can do. Teachers and caregivers described their methods of working with children with autism and how to react to outbursts and classroom disruptions. Parents made up by far the largest group of participants at all sessions of the conference, which was sponsored by MSU-Billings and Easter Seals of Chicago. They told stories of trying to wade through conflicting information and different views of how to treat autism. ‘Don’t lose hope’ They explained what was best for their child may not be best for others and described different therapies and diets they experimented with before they found what truly worked for them. The underlying message from all parents who had children with autism to parents with newly diagnosed children was “don’t give up” and “don’t lose hope.” Have patience and don’t be afraid to try new things, they said. One child may respond better to P.L.A.Y. therapy while others respond better to ABA therapy. P.L.A.Y. therapy refers to a method of psychotherapy with children in which a therapist uses a child’s fan-
tasies and the symbolic meanings of his or her play as a medium for understanding and communication with the child. Applied Behavior Analysis (ABA) is based on the idea that influencing a response associated with a behavior may cause that behavior to be shaped and controlled. ABA is a mixture of psychological and educational techniques that are used based upon the needs of each individual child. “For families with children with autism, sometimes the future can be very uncertain, and it’s not only navigating some of those really tough issues that our children will have to deal with, it’s battling society,” Missoula parent Ryann Halsey told Amanda Venegas of Montana’s News Station. “So it’s tough. It’s very raw emotion.” Doctors and other experts told the group that the battle starts at home. Combating autism isn’t a matter of taking your child to the doctor, or therapist, letting them do their thing, and then coming home and dealing with it until the next visit, they said. Most child
‘
For families with
children with autism, sometimes the future can be very uncertain.’
— Missoula parent Ryann Halsey
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and family progress takes place at home. Sen. Kim Gillan (D-Billings) and Charlie Briggs, representing adult and community services for Easter Seals Goodwill Northern Rocky Mountain region, two people who played pivotal parts in the passing of “Brandon’s Bill,” the bill that mandates insurance companies to cover autism, received praise and applause at the conference. Also recognized were Lori Gaustad, Brandon’s mother, and Kim Schweikert of MSU-B College of Professional Studies and Lifelong Learning, conference manager and head of the Billings Autism Society, who has been influential in organizing events and raising funds to spread knowledge and awareness of autism. The conference started like most conferences with registration and continental breakfast while the organizers made introductions and answered questions, followed by Dr. Karen Heikel, dean of MSUB College of Professional Studies and Lifelong Learning, welcoming everyone. A balanced approach Neuropsychologist Brenda K. Roche of Arrowhead Psychological and Behavioral Sciences followed the commencement with a talk to help people take “a balanced approach to understanding autism.” After a short break for the exhibit fair, MSU-B Assistant Professor Dr. Cheryl Young discussed facts, myths and statistics about autism spectrum disorder and transitions. She told parents they should know that their children can get
better, can get a job and can live a fulfilling life. She urged parents to not listen to people who tell them otherwise. After a few parents told their stories and answered questions from less experienced parents, a panel that included Jessica Rago of Eagle Mount, Kristen Brook from Billings Public Schools, Chuck Laggate of Vocational Rehabilitation, Lori Gaustad and John Keebler, job navigator at Billings Job Service, took the stage. Positive effects The goal of the panel was to inform parents about high school, post graduation and work opportunities and assistance available for young adults and adults with autism. Many transition, recreation and job resources are offered to those finishing school. Although transitions are tough on children with autism, all of these programs are helpful and proven to have positive effects on the child. Breakout sessions followed. These were split into parents, services, education and transitions,
and took place in separate rooms hosted by people considered experts in their field. At the reception/VIP dinner/ awards ceremony, several people were honored, including Cam Schieno, president of Yellowstone County Tavern Association. The Tavern Association has been a major contributor to the Billings Autism Society. Maurice Snell, a 23-year-old man with autism who received his college degree from St. Xavier University in Chicago in 2003, was the keynote speaker. Snell graduated from high school with honors and now works for Easter Seals in Chicago. He said he plans to live on his own and is contemplating going to graduate school. He gave hope to all parents at the conference, providing living proof that a person with autism can excel and achieve independence. The second day of the conference had fewer speakers and another panel that included Dr. Laura Nicholson, Mark Jurovich, PharmD, R.Ph., Dr. Margaret
Relay Team
Beeson and Dr. Jerry Taylor. This much-anticipated session drew a large crowd that filled up the auditorium. Among the hot topics was the role of diet in autism. Recent studies have pointed to the presence of heavy metals in the body and gastrointestinal problems playing a critical part in the diagnosis of autism. Homework and information After collecting web addresses and book lists and jotting down statistics and studies, conference goers left with a full plate of homework and information. Most people who attended the conference seemed to be pleased with the information they had gathered and were ready to use it in their lives. Many of the doctors at the conferences have booked schedules and long waiting lists, so events like this conference allowed people to ask the questions that they wouldn’t have had the chance to ask before.
Friends and family joined AWARE administrative staff at Anaconda’s Relay for Life at Mitchell Stadium in June. AWARE staff have participated as a team since the Relay started in Anaconda in 2005. Photo by Jim Tracy
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Dr. Taylor
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He sees all patients of all ages in his practice. So far, he has seen about 30 people with autism in his practice, and another 40 or so at Thoughtful House Center for Chilren in Austin, Texas. A unique aspect to his practice is that he offers house calls, which have made up about 90 percent of his patient visits to date. He maintains an office in his home for patients who may find that more convenient. Methods used at Taylor’s Nurturing Hope Biomedical Center include biomedical intervention, orthomolecular and functional medicine, applied kinesiology, prolotherapy (also known as nonsurgical ligament reconstruction), nutrition, botanical medicine, homeopathy and more. “I address conditions such as autism, ADD, ADHD, autoimmune disorders, thyroid disorders, diabetes, arthritis, eczema and many other health conditions combining complementary, alternative and conventional medicine,” he says. At Nurturing Hope Biomedical Center, Taylor and staff provide education, treatment and health care for the entire family. “We believe in forming a partnership with the patient, and working together toward total wellness,” Dr. Taylor says. “We will teach you how to care for yourself and your family. We feel that an appointment at Nurturing Hope Biomedical Center is more than just a visit to the doctor, but it is an investment in your
health and well being, and ultimately a better quality of life.” No time is free, but his discretionary time he enjoys spending with his wife, Allison, and their four children, Brandon, Bryce, Audrey and Blake. He is also a passionate cyclist and can be found visiting patients on his bicycle when the weather permits.
Questions & Answers What is a naturopathic medical doctor (NMD)? After completion of an undergraduate degree, naturopathic medical doctors are trained in four-year medical colleges just as other physicians. In addition to learning the basic medical sciences, including anatomy, physiology, biochemistry, microbiology, pathology, pharmacology, immunology, histology, neuroscience and genetics, naturopathic doctors also take classroom courses in the clinical sciences: obstetrics, gynecology, urology, cardiology, pulmonology, gastroenterology, endocrinology, rheumatology, oncology, gerontology, otorhinolaryngology and dermatology. NMDs also learn the naturopathic therapies. These include: clinical nutrition, botanical medicine, homeopathy, traditional Chinese medicine, including acupuncture and Chinese herbs, environmental medicine, physical medicine and hydrotherapy. Naturopathic doctors are trained in the classroom and in a variety of clini10
cal settings. Naturopathic physicians are licensed to diagnose and treat disease with any combination of the therapies listed above. What is the difference between a homeopath and a naturopathic doctor? Homeopathic medicine is a specific form of therapy that is safe and non-toxic. Naturopathic doctors are trained in homeopathic medicine but training is far more extensive than homeopathy alone. When practitioners identify themselves as homeopaths, it does not necessarily mean they have a medical background, whereas a naturopathic physician must complete the doctorate in naturopathic medicine as described above. However, many naturopathic, osteopathic and medical doctors study homeopathy and incorporate it into their medical practice. What conditions do naturopaths treat? Naturopathic physicians are trained as primary care providers. As such, they may be the first practitioner to see a patient for any given complaint. Taylor provides complete family health care including: allergies/asthma arthritis autism and related disorders Asperger’s ADD ADHD PDD-NOS autoimmune disease cancer
cardiac health colds and flu depression diabetes digestive health endocrine health fibromyalgia high cholesterol hypertension joint pain pediatric health pulmonary health stress/anxiety weight concerns Does insurance cover Dr. Taylor’s services? In Montana, Dr. Taylor is licensed as a primary care physician. His office is a fee-for-service provider with the issuance of a Health Insurance Claim Form (HICF). The patient submits this form to the insurance company with a copy of their insurance card for reimbursement. Coverage varies from company to company and from plan to plan within each individual insurance company. Some companies and plans will pay 100 percent up to a specified amount, some will pay 50 percent to 75 percent, and some less. The best policy is to refer to the “freedom of choice of practitioners statute” under the patient handout tab, and then call and question your insurance company representative. Are Dr. Taylor’s patients advised to use special diets such as GF/CF, SCD, low-oxalate, etc.? He does use these nutritional changes when indicated, but it all depends on the need of the individ-
ual based on a thorough assesment. Will Dr. Taylor collaborate with other specialists he will be dealing with (e.g., gastroenterologists)? “If they are willing to work with me, I can work with anyone,” he says. Is he willing to collaborate on treatment and testing with a child’s pediatrician if he/she is receptive? “Absolutely.” Does he provide any form of after-hours support? “If it is an emergency, they need to go to the emergency room or urgent care,” he says. “Depending on the issue, I will call them back. I have not had any emergencies as of yet.” Why is AWARE a good fit for Dr. Taylor’s practice? “My practice is focused on neurologic and developmental disorders, including mental health issues. I believe in providing the very best care possible and creating a community based environment to accomplish my goals,” he says. “There are many similarities between my practice and AWARE.” What can a patient expect at his or her first appointment? The first appointment will last approximately 90 minutes. During this time Dr. Taylor will take a detailed medical history, perform pertinent clinical exams and determine if there is a need for lab work. 11
Ample time will be spent reviewing the material and answering any and all questions patients may have. He will determine what lab tests will be necessary and appropriate for their needs, and he will issue you a treatment sheet detailing the reading materials, and other activities needed to complete before the follow-up consultation. Patient and doctor then schedule a follow-up consultation for approximately two weeks from the initial consultation. What are his fees? Dr. Taylor’s fee is $150 per hour. He charges a flat fee of $225 starting at 1.5 hours. The fee for prolotherapy is $90 to $125 per treatment, depending on complexity. How do you schedule a house call? The center offers a free 10-15 minute visit to determine if his practice is appropriate for a potential patient’s needs. To schedule a house-call or office visit, call 406/422-6302.
A human being should be able to change a diaper, plan an invasion, butcher a hog, conn a ship, design a building, write a sonnet, balance accounts, build a wall, set a bone, comfort the dying, take orders, give orders, cooperate, act alone, solve equations, analyze a new problem, pitch manure, program a computer, cook a tasty meal, fight efficiently, die gallantly. Specialization is for insects. — Robert A. Heinlein
Corporate Congress set for Dec. 9-11 AWARE’s Corporate Congress will be held this December 9-11 at the Fairmont Hot Springs Resort near Anaconda. Corporate Congress is AWARE’s three-day work session at which representatives from each service and service area come together with bills that have been written based on the concerns of their constituents. Those bills are debated and rewritten over the course of the session, and finally presented to AWARE’s Board of Directors, CEO and medical director on the last day. Those final bills are then submitted to
AWARE’s Leadership Committee for implementation throughout AWARE policy and practice. Corporate Congress represents a large portion of AWARE’s annual development, and many of the policies that are currently in place throughout the organization are a direct result of bills that were written for Corporate Congress. Also at Fairmont during the Corporate Congress session is AWARE’s annual banquet, culminating in the Unconditional Care Awards. The 10 recipients of the awards, each based upon one of AWARE’s unconSee Congress on Page 24
Teleconference series
Oregon advocacy group presents: ‘healthy relationships’ their own sexuality? How do you tell the difference between healthy and unhealthy relationships? What are some things that people can do when they feel uncomfortable in a relationship? What are some things they can do to make their relationship healthier?
Sign up to participate in two teleconferences featuring real talk among self-advocates, family members and healthcare providers about intimate relationships, personal safety and advice from peers. The teleconferences are sponsored by The Riot!, a newsletter for “self-advocates.” A self-advocate is someone who has a disability and speaks up for themselves. The Riot! is housed at the Human Services Research Institute in Portland, Ore. There are two teleconferences remaining, each lasting 90 minutes. Each teleconference will start at 1 p.m Mountain Time, and will be facilitated by Julie Petty, a nationally respected self-advocate. During each call, speakers will have time to talk with one another and then will answer questions from across the nation. The first teleconference was Sept. 1 – “Do individuals with developmental disabilities have the right to someone special in their life, such as an intimate relationship?” Still to come: October 5 - “What are the dynamics of a healthy, intimate relationship?” Issues of sexuality, personal safety and safe sex/birth control will be discussed. Here’s a sampling of the questions that will be covered: What is a healthy, intimate relationship? Is the meaning of an intimate relationship the same for everyone? What is sexuality? How can self advocates learn about and act on
November 2 - “Self-advocates give their peers advice, ‘Dear Abby’ style.*” Here are some of the questions that will be covered: If you find someone you like how do you let them know? How do you ask someone out on a date? Have you been in a relationship and how did it work out? How intimate have you been in your relationships? What do you think people should know about intimate relationships? Registration fee for each teleconference is $25. You can listen on your own or bring people together around a speaker phone. This is a wayfor self-advocates to hear about what is going on and to join with others nationally. Parents and staff are invited too! For more information, visit The Riot! at www.hsri. org. *There will be a 45-minute question and answer period at the end of this call to give participants an opportunity to ask the panelists for advice on dating and intimate relationships. 12
Psychiatry...
fessional ideas, frustrations and questions. AWARE, Continued from Page 1 however, has created an environment in which the professional ideas and opinions of doctors (and their Providing mental healthcare in Montana presents support staff) are openly shared. many barriers—some based on tradition, some on Dr. Lantz began a monthly meeting between the geography and some on culture. That Montana has members of the psychiatric group, which has enabled consistently ranked highly—when not first—in nahim—as the person responsible for ensuring that tional suicide rates exemplifies that. psychiatric services are delivered AWARE has found, though, that well—to listen to the concerns, by recruiting doctors who underIt’s great to be able to con- needs and successes of AWARE stand and respect the intricacies doctors around the state. of the “frontier” rural populations nect clients with doctors “One of the benefits of meeting of Montana, progress can be made providing treatment and care regularly is the variety of expein strengthening its communities, rience that we share with each families, adults and children. But from hundreds of miles away, other in terms of solving complex it has taken considerable time to problems and the support offered and many of these children build the infrastructure needed to to one another such as providing a both recruit those doctors and to and adults would not receive consultation for a second opinion provide access to those communiregarding a complicated issue,” care without having to drive ties. Lance said. Five years ago, when Dr. “Over the last six months, I long distances.’ Len Lantz began working with have observed that our psychiaAWARE, there were no full-time — Carrie Sayre, telepsychiatry trists are now functioning more practice manager staff psychiatrists. cohesively as a group—despite “Now we have five employed the distance that separates us.” psychiatrists, five contracted psyAnd that distance is significant. chiatrists, a psychiatric nurse practitioner [telepsychiaAWARE psychiatrists are located in every major try practice manager] and strong ties with two child population center of Montana: Dr. John Tupper servpsychiatrists in Billings,” said Dr. Lantz, now serving ing Helena and Great Falls, Dr. Tom Hoffman serving as AWARE’s medical director. “With the greater num- Butte, Anaconda and Dillon, Dr. Jeff Greene and Dr. ber of psychiatrists, AWARE is providing psychiatric Joanne Greene in Bozeman, Dr. Tim Vischer in Bozeservices to more people in more communities.” man, Dr. Erin Ammatto in Billings, Dr. Krista David AWARE’s success in recruiting and retaining in Helena, Dr. Alan Reyes in Missoula, Dr. Suzanne psychiatric staff has been due to an economy of scale, Darr serving Bozeman and Butte, Dr. Ira Lourie, of sorts. Many of the retention issues faced by other AWARE’s chief medical consultant in Hagerstown, mental health providers in the state surround isolation Md., and Dr. Len Lantz, AWARE medical director, and the difficulty in providing any sense of team. located in Helena. Since the beginning of AWARE’s psychiatry proSharing ideas and opinions gram, one of the goals has been to provide access to By shifting their limited resources toward putting mental healthcare for traditionally underserved popua psychiatrist in the farthest reaches of the state, that doctor may, over time, feel the isolation of not being a lations and areas around the state.
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we’ve been able to be more aggressive in really thinking about where and how these services might be The marked increase in the number of doctors is needed. When a community tells us that a need exone way to do that, and another is to provide doctors ists, we’re able to react quickly, which is a really good with the necessary tools to bring psychiatry to areas position to be in, considering the barriers that exist for that are harder to reach. The telepsychiatry network rural areas across the nation.” is one of those tools and now includes 14 sites around With the infrastructure in place, the support of the state. As the network has grown, so has the need major stakeholders and the state and AWARE’s diverse for a person whose sole job is to manage that growth team of psychiatrists that offer real choice, AWARE is and ensure that both doctors and communities being preparing to offer the telepsychiatric network’s capaserved by the network are getting the support they bilities to communities around the state that may want need. to use them. The first of those communities is Miles Carrie Sayre (pronounced “say-er”) was hired in City. AWARE representatives will meet with commuearly August as AWARE’s first telepsychiatry practice nity families, stakeholders, institutions and organizamanager. tions to see what—if any—psychiatric supports may “Managing a telepsychiatric network really interests be needed. me,” said Sayre. “It’s great to be able to connect clients “We’re not going into any meeting with a preconwith doctors providing treatment and care from hunceived notion of what we think they need,” said Foldreds of miles away, and many of these children and som. “They’ll tell us what they want or need, or if it’s adults would not receive care without having to drive even a good fit.” long distances.” A large part of AWARE’s ability to expand the A safe buffer breadth of its services—in all categories—has been the belief that a community can and will speak for Early on, there were concerns that people—espeitself, using its own systems of support and care, and cially children—would not feel a true connection to a doctor when he or she may be 400 miles away, a con- that the things AWARE can bring to the table are often cern that a client would not open up and that a session merely supplemental. “Prior to moving to Montana, I expected that it would be ultimately unproductive. But AWARE has would be very difficult to deliver quality psychiatric found that in most cases, the distance between doctor care in rural areas,” said Dr. Lantz. “I did not anticiand patient actually increases the level of openness, providing a safe buffer for a person to feel comfortable pate the higher level of personal attention and concern by community members in some of the smaller towns. and get the most out of a session. It was a new and refreshing experience for me to have Response to AWARE’s network has been positive a high school principal or superintendent show up from the people it has been serving, saving families to a psychiatric medication visit and say something significant travel costs. But others have noticed the like, ‘I’m concerned about this boy. What can I do to advantages, too, and the state’s Department of Public help?’” Health and Human Services’ Addictive and Mental Disorders Division has bought in to the program. Custom-built program “It means a lot that AMDD sees the value in this If the people of Miles City feel as though they are undertaking,” said Jeff Folsom, AWARE’s chief of able to use the technology and psychiatric efforts of operations. “As we do, they see the importance of ofAWARE staff, they can be implemented there very fering access, first and foremost.” quickly and be suited to the needs of the community “Also,” Folsom continued, “with their support, —a custom-built program—from day one. If and when 14
Telepsychiatry manager tuned into ‘quality of care’
AWARE welcomes Carrie Sayre, corporate practice manager for psychiatry/telepsychiatry.
The year-long growth of AWARE’s telepsychiatric network has spurred the need for a manager to coordinate that growth and ensure that doctors, clients and communities receive the support they need. Carrie Sayre is that person. Hired in August, Sayre is responsible for updating and assessing the technological aspects of the network, working with communities to gauge their psychiatric needs and working with AWARE’s staff of doctors. “Ms. Sayre has been valuable in regards to meeting with our psychiatrists and assessing their needs, setting up our monthly group meeting and helping to push forward our quality of care measures,” said AWARE medical director Dr. Len Lantz. Sayre has an undergraduate degree in biology from Trinity College of Vermont and an MBA from Regis University in Denver, Colo. In Vermont, she worked for Macro International on a government contract for the National Oceanic and Atmospheric Administration for eight years. She worked as a district director for the Muscular Dystrophy Association in New Mexico. She also worked in the government affairs department for the nonprofit organization: the Association of Perioperative Registered Nurses in Denver. Sayre is stationed at Butte’s AWARE offices at 227 East Mercury St.
other communities around the state decide after meeting with AWARE that their community could benefit from some or all of what AWARE’s mental health services have to offer, they can be implemented there, too, with equal expediency. There is not a blanket policy, though, and five years from now, there may be many small communities with programs that look completely different from one another, again depending on the specific needs of the community. “Maybe one community feels like they need some psychiatric supports in a school. Another may need something in their community health center. Point is, we don’t know what communities need, they’re driving this thing, and they’re the only ones that can,” said Folsom. Dr. Lantz is encouraged by the growth of the psy-
chiatric program and network, and is eager to become more deeply involved with communities around the state. “We continue to strive to achieve better outcomes and to implement evidence-based strategies…I’d also like to partner more actively with community pediatricians to help extend the mental health workforce in Montana.” AWARE’s mission statement is to provide quality community-based services to people with challenging mental, emotional, and in some cases, physical needs who would otherwise be served in a more restrictive setting…or perhaps would not be served at all. The nature of this initiative is technologically complex, but the ways in which it can be adapted to fit the needs of families and communities is not; it is based on AWARE’s mission to offer whatever help necessary to people who may not be getting any help at all.
Men fear thought as they fear nothing else on earth — more than ruin, more even than death.... Thought is
subversive and revolutionary, destructive and terrible, thought is merciless to privilege, established institutions, and comfortable habit.” — Bertrand Russell (English Logician and Philosopher 1872-1970) 15
NEWS BRIEFS Adult Day Center opens in Hamilton
Japanese wheelchair design would lessen reliance on caregivers
Story by Marysa Falk — Ravalli Republic The Garden Day Center in Hamilton became a limited liability company in December 2008 and has opened its doors for business. The center is run by Laura Grenfell and Suzanne Albright at Grenfell’s home. The Center has 23 animals – kittens, dogs, sheep and horses – to provide a farm-like atmosphere. Every day, two people with disabilities come to the Garden to learn life skills and improve their independence. The facility also allows customers to stay overnight and on weekends. A customer’s day includes breakfast, jumping on a trampoline and other recreation, making lunch, going on field trips and spending time in the sensory room. “We want this home to seem less institutionalized,” said Grenfell. Field trips such as Farm Days allow visitors to play with animals and do old-fashioned tasks like churning butter. These activities help visitors learn responsibility and improve their quality of life, according to Albright. “Our goals are to make this a rewarding place for everyone to feel safe and welcome,” she said. “The best part is when you get a smile. When we see them enjoying themselves.”
Story by Shaun Heasley of Disabilityscoop.com Inventors in Japan recently unveiled wheelchairs that have a whole new look and feel. In attempts to enable the wheelchair user to get in and out with less assistance, the prototype looks more like a motorcycle. The user straddles the chair and leans forward. The chair allows the user to slide onto and off the device more easily. Plans have not been set to distribute the chair commercially, but researchers are working hard to make it available, along with other new options, to people with physical disabilities.
AAHD scholarships announced The American Association on Health and Disability has created the 2009 AAHD Scholarship Program. This program supports students with disabilities who are pursuing higher education. The scholarships give preference to students with disabilities who want to study in the fields of public health, health promotion and disability studies. To find out more about the scholarship program and to download the application, visit www.aahd.us.
School boasts ‘Boundless Playground’ Story by Paris Achen — Mail Tribune
Complex features accessible ball field Story by Nicholas Ledden of The Daily Inter Lake
More than 1,600 children in Jackson County, Ore., are diagnosed with a disability, and now they have a playground they can use. This $121,000 playground is completely accessible, with wheelchair ramps to all five levels of its main play structure and sensory activities for children with autism. Hoover Elementary is the first playground in Oregon to have a certified ‘Boundless Playground.’ This playground has padded-tile surfacing and bark dust to allow easy movement by wheelchairs. “I think it fosters acceptance of diversity and inclusiveness, and it’s a huge social benefit for everyone,” said Pam Philips, head of the Parent-Teacher Organization. Donations, grants and in-kind donations funded the project that has scheduled its ribbon cutting to take place in conjunction with Hoover and Roosevelt Back To School Night Sept. 24.
Parents, children and young adults with disabilities assembled to unveil and break in the new “Miracle Field” in Kalispell. The Field is complete with a flat, rubberized surface and wheelchair accessible dugouts. “This has been a goal of ours for about 12 years, since Kidsports was started,” Kidsports President Dan Johns said. “The field is kind of the crown of the complex.” On opening day at Miracle Fields, residents of the Lighthouse Christian home sang the National Anthem and the West Mont Cheer Squad of Helena rooted for the players. “It’s incredible the opportunity that we have,” said Kalispell Mayor Pam Kennedy. “Everyone deserves the opportunity to play sports. I’m excited to be a part of it.” 16
“I think one of the things this might do is change the way playgrounds are made, so that they are completely accessible,” Philips said. “It can be more costly, but I think it’s worth it.”
how society deals with the mentally disabled, there are still backwaters of the heart, lacking in compassion for those who are more vulnerable through no fault of their own.”
Bike Camp helps kids with disabilities
Billings group gives kids special ride
Story by Kim Kozlowski — The Detroit News The University of Michigan recently landed a half million-dollar grant from the U.S. Department of Education to perform a study of the activity level of children with autism and Down syndrome when they learn how to ride a bike. Studies show that only 10 percent of children with Down syndrome and 18 percent of children with autism can ride a bike, but after this five-day camp most who attend learn how. The study showed that those who learned how to ride a bike have a better chance to stay physically active. This is especially good for those with Down syndrome since it often leads to excess weight, and some medications used to treat autism cause weight gain. Aside from the health benefits, riding a bike has shown to improve the children’s social and verbal skills as well as creating independence. “Riding a bike is a rite of passage for a child,” said one of the children’s mothers. “You can see the confidence difference in every one of these kids. The more confidence they have, the more things they will try and see that they can overcome.”
Story by Amanda Venegas — Montana News Station In July, kids from Head Start, EagleMount and Autism Speaks received a free train ride aboard Thomas the Tank Engine, thanks to the Dennis and Phyllis Washington Foundation and Montana Rail Link. The Washinton Foundation donated $10,000 for the rides and everything ran smoothly as the children got the ride of their life. “I’m sure that most of those children and parents have never been on a train,” said MRL spokeswoman Lynda Frost. “And so for them, even though it was short, for them to have that experience and all of that excitement, I think it’s been something that will really leave a wonderful memory.”
Unions set sights on in-home providers Story by Shaun Heasley of DisabilityScoop.com Recent changes in Illinois law will allow “individual providers of home-based support services” to organize. This has spurred unions to target the 3,000 people in Illinois who are paid by the state to provide in-home care to those with developmental disabilities. Union officials say that organizing could provide caregivers increased wages and benefits, but many parents are skeptical. A large portion of the caregivers in the state are parents that provide for their disabled child. They worry that the increased wages and benefits for them will only take away money from their child’s cost plan. Also, parents are concerned that some day the union will force workers to strike, leaving their own children uncared for. Caregivers in a dozen states have already unionized. The two unions competing to represent Illinois are the American Federation of State, County and Municipal Employees and the Service Employees International Union.
‘Fight club’ defendant found guilty Story by Megan Chuchmach of ABC News Jesse Salazar, a 25 year-old Texas state employee, was found guilty of intentionally causing injury to a disabled person last August. Salazar faces up to 10 years in prison. Salazar and other workers at a state school in Corpus Christi allegedly forced residents to fight one another while employees taped the incidents on their cell phones. Six people have been charged in the case. Vincent Johnson and D’Angelo Riley have pleaded guilty. Two others have pleaded not guilty, while one other awaits a court date to make a plea. “They planned this. They did this on a regular basis,” said Nueces County Assistant District Attorney Doug Mann in his closing argument. “This was all about their entertainment.” Frank James of NPR news later commented, “The Texas case is shameful proof that despite advances in
— Compiled by Bryan Noonan
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Shrink wRap This program was based on serving kids in their communities using natural resources from that community and I always felt that it was as close By Ira S. Lourie, M.D. as I had ever seen a program come to reaching cultural proficiency, which recently was involved in teachis the highest level of cultural coming a course on wraparound petence. However, when this student services over the internet. This was discussing the history of services type of learning is fascinating as one to the Native Alaskan population has conversations via what is called with me, she negatively referred to an electronic blackboard with people AYI as something that “was done to whom you never see face to face. Native communities, not with Native One of the students was a Native communities.” You can imagine my Alaskan from the Anchorage area surprise! who submitted a final project for Before we go further, let’s look at Dr. Ira Lourie the course in which she discussed how the concept of cultural competence the application of Unconditional Care has been defined. In my teaching I’ve Principles, in this case wraparound services, to a portrayed it as a continuum along which each of us group of nine communities (8 rural and 1 urban) lies in terms of our understanding of the need to around Anchorage. factor culture into our interventions with the people This project report along with the discussion we serve. I’m now going to describe the five levels that followed from it taught me a new lesson about along this continuum and I would like each of you cultural competence, a concept which you will find to try and figure out where you stand. reflected in AWARE’s Unconditional Care PrinThe first level is Cultural Incapacity. Folks here ciples as “I’m Okay, You’re Okay,” are intolerant of differences among people and appear biased and prejudiced placing positive values Still more to learn on one set of cultures and negative values on others. I thought that I knew all about cultural compeThe result of cultural incompetence is racism and tence. After all I wrote a chapter about cultural the desire for people to make everyone else like they competence in Everything is Normal Until Proven Otherwise, the book I wrote with Karl Dennis about are. Folks in this category are more likely to belong to the Klan than to be AWARE employees. wraparound. Some people even give me credit for The second level is Cultural Blindness. Folks the concept of cultural competence having been developed in child mental health over the last 20 years. here try to believe that culture doesn’t matter and that we are all the same. Kind of like the 1960s hipNow I have come to discover that I still have more pies with their peace, love and happiness for everyto learn. one. The problem with this is that most of the folks When I teach cultural competence as it pertains who are at this level use themselves as the reference to wraparound I most often tell about the Alaska as to whom “everybody” is, and while they have Youth Initiative (AYI), which was the first statetolerance for people who look different, they still wide experiment in wraparound service delivery.
I’m Really Okay, You’re Really Okay
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positive values that they have inherited from it. One might explore with the Native American child in the last paragraph if the family felt that a healing ceremony might be something they valued. And if they answered positively, one would then help them find that resource. Where do you fit on this continuum? I thought I fit into the highest category, Cultural Proficiency. But, suddenly I was learning from a Native Alaskan that AYI, a program I thought so highly of, was perceived by a lot of native people as negative toward them. I was learning that, no matter how much I might celebrate the value of an individual’s culture and the role it could play in helping him or her, I was not taking into consideration the fact that that individual or his or her family might not appreciate or value my ideas. They might not like or trust the non-Native services I suggested they could benefit from. How could I be so Culturally Proficient and Culturally Blind at the same time? Well it’s easy. It is like that famous George Carlin routine where he describes the fact of life that, “My s____ is stuff, and your stuff is s____!” Because most of us think this way at some level, it takes an extreme effort to reach beyond our comfort zone and begin to think that maybe “Your stuff is as good as or even better than mine!” Or at the very least, “Your stuff might work better for you than mine!” But, it goes even further than that because our society has a bias toward the values of the predominant culture. As a result, we often have to help people from other backgrounds understand that instead of accepting my stuff without question they should look into the stuff from their own culture for all or part of the answer to their problems.
expect them to act and react the same as they do. And when they don’t, the culturally blind make bad assumptions about them and their needs. The middle level is Cultural Precompetence. At this level, there is an awareness that culture matters and we try to accommodate for the difference between and among folks from different cultural backgrounds. However, with precompetence we most often make the judgment that all people from one cultural group are alike. When we do this, we make mistakes, like feeling that we have met the cultural needs of a person with a Latino background by merely giving him or her a Spanish-speaking therapist or case manager. Making assumptions The problem with this is that it is done without factoring in that each Spanish-speaking culture is different and the language is spoken very differently in the various countries. At this level of cultural competence, a worker might make an assumption about a client’s need for a Spanish-speaking therapist based merely on the fact that the client has a Latino surname and/or comes from a predominately Spanish-speaking neighborhood only to find that English is the client’s first language. The next level is Basic Cultural Competence. At this level folks recognize the differences between sub-cultures and more importantly, that not all people from a culture or sub-culture are the same. In fact, some people would rather not identify themselves as being from that cultural group at all. So you might see someone with this level of cultural competence ask a child with a Native American background, “Do you identify yourself as Native American?” And, if the answer is “yes,” then follow with questions about what tribe or tribes he or she is connected to, how connected they are and how connected they want to be, and go from there. The highest level is Advanced Cultural Competence or Cultural Proficiency. At this level, we go the next step. We come to celebrate a people’s diversity and explore with them how that culture strengthens them and where there are helping resources within their culture. We would look with people at their backgrounds and help them see the
Tension points How well do we take into consideration the tension between the predominant culture and the culture of our many Native American tribes in Montana? My student discussed with me the many such tension points between the Native Alaskan and predominant Western-based Alaskan cultures. Maybe the most important of these is the fact that our society did its best to destroy the cultures Continued on next page 19
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struck when I visited the psychiatrist at the Indian Health Service hospital in Bethel, which was part of Continued from Page 21 the U.S. Public Health Service (USPHS). of the native people of this country, and there is At that time, I was working for the USPHS at the still a strong well-earned mistrust toward Western National Institute of Mental Health, in Rockville, values, which includes our understanding of what Md. My first reaction upon entering the hospital was mental health treatment should be. Has Western to notice how much the building was like Rockville, mental health ever incorporated the traditional Naand how little it was like the Alaska I was coming tive concept of the medicine wheel in which holistic to know (it even had the same USPHS clocks on the healing is felt to work by having individuals address wall). My second reaction was more startling. imbalances in their lives by first considering their By the time I got to Bethel, I had been traveling environmental context, secondly using their mind to in the Alaskan bush for only two days but felt like I do reality self-checks, third considering the physifit in. I felt comfortable in the informal bush clothes cal health of their body, and fourth, tending to their I was wearing and felt like I fit into the communispirituality? Have you? ties I was visiting (including Bethel) and had been The circularity of the wheel received well. But all of a sudden as I entered the hospital, I felt out of place. I thought that if I felt so In fact, you might notice that I just took the “circular” concept of the Medicine Wheel and made out of place here in the hospital, how must the Native Alaskans feel. it “linear” by using the words first, second, third Then I met the psychiatrist, who had a strong and fourth in my discussion rather than stressing the circularity of the wheel. I could have edited this German accent and came from the Washington, D.C., area and was talking psychoanalysis to me. sentence to be more circular, but I left it the way it Because I was not really an Alaskan but rather a is to make the point of how easy it is to place our psychiatrist from Maryland I began to feel more Western ways on Native concepts. Has Western mental health ever taken under con- comfortable over the course of this meeting, however I also recognized that my growing comfort level sideration that the “linear” underlying concepts of Cognitive Behavioral Therapy, CBT, (one of our evi- demonstrated how out of place the whole hospital was for the community it was serving. I also learned dence-based practices that we love so much) might that the hospital staff sensing their differences from make no sense at all under the “circular” concepts the Native culture for the most part lived a commuof thinking underlying much traditional Native American thought? Have you? Yet our mental health nity of their own. system urges us to use CBT, regardless of whom we Learn and adapt are using it with. Do our Native American clients feel as out of How well do we take into consideration how difplace in our services as those in the hospital in ferent Reservation lifestyle is from Western? Let Bethel? How about our Latino and African Amerime tell my Alaska story. When I first visited Alaska can clients? (I’ve even come to the understanding in 1985, I was initially taken to the small village of that, in order for me to work in Montana, I’ve had Sleetmute with a population of about 100, then into to learn and adapt for the differences between the Aniak which had a population of about 500 and had predominant culture of Montana versus my home a mental health clinic, and finally into Bethel a city culture of Maryland.) It is important for us to underof about 3,000 with a large Indian Health Service stand these issues and ones we haven’t even thought hospital. about yet before we can truly call ourselves CulturI was struck then by the fact that even when the ally Proficient, or in AWARE lingo, “I’m really okay caregivers were from the community, the menand you’re really okay.” tal health system and values were still Western, ultimately sending the kids with the most severe Dr. Ira Lourie of Hagerstown, Md., serves as problems to Anchorage, Seattle and/or residential AWARE’s senior medical consultant. treatment centers all over the lower 48. I was most 20
Book MARKS Marks BOOK Each issue of AWARE Ink includes books, articles, documents, texts, and even movies recommended by staff, covering a range of topics related to the work we do. This issue features a title suggested by Jeff Folsom, AWARE’s chief operating officer. When asked to identify a handful of books I would suggest to the AWARE Ink ‘Book Marks’ I vacillated between favorite books, service related books, books that have become reference points or simply my most recent reads which have the benefit of still being fresh on my mind. I am not sure how or if I decided to solve this challenge. If a theme is here, I will let you make that determination.
crew survived the ordeals thanks in no small part to Shackleton’s leadership. Beyond Difference Al Condeluci Condeluci’s work with people with disablilities fits hand in hand with the philosophy and approach we have developed at AWARE. He understands and explains how the institutions and structures that we work within for our clients are often counterintuitive from a strengths based unconditional care approach. The book describes our role in creating bridges and fostering interdependence with those who are different than we are whether from disability or other reason.
The Careless Society: Community and Its Counterfeits John McKnight I use this as an assigned reading in a social work class I teach in Missoula from time to time. It is a provocative read, challenging the basis of how and what we provide as human service providers. As human service systems have grown to a full-blown industry, what has become of the fundamentals of family and community relative to meeting the needs of our “clients.” McKnight reminds us that as “experts” we are limited and at times may have a disabling effect of our own.
Touching the Void Joe Simpson Touching the Void is a non-fiction account of a climbing accident and one mans remarkable survival. Life changing decisions’, despair, hope, possibility and incredible resiliency are all captured. This is another one of those inspiring books that puts your day-to-day challenges in context.
Shackleton’s Way: Leadership Lessons from the Great Antarctic Explorer Margot Morrell Stephanie Capparell
Illusions Richard Bach
For anyone who does not know this story, seen the movie or read this book, this is a must read. Sir Ernest Shackleton is often cited as the greatest leader bar none despite his numerous failed efforts to reach the South Pole and Antarctica. This book focuses on his two-year expedition to Antarctica in 1914. At once, Shackleton’s Way is a great adventure story and a model of great leadership and guidance in a time of crises. The expedition was entrapped in the ice of the Antarctic Circle for 10 months, only to have the ship crushed and leave the crew shipwrecked for another five months before some of them set sail across 800 miles of open sea in lifeboats to seek rescue. All of the
In this tale, the Messiah returns to the Midwest. Flying small planes and unable to manage the pressures and demands the people place on him to perform miracles and make them happy, he quits. The book follows his path as he tries to recruit a traveling companion to take the job. His companion is reluctant, but through the use of the “messiah’s handbook” we examine the world around us and challenge what we believe to be the obvious truths and understanding of ourselves. Continued on Page 22
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Everything is Normal Until Proven Otherwise Ira Lourie Karl Dennis This book has been reviewed and discussed several times in Book Marks, but I list it still. Wraparound philosophy, wraparound services, wraparound care…. “wraparound” is a phrase that has been thrown around
many times in many ways. At risk is the diminishment of an important body of work. Everything is Normal provides a firm foundation of the principles and elements of partnering with families that truly captures the essence of what we hope more and more families will experience. As we move beyond wraparound in the years to come I believe Karl’s stories and Ira’s discussion provide an invaluable platform to develop more and more meaningful gains for families.
COMING EVENTS September 15 ADA Audio Conference Series: Accommodating College Students with Autism and Other Intellectual Disabilities Noon – 1:30 p.m. Teleconference, streaming audio via the internet, realtime captioning via the internet Contact: (877) 232-1990
9:30 a.m. – 5:00 p.m. Monday 8:30 a.m. – Noon Tuesday Hilton Garden Inn: 2023 Commerce Way, Bozeman Contact: Barbara Kriskovich (406) 496-6086 September 24-25 Disability & Work: Using Social Security Disability Programs to Move People Out of Poverty 9:30 a.m. – 5:00 p.m. Thursday, 8:30 – 12:00 pm Hilton Garden Inn: 939 25th West, Billings Contact: Barbara Kriskovich (406) 496-6086
September 16 The Financial Side of Self-Employment Time TBA Webcast Contact: (804) 828-1851, tcblnake@vcu.edu
September 24-25 20th Annual McGuire Memorial Conference on Family Violence Time TBA Billings Clinic: corner of 9th and 27th streets., Billings Contact: Billings Clinic
September 16 Autism: Causes and Management 6:30 – 8:30 pm Glendive Public Library: 200 S. Kendrick, Glendive Contact: Pete Bruno (406) 377-7515
September 28-30 Montana Nonprofit Association Annual Conference Starts 8 a.m. Monday; ends 4 p.m. Wednesday Holiday Inn Downtown at the Park: 200 South Pattee, Missoula Contact: Gail Brockbank (406) 442-4141
September 17 Mental Health Oversight Advisory Council 10 a.m. Disability Rights Montana: 1022 Chestnut, Helena Contact: Marlene Disburg (406) 655-7660
October 5 Statewide Independent Living Council 1 p.m. Summitt Independent Living Meeting Room: 700 Southwest Higgins, Missoula Contact: Mike Hermanson (406) 444-4175
September 18 Mental Health Oversight Advisory Council 8:30 a.m. Brondel Center – St. Helena Cathedral: 530 N Ewing, Helena Contact: Marlene Disburg (406) 655-7660
October 6 Family Health Advisory Council 10:30 – 12:00 pm Diane Building conference room and teleconference Contact: Jo Ann Dotson (406) 444-4743
September 21-22 Disability & Work: Using Social Security Disability Programs to Move People Out of Poverty 22
October 7-9 MAR/Transition Conference 2009 Time TBA War Bonnet Inn, Butte Contact: June Hermanson (406) 442-2576
October 9 Diabetes Care in Montana 2009: Back to Basics 8 a.m. – 5 p.m. Crown Plaza Hotel, Billings Contact: Susan Day (406) 444-6677
October 8 Diabetes Care in Montana 2009: Back to Basics 5:30 – 7 p.m. Location TBA Contact: Susan Day (406) 444-6677
October 15-16 MEA-MFT Educators’ Conference Time TBA Billings, Location TBA Contact: (406) 442-4250
The Big picture Anaconda artist Roger Wyant is known across the state for his sweeping murals. His Anaconda portfolio includes a panoramic South Seas theme at a local casino and stunning views of the Anaconda Range on the outside and inside walls at the Mesquite Bar & Grill. Wyant also enjoys a reputation for his wildlife art. He recently put his talents to work for AWARE, painting the corporate logo on the Recycling Center at 200 North Polk in Anaconda. Photos by Jim Tracy
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AWARE, Incorporated
205 East Park Avenue Anaconda, Montana 59711 1-800-432-6145 www.aware-inc.org
Printed on recycled paper
Congress...
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ditional care principles, are chosen based upon nominations from their peers. An election will be held in October for AWARE employees who would like to serve as a delegate representing either their specific service throughout the state or all AWARE staff and customers in their area. Delegates serve a two-year term. They must be nonmanagerial and must attend the three-day session in December. Leading up to the session, delegates will be supported as they gather information from constituents that will help them write a truly representative bill for the session. The following service delegate positions are open: Comprehensive School and Community-based Treatment Youth Case Management Targeted Case Management Adult DD Residential Services Early Head Start Autism Residential Services Transportation Services
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The following area delegate positions are open: Butte/Dillon Eastern Montana Helena/Great Falls Galen Anaconda If you are interested in running for one of these positions, please inform your supervisor and tell him or her that you would like to be placed on the ballot for the October election. Please specify what position you will be running for and write a short paragraph that explains to your colleagues throughout the state why you are running and what you feel you can offer at Corporate Congress. This process is a one-of-a-kind opportunity to help make AWARE’s services better across the state. Many organizations talk about listening to staff; AWARE listens, documents and implements the recommendations of its staff and customers. Please consider representing your service or your area. If you have questions about Corporate Congress, the process or the expectations, please feel free to contact Tim Pray at 406/563-8117, extension 15.