INKApril-June 2013Volume 7, No. 2

“The Right Services...To the Right People...At the Right Time!”

AWARE

Brandy Wilson is one of two full-time employees who also receive services from AWARE. They rotate between various duties at KANA Radio and receptionist duties at AWARE’s corporate office. They are treated as equal members of the team, receiving the same orienta-tion as other employees, and like all employees, they are expected to meet job training requirements. Photo by Bryon Higgins

By Bryon Higgins

A new employment model at AWARE provides community-based employment to people with

disabilities. Craig Keller and Brandy Wilson are the first to test out this new model with assistance from job coaches, Desarae Kulaski and Trista Lipscomb.

For now, the model is being unveiled at KANA – “The Mighty 580,” AWARE’s recently acquired AM radio station, and the Anaconda corporate office. In the future, the model will be spread across the AWARE

AWARE pioneers employment modelBusiness Network, a collection of self-sustaining businesses operated as traditional, for-profit establish-ments.

The ultimate goal of the new model is to have people with disabilities fully integrated into the work-force. This means jobs at radio stations, retail stores, magazines and anywhere else high-level jobs are available. For years, the employment norm for people with disabilities has included a sheltered workshop setting and a piece rate wage. These jobs were simple,

DPHHS rule changes line up with AWARE care principles

Training determines caregiver success — Page 14

AWARE SchoolArt & Science Fair— Page 5

Note to staffand friends — Page 2

Lead cliniciansemphasize coaching— Page 11

AWARE celebrateshomeownership — Page 16Inside...

See Employment model on page 6

By Jim Tracy

AWARE has embraced recent changes by the state Children’s Mental Health Bureau in the way provid-ers deliver services to families and how they measure outcomes.

The overhaul of family services, which has touched employees from Successful Starts to payroll, has al-lowed AWARE to stay true to its principles of uncon-ditional care and faithful to family driven, strength-based, individualized solutions for families.

See Rule changes on page 8

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As usual, AWARE staff are busy. What else is new?

AWARE Ink is published bimonthly by AWARE, Inc., a 501(c)3 non-profit organization at 205 E. Park Ave., Anaconda, MT 59711. Copy-right ©2013, AWARE Inc. All rights reserved. No part of this newsletter may be used or reproduced in any form or by any means without prior written permission of the publisher.

Please send correspondence to: jtracy@aware-inc.org

Lawrence P. Noonan, CEOGeri L. Wyant, CFOJeffrey Folsom, COOMike Schulte, CHO Board of Directors John Haffey, President Al Smith Cheryl ZobenicaEd AmbergMarlene HolayterRussell CarstensStephen AddingtonBarbara AndreozziJesse Laslovich

Editor: Jim TracyStaff writers: Tim Pray Jacquie Peterson

Dear staff and friends,

There are so many things going on right now that I scarcely know where to begin.

As some of you may know, we have assumed ownership of Cold Mountain Pottery in Billings. This company produces handmade mugs and ships them

all over the world. If you’ve ever found yourself in a gift shop in Yellowstone Park, you’ve seen the mugs. This operation will eventually move into the Billings offices once construction for the kilns and other equipment is finished. However, we’re already employing people with disabilities, which, as you know, is one of our primary initiatives at AWARE—providing people with opportunities. Those we’re

employing are handling the shipping and receiving elements of the production, and as time goes on and we get more familiar with the intricacies of the business, we’ll be able to offer even more jobs.

While I’m talking about our recent endeavors that present a number of intricacies, we’re ramping up for the summer at Anaconda’s KANA radio station. We’re in the process of replacing and upgrading some equipment at the station. Besides strengthening our signal and enhancing the quality of the broadcasts, it allows staff at the station time to sell advertising, which, as you can imagine, is crucial to the success of any media.

We continue to be the go-to agency in Montana for children with autism and their families who are desperately seeking real world strategies and opportunities. As time has passed, the services have become more dynamic. Providing comprehensive services to a population of well-informed families and their children who have struggled with their services in school, the community, and at home is a challenge. Five years ago, when we opened the

Candlelight Home in Bozeman, it was the first home of its kind in Montana. Now there are six homes throughout the state, all of them operated with a wealth of experience and knowledge. Our continued relationship with the Kennedy Krieger Institute has been of critical importance and has affirmed our belief that what we’re offering is truly state of the art and outcomes based.

Soon we’ll undergo our CARF review (for those who don’t know, CARF stands for ‘Commission on the Accreditation of Rehabilitation Facilities’—an international agency with thorough auditing process in which no stone is left unturned). The last time we were reviewed was three years ago, and we received exemplary marks in virtually all categories of services, administrative practices and ancillary services such as Apostrophe. I’m eager for them to witness all that has developed in that time: work opportunities for people with disabilities, more services for people with autism, the development of the Big Sky Psychiatry Conference into a leading event in the

Nothing makes me more proud than shattering myths about people and disabilities.

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Larry Noonan

field, the Center for Excellence, Growth Thru Art… it’s really astounding to list all that’s been accomplished in three years, and even more astounding to consider the directions we’ll be going in another three.

There have been, and there will continue to be, changes in the ways our services our provided. As many of you know, the intricacies of both youth case management and what was therapeutic family care have become much more intertwined, complete with changes in roles and responsibilities. The sudden transition into a new division of labor has been handled beautifully

by staff who never lost sight of the fact that, despite any difficulty on our end, the families we serve must not be a part of that difficulty.

As the year continues to roll on, we’ll continue to look at the ways we do things and ask ourselves if we can be doing it better. If we can, we’ll figure out a way to do it. Sometimes those changes are daunting, changes like our conversion to electronic medical records that will begin in the next year. But I’m particularly proud of the small changes that occur over time, too. At more and more of our reception desks across the state, we have people with

disabilities answering the phones and doing other administrative tasks. It seems simple, but you’d be surprised at the number of people who have told me that it completely shattered their notion that people with developmental disabilities could not or would not work. Nothing makes me more proud than shattering myths about people and disabilities. So, again, thank you all for your support, hard work, attention to detail, and for putting the needs of those you’re serving first.

With best regards,

Pledge night

AWARE volunteers chat with Drew Jenkins of Montana PBS during a break at the telephone banks March 4. The volunteers participated in a pledge night that featured the station’s Celebrate America Across Montana show. Left to right, they are Autumn Kirby, Jaci Noonan and Jennifer Leverett. Also volunteering as part of AWARE’s Apostrophe magazine team were Jacquie Peterson, Bryon Higgins, Tim Pray and Jim Tracy. PBS runs on-air ads for Apostrophe in exchange for PBS ads in the magazine. Photo by Jim Tracy

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Art and Science Fair

Students at AWARE’s school in Anaconda exhibited their projects at the annual Art and Science Fair May 17 in the gymnasium at the Anaconda High School vocational education center. At left, Anthony Runfola explains his project on motors and race cars. Below, Silas Baker (left) and Ethan Miller built a hovercraft using a leaf blower and then demonstrated how it works. Photos by Jim Tracy

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EmploymentmodelContinued from page 1

and receptionist duties at AWARE’s corporate office, this means being treated as an equal member of the team. They receive the same orien-tation as other employees, and they are expected to maintain their job training requirements like everyone else.

“I am really glad to be out in the community doing a real job that allows me to help others out,” says Brandy about the model. “Learning new things and getting to help out are my favorite parts.”

At the radio station, Craig’s and

Brandy’s duties include answer-ing the phones, greeting guests, responding to email and other office tasks. The highlight of the radio station, though, is operating the board during live play-by-play broadcasts of Anaconda Copper-head Sports with announcer Blake Hempstead. Duties during the live events include using radio traffic software to initiate the broadcast, loading and playing commercials during timeouts and counting Blake back onto the air by telephone as commercial breaks end.

“You’ve got 30 seconds Blake,” the excitement in the studio builds, “and 5…4…3…,” as the volume of Craig’s voice in-creases with the final countdown. He motions with hand signals while he talks into the phone, making sure Blake is ready to come back onto air at just the right moment. It is obvious that this is Craig’s favorite part of the job.

Communication between the announcer and the board opera-tor is critical because the du-ties are performed in separate locations. While Blake is on the field watching and announcing

Craig Keller’s duties include answering the phones, greeting guests, responding to email and other office tasks. The highlight of the radio station, though, is operating the board during live play-by-play broad-casts of Anaconda Copperhead Sports.Photo by BryonHiggins

requiring little to no skill, and wages were based on the number of “pieces” com-pleted.

With AWARE’s new model, the main empha-sis is placed on individualized career placement. While the shel-tered workshop model provides an approach for some people, it often limits people with disabilities who have a wide spectrum of talents to offer in the workforce.

AWARE’s new employment model is designed to help people with disabilities become indepen-dent, develop innate talents and integrate into the community. It consists of two separate elements – a supported employment program and job placement based on inter-est and skill level. An emphasis is placed on the separation of pro-gram and employment elements because businesses lose their primary focus when they become responsible for programmatic details like transportation, doc-tor’s appointments or behavioral issues. In some cases, these things can reduce business productivity by as much as 40 percent. In ad-dition, maintaining this separation provides clarity for people as they make the psychological shift from program to job placement and ul-timately functioning as a reliable employee.

For Craig and Brandy, both full-time employees rotating between various duties at KANA

I am really glad to be out in the community doing a real job that allows me to help oth-ers out. Learning new things and getting to help out are my favorite parts. — Brandy Wilson

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Billy Plummer — Shot put Jacob Sherman — Team bocce and bowlingRuss Carstens — Coaching AssistantJudy Armbruster — BowlingAimee Roberson — Team bocce and bowlingJay Arensmeyer — Team bocce and bowlingDan Bowen — Team bocce and bowlingCasey Fisk — CheerleaderDan Ramsey — Cheerleader

Coaches: Deon Brown (head coach), Bill Tiskus and Katie Huot

the game, he is relying on Craig or Brandy in the studio for timing cues and volume levels. Without this information, it would be dif-ficult, if not impossible, to air the live events.

At the corporate office, recep-tionist duties primarily include an-swering the phones and transferring calls to the appropriate people. In many instances, Craig and Brandy have each answered the phone over 100 times in a four-hour period. Other duties include making public office announcements over the intercom, paging employees and handling incoming/outgoing mail.

Job coaches, Desarae and Trista, help Craig and Brandy with their duties, but on a minimal level and only when necessary. The main goal for Desarae and Trista is to have Craig and Brandy work inde-pendently without assistance. The amount of assistance provided will decrease over time until it is no longer required.

The new employment model is among the first of its kind, and AWARE is excited to see it take shape. As the model is incorporated across AWARE’s growing Business Network, people with disabilities will have an increasing number of opportunities for employment. The model will become an essen-tial piece of AWARE’s work with young people who have disabilities as they make the transition from adolescents to young adults and active members of the commu-nity. It is yet another example of AWARE’s promise to provide the right services, to the right people, at the right time.

Jay Arensmeyer Judy Armbruster Dan Bowen

Russell Carstens Casey Fisk Jacob Sherman

Billy Plummer Dan Ramsey Aimee Roberson

I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel. — Maya Angelou

AWARE Special Olympians

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Rule changesfrom page 1

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Jaci Noonan, director of case management and home support services, said the changes AWARE has made bring together services and the people who administer them in ways that didn’t always occur before. And the beneficiaries, she said, are the children and fami-lies who receive services.

“That was one of the reasons we wrapped our arms around this rule change,” Noonan said, add-ing, “I think there is nothing but excitement about the reorganiza-tion. Certainly there are tweaks that still need to be done, but we have accomplished most of what we set out to do.”

“It gets down to the whole premise of engaging families,” said Mike Kelly, whose new title under the reorganization is director of psychiatry and clinical services. “Once you have a family engaged and you have a relationship with them and your staff, it’s blue sky.”

AWARE already was looking at better ways to deliver family ser-vices when the state Department of Public Health and Human Services changed its focus … and changed the rules.

UCC principles“A group of us were looking at

our principles of unconditional care and how we could better provide quality services for the families and kids we were serving,” Kelly said. “While that was happening, the state began meeting with providers and looking at changing the rules to improve the quality of services. So, it was very timely. It was parallel with our discussions at AWARE about improving the quality of our services.”

Besides Noonan and Kelly, the

leadership group included Jeff Fol-som, chief operating officer; Melin-da Edwards, director of early child-hood services; and Pandi Highland, quality management director.

Frequent meetings They began meeting weekly by

phone in January to formulate a plan to comply with the state’s rule changes. The plan required a lot of give and take and willingness to listen to other points of view, Noonan said.

After about four months, they finished the reorganization plan, presented it to AWARE’s manage-ment and began making admin-istrative adjustments to make it happen about May 1. That included allowing current employees to move into new jobs with new titles and hiring new employees from outside. It also included training staff at all levels.

“We moved ahead,” Kelly said. “And we’re not looking back.”

While AWARE has welcomed the state rule changes, other provid-ers of the same services apparently are not as keen about them.

“We are the only provider I’m aware of that has embraced these new rules,” Kelly said. “The rule changes are not what drove our reorganization, but they were abso-lutely a significant part of it.”

Along with other providers, AWARE attended a meeting at the Children’s Mental Health Bureau in May. But unlike many other pro-viders, AWARE has already imple-mented the department’s recom-mendations.

According to Dan Ladd, pro-gram planning supervisor in the Children’s Mental Health Bureau, about half of the youth mental health providers across the state have participated in the changes.

Ladd said the changes were prompted by communities and providers “asking for more/better options to support keeping youth in their homes and communities while reducing the use of group home and residential settings.”

Wraparound services, he said, provide a more coordinated effort to support the success of youth and families. He hopes the result will be an increase in the number of children being served in their home communities.

Ladd offered no deadline for when he expects the changes to be fully implemented. Instead, he said, putting the changes in place “will be an ongoing challenge for the bureau and providers.”

“As we continue to develop healthy partnerships with provid-ers, the effectiveness of these pro-grams should continue to increase over time,” he said.

With the changes, Kelly said DPHHS hopes to develop and promote wrap-around services, a philosophy AWARE adopted more than 15 years ago.

Wrap-around services are “in-dividualized,” which means every family gets a unique plan that fits them and their beliefs and values, not the cookie cutter plan that ev-erybody else gets.

Greater flexibility“The program that has been de-

veloped in light of the rule changes will have greater flexibility in in-dividualizing services provided to families and children,” said Jacob Henderson, one of eight commu-nity service administrators.

AWARE also has two early childhood service administrators.

“If I had to sum up the philoso-phy of wrap-around in one word or two words, I would say it means

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individualized services. The new program will provide strong facili-tators to work with kids and fami-lies with a focus on individualizing our services to meet a family’s needs.”

AWARE prides itself on pro-viding strength-based services. That means the wrap-around plans help individuals build on what is working in their lives instead of focusing exclusively on what isn’t working.

A key part is the emphasis on family-driven services, which means plans are centered on the whole family and its choices.

Noonan noted that proving out-comes may be easier for AWARE than for other providers because the company already tracks the prog-ress of children and their families with several assessment tools and data collection.

Staff already use the Wrap-around Fidelity Assessment Sys-tem. AWARE is considering adding CANS to its toolbox.

CANS, or Child & Adolescent Needs and Strengths methodology, guides service delivery for children with mental health needs, devel-opmental disabilities, issues of sexual development, juvenile jus-tice involvement and child welfare involvement.

Quality assuranceCANS “provides information

regarding the child and family’s service needs for use during system planning and/or quality assurance monitoring,” according to the de-scription of the tool on the Mary-land government website.

The Wraparound Fidelity As-sessment System, or WFAS, has been described as “a multi-method approach to assessing the quality of individualized care planning

and management for children and youth with complex needs and their families.”

“We collect data on everything that has to do with child out-comes,” said Edwards. “We use standardized instruments that help us measure how much progress a child has made. We can measure pre- and post-intervention.”

She said AWARE also uses data from Head Start for comparisons to gauge the success of its services.

Edwards believes the new ap-proach will be especially effective for families who are receiving services for their children in pre-school and lower grades.

‘A logical focus’“It’s a logical focus for those of

us in early childhood,” she said. “One of our foundation pieces is to work primarily with families. If we are going to make changes with a child, we need to be working with a family.”

The new approach, Edwards said, “is completely aligned with our early childhood philosophy at AWARE.”

That philosophy emphasizes the value of working with children and families in a natural environment — in this case the home rather than, say, a therapist’s office.

AWARE works with families with children in Head Start and Early Head Start programs in Bill-ings, Miles City, Butte, Ronan, Lewistown, Great Falls, Bozeman and Helena.

“Because we are housed in Head Start programs, we get referrals from a screening or parent request or teacher observing in the class-room,” Edwards said.

She noted that most referrals involve children exhibiting aggres-sive behavior, although occasional-

ly other behaviors, such as extreme shyness, can draw the attention of teachers.

“We don’t want to lose sight of the kids who tend to be wallflow-ers,” Edwards said.

Once AWARE professionals begin working with a child and his or her family, they stay with them even after the Head Start connec-tion ends.

AWARE’s “wrap-around” sup-port often involves home visits that focus on skill building and helping parents support and nurture their child’s social and emotional devel-opment.

“When they don’t get that, it’s often a big void in their lives,” Edwards said. “Once children leave Head Start, AWARE is the consistent link in that family’s life, and that is what helps increase the child’s chances of success in school.”

Edwards noted that 6 percent to 8 percent of all children of pre-school age need support.

“However, when we look at the Head Start population — those children living in poverty — that number jumps to about 30 to 35 percent, which in and of itself brings significant risk,” she said.

Kids at riskBecause AWARE has contracts

with Head Start programs around the state, the majority of AWARE Successful Starts services are with Head Start children and families. Hence at-risk children in the com-munity who are not in Head Start programs probably aren’t getting all of the help they need to succeed in school.

“If the professional is not there (in the classroom), they can’t see the need,” Edwards said. “Because

Continued on next page

Data is not information, information is not knowledge, knowledge is not under-standing, understanding is not wisdom. — Clifford Stoll (American astronomer and author)

Give me six hours to chop down a tree and I will spend the first four sharpening the axe. — Abraham Lincoln

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“Change can always bring strong emotions,” said Henderson. “We have seen a lot of excitement from crew members in regards to the op-portunities with the new program, along with some anxiety. Overall I have been pleased to see from my crew that their focus has been on the kids and families we serve.”

“Philosophically,” added Kelly, “it’s one of the best things AWARE has done.”

Continued from page 9

we are present on site, we can identify children’s needs at an early stage.”

At Bozeman’s Head Start, for example, only one child was referred for social service support before AWARE became involved with the program.

“This year alone we’ve had 20 referrals in Bozeman, and we’ll probably have more next year,” Edwards said.

“Early childhood intervention works,” she added. “If they don’t get intervention early, we or an-other mental health agency will see these kids later.”

While the change affects people

AWARE promotes a “wrap-around” philosophy so that services are strength-based, family focused, individualized, and comprehensive.

Children’s Mental Health

Youth Case ManagementYCM - The primary functions of

Youth Case Management include walking families through vari-ous application processes, helping coordinate services and advocating for the needs of children and their families

Home Support ServicesHSS- Home Support Services is

a family-centered program de-signed to keep kids who have been identified as high-risk with their families; workers in this program are called Child and Family Spe-cialist or CFS.

Community Based PsychiatricRehabilitation and SupportCBPR&S – Behavior Support

Coordinators (BSCs) helps kids and families meet basic needs related to living in the community including housing, transportation, education, employment, social skill building, and any other areas that need attention as identified in a strength-based plan.

Early Head Start/ Head Start and Successful Starts

Successful Starts: AWARE’s collaboration with Head Start pro-grams throughout the state provides mental health services and supports directly to Head Start students and their families.

Comprehensive School andCommunity Based-Treatment CSCT- AWARE’s Comprehen-

sive School and Community-based Treatment Services make addi-

tional supports available for young people who are struggling with behavioral and emotional issues in school.

Psychiatry and Outpatient Services Psychiatry and Outpatient ther-

apy is provided to youth, adults, and their families. Qualified pro-fessionals develop treatment plans suited to the individual or family, depending on their needs. Services are provided in a center (such as a clinic), at an AWARE office or at an appropriate and confidential community site of the customer’s choice.

Adult Mental Health

Adult Mental Health Case Management The primary functions of Adult

Case Management include walking individuals through various appli-

receiving services, it also impacts AWARE administration.

New position addedNoonan noted that the change

has meant increased midlevel su-pervision. And with new positions and new titles (AWARE has even created a new position, the child and family specialist) staff in the business office, especially payroll, have been redoubling efforts to ensure a smooth transition.

Staff who work on the front lines with families have welcomed the changes, Noonan said.

“They are mostly excited about it. They are talking about it with families. It’s a more focused team approach with more cohesiveness.”

A snapshot of AWARE Community Services

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cation processes, helping coordi-nate services and advocating for the needs of the individual in services.

Community Based Rehab and SupportThe CBPR&S program is paired

with the ACM program and pro-vides one-on-one assistance to individuals to meet goals outlined in the plan of care.

Developmental Disability Services

Adult Targeted Case Management AWARE’s DD Targeted Case

Management provides case man-agement services to adults with a developmental disability, the TCM’s assist individuals with ac-cessing community services and developing a plan of care to meet the individuals needs.

Children’s Waiver Services — Family Support Specialist (FSS)

AWARE’s services for children with developmental disabilities (Children’s Waiver Services) pro-vide every family with the indi-vidualized supports they need to keep their child in the home, while supporting their child to reach his/her highest potential in living a fulfilling life.

Community Service AdministratorsJake Henderson — Kalispell and MissoulaSuzanne Morgan — HelenaAutumn Kirby — BozemanDawn Ann Peterson — ButteKatie Noctor — Anaconda, Deer Lodge and DillonKim Lewis — BillingsKeith Polesky — Eastern Montana (Glasgow, Glendive, Miles City and Red Lodge)

Lead clinicians emphasizing coaching By Jim Tracy

Besides reorganizing community services, AWARE has increased its emphasis in training clinicians.

“We want our clinicians to understand completely what’s expected of them, and we want to develop our own internal experts in specialized content,” said Mike Kelly, whose new title is director of psychiatry and clinical service.

“In conjunction with the re-organization, for the past nine months, we’ve been looking at our lead clinicians to do three things: develop their leadership skills so they can coach front-line staff; coach early career thera-pists who are working toward licensure; and develop their own professional skills.”

To help make that happen, six priorities for clinical services were identified and developed:

1. Provide quality assessment services as a foundation to the development and implementation of all services provided.

2. Act as engaged treatment team members who provide leadership, direction and coaching consistent with AWARE’s unconditional care principles.

3. Provide clinical coaching of mental health center services staff, in-cluding review and oversight of implementation of strength-based service plans.

4. Provide outpatient therapies through the use of evidence-based prac-tice skills.

5. Accurately and consistently provide required documentation, includ-ing billing, prior authorization and documentation of client progress and outcomes.

6. Participate actively in the crisis response system, including primary attention to crisis planning and responsiveness to crisis calls.

Lead clinician staff are Cindy Tadday, Kalispell; Carol Chisholm, Helena; Mindy Hayes, Great Falls; Jenn Leverett, Bozeman; Janelle Van Steeland, Billings; Anna Rapson, Miles City; and Laurie Helmer, Butte and Dillon.

Lead clinician staff for AWARE’s Successful Starts pre-school program are Andrea Savage, Great Falls; Danielle Eldridge, Billings; and Jamie Knott, Butte.

Engaging families means developing trusting relationship that allow families to better express themselves and identify their strengths, areas they want to improve, skills they want to develop and goals they want to reach. — Mike Kelly

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“Kelly said the goal for clini-cians is be to become leaders in clinical services and build knowl-edge and skills in specific areas.

“They would bring that infor-mation to other clinicians and front-line staff and train them to develop their own level of expertise,” he said. “AWARE staff are working on strategies to engage families. Engaging fami-lies means developing trusting relationships that allow families to better express themselves and identify their strengths, areas they want to improve, skills they want to develop and goals they want to reach. It definitely takes skill to engage families. Staff across the state also are working closely with Mary Grealish in developing skills that engage families.”

Grealish, who works for AWARE, is a pioneer in implementing person- and family-centered practice, the wrap-around process, therapeutic foster care, com-munity assessment, system design and strengths-based behavior interventions.

‘Work from their strengths’A mother of two, including a young adult who

has serious and persistent mental illnesses, Grealish is known for her simple and seemingly obvious ap-proach: “Tailor the necessary services to suit each consumer, each child, and each family, and work from their strengths.”

Under Grealish’s tutelage, AWARE staff are learn-ing how to complete functional assessments.

“From that, they are being coached in implement-ing lesson plans that help families gain abilities and insights to accomplish goals they have identified,” Kelly said.

They are also becoming experts in specialized content such as Theraplay, trauma-focused cognitive behavior therapy and family therapy.

Theraplay is a child and family therapy for building and enhancing attachment, self-esteem, trust in others and “joyful engagement,” according to the Theraplay Institute.

“It is based on the natural patterns of playful, healthy interaction between parent and child and is personal, physical and fun,” the institute’s website

says. “Theraplay interactions focus on four essential qualities found in parent-child relation-ships: structure, engagement, nurture and challenge.”

Children, specifically adoles-cents, who are suffering severe emotional repercussions due to trauma respond extremely well to trauma-focused cognitive behav-ior therapy, Kelly said.

The therapy helps children who have experienced repeated episodes of trauma, as in abuse or neglect, or those who have suf-fered one occurrence of sudden trauma in their lives.

It can also be used to treat children who are learning to cope with the death of a loved one.

Family therapy is based on the belief that the fam-ily is a unique social system with its own structure and patterns of communication. The patterns are deter-mined by factors that include the parents’ beliefs and values, the personalities of family members and the influence of the extended family (grandparents, aunts and uncles). As a result of these variables, each family develops its own unique personality, which is power-ful and affects all of its members.

Health professionals who use the family systems model in caring for people always consider the whole family. They view any problem in one member as a symptom of change or conflict in the group.

“So we’re using different techniques,” Kelly said. “We want to use an array of therapies because we indi-vidualize our services.”

Formal clinical coachingKelly said the lead clinicians coach less experienced

therapists to provide evidence-based treatment“It’s formal clinical coaching of staff who are work-

ing toward licensure,” Kelly said.“The word ‘coaching’ can be interchanged with

clinical supervision,” he added. “They give them feed-back on their technique. We use coaching because it better describes what they are doing.”

Lead clinician Carol Chisholm of Helena likens what she does to a basketball coach who teaches play-ers mechanics, conditioning and strategy.

“A good teacher knows how to break fundamentals into skill sets,” Chisholm said.

What I do is help the young professional with skill sets, like crisis man-agement, how to de-esca-late crisis situations, how to engage families. You build a sense of trust with a person while at the same time you’re helping this person get involved in their own treatment. — Carol Chisholm

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Skills could involve something as seemingly simple as learning to make eye contact with a client.

“The way someone gets good at those is they practice and they practice and they practice,” she said. “What I do is help the young professional with skill sets, like crisis management, how to de-escalate crisis situations, how to engage families. You build a sense of trust with a person while at the same time you’re helping this person get involved in their own treat-ment.”

Most of her coaching and mentoring involves home service specialists, a new position created as part of AWARE’s reorganization.

“A lot of them are bachelor level professionals who have an eye to becoming licensed therapists,” Chisholm said. “I’m providing support that will give those folks a boost up.”

She encourages them and helps channel their enthu-siasm.

“I work with the eager and young potential social worker and therapist who wants to work within family structures and family systems and bring those families to their full potential,” she said.

Chisholm supervises five children and family spe-cialists who work in the community, what she calls “the trenches.” Each specialist gets an hour a week alone with her.

‘We practice over and over’“I give them tips, then I do group supervision,” she

said. “We practice general skills. We might role-play a family who is having a tough time or a defiant teen-ager so we can figure out how to get some leverage in opening the person up. That’s what we practice over and over and over.”

A specialist in family systems therapy, Chisholm is trained to know and understand relationships among family members. She passes on that understanding to staff in her charge.

“So much is embodied in rela-tionships with families,” she said. “I really work at larger meaning systems and helping people hold on to what’s good and wonderful about their families and traditions that have been passed on. We want to keep those traditions and move away from other behaviors that haven’t been so helpful.”

Examples of other “unhelpful”

behaviors, or meaning systems, include ingrained behaviors like incest, physical abuse and drug and alcohol abuse.

“We work with families that really don’t see the problem,” Chisholm said. “We work on those larger meaning systems that really affect their lives.”

At the same time, she said, therapists can sometimes get ahead of the family in an effort to change behavior. Anger management may sound like a good strategy, for example, but forcing someone to “manage” their emotions may produce the opposite result, she said.

Resisting change“Anytime someone hears that they have to change,

there’s resistance,” she said. “Engagement really means a conversation, a collaborative conversation that gets behind people and helps them get involved in their own rescue.”

Lead clinician Danielle Eldridge of Billings be-lieves the changes have helped her become more con-nected.

“For new clinicians, I think it increases connections and helps foster a sense of support and community within AWARE,” Eldridge said. “I also feel AWARE’s emphasis on coaching has increased the quality of service delivery and ensures a sense of consistency in expectations. It has also helped me to be more con-nected with other communities.”

She supervises clinicians in Billings, Bozeman and in Helena.

“As each program, runs things a little differently,” she said. “I am challenged to find ways to accept differences and also strive for consistency in service delivery.”

She also feels challenged to keep abreast of new developments in her field and to understand rules, policies and AWARE’s expectations.

“I have become more self-reflective of how I can encourage and teach others and more aware that other

people have different learn-ing styles,” she said. “It has also helped increase the qual-ity of my own work as I spend so much time reflecting and thinking about things like as-sessments and how therapy notes should be written as well as recognizing how families are responding and what might ”

“I have become more self-reflective of how I can encourage and teach oth-ers and more aware that other people have different learning styles. — Danielle Eldridge See Lead Clinicians on page 24

14

By Chad BushmanAWARE Training Coordinator

To succeed, the professional caregiver must be able to suc-cessfully navigate the treacherous administrative waters.

This includes understanding regulations to ensure clients re-ceive proper care, successfully completing employee performance evaluations, correctly document-

ing account expenditures and accu-rately billing for AWARE services.

Supervi-sors, system administra-tors and ser-vice directors are expected to remain knowledge-

able of the ever-changing admin-istrative policies and procedures. Additionally, it is implied they will also mentor and guide those under their charge on how to interpret, handle and manage administrative issues. To facilitate their endeavor, AWARE offers recurring adminis-trative training opportunities.

The latest informationAdministrative training is held

once a quarter at the Corporate Office in Anaconda. The one-and-a-half-day class is geared toward supervisors with the intention of helping them assume their new role armed with the latest information. Attendees are briefed by personnel from the different corporate depart-ments, such as human resources,

accounts payable, accounts receiv-able, transportation, information technology and payroll. The benefit of this interaction is two-fold.

First, attendees receive instruc-tion directly from subject matter experts equipped with the most up-to-date material. As such, attendees are able (and encouraged) to seek answers to their toughest questions, which helps separate fact from rumor.

Put a face to a nameAdditionally, attendees and pre-

senters get the opportunity to meet and put a face to name, which is the second benefit of this training. Face-to-face interactions allow frontline caregivers and corporate staff the opportunity to reduce the communication gap as well as to bring to light differences in their professional perspectives.

This interaction is an AWARE-wide benefit because corporate staff gets the chance to commu-nicate the importance of adminis-trative issues, such as the reason behind required deadlines. On the flip side, frontline caregivers are able to relate real-time challenges they face on a daily basis.

Understanding and appreciat-ing these differences has not only helped identify and select which topics are presented during the training event, but also helps cor-porate staff improve service to their customer (the frontline caregiver). In turn, it helps frontline caregivers enhance their care and customer service to their clients.

Administrative Training covers a wide variety of information. A few examples of the specific brief-ing topics include: completing an

intake and discharge form, identify-ing Medicaid eligibility, petty cash actions, sub-account allocations, hiring methods, employee disci-plinary process, NOVAtime, 401k, worker’s compensation and pur-chase order procedures.

This is just a smattering of the material presented.

Inviting supervisors to Anaconda for the one and a half day event al-lows department personnel to brief attendees en masse, allowing for maximum interaction.

Many attendees take advantage of the opportunity to visit one-on-one with corporate personnel to address more specific or unique issues they are handling.

Offered quarterlyWhile the course was designed

for the newly appointed supervisor, it is also a great refresher training opportunity for those who feel the knife edge on their administrative knowledge has dulled.

As stated earlier, administrative training is offered quarterly with the next two sessions being held Aug. 26-27 and Oct. 28-29.

Supervisors can register employ-ees for this training by using the training signup email: trainingsign-up@aware-inc.org. In the email, please provide the following: par-ticipants’ name; desired training; date; and training location.

Take advantage of this training opportunity. It is geared to help su-pervisors successfully navigate the treacherous administrative waters.

Training determines caregiver success

Chad Bushman

Do what you can, with what you have, where you are. — Theodore Roosevelt

Pull, aim squeeze, sweep

Sharati Pia, an associate in accounts payable, demonstrates the proper use of a fire extin-guisher as part of AWARE’s ongoing training. Use “PASS” to remember the technique: Pull the pin, Aim at the base of the fire, Squeeze the lever slowly and Sweep from side to side. Photo by Chad Bushman

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Governor agreesto 4 percent increase

AWARE and other nonprofits that provide services to people with developmental disabilities across Montana will receive a 4 percent increase in state payments starting in July, according to a news report from the Lee State Bureau.

The 2013 Legislature approved the 4 percent increase, but the ad-ministration of Gov. Steve Bullock last month proposed granting only a 2 percent rate increase this year and possibly basing the additional 2 percent on “performance outcome measures” for groups getting the money, the Lee Bureau reports.

After provider groups protested, the state relented and agreed to pay the full 4 percent.

There are 70 private, nonprofit companies that run group homes or provide day services for adults and children with developmental dis-abilities across the state.

Richard Opper, director of the Department of Public Health and Human Services, told the Lee Bureau his agency still wants to explore the possibility of outcome measures next year, so the best providers might get more than a 4 percent raise in state payments.

“I don’t know if we can get there or not. … But I’d sure like to have that conversation with them,” Opper was quoted as saying.

Providers argued that the 2013 Legislature approved the 4 percent annual increase for each of the next two years, without any performance measures.

The nonprofit companies are funded almost entirely by Medicaid, the state-federal program that pays medical costs for poor people and people with disabllities. The state, through the Legislature, sets the rates for these providers.

Anaconda

Work

And

Residential

Enterprises

Sheila Rice, director of NeighborWorks in Great Falls (holding the AWARE banner) and Michael O’Neil, a program officer for AWARE (with the folder under his arm) spoke at a housewarming June 3 for Sierra Lode of Helena. Lode and Michael Kornec of East Helena are the latest Montanans to get a boost from organizations like NeighborWorks and AWARE that help people with disabilities buy their own homes. Photo by Jim Tracy

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By Jim Tracy

With the help of NeighborWorks, AWARE, other groups and fam-ily and friends, Sierra Lode and Michael Kornec are living in their own homes.

Lode moved into a two-bed-room, one-bath home in a quiet northcentral Helena neighbor-hood in early May. The home is fully accessible, a primary consideration since she uses a wheelchair.

Kornec’s three-bedroom, two-bath home is on Main Street in East Helena.

The two young adults cel-ebrated their recent participation in the American dream with more than two dozen family members, friends and support-ers at a housewarming at Lode’s home on June 3.

“We can’t express the apprecia-tion we have for all of you to help this dream come true,” Carol Lode, Sierra’s mother, told the assembled crowd.

“Michael has been able to find a home that is way nicer than

anything he could rent,” Kornec’s mother, Shawn Brandt, said. “He wanted a house with a fenced yard so he could own a dog. Without you all it would not have been pos-sible.”

Well-wishers included Darren Larson, an independent living specialist at Summit Independent Living Center in Missoula and a member of the Montana Inde-pendent Living Centers Housing Task Force.

“All people are deserving and need a place to call home,” Larson said. “Sierra Lode and I go way back. I am excited to see her beautiful new, accessible home. If Sierra’s home is the 130th home purchase assisted by AWARE, then I want to own the 131st.”

Also attending was Montana

NeighborWorks has

helped more than 5,000

Montanans statewide with

financing the purchase of

their homes, and AWARE

Inc. has helped more than

130 people with disabilities

achieve homeownership.

NeighborWorks, AWARE celebrate homeownership

Sierra Lode, foreground, has purchased her own home in a quiet northcentral Helena nighbor-hood with the help of NeighborWorks, AWARE and numerous other private and public organi-zations. Standing behind Sierra are her father, Fred, housemate, Beth Rolfe, and mother, Carol. Photo by Jim Tracy

17

Lt. Gov. John Walsh.“I know how truly important it is

to be a homeowner,” Walsh told the group. “We know as a team we can make things happen.”

Sheila Rice, executive director of NeighborWorks in Great Falls, noted that homeownership gives people independence and confi-dence.

“Owning a home is the most im-portant goal anyone has,” she said. “Home matters. Home is where it all begins.”

“Everyone should have the opportunity to own a home,” she added.

“Sierra and Mike’s accomplish-ments took the dedication of the homeowners and their families along with the collaborative ef-forts of many organizations and individuals who believe that Home Matters especially for people with disabilities,” said Michael O’Neil, an AWARE program officer.

5,000 homeownersNeighborWorks has helped more

than 5,000 Montanans statewide with financing the purchase of their homes, and AWARE Inc. has helped more than 130 people with disabilities achieve homeowner-ship.

The housewarming guest list included Gail Mann of Ameri-can Federal Savings Bank; Mary Caferro, coordinator for The Arc of Montana; Darren Larson of Mon-tana Independent Living Centers Housing Task Force; Leslie Torg-erson and Josh Lafromboise of Helena Housing Authority; realtors Rita Williams and Kyle Cour-chane; Richard Opper, director of the Montana Department of Public Health and Human Services; Erik Amundson, field office director for the U.S. Department of Housing

and Urban Development; Debbie Morrison of Montana Department of Commerce HOME and Housing Choice Voucher programs; Bruce Brensdal, executive director of the Montana Board of Housing; Re-becca deCamara, administrator of Montana’s Developmental Services Division; Robin Homan, program

manager in the Community Servic-es Bureau of the Senior and Long-Term Care Division; and represen-tatives of the Montana Board of Housing, Rocky Mountain Devel-opment Council and USDA Rural Development.

Waiter sticks up for child with special needs

[blog.sfgate.com]uk.reuters.com.

Compiled by Jacquie Peterson

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Michigan teen with cerebral palsy completes triathlonJUSTINE McGUIRE [NECN.com]

The triathlon finish line represents a sense of ac-complishment and often produces a surge of emotions. High school sophomore Bradley Langemaat, who has cerebral palsy, recently created plenty of each when he crossed the finish line of the Seahorse Challenge triathlon, according to a June 1 article at NECN.com.

Along with his triathlon helpers, Langemaat pro-duced an inspirational moment for his family, class-mates and teachers — many of whom were on hand to witness the occasion, according to the Muskegon Chronicle.

Langemaat received assistance from three teachers en route to completing the three legs of the race — a 500-meter swim, a 12.4-mile bike ride and a 3.1-mile run. The event also featured 70 other Grand Haven High School students who all completed the event.

Derek Warner, who teaches the high school’s triath-lon class, pulled Langemaat in a boat during the swim portion of the event. Tom Foley, an English teacher at the high school, pulled Langemaat in a bike trailer during the biking portion of the race, while Melissa Richardson, Langemaat’s main teacher, pushed him in a large stroller during the 3.1-mile run.

Find the complete story at necn.com/06/09/13/Grand-Haven-sophomore-with-cerebral-pals/land-ing_nation.html?&apID=b75f9c196472451db88b1cfc3cf6bca4.

Boy with disability receives renovated home[PRWeb.com]

As part of a continued effort to support and give back to the local community, commercial painting company ProGroup Network and its employees re-cently took on yet another community service project, this time helping to renovate the home of Jeremiah, Aiden and Cindy Jeffers reports PRrweb.com.

Called “Jeremiah’s Project,” more than 60 volun-teers helped to completely renovate the home, gutting interior and exterior walls to create a more livable and moveable space for Jeremiah and his family.

NEWS BRIEFS Compiled by Jacquie Peterson

Jeremiah is a 12-year-old boy with cerebral palsy. Both he and Aiden, his younger brother, are under the care of their grandmother, Cindy Jeffers.

On April 26th, the family got the surprise of their life. Jeremiah, his brother and Cindy were picked up from their home in Wareham, Mass., and sent on vacation for a week, under the impression that small renovations would be done to their home.

Little did they know that the small renovations were actually a complete gut and renovation of their entire home to make it handicap accessible. More than 60 volunteers, including those from ProGroup Network, worked around the clock to install new electric and plumbing, install a new exterior roof, build and install a new ramp to the property, and make improvements to enhance Jeremiah’s quality of life within the home. ProGroup Network also painted the entire interior and exterior of the home.

Find the complete story at prweb.com/releases/com-merical_painting/volunteer/prweb10807257.htm.

Students take ballroom dancing classesCHRISTIN LOVVOM [AL.com]

Tuesday evenings members of the Down Syndrome Society of Mobile County, Mobile, Ala., put on their dancing shoes to learn ballroom dancing at the Azalea City Center for the Arts. The class is taught by Ann Druhan as part an etiquette class, reports AL.com.

“We wanted to teach traditional ballroom dancing and etiquette skills to young adults with Down syn-drome to help them gain poise and confidence when in social situations,” said Lisa Gibert whose daughter, Britt, is a member of the Icebreakers.

“Our etiquette class covers the basics of a tradition-al etiquette class and provides extra time to learn and practice the skills being taught,” Gibert said.

According to the June 3 article by AL.com, the classes that average about 18 students 18-30 years old, were part of a pilot program funded by grants provided by the Down Syndrome Society of Mobile County and the Global Down Syndrome Foundation.

To learn more about the class go to blog.al.com/pr-community-news/2013/06/etiquette_and_dance_class-es_fo.html.

20

A ride that changes livesSUE DeWERFF [FloridaToday.com]

Extremely emotional, sometimes tearful and truly awesome are just a few of the words Tracy Bastante has used to describe past Surfing for Autism events, which she and her 11-year-old son, Damian Richter, have attended, according to a June 1 FloridaToday.com article.

Bastante of Florida says her decision to take her son who has special needs to the beach in 2008 for the inaugural Surfers for Autism event was one of the best she has ever made.

“When they put Damian on the surfboard and he rode his first wave in on his knees (he was just 5-years-old then) — with the biggest smile on his face — I warned the volunteers who asked him if he wanted to do it again that he was going to say yes, again and again,” she said.

FloridayToday.com reports that Surfing for Autism events spans throughout more than a dozen counties in Florida and was spearheaded by former lifeguard and long-time surfer, Don Ryan.

“It has been a marvelous way to bring autism awareness to the forefront, not only throughout the state, but nationwide.”

Read the complete story at floridatoday.com/arti-cle/20130602/SPORTS05/306020028/Surfers-Autism-ride-changes-lives?nclick_check=1.

French company markets robot that helps children with autismCHRIS REIDY [Boston.com]

Aldebaran, a French robotics company that recently opened an office in Boston, is now marketing a hu-manoid robot specifically programmed as a teaching tool for children who are autistic, according to Boston Globe reporter Chris Reidy.

Reidy reports that the company’s autism team was created in Boston in February mainly because the U.S. is a front runner in the search to improve the lives of those with special needs. The June 3 article says the new office includes 15 employees while the company employs about 300 people worldwide.

For several years, Aldebaran has marketed a robot called NAO, which is described as a “programmable, autonomous humanoid robot able to run educational, entertaining and daily life assistance applications.”

More than 3,500 units have been sold around the world, the company said.

That robot has now been customized to help chil-dren who are autistic. The new model is dubbed ASK NAO — ASK stands for Autism Solution for Kids.

Find the complete story at boston.com/businessup-dates/2013/06/03/aldebaran-markets-robot-designed-help-children-with-autism/QqMCjZGkLCNZGvg0h-BTzxN/story.html.

Facebook hate speech problematic, advocates sayMICHELLE DIAMENT [DisabilityScoop.com]

Under pressure, Facebook recently said it will im-prove its efforts to weed out hate speech on the social network. Disability advocates say the move is long overdue, according to DisabilityScoop.com article by Michelle Diament.

The June 11 article reports that late last month Facebook acknowledged that it needs to do more to monitor and remove postings and pages featuring hate speech. The announcement came after a coalition of women’s rights groups successfully urged major companies to pull their advertisements from Face-book, accusing the social network of including content promoting violence against women.

Many in the disability community have complained about Facebook pages featuring questionable content and misappropriated photos of those with disabilities.

Diament talked to Hannah Jacobs, a New York City mother of a teen with an intellectual disability, who has spent years actively working to report offensive Facebook pages. Jacobs said she continues to find con-tent on the social network each day that she considers to be problematic. She’s flagged pages with names like “I Am Retarded,” “I Hate Fat People in Wheelchairs” and one called “Retards in Cages.”

“It’s a little like playing Whac-A-Mole. One group down, two more pop up,” said Jacobs who runs Family Member, a nonprofit dedicated to promoting fair repre-sentations of people with disabilities in the media.

Jacobs’ efforts have won her meetings with Face-book officials in recent years. When she first spoke with the company, Jacobs said that disability wasn’t even an option on the drop-down menu to report prob-lematic content.

Find the complete article online at disabilityscoop.com/2013/06/11/facebook-problematic/18131/.

21

ELC graduate Zach Miller (center) poses with his parents on graduation day. At left is Zach’s mother, Liz Miller, and at right is father Norm.

By Tim Pray

Four years ago, in close collaboration with Bill-ings’ School District 2,

AWARE developed Montana’s first and only school for youth with autism.

And now, after massive amounts of hard work, four students have graduated the Enterprise Learn-ing Center and are beginning, like everyone their age, their transition into adulthood.

For many of the youth in the Learning Center, their Individual-ized Education Plans (IEPs) went beyond what the resources of a school district’s special educa-tion staff were able to provide in a traditional classroom setting, and

talks between AWARE and school district staff began. What resulted was a classroom that could provide the one-on-one attention and func-tional academics that, with further support from the Kennedy Krieger Institute at Johns Hopkins Uni-versity in Baltimore, Md,, began producing positive outcomes with time, hard work, and patience.

While each student’s educational plan is unique, the ELC mixes academic, pre-vocational, and daily living skills management.

The environment in the school allows students to form relation-ships at their own pace as opposed to faster-paced traditional venues.

Further, significant time is spent allowing for trust to build between the students and the staff.

Each of the families with chil-dren attending the ELC have been intricately involved in both pro-grammatic and social elements, working with staff and their chil-dren on bridging the gap between graduation and adult life.

The prevocational aspects of the education are steeped in involve-ment at home and throughout the community, and regardless of each specific plan of action after high school, each are entering a signifi-cantly less restrictive environment than they knew prior to their time at the ELC.

After four years of hard work, we are proud to introduce and congratulate the inaugural 2013 graduating class of the Enterprise Learning Center.

Enterprise Learning Center celebrates first graduates

22

ELC graduate Spencer Cooper (holding his diploma) and his family, from left, brother Harrison, mother Carina and, to the right of Spencer, father Mark.

ELC graduate Ryan King, at right, with his father Greg King.

From left to right, mother Dianne Booth, ELC graduate Logan Booth, and father Jim Booth

Enterprise Learning Center2013 GraduatesPhotos by Stacey Casterline

23

24

cal Director Dr. Len Lantz — is to continue to develop the leader-ship of these two teams,” he said. “We’re trying to bring these teams together to work more closely with other staff.”

Kelly said AWARE is also cultivating specific areas of exper-tise among its doctors, which now number 14, including full-time and contract psychiatrists.

“This is all in the pursuit of excellence,” he said. “We’re tak-ing from what others know and from the professional literature and we’re creating our own model.”

NONPROFIT ORGUS POSTAGE

PAIDANACONDA, MTPERMIT NO. 14

AWARE, Incorporated205 East Park AvenueAnaconda, Montana 59711

1-800-432-6145www.aware-inc.org

Printed on recycled paper /

be more effective ways to engage them.”

“I think this new role has pulled me out of my own little world more and caused me to seek others out to clarify and make sure I understand things clearly so that I can feel I am guiding new clinicians in a consis-tent and effective manner.”

Therapists who are receiving coaching from Chisholm and other lead clinicians have a contract that is required by AWARE.

The contract spells out the role of the lead clinician and therapist and requires specific outcomes.

Generally it takes two years for an unlicensed therapist to acquire 3,000 hours of clinical supervision to become licensed.

“AWARE is making a big invest-ment in the unlicensed therapists,” Kelly said. “It’s a positive invest-ment. We want to make sure the clinical supervision — the coach-ing — that the unlicensed therapist is receiving is of high quality.”

At the same time, he said, AWARE doesn’t want all clinicians to have expertise in all areas.

All kinds of expertise“We don’t want everyone to

know how to do Theraplay, for ex-ample,” he said. “We want to have all kinds of expertise across our clinical team.”

Kelly’s new role will be to supervise all clinical leadership, including lead clinicians and psy-chiatrists.

“One of my roles — and I work really closely with AWARE Medi-

Lead cliniciansContinued from page 13

If you have an apple and I have an apple and we exchange these apples then you and I will still each have one apple. But if you have an idea and I have an idea and we exchange these ideas, then each of us will have two ideas. — George Bernard Shaw (Irish literary Critic, Playwright and Essayist. 1925 Nobel Prize for Literature, 1856-1950)