The MacDonald Training CenterThe MacDonald Training CenterResidential Services ModelResidential Services Model

October 15, 2009October 15, 2009

We currently serve a total of 65 people in our residential services

Live-In IHS = 38 33 = 3 to 1 (11 settings) 4 = 2 to 1 ( 2 settings) 1 = 1 to 1 ( 1 setting)

Non Live-In IHS = 7 4 = 2 to 1 ( 2 settings) 3 = 1 to 1 ( 3 settings)

Supported Living Coaching only = 20

Current Service ConfigurationCurrent Service Configuration

Adults with a wide variety of needs including:•Walkers•Wheelchairs•Expressive communication challenges•Receptive communication challenges•Incontinence•Behavioral challenges – typically interpersonal in nature

The range of services & supports is determined by the individual with help from family and friends

Service Needs AddressedService Needs Addressed

Live-in HIS

Weekend & vacation relief

Non live-in HIS

Supported Living Coaches

Team leaders

Staff CoverageStaff Coverage

No campus setting

Highly flexible

Highly mobile

Focused & responsive to personal choice

We perceive our community as the entire Hillsborough County / Tampa Bay area

Outstanding CharacteristicsOutstanding Characteristics

North HillsboroughNorth Hillsborough CountyCounty3 to 1

2 to 1

1 to 1

MTC locations

A lot of socializing between and among homes and individuals

Significant interaction with families, including the live-in companion

More one-on-one contact with neighbors

Less restrictive than a group home

More restrictive than a person living alone

Community & Natural SupportsCommunity & Natural Supports

Eating out a lot …Hyatt at Disney

Theme parks – Busch Gardens, Adventure Island, Disney, etc.

Day cruises

A lot of drive-in movies

Beaches

Camping

Social Life & EventsSocial Life & Events

Spontaneous nights out•See it on TV and go…follow the coupons

Moving closer to friends•Bay Waters apartments…1-2-2•Country Wood apartments…1-1-1-2

Social Life & EventsSocial Life & Events

Day services - Live skills• Meals on Wheals• Food Bank• Humane Society• other volunteer opportunities

Day Services – Job skills•Job club•Job searches & related activities

Day Services – Art•Museums•Exhibitions

Meaningful Days & Meaningful Days & Community ContributionsCommunity Contributions

Year-by-year leases allow mobility annually

Always asking or listening to what we are being told

Decisions in the homes made individually or by consensus

If new residence is needed, the residents make the choice

(Example: did not close home when only one person was in residence)

Individual ChoiceIndividual Choice

We adjust our residential services model based on the needs and choices of the people we serve

We modify homes as needed…sometimes at our own cost

We are working on serving individuals with complex challenges•Currently limited by APD’s refusal to fund

Addressing Change in the Lives Addressing Change in the Lives of the People We Serveof the People We Serve

Waiver Support Coordinators

Supported Living Coaches

Family members

Day services team members

Team leader visits

Regular medical visits

OversightOversight

Intensive training by RN

Fire drills

Disaster drills

Teaching individual survival skills

Working in teams with 24/7 back-up

Safety as a FactorSafety as a Factor

Low turnover means the companions know the individuals (non-verbal communication)

Individuals look out for each other

Risk management assessments

Safety as a FactorSafety as a Factor

All staffed trained by RN

RN on call 24/7

RN & SLC’s coordinate with doctors•SLC’s take the lead

Access to Medical & Access to Medical & Mental Health ServiceMental Health Service

No zoning issues

Any and all residential areas are an option

Shop the market

Negotiate rents (MTC underwrites so rents are secure)

High mobility & year-to-year leases maximize options

Housing & AffordabilityHousing & Affordability

For MTC

Flexibility in creating new living situation• No zoning issues

Very little turnover•Experienced, stable staff that communicate effectively

Conducive to the use of self-directed teams

Advantages & StrengthsAdvantages & Strengths

For the people we serve

Mobility in housing

Greater mobility & exposure in the community…or not•Ex: Plant City…we never see your vans anymore

Stability•Typically only 2 or 3 companions a year so relationships are personal in nature

Advantages & StrengthsAdvantages & Strengths

For the people we serve

More contact with neighbors resulting in natural supports

Privacy •Private rooms

Near total reduction in attention seeking behaviors

Advantages & StrengthsAdvantages & Strengths

Finding quality live-in staff can be a challenge and can take time

APD has repeatedly refused to fund additional 1/4hrs of IHS services for people with extra ordinary needs•We are currently funding 3•We have lost others to nursing homes prematurely•No aging in place with dignity

Currently looking at technology as a way for addressing future service needs in a hostile funding environment

Disadvantages & WeaknessesDisadvantages & Weaknesses

Betty BeauchaineBetty Beauchaine

Steve BeauchaineSteve Beauchaine