The CIL Pathfinder
for Services & Programs for Older Americans
Taking
Stock of Best Practices in CIL Management Part I
Would
You Take A Three-Year Trip Without a Map? A Strategic Planning Road Map
Board
Orientation Training Program
Quest
For Clearer Response To Training & Technical Assistance Needs
VR - IL Collaboration Training Program Offerings
Centers for Independent Living
and Transition-Aged Youth:
Building Support for
Transition-Aged Youth with Disabilities
Over
the past three years, the RRTC-ILM and the Beach Center on Disability at the
University of Kansas have examined CILsı roles in transition services for youth
with disabilities. This projectıs three goals are: 1) an analysis of the
literature on CIL involvement in transition services for high school aged youth
with disabilities and their families, 2) identification of innovative models or
CIL best practices serving youth and their families, and 3) replication of
model programs, training, and dissemination of information and resources to the
CIL audience. Previous RRTC-ILM Newsletter articles highlighted outcomes from this projectıs first two goals. This
article reviews the primary means by which we are achieving the third goal -
disseminating information and resources to CILs through a website that contains
information, resources and strategies for ways that CILs can support
transition-aged youth to become fully integrated into the community.
Development
of the Centers for Independent Living: Building Support for
Transition-Aged Youth website began in Spring 2004. Deborah Benitez, a
Beach Center doctoral student, prepared a preliminary outline of the web page
to include sections on:
The
content of the web page is based upon our previous project activities which
included a literature review of research and services provided to youth in
transition at CILs and a survey of transition services provided to
transition-age youth by CILs. Our intention is to provide an accessible website
that will be useful to CILs who are providing support to youth in transition
all over the country. Obviously, it is critical that such web-based information
is accessible and project staff worked hard to ensure this outcome. The web
page will provide resources on multiple relevant topics and will be linked
through RRTC-ILMıs web page. Our intention is to ensure that information is
straightforward, accessible, educational, and useful for CILs to promote
transition outcomes for youth.
Emphasis
is placed on best practices that have been experimentally evaluated or which
are currently being implemented by CILs, as identified by our survey or the
literature review. Three of the best practices were evaluated through project
activities: Youth Empowerment, Peer Mentoring, and the Self-Determined Career
Development Model. The first was an examination of the efficacy of ³empowerment
groups² operated by a CIL for transition-age youth. Project staff examined
efficacy with transition-aged youth who met weekly at a CIL to learn to set
transition related goals and assume greater responsibility for their transition
planning. Implementing The Self-Determined Career Development Model to enable youth to self-regulate career and
employment decisions, a second best practice was examined by training and
supporting CIL-based peer mentors to support youth to set transition goals. A
third evaluated best practice was CIL involvement in Youth Leadership Forum
activities. On the website, best practices are set up for a user to walk
through the process of implementing the best practice. This includes
instructions on implementing the practice along with questions that have to be
answered in order to individualize the practice for consumers. Additional best
practices (forthcoming) will include the role of CILs in assisting
transition-aged youth to access social security work incentive programs like PASS
and the role of CILs in developing customized and supported employment outcomes
for youth.
The
Centers for Independent Living: Building Support for Transition-Aged
Youth web page will be officially unveiled in October at
the 10th Annual National Conference on Rural Independent Living sponsored by The Association of Programs for
Rural Independent Living (APRIL). It
will be available via a link on RRTC-ILMıs web page after that time.
- Jennifer Lattimore, PhD, Michael Wehmeyer, PhD and Deborah Benitez, MA
Beach Center on Disability, University of Kansas
The CIL Pathfinder for Services & Programs for Older Americans
The
RRTC-ILM and the Rehabilitation Engineering Research Center on Technology for
Successful Aging (RERC Tech-Aging) have been exploring how centers for
independent living (CILs) can play a major role in providing services for older
consumers (age 60+). One objective is to encourage collaborations between CILs
and the aging network of organizations.
Current
research studies indicate that our aging population will increase dramatically
by 2030 as more ³baby boomers² reach age 65. People over age 85 are the fastest
growing population segment. While medical technology has made it possible to
live longer lives, quality of life issues remain. As ³boomers² age, they will
become the most affluent and largest potential consumer base for CILs during
the next twenty years. As the number of older people increases, assistance may
be required by two older groups: people with disabilities acquired earlier in
life who are now dealing with age-related changes and older people who acquired
a disability later in life.
In
2001, the U.S. Census Bureau reported that 14.2% of the elderly population had
difficulty performing at least one activity of daily living (bathing, dressing,
eating, and mobility) and 21.6% had difficulty with instrumental activities of
daily living (managing finances, cooking and housekeeping, shopping and using
transportation).¹ The Administration on Aging (2001) reported that 35 million
Americans were age 65 years and older, which represented 12.4% of the U. S.
population. Minority populations are projected to
represent 26.4% of the elderly population in 2030, up from 17.2% in 2002.²
As the numbers of elder consumers (and caregivers) increase, so will the
demand for services and resources. CILs are well situated to provide services
through existing programs or to develop new programs to meet older consumersı
needs including fee-for-service programs funded under the Older Americans Act.
The
RERC Tech-Aging and RRTC-ILM have developed an aging services manual called The
CIL Pathfinder for Services and Programs for Older Americans. It is designed
to help CILs:
The
Pathfinder consists of thirteen sections including information
on: the aging network of organizations, a comparison of CIL operations and
programs and those of Area Agencies on Aging, and issues that affect older
people such as home modification, transportation, housing, assistive
technology, health status and chronic conditions. At the beginning of each
section, there is a brief summary called Relevance for Centers for Independent
Living (CILs).
The
Pathfinder is being
edited. Upon completion in October, it will be posted to the RRTC-ILM and the
University of Floridaıs RERC-Technology-Aging websites. All CILs will be
notified when the Pathfinder
is available.
¹U.S. Department of
Health and Human Service, Administration on Aging. (2004). A profile of
older Americans: 2003. Retrieved
September 13, 2004 from http://www.aoa.gov/prof/Statistics/profile/2003/4.asp#figure1)
²U. S. Census Bureau.
(2001). Americans with disabilities, 1997. Current population reports, p
70-73. Retrieved September 13, 2004
from http://www.census.gov/hhes/www/disable/sipp/disable97.html
-
Linda F. Fraas, MA, OTR/L, ATP, CEAC
Research Support Specialist, Dept. of Rehabilitation Science
University at Buffalo
and
William C. Mann, OTR, PhD
Professor and Chair, Dept. of Occupational Therapy
PI, RERC on Technology for Successful Aging
University at Florida
Taking Stock of Best Practices in CIL Management Part I
The
RRTC-ILM is conducting a series of research studies that help identify and
replicate suitable management models from CILs and from other organizations.1
An earlier RRTC-ILM2 study profiled the vision of an effective CIL
in the eyes of its diverse stakeholders (board members, executive directors,
funders, volunteers, staff and consumers).
An
essential initial step is knowledge of the status quo of CIL management
practices, which are rooted in the IL philosophy and have evolved as a response
to each CIL's community needs. As each CIL built and rebuilt itself
organizationally, each collectively built the national CIL network of
organizations. The RRTC-ILM is conducting a second study to uncover the status
quo of CIL management practices across the national network. We seek to
identify CILs' collective view of current practices as well as what practices
are important for an effective CIL. This information can serve as a basis for
reconstructing a useful model.
This
study involves three steps:
We
drafted an initial survey of management practices and asked executive directors
from a sample of top performing CILs to judge, modify and expand upon the list.
Our earlier study on CIL organizational profile (on elements and outcomes of an
effective CIL) suggested nine management categories. We used these nine
categories as a basis for organization of this survey and we structured the
survey for telephone administration.
In
order to identify top performing CILs, we did an analytical examination of the
2001 704 Report data (242 CILs). We focused on disability types (cognitive,
hearing, vision, mental emotional, multiple disability, etc.), examined the
number of Goals Set and Goals Met by CILs in relevant areas (communication,
community educational, informational access, mobility, personal resource, and
self-advocacy, vocational goals), and looked at age and ethnic background. We
also looked at CILs' performance in preventing people from entering
institutions as well as in relocating individuals from institutions. This
analysis resulted in 38 different data sets. Working systematically through
these data sets, we compared CILs' averages with corresponding national
averages (from Census Bureau 2000 data). We identified 183 CILs who were
performing well (at least 20% above the national average) across all data sets.
Among these CILs, we identified the top ten centers (one in each of ten
geographic regions) based on the frequency of their appearance in the list.
A
draft management practices survey was administered to the executive directors
of the top ten CILs during July and August 2003. All telephone interview
responses were recorded on hard copies of the questionnaire and most were tape
recorded for later analysis and reference.
This
data was analyzed. We obtained a refined set of management practices based on
the frequency of respondents' agreement to include each practice as well as on
the additions suggested by respondents. This list of practices was then put
into a Kano format structured for telephone administration. Each question
called for the degree of agreement (on a rating scale of 1 to 5) about the
importance of a specific practice. The final survey consisted of 181 pairs of
questions. Each pair consisted of a practice stated in the positive and the
negative as per Kano requirement.
During
December 2003 and January 2004, we identified a national sample of CIL
directors to participate in the Kano survey stratified by the center's age
(young, mid-age and old), its size (small, mid-size and big) and geographical
category (urban and rural). We obtained the needed additional demographic data
on CIL age and size (number of employees at the center) through our Independent
Living Organization Survey data and
telephone contact. We used Census Bureau data for 2000 and criteria developed
by the Association of Programs for Rural Independent Living (APRIL) for
classifying centers as rural or urban. In constructing the sample, we first
categorized all 390 main centers into the 10 federal regions. We then
classified them by size (big, mid-sized and small), age (old, mid-age and
young) and geographical category. Age classification criteria were defined as:
established before 1979 (old), established between 1980 and 1992 (mid-aged),
and established after 1992 (young). Size criteria were defined as: 2-14
employees (small), 15-50 employees (mid-sized), 50 employees or more (big). We
defined a rural center using APRILıs definition of "a center located in
city of less then 50,000 persons." Using a random number table, we
constructed a stratified sample of 131 centers distributed by region, age, size
and geographic category.
From February to April 2004, we administered the Kano survey via telephone interview to 131 executive directors. Preferably, interviews were held in two sittings, with each session taking approximately 75 minutes to complete. We acknowledge the executive directors' professionalism and cooperation in responding to a comprehensive, yet long, questionnaire. Many preferred to combine the two interview sessions. Not surprisingly, a quick, cursory analysis of each "response-pair" revealed need for confirmation of particular responses to particular questions. We had to follow-up in order to minimize possible measurement error. During May and June 2004, we customized re-surveys of 111 respondents. The number of responses to be verified by these executive directors was small (ranging from 2 to 18 question-pairs) compared to the total (181 question-pairs).
Some
executive directors remarked that the survey was "thought provoking,"
although several found it "too long." Some acknowledged that they had
not considered some of the management practices mentioned in the survey and
that they would look into employing them at their centers. Others revealed
their level of interest in the survey by suggesting that we include other
practices. For example, one executive director commented that the survey lacked
practices concerning "staff development or staff enrichment." Another
suggested that we should have addressed practices concerning
"environmental concerns" at centers.
We
are in the process of examining the data using Kano analyses. We hope to answer
such questions as: What practices are CIL directors currently using? What
practices are important according to CIL directors? Are priorities different
for centers based on size, age and type of communities served (urban/rural)?
Are there strengths that might be tapped and transferred between centers? Is
there a need for external models or strategies?
Stay
tuned! You may find the emerging model a useful resource and management guide.
- Vathsala I. Stone, PhD, RRTC-ILM, University at
Buffalo
and Mark E. Montgomery, JD, RRTC-ILM
1Western New York Independent Living
Project, Inc. (2000). Rehabilitation Research and Training Center for
Independent Living Management. [A grant proposal submitted to NIDRR].
Unpublished.
2Usiak, D.J.,
Stone, V.I., House, R.B & Montgomery, M.E. (2004). Stakeholder perceptions
of an effective CIL. Journal of
Vocational Rehabilitation, 20(1)
35-43. (Also available at: http://www.wnyilp.org/RRTCILM/dissemination/publications.html).
3Kano, N.(1984).
Attractive quality and must be quality. Hinshitsu, The Journal of the
Japanese Society for Quality Control, 14(2)147-156.
Would You Take A Three-Year Trip Without a Map?
A Strategic Planning Road Map
Donıt
call the automobile club, call the RRTC-ILM !
Itıs
that time again. Itıs time to embark on a journey to the future of your
independent living center. Legislative and funding changes, program
opportunities and reporting requirements create new routes and new destinations
for your center to explore. Itıs crisis management. Youıve seen the symptoms.
Consumer needs are growing, programs are changing, staff is complaining about
space, resources are spread thin, and you seem to be buying some kind of
computer technology every other week. So how do you find your way? Where do you
start?
Does
this sound familiar? Do you need a way to sort things out in order to become
pro-active rather than re-active? Then maybe you need the Organizational
SnapShot. Whatıs the Organizational
SnapShot? Itıs a strategic planning tool that gives you a picture of your
center and makes your board, staff and consumers part of your planning team.
The
Organizational SnapShot is a step-by-step questionnaire that enables you to
take a picture of your center as it exists today. Structured within nine
management categories, the questions guide you to identify various resources
that support the day-to-day operations of your organization. These resources
include policies, procedures, programs, services, finances, equipment, staff
and more. It can reveal everything about your organization to get as complete a
picture as possible.
The
Organizational SnapShot is an investment of your time and an investment in the
future of your organization; the greater your effort, the greater the payoff
for your center. It all begins when you and your board members look at the
organizational culture (IL philosophy) of your center and the elements that
create that culture. You begin to examine the administrative management
practices and governance of your center along with other management practices
including human resources, financial resources and physical plant. The
Organizational SnapShot guides you through programs and services, consumer
involvement and community relations.
Your
completed responses to the SnapShot questions give you an overall picture of
your center with enough depth and detail to support your strategic planning
efforts. At this point, getting board, staff and consumer input will add to the
richness of the information you have collected. As you identify what you currently
have in place at your center, you also identify things you do not have and
might need to meet future consumer and community needs. This list of potential
needs becomes a list of discussion points for your strategic planning process.
Once
your board, consumers, staff and volunteers have had time to review the
Organizational SnapShot, schedule a planning session where all attendees have
an opportunity to review and set goals in each of the nine management
categories. Then, examine the urgency and the importance of these goals as they
contribute to the vision and mission of the center, establishing their
priority. Schedule the sequence through task planning, activity assignments and
deadlines, and committing resources in a three to five year strategic plan.
This
becomes a map to your centerıs future. Once in place, the Organizational
SnapShot becomes a benchmark. In three to five years, when it is time to do it
again, the Organizational SnapShot shows where you were and how far your center
has come.
How
do you get this useful strategic planning tool? Contact the RRTC-ILM @ info@wnyilp.org or call 716-836-0822,
extension 166, and ask, ³What is this Organizational SnapShot, and how do I get
it?²
-Douglas J. Usiak,
Principal Investigator, RRTC-ILM,
Executive Director, WNYILP, Inc.
Board Orientation Training Program
A three-year study to
determine the elements of a model CIL in the view of its stakeholders resulted
in the development of a CD called Effective Independent Living
Board/Staff Relationships. This
orientation instructional CD for staff and members of the board of directors
provides instruments, resource guides, and training materials to the
independent living community.
Analysis of the pilot
study of stakeholders' perception responses identified nine functions of a CIL.
Among these was governance, which is the focus of this CD, directed to board
members. The theme of governance is to provide direction to CIL activities
though policies and principles underlying IL philosophy. The board also serves other functions,
including consumer representation, communication, and an exchange of
information between the community and the CIL.
One mission of the
RRTC-ILM is to identify and adapt research findings and training materials to
CILs from other management or community-based models. Applied Research and Development International, Inc. (ARDI)
shared a similar mission ³to strengthen the management and leadership of public
benefit nonprofit organizations."
ARDI granted RRTC-ILM rights to their training materials designed for
nonprofit boards. ARDIıs video training materials on effective nonprofit boards
of directors focused on the board membersı legal responsibility to meet
requirements established by the government for a 501(c)(3) not-for-profit
organization. The video training materials were modified to reflect a CIL board
of directors meeting. This is the basis for the production of the instructional
CD, which includes several scenes of a board addressing governance in legal,
financial, membership, physical plant, program services and policy issues.
The CD includes a
version with a self-assessment survey instrument and instructional manual that
can be used either by an individual or by a group for an orientation to board
relations. The open captioned 30-minute CD incorporates an instructorıs manual
with original handouts for participants, a facilitator guide, materials for
discussion and analysis of the five segments presented. Telephone Ron House at
(716) 836-0822, ext. 165.
-
Ronald B. House and
Douglas J. Usiak
Questioning
the validity of a question, the response for which is vital to planning or
allocating funds to meet CIL needs in training or technical assistance. That is
the basis of a study that was conducted by RRTC-ILM.
The
contention is that the current phrasing of the query on the 704 Annual
Performance Report on Training and Technical Needs is misleading, causing
subsequent confusion in responses from executive directors of CILs and thereby
jeopardizing the priority of the needs. The 704 Form question concerns
"training and technical assistance needs for the next year." The
point of confusion stems from the conjunction "and." Are CIL
directors responding to training needs or technical assistance needs
individually? Or is the response to both needs as one and the same?
The
objective of this study was to examine consistency of response to this question
and determine if the priority of training needs reflected the perceived needs
of CIL directors.
The annual 704 Report is required of CILs as a result
of the 1978 Title VII (an
amendment to the Rehabilitation Act of 1973) that mandated allocation of
funding to the states to establish CILs. The law also required CILs to provide
quantitative and qualitative information regarding how they were meeting the
Section 725 Standard assurances defined in Title VII. The report includes CILs
in the 50 states, the District of Columbia, the Commonwealth of Puerto Rico,
U.S. Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern
Marianas Islands.
This
research study was based on the population of 242 CILs completing the 704
Report in 2001. The analysis of the response to the question on training and
technical assistance needs required respondents to check a response for 20
topics. The analysis of the response to the 704 Form question would indicate
the priority of CILsı training needs and technical assistance needs. To
determine the validity of the question as to the priority of results, a survey
was designed to obtain information on the perception of training and technical
assistance. A sample of 25% of the 242 CILs was selected through a randomized
sample. An e-mail survey was sent to 60 executive directors. The survey
included a definition of training and technical assistance and a request to
respond to two questions. 26 returned for a 43% survey response.
The
survey provided a definition of training and technical assistance in order to
clarify the meaning of both terms. The definition of training used is ³the role
performed by the organization for the education, training and development of
personnel.² The definition for technical assistance used is ³the direct
intervention or assistance onsite of a person(s) to address or provide
knowledge to solve a problem or issue involving the effectiveness of the independent
living organization or services being performed."
The
first question on the survey required respondents to check A, B, or C in answer
to the 704 Form question on ³training and technical assistance needs for the
next year:²
A. Did you respond to the
question as Training Needs?
B. Technical Assistance
needs or as
C. Training and Technical
Assistance needs as one and the same by definition.
The
second question listed the 20 topics as they occurred on the 704 Form in 2001
except that there was a separate response column for training and another for
technical assistance. The instruction read: ³Please indicate your choice by
putting a check in the appropriate column for each of the 20 topics below.²
The
research focus was on the context of the question as to whether the appropriate
responses were valid. The response to the first question of the survey
indicated that 6 of 26 checked A. There were no responses to B. 20 responded to
C. This indicates that it is a ³confounded² question. Survey questions should
be clear and unambiguous. How respondents perceived the question will determine
how they respond. The first problem is that the survey question asked the
respondents for a single answer to a combination of questions. A second problem
occurred when the word "and" appeared in the question. This indicated
a double-barreled question. Some respondents perceived the question as a
request for information on training while others perceived it as a request for
information on technical assistance. The important issue in question
construction is ensuring that the response reflects the intent of the question.
Results indicate that this survey question needs to be reviewed and rewritten.
The
summary of the interpretation of the data illustrates the comparative
difference in the priority of training needs as a result of the revised
question versus the original ³confounded² question on training and technical
assistance. The response to 704 Form Survey "Confound" question
listed priorities in this order: Fee-For-Service, Systems Advocacy,
Community/Grassroots, Institutionalized Potential Customers,
Medicaid/Medicare/PAS/Waivers/
Long-term Care and
Ticket-to-Work.
When
the question is written requesting a response for training and a separate
question for technical assistance needs, the following priorities emerge:
Response to Training by Priority Response to Technical
Assistance
1.5 Ticket to Work
1.5 704 Reports
1.5 Institutionalized Potential
Customers 1.5 American Disability Act
3. Individual Empowerment
4. Community/Grassroots
Org.
4. Community /Grassroots Organizing 4. Grant Writing
6. Systems Advocacy
4. Case
Management
6. Case Documentation
6. Workforce Investment Act of 1998
In summary, there is clearly
a misinterpretation of the question on training and technical assistance.
Respondents to our survey indicated very different priorities for training and
technical assistance when the question is unambiguous. It is apparent that the
704 Form question regarding training and technical assistance needs is not
providing the proper solicitation of information that would be useful in
prioritizing training or technical assistance needs, and the subsequent
planning or allocation of funds to meet those needs for CILs. Our
recommendation is that the question on training and technical needs can be
corrected by providing the appropriate definitions of training and technical
assistance and by breaking the question into two parts: one question to respond
to training and the other to technical assistance needs. A different response
form that would allow for rank ordering and would improve the questionıs design
is clearly in order. Our research also suggests that a pre-test of the revised
questions be conducted with a sample of CIL executive directors reviewing the
question for validity and reliability. The result will be a more standardized
question - one that is less subject to error and more accurately indicate the
needs of training and technical assistance of CILs. This research data is being
submitted to RSA for consideration and redesign of the 704 Annual Performance
Report.
-
Ronald B. House, PhD
and Mark Montgomery, J.D.
VR - IL Collaboration Training Program Offerings
The
training program Successful Collaboration: Independent Living Centers and
Vocational Rehabilitation Agencies
is now available to VR agencies, ILCs, and SILCs as an on-site program. This
evidence-based program, developed by Susan Stoddard of InfoUse and Brenda
Premo, Western University of Health Sciences, combines results from our Center
research and from empirical studies of successful collaboration with our own
experiences in ILCs and in the VR system. In a survey of VR agencies, ILCs and
SILCs, InfoUse and the Western University of Health Sciences explored the
status of collaboration between ILCs and VR, with respect to employment of
people with disabilities. Our research shows that while 40% of ILCs and 27% of
VR agencies rate current ILC/VR collaboration as poor or less than adequate
today, almost all ILCs and VR agencies see this collaboration as important, and
over half of ILCs and 29% of VR agencies see it as essential.[1]
"Because of the success of existing relationships we're coming to realize
that we can do more together than apart to improve employment outcomes for
persons with disabilities."[2]
Because
employment of people with disabilities is such an important goal, and because
collaboration on employment has potential for expanding the effectiveness of
ILCs and VR, we believe that all organizations should add collaboration skills
to their management "toolkits." Training participants will learn:
the essential elements of collaboration,
good examples of successful collaborations in VR agencies and ILCs,
good examples of ILC employment services,
how to analyze and identify potential for collaboration, and
ideas for getting started in building successful collaborations.
The
training program is currently available as an on-site presentation using
Powerpoint. We have tested and refined the content and presentation with ILC
and VR participants at the National Rehabilitation Association Conference, in
two state meetings of VR administrators, and in one state SILC. Participant
evaluation feedback is very positive, and we look forward to bringing the
training to other audiences in the coming year. The training format varies from
a one-hour overview to a full day workshop.
At
this time, we are taking applications for our 2004-2005 training year.
Organizations (ILCs, VR agencies, SILCs - either individually or in combination)
interested in arranging for training can contact sustoddard@aol.com. We will continue to
collect examples of good collaboration and good ILC employment services as we
expand and refine the training.
"As
we work together toward a common goalit will be even more important to
collaborate in our efforts."[3]
- Susan Stoddard, InfoUse
-
References
1. Stoddard, S., &
Premo, B. (2004). Expanding employment opportunities:
Independent living center
employment services and collaboration with vocational
rehabilitation. Journal
of Vocational Rehabilitation, 20(1),
45-52. [Also available at:
http://www.wnyilp.org/RRTCILM/dissemination/publications.html].
2. Survey
comment.
3. Survey
comment.
[1] Stoddard, S. and Premo, B.(2004), Expanding employment opportunities: Independent living center employment services and collaboration with vocational rehabilitation, Journal of Vocational Rehabilitation, Volume 20, Number l, pp. 45-52.
[2] Survey comment
[3] Survey comment