Coming Attractions

As the year comes to a close, I thought I’d share some issues currently on my mind surrounding the funding and delivery of services to individuals with intellectual and developmental disabilities locally, across Colorado, and across the country. I’m not going to go into details here, but expect to see posts on the subjects below in the coming year. I am going to take the next couple of weeks off from making posts, but I’ll be back and raring to go in 2014.

In the meantime, here’s what I'm thinking about as we look forward to a new year:

• Contradictions are everywhere in our system and field. 
• System instability, turnover, and leadership for the future are big concerns of mine. Are we set for another 50 years at Imagine!? Outside Imagine!? 
• Can we move beyond some of the outdated ideas about training in our field? Does every training need to be live? Can’t we embrace technology to be more efficient and cost effective in how we are preparing our employees for their jobs? 
• In fact, let's talk more about all sorts of emerging, available, and ignored technologies. We should start including cost benefit comparisons in those discussions. The results may be quite illuminating. 
• Conflict Free Case Management - let's get the whole picture. 
• Waitlists for services – is there an end in sight? Should CCBs be managing the waitlists? Should there be waitlists at State Operated Regional Centers? 
• Where do the best ideas come from? They may be closer than you think. 

What issues or concerns do you see for the coming year? Feel free to post in the comments, and I will talk to you in January!

50 Years, 50 Stories - Ashley Himber

The stories keep coming, so we’ll keep publishing them! This bonus edition of “50 Years, 50 Stories” comes from Ashley Himber, who shares her experiences from the early days of Imagine!’s Out & About department.

Thanks for sharing, Ashley!

When The South Meets West 

By Ashley Himber 

Ashley Himber (center) with Lisa Fiero (left) and Colette Marie.

I, Ashley Himber, am the true Southern Belle. I love my football, mud, and hunting. My personality is that of charm with just a tad bit of sassiness. Well, that was the case until May of 1999, when I joined an organization called Out & About, a division of the Developmental Disabilities Center of Boulder County. Yes, it was still the DDC when I started there! I was Out & About's first Therapeutic Recreation intern, and my supervisor was Ansley Dickens, another southerner from Georgia. I thought, “what's up with this place attracting us southerners to the mountains?” And then I walked into the doors and I knew . . . . a place as open minded and wide as the back ground scenery of the Rocky Mountains. 

I then met Colette Marie, the Director of Out & About, and her fast talking gypsy soul changed my view and outlook on life forever. Colette envisioned Out & About to be so much more than just a babysitting service for people with disabilities, and she looked to Ansley and me to bring in that therapeutic aspect to our community based recreation activities. If I could only count how many hours Colette spent writing, revamping, rewriting, rewording, and rereading Out & About's mission and vision statement to fit the direction of the program's path. 

I will never forget the many experiences and learning’s that I took away while working at Imagine!:

1. The first being Mark Emery explaining to me why one should always answer “Perfect!” when one is asked how they are. 
2. The second being . . . NetSuite! Enough said on my part! 
3. The third being a company purchasing gym passes for their employees. This would never happen in the South. 
4. The night of the mil levy vote . . . waiting anxiously in the O'Shea room to let out screams as it was passed and the DDC then became known as Imagine!. 
5. Playing on DDC's softball team in the snow during the springtime. This, again, would never happen in the South. 
6. AND my last and very least favorite . . . balancing the budget!!! Making non-billable hours justify the importance of Therapeutic Recreation in the Out & About program. 

It has been said that the South is roughly ten years behind as compared to the West when referring to the delivery of services to people with disabilities. And if this is to be true, then I am proud that I was a full century ahead of time, and my experiences with Imagine! converted this Southerner to a WILD Westerner.

Good News Friday!

Once again, I have the pleasure of sharing news about college students working to improve the lives of individuals served by Imagine!.

A group of University of Colorado Engineering students in a 2013 Fall Semester class taught by Associate Professor Melinda Piket-May worked on projects to design simple adaptive technologies that aid increased independence for some of the individuals Imagine! serves. We have been collaborating with Professor Piket-May for more than four years now, and are so grateful for the opportunity.

Here are four short videos of students explaining their projects.

Interactive Money Game

 

 Can’t see the video? Click here.

 

Wheelchair Arm Stop

 

 Can’t see the video? Click here.
 

3-D Hand Operated Maze

 

Can’t see the video? Click here.

Interactive Activity Board

 

Can’t see the video? Click here. 

50 Years, 50 Stories - Tom Riley

Yes, I know we have already posted 51 stories in a series that was supposed to include only 50, but we still have one more to share. Tom Riley directs Imagine!’s CORE/Labor Source department, and his story provides some great insight into how the once separate departments of CORE and Labor Source came to be a single, integrated department. Tom also provides an excellent illustration of what I think makes Imagine! so special – our ability to see opportunity in the face of significant challenges. I can’t think of a better way to end this series.

Thanks for sharing, Tom!

Stronger Together 

By Tom Riley 

Tom Riley out in the community promoting Imagine!'s CORE/Labor Source department.

I started with Imagine! in 1997 as a residential counselor for Innovations. I was in grad school and needed the $6.50 an hour job so that I could eat. My student loans didn’t cover my expenses like they did when I was in state school in California. A colleague in school worked at Imagine!’s Iris House, which has long been torn down and replaced with the Bob and Judy Charles SmartHome. I walked in my first day and was caught a little off guard. It was very ungrounding. I hadn’t done this sort of work before. 

Funny thing about working with the folks we serve. They quickly become like family -- especially so in a home setting. And, Rick, Wes, Carol, Kim, Fred, Ida, and Andy quickly became family. My favorite thing to do was to take folks out into the community for “day program.” Sixteen years ago, which doesn’t seem that long ago, but in terms of day program it was the dark ages. Activities were not structured and in some cases consisted of van therapy and sometimes even a video from Blockbuster. Well, as time went on I wished for something more for the clients with whom I worked. When I became a coordinator type in 1999 I began planning on how to improve the services of folks that other day programs would not serve. In 2000 (or maybe 2001) I presented to Imagine!’s Board of Directors the idea behind CORE - that the individuals from 19th Street and Iris needed a better day program. One that provided a richness of experience and met the requirements of Medicaid in ways that Blockbuster and van therapy did not. So with a budget of $147,000, CORE was started. We served 9 individuals: Wes, Rick, Kim, Dale, Mike, Vicki, Pam, and Bill. Other day program would not serve these individuals. We were told they were too expensive to serve. That Medicaid didn’t pay enough. 

The idea behind CORE was to provide a rich curriculum of art, theater, dance, and music taught by local artists. We rented some space in the Dairy Center for the Arts and other studios around town. We were a small program and there were many great things about being small. But life got more and more complicated as the state began to get more rigid with rules and funding and we became more knowledgeable about how we wanted things to be. 

We developed a vibrant curriculum specific to the folks we served. Others began to notice and wanted to join. We began to take in people from Imagine!’s Host Homes and other group homes. We grew from 9 participants to 90 in about 3 years. There were many growing pains. And, many, many opportunities. We started to lease dedicated spaces in Boulder and Longmont. In another year we’ll likely get a third site out in Lafayette/Broomfield. 

 In 2005, the state was talking about turning CORE into a fee-for-service model paid in 15-minute increments. At the same time, the CEO of Imagine! was about to retire. Imagine! called and said that CORE and Labor Source had to merge so that it could blend it’s day habilitation and employment services with the hope of saving money by operating things more efficiently. They asked me to not be part of this and instead to focus on residential services. I reluctantly stepped aside. 

Two years later, CORE and Labor Source began to feel the full brunt of what it meant to be a fee-for-service 15-minute billing entity. The practical outcome of this fee for service model was a nearly 50% cut in funding from the state. Where we had received a block grant prior to 2006 that allowed us to serve people from 0 to 18 hours a week, the state changed our services to having to provide 30 hours a week in order to get the same funding. On top of this came the realization that folks were absent 15 to 20% of the time and we would not be paid even though we provided the staffing for services. As the funding shortfalls were realized CORE and Labor Source lost nearly $500,000 in 06/07. Both CORE and Labor Source continued to provide the same quality services they always had. But something needed to be done to allow us to stay in business. 

The opportunity was in employment. Labor Source came into existence well before my time began with Imagine! in 1997. It started in 1984 to be exact. Labor Source was established from the beginning so that individuals could receive community based services and realize their full potential with employment. With the great foundation that Labor Source had put together, we saw that getting folks employed provided the possibility of running a more cost effective service. With this in mind, CORE/Labor Source began to grow employment from within. Any client that was employable was given the opportunity to get a job. So from 2007 to 2010 we doubled the number of clients employed, from 54 to over a hundred. The staff members at Labor Source worked their butts off to do this. At the same time, CORE staff members worked their butts off to get people the foundational skills for getting a job. 

It wasn’t enough to just get people employed. We had to provide more and better structured activities to serve the individuals of CORE. We began a push of curriculum development, and today have more than 90 different classes developed and now offer more than 20 different activities every day. Having such a rich curriculum helps us run a quality program and ensures that our clients receive consistent and sustainable services. 

As we developed the curriculum, people from Labor Source began to receive the blended services of day habilitation and people from CORE began to experience the blended services of employment. It was an adjustment for everyone. When the idea of “choice” came up at meetings across the state the running joke (that wasn’t so funny) was that choice isn’t a need, it’s a “want,” and Medicaid is NOT designed to pay for choice. Well, I believe with the design of our services CORE/Labor Source is able to provide for both choice and what individuals need. 

The state average for the employment of individuals in day program services is 24.5%. CORE/Labor Source is at or near the top at nearly double the state average at 48%. We have representation on state committees for employment services design and for the setting of rates for employment. We serve 254 clients: 234 receive day habilitation and 120 receive supported employment. We have a large volume of lesson plans and the richest curriculum I have seen across the state for individuals in all areas of life. We have a dozen good folks teaching classes and a dozen and a half supporting employment, and dozens more wonderful people supporting our clients in gaining all sorts of life skills in day habilitation activity. We are no longer CORE and we are no longer Labor Source. We are now stronger together and go by CORE/Labor Source. 

Thank you to the staff members of CORE/Labor Source. The good work that they do plays the main role in what we do and how far we’ve come.

50 Years, 50 Stories - Gerald Huang

Yes, I know we have already posted 50 stories, but we still have more to share! If you read the story below, given to us by former Imagine! employee Gerald Huang, you will see why we simply had to include this in our series, even if it means that technically it isn’t 50 stories any more.

Thanks for sharing, Gerald!

The Spirit of YEEHAW! 

By Gerald Huang 

Gerald Huang (left) and his wife Terrie on their wedding day, with good friend (and Imagine! client) Greg joining them to celebrate.

When I first started working for Imagine!, which was known as the Developmental Disabilities Center back then, I did not anticipate the impact it would have on my life. It has been 13 years since I left Imagine!, but I am reminded daily of the influence it has had on my life. 

I was in my early 20s when I first joined Labor Source, the vocational training program at Imagine!. Having just moved to Boulder after college, I quickly made good friends, many of whom I am still close with today. The focus of our work was job training and community integration. Our activities would take us out to the Pearl Street Mall, or working a shift at Eco Cycle, or getting a restaurant like The Hungry Toad prepared for a day of business. 

One day I had the idea of expanding the community participation beyond the borders of Boulder County. One consumer I worked with, Greg, had a fondness for fishing and the outdoors. Unfortunately, he had never had the opportunity to go camping, let alone to leave the state of Colorado. As his birthday coincided with a long holiday weekend, I asked him if he would like to go camping in Moab where he could fish the Colorado River. A long road trip, a weekend getaway, sleeping in a tent. It was an adventure all of us have had, and now Greg and I were having one as well. Of course, I had to coordinate plans with his residential counselor, Terrie. Pretty soon there were four of us on the trip: Greg, his roommate, Terrie, and myself. 

The trip was a success, and not long thereafter we had our next big adventure. This time Greg was headed to Vegas. By plane. With Terrie and me by his side, we endured a turbulent descent into Las Vegas. The plane was silent with the anxiety and quiet anticipation of doom, but at the moment we landed and knew that all was well, Greg channeled the relief of all the passengers by throwing his fists into the air with a loud cowboy "Yeehaw!," filling the cabin with laughter and joy. 

That spirit of Yeehaw has been infectious. It has united a crew hard at work at Eco Cycle, a lunch crowd at North Boulder Park, a campsite in Moab, and a plane full of weary and frightened passengers. And for the past 14 years, it has united my wife, Terrie and me. As our two children run around in laughter and play, I am reminded of that time with Imagine! that continues to bless me today.

Good News Friday!

As the end of the year approaches, I thought it would be a perfect time to share a recap of some of Imagine!’s recent accomplishments. The information below is from Imagine!’s 2012-2103 Annual Report.

During fiscal year 2012-2013 – our 50th year of service to the community – Imagine! coordinated care for a total of 2,590 individuals with developmental disabilities or delays throughout Boulder and Broomfield Counties, helping them to access and contribute to their community.

Imagine!’s Family Support division:

• provided information and referrals to services to more than 1,400 families providing at-home care of a person with a developmental disability. 
• provided financial support to the families of 55 children with extraordinary needs arising from developmental and physical disabilities who were waitlisted for Medicaid-funded services. 
• helped parents of 58 children with autism spectrum disorders to select and pay for services such as psychological counseling, social skills coaching, and behavioral therapy. 
• helped caregivers of 197 individuals with developmental disabilities living at home to pay for the services and supports that were most important to their families, such as respite care, medical or dental care, therapies, or devices to help the individual with special needs function better at school or work.

Imagine!’s Out & About division:

• helped 41 school-aged children with developmental disabilities to learn vital socialization skills to help them to participate more fully in society, while affording their parents the peace of mind that comes with safe and appropriate childcare during work hours, through after school, summer camp, and school closure day programs. 
• promoted the safety, growth, and development of 122 local adults with developmental disabilities by enabling them to participate in special outings and activities in the community. 

Imagine!’s Behavioral Health Services division:

• provided comprehensive mental health services to 220 individuals with dual (mental illness/developmental disability) diagnoses. 
• provided a broad range of behavioral health services to 86 individuals, and educated their parents and caregivers about ways to build cooperative behavior. 

Imagine!’s Early Intervention and Dayspring divisions:

• helped 908 babies and toddlers with developmental disabilities or delays to improve their communication, motor, and/or social skills. 

Imagine!’s CORE/Labor Source division:

• provided job training, placement, coaching, and supervision for 131 adults with developmental disabilities. 
• fostered the growth, development, and safety of 265 adults with developmental disabilities through enriching and therapeutic day programs and classes. 

Imagine!’s Innovations division:

• supervised foster placements and care for 40 children whose special needs could not be met by their birth parents. 
• provided a variety of residential services – responsive to individual needs and capabilities – to 195 adults with developmental disabilities. This number included 21 individuals who required round-the-clock, hands-on staff supports. 

The community’s generosity was especially important to a number of Imagine!’s efforts over the past year. During our fiscal year 2013, with support from foundations, corporations, individuals, municipalities, churches, and community groups, we enhanced the therapies provided to 123 babies and toddlers with developmental delays with 78 Community Calendar Activities (music, play, and fitness activities in a range of settings, led by experienced therapists). Through Family Support Grants we helped 60 families in Broomfield and 139 families in Boulder County to pay for the extraordinary costs of caring for a person with special needs in the family home. We provided limited financial assistance to help 41 individuals with developmental disabilities meet urgent or extraordinary needs not covered by Medicaid or other funding sources through our Case Management Emergency Fund. We prepared to break ground on a new residential facility – the Next Step Group Home – which will allow six low-income seniors with developmental disabilities to live in an integrated community setting while receiving specialized care that would otherwise be available only in a nursing home. Residents of the Bob and Judy Charles SmartHome in Boulder and the Charles Family SmartHome in Longmont (the first residential facilities in the nation to use technology in a comprehensive way to improve clients’ independence and self-sufficiency) continued to flourish and engage with their community through work, creative pursuits, and increased self-reliance.

Thank you to the Imagine! staff members who worked so diligently to make all of the accomplishments listed above happen. Thanks also to the many, many generous and supportive community members who do so much to help us meet our mission every year.

Holding Out For A Hero?

A few months ago, I learned that my good friend and esteemed colleague Gary Stebick would be retiring from Imagine! next year, after spending thirty plus years of his life dedicated to our organization and the people we serve. Gary and I started working at Imagine! at around the same time and we have been close ever since, so his retirement really hits home.

But it isn’t just Gary who is leaving this field of serving individuals with intellectual and developmental disabilities in which we work. All around me, not just at Imagine! but across the state and indeed the country, I am seeing people who have dedicated their lives to improving the quality of life of some of our most vulnerable citizens stepping down from positions of leadership. In just this year alone, several Colorado Community Centered Board Executives who have my deep respect have or will step down after years of service. It is happening within advocacy organizations and at the State level as well.

This trend isn’t surprising. Many of the leaders in our field are members of a baby boomer generation that heard the siren call of a career path involving service to their fellow human beings and were unable to resist. They served with dedication and compassion, and created amazing opportunities for community engagement for individuals with cognitive disabilities that would have been unthinkable a few decades ago. But they are reaching the point where they simply can’t continue to serve in leadership roles.

While the trend is not surprising, the lack of meaningful planning to replace these leaders as they head off to new adventures is surprising. Surprising and disturbing, in fact. I just don’t see much happening in our field in the way of developing the next generation of leaders. I’m not sure why this is. Maybe people are in denial. Maybe it is assumed new leaders will develop organically. Maybe they are holding out for a hero. 


Can't see the video? Click here.

The thing is, the heroes are already here. They are already working for us. There are so many intelligent, dedicated, and capable people working in our field who could easily take the reins and take our country even further down the path toward full inclusion for the people we serve. But it won’t just happen. Being a great Direct Support Professional doesn’t mean that a person will also be a great manager or leader. Those are different skill sets, and we need to start developing those managerial and leadership skill sets in our younger employees before it is too late. There is a lot of opportunity for the next generation of leaders to grow, but those of us in charge of making that growth happen have been extremely remiss in cultivating those opportunities.

Even at Imagine!, where we have a Leadership Development Program that I am extremely proud of, we still haven’t fully figured out how to continue to support participants after they complete the program. We must carry the momentum and recognize opportunities for growth especially among those we have identified as potential leaders for our organization.

So I encourage all of us to look more strategically at leadership development in our field. The current leaders have done amazing things over the years to further the cause of inclusion for people of all levels of abilities. But we risk losing some of what we have gained if we don’t make the necessary preparations to ensure that the next generation of leaders can pick up right where we left off.

Then again, what do I know?