lifenet case management program · • lifenet support activities (basic tier): signing up for and...
TRANSCRIPT
LifeNetCaseManagementProgram
JayO’Brien,MPA-ProgramDirector
AndreaLong,Psy.D.-ClinicalCaseSupervisor
1 ©2019AANE.
©2019AANE.
WhatisLifeNet?
• Casemanagement/independentlivingsupportserviceforadultswithAsperger/autismprofiles
• Keyquestionsaddressed:○ Parents:Whowillsupportouradultchildwhenwe’regone?○ Adults:HowwillIgetthesupportIneedtoliveonmyown?
• “LifeNet”=supportnetwork,safetynetasanadultnavigatesadulthood
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WhatisCaseManagement?
• Supportthatcoversafullrangeoflifelongresponsibilitiesandeverydaytasks:○ housekeeping,homeorganization,homesafety○ groceries,nutrition&foodsafety○ healthcare-appts.,referrals,ins./refillreminders,medicaladvocacy○ benefitapplications,bills&moneymanagement○ companionship&socialengagement○ shopping&errands○ recreation,exercise&personalhygiene○ transportation&travelguidance○ executivefunctioning&decisionsupport○ self-advocacy
• Collaborativeassessmentofadult’sindividualneeds&goals○ Arrange,Coordinate,Monitor,Evaluate,Advocate(NASW)
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WhatmakesLifeNetunique
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• Employsateam-basedcasemanagementapproach:
• LeveragesAANE’sexpertiseinautism/neurodiverseprofilestodeliverindependentlivingsupportforadultsofanyage○ Youngest:21○ Youngestatheart:85
Frontlinestaff: PersonalAdvocate(PA) SupportPartner(SP)
Supervisory: ClinicalCaseSupervisor(CS) ProgramDirector(PD)
Volunteersupport: HostFamily(HF) Peer/Friend(PF)
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HowLifeNetisstructured
• 3ServiceTiersfeaturing:○ PersonalAdvocatecheck-ins(dailytoweekly)○ SupportPartnerin-homevisits(weeklytomonthly)○ Teamvisitstoreview/reviseLifeNetSupportPlan○ Hostfamilyand/orPeer-Friendactivities○ AccesstoPA/SPsupportin-betweenscheduledinteractions○ Afterhourson-callmessageservice○ Emergency‘flex-up’hours(forhourlyfeetocovercosts)
• Privatepaymodel○ From$5K/yearto20K/year,plusone-timein-takefee○ Buildingevidencebaseforfunderstomakeaccessibletoall
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LifeNeteligibility
• Geography:adultliveswithin~1hourdrivefromAANE
• Age:21yearsandup• Diagnosis:Aspergerorsimilarautismspectrumprofile
• Co-occurringconditions:evaluatedoncase-by-casebasis• Levelofneed:beabletoliveindependentlywithsupport• Willingnesstoparticipate:beopentoreceivingsupport
• Resourcestofundprogram
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HowWeGotHere
• FormedAdvisoryCouncil
• Designedsustainableprogram&financialmodel
• Preparedvideo&webpage(www.aane.org/LifeNet)
• Distributedsurvey• Followedup1-on-1withprospectiveclients• Securedcommitsfrominitialgroupof~20LifeNetAdults
• ReceivedboardapprovaltolaunchinJanuary2019
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PreparingtoLaunch
• #1Priority:Hirerightteam○ ClinicalCaseManager/PersonalAdvocate:MelissaReganOTR/L○ ClinicalCaseSupervisor:AndreaLongPsy.D.○ SupportPartner:BetsyDeLorenzo
• Created&signedClientServiceAgreements
• ImplementednewcasemanagementCRMsystem
• Performedin-takeassessmentsinclient’shomeorapt.
• CreatedpersonalizedLifeNetSupportPlans(LSPs)• BeganPAcheck-insandSPsupportvisits(Jan.‘19)
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5CaseExamples
9 ©2019AANE.
©2019AANE.
Caseexample:Emma
• 26yrs.old,liveswithparents• Sharp,happy,friendly,engaging;hasAS,anxiety,trauma• Interests:volunteering,music,dance,art,travel,boyfriend,pets
• Emma’spriorities:○ Gainingcomfortwithideaofmovingintoherownplace○ Havingsupportinfindingandadjustingtonewjob○ Seekingopportunitiestomeetfemalefriends
• LifeNetsupportactivities(Introductorytier):○ Learning/practicingcooking,laundry,&otherhousekeeping○ PursuingjobatCollettey’sCookies○ AttendingnewAANEsocialevents,e.g.Women’sSocialGroup
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Caseexample:Marshall
• 71yrs.old,livesindependently• Quiet,kind,cultured;ASprofile(noformaldiagnosis)• Interests:finearts,museums,science,MITopencourses,walks
• Marshall’spriorities:○ Creatingmoreartworkandfindingnewsourcesofinspiration○ Addingexercisetohisdailyroutine○ Meetingpeoplewithsimilarinterests,likeart,physics,orchemistry○ Havingextrasupport/companionshipforerrands
• LifeNetsupportactivities(Basictier):○ SigningupforandattendingAANE’sSundayoutingtotheMFA○ Accompanyinghimtolocalgym,askingquestions,gettingtour○ Encouraginghimtoinviteseniorcenterbootcampclassmatetocoffee
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©2019AANE.
Caseexample:Michael
• 34yrs.old,livesinagroupresidence• Smart,wasathletic;hasAS,socialanxiety,weightissues• Interests:entrepreneurship,writing,art,web,family,tennis• Michael’spriorities:
○ Gettingoutofhisroommore(95+%oftime)○ Keepinghisweightdown○ Sellingmorebooksandart
• LifeNetsupportactivities(Basictier):○ Held2ndSupportPartnervisitonporch;next:walkingaroundblock○ Buildingcommunityschedule:walktomuseum;starttennisinSpring○ Brainstorming/pursuingmarketingideas,newcollaborations
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Caseexample:Jonas
• 21yrs.old,transitioningtoownapartment• Cool,dapper,polite;hasAS,executivefunctioningissues• Interests:fashion,walks,goodatIT• Jonas’spriorities:
○ Developingskillstoliveindependently(withroommates&supports)○ Findingrighthousing&applyingforbenefitprogramshe’seligiblefor○ SecuringacompetitivejobinIT
• LifeNetsupportactivities(Comprehensivetier):○ Helphimcookhisseafoodrecipe;startusingtheTaroundBoston○ Exploremanyhousingoptions&facilitateintroductions/evaluations○ GuidecompletionofMRC,DDS,SSI,Section8programapplications○ ReinforcetheworkofhisLifeMAPjobcoachtohelphimstayontask
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Caseexample:Bill
• 37yrs.old,livesindependently• Gentle,caring,funny;hasAS,OCD,LD,hearingloss,anxiety• Interests:wordplay,politics,writing,movies,cats,Starbucks• Bill’spriorities:
○ Makingsureeverythingisworkingathome;generalmaintenance○ Seeing“blindspots”-suchaswhenheneedstoexerciseorgetahaircut○ Takingonmoreofresponsibilitiesstillmanagedbyparents○ Budgetingandbuildingconfidencetousecreditcard
• LifeNetsupportactivities(Comprehensivetier):○ IdentifymissinghearingaidTVpart,goonline,priceshop,andbuy/shippart○ Motivatinghimtousestationarybikewhileoncheck-incallsw/CaseManager○ Buildingstrategiesforstayingontopoferrandsandlaundry○ Makingsmartershopping/buyingchoices
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WhatFamiliesSay...
“Ifweweretowriteoutwhatwe'relookingfor,thiswouldbeit.””Weneedsomeonewetrusttolookafterhimlikewedo.”
“Thissoundslikeexactlywhatwehavebeenlookingfor,aswehavebeenconcernedhowoursonwillmanagewhenwearenolongerabletohelphim.Wefeelheneedstostarthavingasupportsystemandpeopletohelphimoutsideourfamily.”“Icantellyouguysreallygetwhat'sneeded.Sothoughtfulinunderstandingwhatthechallengesare.Knowingthatsomething'sinplacemeansalottome...aperfectfit.”“Wesawthisandit'sexactlywhatwe'retryingtoputtogetherforhim.”
“Thisiswhatwe'vebeenwaitingfor.”
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Questions&Answers
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