Provider Best Practices

Submission date: 7-22-08
Submitted by: Trudy Acevedo
Provider name: Sue Dilenge of Lifetides
APD Area: 23

Practice: 
Ms. Dilenge has created a “Communication with family and others involved in your care” form. The intent of this form is to sit down with the individual in which you render services to and talk to them about their preferences related to confidentiality. This form specifies the person and their relationship to the client and specific instructions and limitations the individual has relayed to the provider for sharing of information with their circle of supports. Individuals have expressed that they don’t want their health information or financial information shared with a particular person or details of what information they would like shared. The details of the person’s preferences are tracked on this form and the form is placed in the individuals file. The individual is informed of their right to update or make changes to this form at any time. It is the practice of Ms. Dilenge to review this form with each person at least annually and as deemed necessary.

Who Benefits?
How? The individual benefits as this system captures the persons preferences related to confidentiality as well as provides an opportunity to teach the individual about their right to confidentiality. Staff benefit as there is a clear system that lets them know who they can and can not release information to and what information can be released.

Submission date: 7-21-08
Submitted by: Robyn Moorman
Provider name: Making Your Choice Inc
APD Area: 23

Practice: 
The provider has created a database that links the individual, WSC, and provider. The site has security protocols to ensure HIPAA compliance. Employees enter the service logs directly. The provider ensures a back up system in a secure environment. WSC’s can access the database to obtain implementation plans, monthly summaries, annual summaries, and to view service logs. Additionally, the WSC can share the individual support plan. The individual has access and also utilization of an electronic signature that is password protected by the individual.

Who Benefits?
How? Individuals and families benefit as they are able to view their own service logs and other billing documentation for accuracy WSC benefit as they are able to access the documentation easily. The provider benefits from the ability to track service logs as well as the reduction of overhead costs

Submission date: 7-9-08
Submitted by: Jose Navarro
Provider name: CK Group Home, Inc.
APD Area: 11

Practice: 
Individuals are conducting fire drills in their home and assuming a role that was previously a staff responsibility. The Local Fire Department trained the group home director, staff and individuals on evacuation procedures, locating exits, using fire extinguishers and helping one another in case of emergency including the rolling technique. Individuals learned how to evacuate their group home and follow the safety procedures taught by the Local Fire Department. One of the individuals considers it cool that he gets to document the procedure, time and duration of the evacuation. According to the group home director, the staff and group home manager supervise the process but the individuals are empowered to take a leadership role for their safety. Individuals are eager to continue practicing these drills as they rotate every month. Individuals are continuously learning how to secure their safety in case of a fire.

Who Benefits?
How? Individuals are continuously learning how to react to secure their safety in case of a fire.

Submission date: 7-2-08
Submitted by: Marion Olivier-Ruelas
Provider name: Melody Smith, My Personal Choices
APD Area:

Practice: 
Once a year during a house meeting, the provider invites a representative of the Advocacy Center to attend. During this meeting, the “house rules” are reviewed and developed with the individuals. The Advocacy Center ensures individuals’ rights are upheld.

Who Benefits?
How? Individuals have an outside entity ensuring their rights are not being violated and become aware of this community resource. The provider benefits by making the connection with and utilizing this community resource on behalf of the individuals served.

Submission date: 5-14-08
Submitted by: Noeline Coore
Provider name: Community Options for the Developmentally Disabled
APD Area: 9

Practice: 
Happy Mail Club--a pen pal program with soldiers stationed in Iraq, which started three years ago. Individuals correspond with deployed soldiers overseas via letters, cards, care packages, etc.

Who Benefits?
How? Individuals in the Pen Pal program, as well as soldiers serving in the US Armed Forces benefit from the contact. Relationships are forged, developed and maintained throughout the years.

Submission date: 5-14-08
Submitted by: Noeline Coore
Provider name: ARC of Palm Beach County
APD Area: 9

Practice: 
The ARC of Palm Beach County has been the lead Agency for the Supported, Competitive, and Integrated Employment Training (SCIETT) Project funded through the University of South Florida and the Florida Developmental Disability Council. This project has brought extensive training by national experts to the community and is attended by employment staff. There are network meetings as part of the SCIETT project including teams throughout the state and local meetings attended by provider agencies.

Who Benefits?
How? This project is in its second year and the leadership teams are working towards improving employment outcomes for individuals with disabilities.

Submission date: 3-6-08
Submitted by: Robin Moorman & Linda Tupper
Provider name: Excelsior Care/Northwest Care Centre Inc
APD Area:

Practice: 
During the tour and observation of the group home the provider showed the consultant and Nurse the medication cart. It was a refurbished dresser and it fit in with the home décor.

Who Benefits?
How? All the individuals benefit from this practice as it enhances the home environment atmosphere over a medical environment. When guests visit, they would not be looking at a medication cart since the furniture fits in with the home, enhancing areas of dignity and privacy for individuals.

Submission date: 3-3-08
Submitted by: Trudy Acevedo
Provider name: Red Apple
APD Area: Suncoast Region (23)

Practice: 
The provider affords individuals the opportunity to participate in educational classes within the Adult Day Training program that teaches the skills necessary to apply for a paid position in the community. The people attending this class learn how to complete an application, how to dress for an interview and role play interviewing skills. After receiving training in this area an “Interview Day” is set up at the Day Program. On this day, the people dress as if they are going to apply for a job. Upon arrival at the day program they fill out an application and proceed through an interview process with the day program staff. The person is then evaluated on their strengths with completing the application, their appearance and interviewing skills as if they were applying for a paid position in the community. The provider utilizes real applications obtained from the community for practice. The areas needing improvement continue to be addressed as part of the training class. For those who want to pursue this further, referrals are made so that the person can receive the services to support their desire to pursue employment out in the community

Who Benefits?
How? The person receiving services benefits because they have the opportunity to experience what it would be like to go through the steps of applying and interviewing for a job and enhancing their skills.

Submission date: 3-3-08
Submitted by: Linda Bodo
Provider name: Center for Independence
APD Area: Suncoast Region (23)

Practice: 
Provider affords opportunities for all within their group homes to receive their own mail within the home. Provider has individual mailboxes in the home for each resident. One person gets the mail and then delivers it to each box. The boxes were designed with creativity by each person with their picture on it. They also deliver mail for the group home in its own box.

Who Benefits?
How? The person receiving services benefits because it gives them a sense of independence with checking their own mail, privacy, and a sense of home as we all check our mail in this fashion.

Submission date: 3-3-08
Submitted by: Trudy Acevedo
Provider name: Center for Independence
APD Area: Suncoast Region (23)

Practice: 
Provider affords opportunities for all individuals who choose to have a key to their group home to attend key safety training classes at the Adult Day Training program. The classes provide education on all aspects of the responsibility of having a key to your home and the importance of safety as it pertains to having a key to your home.

Who Benefits?
How? The person receiving services benefits because it supports the individual to exercise their right to have a key to their home and educates the individual on the responsibilities that come along with this right.

Submission date: 3-3-08
Submitted by: Trudy Acevedo
Provider name: Center for Independence
APD Area: Suncoast Region (23)

Practice: 
The provider tapped into one individual’s interest in learning to do crafts. The woman was educated about various crafts (scrapbooking, beading, etc.) through the ADT program. From there, they supported her to be exposed to new craft ideas through craft classes in the community where she was able to enhance her skills. She was also afforded the opportunity to volunteer at a nursing home where she could put her skills to work. As a result she is now exploring the possibility of experiencing a paid position utilizing her skills (she is in the process of applying to become an activities coordinator in a nursing home).

Who Benefits?
How? The person receiving services benefits because she has been able to receive education, exposure and experience in order to make an informed decision about a paid position she wants to pursue that matches her interests.

Submission date: 2-14-08
Submitted by: Christie Gentry, QIC
Provider name: Lorna Thomas GH
APD Area:

Practice: 
I had the opportunity to interview a young man at a Group Home more than 3 years ago. The young man was quite shy, legally blind, and spent most of the interview sitting in the corner playing with his recorder and listening to his music. He participated very little despite my attempts to get him involved in the interview.
A few months ago, I had the opportunity to interview the same young man at the group home. I could not believe the transformation in this young man. He sat with us during the entire interview and answered practically all of the questions on his own. He was very friendly, polite, and hospitable during the interview. He always had a passion for music and Mrs. Thomas explored with him if he would like to learn to play an instrument. He wanted to learn to play the guitar and Mrs. Thomas searched and found a wonderful music instructor. Last week I was at a WSC meeting and he and his music instructor performed some selections for us where he played his guitar and sang. I understand that this is not his first public performance.

Who Benefits?
How? All persons benefit when the provider attempts to assist the person to build on their strengths, interests, and abilities. This particular young man is obviously more self-confident and social. He had developed new dreams of performing for a living and also one day having his own place which in our prior interview he did not identify any such dreams.

Submission date: 5-11-07
Submitted by: Barbara Hawkins
Provider name: Visions ADT
APD Area: 14

Practice: 
The provider has assisted individuals to develop their own personal phonebooks. Individuals were assisted to make a page with their picture, phone number, and interests. They could then choose who they wanted to give their information to. Once information was exchanged, each person was assisted to put their phone books together for their own use.

Who Benefits? Individuals
How? Individuals benefit as they have been assisted to reach out and request information about friends at their ADT.  This may then carryover so that their friendships are not dependent on them attending the same ADT; they have a resource to reach out and make contact so their lives are not so compartmentalized.

Submission date: 4-27-07
Submitted by: Trudy Acevedo, QIC
Provider name: Kitty Adams of Creative Care, Inc.
APD Area: 23

Practice: 
Kitty Adams has assisted two individuals with making a photo album recipe book using labels from the ingredients necessary to make the recipe.  The photo album has various recipes of the individual's choosing (such as chop suey). Since both individuals have difficulty with reading, the provider came up with a creative way to help them know what ingredients are needed for each recipe.  The recipes in this book are ones that do not require specific measuring, and are casserole recipes or one dish recipes. The provider assists the individual with taking the labels (stewed tomatoes label, macaroni label, ground beef label, etc.) off of all the ingredients needed to make the recipe.  In the example of the chop suey recipe which requires an onion, she pressed the skin of the onion just like you would press a flower in a photo album.  The various labels and onion skin were placed on the photo album page under the plastic film that would normally cover your pictures in the album.   On the top of the plastic film, each label had a piece of Velcro.  A second label or pressed onion was then laminated with a Velcro piece on the back.  The individual was able to match the labels and the onion to its corresponding place in the album.  This has helped the individuals to take the top labels and go to the store to independently purchase all of the ingredients they need for this particular recipe and when the come home they are able to match the pictures back up with the ones in the album (the ones placed under the film) so that the ingredients for each recipe do not get mixed up. 

Who Benefits? The individuals receiving services benefit.
How? Because, the practice promotes practical learning and independence.

Submission date: 3-28-07
Submitted by: Marion Olivier-Ruelas
Provider name: N/A
APD Area: N/A

Practice: 
The provider has developed a “non-consent for release of information” form which identifies who and what information the person does not want shared with anyone.
The provider reviews this information and the regular consent- to- release information form with the person quarterly to determine if there are more people or other information the person does not want shared with anyone.

Who Benefits? Individuals
How? The individual benefits from this practice because it helps to ensure that privacy is defined by the person and that their preferences for privacy are being upheld by the provider.

Submission date: 3-11-07
Submitted by: Christine Stevenson, QIC
Provider name: The ARC of Putnam County
APD Area: 3

Practice: 
With the technical support of the organization’s academic instructor, individuals developed “Dance To The Stars,” a booklet designed by people with various disabilities to educate the public on the fact that they are people first, and they have preferences.

Booklet Preface
“This book was written by The Arc of Putnam County Employability Skills Summer Training Class.  These authors are young adults with various disabilities.  These young adults interviewed other young adults with disabilities.  The disabilities of these young adults include Impaired Vision, Impaired Hearing, Cerebral Palsy, Spinal Bifida, Down Syndrome, and Autism.

What happens when a group of young adults with disabilities decide to write a book on their own?  My heart begins to open.  The feelings flow, the pages begin to fill pictures and form in my mind.  This instructor has become the student feeling humble and blessed to be allowed into this “Normal Circle”, where wheelchairs, blindness, autism, C.P., and Spinal Bifida are the majority and that which is considered “Normal” becomes the minority. -Cindy Burgoyne, EST Instructor.”

Excerpt
“We asked Jeff if he liked for a person to sit or stand when they are talking to him.  Jeff requests that you please try to sit or get at eye level with him.  Jeff says his neck will hurt if he has to look up to the person talking to him.  Jeff says it makes him feel small when people stand over him.

Jeff also feels left out when someone asks staff or others things concerning him that he could answer himself.

Jeff is visually impaired but not hearing impaired.  You do not need to talk louder when you converse with him...Lots of people tend to do that.

Who Benefits? Staff, new staff, the public, and the people who developed the booklet all benefit.
How? Because, it is one thing when ‘professionals’ are the teachers, but infinitely more meaningful when the information and inspiration comes from the person.

Submission date: 1-29-07
Submitted by: Charmaine Pillay
Provider name: N/A
APD Area: 14

Practice: 
The provider meeting held in Area 14 on Friday 1/25/07 was an incredible experience. A collaborative effort by providers, the steering committee, the AQL and APD culminated in a very moving awards ceremony honoring direct support workers. People who don’t often have contact with other providers or APD were publicly recognized for their efforts. The entire event not only went a long way in staff recognition and retention, but also fostered an atmosphere of togetherness. Providers generously donated funds for gift certificates and a photographer was on hand to capture the moment. Many kudos to the staff who were recognized, and all who made the event possible.

Who Benefits? All
How? Individuals benefit by having such dedicated staff work with them. Staff benefit by receiving public acknowledgement of their efforts. Provider organizations benefit by recognizing quality staff and thereby increasing staff retention. APD benefits by supporting great staff which could lead to an increase in individual’s outcomes and an increase in public trust.

Submission date: 11-26-06
Submitted by: Denese Anderson
Provider name: Magnolia Oaks
APD Area: 4

Practice: 
Magnolia Oaks group home makes it a standard practice to be sure the group home operates and has the appearance of a private home rather than a business. Employees do not wear scrubs, business files and records are disguised in a homelike setting. All office equipment is kept in an out of the way room. All employee notices, bulletins, schedules and business aspects are virtually unnoticeable. All employees are repeatedly trained to understand they are entering someone’s home each time they come to work, and that they should treat it and the people residing there with respect and dignity.

Who Benefits? All
How? All individuals living in this home benefit by the respect and dignity with which they are treated. They are living in a home not a business venue.

Submission date: 11-26-06
Submitted by: Denese Anderson
Provider name: Henderson Haven
APD Area: 4

Practice:

1. Provider has established a free of charge lending library of donated communication devices for individuals to use.
2. Provider assists individuals and families to pair up to mentor and support one another naturally.
3. Provider participates in numerous community events to promote community awareness.
4. Provider has created online training on various topics for staff development.
5. Provider created a multimedia presentation for public, families and individuals to promote choice for individuals with disabilities.
6. Provider participates in IEP (Individual Education Plan), advocacy and parent/ school team building.
7. Provider collects donations of computers and computer parts and restores/ refurbishes them, then donates them to individuals with developmental disabilities that need them, at no charge; this service is provided to individuals they offer services to and individuals receiving services from other providers.
8. The provider assists all individuals they serve to develop social capital in many creative ways, and most importantly in a manner that is directed by the individual.

Who Benefits? All
How?

• The individuals receiving services benefit from all above mentioned best practices. Promoting independence, social capital and dignity.
• The community benefits by the replacement of misunderstanding with understanding, knowledge and acceptance.
• Other providers benefit by having a resource they can tap into with this provider and their vast knowledge.
• The local schools benefit from an outside assistance to promote continuity and collaboration in IEP meetings

Submission date: 11-1-06
Submitted by: Denese Anderson
Provider name: St. Augustine Group Homes/Adams Acres
APD Area: 4

Practice:
A Behavior Analyst creates an easy to follow and easy to understand “Cheat Sheet” for direct care staff members to utilize when they are with individuals.
This helps all staff to follow through with what is designated on behavioral plans. These “Cheat Sheets” are laminated and kept where Direct Care staff can access and utilize them

Who Benefits? All
How?

• The individual with consistency in trainings
• The direct care staff with easy to understand and follow directions
• The Behavior Analyst with plans that are being used and followed

Submission date: 9-22-06
Submitted by: Krista McCraken & Sharon Searcy, QICs
Provider name: ARC Gateway, Pensacola
APD Area: 1

Practice: 
The provider has developed a workbook to be reviewed with each individual covering the 25 Personal Outcomes, Rights, Abuse, Grievance Procedure and Due Process.

• My Personal Outcomes – They have taken information from CQL, identifying each outcome and questions the staff should ask to gather information about that outcome.  At the end of each outcome they have a section that asks what they can do to provide support in this area. They have some standard suggestions, but also leave space for the individuals and staff to write ideas.
• My Rights – They have used person centered language as well as some descriptive clip art to discuss each of the rights.
• Abuse is Wrong – they have used a mixture of person centered and process language as well as descriptive clip art to discuss abuse, neglect and exploitation.
• Grievance Procedure – A one page step by step method to follow using person centered language.
• My Rights to Due Process – A mixture of person centered and process language as well as descriptive clip art to discuss the Due Process steps.

Who Benefits? Individuals
How? Currently the provider is using it with individuals who receive Residential Habilitation (RH) and Supported Living (SL) services.  They plan on expanding to all of the other services over the next year. This is an excellent way for the staff to get to know more about the individuals and learn what is really important to them, as well as to find ways to address things that individuals want to change. This is also beneficial for the individuals to be able to receive education about the topics in easy to understand language.  Individuals are able to share information with the provider that they might not discuss if not asked.

Submission date: 7/26/06
Submitted by: Marion Olivier-Ruelas
Provider name: Resources for Human Development
APD Area: 2

Practice:
In order to ensure that staff are truly understanding the training being given, the Director of the agency developed a post questionnaire for staff to complete.  It helped the director identify whether any staff person may have missed or misinterpreted the message of the training so that additional training could occur.  The two questions were: 1) This training will help me perform my job better because….2) The most important thing that I learned during this training is….

Who Benefits? Staff
How? Ensuring that they understand the training they received in order to either improve or maintain quality supports and services.

Who Benefits? Agency Provider
How? Helps them ensure staff understand the content of the training.

Who Benefits? Persons receiving services
How? The training staff receive will assist them in providing quality supports and services.

Submission date: 7/24/06
Submitted by: Charmaine Pillay
Provider name: N/A
APD Area: 14

Practice:
Providers in Area 14 formed a stakeholders group in response to the need for training in a variety of areas. They also identified the need for a provider network, more provider meetings, ongoing communication with the Area staff and mentoring. The group included providers, individuals receiving services, APD staff and Delmarva staff. The goal of receiving additional training has been initiated and provider meetings are held every 3 months, with providers taking the lead on facilitation and delivering training and education on a number of topics. Several provider networks have arisen as a result of the stakeholders efforts. Recently, a member of the group, became a liaison between the Area Steering Committee and the stakeholders group, in order to continue positive communication between the provider community, Area staff and the local steering committee.

Who Benefits? Providers
How? Providers benefit from the additional training and the opportunity to discuss and brainstorm any problem areas during provider meetings. Individuals benefit from the ongoing networking and focus on the attainment of outcomes. APD benefits from providers decreased reliance on the Area for all of their training needs. All benefit from the ongoing communication and focus on continuous improvement.

Submission date: 3/29/06 
Submitted by: Christine Stevenson, QIC
Provider name: Sumter County ARC
APD Area:

Practice:
In an effort to promote self-reliance, Sumter County ARC initiated a new practice for their monthly fire drills in group homes as well as Adult Day Training. Rather than pulling the alarm and directing individuals out of the building, they place a “block exit” (model of a fire) in a different location for each drill with the expectation that residents or participants will pull the alarm. The change in procedure was announced during a routine visit from the local fire chief.

Who Benefits? Group Home residents & Adult Day Training (ADT) Participants
How? Group Home residents & Adult Day Training (ADT) participants become self-reliant rather than looking to staff to direct their every move.
The question, “What would happen if staff were incapacitated?” is addressed and resolved.

Submission date: 3/22/06 
Submitted by: Noeline Coore, QIC
Provider name: Kimberly  K, SLC
APD Area:

Practice:
A SLC provider works with individuals, by tapping into their particular interests, and enhancing these interests.  For example, for individuals who are interested in Painting, Art work and Poetry, the provider encourages the individuals to tap into their artistic abilities.  She travels with them to various Art Shows throughout their local communities, where they’re able to present their work and put it up for sale—from paintings, to books of poetry (which the provider works with the individuals on), etc.  Some individuals have sold some of their Art work and books of poems.  The provider has also assisted people to  develop websites, in order for them to showcase their work for potential customers.  In addition, other individuals had expressed wanting to make some extra money.  The provider assisted them to purchase gumball machines and placed them in the local APD offices, where they’re able to get some business.  This has proven to be very successful and the individuals are THRILLED!  The provider recently returned from a Mexican Cruise vacation, with a select group of individuals, who had expressed wanting to go on vacation overseas. 

Who Benefits? Individuals
How? The individuals have all expressed how excited they are to be able to express themselves through different forms of personal interests.  In addition, the vacation in Mexico enabled the individuals to experience different  customs, and culture through education, exposure and experience.

Submission date: 1/10/06
Submitted by: Christine Stevenson
Provider name: The Center for Independence
APD Area: 23

Practice:
People receiving services from this organization personally hand out paychecks to staff. The organization initiated the idea after attending a training by CQL (The Council on Quality and Leadership).

Additionally, a group home manager with this organization took the lead from one of the residents and renamed “House Rules” as “House Agreements”. When evolving from management developed house rules to “rules” developed by the residents themselves, the manager heard one resident say, “I agree” after a rule was suggested by a resident. She listened, and she agreed.

Who Benefits? All
How? Regarding the paychecks, the staff benefits from the reminder that although they are hired by the organization, they work for the people. The people receiving services benefit from the empowerment derived from the action. The organization as a whole benefits from an action that is symbolically very powerful, while not consuming any extra resources. Regarding the “House Agreements”, the resident benefited when his remark was heard and valued. All residents benefited by no longer being subjected to “rules” in their own home. They learned about compromise, consensus and self-governing. Other staff benefit from the realization that they too can seize upon opportunities to innovate and contribute

Submission date: 4/13/05
Submitted by: Christine Stevenson
Provider name: Supported Living Coach
APD Area:

Practice:
A provider developed creative strategies to teach money management skills on the basis that most often what individuals really want is to make their own purchases and control their own money although a support plan goal may read, “Learn money management skills” or “Learn to make change” or “Learn to count coins”… Instead, individuals obtain a pre-paid debit card. Then the training focus can be on safekeeping the card, learning their four-digit code, confidentiality, learning how to use different types of keypads, and retaining receipts. The provider developed a system to assist individuals in managing their accounts; two strips of colored paper that fit into slots in poster-board sandwiched together. At the beginning of the month, the slots are full signifying the days left in the month (red) and the money left in the card (green). As the individual uses the card, he saves receipts, and his coach adjusts the colored strips to give him a visual of how much money remains for the remainder of the month.
Another provider, unable to locate a user-friendly bank, identified with the individual her favorite stores and assisted her in purchasing refillable pre-paid gift cards at those stores.  As a result, the individual was able to make her purchases at her favorite store just like anyone else, which is all she really ever wanted.

Who Benefits? Individuals
How? Individuals achieve what is really most important to them. By getting to the bottom of what individuals really want, providers avoid years, sometimes decades, of ‘coin counting’ activities.

Submission date: 4/4/05 
Submitted by: Christine Stevenson
Provider name: Goodwill-Suncoast
APD Area: 13

Practice:
This provider involves the individuals in the development of their monthly summaries. At the end of each month, a staff member meets with the individual and asks a series of questions:
What is one new thing you learned this month?
What is one new thing you experienced this month?
What worked for you this month?
What did not work for you this month?
And, a fifth question about progress on their specific personal goals.
Then, the provider adds the summary of their data collection for the month.

Who Benefits? Individuals and the provider.
How? The individuals have a greater sense of partnership. They come to expect to be learning something new, to expect to have new experiences, and, that it matters if strategies are to their liking. They develop ownership of their goals, and their implementation plan, and their learning.
The provider benefits from the frequent feedback.