1. The MacDonald Training Center Residential Services Model October 15, 2009

2. We currently serve a total of 65 people in our residential services Live-In IHS = 38 33 = 3 to 1 (11 settings) 4 = 2 to 1 ( 2 settings) 1 = 1 to 1 ( 1 setting) Non Live-In IHS = 7 4 = 2 to 1 ( 2 settings) 3 = 1 to 1 ( 3 settings) Supported Living Coaching only = 20 Current Service Configuration

3. Adults with a wide variety of needs including: Walkers Wheelchairs Expressive communication challenges Receptive communication challenges Incontinence Behavioral challenges – typically interpersonal in nature The range of services & supports is determined by the individual with help from family and friends Service Needs Addressed

4. Live-in HIS Weekend & vacation relief Non live-in HIS Supported Living Coaches Team leaders Staff Coverage

5. No campus setting Highly flexible Highly mobile Focused & responsive to personal choice We perceive our community as the entire Hillsborough County / Tampa Bay area Outstanding Characteristics

6. North Hillsborough County 3 to 1 2 to 1 1 to 1 MTC locations

7. A lot of socializing between and among homes and individuals Significant interaction with families, including the live-in companion More one-on-one contact with neighbors Less restrictive than a group home More restrictive than a person living alone Community & Natural Supports

8. Eating out a lot …Hyatt at Disney Theme parks – Busch Gardens, Adventure Island, Disney, etc. Day cruises A lot of drive-in movies Beaches Camping Social Life & Events

9. Spontaneous nights out See it on TV and go…follow the coupons Moving closer to friends Bay Waters apartments…1-2-2 Country Wood apartments…1-1-1-2 Social Life & Events

10. Day services - Live skills Meals on Wheals Food Bank Humane Society other volunteer opportunities Day Services – Job skills Job club Job searches & related activities Day Services – Art Museums Exhibitions Meaningful Days & Community Contributions

11. Year-by-year leases allow mobility annually Always asking or listening to what we are being told Decisions in the homes made individually or by consensus If new residence is needed, the residents make the choice (Example: did not close home when only one person was in residence) Individual Choice

12. We adjust our residential services model based on the needs and choices of the people we serve We modify homes as needed…sometimes at our own cost We are working on serving individuals with complex challenges Currently limited by APD’s refusal to fund Addressing Change in the Lives of the People We Serve

13. Waiver Support Coordinators Supported Living Coaches Family members Day services team members Team leader visits Regular medical visits Oversight

14. Intensive training by RN Fire drills Disaster drills Teaching individual survival skills Working in teams with 24/7 back-up Safety as a Factor

15. Low turnover means the companions know the individuals (non-verbal communication) Individuals look out for each other Risk management assessments Safety as a Factor

16. All staffed trained by RN RN on call 24/7 RN & SLC’s coordinate with doctors SLC’s take the lead Access to Medical & Mental Health Service

17. No zoning issues Any and all residential areas are an option Shop the market Negotiate rents (MTC underwrites so rents are secure) High mobility & year-to-year leases maximize options Housing & Affordability

18. For MTC Flexibility in creating new living situation No zoning issues Very little turnover Experienced, stable staff that communicate effectively Conducive to the use of self-directed teams Advantages & Strengths

19. For the people we serve Mobility in housing Greater mobility & exposure in the community…or not Ex: Plant City…we never see your vans anymore Stability Typically only 2 or 3 companions a year so relationships are personal in nature Advantages & Strengths

20. For the people we serve More contact with neighbors resulting in natural supports Privacy Private rooms Near total reduction in attention seeking behaviors Advantages & Strengths

21. Finding quality live-in staff can be a challenge and can take time APD has repeatedly refused to fund additional 1/4hrs of IHS services for people with extra ordinary needs We are currently funding 3 We have lost others to nursing homes prematurely No aging in place with dignity Currently looking at technology as a way for addressing future service needs in a hostile funding environment Disadvantages & Weaknesses

22. Betty Beauchaine

23. Steve Beauchaine