24 Hour Care & Retirement Services

1. To provide a broad array of support services to promote the physical, emotional, and mental well being of the member.

2. To enable the member to acquire knowledge and skills and be a valued member of his/her community based on his/her own choices.

3. To provide training and supervision for the member to increase or maintain his/her self-help, socialization and adaptive skills to reside and participate successfully in his/her own community.

4. To develop positive relationships for members and their families.

5. To provide opportunities for members to interact socially with family, friends and the community at large including providing information regarding interaction and facilitating access to community resources.

6. To assist the member in achieving and maintaining a quality of life that promotes the member’s vision of the future.

Objective 1: 

In accordance with the member’s ISP process, develop an individualized support plan including:

• Establish habilitation-related service objectives based on assessment data and input from the member and the member’s representative(s) which will allow the member to achieve his/her long vision.

• Develop a specific training/teaching strategy for each objective, e.g., schedule for implementation frequency of services, teaching strategies, and data collection methods.

• Based upon the presence or absence of measurable progress, make changes to objective(s) and/or strategies, as agreed upon by the ISP team.

Objective 2:

As identified in the member’s ISP and support plan, provide a broad array of support services such as:

• Assistance and training related to personal and physical needs and routine daily living skills.

• Implementing strategies to address behavioral concerns, developing behavior intervention programs, and coordinating with behavioral health programs to ensure proper review of medication treatment plans.

• Ensuring that the health needs of the member are being met, including, providing follow up as requested by the member’s primary care physician or medical specialist.

• Implementing all therapeutic recommendations including speech, occupational, and physical therapy and assisting members in following special diets, exercise routines, or other therapeutic regimes.

• Mobility training, alternative or adaptive communication training.

• Providing general supervision to the member.

• Opportunities for training and/or practice in basic member skills such as cooking, shopping, banking, money management, access and community survival skills.

Objective 3:

• Develop, maintain, or enhance independent functioning skills in sensory-motor  areas, cognition, personal grooming, hygiene, dressing, eating, toileting, self-medication and first aid, recognizing symptoms of illness, and preventing accidents and illnesses.

Objective 4:

• Assist each member in developing methods of starting and maintaining friendships of his/her choice, as well as appropriate assertiveness, social skills, and problem solving abilities for use in daily interactions.

Objective 5:

• Provide opportunities for members to participate in community activities and facilitate member utilization of community resources.

Objective 6:

• Provide transportation to support the member in all daily living activities, e.g., day treatment and training, employment situation, medical appointments, visits with family and friends and other community activities. Promote, as appropriate, the acquisition of skills necessary to access community transportation resources.

Objective 7:

• Develop a monthly on-site/community integrated schedule of daily activities and document members direct input into the monthly schedule. Daily activities and schedules are based on member choice, development level, ISP goals, and enrichment of life experiences. Allow for reasonable choice in activity participation, and offer alternative activities. This schedule shall be available to members, member representatives, or others upon request.

Objective 8:

• Play an active role in ensuring that services with other involved entities, such as: day treatment and training, health care providers, and job training are coordinated to meet the needs of the members served.