Montana. Dept. of Social and Rehabilitation Servic.

Social services block grant for Montana / Dept. of Social and Rehabilitation Services (Volume 1985) online

. (page 2 of 3)
Online LibraryMontana. Dept. of Social and Rehabilitation ServicSocial services block grant for Montana / Dept. of Social and Rehabilitation Services (Volume 1985) → online text (page 2 of 3)
Font size
QR-code for this ebook


into community life with each client's health, safety and
well-being insured in each residential setting. Opportuni-
ties for socialization and the development of leisure time
skills are also available.

The primary goal of Residential Services is the provision of
instruction and intervention in accordance with the develop-
mental model and the principal of normalization. The pro-
vision of service is directed towards maximum skill acquisi-
tion in order to increase personal independence.

Each client's Individual Habilitation Planning Team provides
the general goals and specific objectives towards which each
residential service directs it's efforts. The IHP, based
upon the results of a formal assessment and identification
of client needs, also specifies the appropriate residential
alternative in which services will be provided.

14



Each residential service coordinates it's service activities
with those of other specialized services such as: day habil-
itation, special education and other generic coimnunity
services .

Adult Intensive Training Community Homes are licensed,
family oriented living arrangements in which four to eight
adults clients, not less than sixteen years of age, reside
under the supervision of specially trained staff.

The individuals who receive services in intensive training
homes display fewer self-help skills and/or more severe
problem behaviors than the clients found in typical adult
community homes have been screened against a standard
"intensive needs" assessment and have been determined as
inappropriate for placement in less restrictive residential
settings.

Training is provided in a highly structured environment, by
staff who are sophisticated in the skills of behavior
management. Training focuses on the behaviors necessary to
maintain the individual in the community-based service
system and, if possible, move to a less restrictive setting.

1) Individual Self Help Skills, such as toileting, eating,
dressing, bathing, hair care, grooming, health care,
motor skills, social interaction, and sexual awareness.

2) Home Related Skills, such as clothing care and
selection, household chores, cooking, response to
emergencies, home repair and maintenance, time telling,
leisure and recreational skills, and telephone use.

3) Community Awareness Skills such as shopping skills,
transportation, restaurant use, and safety and traffic
signs .

4) Leisure and Recreational Skills, such as hobbies,
sports, and games.



VIII. RESIDENTIAL SERVICES - SENIOR ADULT COMMUNITY HOME

The purpose of Residential Services is to provide a continu-
um of living arrangements to meet the needs of senior
developmentally disabled clients and to facilitate their
integration into community life with each client's health,
safety and well-being insured in each residential setting.
Opportunities for socialization and the development of
leisure time skills are also available.



15



The primary goal of Residential Services is the provision of
instruction and intervention in accordance with the develop-
mental model and the principal of normalization. The pro-
vision of service is directed towards maximum skill acquisi-
tion in order to increase personal independence and main-
tenance of current skill levels.

Each client's Individual Habilitation Planning Team provides
the general goals and specific objectives towards which each
residential service directs it's efforts. The IHP, based
upon the results of a formal assessment and identification
of client needs, also specifies the appropriate residential
alternative in which services will be provided.

Each residential service coordinates its service activities
with those of other specialized services such as: day habil-
itation, special education and other generic community
services.

Senior Adult Community Homes are licensed family-oriented
living arrangements in which two to eight clients reside
under supervision of community group home trainers. Clients
are determined to be appropriate for this service by their
Individual Habilitation Planning Teams by virtue of their
age, functioning levels and desires. Each senior client is
provided habilitation services which include general care,
supervision, guidance, organized group activities,
maintenance of previously acquired self-help and social
skills and training in leisure-type activities.

The main purpose of Senior Adult Community Homes is to
maintain appropriate community placement and to prevent
needless institutionalization (e.g., nursing home) through
the provision of services determined necessary by the
client's IHP Team. Senior Adult Community Home services
should be flexible enough to provide for each individual's
personal needs, goals and desires.

1) Individual Self Help Skills, such as toileting, eating,
dressing, bathing, hair care, grooming, health care,
motor skills, and social interaction.

2) Home Related Skills, such as clothing care and
selection, household chores, cooking, response to
emergencies, leisure and recreational skills, and
telephone use.

3) Community Awareness Skills such as shopping skills,
transportation, restaurant use, and safety and traffic
signs.

4) Leisure and Recreational Skills, such as hobbies,
sports, and games.



16



IX. TRANSITIONAL LIVING TRAINING

The purpose of Transitional Living and Training Services is
to assure that each individual receives habilitation
services designed to enhance the independence of that
individual who is at least eighteen years of age.

The Individual Habilitation Planning Team determines the
readiness of each individual to receive these services ac-
cording to established criteria as well as the degree and
amount of guidance and training each individual will
receive.

Each individual is provided the following habilitation ser-
vices, which include: guidance; home and community life
training; client service coordination and support in varying
degrees of intensity.

Transitional Living and Training Services are provided to
individuals residing in a Transitional Living environment.
Individuals receiving services in Transitional Living and
Training Services display fewer independent living skills
and/or less preparedness for community living and usually
require more structured living environment and training
and/or more supervision/assistance than individuals in
Independent Living Training.

Transitional Living and Training Services include the
following components:

1) Training is directed toward advanced skill training in
personal, home, and community life skills. Training
occurs within the natural environment and addresses
naturally occurring demands and contingencies. Train-
ing areas include:

a) Advanced Personal Skills, such as grooming, health
care, social interaction, sexuality, and clothing
care and selection.

b) Home Related Skills, such as household chores,
cooking, response to emergencies, home repair and
maintenance, time telling, leisure time skills,
home safety, and money management.

c) Community Life Skills, such as utilization of
community services, transportation, restaurant
use, community recreation, safety and traffic
signs, social behavior, and shopping skills.

2) Service Coordination involves assisting DDD and/or
social service staff in locating, developing and coor-
dinating community generic services which support
clients being served.



17



3) The Provider must present documentation upon request
that the 24 client supervision is available on a
regular basis and upon immediate need of each
individual. Client Supervision is for safety,
habilitation, crisis intervention, and advocacy for the;
client.

4) Evaluation involves bringing a prospective client
on-site to be evaluated by Transitional Living Staff.
The evaluation will at least address those necessary
skills, listed in the programs entrance criterion and
supervision criterion, so as to provide adequate
information to the screening committee for the process
of actually selecting a client for a vacancy.



INDEPENDENT LIVING TRAINING

The purpose of Independent Living and Training Services is
to assure that each individual receives habilitation
services designed to enhance the independence of that
individual who is at least eighteen years of age.

The Individual Habilitation Planning Team determines the
readiness of each individual to receive these services
according to established criteria as well as the degree and
amount of guidance and training each individual will
receive.

Each individual is provided the following habilitation
services, which include: guidance, home and community life
training, client service coordination, support, and follow-
along in varying degrees and intensity according to each
individual's need.

Independent Living and Training Services are provided to
individuals who reside in neighborhood housing located
throughout the community. Individuals receiving services
in Independent Living and Training Services require minimal
supervision/guidance but require periodic contact to
maintain a more independent style of living.

Independent Living and Training Services include the follow-
ing components:

1) Training is directed toward advanced skill training in
personal, home and community life skills. Training
occurs within the natural environment and addresses
naturally occurring demands and contingencies. Train-
ing areas include:



18



a) Advanced Personal Skills, such as grooming, health
care, social interaction, sexuality, and clothing
care and selection.

b) Home Related Skills, such as household chores,
cooking, response to emergencies, home repair and
maintenance, time telling, leisure time skills,
home safety, and money management.

c) Community Life Skills, such as utilization of
community resources, transportation, restaurant
use, community recreation, safety and traffic
signs, social behavior, shopping skills.

2) Service coordination involves assisting DDD and/or
social service staff in locating, developing and coor-
dinating community generic services which support
clients being served.

3) Minimal guidance is provided to individuals receiving
Independent Living Training Services for emergencies on
an on-call basis.

4) Support services include assisting clients upon their
request, when a need arises, or upon the direction of
the IHP Team.

5) Follow-along services are intended for those clients
meeting program exit criterion and agreement by the IHP
Team. Follow-along services are implemented through a
written plan determined by the IHP Team. These serv-
ices are provided when appropriate, and when no other
or insufficient services are available.

6) Evaluation involves bringing a prospective client
on-site to be evaluated by Independent Living Training
Staff. The evaluation will at least address those
necessary skills, listed in the programs entrance
criterion and supervision criterion, so as to provide
adequate information to the screening committee for the
process of actually selecting a client for a vacancy.



XI. FAMILY TRAINING AND SUPPORT SERVICES

The purpose of Family and Children Services is to provide
training, information, and support services to families to
assist in the development and care of their child who is
developmentally disabled or at risk. These services are
coordinated with other generic and specialized community
services. The major goal of Family and Children Services is



19



to assist the natural or foster family in maximizing the
developmental potential of their child and to maintain their
child in the appropriate least restrictive environment.

Within this area of service, the following types of services
are provided to eligible children and their families based
upon their needs.

1) Family Training Services are provided to assist the
natural or foster family to maximize the developmental
potential of their child by training the family to
train the child. There are two types of Family
Training.

a) Family Focused Training is directed towards
enabling family members to function as
independently as possible in providing or
obtaining needed services for their child so that
the need for Family and Children Services is
reduced or eliminated.

b) Child Focused Training is directed towards
enabling family members to conduct specific skill
acquisition or behavioral intervention programs
with their child in order to teach the child new
skills, enhance development or otherwise alter the
child's behavior.

2) Client Training is direct training by provider staff
with a child living in a natural or foster home for the
purpose of skill acquisition or behavior deceleration.
Major training responsibility is not shared by the
parent or family members.

3) Resource and Support are services provided by provider
staff directly to a family or their child to assist in
the development and maintenance of the family unit
and/or the child. These services are individualized
according to family needs.

4) Service Coordination is provided through working with
other Agencies on behalf of the family or child. The
goal is to assist the family in obtaining all necessary
and appropriate services and promote coordination of
these services.

5) Information and referral is the provision of a service
by provider staff which directs families not currently
on the provider case load to the most appropriate
available services which meet their needs and provides
any information requested by families.



20



XII. SPECIALIZED FAMILY CARE SERVICES

The purpose of Specialized Family Care is to prevent place-
ment out of family settings, and to create movement to
family settings from more restrictive environments for
children with intensive needs.

By providing additional components to existing resources
that would otherwise not be available, a comprehensive
package of services is made available to enable foster and
natural families to return the severely handicapped child to
a home setting, or to maintain the child in a home setting.

The goal of Specialized Family Care is to provide a
specialized array of services including case management,
resource/services, and purchase of subcontracted services
which are designed to maintain children in home settings v/ho
would otherwise require placement in a more restrictive
setting. These services will include activities/services
accomplished by provider staff, family, contracted
personnel, or other agencies/professionals.

Case Management Services generally involve developing,
coordinating and monitoring of services to clients with
intensive needs and their families.

Due to the intensive needs of the child and thus, of the
child's family, specialized resources and services will be
made available to further assist the family in caring for
the child and maintaining the current family placement.

Eligibility ; Children in natural homes, foster homes, group
homes, nursing homes and institutional settings who are
determined to have the characteristics described below are
to be considered for services.

The program will serve those developmentally disabled
children (less than 22 years of age) who are determined by
the Contractor or a statewide review panel to meet the level
of care requirements defined in ARM 46.12.1303. That is:

1) without specialized services they would be in jeopardy
of institutional placement due to the inability of the
natural or foster family to maintain the child in the
home without additional resources; and

2) they have one or more of the following characteristics:

a) they are severely/profoundly mentally retarded,
including extreme deficiencies in self-care and
daily living skills as compared to age peers;



21



b) they have significant maladaptive social and/or
interpersonal behavior patterns which require an
on-going supervised program of intervention; this
may include autism or autistic-like behaviors;

c) they have severe medical or health related related
problems (e.g., sensory or physical deficits)
requiring substantial care; and

3) they are determined to be Medicaid (assuming waiving of
deeming) eligible.

In addition to the severity of a child's disability and the
degree of stress caused by the care for a child, for
purposes of client selection, higher priority will be given
to children who are more likely to move to a more restrictve
setting.



XIII, RESPITE CARE SERVICES

Respite Care Services provide for temporary relief to
natural or foster parents from the continuous care of an
eligible developmentally disabled or "at risk" family
member. Respite Care Services are comprised of two
component services.

Respite Care providers develop and maintain lists of
individuals who have been appropriately trained and are
available to provide respite care. They also disburse
funds, as appropriate, to families in need of respite care.-
Payments are made directly to the family (not the
caregiver) . Except as approved in writing by the
Provider Board of Directors, the maximum payment to
each family is $360.00 per year.

Contractors maintain a current list of caregivers who are
available to provide respite care within a given community
and provide an orientation to all respite caregivers.



XIV. EVALUATION AND DIAGNOSIS SERVICES

The purpose of a Transdisciplinary Evaluation Service is to
(in part) identify presence/absence of handicapping condi-
tions, determine client needs, formulate specific recom-
mendations to address those needs, or select treatment/
intervention alternatives. Further, when appropriate, the



22



transdisciplinary evaluation staff should see clients for
the purpose of making statements regarding the rate of
progress as well as prognosis. Not infrequently the purpose
of evaluation services varies widely as a function of the
questions/concerns stated at the time of referral. Example:
"Does this child hear?" "Is this child generally delayed?"
"Are the existing program goals and objectives appropriate?"
etc. Evaluation Service then, is a multipurpose activity
that has the potential for making substantial change in the
daily routine of each and every client seen.

Service components include intake, case coordination,
evaluation, case conference, treatment plan, interpretation,
and follow along.



XVi ADAPTIVE EQUIPMENT PROGRAM

The purpose of the Adaptive Equipment service program is to
provide specialized (custom designed) adaptive equipment and
program consultation to multiply handicapped developmentally
disabled clients in the state of Montana. The primary aim
of the service is to enhance the functioning ability of each
client through proper positioning and self-care aids.

Clients are evaluated in their living environments to insure
that appropriate and realistic recommendations are estab-
lished.

All clients on active status receive consistent follow-up to
assure that equipment and/or program recommendations are
still appropriate for the clients. Changes are made
on-going based on the outcome of the follow-up reviews.

The aim of the adaptive equipment program is to provide
specialized equipment and consultation for programming only
when local resources are unavailable for such programming.
It would be to the benefit of the client to utilize these
local resources.



XVI ^ INTENSIVE ADULT HABILITATION SERVICES

The purpose of Adult Habilitation Services is to provide
functional training in non-residential settings which is
based on the Individual Habilitation Plans of Development-
ally Disabled Adults. Adult Habilitation Services includes
training which addresses basic life skills, pre-vocational



23



skills, work activities, sheltered employment skills, reduc-
tion of behavior problems and increasing socially appro-
priate behaviors. Training is generally directed toward
skills pre-requisite or integral to vocational activities.
Adult Habilitation Services direct their training activities
toward movement of individuals to increasingly higher levels
of independence.

Intensive Adult Habilitation programs are vocationally
oriented physical and/or mental habilitation programs serv-
ing adults with physical and/or mental handicaps. These
programs are oriented toward serving the more severely
handicapped person and is dedicated to the philosophy that
work can be meaningful, challenging and rewarding to all
people.

The individuals who receive services in intensive adult
habilitation display fewer self-help skills and/or more
severe problem behaviors than the clients found in typical
adult habilitation, have been screened against a standard
"intensive needs" assessment and have been determined as
inappropriate for placement in less restrictive adult
habilitation settings.

Training is provided in a highly structured environment, by
staff who are sophisticated in the skills of behavior
management. Training focuses on the behaviors necessary to
maintain the individual in the community-based service
system and, if possible, move to a less restrictive setting.

The Intensive Adult Habilitation Program provides at least
the following areas of training:

1) Individual self-help skills, such as toileting,
feeding, dressing, bathing, hair care, grooming, health
care, fine and gross motor skills, social interaction,
sexual awareness, mobility, care of mobility devices,
and communication.

2) Home related skills, such as clothing care and
selection, household chores, cooking, use and care of
refrigerator, stove, microwave, dishwasher, washer and
dryer, responsiveness to emergencies, leisure skills,
recreational skills, telephone use, lunch making,
nutrition, and preparation, wrapping and storage of
food.

3) Community awareness skills, such as shopping,
transportation, restaurant use, and safety and traffic
signs.

4) Leisure and recreational skills, such as hobbies,
sports, and games.



24



5) Vocational behaviors, such as independence,
dependability, appearance, initiative, versatility,
work attitude, honesty, break behavior, relating to
supervisor, relating to co-workers, appropriate sexual
behavior, work safety, employer property, work area,
job assignment, productivity, and work quality.

6) Specific vocational skills, such as mailing (collate,
stuff, staple, fold, label, seal); packaging (patient
kits, small items) matching; wrapping; sorting; small
assembly; color and shape identification; use of button
machine; use of sewing machine; and pen assembly.



D03/a



25



PUBLIC LAW 98-473 Funding Plan

(

Public Law 98-473 provides funding for scaces to addres-. th.
problems of abuse occurring in child Sare facilities The LnS^
available are to combac child s^-xuni =k,,o^ 7^^ tunds

other facilities for chilSJen ?ht intent o? ttl T^^ "^'"^' ^^^

ground checks, and training of child care workers =^^=^s. back-

According to Section 401 of Public Law 98-473' Title IV t-h^
allotment being made available may be used onlv for rhl r,™ ^

.._. The amount available for Federal Fiscal Year for Montana is $86,008,



IMPLEMENTATION



and oS!sS„i%«ii> :^f c^ih^nri ^Li^iiici/— ^"^ "^ "^-^^-

SELECTION

licen^ino foer ^^>=^^^^Y^^S ^^^ ^^^e homes, group day care and
coSdCltSa b?'stIte°T!Iensine's?af? ^"^^-P^i^hed after' interviews are
homes, day caJe centers and ch?f^ ^°^^'^' ^"""^ managers of group
Child carJ sSf"in'those'?acilitier" "^^"'^^^^ generally hire the

or the'fac'Ility "Jls'criticar'?^ ' ^"°^^^^ '^ '^"^ ^^^ ^^^ ^""
Che succec:^ oF : 1- critical The process muse be able to predict

who would nr! "^P^""'^" ^\''f^^ ^^ screen out inappropriate applicants
wno would present possible risks to the children in care.



ONGOING TRAINING

There is an ongoing need for staff in child care programs to be
aware of the specific purpose for the care being provided, the
components necessary to provide quality programs and their role in
the provision of adequate and quality care.



26



22,004



BUDGET

1. Development of an assessment process to include
employment history checks, non employment background inform-
ation such as education and organizational affiliates and when
■appropriate, criminal record checks. This will be developed for
the three categories of day care, foster care and residential
care

2. Development of screening processes which will insure
the selection of qualified and skilled care care workers for

the three categories 2T, 00.4^

3. Provision of training programs for staff to include
purpose, components of program, staff role clarification and
specific skill development to deal with children placed from
risk situations. Other skill development areas will include


2

Online LibraryMontana. Dept. of Social and Rehabilitation ServicSocial services block grant for Montana / Dept. of Social and Rehabilitation Services (Volume 1985) → online text (page 2 of 3)