NYSACRA

New Residential Option Design in the Crawford Community Residence

Crystal Run Village, Inc. (CRV) is applying to the NYS-OPTS pilot program to create a new residential option designed in specific response to several needs expressed by parents/guardians and by many of the 12 people living in our Crawford Community Residence. PART II: EXECUTIVE SUMMARY Crystal Run Village, Inc. (CRV) is applying to the NYS-OPTS pilot program to create a new residential option designed in specific response to several needs expressed by parents/guardians and by many of the 12 people living in our Crawford Community Residence. Given the swiftly changing mobility and/or medical needs of several current residents of the home, coupled with the outstanding needs of others living in the Orange County area, we recognize that we must make better use of this space, as we have a limited number of single level homes in the Orange County area. We are simultaneously working to honor the friendships and preferences of all persons affected by this pilot project. A second home is needed to accommodate some people who will move on from this location, and will address a variety of other concerns voiced by current residents- that of the need for more privacy, physical space and staff time to increase their presence in community life. The need to address conditions related to the aging process and changes in physical needs for people we serve has been identified in our agency strategic plan and is a top concern for our Board of Directors; in addition to reigning high among the topics discussed at a retreat this summer by members of a self-advocacy group from the Orange County area. Indeed, this area of concern has taken precedence throughout the agency and is prevalent in discussions in house meetings and private conversations with the people who currently live in the agency’s homes, notwithstanding as a constant topic at the Crawford House. In determining the best course of action, we have had conversations with people who currently live at the Crawford Community Residence, their parents, guardians, and /or advocates, current and past staff, and their Medicaid Service Coordinators. Communication is ongoing with subtle changes still to be expected as the process continues to unfold. A committee was appointed by our Executive Director in March 2004 and members have been meeting regularly to work with the residents of this home to determine where and with whom they would like to live. Over the months, several options have been discussed with residents, families, service coordinators and members of the Hudson Valley Developmental Disabilities Services Office (HVDDSO), leading us to the current proposal. Our plan is to make optimal use of this 8 bedroom, single level Community Residence located in the Town of Crawford in Orange County, by relocating some people to a separate, single level home with people they have chosen as housemates, while redesigning the Crawford home to accommodate the changing mobility and medical needs of 4 current residents who have chosen to live together, and providing a more appropriate environment for one gentleman who was a former resident in Crawford who shall be returning to us from a rehabilitation center in several months. This project also will include a man who now lives at our two- story Minisink IRA, as he presently has a strong need to move to a single level home in the Orange County area. In addition, two men who currently live in the home will move to another CRV Orange County area home. One man has advocated for this change himself, and has the full support of his family and will be living in closer proximity to them. The second man does not need to live in a single level home, has no medical conditions, and his team feels he may be better served by living with a younger group with whom he previously resided on the Middletown campus who are more active in their community. While he has not voiced any displeasure in his home, we feel that we need to advocate on his behalf to improve the scope of community options available to him. Presently, we are involved in coordinating continued visits to several homes to assist the two men in their decision-making process. We also intend to create a respite bed as a step-down for people coming out of rehabilitation centers or hospitals that receive services within our agency as well as others in the local region. At any given time, one or more persons receiving residential services from our agency are hospitalized simply because they have either inadequate clinical supports to expedite a discharge or they live in houses that are bi-level and cannot ambulate stairs until healed. We have met with Steve Diener of the HVDDSO and are presently involved with a consultant from the Center for Discovery to assist us with our plans for redesigning the Crawford home to specifically accommodate the mobility needs of people involved in our proposal. Six of the eight bedrooms will be for permanent residents, one will become the respite bedroom, with the remaining room being converted to a therapeutic environment to assist people with physical and occupational therapies, as well as individualized recreational pursuits. The enriched staffing, nursing and therapeutic modalities planned will benefit all. Our evaluation for the project shall include a pre and post satisfaction survey tool. We have revised our current Consumer Satisfaction Survey tool with input from members of the Orange County based Wishes and Dreams self-advocacy group. This tool includes a section to elicit responses to open-ended questions to ensure a qualitative tool that addresses each person’s subjective experience balanced with an objective quantitative component. It shall be completed with each individual with assistance from their Medicaid Service Coordinator prior to the NYS-OPTS program changes, and again after settling into the new location. Areas of need will be identified and formally addressed. This tool shall again be revisited as part of the next formal program-planning meeting to insure follow through of outstanding items. Subsequently, the tool shall be administered each year, or as often as the person, family or advocate requests. In addition, people involved in this project shall be mapped over the course of several years. We shall use the Personal Futures Planning method developed by Dr. Beth Mount and shall complete one to two maps at each ISP/ RHP/ DHP meeting. The components that are identified in each map as areas of need and/or desire will become the formal goals for each person for the next six-month period. Clinical Coordinators shall be the facilitators of the mapping process, with residential, day program and service coordination staff assisting in insuring needs are met that are meaningful and related to the individual’s valued outcomes. The combination of administering a consumer satisfaction tool, complemented by a mapping process that will be formally incorporated into each person’s ISP will be effective measures of people’s desired outcomes. Data shall become the quantitative method for insuring that the individual’s qualitative needs and desires are met. Once the 5 basic and optional maps are completed, the planning meetings shall continue as part of the ISP/RHP/DHP meetings to review the personal futures plan. This shall provide a formal mechanism to move the process forward, to note and review accomplishments, determine if changes need to be included, and to insure the circle of support continues on to assist the individual with realizing their personal vision for their future.