A New Threat Looms

by Mike Hyland, Venture President & CEO

People living with disabilities already face a multitude of challenges including chronic illness, access to medical care, bullying, discrimination, adequate education, access to the community, and meaningful opportunities for employment.  They also encounter all too often the stigma that is still attached to living with a disability.  Now a new threat looms: a potentially major shift in Medicaid.

In 1965, the Medicaid program was created to provide assistance to low income and disabled persons who could not otherwise afford it.  It also provides matching funds to states that participate and meet certain requirements set forth by the federal Centers for Medicare and Medicaid Services.  In Massachusetts, these funds are absolutely crucial for the development of programming that allows people with disabilities to live in the community with the supports that ensure dignity, safety, and opportunity.  Currently, there is discussion within the Trump administration about eliminating these matching funds and moving the Medicaid program to a Block Grant funding system.  Such a move has the potential for devastating consequences for the people who rely on community-based services.

Under a Block Grant system, Massachusetts and all other states would receive a lump payment rather than matching funds now received for needs based service delivery.  A lump sum would be a one-time annual payment, and once the payment is exhausted, states would be on their own to pay for programs that support people in the community.  Typically this would require states to spend money they simply don’t have, and in that case, people who rely on supports to survive, could be left without vital services.  This jeopardizes their independence and their safety as well as eliminating any chance for growth.  To put it mildly, that’s an indefensible burden to put upon people who already have to overcome significant struggles on a daily basis.

Any plan that reshapes Medicaid into a system that is not directly tied to individual service needs is nothing short of a betrayal to the thousands of people currently receiving help in the Commonwealth.  It’s also dangerous.  A recent posting from the Association of Disabilities Providers notes in an analysis that “without the guarantee of matching funds, states will not be able to sustain existing services-much less expand them to meet the tremendous unmet need in the disability community”.  The reduction in services would undoubtedly be the first step on the road to eventually eliminating some services and would surely put people with disabilities, particularly older people, at genuine risk of being re-institutionalized in facilities and nursing homes.  Society has kind of already been there and done that and it was an epic fail.  To create a system that could put people back into situations that shutter them further from society is not misguided; it is unconscionable.

We must be mindful that people who are already disadvantaged cannot be left behind yet again.  It is most important that their voices be heard through advocates in society and on Capitol Hill. The new administration needs to hear that a Block Grant program will harm elders and people with disabilities.  Doing anything that knowingly puts that population front and center in harm’s way and cuts at the heart of the progress made in society over 40 + years, would be nothing short of a national disgrace.

We Could Use A Little Less Anger

by Mike Hyland, Venture President & CEO

The country is once again moving toward a new beginning, as is inevitable every four to eight years when a new presidential administration is peacefully installed.  Though often chaotic, this transfer of power is the most basic tenet of our democracy and should not pass unnoticed.  There is a great deal of work to be done and it is more necessary than ever that people set aside disagreements and get on with the task of ensuring that people who need help can get it.  In short, we could use a little less anger these days.

One of the great tragedies in government is the erosion over time of simple cooperation between people.  The very notion of moving forward requires overcoming disagreements and finding compromise for the sake of a greater good.  Unfortunately, in too many cases this requirement is completely lost.  Instead of compromise, our system has devolved into something where disagreement has become animosity and cooperation has become forbidden.  The sad and predictable result is that people who need help are at constant risk of being left behind because important issues that help them stay safe are used as tools by competing interests rather than as building blocks for growth.  These people too are victims of the anger that dominates national discussion now.

It is inevitable that change accompanies any transition of leadership and that old practices and policies are replaced by new ones.  What must be kept sacred are the safety nets that allow people supported by human services agencies to live and thrive in the least restrictive environment.  This means continued access to programs that provide opportunities for community inclusion, employment, education, and recreation.  There also needs to be a renewed commitment on a national level to initiatives that enhance our workforce.  It is crucial that we have an actual plan to create a genuine living wage for all direct support professionals as well as a recognition that professionals who do this work are a major economic force in this country.  And as always, there must be a united effort from all of the leaders in this country to finally and legitimately remove all stigma and abuses that people with disabilities still face.  Adults and children with disabilities are still victims of crime and abuse at a higher rate than their peers without disabilities.  It’s time that people with power publicly acknowledge this and take immediate steps to address it.

There should be no debating the idea that people who need help are entitled to receive it in a safe and dignified way.  It should also not be debatable to suggest that those who provide support must be paid and respected in a meaningful way.  There shouldn’t be anything political about these issues and prioritizing them certainly should not be cause for anger on anyone’s part.  To quote our outgoing president, “ultimately we’re all on the same team”.  We need to finally behave that way for the sake of the people who tend to be dismissed far too easily.

 

Adaptive Gardening

Gardening season is in full swing! With the advent of accessible equipment and a greater emphasis on the therapeutic nature of this valuable skill, gardening is becoming more available to people with disabilities. Whether it’s tending to the beauty of a flower garden or the resourcefulness of a vegetable garden, this hobby has remarkable rewards for all. In fact, many Venture residential programs have developed their own vegetable gardens and are enjoying the fresh produce! Our day habilitation programs also offer horticulture as an activity.

Horticultural therapy has been gaining recognition for its positive effects for individuals with mental illness, intellectual disabilities, physical limitations, dementia, brain injury, and more. According to the American Horticultural Therapy Association, this modality can improve cognitive abilities, enhance memory, develop social skills, and advance communication. Physically, gardening can assist with balance, coordination, endurance, and strength. Horticultural therapy is also an excellent source of sensory simulation, especially for those with autism. For more information about local resources, check out the Northeast Horticultural Therapy Network.

Another great local resource for therapeutic and accessible gardening is Tower Hill Botanic Garden located in Boylston, Massachusetts. Venture recently assisted them in an advising capacity as they developed their Garden Within Reach program, which offers an innovative and inclusive design for those of all ability levels and breaks down barriers for those with mobility issues.

For more resources, be sure to follow Venture’s Adaptive Gardening board on Pinterest and check back often for updates!

Advancing Autism Services

Venture was proud join Bridgewell as a sponsor of their annual autism conference in Framingham yesterday.  The focus of this year’s event, Conquering the Cliff: Autism’s Journey into Adulthood, provided a great opportunity for us to prepare for our new autism outreach center in Uxbridge.  At Venture, we believe it is our responsibility to address the needs of the disability community in a meaningful way and this conference provided a helpful step in our process of building innovative programs and services for children with autism and their families.  We were able to talk to parents who are working to prepare their children for a bright future.  Many wonder how their kids will receive job training, or where they might live.  Many parents worry about who will advocate for their adult children when they are no longer able to do so.  Some are concerned about the lack of social and recreational opportunities in a safe and understanding environment.  The keynote speaker, Susan Senator, touched on some of these subjects.  She has three sons, the oldest of whom has autism.  She is an author, blogger, and frequent guest speaker on autism parenthood.  Visit her web site for articles, resources, blog, and more.

Our visit to the conference has further inspired us to reach out the autism community all around us.  Please check back soon for news about our upcoming open house and forum, when we hope to hear from families of children and young adults with autism in the Blackstone Valley region and in Worcester County.  Our center will offer in-home Applied Behavior Analysis, center-based social skills programs, family outreach, pre-vocational training and more.  We want to provide the best possible support – which means we want to hear from you!  For more information, please contact Kevin Hughes, Vice President of Day Services, at khughes@venturecs.org.  Also, don’t forget to check out our Pinterest board with lots of useful autism information and resources.

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Effective Community Day Programs

I’m pleased to introduce Kevin Hughes, Vice President of Day Services, as this week’s guest blogger from Venture’s senior leadership team.  Kevin can be reached at khughes@venturecs.org.

Graduating from high school and entering the “real world” is a significant transition for any young adult.  Typically, these young adults continue onto college or enter the workforce – but for the young adult with intellectual disabilities, the choices can be different.  A small percentage will continue their academic pursuits but the majority will enter the workforce, participate in community based day supports, and/or continue skill development in day habilitation programs.  To complicate matters, some of these young adults will also move into new residential settings as they transition from children services to adult services.  As you can see, the transition can be very difficult and confusing for the young adult as well as the family.

Many agencies offer different residential and day service models, as one model does not fit everyone.  The focus of this blog will be on one model, the day habilitation model.  All day habilitation programs are approved and regulated by MassHealth and must adhere to their standards.  However, many agencies in the field of developmental disabilities are recognizing the need for change within the day habilitation program to offer support to a changing population.

For example, the need to create programs for those diagnosed with autism is changing our field.  Valuable programs include sensory rooms with treatment protocols written by an Occupational Therapist which allow some individuals to interact and manipulate their environment in such a way that is meaningful to them.  Other therapeutic models, such as adaptive yoga, are both enjoyable and allow for growth.  Venture’s Sturbridge community day program offers adaptive yoga and massage therapy in-house and some individuals also participate in therapeutic horseback riding.

Individuals that require behavioral support have the right to competent behavior analysts that have the education and experience to deliver this level of service.  Board Certified Behavior Analysts (BCBA) that work together with the team to address problem behavior while increasing skill development is an excellent addition to these types of programs.  In addition, consulting a licensed psychologist or a doctoral level BCBA is recommended for treatment that is more complex. A Licensed Independent Clinical Social Worker can also offer additional support and counseling for individuals that benefit from a more traditional therapeutic relationship.

Finally, and most importantly, day program environments should be aesthetically pleasing and well maintained. Individuals have the right to a “physical and social environment that is safe, humane, and responsive to individual needs” (Van Houten et al, 1988).  This includes offering activities that are preferred, focus on skill development, and are age appropriate.  The availability of community activities and volunteer opportunities ensure that skills taught in the program generalize or transfer to community settings.  Functional skill development that is person-centered, encompasses multi-treatment modalities, are preferred, and delivered in pleasing environments.

Van Houten, R., Axelrod, S., Bailey, J. S., Favell, J. E., Foxx, R. M., Iwata, B. A., & Lovaas, O. I. (1988). The right to effective behavioral treatment. Journal of Applied Behavior Analysis, 21(4), 381–384. http://doi.org/10.1901/jaba.1988.21-381

About Venture’s New Multi-Sensory Experience

We’re proud to share an article by Mike Hyland, President and CEO, that appeared in the most recent edition of The Provider.  This newspaper is the flagship publication for the Providers’ Council and is widely considered the voice of the private provider industry in Massachusetts.  With a combined hard copy and electronic circulation estimated at over 5,000, it is the most widely read — and respected — publication of its kind in the state.

Technology has vastly changed the way most of us live. We send e-mail instead of letters, we scan documents rather than fax them, we talk to each other through our cars, and we watch television on 46 inch screens at home and 8 inch screens on trains and park benches. Technology has also brought many tools to the human services industry, from iPads to alternative communication devices. One of the best advances in supporting people living with autism has come in the proliferation of sensory rooms.

Sensory rooms have been in use in Europe since the 1970s and are now becoming increasingly common in the U.S. They are safe places for many populations including those with dementia and people who have suffered a traumatic brain injury. The sensory room is now a vital tool in supporting children and adults on the autism spectrum who typically do not perceive their surroundings in the same way that most of us do. At Venture Community Services we use sensory rooms to give a person control of sensory experiences in a way that is not possible in public spaces.

Our two most recently built homes were both constructed with space for sensory rooms. In fact, all future Venture programs will be designed with sensory rooms in mind. Currently, the agency is finishing construction on a sensory room in our Sturbridge Day Hab program. This space is the result of a generous donation from the Hoyt Foundation and it creates specialized programming opportunities for several populations.

Like all sensory rooms, the agency’s newest one is being built with careful attention to detail around lighting, flooring, colors, sound, and tactile options. The room is equipped with tools that allow for safe exploration while also helping individuals de-escalate away from the larger group. It is also a space where staff members can work directly with individuals to develop coping techniques as well as to experience sensory stimulation in a way that is meaningful to the individual. Although many people will use the sensory room, each person will experience the environment in a unique way.

Perhaps the most exciting element in our new sensory room is the Smart Board. It opens the door to countless options that encourage an individual to express creativity, feelings, and ideas in a soothing way. The technology keeps evolving but the board itself essentially becomes a large touch pad that allows a person to manipulate words, pictures, or environments to either express feelings or to simply relax through an active process. The work station allows staff members to present the people we support with highly individualized opportunities to experience sensory stimulation on a spectrum that is non-threatening and actually controlled by the individual. We see the Smart Board as an essential tool in helping individuals to experience sensory stimulation in an affirmative way.

In addition to the Smart Board, Venture’s latest sensory room is equipped with other tools that both soothe and stimulate anyone struggling with sensory processing. A marble board allows an individual to work quietly with his hands, special lighting allows an individual to control the way the room looks visually, special carpeting controls sound amplification, and special furniture creates a space of comfort. We encourage participants to touch because everything in the room is safe. We also encourage participants to tell us what helps them to relax so that we can help them maximize the benefits of the sensory room. In this context, our sensory rooms are truly a space where collaborative treatment occurs.

The vital treatment that is provided by the human services workforce in this state is certainly as challenging as it has ever been, probably even more so. However, the more that we as providers are able to do with technology, the better treatment centers and workplaces we can create.

Visit with Lieutenant Governor Karyn Polito

Venture Community Services would like to extend our thanks to Lieutenant Governor Karyn Polito, State Senator Anne Gobi, and State Representative Todd Smola for visiting today.  We greatly appreciate the opportunity to introduce members of state government to our Sturbridge Day Program, our dedicated staff members, and our administrative offices.  We are always grateful for the chance to talk about the incredible working being done by our staff members every day of the year. We also enjoyed exchanging thoughts and ideas about the future of autism services, life skills training for transitional populations, foster care for both children and adults, and our plans to build a new facility to expand community support in Central Massachusetts.  After a visit to the day program, the conversation turned to discussion of the human services industry and our commitment to innovative solutions to complex social problems, including community based treatment and support services for families through the Department of Children and Families.

Be sure to visit Lieutenant Governor Polito’s Twitter profile to see more about her visit.