Granite Bay Connections

Newsletter

Building CONNECTIONS Between Us

April 2011
Vol 1, Issue 2


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What's in a Name? Carrying the Ideals of "GBC" Forward to "Connections"
During the last several months, Granite Bay Connections has been making a determined effort to distinguish itself from among the many other human services organizations providing much needed services to individuals with intellectual and physical disabilities. Having identified itself for years as “GBC”, there was a growing awareness among leadership that others outside of the organization, had begun to define what the Agency stood for, believed in, and wanted to do to make a difference. On occasion, the moniker “Granite” became confused with Agencies possessing similar names. In due course, Granite Bay Connections became known within the industry as the organization serving a certain kind of consumer with very narrow needs. Ironically, when it’s Maine sister organization (Granite Bay Care) was in its formative stages, the shortened “Connections” was used to distinguish the older established organization from its newer counterpart. Indeed, beyond the shared “Granite Bay” preface, each organization has always been distinguished from the other in vision, mission, and values. While we are proud of our sibling Agency, “CARE”, and the common heritage that links us together, Connections is equally proud of those things that make us distinct and special. It was never either organizations' intent for the “GBC” appellate to become a shared identity, making each indistinguishable from the other. Moreover, the Agency hoped the positive associations conjured by the word “Connections” would fittingly represent the organization’s continued commitment to reach out to those in need, to assist them in bridging the divide between institutionalization and dependence to community inclusion and self-determination. As the “Connections” part of the Agency’s name became increasingly invisible as part of our day-to-day conversations with others, it is understandable how the organization’s emphasis on developing community connections became increasingly obscured by words like “residential supports” and “day programming”. In an effort to renew our promise to provide care to those individuals who are perhaps most in need of our assistance, mentoring, and modeling, Granite Bay Connections has been working toward shifting our corporate culture to reflect our long-held core values. Consistent with these internal changes, the Agency is re-branding our logo to extoll our mission of “Connections”. Neither a token nor superficial change, this re-branding reflects a significant shift in our priorities. Indeed, this newsletter article and the newsletter as a whole reflect our intent to be a more transparent organization. We invite all interested parties to take a closer look. As we unveil special organizational initiatives or just share simple life perspectives, we hope to more fully share what occupies our thoughts and energies. While Connections hasn’t cornered the market on community inclusion, the Agency nonetheless believes we must hold ourselves responsible for securing meaningful and enduring community “Connections”, to the end of making New Hampshire a better place to live. We are determined to stretch and reach our hands out to those as yet unfamiliar with the organization and its mission. We hope you let us know how we are doing during this transformational process and share your positive experiences with others who could benefit from our expertise in building connections.
~Caroletta Alicea, President

The Ray E Story:

Putting Together the Pieces of Success

For many of us, success can be measured in different ways. Status within the community, educational accomplishment, financial security, personal wealth, and materials goods are all viewed as legitimate barometers of success. For some, like Ray E, success is not something to be measured but something to be built upon, it is not a destination but a journey. Indeed, those privileged to stand by Ray during the ups and downs evident in his fifty year journey through life appreciate the wisdom in this perspective. By embracing all that life has had to offer, both the good and the bad, Ray has learned to work through personal adversities, overcoming circumstances that might otherwise consume him.

The pivotal moment for Ray came just three (3) years ago. Through a collaborative effort between Ray, the Office of Public Guardian, Granite Bay Connections (Connections), and Gateways Community Services, Ray was offered an opportunity to leave a familiar but limiting life course, and begin what would become a wonderful awakening. He seized this outstretched hand and entered a new world of experiences, perhaps mundane and ordinary to some, but wondrous and life-changing for Ray. Relatively small things like visiting a library, shopping at the mall, and building relationships by sharing similar interests with persons outside of his immediate family, allowed Ray to develop a greater awareness of self and others.

This is not to say that Ray’s progress has been completely “blue sky”. Ray encountered his fair share of rain clouds along the way, particularly during his initial transition from his family home to a new living situation with a roommate. There were a few stormy moments when Ray freely cried about how hard it was to move from his family. But Ray persevered. Moving to a new home and community presents challenges for each and every one of us. For Ray, the unfamiliar was understandably scary.These challenges, to name just a few, included:

1)      Getting to know a new roommate,
2)      Learning how to find important locations in the community, and
3)      Developing a daily routine with a focus on personal choice and empowerment.

With each new experience, Ray developed greater confidence in his own abilities and a deepening trust in his growing circle of support. Of all these achievements, Ray takes the most pride in a very personal accomplishment. With considerable effort and time, he has learned to write his name. Ray takes great pride in demonstrating this to people he knows, beaming with joy as he carefully draws the three letters… R… A… Y. With this skill under his belt, Ray is able to enjoy the privilege of cashing a check made out to him at a local bank or carefully signing his name on the dotted line of his annual Individual Service Plan. Perhaps a small accomplishment by any measure, but evidence to Ray, and those around him, that he is exerting positive control over his life.

But life isn’t all about personal gains. Grateful for what others have done to support his journey to personal empowerment, Ray expresses his appreciation by giving back to others, volunteering in his surrounding community. He spends two days a week helping out at two nursing homes within the Manchester area. At the nursing home Ray spends time working in the dining room folding napkins and setting the tables for the residents. He has learned to complete these tasks with very little assistance or supervision. A joyful spirit, Ray relishes any opportunity to join the residents in a song or workout routine. If there’s a puzzle to be solved, Ray is there to help look for the missing piece. He, in turn, has been welcomed by residents and staff alike as an extended member of their community.

Ray also lends a hand at a local Bedford farm. His duties include helping to keep the stalls clean, feeding the animals, and collecting the eggs from the chicken coop. Ray is able to independently complete these task and reports directly to the farm owner when he is finished. Whether singing with elders in the cafeteria or humming as he sweeps the barn, Ray enjoys a genuine sense of belonging in these positions he has carved out for himself.

At home, Ray has developed self-care skills, preparing simple meals or snacks for himself. On occasion, he has delivered his home-baked cookies to the staff at Connections, always taking time to explain how he prepared them. As with other activities of daily living, Ray was also challenged to learn basic safety skills including how to:

Evacuate the home safely in the event of a fire,
Use the phone to contact his roommate, or call emergency services if needed, and
Visit independently with neighbors with whom he has fostered friendships.

As a means of stretching his independence, Ray has been working on spending “alone time” within his home demonstrating sufficient safe self-care to spend two hours each day by himself.

Though it can be easy to measure life as the sum of what one gets out of it in accomplishments or possessions, Ray has learned to measure his life by what he has put into it and what he shares with others. Rather than struggling to identify all the ways Ray’s circle of support has improved his life, it is far easier to count the many ways he has improved the world around him. In Ray E’s success, there are powerful lessons for all of us!

~Rumyana Hanks, Program Manager

Expanding Community Support Service:
Promoting Independence and Inclusion

With a growing demand from Individuals to “live on their own”, never before has consumer self-advocacy been at such odds with fiscal reality. In the last few months, the rights of the few, the disabled, have been weighed against the rights of the many, the taxpayer. The sum product of this amounts to an ideological debate about what constitutes minimum standards for community integration and inclusion.

To better understand the efforts to arrive at this calculation it may be helpful to take a step back and consider one of the fundamental questions at the heart of this issue.

What is Community Support Services (CSS), or as it is more commonly referred to, Independent Living?

The focus of CSS is to promote personal growth in activities of daily living with specific assistance from trained staff. Individuals receiving CSS services live in their own apartments or homes and receive a set number of hourly supports on a weekly basis.This may include, but is not limited to, assistance with scheduling/attending medical appointments, preparing household budget/payment schedule, organizing grocery shopping, learning how to access public transportation, and building natural community-based supports. The goal of CSS is to:

1)      Bridge the gap between the individual and the community,
2)      Increase genuine consumer self-determination and inclusion, and
3)      Promote personal well-being and quality of life.

Sounds simple, huh? While the degree of difficulty associated with this process may be difficult for the neurotypical non-disabled adults to relate to, it can be likened to a more familiar milestone, the graduation from high school to college and the transition from home to a dorm or apartment. Once determined by a parental authority, simple decisions are now in the hands of this recent graduate. While no means an exhaustive list, some of these included decisions ranging from:

When and how to clean,
When and where to grocery shop,
When to go to bed and when to rise, to
How to balance studies and work with recreation.

It isn’t difficult to remember the power of choices we perhaps now take for granted.Gone were the days when an immediate evaluation of our performance from a parental authority would ring in our ears, “clean up the pigsty of a room”. Still, with new found freedom comes responsibility and we soon found that our choices were not without their costs.

Failure to clean could result in landlord complaints.
Failure to properly plan for meals could result in increasing inches around the midsection and decreasing riches in our bank account, and
Failure to regulate personal habits and inadequate sleep could result in poor performance at work or school.

Many of us learned the painful reality that choice carried consequence and freedom did not constitute a blank check. Hopefully, we eventually discovered how to thrive, not just survive. For a few of us, this transition was marked with some notable failures, perhaps requiring we move home for a period just long enough to reorganize and re-launch our efforts to live independent lives. Let’s be honest, achieving independence can be a messy process.

If this experience has conjured up some embarrassing and even unpleasant memories, try to imagine those events with little or no parental support. Then, try to imagine this struggle in a wheelchair, with expressive language difficulties, with a myriad of pressing health challenges. Some of the challenges faced by disabled persons may be so outside our reality as to be effectively incomprehensible. Like us, those with disabilities want an opportunity to learn independence and, regardless of momentary setbacks, to be valued for unique skills. Like us, they want their contributions to society to be realized. CSS is intended to help the persons with disabilities realize their full potential as citizens, living independently in the community, contributing to the greater fabric of society.

Understandably, while the goal of independence may be clear, the journey is seldom simple. In efforts to assist individuals toward community inclusion, Granite Bay Connections (Connections) is expanding our CSS programs, working to offer supports better designed to serve the needs of the individual. With our focus on empowerment, Connections will assist individuals to more effectively exercise self-advocacy, better accessing provisions available to all citizens within the community rather than creating structures apart from the community. Promoting independence through the use of existing structures, such as the use of public transportation rather than staff vehicles for grocery shopping, doctor’s appointments, and employment will require greater flexibility and planning by support teams and Connections’ employees.

The Connections team is committed to providing outreach supports that best accommodate the consumer. Using existing community supports, in addition to promoting genuine independence, reduces expenditures by shifting services from “stand alone” costs to more public cost centers. By promoting genuine empowerment, everyone gains, the consumer living in the community, and the community by virtue of the consumer’s contributions.

~Ken Clark, Area Director

Our Employee of the Month and The Unique Perspective of:
Rashmi Rajbhandari

Imagine being escorted by a close friend to a grocery store in a foreign land with unfamiliar customs. You are tired, hungry, and a little overwhelmed from your travels. With little understanding of where you are or what route you took to arrive at the store, and the strange arrangement of goods compound your growing disorientation.

How can I find what I’m looking for? How can I understand what the package says? How much will it cost me and do I have enough money to secure the purchase? Thankfully, your escort is a native and offers immediate and repeated reassurance support, patiently serving as both guide and translator. The other shoppers around you are not nearly so patient. They have places to go and people to see and your plodding efforts to make sense of this world are hindering them from getting on with their lives. Clearly, you are different from them in appearance and tongue. From some of these fellow patrons, you notice a palpable shift from impatience to other even less generous emotions. To varying degrees, this is reminiscent of events encountered by many new immigrants; an experience familiar to Rashmi Rajbhandari, Granite Bay Connections' (Connections) April “Employee of the Month”. Some six (6) years ago, Rashmi and her family emigrated from Kathmandu, Nepal to the United States, first to Texas and then three (3) years ago to New Hampshire. Like many immigrants from Nepal, she expended considerable resources leaving native home and lifetime friendships for the promise of a better future in this country. Continuing this personal sacrifice and resolve, Rashmi worked to assimilate into the local community, struggling to master the language and acculturate western values. Introduced to Connections by a friend, Rashmi evidenced her determination to “fit in” right from the start. While the Connections New Employee Training program offers all employees an opportunity to appreciate the experience of individuals with intellectual and physical disabilities as they struggle toward full community participation and inclusion, the instruction can touch the hearts of new immigrants at a much deeper level. Indeed, the entire first paragraph of this article might just as well have been written from the perspective of a person with a disability. This shared perspective has afforded Rashmi a level of empathy not easily acquired by a local native. Moreover, as a flesh and blood example of integration, Rashmi radiates a conviction, a belief in the capacity of all to carve out a place within the community. As both an Enhanced Family Care provider and a Direct Support Professional, her quiet courage has a notably beneficial impact on individuals she supports. An outstanding Agency contributor, and a model for all employees to follow, Connections is pleased to recognize Rashmi as employee of the month. We look forward to her continued contributions as a professional to the care of persons with disabilities, to the community as a good citizen, and to the immigrant community as a goodwill liaison. Connections believes the strength of the organization derives from the diversity of its employees. In the myriad of life struggles routinely overcome by each and every Connections employee, is an opportunity to apply these life lessons to those entrusted to our care. We thank Rashmi for her example.
~Ken Clark, Area Director

Tailoring Services to Provide Better Fit Is Not just Fiscal Belt Tightening With all the fiscal and budgetary uncertainty confronting the State, there are a number of questions still left to be resolved. Among these, there are few more pressing than those surrounding the impact of budget reductions on New Hampshire’s most vulnerable citizens, those with physical and intellectual disabilities. As the Health & Human Service financial crisis continues to devolve, agencies are confronted with difficult and even dire funding prospects.
The new fiscal reality can probably be summed up in a few words, “eking by with less”. While the process of coming to grips with this reality has been likened to a family gathering around the table discussing ways to tighten the proverbial belt, this is not nearly as straightforward a proposition when adjusted to the scale of statewide services. Cuts to services for severely impaired may have the net effect of essentially nullifying the hard-fought legal victories for self-determination secured by the disabled during the last thirty (30) years. Given the stakes, it is incumbent on service providers to look for ways to creatively and collaboratively support individuals with disabilities to exert genuine “choice and control” within the confines of ever shrinking resources. With the increasing number of individuals coming into services, the focus on what an individual actually needs to enjoy a meaningful quality of life must become more focused, narrower in scope, and better defined. In the past, Area Agencies relied on the Inventory for Client and Agency Planning (ICAP) assessment to help identify specific consumer capabilities and the supports required to ensure their well-being. The Supports Intensity Scale (SIS) has recently replaced the ICAP as the preferred assessment tool to measure or quantify the level of required consumer supports. Regardless of what tool is used, the changes occurring over the last year have escalated the level of urgency to identify a reliable and equitable method for conserving and allocating increasingly precious service dollars. Using the SIS, it could be possible to better tailor new and/or existing services to better fit the needs of the consumers while having a corollary net effect of reducing costs. Using the analogy of a suit of clothes, if the price of cloth skyrockets, conserving cloth and limiting waste by skillfully tailoring a custom-fitted suit may theoretically be less expensive than it’s one-size-fits-all off the rack counterpart. And as an upside, how much happier would the wearer be with a suit patterned to address them as a unique individual? Of course, likening life essential supports to a suit as much trivializes the issue as comparing family dinner table finance discussions with the State Budgetary process. Nonetheless, Connections has carefully examined the experience of other vendors and states already tying SIS assessment results to funding decisions and has found the research compelling (SIS, Human Service Research Institute of RI, Iowa MH/DD System). As a small application of the SIS, by measuring the nature and extent of consumer needs, it could be possible for person-centered teams to more effectively identify shared day-program opportunities organized around adaptive functioning levels. To this end, with the consent of person-centered teams, Connections has already begun exploring ways to effectively partner with other vendor agencies and community resources in the development of temporary and long-term service collaboration. Clearly, like all New Hampshire service providers, Connections must find new and innovative solutions to providing more cost effective services to more individuals.
~George Barrett , State Director

Past Newsletters may be found archived in the Newsletter section of the CONNECTIONS website.

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