1. AGENCY TRANSFORMATION: AGENCY TRANSFORMATION: Sustaining Conversion… Raising the Bar… and Changing Lives! Presented by: Gail Fanjoy, Executive Director, KFI 1024 Central St., Suite A, Millinocket, ME 04462 gfanjoy@kfimaine.org

2. Maine’s mile high mountain – Mt. Katahdin

3. KFI… Making it Work Customized supports assist people to:  Live in their own homes  Work in regular community businesses  Be members of and contributors to their communities

4. It has not always been this way … KFI is a 50 year old community service agency. We spent the first 20+ years developing programs and erecting buildings that served to segregate people with intellectual disabilities from society, but kept them busy and safe.

5. Segregated Special Purpose School Segregated Special Purpose School Sheltered Workshop Sheltered Workshop Segregated Day Program Segregated Day Program Foster Homes or Living With Family Foster Homes or Living With Family Everyone Transported To One Location Everyone Transported To One Location Agency Owned and Operated Vans Agency Owned and Operated Vans Services Provided In KFI Owned Buildings Services Provided In KFI Owned Buildings Groups, GROUPS, GROUPS Groups, GROUPS, GROUPS What KFI Looked Like 30 Years Ago:

6. KFI’s Work Activity Center circa 1980 Leo attended the day program 5 days a week. Leo attended the day program 5 days a week. Slow worker Slow worker Great social skills Great social skills Lived with his father in a neighboring town Lived with his father in a neighboring town Leo got his big break in 1986 – a job in his home town!

7. Supported Employment’s failure to solve all problems and why we did not have to launch a second career Supported Employment’s failure to solve all problems and why we did not have to launch a second career

8. Owns his own home Owns his own home Works at a credit union 20 hours/week with natural supports (for over 20 years) Works at a credit union 20 hours/week with natural supports (for over 20 years) Member of the Knights of Columbus Member of the Knights of Columbus Volunteers at his church’s thrift store every week Volunteers at his church’s thrift store every week Receives 7 hours a week of paid supports to help him in his home. Receives 7 hours a week of paid supports to help him in his home. LEO

9. Questions from the early 80’s: Is there anyone anywhere doing anything better Is there anyone anywhere doing anything better Why can’t we do that Why can’t we do that

10. The state has the dollars… We’ve got the sense. Why apartments are better than galvanized washtubs. Why apartments are better than galvanized washtubs. JACKIE

11. Notes from a KFI Management Team Meeting on July 8, 1987: “The ideal program would use an individual formula to address vocational, personal, social, and recreational needs of each individual. Where do we begin?”

12. Maine’s Funding Structure Then Block grants to programs – although state dollars represented a fraction of what we get today, they provided maximum flexibility. Block grants to programs – although state dollars represented a fraction of what we get today, they provided maximum flexibility. $24,500 grant from our DD system to do supported employment. $24,500 grant from our DD system to do supported employment. Bridge money from Vocational Rehabilitation to establish an assessment and training site in a local hospital. Bridge money from Vocational Rehabilitation to establish an assessment and training site in a local hospital. Took “day program dollars” and helped support people in jobs and to move into their own homes. Took “day program dollars” and helped support people in jobs and to move into their own homes. Redefined a unit of service from a “day” to an “hour” to begin customizing people’s supports. Redefined a unit of service from a “day” to an “hour” to begin customizing people’s supports. Redefined what people’s “day” looked like. Redefined what people’s “day” looked like. Designed staff schedules and duties around their preferences, skills, and interests. Designed staff schedules and duties around their preferences, skills, and interests.

13. “Just as important as the decision on what new and different things to do, is the planned systematic abandonment of the old that: no longer fits the purpose and mission of the business, no longer fits the purpose and mission of the business, no longer conveys satisfaction to the customer, no longer conveys satisfaction to the customer, no longer makes a superior contribution…” no longer makes a superior contribution…” Peter Drucker

14. KFI’s “CONVERSION MILESTONES” 1985: KFI’s private segregated school for children between the ages of 5 and 20 was phased out. 1985: KFI’s private segregated school for children between the ages of 5 and 20 was phased out. 1987: Due to the success of job placement and supported employment, KFI closed its sheltered workshop. 1987: Due to the success of job placement and supported employment, KFI closed its sheltered workshop. 1989: All sheltered work was abolished in favor of community employment and KFI’s day program was transformed into a program which provided broad opportunities for community participation. 1989: All sheltered work was abolished in favor of community employment and KFI’s day program was transformed into a program which provided broad opportunities for community participation. 1996: KFI ended all center-based services and provided personalized supports in people’s homes, workplaces, and communities. 1996: KFI ended all center-based services and provided personalized supports in people’s homes, workplaces, and communities.

15. Some Fundamentals GET TRAINING GET TRAINING Get as much information about innovative and emerging best practice: read journals, connect to websites, go to conferences. Get as much information about innovative and emerging best practice: read journals, connect to websites, go to conferences. UNDERSTAND THE ART OF THE POSSIBLE UNDERSTAND THE ART OF THE POSSIBLE Know that there is someone doing daily what others say cannot be done at all. Know that there is someone doing daily what others say cannot be done at all.

16. START WITH THE IDEAL AND COMPROMISE FROM THERE. DON’T START WITH COMPROMISE START WITH THE IDEAL AND COMPROMISE FROM THERE. DON’T START WITH COMPROMISE Define “ideal.” Our supports to people will never be perfect, but we can try to figure out what makes the most sense and set our sights on that. Be committed to working through obstacles. Define “ideal.” Our supports to people will never be perfect, but we can try to figure out what makes the most sense and set our sights on that. Be committed to working through obstacles. BE A GENTLE SALESPERSON BE A GENTLE SALESPERSON Always keep the person’s desires on the agenda to allow you to advocate within the organization, to funders, to family and other providers. Always keep the person’s desires on the agenda to allow you to advocate within the organization, to funders, to family and other providers.

17. STOP TRYING TO FIX PEOPLE STOP TRYING TO FIX PEOPLE People do not need to pass a test to receive meaningful supports. People are ready NOW for their own home and a real job - they do not need to earn it! Eliminate the continuum! People do not need to pass a test to receive meaningful supports. People are ready NOW for their own home and a real job - they do not need to earn it! Eliminate the continuum! ABANDON SERVICES ABANDON SERVICES “Nothing is less productive than to make more efficient what should not be done at all.” Peter Drucker “Nothing is less productive than to make more efficient what should not be done at all.” Peter Drucker

18. PROVIDE SUPPORTS IN THE PERSON’S COMMUNITY PROVIDE SUPPORTS IN THE PERSON’S COMMUNITY Don’t move the person to your community or the day program’s community. Don’t move the person to your community or the day program’s community. EMPOWER STAFF EMPOWER STAFF Create opportunities for staff to try new things. Give staff responsibility and authority. Reward and celebrate successes. Create opportunities for staff to try new things. Give staff responsibility and authority. Reward and celebrate successes. DON’T BACKFILL DON’T BACKFILL When one person is out of the group, don’t accept another person into the program. You’ll never convert the program that way! When one person is out of the group, don’t accept another person into the program. You’ll never convert the program that way!

19. TAKE ONE PERSON AT A TIME TAKE ONE PERSON AT A TIME Programs aren’t converted overnight; supports to people must change. Be flexible and creative! Reward initiative and even failures, especially if they represent acts of commission. Programs aren’t converted overnight; supports to people must change. Be flexible and creative! Reward initiative and even failures, especially if they represent acts of commission.

20. KFI’S How-to’s…Down and Dirty Invest in Values-based Training Join APSE and TASH and other organizations that promote personalized supports. Join APSE and TASH and other organizations that promote personalized supports. Listen to the gurus Listen to the gurus Read the newsletters and journal articles Read the newsletters and journal articles Connect to web sites Connect to web sites Seek out conferences featuring cutting-edge ideas Seek out conferences featuring cutting-edge ideas Answer the question: “Is anyone, anywhere, doing anything better for people with disabilities?” Answer the question: “Is anyone, anywhere, doing anything better for people with disabilities?”

21. KFI’S How-to’s…Down and Dirty Hire the Right Staff Hire people for their values, rather than their experience, certification, degrees… Hire people for their values, rather than their experience, certification, degrees… Hire people from the same community as the people they support Hire people from the same community as the people they support Hire people who can describe how they are connected to their communities Hire people who can describe how they are connected to their communities Give people permission to use their personal connections on behalf of the people they support Give people permission to use their personal connections on behalf of the people they support Involve people with disabilities and their families in the hiring process Involve people with disabilities and their families in the hiring process Ask, “Is this prospective employee a person we can stand up and cheer about?” Ask, “Is this prospective employee a person we can stand up and cheer about?”

22. Direct Support Staff: Requires a high degree of trust – you don’t see them every day Critical to your mission and values Critical to your mission and values Ambassadors for the people they support and your agency Ambassadors for the people they support and your agency Highly visible Highly visible Need to make independent decisions and judgments throughout the day Need to make independent decisions and judgments throughout the day Need to feel connected to the mission while working independently Need to feel connected to the mission while working independently Agreeable to field-based mentoring/teachable moments Agreeable to field-based mentoring/teachable moments Negotiators and askers Negotiators and askers Require different skills and abilities and flexibility Require different skills and abilities and flexibility This work is not for everyone! This work is not for everyone!

23. KFI’S How-to’s…Down and Dirty Control Physical Space and Location Sell/rent/abandon “group work, activity, and living spaces” and locate offices in the heart of your community Sell/rent/abandon “group work, activity, and living spaces” and locate offices in the heart of your community Avoid buildings with large open spaces Avoid buildings with large open spaces Don’t invest in any new real estate Don’t invest in any new real estate Avoid being the landlord or employer of service recipients Avoid being the landlord or employer of service recipients Provide supports in the person’s home community Provide supports in the person’s home community Teach skills in real environments (instead of inventing an artificial environment which is “lifelike”) Teach skills in real environments (instead of inventing an artificial environment which is “lifelike”) Use what the community offers – it is full of real life Use what the community offers – it is full of real life

24. The great soda machine debate What it was and what it said about us

25. KFI’S How-to’s…Down and Dirty Evaluate Your Organization Ask hard questions about your present services and give brutally honest answers Ask hard questions about your present services and give brutally honest answers Abandon the notion of “readiness”, the “continuum of services”, and the idea that people need “fixing” Abandon the notion of “readiness”, the “continuum of services”, and the idea that people need “fixing” Don’t license anything that you don’t absolutely have to Don’t license anything that you don’t absolutely have to Find like-minded allies within and outside of your organization Find like-minded allies within and outside of your organization Empower staff and flatten your organizational structure Empower staff and flatten your organizational structure When one individual leaves a group service, don’t backfill When one individual leaves a group service, don’t backfill Plan the systematic abandonment of services that are not individualized, personalized, and/or based on people’s dreams, abilities, and desires Plan the systematic abandonment of services that are not individualized, personalized, and/or based on people’s dreams, abilities, and desires Work in a state of positive discontent – know that there is always a better way Work in a state of positive discontent – know that there is always a better way

26. KFI’S How-to’s…Down and Dirty Look at Whole Lives, Not Programs Implement true person-centered planning Implement true person-centered planning Talk about your dreams for individuals, set your sights high Talk about your dreams for individuals, set your sights high Assure there are no double standards – people’s lives should reflect what you would want and need Assure there are no double standards – people’s lives should reflect what you would want and need Ask, “If a person had the right supports, would (s)he need to go to a day program, sheltered workshop, or live in a group home?” Ask, “If a person had the right supports, would (s)he need to go to a day program, sheltered workshop, or live in a group home?” Build the right supports Build the right supports Focus on one person at a time Focus on one person at a time

27. Steps Along the Way Flexible hours for the benefit of the person receiving services AND the agency’s employees. Flexible hours for the benefit of the person receiving services AND the agency’s employees. Understand that past practices are not necessarily fulfilling a funding/legal requirement (e.g. redefining services from days to hours). Understand that past practices are not necessarily fulfilling a funding/legal requirement (e.g. redefining services from days to hours). Be prepared to lose some employees, families, Board members, and supporters. Be prepared to lose some employees, families, Board members, and supporters. We are always learning, improving, and disagreeing because supports are about individuals. Programs are about groups. We are always learning, improving, and disagreeing because supports are about individuals. Programs are about groups. Without a commitment to help people with disabilities have a better life, the system will beat you down. Without a commitment to help people with disabilities have a better life, the system will beat you down.

28. Key Components That Sustain Conversion Schedules designed around real life needs. Schedules designed around real life needs. Staff duties assigned around their interests, connections and talents. Staff duties assigned around their interests, connections and talents. Flexible, wraparound supports Flexible, wraparound supports Service provided based on identified needs and desires, not time of day Service provided based on identified needs and desires, not time of day Shared supports based on real interests and activities, not ratios. Shared supports based on real interests and activities, not ratios. Emphasis on Employment First! Emphasis on Employment First!

29. Challenges to KFI Low expectations and attitudes about employment on the part of people with disabilities, family members, case workers, etc. Low expectations and attitudes about employment on the part of people with disabilities, family members, case workers, etc. Reluctance for people and their families to risk losing benefits. Reluctance for people and their families to risk losing benefits. The volunteerism trap – it doesn’t naturally lead to paid employment. The volunteerism trap – it doesn’t naturally lead to paid employment. Of the approximately 55 people KFI supports under Maine’s developmental disability Waivers: Of the approximately 55 people KFI supports under Maine’s developmental disability Waivers:  95% are involved in a community group, club, or class  81% volunteer  39% are currently employed  64% have experienced competitive employment. People fall into 4 categories: employed, retired, do not desire employment, in the process of becoming employed/re-employed

30. Taking a Holistic Approach Doing something in the community that has nothing to do with work may have everything to do with work. “I know Robert.” Doing something in the community that has nothing to do with work may have everything to do with work. “I know Robert.” Building social capital Building social capital The power of civic involvement & networking The power of civic involvement & networking

31. Robert’s Story - Special Education Perspective Acts out Acts out Disruptive Disruptive Hostile Hostile Significantly limited “adjustive resources” Significantly limited “adjustive resources” Difficulty making appropriate choices Difficulty making appropriate choices Impulsive Impulsive Does not appear to be in a position to make meaningful decisions Does not appear to be in a position to make meaningful decisions Great difficulty expressing himself Great difficulty expressing himself Unable to problem solve Unable to problem solve Misinterprets conversations Misinterprets conversations Behavioral problems Behavioral problems Clearly indicates a need for guardianship Clearly indicates a need for guardianship

32. Robert’s Story - His Perspective  Wants his own home (NOT an apartment) – a one story home with at least two bedrooms near the woods  Wants a job – something working around cars  Wants a red truck  Wants a woman – someone who can clean his house and hang curtains

33. Home Owner Works 14 hrs/wk Volunteers 20 hrs/wk; receives 21 home support and 4 community support hrs/wk Robert’s Whole Life Supports

34. Other Valued Roles… Member Knights of Columbus Member of Lifestyle Fitness Center Advocate and Public Speaker Good Neighbor

35. KFI, 1024 Central St., Millinocket, ME 04462 Community is relationships places NOT places - the real hurdle

36. Courtney’s Labels Profound cognitive impairment Profound cognitive impairment Autistic disorder Autistic disorder Cerebral palsy Cerebral palsy Seizure disorder Seizure disorder Static encephalopathy Static encephalopathy Ataxia with low tone Ataxia with low tone Nonverbal Nonverbal Does not have self-protective reflexes Does not have self-protective reflexes No reliable communication system No reliable communication system

37. Courtney’s Story Graduated from high school June 2012. Graduated from high school June 2012. Owns her own home. Owns her own home. Enjoys hanging out with her friends. Enjoys hanging out with her friends. Volunteers in her community. Volunteers in her community. Has her own credit card and checking account and is building excellent credit. Has her own credit card and checking account and is building excellent credit. Established a vending machine business. Established a vending machine business.

38. “The bottom line of the social sector organization is ‘changed lives’.” Peter Drucker