Residential Director Core (RDC) Training Program

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Residential Director Core (RDC)

Training Program

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MODULE 1

STAFFING

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Residential Directors: Who They Are and What They Do

For the purposes of this course, residential directors are the person who directs and oversees the day-to-day operations of a residential program in a variety of settings, e.g., CILA, ICFDDs.

They:

•

Assure that individuals in the program have optimal placements.

•

Work with day services providers in planning for a holistic approach to the individuals’ overall

support.

•

Work with family members and significant others to better support individuals in residential programs.

•

Work to achieve the highest standards of support, health and safety for those in the program.

•

Work as part of the interdisciplinary team to acquire maximum independence, satisfaction and joy for those supported in the residential program.

•

Assist individuals in the attainment of identified goals and objectives, as well as achieving outcomes they have identified.

•

Work with other agencies and providers of services, both public and private, to obtain needed services and supports.

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Interview, hire and train staff for the program.

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Manage the program budget.

•

Ensure staff development.

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SECTION 1 - HIRING

The topic of staff hiring is included in this training because many Residential Directors are responsible for personnel

management duties themselves, or oversee their agency’s

personnel departments. Their responsibilities may include hiring new staff, conducting performance reviews, facilitating teamwork

and staff meetings, writing job descriptions, encouraging effective communication,

defusing conflicts between staff and implementing grievance procedures if necessary. This training will suggest ways to help reduce the high turnover rate of direct support workers that many agencies experience.

Although residential directors oversee a variety of staff positions, much of this training will pertain to Direct Support Persons (DSP) staffing and training procedures.

Developing a Job Description

A simple and clearly stated position description will be your initial offering to prospective candidates.

The job description should be accurate as well as comprehensive. The ideal position description would include a copy of the associated competencies for the positions.

It should also be written at an eighth grade comprehensive level.

A DSP’s job description should also be based on the DSP Informational and Interventional Competencies that can be found at:

http://www.dhs.state.il.us/page.aspx?item=48122

The key features that should be included in the job description are:

• Job Title

• Job Objective or Overall Purpose Statement - This statement is a summary designed to orient the reader to the nature, level, purpose and objective of the job.

Include a description of how this position will function within the agency. This should be no longer than three or four pages.

• List Duties or Tasks Performed - List principal duties, continuing responsibilities, and accountability of the position. It should also include the percentage of time allotted to each. The list should start with the most important task and continue down in order of significance.

•

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• Relationships and Roles - Provide a description of the relationship and roles the applicant of that position holds within the agency and or other working relationships.

• Level of Supervision - Describe the nature and extent to which completed work will be reviewed (e.g., procedures, manuals, the law, instructions from the

supervisor, management directives)

• Job Specifications, Standards and Requirements The minimum requirements needed to perform the essential functions of the job such as education, knowledge and skills. For example: for a receptionist, critical skills may be having 1) a professional and courteous telephone manner, 2) legible handwriting for messages, 3) the ability to handle multiple-line phone system and 4) the patience and endurance to sit behind a desk all day.

• Job Location - where the applicant will be working.

• Nature, purpose and frequency of contacts with persons other than the

supervisor or subordinates, which are necessary to accomplish work assignments.

• Percentage of Time - Include an approximate percentage of time required to perform each assignment. Assign percentage in increments of 5%. Percentages should total 100%.

• Equipment - What type of equipment will they need to use in the performance of the job? i.e., Hoyer lifts, computers for documentation; etc.

• Salary Range - What is the pay for the position?

• Yearly training – Mandated or in-service training.

• Education level degrees or cognitive levels an individual must have to perform a job successfully. You must show that these are necessary requirements for the job.

• Hours – Part-time or Full time schedules days off, etc.

• Description of individuals applicant will be working with

*Remind the applicants that there may be additional responsibilities that are not included in the job description.

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Job Analysis

You should also perform a Job Analysis when developing a job description for the new DSP.

A Job Analysis is a structured process that identifies the skills, knowledge, abilities and attitudes needed to achieve outcomes and carry out the mission and vision statements for an organization or employer. This will ensure that the job description is an accurate reflection of all the job duties and responsibilities.

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ACTIVITY – WRITING A JOB ANALYSIS

You may find this Job Analysis Worksheet helpful when developing position descriptions

:

Position: Date: _________________

Task % of Time Training

TOTAL

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Recruiting Candidates

Recruitment, retention and training have challenged human service agencies for many years. Recently, however, they have reached near crisis proportions. To compete

successfully for a dwindling supply of employees, human service agencies must consider what sets them apart from other human service agencies and from other service industries.

Agencies must then develop, implement and evaluate comprehensive marketing plans designed to let prospective and new employees know what the

organization is about, its mission, vision and values Job candidates can be found by:

• internal recruitment or

• external recruitment

Note: According to the Centers for Medicare and Medicaid Services, employees hired from inside sources stay on the job longer than those hired from outside sources. Inside sources often provide information about the candidate that would not be available to the employer otherwise. Inside sources include rehired, referrals from existing employees, and in-house postings.

External Recruitment

 Brochures

 Internet (Facebook, Craig’s List, Lined In, etc.)

 Newsletters

 Newspaper

 Networking at Professional Conferences/Workshops

 Radio/TV

 Job Fairs

What other strategies are available?

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Staff Qualifications at a Glance

DSP QIDP Nurse Trainer DT Instructor

Educational

Requirements 8th grade or

Equivalent* Bachelor’s Degree in Human Services or licensed in selected professions

Licensed Registered Bachelors Degree

Experience None Required 1 year of direct

experience 2 years, 1 in DD None

Driving Agency policy Agency policy Agency policy Agency policy Background

Check Required Required Required Required

Required

Training 120 hours 40 hours 12 hours Med

Admin. 120 hours

Registry/Data

base, License Health Care

Worker Registry QIDP database License None required

Detailed information about these requirements can be found at:

*if the DSP will be passing medications, they are required to be a minimum of 18 years old and have a high school diploma or GED and an 8^th grade reading level verified by TABE testing.

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Demographic Trends in the DSP Workforce

DSPs are “increasingly first generation Americans” whose first language is not English.

These workers have experience and training as health care professionals from working in their native countries, and many are “pursuing credentials to practice their profession in the United States while working as DSPs”.

Source: The National Direct Service Workforce Resource Center (2008).

Cultural Competency

What Are Cultural Competencies?

They are the skills you use to work well with people of all cultures.

What is “Culture?”

Although “culture” is generally thought of as relating to ethnic or religious background, it can involve much more. Components of “culture” can also include:

• Age

• Race

• Sex

• Skin color

• National Origin

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Communication Skills in a Multicultural Workplace

The way your culture communicates may be very different from the norms of other

cultures. Certain aspects, such as personal space and eye contact, can create conflict and misunderstanding in a multicultural workplace. Try to be aware of the cultural values of your coworkers and the people you support, but avoid stereotypes!

Cultural competency does not mean knowing everything about every cultural group you work with but it does mean being aware of cultural factors and taking appropriate steps such as asking questions and doing research to learn about people’s cultures.

According to nationwide statistics, Residential Directors may be faced with challenges due to the increasing diversity among the workforce and will need to understand attitudes and practices of other cultures.

Competent Cultural Skills Involve:

• Treating each person as an individual.

• Considering the person’s culture when working with them. Factors to consider include:

* views about health & health care * family & community relationships * language & communication styles

* ties to another country or part of the US * food preferences

* religion

* views about death and dying * views about gender roles in society

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Interviewing Applicants

Sample Questions to Ask When Conducting a Job Interview

Competency Area 1: PARTICIPANT EMPOWERMENT

• Describe a situation where you’ve encouraged someone to advocate for themselves.

• You and a person you help support are at a local restaurant. When the waitress comes to take your order, she looks and speaks only to you. The person you are with can give his/her own order. What would you do?

Competency Area 2: COMMUNICATION

• Describe ways in which you have communicated with a person who does not communicate verbally.

• Your new coworker is Muslim. During the month of Ramadan he is fasting during the day, and has asked you to change duties with him so he will not have to cook for the people who live in the group home. You cook a great deal already, and don’t want to take on the extra duties for him. How do you respond to him?

Competency Area 3: ASSESSMENT

• Rachel’s mother expresses concern that Rachel may be hard-of-hearing, because mom says Rachel tends to ignore her while talking. You have noticed this, but have also found that when Rachel is around friends or watching TV her hearing appears to be fine. You suspect Rachel is choosing to not to listen to her mother. Rachel’s mother recently told you she wants her daughters hearing tested and asks you your thoughts. How might you share your assessment of the situation with her mother?

• Describe a time when someone was injured and you had to make an immediate judgment on what needed to be done to help the person.

Competency Area 4: COMMUNITY & SERVICE NETWORKING

• Describe the most embarrassing situation that you have experienced when you were with a person with a disability. What was the situation, what did you do, what happened as a result? What, if anything would you do differently if you experienced a similar situation in the future?

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• Midori, a Japanese-American is quiet and doesn’t leave the house. She is not involved in any activities and has no personal relationships. Midori claims that she has no areas of interest but seems unhappy with her life. How might you assist Midori in recognizing and developing areas of interest?

Competency Area 5: FACILITATION OF SERVICES

• A few weeks after developing her support plan, Darla changes her mind about wanting to get a job. How might you respond?

• When working with persons with developmental disabilities, what do you think is the key to establishing a solid working relationship?

Competency Area 6: VOCATIONAL SUPPORT

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Mali would like to join a Hmong quilting group, but she has not method of

transportation other than the bus, which is a long and confusing ride. What could you do as her DSP to support her in gaining access to this program?

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Describe the first job you ever had. What would you do to adapt that job so that it could be performed by someone who could not walk (talk, see, hear, etc.)?

Competency Area 7: ADVOCACY

• Describe a time when you witnessed a person with disabilities being teased by a coworker or other person. What did you do? What could you have done to assist that person?

Competency Area 8: CRISIS INTERVENTION

• Margaret, a person in the home where you work is sensitive to loud noises. One afternoon, the maintenance crew comes to the house to do yard work and the sound of the mower sends her into a panic. She begins pacing rapidly while crying and covering her ears. She picks up a nearby object in attempt to throw through the window towards the maintenance worker. How would you handle this situation?

• Describe the most difficult person you remember ever dealing with at work or school. Describe the most difficult situation you encountered with this person. Did you ever discuss your differences with this person? If not, why not?

Self-Evaluation/Opinion Questions

• What one or two words would most all of your previous supervisors use to describe you?

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“

Sample Structured Interview Questions” Questions based on theCommunity Support Skills Standards: http://rtc.umn.edu/docs/interview.pdf

CATEGORIES EMPLOYERS MAY ASK EMPLOYERS MAY NOT ASK

Age Are you a minor (under the age of

18)? When were you born?

How old are you?

Ancestry/National

Origin No questions What is your language, ancestry or

national origin?

Birthplace No questions Where were you born? Where was

your husband/wife born? Where were your parents (or other close relatives) born?

Citizenship Are you a citizen? Do you intend

to become a citizen? Are your parents/husband/wife citizens? Are you/your

parents/husband/wife naturalized or native born citizens? When did you/they become citizens?

Character Are you honest? Are you

trustworthy? Do you belong to a church? Do you

go to church regularly?

Criminal Records Have you ever been convicted of a felony? (Refer to criminal

background check rules.)

Have you ever been arrested? Have you ever been convicted of a

misdemeanor?

Dependents No questions Do you have any children? Do you

intend to have children? What child care arrangements have you made?

Disability No questions, except for the purpose of reasonable accommodation.

Do you have any disability? What kind of disability do you have? How severe is your disability?

Driver’s License What type of driver’s license do you have? (Only if driving is necessary to the job.)

Do you have a valid driver’s license?

(If the job does not require applicant to drive.)

Education/Experience What school, college or vocational program did you attend?

Graduate? What is your work experience?

The answer to: “When did you attend or graduate?" Should not be used to determine an applicant's age. The answer to a question about date of work should not be used to determine an applicant's age.

Marital Status/Relatives No questions. Have you gone by any other name in the past?

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Military Experience Are you a U.S. veteran? What is

your military service history? Are you receiving a service connected disability pension?

Name Have you ever worked under

another name? Only for the purpose of verifying past work record.

Any questions which would reveal applicant's lineage, national origin, marital status, etc. (e.g., maiden name?) Mr., Mrs., Miss. Ms.?

Organizations/Professional

Associations Are you a member of any

organization which advocates overthrowing the U.S. government by violent means? Are you a member of any job-related clubs or associations?

Do you belong to the NAACP?

B’nal B'rith? Or any other organization the nature, name, or character of which indicates the religion, race, or national origin of its members. What are all organizations, clubs or associations which he/she belongs to and or political affiliations.

Photograph Only for identification purposes,

after hire. For a photograph before hire.

Polygraph/Lie Detector No That an applicant be required

to take a test as a condition or employment.

Race/Color No questions What is your race? Or that a

photo is submitted with an application.

References Names of persons willing to provide

professional or character references. For submission of: religion references, or references which would elicit information on race, color, national origin, marital status, disability or sexual orientation, or political affiliations.

Religion No questions What religious denomination,

church, or synagogue do you belong to? What are your religious obligations? What religious holidays do you observe?

Sex No questions No questions

Sexual Orientation No questions. Any questions concerning

heterosexuality, homosexuality or bisexuality issues.

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Required Registry & Criminal Fingerprint Background Checks

1. Required Fingerprint Criminal Background Checks and Enrollment in the Illinois Department of Public Health (DPH) Web Portal

The Illinois Health Care Worker Background Check Act (225 ILCS 46) web site at:

http://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1303&ChapterID=

24 requires health care provider employees and selected others to have an Illinois State Police criminal background check result completed and reported to the Health Care Worker Registry. The law also requires health care providers to enroll in the DPH Health Alert Network (HAN) for obtaining Illinois State Police electronic

fingerprint criminal background checks instead of name-based background checks.

HAN portal web site: http://portalhome.dph.illinois.gov/

Failure of health care providers to register with DPH for access to the HAN Web Portal and subsequently using the Portal after receiving access may subject providers to fines and penalties levied by the DPH and administrative sanctions issued by the Illinois Department of Human Services (DHS). Until IDPH

authorizes access to the HAN Web Portal and electronic fingerprinting system, providers may continue to use name-based Illinois State Police criminal background checks and report the results manually to the DPH Health Care Worker Registry.

Persons who have been employed with an agency since October 1, 2007 and have met requirements for name based background checks (UCIA) do not need to have the fingerprint background checks performed unless they change employers. All newly hired employees must have a fingerprint-based criminal background check (FEE_APP) performed and reported to the Health Care Worker Registry once the provider has been given access to the HAN Web Portal System.

For more information on Electronic Fingerprint Background Checks, go to:

http://www.dhs.state.il.us/page.aspx?item=48125 2. Health Care Worker Registry (HCWR) clearances, go to:

http://www.idph.state.il.us/nar/home.htm

The HCWR contains information from various sources on Developmental Disability Aides (DD Aides), also referred to as Direct Support Persons (DSPs); and Nurse Assistants, also referred to as Certified Nursing Assistants (CNAs) and must have clearances documented in each employee’s personnel or training record or other location readily accessible to Department reviewers. The HCWR clearance verifies the following requirements:

Criminal Background Check Result

Providers must not hire an individual until they have cleared the individual’s name on the DPH Health Care Worker Registry. Individuals whose Health Care

Worker Registry record must report a criminal background check result (either UCIA, name-based, or Fee_App, fingerprint). If one is not present, the employee must be sent to get one within 10 days of hire. UCIA name based criminal background

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checks should not be more than 2 years old, but Fee-App fingerprint criminal background check results never have to be completed again.

Disqualifying Criminal Convictions

In addition to verifying a criminal background check result, the person’s name must be cleared on the HCWR and documented not to report a disqualifying criminal conviction unless there is a waiver from DPH for that conviction reported on the HCWR.

Abuse, Neglect, or Financial Exploitations

The person’s HCWR clearance must also document that the person does not have an administrative finding of abuse, neglect, or financial exploitation reported pursuant to 42 CFR Section 483.13 and 225 ILCS 46/25.

The clearance of the individual’s name on the Health Care Worker Registry must be completed and documented at the time of hire and then annually thereafter.

3. DCFS State Central Register/Child Abuse and Neglect Tracking System (CANTS) Clearances

A request for this clearance is sent to DCFS. Employees can be employed while the request is in process with DCFS. The clearance contains information indicating whether there is a DCFS determination of a substantiated case of abuse or neglect.

If so a disqualification period will be identified (5 years, 15 years or 50 years depending on the severity of the findings). The provider must not employ

individuals in any capacity found to have a substantiated finding of abuse or neglect unless there is a waiver granted by the Illinois Department of Human Services.

Please see definition of disqualifying convictions and substantiated cases of abuse or neglect as defined by Part 385 of Title 89 of the Illinois Administrative Code.The clearance of the individual’s name through the DCFS/CANTS system must be completed and documented at the time of hire and then annually thereafter. See Part 385 of Title 89 of the Illinois Administrative Code web site at:

http://www.ilga.gov/commission/jcar/admincode/089/08900385sections.html 4. Illinois Sex Offender Registry Clearances, go to:

http://www.isp.state.il.us/sor/sor.cfm

Providers must conduct and document the results of this online clearance of the individual’s name. Providers can not employ individuals until they have inquired of and received the results of this clearance for prospective employees. If this registry reports a record for the individual, the provider must not employ the person in any capacity. If, at the time of the annual check, an employee’s name is reported on

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5. Healthcare and Family Services (HFS) Office of the Inspector General (OIG) Sanctions List Clearance

Prior to employment of an individual or use of a subcontractor or licensed

practitioner, providers must confirm and document that the individual or entity is not on the HFS OIG Sanctions List of terminated or suspended providers and barred entities and individuals.

The list of these individuals and entities is on the HFS OIG Sanctions web site:

http://www.state.il.us/agency/oig/sanctionlist.asp

If an individual or entity is on the Sanctions List, Providers must get approval of HFS to hire the individual or entity per guidelines. The clearance of the individual’s name on HFS OIG web site must be completed and documented only at the time of hire.

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Illinois Code Rule - Health Care Background Check

For more information go to:

www.ilga.gov/commission/jcar

 click on “Administrative Codes

 click on Title 77

 click on part 955

Child Abuse and Neglect Tracking System (CANTS)

Provider Compliance Abused and Neglected Child Reporting Act For more information see DHS web site link at:

• Providers must certify that they are in compliance with all requirements and regulations issued pursuant to the Abused and Neglected Child Reporting Act 325 ILCS 5/1 web site:

http://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1460&ChapterID=

32

• Providers must also certify they will check at least annually the status of all current employees on the:

1. DCFS State Central Register, and 2. Illinois Sex Offender Registry

• Providers must terminate employment of employees whose records on these

registries indicate a finding of physical or sexual abuse or egregious neglect against the employee or a disqualifying criminal conviction for which there is no waiver by the Department of Public Health.

• Documentation of these initial checks and annual rechecks must be filed in each employee's personnel record.

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Administering the TABE Test

Administer the TABE Survey Reading Test, in order to determine functional literacy of direct support staff and all staff that are required to have functional literacy determined prior to administering medications.

Instructions on how to administer the TABE reading test are explained in a computer-based learning (CBL) course that is available on the Illinois Department of Human Services’ One Web/NetLearning system at: http://si.netlearning.us/ildhs

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REALISTIC JOB PREVIEW

Realistic job previews are a critical component to hiring people who are right for the job. A realistic job preview is any technique an organization uses to help

prospective employees understand enough about the realities of the job that they can make an informed decision about whether to apply or accept a position or not.

Key Criteria for Realistic Job Previews

 Make the purpose clear to the applicant (To help people decide whether to take a job if offered)

 Use credible information about actual work life (For example, preparing and eating meals, participating in staff meetings, shopping with individuals, assistance with ADLs)

 Include specific thoughts and feelings of current workers about the job

 Balance positive/fun and difficult/unpleasant tasks to reflect actual experiences. (For example, participating in a 5K run with an individual and assisting with ADLS.

 Highlight a variety of job features to show the depth and breadth of the work (For example salary & benefits, coworker characteristics, staff training opportunities.

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SECTION TWO - TRAINING

New Employee Orientation

After the candidate has been selected and they arrive at work:

Meet with employee to welcome him/her.

Show the employee the facility.

Provide a schedule for the first week.

Brief the employee about the agency.

Provide keys if necessary.

Discuss confidentiality policies.

Review policies or procedures.

Meet with the new employee for comments at the end of the day.

Assign formal training - (DSP/QIDP training, etc.).

Provide agency specific training.

Encourage continuing education (e.g., junior college, GED, adult learning, graduate program).

Monitor progress.

New Employee Training

Residential Directors should ensure that staff receives their required training, support and supervision in a productive and respectful atmosphere that provides opportunities for each employee to contribute their input, talent, and creativity to accomplish the mission, vision, and work of the organization.

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Required Training -

All Staff:

Rule 50 Abuse and Neglect Training

All agency staff must successfully complete DHS OIG approved 59 Ill. Admin. Code 50 training within 10 working days of first day in paid status and prior to any direct contact with persons served by the agency. Staff must also complete a biennial (every two years) refresher training course approved by DHS OIG Department of Human Services Act (20 ILCS 1305/1-17). The initial and biennial requirement for OIG Rule 50 training can also be satisfied by completing Abuse & Neglect Module 3 of the DSP Classroom Curriculum. The DSP Abuse & Neglect Module 3 classroom curriculum can be found at:

The Department of Human Services training requirements are summarized below for the following positions:

Direct Support Persons (DSP) must receive 40 hours of classroom and 80 hours of On- The-Job training. Each contains competencies that the employee must be able to

demonstrate knowledge of, as required by DHS. The entire 120-hour DSP training program cannot be presented in a time frame of less than three weeks (21 calendar days) of when it starts, but must be completed within 120 calendar days of hiring persons as DSPs. The only exception is if a community college or other educational institution conducts the classroom training component of the agency's DSP training program. In these instances, the completion date is tied to the end of the term, semester or trimester. The full detail of DSP requirements can be found at:

Qualified Intellectual Disabilities Professional (QIDP) must meet the state and federal definition of a QIDP (QMRP). After a credential review confirming qualification, the QIDP will be added to the state QIDP-Eligible database. All QIDPs must have 12 hours of continuing education units (CEUs) each state fiscal year beginning the first state fiscal year after completing the 40-hour QIDP training. Six of the 12 annual Continuing Education hours must be obtained outside the employing agency. Topics must be related to the field of developmental disabilities or to the work of a QIDP. QIDPs that have completed QIDP Orientation training and have a gap in service of less than two (2) years will not need to repeat this QIDP training as long as they have met the annual 12 hour continuing

education requirement during the gap in service. More details of QIDP training

requirements can be found at: http://www.dhs.state.il.us/page.aspx?item=48245 Residential Directors are responsible for managing one or more shifts of staff that

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Competence Based Training

Beginning a Competency-Based Training program is a complex and challenging process, but the payoff is a more competent and

satisfied workforce.

What is Competency-based Training?

Competency-Based Training (CBT) is an effective training model that is based on what the DSP needs to learn to do their job well and ways to teach these needed skills. It is a set of structured processes for identifying the skills, knowledge and attitudes needed by DSPs and the organization of these job skill requirements into a system of teaching approaches or models. CBT defines what skills, knowledge, abilities and attitudes are needed to perform effectively on the job. It provides training that will help the trainee develop those skills and help supervisors build the DSP’s confidence and competence. As the employees learn what their job responsibilities are and they are taught how to perform them, they will demonstrate the skills needed to meet those job expectations, and, it will be easier for them to meet and exceed job performance expectations.

What can effective competency-based training programs do?

• Create a positive employment experience

• Improve retention of valuable employees

• Build skills to prepare DSPs to take on added responsibilities

• Improve the DSPs’ performance evaluation ratings.

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What are competencies?

Competencies are the employee’s classroom and on-the-job knowledge, skills, attitudes, and behaviors that demonstrate a specific level of performance needed to meet job expectations.

The DSP's supervisor must have a clear understanding of the competencies in order to communicate competencies and their meaning to the employee. The employee needs to understand

and be willing to learn more about them, and to demonstrate their competency when performing each task.

Competency-based training is carefully designed, flexible and learner centered. It is based on:

• What the employee needs to learn

• When the employee needs to learn the material

• How the employee needs to learn the information

Why is Competency-Based Training Important? New DSPs often start their jobs with little or no experience in providing support to people with disabilities. They may struggle with the realities of direct support work. Many times they do not understand the duties and responsibilities nor have realistic job expectations. This conflict can lead to dissatisfaction with the job and often results in people resigning.

Supervisors should communicate with DSPs about what the expectations are, and observe them as they perform their job, to determine their level of competency at each of the tasks they are responsible for. As they observe them, they should be thinking about:

• What does the employee need to know to do their job well?

• What do they already know?

• What do they need to learn?

The employee needs to understand and be willing to learn more about the competency, if needed, and to demonstrate they are able to perform each competency as required.

Staff who meet and exceed competency-based training expectations are:

• More confident, competent and provide better quality supports

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Examples of DSP Competencies:

Some of the competencies that DSPs must know are listed below.

Refer to link: http://www.dhs.state.il.us/page.aspx?item=48122

Informational Competencies include:

• how to identify and report possible abuse and neglect incidents to OIG or IDPH

• strategies for preventing abuse and neglect

• the basics of human growth and development

• proper nutrition guidelines

• basic characteristics of categories of developmental disabilities

• some causes of intellectual disability and potential prevention methods

• the differences between intellectual disability and mental illness

• methods of communication

• his/her role on the community support team/IDT

• service plans

• infection control practices

• basic health and safety.

Interventional Competencies include:

• create opportunities for the individual to speak on his/her own behalf in a variety of situations

• gather and document information in an accurate, objective and unobtrusive manner

• provide information needed to complete assessments that are relevant to the individual’s goals, interests and preferences that are consistent with relevant professional practice

• name and define life skill areas and demonstrate observable skills and tasks Χ define developmental disabilities and list associated characteristics

Χ document and communicate identified strengths, abilities, desires, concerns and needs of the individual

Χ follow established directions and procedures.

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ACTIVITY – Writing Competencies for a Residential Director Position

Directions: Think of the Residential Director position at your organization and list the competencies for that position.

Position: _______________________

Informational Competencies:

•

Interventional Competencies:

•

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SECTION THREE - RETENTION

Residential directors are often faced with the challenge of retaining DSPs after they are hired. Let look at some of the factors that contribute to high DSP turnover rates.

According to the Centers for Medicare and Medicaid Services, job characteristics associated with DSP turnover include:

•

Full-time hours if desired with stable work schedules, balanced workloads, and no mandatory overtime

•

^Wages

•

Health insurance and other family-supportive benefits

•

Excellent training that helps workers develop and hone skills

•

Participation in decision–making

•

Non-financial incentives such as positive performance reviews and recognition

•

Pleasant physical work environment

•

Informal support from co-workers

•

Career advancement opportunities, professional challenge

•

Flexible work schedules

•

Supervisors who set clear expectations and require accountability, and at the same time, encourage, support and guide each DSP.

DSP retention could become even more important in the future given the projections that the growth rate of the core labor supply is expected to decline while the demand for direct support workers is expected to increase.

Additional training and motivational practices may become necessary to lower the DSP turnover rate.

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Retention through Organizational Strategies

• Orientation and training strategies improve the effectiveness of employees by supporting new employees adequately and by providing all employees the information and skills they need to do their jobs effectively.

• Effective orientation practices focus on welcoming new employees to the organization.

• Competency-based training approaches ensure that workers can actually

demonstrate new skills on-the-job before giving them credit for completing training.

• Performance evaluations are used to provide feedback to employees and to establish goals for future performance.

• Mentoring programs provide one-to-one support from someone who is not the person’s supervisor to reinforce learning and facilitate successful employment.

• Recognition strategies acknowledge the contributions made by all employees.

Recognition includes treating DSPs as professionals and providing regular meaningful reminders to employees acknowledging them as individuals (e.g., birthday cards), and as employees.

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Realistic Job Preview

Realistic Job Interviewing is a retention strategy that reduces turnover due to the job not meeting the new employees’ expectations. Managers should give potential employees clear expectations about the positive and negative aspects of the job for which they are applying that they would not be likely to know otherwise. Potential employees are told about the actual duties and responsibilities of the job before they decide to accept a job offer. A Realistic Job Interview helps reduce the time used to interview hire, orientate and train people who are not well suited to direct support work.

A Realistic Job Interview gives detailed and balanced information about:

• the employer (salary, benefits, etc.)

• the job duties; for example, cooking, cleaning, shopping, staff meetings;

• job expectations

•

explain the types of daily personal care routines

•

what participating in the community really looks like

•

hours of work and overtime expectations

• characteristics and needs of consumers

• types of work sites.

• Fun aspects of the job!

Being realistic about the job will help recruits see that the job can be fun and rewarding but that there will also be parts of the job that are challenging. It will save time and energy because your facility can screen out recruits who are not a good match with direct support work and the applicant can ask to stop the job interview process when they realize that this job is not what they expected it to be.

A realistic job preview can be handled in ways that include:

•

observation

•

talking with persons who receive supports

•

watching DVDs

•

work on a trial basis/internship

•

conversing with current direct support staff

•

volunteer opportunity

•

meeting with family members.

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Employee Performance

Person-Centered Approach for Employees:

Many organizations use a person-centered planning approach with persons receiving supports. However, some of these same organizations may not apply this philosophy with their employees. The person-centered approach for persons served is not very effective or long-lasting if there is a “disconnect” between the individuals’ person-centered planning strategies and the organization’s employee policies and philosophies.

Treating Employees with Respect and Showing Appreciation for their Skills Once employees are hired, they should be made to feel valued, treated with respect as the integral and indispensable people they are. They should develop a recognized set of skills for which they are held accountable and for which they can be proud.

Performance Evaluations

One way to obtain feedback for use in a DSP’s performance evaluation is to observe the DSP while on the job.

However, the frontline supervisor may want to obtain input from other sources.

Questions to ask about your agency’s performance evaluations:

• Who completes them?

• Survey DSPs and ask are these evaluations helpful or not? Why or why not?

• How well do performance reviews align with job descriptions or actual duties?

• With training opportunities?

• With your organization’s mission, vision, and values?

• Are performance reviews timely? Why or why not?

With job descriptions tied to the competencies, you can develop performance evaluations and training programs that are competency-based.

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Employee Recognition

Employee recognition is not just a nice thing to do for people. Employee recognition is a

communication tool that reinforces and rewards the most important outcomes people create for your business. When you recognize people effectively, you reinforce, with your chosen means of

recognition, the actions and behaviors you most want to see people repeat. An effective employee recognition system is simple, immediate, and powerfully reinforcing.

When you consider employee recognition processes, you need to develop recognition that is equally powerful for both the organization and the

employee. You must address five important issues if you want the recognition you offer to be viewed as motivating and rewarding by your employees and important for the success of your organization.

The Five Most Important Tips for Effective Recognition

• You need to establish criteria for what performance or contribution constitutes rewardable behavior or actions.

• All employees must be eligible for the recognition.

• The recognition must supply the employer and employee with specific information about what behaviors or actions are being rewarded and recognized.

• Anyone who then performs at the level or standard stated in the criteria receives the reward.

• The recognition should occur as close to the performance of the actions as possible, so the recognition reinforces behavior the employer wants to encourage.

• You don't want to design a process in which managers "select" the people to receive recognition. This type of process will be viewed forever as "favoritism" or talked about as "it's your turn to get recognized this month." This is why processes that single out an individual, such as "Employee of the Month," are rarely effective.

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Some Ways to Recognize Employees

• Flex work hours and work schedules (Employee determines schedule)

• Send a hand written note

• Days off

• Start an employee recognition board

• Reserve a special parking spot

• Celebrate success in newsletters or websites

• Two simple words “Thank you!”

• Sports Tickets

• When an employee exceeds expectations, put the

name in a “recognition pool”. Once a month, pull a name and award that person a gift.

• Membership in a professional organization

Mentoring

Mentoring can be an excellent strategy for providing learning and professional growth opportunities to experienced and motivated DSPs and for employers to demonstrate a high level of recognition for employees.

Mentoring occurs when an experienced DSP helps someone with less experience and skills expand, refine and build new skills and gain a better understanding of “best practice”

policies (for example, person centered supports). Mentoring can provide benefits to both the employees and the individuals they serve

Staff who work with a mentor:

• tap into the accumulated knowledge and experience of their mentor

•

have increased opportunities for feedback

•

can share anxieties and concerns with their mentor

•

connect socially with others

•

have decreased feelings of isolation

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Mentors

•

Receive recognition for their skills and abilities

•

Have opportunities to develop new skills and achieve advancement

•

Often have a renewed interest in their jobs

Persons Receiving Supports

•

Receive better quality supports and services

•

See less staff turnover which leads to higher quality relationships

•

Have more and varied community inclusion opportunities

•

Learn new and different interests and skills

Improving the Work Environment

A variety of approaches, including mentoring, use of self-directed work teams, and career ladders have been closely linked to employee satisfaction.

The relationship between supervisors and DSP plays a significant role in job satisfaction and the intent to stay.

According to the Centers for Medicare and Medicaid

Services National Direct Service Workforce Resource Center the key attributes of an effective supervisor include:

•

The ability to listen attentively in order to

understand the perspective of the worker when a problem arises

•

The ability to constructively present and address problems

•

The capacity to help workers develop problem- solving skills and

•

The ability to build relationships with supervisees

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Mission and Vision Statements

DSPs’ Participation in the Agency’s Mission and Vision Statements:

Organizations should have a clearly defined mission and a means to continually assess, evaluate, plan and deliver services in a meaningful manner. Agencies must recruit, select, and retain persons who will work toward fulfilling that mission.

DSPs should be given opportunities to be involved in your agency’s Mission Statement.

Suggestions on how they can be involved are: by providing input into the development or updating of the mission and vision statement; by participating in committees, work groups, and planning sessions. Their involvement will help shape and direct an

organization/employment situation in ways that value, respect, and affirm each employee’s input, talent, and creativity to accomplish the mission, vision, and work of the organization.

Some of the benefits of DSPs being involved in carrying out mission and vision statement include:

• Provide opportunities for DSPs’ voices to be heard.

• Give DSPs and frontline supervisor’s perspective about what will or will not work in the development of policies, procedures, and practices.

• Enable the organization/employer to have broader and more diverse views and creativity in teams, groups, and committees.

• Creates an environment of openness, integrity, and respect.

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Preventing and Dealing with Incompetence

A culture of inferior work behavior is caused when

supervisors ignore or treat lightly poor staff performance, or fail to make DSPs feel that their jobs are worthwhile or important...

• The quality of supports will decline when poor performance becomes the norm.

• Unacceptable job behaviors must be immediately addressed and corrected.

• If you determine the cause of poor performance is a skill gap

between expected performance and demonstrated performance, be sure to keep logs documenting the initial poor work performance that was observed, the training or other measures that were used in an attempt to improve staff performance, and follow-up documentation of your observations after staff’s remedial training is completed.

Remember, when DSPs are not recognized or made to feel like the jobs they do are worthwhile, it can hurt the people they support. For the unrecognized and poorly motivated employee, coming to work every day begins to feel like a chore and becomes draining, rather than energizing. Instead of finding creative and new ways to work with coworkers and people they support, undervalued DSPs may begin to dread their jobs and do only what is absolutely necessary to get through the day. This can lead to problems such as poor work attendance, poor quality of work performance, and eventually an increase in agency turnover.

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101 WAYS TO COPE WITH STRESS

Courtesy of the Tripler Army Medical Center, Honolulu, Hawaii

Get up 15 minutes earlier ♦ Prepare for the morning the night before ♦ Avoid tight fitting clothes ♦ Avoid relying on chemical aids ♦ Set appointments ahead ♦ Don't rely on your memory ... write it down ♦ Practice preventive maintenance ♦ Make duplicate keys ♦ Say "no" more often ♦ Set priorities in your life ♦ Avoid negative people ♦ Use time wisely ♦ Simplify meal times ♦ Always make copies of important papers ♦ Anticipate your needs ♦ Repair anything that doesn't work properly ♦ Ask for help with the jobs you dislike ♦ Break large tasks into bite size portions ♦ Look at problems as challenges ♦ Look at challenges differently ♦ Unclutter your life ♦ Smile ♦ Be

prepared for rain ♦ Tickle a baby ♦ Pet a friendly dog/cat ♦ Don't know all the

answers ♦ Look for a silver lining ♦ Say something nice to someone ♦ Teach a kid to fly a kite ♦ Walk in the rain ♦ Schedule play time into every day ♦ Take a bubble bath

♦ Be aware of the decisions you make ♦ Believe in yourself ♦ Stop saying negative things to yourself ♦ Visualize yourself winning ♦ Develop your sense of humor ♦ Stop thinking tomorrow will be a better today ♦ Have goals for yourself ♦ Dance a jig ♦ Say

"hello" to a stranger ♦ Ask a friend for a hug ♦ Look up at the stars ♦ Practice

breathing slowly ♦ Learn to whistle a tune ♦ Read a poem ♦ Listen to a symphony ♦ Watch a ballet ♦ Read a story curled up in bed♦ Do a brand new thing ♦ Stop a bad habit ♦ Buy yourself a flower ♦ Take time to smell the flowers ♦ Find support from others ♦ Ask someone to be your "vent-partner" ♦ Do it today ♦ Work at being cheerful and optimistic ♦ Put safety first ♦ Do everything in moderation ♦ Pay attention to your appearance ♦ Strive for Excellence NOT perfection ♦ Stretch your limits a little each day ♦ Look at a work of art ♦ Hum a jingle ♦ Maintain your weight

♦ Plant a tree ♦ Feed the birds ♦ Practice grace under pressure ♦ Stand up and

stretch ♦ Always have a plan "B" ♦ Learn a new doodle ♦ Memorize a joke ♦ Be

responsible for your feelings ♦ Learn to meet your own needs ♦ Become a better

listener ♦ stretch ♦ Know your limitations and let others know them, too ♦ Tell

someone to have a good day in pig Latin ♦ Throw a paper airplane ♦ Exercise every

day ♦ Learn the words to a new song ♦ Get to work early ♦ Clean out one closet ♦

Play patty cake with a toddler ♦ Go on a picnic ♦ Take a different route to work ♦

Leave work early (with permission) ♦ Put air freshener in your car ♦ Watch a movie

and eat popcorn ♦ Write a note to a far away friend ♦ Go to a ball game and scream ♦

Cook a meal and eat it by candlelight ♦ Recognize the importance of unconditional love

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MODULE 2

HUMAN RIGHTS

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TABLE OF CONTENTS

INTRODUCTORY MATERIALS ... 4 EVOLUTION OF HUMAN RIGHTS ... 5 SELF-APPRAISAL ... 6 RULES ... 8 THERIGHTSOFINDIVIDUALSLIVINGINCILAS ... 8 LEAST RESTRICTIVE ENVIRONMENT ... 9 MENTAL HEALTH CODE ...10 CONFIDENTIALITY ...11 CONSENT FOR RELEASE OF PRIVATE INFORMATION ...12 INFORMED CONSENT ...13 DEATH OF AN INDIVIDUAL ...14 DISCLOSURES TO INSURANCE COMPANIES ...14 DUE PROCESS ...15 HEALTH CARE SURROGATE ACT ...16 ADVANCE DIRECTIVES ...16 FREEDOMS OF EVERYDAY LIFE ...17 RESIDENT RIGHTS EXERCISE ...18 PROMOTING RIGHTS ...19 PEOPLE FIRST LANGUAGE ...20 PRIVACY ...22 PRIVACY –ACONSTITUTIONAL RIGHT ...22 THE RIGHT TO INTIMACY ...23 SEXUALITY AND EDUCATION ...24 RESIDENT COUNCIL ...25 SELF-ADVOCACY ...25 INDIVIDUAL RIGHTS RESTRICTIONS ...26 HUMAN RIGHTS COMMITTEE (HRC) ...26

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THE CHOICE MAKING PROCESS ...32 ISPS AND RIGHTS ...32 ADVOCACY GROUPS: ...33 THE HUMAN RIGHTS AUTHORITY ...38 ACTIVITY - MOUNTAIN VIEW ...39 MOUNTAIN VIEW -ISSUES FOR DISCUSSION: ...40 YOU AND I ...41

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INTRODUCTORY MATERIALS A Self-Advocate’s Viewpoints on Privacy

“My privacy is just like anyone else’s...it’s private.”

Sound familiar?

“Someone is always hovering around when I’m with my boyfriend.”

“My caregiver stole money from me.”

“The doctor told my health story to a bunch of strangers in the room.”

“My helper tells other people all sorts of stuff about me.”

“What I do in my room is my business.”

“I should decide what others can know about my life.”

“No one should read my letters unless I say it’s OK.”

“No one can listen to my phone calls unless I say it’s OK.”

“Helpers have no right to tell others what they know about me.”

“I have the right to private space to be with my boyfriend.”

Rosemary Kayess, self-advocate

Note: Organizations should protect and promote the rights of

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EVOLUTION OF HUMAN RIGHTS

Historically, society has tended to isolate and segregate individuals with disabilities. Many early institutions were simply warehouses where people were sent for a variety of reasons; not all of which were related to mental illness or intellectual disability. Very few ever received any form of individualized treatment or habilitation.

As a result of the landmark court decision in 1970 Wyatt

vs. Stickney, we recognized that persons with intellectual disability are citizens who have "rights" under the constitution. This case resulted in the establishment of 49 Principles of service which include the requirement to establish a seven-person Human Rights Committee to review all habilitation plans to ensure that the human rights of the residents were preserved.

It also resulted in the establishment of:

•

Qualified Mental Retardation Professionals (Now called Qualified Intellectual Disabilities Professional or QIDP)

•

A "Right to Treatment

•

Development of Human Rights Committees

•

Staff to client ratios

•

Physical plant features/dimensions

•

Development of behavior plans

For more information on the history of treatment of people with Developmental Disabilities go to:

http://www.mncdd.org/dd_act/dd-act.html

Baker, Steve and Tabor, Amy Human Rights Committees, High Tide Press, Homewood, Illinois, 2006

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SELF-APPRAISAL

LEGAL RIGHTS OF PEOPLE WITH DEVELOPMENTAL DISABILITIES The following questions will help you evaluate your knowledge

about the legal rights of people with developmental disabilities.

For true-false questions, check the correct answer. For multiple choice questions, circle the correct answer(s).

1. The Constitution states that all people:

a. Have equal potential

b. Should have the same opportunity to use their abilities c. Have equal rights

d. Can do the same tasks.

Answer: ______

2. People cannot be treated differently solely because of a developmental disability.

_____ True _____ False

3. A person can be determined to be mentally incompetent only by:

a. A physician.

b. A physician and a psychologist

c. A Qualified Intellectual Disabilities Professional (QIDP) d. A court proceeding.

4. Which of the following questions should be raised when rights are restricted?

a. The type of right being restricted

b. The length of time the restriction will be in effect

c. Whether the restriction is the least intrusive measure possible d. Whether training is provided to make the restriction unnecessary

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6. Informed consent requires that the following must be explained:

a. Nature and outcome of the procedure b. Side effects and risks of the procedure c. Withdrawal of consent without penalty

d. Co-signature of the program supervisor on the consent form

7. Commonly recognized rights of persons in the community-based residential programs include:

a. The right to services in the least restrictive environment b. The right to dignity and respect

c. The right to appropriate clinical, medical, and therapeutic services d. The right to private communication

8. The human rights committee in community services agencies a. Links the agency to outside independent advocacy programs b. Protects the rights of person with developmental disabilities c. Monitors policies and procedures of the agency

d. Files legal briefs in state court proceedings

9. Legal rights require responsible behavior in the exercise of these rights.

_____ True _____ False

10. Major laws providing legal guarantees for people with disabilities are:

a. The Individuals with Disabilities Education Act Amendments of 1991 b. The Developmental Disabilities Assistance and Bill of Rights Act of 1990 c. The Rehabilitation Act of 1973

d. The Crippled Person Reform Act of 1979

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RULES

THE RIGHTS OF INDIVIDUALS LIVING IN CILAs

The rights of individuals living in CILAs and the rights of individuals receiving services through the DHS Medicaid Home and Community-Based Services are protected by the DHS Medicaid Home and Community-based Waiver, Rights of Individuals. (59 Ill. Admin. Code 115.250).

The law requires that CILA agencies provide their individuals with a statement describing their rights, written so that they can understand it.

The rights of individuals living in CILAs and the rights of individuals enrolled in DD Waiver are summarized below:

•

The use of seclusion will not be permitted.

•

The right of individuals' confidentiality is protected by the Confidentiality Act.

•

Individuals have a right to contact (and a right to assistance to do so) the Guardianship and Advocacy Commission; Equip for Equality, Inc, the

Department's Office of Inspector General and the CILA agency's human rights committee.

•

They cannot be abused and/or neglected.

•

They can purchase and use private physicians and other mental health and DD professionals of their choice. The names of these professionals will be

documented in their service plan.

•

The individuals' files contain documentation that they were advised of their rights and will contain justification for any restrictions of their rights.

•

The individuals have a right to submit grievances and appeal decisions of the

Residential Director Core (RDC) Training Program