Activities include applied research and policy analysis, design and implementation of model programs, provision of technical assistance and consultation to state and county agencies, consultation to federal agencies on public policy, wide scale efforts to provide training for direct care staff in community-based residential and day programs, and personnel preparation and staff development.
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The following projects exist within the RTC. These RTC projects are funded by the National Institute on Disability and Rehabilitation Research (NIDRR), US Department of Education, unless otherwise indicated.
Assessment of the Outcomes Associated with Consumer Controlled Movement from a Large Institution to Small Community-Based Settings assesses outcomes associated with the movement of more than 100 adults with mental retardation from a large private institution to small community settings based upon their preferences and decisions. Over the course of this longitudinal study, a variety of outcomes will be assessed with a focus on determining the extent to which individuals are able to build lifestyles based on their personal values. Contact: Brian Abery, 612-625-5592, abery001@tc.umn.edu.
Community Building for People with MR/DD within Community Organizations engages 5 or more community organizations, 20 individuals with MR/DD, and 3 human services agencies to determine how persons with MR/DD, community organizations, and members of those organizations can accept accountability for supporting community inclusion and develop roles that achieve community inclusion. Contact: Angela Amado, 651-698-5565, amado003@tc.umn.edu.
Consumer Controlled Housing: Education and Counseling develops a training curriculum and ongoing evaluation of training and supports to promote the ideals and provide for informed decision making and consultation in a multi-agency, consumer-controlled housing initiative. Contacts: Charlie Lakin, 612-624-5005, lakin001@tc.umn.edu; Angela Amado, 651-698-5565, amado003@tc.umn.edu.
Costs and Benefits of Family Care and Family Support: A Review of Methodology and Findings examines published and unpublished studies on the costs, outcomes, and cost-benefits of family care and family support on three dimensions: 1) the methodologies and methodological issues in this research, and problems inherent in most past studies, 2) the research findings, and 3) the factors that are relevant to the computation of costs and benefits of family care and family support. Implications for policy, practice, and future research will be presented. Contact: Darrell Lewis, 612-624-2367, lewis004@tc.umn.edu.
Cultural Influences on the Definition and Valuing of Self-Determination: A Four Culture, Three State Study compares and contrasts the meaning, value, and achievement of "self-determination" within four cultures. Results will be used to suggest implications of and accommodations to cultural group membership in the support of self-determination. Contact: Brian Abery, 612-625-5592, abery001@tc.umn.edu.
Developing Within Agency Capacity to Serve Individuals With Challenging Behavior in the Absence of Institutional Alternatives provides and evaluates a model of longitudinal technical assistance to develop capability among residential service providers to deliver all needed behavioral support to individuals with challenging behavior in a system without an institutional "safety-net" for support failure. Technical assistance providers will be trained and supported by the RRTC while employed by the Metro Crisis Coordinating Program. Contact: Joe Reichle, 612-625-6542, reich001@tc.umn.edu.
Development and Evaluation of Self-Determination Training and Support for Direct Support Staff and Supervisors assesses staff training needs to support adults with MR/DD to exercise self-determination and develops and evaluates a training program based on those needs. Contact: Brian Abery, 612-625-5592, abery001@tc.umn.edu.
Direct Support Staff Learning Experiences and Outcomes Using Alternative Instructional Strategies investigates the use of alternative CD-ROM or internet-based instructional strategies to provide learning opportunities for DSS who work in small geographically dispersed community agencies. Contact: Amy Hewitt, 612-625-1098, hewit005@tc.umn.edu.
An Ecobehavioral Analysis of Self-Determination uses behavioral observation to examine the relationship between environmental factors and the exercise of self-determination among adults with MR/DD living in community residential settings. Analyses will result in a description of resident relative to staff behavior and the ecology of the setting (e.g., location, activity, structure). Contact: Brian Abery, 612-625-5592, abery001@tc.umn.edu.
Effects on Families of Children and Youth with MR/DD of Being Terminated from Medicaid Services conducts a comprehensive, follow-up study of the effects on families of children and youth with MR/DD and health needs who were terminated from Minnesota's Medicaid TEFRA services and supports program. The goals of the project are to examine the economic impact of being terminated from the TEFRA program, the family experiences with being terminated from the program, and the families' quality of life after being terminated from the program. Collaborates with the Minnesota Department of Health, Division of Family Health, Minnesota Children with Special Health Needs. Contacts: Mary Hayden, 612-625-6046, hayde001@tc.umn.edu.
Evaluating the Impact of Person-Centered Planning and Service Provision examines selected outcomes of person-centered planning and mediating ecological factors that may need to be considered when adopting this approach to providing supports to individuals with mental retardation and other developmental disabilities. Contact: Brian Abery, 612-625-5592, abery001@tc.umn.edu.
Evaluation and Support for the Metro Crisis Coordination Program (MCCP) establishes and implements an evaluation plan for a demonstration project that provides appropriate preventive and crisis response services to persons with severe behavior disorders who are at risk for placement in institutions or psychiatric wards. Provides joint MCCP and RTC training of community support providers. Contact: Charlie Lakin, 612-624-5005, lakin001@tc.umn.edu.
Evaluation of a Multi-Component Program for Training Person-Centered Planning Facilitatorsinvolves implementation and evaluation of a training and technical assistance program for person-centered planning facilitators that combines classroom training, ongoing field supervision, continuing education, technical assistance, peer support, and distance learning. Contact: Brian Abery, 612-625-5592, abery001@tc.umn.edu.
An Examination of a Person-Centered Service Delivery System for People with Developmental Disabilities evaluates the effectiveness of the transformation of service delivery in the Dakota County Community Services Developmental Disabilities Unit from a program-centered system to a person-centered system. Contacts: Mary Hayden, 612-625-6046, hayde001@tc.umn.edu; John Smith, 612-624-0219, smith144@tc.umn.edu; Charlie Lakin, 612-624-5005, lakin001@tc.umn.edu; Marijo McBride, 612-624-6830, mcbri001@tc.umn.edu.
Health Care Utilization, Satisfaction and Unmet Needs of Persons with MR/DD in Managed Care and Fee-for-Service Health Plans and Those Who Are Uninsured analyzes data on a national sample of 680 managed care enrollees with MR/DD and 1220 fee-for-service enrollees from the 1994/1995 NHIS-DS. It will examine type of health insurance provider, out-of-pocket expenses, services received under the health care coverage, satisfaction with the services received and denial of coverage. Funded by the National Institute on Disability & Rehabilitation Research (NIDRR) and the United States Department of Education (USDOE). Contacts: Sheryl A. Larson, 612-624-6024, larso072@tc.umn.edu; Charlie Lakin, 612-624-5005, lakin001@tc.umn.edu; Robert Doljanac, 612-625-1842, dolja001@umn.edu.
Increasing Self-Regulation of Individuals with Escape-Motivated Challenging Behavior examines, through two studies, the efficacy of "tolerance for delay in reinforcement." The first study examines enhancing participation in tasks for which a choice of non-participation cannot be honored for health and safety reasons (e.g., taking seizure control medication). The second study examines "tolerance for delay" procedures within community service agencies. Contact: Joe Reichle, 612-625-6542, reich001@tc.umn.edu.
Job Analysis and Validation of Direct Support Personnel and Front-Line Supervisor Competencies and Training Needs uses survey methodologies to validate nationally the results of two comprehensive Minnesota analyses of competencies needed by DSS and frontline supervisors (Hewitt, 1998; Hewitt, Larson, Sauer, O'Nell, 1998). This study will extend the existing analyses by sampling DSS, first-line supervisors and managers in 80-100 agencies in four to six states. Contacts: Sheryl A. Larson, 612-624-6024, larso072@tc.umn.edu; Amy Hewitt, 612-625-1098, hewit005@tc.umn.edu; Robert Doljanac, 612-625-1842, dolja001@tc.umn.edu; Pat Salmi, 612-625-0171, posalmi@aol.com.
Longitudinal Study of the Costs and Benefits of a Comprehensive Pre-service Training Program for Direct Support Staff in Community Settings follows 120-150 DSS who complete the certificate program of the Community Supports for People with Disabilities Program (CSP), a comprehensive pre-service training program offered by Minnesota's Technical and Community Colleges to train DSS for community settings. This study will measure the costs and benefits of using the CSP program for training as compared to traditional training methods in terms of several different types of agency, staff, and individual outcomes. Contacts: Sheryl A. Larson, 612-624-6024, larso072@tc.umn.edu; Amy Hewitt, 612-625-1098, hewit005@tc.umn.edu.
Nature and Quality of Supports for Families in the Disability Supplement of the National Health Interview Survey examines supports available to children ages 0-59 months, children ages 60 months to 17 years, and adults ages 18-39 and 40 and older with MR/DD in the 1994-1995 National Health Interview Survey/Disability Supplement (NHIS/DS) sample. It describes the supports available to individuals and families in terms of the type, frequency, funding source and satisfaction, and their perceptions of unmet needs, their out-of-pocket expenditures other indicators of inadequate support. Contacts: Sheryl A. Larson, 612-624-6024, larso072@tc.umn.edu; Charlie Lakin, 612-624-5005, lakin001@tc.umn.edu; Robert Doljanac, 612-625-1842, dolja001@tc.umn.edu.
Outcomes for Persons with MR/DD in TennCare Demonstration collaborates with Mathematica Policy Research (MPR) in a major federal study of managed care participation and outcomes of mandatory enrolled in TennCare (Tennessee's Medicaid managed care program) with specific attention health services for SSI beneficiaries with MR/DD. Contacts: Mary Hayden, 612-625-6046, hayde001@tc.umn.edu; Charlie Lakin, 612-624-5005, lakin001@tc.umn.edu.
Policy, Environmental and Individual Factors Associated with Full Participation and Integration in a Large Multi-State Sample involves a secondary analysis of the integrated multi-state Community Living Outcomes database (described earlier) to examine the contribution of policy factors (e.g., state, funding source, costs); environmental variables (e.g., home size, staffing patterns, services received); and individual variables (e.g., functional skills, challenging behavior, secondary disabilities and support needs) on community participation, social integration, and independence and other outcomes. Collaborates with the Center on Outcomes Analysis. Contacts: Mary Hayden, 612-625-6046, hayde001@tc.umn.edu; Charlie Lakin, 612-624-5005, lakin001@tc.umn.edu.
Promoting Universal Access to Outdoor Recreation and Adventure extends implementation, validation, and dissemination aspects of the Universal Program Participation Model for outdoor recreation adventure by assessing gains related to inclusion (i.e., skill development, self-esteem, self-efficacy) by individuals with MR/DD who participate. The project will develop "quality indicators" for inclusive outdoor recreation, increase collaboration among organizations providing outdoor adventure services in North America, and sponsor a North American conference and training course on integrated outdoor recreation and adventure. Contacts: Leo McAvoy, 612-625-5887, mcavo001@tc.umn.edu; John Rynders, 612-624-5421; Tom Holman, 612-624-4847, tkholman@yahoo.com; John Smith, 612-624-0219, smith144@tc.umn.edu.
Qualitative Analysis of the Effects of Direct Support Workforce Challenges on Individuals with MR/DD and Their Family Members investigates the effects of current challenges of recruitment, retention and training of DSS on the lives of individuals with MR/DD and their family members. These effects will be studied through a series of structured focus groups in Minnesota. Contacts: Amy Hewitt, 612-625-1098, hewit005@tc.umn.edu; Sheryl A. Larson, 612-624-6024, larso072@tc.umn.edu; Lynda Anderson, 612-626-7765, ander447@tc.umn.edu.
Qualitative Case Study of Best Practices in Direct Support Staff Workforce Development conducts six in-depth case studies of best practices in DSS workforce development in the United States and descriptions of other identified workforce initiatives. Case studies will focus on programs and initiatives advancing the goals of the National Alliance for Direct Support Professionals (NADSP). Models of best practice will be identified through solicitations in the Frontline Initiative newsletter and through member organizations of the NADSP and those best reflecting NADSP goals will be visited. Contacts: Amy Hewitt, 612-625-1098, hewit005@tc.umn.edu; Sheryl A. Larson, 612-624-6024, larso072@tc.umn.edu.
Review and Synthesis of Research on Self-Determination and Inclusion conducts an extensive review of current knowledge and practice in self-determination and full inclusion. This review will involve all RRTC participants, serve as the background papers to a national "state-of-the-science" conference in Year 4, and be published as a second edition to the RRTC's Challenges for a Service System in Transition: Ensuring Quality Community Experiences for Persons with Developmental Disabilities (Hayden & Abery, Eds., 1994). Contacts: Mary Hayden, 612-625-6046, hayde001@tc.umn.edu; Brian Abery, 612-625-5592, abery001@tc.umn.edu.
Secondary Analysis of Training Needs and Issues for Supervisors and Direct Support Staff from the Minnesota Study of Direct Support Staff provides a secondary analysis of the training needs and issues for both frontline supervisors and DSS from a recently completed longitudinal study of frontline supervisors and newly hired direct support staff (DSS) in 110 small group homes in Minnesota. Analyses will examine training issues, factors influencing training issues, and training needs for both supervisors and DSS. Contacts: Sheryl A. Larson, 612-624-6024, larso072@tc.umn.edu; Amy Hewitt, 612-625-1098, hewit005@tc.umn.edu.
Status and Trends in Medicaid Long-Term Care Programs integrates the Medicaid ICF-MR, HCBS waiver and Nursing Facility data collection and reporting systems capability of the RRTC (both Minnesota and Illinois sites) and of the National Association of State Directors of Developmental Disabilities Services into a national and state-by-state program of information on status and trends in management of Medicaid resources to increase access, cost-effectiveness and quality of Medicaid-financed services. Funded by the Administration on Developmental Disabilities (ADD) and National Institute on Disability and Rehabilitation Research (NIDRR), US Department of Education. Contacts: Bob Prouty, 612-626-2020, prout004@tc.umn.edu; Charlie Lakin, 612-624-5005, lakin001@tc.umn.edu.
Supervising and Training Direct Support Professionals: Outcomes, Costs and Benefits gathers and synthesizes research findings on the recruitment, retention, and training of direct support staff and supervisors with a particular emphasis on outcomes, costs, and benefits of various supervision and training interventions. Contacts: Sheryl A. Larson, 612-624-6024, larso072@tc.umn.edu; Amy Hewitt, 612-625-1098, hewit005@tc.umn.edu; Traci Laliberte, 612-626-1721, lali0017@umn.edu.
Supporting Families With Whole Family "Supported Respite" in an Inclusive Outdoor Recreation Program applies Wilderness Inquiry's (WI) Universal Program Participation Model to support whole families with young adult members with MR/DD as an alternative to respite support. It will 1) assess outcomes in family efficacy, family empowerment, family cohesion, family and individual's future participation in outdoor activities, links with other families and community resources, b) identify indicators of high quality, socially integrated family outdoor recreation; c) identify support and training needed by families to use other community recreation resources; and d) identify new ways to improve training and other outdoor and wilderness organizations in supporting families with members with MR/DD. Contacts: Leo McAvoy, 612-625-5887, mcavo001@tc.umn.edu; John Rynders, 612-624-5421; John Smith, 612-624-0219, smith144@tc.umn.edu.
Survey of National Databases, State Laws, Policy, Initiatives, and Strategies to Respond to Persons Waiting for Services conducts a national survey of state Mental Retardation/Developmental Disabilities directors, state Arc chapters, and state Councils on Developmental Disabilities to obtain information about databases/ waiting lists for services for persons with developmental disabilities. Surveys ask questions related to the general description of the databases/ waiting lists; laws, policies and initiatives to reduce or eliminate waiting lists; assistance; and access. Contacts: Bob Prouty, 612-626-2020, prout004@tc.umn.edu; Charlie Lakin, 612-624-5005, lakin001@tc.umn.edu.
