Directory of Services

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1 The Jefferson Rehabilitation Center Directory of Services

2 Table of Contents The Jefferson Rehabilitation Center Page 1-5 Input Forums Page 6 Criteria for Referral/Admission/Exiting Page 7 Staff Qualifications Page 8 Service Coordination Page 9 Career Connections Page 10 Day Habilitation Page 11 Intermediate Care Facilities Page 12 Residential Services and Programs Clinical Services Page Page Production Unlimited and Contract Sites Page Bright Beginnings Early Learning Center Early Intervention Integrated Preschool / Daycare Program Page 26 Page Mission Statement/ Values Page 30 Organizational Chart/Management/Key Personnel

3 The Jefferson Rehabilitation Center Array of Services: The Jefferson Rehabilitation Center (JRC) provides a full array of services covering all age levels beginning at infancy. Our focus is residential, day programming, vocational, and case management services. Staff Training: Staff are trained to meet the service needs of program participants, in two ways. First is an overview of the agency and how to meet the needs of those who live with a variety of disabilities. This training begins on the first day of employment. Secondly, once a staff member has been assigned to a site of a program model, their training becomes site specific in order to meet the needs of participants. Training continues as long as a person in employed by the JRC. Service Availability: Service availability is based on many factors that range from if a person meets our eligibility requirements to whether there is an opening in a site where one s needs can be met. When possible, program candidates are offered choices of sites and staff. In New York State, there are other factors that impact wait times such as the person s present living arrangements or the certified capacity of a given site or program. Meeting Needs: One aspect of the admission process is to screen for those service needs the agency is capable of meeting. Transportation, the need for adequate staffing, the availability of specialized clinical services, and a need for services that exceed our capacity are all factors that can determine placement and start times. It is our goal to meet as many needs as possible. Outcome Performance: Each program participant will develop his or her own service plan that details the outcomes they wish to achieve. These outcomes can be short term of a year or less, or long term. Performance will be measured and reported on according to the specific requirements of the program model. Cost of Service: Whenever possible all funding sources are utilized to provide services for the people we serve. Generally all services provided are funded by government sources. However if there is insufficient funding, the agency will work with those in need to provide financial assistance for certain issues such as guardianship. 1

4 The Jefferson Rehabilitation Center Responsibility of Person Served: Regardless of the service model, each person, family, or guardian will be notified of their responsibilities, including payment prior to when theses services begin. All programs have an Admission Agreement that outlines theses responsibilities. It is possible for candidates to have one such agreement from their day service model and another from their residential model. Mission and Values: Please see our Mission and Values statement on page 29 of this handbook. Program participants are asked to review and advise the organization as to the continued appropriateness of the Mission or the Value Statements. Potential for Conflict of Interest: The agency policy prohibits all employees, as well as board members and vendors, to engage in any situation that creates a conflict of interest or creates the impressions of such. Employees may receive nominal gifts from program participants or family members. All employees must report such gifts to these supervisors/corporate compliance officer for a determination. Understandable Formats: The agency makes every effort to communicate in a fashion that will be suited to the needs or the language of the persons served. JRC services are available in a variety of formats. Service Planning Results of Services: It is the agency s expectation that each service component, which is typically goal based, demonstrate progress after one year of implementation. All services have a progress report generated at interval determined by the program model. Whenever a goal or objective does not achieve the progress, the expectation is that this will be revised to achieve progress, if still relevant. How Services Will Be Delivered: Services will be delivered by trained staff in the most appropriate setting that produces the greatest benefit to the person. When possible, this will take place in a community-based setting. Service Duration: This facet is determined by the person who develops the service. It is based on the need to achieve progress or to maintain a person at a specific performance capacity. Services will last as long as appropriate. 2

5 The Jefferson Rehabilitation Center Service Alternatives Within the Organization: Within the confines of eligibility or availability a program participant will be exposed to other service models within the JRC that best meets a person s needs. To access these services, a contact to a person s Service, Treatment, or Vocational Coordinator or the Program Administrator is all that is needed. Within the Community: Community Services will be utilized when we are unable to meet the needs of the person or if a request is made by the person/family or guardian. Referrals will be made with the full knowledge and involvement of the person served. How Will Results be Evaluated: All services will be evaluated for effectiveness to determine if a desired outcome is being achieved by the service intervention. These results will be communicated to the person served. Future Planning: This is a casework function. It may include training, assistance, or information sharing for such issues as health care proxy, burial, living wills, and guardianship. It can also extend to residential placements or services from other providers. Staff Selection Process Individual Choices: Whenever possible, program participants are directly involved in employee interviews. This begins during the initial phase of hiring and for transfers into other positions within the organization. Wants/Desires: An individual may express a preference for working with certain staff. Whenever feasible this will be honored, however the organization reserves the right to place staff, as a resource, in the most advantageous position in the agency. Whenever possible the agency takes into consideration the desires of both the employee and the individual. The agency recognizes that certain employees work more effectively with certain individuals. The agency is able to create a number of opportunities for continued friendship between individuals and staff as deemed appropriate. 3

6 The Jefferson Rehabilitation Center Service Coordination : Those persons enrolled in a Medicaid Waiver Program have direct access in selecting their Service Coordinator, per the Office of Persons with Developmental Disabilities (OPWDD) Regulatory Process. Other Factors: The JRC will also take into consideration the specific needs of those served by making a consideration of these needs in regard to their plan or services as well as more specific elements of those service plans such as behavior interventions or risk management plans, etc. Individual Service Plans Opportunities for Inclusion: Engagement in the community is one area of choice that is provided to those who seek services. This includes a process of exposure to new activities and experiences, which allow the person to make more informed choices later on. Community exposure extends outward from their immediate residence into their neighborhood, to the larger village or town, to Jefferson County, and across the state. Persons served are asked for their choice of church, recreational events, and where they would like to spend their money. The agency attempts to provide as many activities as possible in a community setting. It is the desire of the agency that the ultimate outcome of inclusion is that each program participant will be able to develop a wider range of social contacts from this activity. The agency will also facilitate travel plans with other organizations to enable those able to vacation at a variety of locations across America. Risk Versus Choice: As program participants develop new skills and gain more independence, they will be exposed to greater risks, especially while in a community setting, as the staff lessens their oversight. These risks will be evaluated by the treatment team with the intent of determining what the participant understands about the risk, who will provide consent to participate in the risky activity, and if these risks can be managed with more training. Quality of Life Social Contacts: As desired or tolerated, program participants are exposed to methods to allow them to achieve a greater circle of friends and acquaintances. This takes place in their day and residential settings as well as in the community. A person s friend will be noted in their case file. Staff will facilitate activities to support these friendships. Agency staff may choose to take individuals to their homes or on activities when it is their day off to further provide opportunities for social development. Personal Relationships: When possible the agency will honor those personal relationships that were created prior to seeking services within the organization. The person s team assists the program participant in fostering additional relationships using inclusion principles. The names of these friends will be made known to the staff and sites where the services are received. 4

7 The Jefferson Rehabilitation Center New Supports: Supports are viewed by the agency as a natural extension of the array or services that the JRC offers the program participants. Supports may be natural such as in the case of family contacts or their religious beliefs. These may also be more generic such as teaching a person how to use a variety of forms of public transportation. Developing New Skills: The primary component of skill development is through a service plan, although it may have several different titles. The person served and their families are directly involved in providing input into the plan. Program implementations are based on a need to develop new skills. Maintaining Skills and Supports: This is another aspect of treatment that is provided by the organization. It is the function of the person s team to evaluate when it is prudent to incorporate activaties to allow a person to maintain their functioning ability. The object of the training and services at the JRC are to maintain a person at as high a level of functioning as possible. This is proven beneficial to the person in terms of optimizing their health. The Mission and Value statement specifically address this concept. Developing New Supports: New supports are requested from the team, family and the person served. These supports may be helpful in meeting the needs or desired outcome of the person served. As with all supports or services it will be one of the person s human rights to reject such services if they have the capacity to make such a decision. Identification and Networking with Community Resources Life Experiences: Agency employees work to create a new set of life experiences that may take the form of new work experiences, exploring different religions or churches, hobbies, their local and adjoining communities, and a variety of recreational events. Documentation for these are found in a team meeting minutes and in the inclusion log. Many of the agency programs use new experiences as an operational goal to manage throughout the year. Community Access: Whenever possible we provide the program participants with access to a variety of community events. These will be locally, such as in a neighborhood, around the block, the town or city, and across the state. These locations will be recorded and tracked to allow the person to attend more often those of their choice and to avoid places where they do not wish to go. We stress activities of choice for the program participant. Inclusion: Inclusion is the ultimate goal of the agency s services by ensuring that program participants develop a strong network of friends in the community. These life experiences and new experiences will assist the program participants to live a more independent life. 5

8 The Jefferson Rehabilitation Center Input Forums The JRC seeks direct participation from the program participants in the day-to-day operations of the organization. This is one way in which the service recipient is trained to gain greater access to their human rights and the larger community. Each Residence, and Day Habilitation classrooms, and departments of the Work Training sites hold monthly meetings with those program participants, who in turn, present their ideas, desires, and concerns to a larger Advisory Board, made up of participants. These Advisory Boards participate monthly with members of the Management Team at meeting of the Program Committee, where the concerns are set into motion and acceptance. The Agency has asked for a person with disabilities to participate on the Human Rights Committee, Health and Safety and on the Program Committee. Program participants routinely are asked to attend the Strategic Planning process and to fashion their own satisfaction surveys. One example of how their input has been used can be viewed on the revised agency Mission and Values statements. Another input forum has been the North Country Self Advocates, a group of persons from Jefferson County, many of whom receive no services from the JRC. This group of disabled persons seeks to make their needs known and to influence local and state forms of government. The North Country Self Advocates are affiliated with the larger Self Advocacy group of New York called SANYS. The JRC provides financial support, transportation, and even personal support to members of the North Country Self Advocates by lending them a staff liaison, which facilitates their activities and provides training on how to effectively influence others about their desires. 6

9 The Jefferson Rehabilitation Center Criteria for Referral/Admissions/Exiting Referral Process: Information necessary to complete the referral process includes: A physical examination which has been completed within the past 12 month period A Psychological or Psychiatric evaluation current within the last 12 months. Purified Protein Derivative Test (PPD) Written proof of a developmental disability originated prior to age 22. This can be provided by a physician, psychologist or school records. Medicaid eligibility Waiver enrollment and service coordination (if applicable) Individualized Education Plan (IEP) if applicable Meet OPWDD eligibility requirements (for most programs) For Adult Day Programs: All referrals are to be submitted to the agency Admissions Coordinator at 444 VanDuzee Street, Watertown, NY Upon receipt of the referral it shall be reviewed by the JRC Admission/Discharge Committee; this committee meets on a monthly basis generally. For Residential Programs: All referrals are to be submitted to the placement office of Sunmount Developmental Center, 2445 State Route 30, Tupper Lake, NY The placement office will then send to designated agencies a placement packet to be reviewed by the agency Admissions/Discharge committees. The Admissions/Discharge committee will then review the packet for appropriateness and eligibility and if found appropriate the individuals will be placed on a waiting list or offer them placement if an opening exists that meets their needs. This committee meets on a monthly basis. Criteria for Admission: Please refer to specific program pages for admissions criteria. Exiting the Program: A person may leave the program when they: Choose not to participate Have health or medical condition that prohibits them from returning to programming No longer meet eligibility criteria Require alternate programming Choose to participate in alternate programming 7

10 The Jefferson Rehabilitation Center Additional Information for Residential Programs: They choose to move to another program if capable or their family requests such and an alternative program is found Have health or medical need that prohibits them from returning to the level of care the JRC can provide Choose to move home with their family. We are not able to meet their needs due to medical, behavioral or programmatic changes. Staff Qualifications JRC is an independent, not-for-profit corporation employing over 625 staff members. A dedicated staff of medical, educational, and therapeutic professionals, and specially trained direct support professional provides the necessary support and training to the individuals they serve. The screening of qualified applicants and their selection for employments are critical activities requiring close attention to the process. It is the policy of the Agency to require a fully completed Application for Employment form for each employee. Human Resources review the application for completion when submitted, to ensure the following information is included: Applicant s educational background Past employment history Criminal history Military Service Record Professional & Personal references Driving History Statement acknowledging that false information on the application form is grounds for dismissal Child Abuse Background check Since various types of employees are hired by the Agency the minimum qualifications for each position differ from one another; however the minimum qualification for employment at JRC (with the exception of working at the FT. Drum dining facility contract) is a High School diploma or GED. We do hire a limited number of non GED candidates in specified locations if they meet our established standards. In many positions whether entry level or professional level the qualifications are predetermined by the New York State Office of Persons With Developmental Disabilities as well as the New York State Department of Education. In order to ensure each employee meets the employment qualifications, the Agency performs initial background verifications to include New York State and Federal Agencies and various internet registries. In Addition, those staff having substantial unsupervised contact with the individuals served must undergo a NYS and Federal criminal background check as required through the OPWDD. Employment is conditional upon having met the conditions for employment with the Agency as well as meeting the qualifications for the position of interest. 8

11 The Jefferson Rehabilitation Center JRC recognizes the importance of improving staff quality and is committed to ensuring success for all staff through an organized training and staff developmental program. It is the policy of the JRC to employ qualified and safety conscious employees. In order to maintain high standards, all employees attend in-service training annually. Additionally, the Agency provides tuition reimbursement for employees who have been with the agency a minimum of 1 year of more, have met or exceeded their job requirements, and are interested in a course of study related to promotional opportunities within the Agency. Whenever possible, the Agency makes it a policy to promote from within for an open position. Service Coordination Medicaid Service Coordination (MSC) is a Medicaid State Plan Service administered by the New York State Office of Persons with Developmental Disabilities (OPWDD). Service Coordinators assist people to access necessary service and supports based on each person s goals and valued outcomes. MSC is designed to help individuals strive for the highest quality of life. The focus of MSC is assisting each person to achieve his or her unique goals and desires in terms of making a home, a job, a circle of friends, enjoyable leisure activities and access to medical clinical and educational services. Persons served: Persons of any age with developmental delays or developmental disabilities Criteria for Admissions: The person must meet OPWDD eligibility criteria Referral process: All referrals for MSC are made to the Program Coordinator. Referrals can be made by anyone including an individual who desires the service. Exiting the Program: Individuals can request a change in their Service Coordinator or a change in agencies providing MSC if they are not satisfied with the service. Requests can be made by contacting the Program Coordinator or Sunmount DDSO at (315) Individuals may withdraw from MSC whenever they no longer desire the service. 9

12 Career Connections This community based employment program prepares adults with disabilities for competitive employment and assists them in finding jobs that match their skills and interests. Occupational Trainers then provide assistance as needed to prospective employers throughout Jefferson County and to the employee to assist both parties in overcoming workplace challenges and in maximizing the employee s job performance. Services are provided for Supported Employment, Mental Health (MH) Programs, School to Work Transition Program, and the Department of Social Services (DSS). Persons Served: Adults age 18 and older Individuals with a documented disability Services Provided: Job Development Job Placement Pre-placement services Extended services Referrals Criteria for Admission: Individual must have a referral from either the Office of Adult Career and Continuing Education Services (ACCES), Mental Health (MH) provider or Department of Social Services (DSS). Must have proof of disability PPD test Documented psychiatric, psychological disability MH participants must be receiving services from an MH service provider Referral Process: To be referred for Supported Employment services referral letter must be provided by ACCES-VR. A Mental Health Provider must generate the referral for a participant being referred to the MH program. The Department of Social Services is responsible for completing referrals for individuals being referred to the DSS program. The referral process varies between programs. For more information contact Career

13 Day Habilitation Day Habilitation is a Medicaid Waiver program that focuses on utilizing community resources. Activities in this program are consumer driven through the choices they make and the desires they express. While more choices and opportunities for each person are offered, the program is continually moving toward the optimum continuum of care. Day Habilitation allows us to take further steps for the people we serve along the entire normalization process. Day Habilitation services are designed to assist program participants in achieving satisfying relationships within their community. Services in this program are individualized for each person and are flexible enough to be provided almost anywhere in the community that a person may wish to learn a new skill. Day Habilitation is also active with volunteerism in the community. The Day Habilitation program focuses on increasing self advocacy through expressing barriers that are identified when in the community. Persons Served: Adults age 21 and older Individuals with developmental disabilities Services provided: Community volunteerism and inclusion Building friendships in the community Accessing community resources Socialization Self-Advocacy and Self determination Domestic skills Enhancing choice making skills Wellness activities Self-esteem and confidence building Medicaid Service Coordination Travel training Money management Occupational Therapy, Physical Therapy, Speech Therapy, Social Work Nursing services Nutritional information available Criteria for Admission: The person must have documentation of a developmental disability. (Level of Care Determination) The person must have documentation of Medicaid eligibility (necessary to have a Medicaid number) It shall be necessary for the person to be enrolled in Medicaid Waiver. It will be necessary for the person to have a Service Coordinator. The person must meet OPWDD eligibility. Day Habilitation must be the choice of the person. Services must be necessary to maximize development of or maintenance of skills and behavior necessary to be a participating member of the community.

14 Intermediate Care Facilities (ICF) The Intermediate Care Facilities (ICF) offer higher level of care and staffing to meet the needs of the persons who are medically frail or who require more supports and assistance in a variety of programmatic areas. There are three ICFs located in Jefferson County, providing residential alternatives for persons ranging in age from teens to 90 s. Resident s participate in activities of daily living, community inclusion, behavior management, clinical services, self care and domestic tasks. All three sites are handicapped accessible. IFC residents are supported through enhanced levels of direct care and clinical services/or consultation such as those provided by Occupational Therapy, Physical Therapy, Speech Pathology, Behavior Management and Nursing. Active Treatment is promoted and programming and services are driven by the needs and desires of the residents Persons Served: Individuals with developmental disabilities who have significant delays and require continual active treatment programming (but not needing 24 hour nursing care). Service Provided: Training in Daily Living Skills Self Esteem and Confidence Building Problems Solving and Coping Skills Interpersonal or Dealing with People Skills Accessing Community Resources Travel Training Self-Advocacy Recreational Skills Clinical Services Criteria for Admission The program shall admit only developmentally disabled individuals who are a diagnosis of mental retardation, autism, cerebral palsy, epilepsy or a neurological impairment and whose developmental disability originated before the person s 22 nd birthday. Review by a physician on the appropriateness (medically) for the program Physical by a physician current within one year of the review Reason for Referral Comprehensive assessment covering physical, emotional and psycho-social development when applicable Copy of Individualized Education Plan (IEP) records if available Review and Recommendation of the ICF Screening Team to determine if the person s needs can be adequately met in the ICF. Psychiatric or psychological current within a year. 12

15 Residential Services The Jefferson Rehabilitation Center offers several different opportunities for individuals including a Community Residence, Supportive Individual Residential Alternative (IRAs), Supervised IRAs and ICFs. Sites vary in size and makeup, which are based on each resident s particular needs, preferences and availability. We have co-ed sites as well as single sex sites, some are handicapped accessible, while others are not, they are grouped by age and functioning abilities as well as by levels of supervision required. There are three Supportive IRAs. These sites provide up to 21 hours of support a week, but average approximately 12 hours a week. We provide assistance in helping the resident develop skills in the areas of food preparation, money management, socialization, community independence and managing the household. There are twenty-six Supervised IRAs. These sites provide 24 hour supervision. Staffing is based on the levels of support required and range from one staff on a shift to six during program time with double overnights. They range in size from two beds up to ten. We provide residential habilitative services in the areas of community inclusion, socialization, behavior management, activities of daily living, self care and varied other skill areas. There is one community residence that houses 12 people and has one respite bed available. This site is a co-ed residence that provides training in the areas of self care, behavioral management, community inclusion, socialization and activities of daily living. The respite bed is for use by families when they need a place for their child or relative to stay for a limited time period; these beds can be used up to 30 consecutive days or 42 non-consecutive days as long as it does not interfere with the operation of the facility. There are 3 ICF s (Intermediate Care Facilities) that each have 12 beds. These sites have an RN and two LPN s on site daily, to ensure the medical needs of the individuals can be met. Individuals needing a higher level of medical care will reside in one of the ICF s. One of the ICF s has a respite bed available for use by families in the community. One of the IRA s has been renovated to meet the needs of our Dementia population. This site has 8 beds and the staff have been specifically trained in the area of Dementia. The residents at this site continue to work on their independence, however many of the activities are at a much slower pace. The residents share in the maintenance of the sites by assisting in the upkeep of the facility. They choose decorations, furniture, the food purchases as well as supplies required and other items necessary for the operation of the site. Staff emphasizes independence and maximizing the potential of all residents. We have a Residential Advisory Board that has representation from the varied sites and they meet monthly to discuss issues, review plans being made by the department and to make recommendations to the administration. Persons Served: We serve people with developmental disabilities, who demonstrate a need for residential services and supports. We serve people in the age range of the children to the elderly. 13

16 Residential Services Criteria for Admissions: The person must have documentation of Medicaid eligibility (it is necessary to have a Medicaid number) It shall be necessary for the person to be enrolled in Medicaid Waiver It shall be necessary for the person to have a Medicaid Service Coordinator. The person must meet OPWDD eligibility requirements The program shall admit only developmentally disabled individuals who have diagnosis of mental retardation, autism, cerebral palsy, epilepsy or neurological impairment and whose developmental disability originated before the person s 22 nd birthday. Physical completed by a physician current within a year. Psychological/Psychiatric evaluation current within a year. Residential Programs WINSLOW STREET INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This residence is co-ed, 11 beds, two-story home, located in Watertown, New York, and is not currently wheelchair accessible. The individuals currently range in age from the 20 s to 50 s; those considered for placement are individuals who are in need of skills that will enable them to successfully make the transition to supported living situations or community, There is a close relationship with supported apartments and opportunities for experience in this environment. The staffing ratio is 1:5 during most programmatic hours. FRANKLIN STREET INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This residence is a 10 bed, two story house for females located in Watertown, New York. The age range is from 25 to 75. This house is not wheelchair accessible. Programmatic emphasis is on developing independence in the areas of travel training, home alone, money management, community integration, cooking and self care as well as household maintenance. The staffing ratio is 1:5 during programmatic hours. SACKETS HARBOR INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This residence is a 10 bed, single level, coed, wheelchair accessible house in the Village of Sackets Harbor, New York. The age range is 40 s to 90 s at present. Programmatic emphasis is on developing independence in cooking, domestics, money management, travel training daily living skills, and community integration. There are both ambulatory and non-ambulatory individuals who live in this residence. The staffing ratio is 1:3.3 during programmatic hours. 14

17 Residential Programs STATE STREET INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This residence is a Chapter 33 facility located in Watertown, New York, with an 9 bed capacity. It is a two story, co-ed residence that does not offer wheelchair accessibility. The current age range is 30 s to 60 s with programmatic emphasis on self care skills, domestic training, socialization and communication as well as community integration. The staffing ratio is 1:2 (Double overnight plus one one sleeper staff) and this may increase according to the needs of the individuals, but will never decrease. This house is appropriate for both behavioral concerns and those who are not selfpreserving. MASSEY STREET INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This residence is a two story, 9 bed, co-ed residence located in Watertown, New York. It is not wheelchair accessible. This Chapter 33 facility is appropriate for those who are not self-preserving. The age range is between 35 and 65 with programmatic emphasis on self-care skills, domestic skills, socialization, leisure and recreation and community integration. This residence is an appropriate placement for individuals who require behavior management programs, The staffing ratio is 1:4 on average and at times 1:3 depending on the programmatic needs of the residents. TEN EYCK STREET INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This residence is a 10 bedchapter 33, twostory house for females located in Watertown, New York. The age range is 20 s to mid 60 s at present. Programmatic emphasis is on independence in the areas of cooking, cleaning, meal planning, money management, travel in the community, laundry and self-care. The level of supervision and assistance provided by staff is in the ratio of 1:3 during programmatic hours. The staffing patterns in this house allows for assistance in dealing with those individuals who are more behaviorally involved. CHAUMONT COMMUNITY RESIDENCE- This residence is a 13 bed, two story, co-ed, house (with one respite bed) located in Chaumont, New York. The age range is 30 s to 60 s at present. The house is not wheelchair accessible. Staffing ratio is 1:3 (double overnight) and is designated to deal with individuals with behavioral problems. Programmatic emphasis is on developing independence in cooking, domestic, money management, travel training, daily living skills, and community integration. PARKER STREET INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- The Parker Street residence is a Chapter 33, 9 bed, two story male residence located in Watertown, New York, this is not wheel chair accessible. The age range is 30 to 70 s at present with programmatic 15

18 Residential Programs emphasis on independence in household maintenance, cooking, travel training, and community integration, money management and staying at home alone. The staffing ratio is 1:45 during programmatic hours. EVANS MILLS INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This Chapter 33 residence is a 10 bed, two story, co-ed residence in the Village of Evans Mills, New York and is wheelchair accessible on the ground floor. This residence serves more mature individuals with the age range of 30 s to 60 s. The staffing ratio is 1:3 during programmatic hours (double overnight) Programmatic emphasis is on daily living skills, domestic skills, money management and community integration. Emphasis is also on the enhancement of the individual s capacity to maintain his/her participation in activities. HOLCOMB STREET INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This residence is a 8 bed, one story residence in Watertown, New York, working with our Dementia Population. This house is wheelchair accessible and is also a Chapter 33 residence (allowing individuals with dementia, who are not self-preserving to reside here). This residence was developed to help those with Dementia be independent for as long as they can. Programmatic emphasis is on daily living skills, socialization, self-care skills, and community integration. Emphasis is also on the enhancement of the individual s capacity to maintain their participation in activities. The staffing ratio is 1:4:5 during programmatic hours. DEXTER INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This two story, 7 bed facility is located in Dexter, New York and is an all male facility. The downstairs of this residence is wheelchair accessible. The population is made up of individuals ranging in age from 40 s to 70 s. The program focuses on Activities of Daily Living skills, domestic training, money management, socialization, leisure/recreation, and community integration. The staffing ratio is 1:2 during programmatic hours. CARTHAGE INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This 8 bed, Chapter 33 residence is a two story. Coed house accommodating residents who are not self preserving. The downstairs bedroom is wheelchair accessible. The present age range is 20 s to 60 s. The programmatic emphasis is on developing independence in the areas of domestic skills, such as cleaning living areas, completing laundry tasks, running the dishwasher, setting the table, money management, self-care, home alone and community awareness programs. The residents in this house have been diagnosed with varying function levels. The staffing ratio is 1:3 during programmatic hours with double overnight staffing. 16

19 Residential Programs WELDON DRIVE INDIVIDUALIZED RESIDENTIAL ALTERNA- TIVE- This three-bedroom townhouse is located in Watertown, New York and is handicapped accessible. The ages range between 30 s and 60 s. Programming consists of selfcare, sensory stimulation, community integration and meal preparation. The staffing ratio is 1:3. This house is appropriate for individuals who require varied levels of assistance and or those in need of wheelchair accessibility during programmatic hours. WELDON DRIVE INDIVIDUALIZED RESIDENTIAL ALTERNA- TIVE- This 3 bedroom townhouse, located in Watertown, New York, is a two story, handicapped accessible residence. The ages range between 30 s and 50 s. Programmatic emphasis is on self-care, community integration, meal preparation, communication, fire evacuation, socialization, and behavior management. The staffing ratio is 2:3 during programmatic hours. Staffing is appropriate in order to provide service to those individuals requiring more assistance. BREEN AVENUE INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This 4 bedroom, all male, ranch style house is located in Watertown, New York. Programmatic emphasis is on domestic skills, money management, home alone, telephone skills, meal preparation and planning, community integration, exercise and modalities recommended by occupational and physical therapists, and travel training. The staff ratio is typically 1:2. This residence is handicapped accessible. SOUTH MASSEY STREET (DOWN) INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This apartment is located in Watertown, New York, has two bedrooms, serving two adult females. Program emphasis is on self-care, community integration, socialization, meal preparation and domestics. The staffing ratio is 1:2 during program hours. The apartment is handicapped accessible. SOUTH MASSEY STREET (UP) INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This apartment, located near downtown Watertown, New York, has two bedrooms serving two adult females. Program emphasis is on money management, meal planning, community interaction, fire evacuation, self-care and domestics. The staffing ratio in this home is 1:2 during program hours. 17

20 Residential Programs HOLCOMB STREET INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This co-ed, two bedroom ranch style home is located in Watertown, New York. Program emphasis is on meal planning, community integration, fire evacuation, self care, and domestics. The staffing ratio is 1:2 due to the need for individualized attention. PALMER STREET INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This 2 bed, co-ed, single story apartment is located in Watertown, New York. It is wheelchair accessible. Current ages for this site are between 40 s and 50 s. Program emphasis is on money management, meal planning, community integration, domestic skills and self care. The staffing ratio is 1:2. PALMER STREET INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This 2 bed, co-ed, single story apartment is located in Watertown, New York. It is wheelchair accessible. Current ages range between 45 and 55. Program emphasis is on money management, meal planning, community integration, domestic skills. The staffing ratio is 1:2; the overnight is a sleep position. PEARL STREET INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This 8 bed all female residence is located just outside of Watertown, New York. It is a single story ranch style home and is not currently wheel chair accessible. The individuals range in age from early 30 s to 50 s. Individuals considered for placement are those who typically have many skills with dual diagnosis or with some psychiatric diagnosis. Emphasis is placed on the development of skills for community inclusion, social skills, coping skills related to the disability, domestic skills, and money management. The staffing ratio is 1:3 during programmatic hours. SCHELL AVENUE INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This four bedroom, co-ed ranch is located in the Village of Evans Mills and is a home to young autistic adults, ranging in age from 20 s to 30 s. Programmatic emphasis is on community integration, sensory stimulation, behavior management, fire evacuation, self-care and domestics. Staffing ratio is 1:5 during the program time. 18

21 Residential Programs ST. LAWRENCE AVENUE INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This 8 bedroom home is located in the Brownville, New York and is home to males with behavioral concerns and those that have been dually diagnosed. Emphasis is on behavioral management, community inclusion, and activities of daily living, and developing independence. This home has 2 handicapped accessible bedrooms downstairs. Staffing ratio is 1:2 during program time and two overnight staff. (awake and sleep) ADAMS CENTER INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This is an eight bedroom, two story, all male home located in Adams Center, New York. One bedroom is downstairs and the remainder are upstairs. Emphasis is on behavioral management, community inclusion, activities of daily living and developing independence. This home is not handicapped accessible. Staffing ratio is 1:1.5 during program time. There is both an awake and asleep staff on duty during the overnight shift. SPRING STREET ADAMS INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This is a five bed, all male house that is handicapped accessible on the first floor. Emphasis will be on activities of daily living, community inclusion, and household management. Age range is 20 s to 30 s. Staffing ratio is 1:2 during program time. GLENN AVENUE INDIVIDUALIZED RESIDENTIAL ALTERNATIVE- This a four bed IRA serving young men with autism with the emphasis on self care, activities of daily living and community inclusion. The staffing ratio is 1:1 during programmatic hours. There is an awake and a sleeping staff on the overnight shift. ICF#1 This Intermediate Care Facility is a 12 bed facility with one respite beds and is located in the community of Dexter, New York. The facility is wheelchair accessible. It is single level home with two double bedrooms and eight private rooms. The site offers enhanced levels of Direct Care and Clinical Services for the medically fail aging population. The age range is from 50 s -90. The site has a Treatment Coordinator, Registered Nurse and 2 LPN s on site. The site places a large emphasis on skill retention as well as the development of new skills. ICF #2 This Intermediate Care Facility is located on Gaffney Drive within the city of Watertown, New York. The site is a one level facility that is wheelchair accessible. The site offers four double rooms and four single rooms. The site offers enhanced levels of Direct Care and Clinical Services. The age range of the population is 40 s -60 s. The site has a Treatment Coordinator, Registered Nurse and 2 LPN s on site. The site places emphasis on intensive training with Activities of Daily Living and sensory stimulation. 19

22 Residential Programs ICF #3 This Intermediate Care Facility is located on Gaffney Drive within the city of Watertown, New York. This site is a one level facility that is wheel chair accessible. The site offers four double rooms and four single rooms. The site offers enhanced levels of Direct Care and Clinical Services, serving young adults ranging in age from 20 s to 40 s. The site has a Treatment Coordinator, Registered Nurse and 2 LPN s on site. The site places emphasis on the acquisition of skills in the area of self care, communication, sensory stimulation, socialization and leisure/recreation activities.

23 David Liscomb We have many different ways for people to participate at the JRC. The JRC tries very hard to give all people opportunities to learn how to advocate for themselves, and for others, especially for people who have severe disabilities. The JRC also helps them to become a better representative for themselves. Our individuals first learn to speak up for themselves at their annual team meetings and by using satisfaction surveys. Then they may choose to join an advisory board or our local Self- Advocacy group that is supported by the JRC. The North Country Self- Advocates began meeting on Apr. 20, Our group teaches people to speak up for themselves and others. My roommate Mark and I founded the group with three other people, and now we have 40 members. We work and advocate for people, for better and more services, and in the community. We have several advisory boards at the JRC. Some are the Workshop Advisory Board. We also have the Residential and the Day Habilitation Advisory Boards. By speaking up at these meetings, people can get answers to questions and make things better where they live and work People who receive services also are members of the Safety Committee and the Program Committee. I served on the Safety Committee from June These committees help a person to develop and to grow. They learn through their participation and advocacy. Also, through advocacy people can change, or help make positive changes and growth in our agency. These are very good for the JRC. I just want to say that I am very proud of the JRC and what services, that it offers. David Liscomb David is currently the immediate Past President of the Self-Advocacy Association of New York State, a member of the NYSARC Board of Governors, a member of the JRC Board of Directors, a member of the OPWDD Commissioner s Advisory Council, a member of the Board of Directors of the National Alliance for direct Support Professionals and a member of the Board of Directors of the Jef- 21

24 Clinical Services Many of the services offered by the Jefferson Rehabilitation Center include a clinical component and the agency employs a number of well-qualified clinical staff from a variety of fields to deliver necessary services. Nursing Department- a team of RN s and LPN s serves the health care needs of all individuals on a daily basis. They are responsible for developing individualized nursing services for those who need them and they train and monitor the direct care staff in the proper delivery of the service including the passing of medications. Each of the three ICF s is served by a team of RN and LPN, with nursing services on site seven days per week. Nursing support is available from a RN on call during all non-business hours. Physical Therapy Department- a team of Physical Therapists and a Physical Therapy Assistant serves the needs of the children and adults in day and residential programming. Physical therapy is the use of physical agents, such as cold, heat, sound, light, electricity, exercise and manual techniques to reduce pain, improve movement and assist in the healing process. Physical therapists also work extensively with adaptive equipment such as wheelchairs, walkers, and braces. Both direct physical therapy and indirect services provided by trained staff members are available to ensure individual needs are met. Therapy is directed at improving and individual s physical condition and improving their movement ability in order to improve their quality of life. Occupation Therapy Department- a team of Occupational Therapists and one Occupational Therapy Assistant serves the needs of children and adults in day and residential programming. Occupational therapy promotes independence with daily living skills such as eating, dressing, grooming, bathing, work and play. To accomplish this, occupational therapists choose from many modalities including exercise, therapeutic activities, passive and active range of motion exercises and activities, heat, cold, adaptive techniques and equipment, sensory modulation, and purposeful activity as well as many others. Speech Department- a team of Speech Language Pathologists and Teachers of Speech and Language Disabilities provide interventions for individuals with communication disorders. When a person has trouble understanding others, (receptive language) then he or she has a language disorder. When a person is unable to produce speech sounds correctly or fluently, or has a problem with his or her voice, then he or she has a speech disorder. Persons who have difficulty swallowing may also be treated. All individuals receive individualized instruction and programming to help them communicate to their greatest potential. 22

25 Clinical Services Psychological Services Unit- a team of Applied Behavior Specialists and ABS Assistants provides functional analyses of behavior, and work closely with the Treatment Team, develops individualized behavioral supports designed to help reinforce positive and appropriate behaviors while decreasing less adaptive behaviors. The department visits sites throughout the agency to provide support and training to the staff and individuals at those locations. The behavior plans are goalbased, proactive in nature, and strive to minimize the use of rights restrictions, and/or artificial consequences. Counseling services are provided as needed under the supervision of the consulting psychologist. Crisis management support is available from a staff on call during all non-business hours. Dietary Services- a Registered Dietician coordinates with nursing staff and primary physicians to ensure that individuals receive nutrition according to diets that meet their individual needs. The dietician reviews menus from all sites to ensure that the meals offered are of adequate nutrition, quality and quantity. The dietician also provides in-service training to staff and individuals to learn how to prepare healthy and enjoyable meals, adhere to prescribed diets, and maintain proper standards for food storage and sanitation. She also has a Diet Tech that works with her. ACCESSING SERVICES: Availability of clinical services varies from program to program and is identified under the Services Provided section for each. Typically, the Interdisciplinary Treatment Team identifies a need with the individual and a program, the Medicaid Service Coordinator or another member of the team will attempt to locate the service in the community. 23

26 Production Unlimited & Contract Sites Production Unlimited provides training and paid work to participants residing throughout Jefferson County. This program provides a comprehensive individualized process which assists persons served with their rehabilitation programs after they have made informed choices regarding the selection of their vocational goals, objectives, and services. The intended results are equal and meaningful employment. The program provides a variety of training opportunities that assist persons served to achieve their goals and reach theirs maximum potential. It is also designed to help individuals understand the demands of working by developing skills, attitudes and behaviors that improve their work functioning. Production Unlimited produces a variety of items including, silk screened binders, military marker tags, vibration gloves, protective footwear, examination booklets for colleges across New York State and assembly work. In addition, community-based sites are also utilized for training. These are affirmative businesses and owned by DOHL Development Corporation and provide real work opportunities to participants. Training schedules are implemented so that any individual interesting in working at one of these sites has the opportunity to do so. Sites include Just-n-Case Convenient Store, Clubhouse Restaurant, LaFargeville Market and Harbor Market. Training is provided for cashier work, pricing, shelf stocking, deli-work, gas attendant, dishwashing, food preparation and busing tables. The Fort Drum contracts, which are custodial services, recycling, dining facilities and Central Issues Facility, are set aide under the Javits-Wagner-O Day Act and provide unique vocational training and employment opportunities for persons with disabilities. These individuals interact with soldiers and civilians at Fort Drum on a daily basis. In conjunction with Fort Drum contracts, the Work Center also has janitorial contracts with the Amy Reserve Center in Watertown and Wellesley Island Border Station. Persons Served: Adults 18 years and older Full time and part time positions available Individuals with developmental disabilities, physical disabilities, mental illness, sub stance and alcohol abuse, and blindness. Individuals with developmental disabilities are required to be OPWDD eligible prior to receiving services. Services Provided: Vocational Counseling Pre-placement services In-services Participation on various agency committees Referrals to community agencies for additional services 24

27 Production Unlimited & Contract Sites Job Training at Production Unlimited: Bench assembly tasks Packaging Bulk Mailing Tag assembly Binder assembly Equipment folder assembly Collating Gainful employment at Fort Drum: Custodial Worker Recycling/Driver/Laborer Dining Facility Attendant Warehouse Worker Stock Clerk General Clerk Cashier Counting and packaging exam booklets Silk screening Criteria for Admission: Production Unlimited Workshop: 18 years of age or older OPWDD eligibility determination for developmentally disabled individuals Independent in area of self care needs with supports in place Has not exhibited major or severe acts of self-abuse or violence for a period of one year Able to perform one step operations Able to maintain attention to talk without verbal prompting for at least a 15 minute period 25

28 Bright Beginnings Early Learning Center Early Intervention Program The Early Intervention program, which falls under the auspices of the Department of Health, is designed to empower parents to seek services for their young child who may by experiencing a delay in one or more developmental domains (Cognitive, Communication, Motor, Social-Emotional, and Adaptive Behavior). The Early Intervention program serves eligible children from birth through three years of age in natural environments. Evaluations are performed at a variety of times and locations to fit the needs of the parents. All teachers in this program are certified by the New York State Education Department and all clinical staff are licensed by the New York State Education Department in accordance with Department of Health regulations. Persons Served: Children ranging from birth until they are eligible for transition into the preschool special education program (approximately age 3) who meet the Department of Health s eligibility criteria for classification as a child with a developmental delay Service Available: Developmental Toddler Group Speech Therapy; Occupational Therapy; Physical Therapy Special Instruction by a Special Education Teacher Transportation Screening Services Multi-disciplinary Evaluation Services Health Services Augmentative Communication Assistive technology Service Coordination Parent Support Transition Services Exiting the Program: A participant may leave the program when: The family chooses not to participate in this purely voluntary program The child transitions into the preschool age program The child is no longer eligible due to age The Individualized Family Service Plan (IFSP) team determines that the child no longer meets the Department of Health s criteria as a child with a developmental delay. 26

29 Bright Beginnings Early Learning Center Integrated Preschool / Daycare Program The Bright Beginning Early Learning Center operates five integrated preschool classrooms, under the jurisdiction of the New York State Education Department, for both typically developing children and students with disabilities between the ages of 2 years 9 months and 5. The Bright Beginnings program promotes social interaction, pre-kindergarten readiness skills and age appropriate self-help abilities. All of this is accomplished in a nurturing environment and in partnership with the child s family.. All special education teachers are certified and all clinical staff (Speech, Occupational and Physical therapists) are licensed by the New York State Educational Department. The Bright Beginnings Early Learning Center is an approved evaluation site and provides a variety of special education programs (8:1:1, 12:1:1, 12:1(3:1)) and related services that may include speech therapy, physical therapy and occupational therapy. Our program follows an open door policy, encouraging parents to visit and participate in their child s classroom activities. Our staff also encourages open communication between themselves and our parents to better serve the children. Our program is open from 7:30 am to 4:30 pm, five days a week and follows the public school schedule. We also operate a 6-week summer program that begins on July 5 and ends on August 13. Persons Served: Preschool Students with Disabilities: Includes children aged 2 years 10 months until eligible for public school placement who have been determined by the Committee on Preschool Special Education of their home school district to be a preschool student with a disability. Typical Students: Includes children aged 2 years 9 months until they are eligible for kindergarten placement. Parents pay a weekly Hour Block tuition fee for their child s JRC preschool services. JRC employees receive a 50% discount on these services. 27

30 Bright Beginnings Early Learning Center Integrated Preschool/ Daycare Program Services Available: Integrated preschool classroom settings available at our Gaffney Drive campus include: 12:1(3:1): Our 12:1(3:1) classroom includes 12 preschool students with disabilities, one special education teacher and one teacher aide for every sub-group of 3 special needs students. There is also an early education teacher and up to 6 typically developing children whose parents have selected the Bright Beginnings program as their preschool provider. 12:1:1: Our 12:1:1 classroom includes 12 preschool students with disabilities, one special education teacher and one teacher aide. There is also one early education teacher and up to 6 typically developing children whose parents have selected the Bright Beginnings program as their preschool provider. 8:1:1: Our three (3) 8:1:1 classrooms Include eight preschool students with disabilities, one special education teacher and one teacher aide. There is also an early education teacher and up to 10 typically developing children whose parents have selected the Bright Beginnings program as their preschool provider. Related Services: Speech Therapy, Occupational Therapy, Physical Therapy and Nursing Special Education Itinerant Teacher (SEIT) Teacher of the Visually Impaired Teacher of the Hearing Impaired Interpreter services for the deaf Parent Support through service coordination Multi-disciplinary Evaluation Services Service Coordination Augmentative Communication Assistive Technology Transition Services Extended School Year program (6-weeks during July and August) PLEASE NOTE: All Special Education programs and services recommended in a child s Individualized Education Plan (IEP) are provided at no cost to the parent. 28

31 Bright Beginnings Early Learning Center Integrated Preschool / Daycare Program Exiting the Program: A participant may leave the program when: The family chooses not to participate in this purely voluntary program The child transitions to a public school program The child is no longer eligible due to age The child s home school district s Committee on Preschool Special Education (CPSE) determines that the student no longer meets the New York State Education Department s criteria for classification as a preschool student with a disability 29

32 Vision Statement The Vision of the Jefferson Rehabilitation Center is to be a leader in service delivery for persons with disabilities. Mission Statement The Mission of the Jefferson Rehabilitation Center is to enhance the quality of life and maximize the potential of persons with disabilities. Values Personal Growth We will provide unlimited opportunities and experiences to encourage individual growth and development in an environment that recognizes choice, independence, inclusion, individualization and productivity. Responsiveness We will adapt to new, different and changing needs of those that we serve by being flexible and receptive to change. Inclusion All persons will be encouraged to contribute to the community where they live, thereby enhancing their self-esteem through the sense of work, belonging and service to others. Dignity All persons will be treated with dignity and respect, their human rights will be protected, and they will be provided with a safe and healthy environment. Excellence We will continually challenge ourselves to improve both the quality of our organization and service delivery by pursuing excellence in standards, service and technology. 30

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