NCSOCRC- Past Conference Minutes: December 11-13, 2006

Conference Minutes, Hot Springs, Arkansas, December 11-13, 2006

NATIONAL CONSORTIUM OF STATE OPERATED COMPREHENSIVE REHABILITATION CENTERS (NC-SOCRC)
IN COLLABORATION WITH GEORGE WASHINGTON UNIVERSITY CENTER FOR REHABILITATION COUNSELING RESEARCH AND EDUCATION

POST NATIONAL CONFERENCE EVALUATION MEETING
Hot Springs Rehabilitation Center
105 Reserve Avenue
Hot Springs, Arkansas
(501) 624-4411
Barbara Lewis, Director

Break-Out Sessions:

Members Present: David Holmes (TN), Donald Dew (GWU), Dick Luck (VA), Barry Newill (KY), Dennis Hart (MI), Barbara Lewis (AR), Greg Schmieg (GA), Laine Wilder (WV), Rick Sizemore (VA)

Absent: Don Rullman (PA), Jean Jackson (MD)

Monday, December 11, 2006 12 Noon

Chairman Holmes welcomed everyone to the meeting and reviewed the agenda. Barbara Lewis introduced her staff to the group who attended the luncheon.

Post-Conference Evaluation and Overview

Chairman Holmes stated that he National Conference track session reports demonstrated the excellent job the session leaders and participants did in their identification and discussion of topics covered. We will discuss recommendations tomorrow as it will set the stage for strategic planning with some being Center specific. Chairman Holmes will also demonstrate the Knowledge Management Center system (KMC) on line which will allow Centers to directly share information with European Platform of Rehabilitation members. Dr. Dew advised that he did not have the conference evaluations with him but the group would be very pleased with the outcome.

General Comments Regarding September 2006 National Conference

The physical plant directors would like to meet quarterly by video-conference for discussions.
An energy management plan was developed in Tennessee to identify and make constructive plans for energy savings with a Capital Maintenance Project. This stemmed from discussions at the National Conference.
Viewed by everyone to be the best national conference based on the participation from each Center as to personal involvement along with reports sent in after the conference.
Down side were the hotel accommodations. Space and accommodations for all participants needed in future planning. National conference pros for holding in Washington versus elsewhere. Only seen advantage to planning it close to a center is that center's staff are move likely to be approved to attend. Plus side in Washington, D.C., availability to meet with Washington constituents as a consortium, maybe even attendance to a CSAVR meeting.
Dr. Dew asked if anyone had been reimbursed.
Start an accomplishment list from this conference.
Attendance estimated at 110 per Dr. Dew.

Individual Center Reviews/Roundtable

Carl Perkins - Barry Newill

Name change to Carl D. Perkins Vocational Training Center
Beth Smith named as Executive Director
Staff are continuing to conduct initiatives for customer service, quality improvement, and continued quality of services.
Vicinity card
which serves as a security system for seven entrances. Allows employees to open doors and can track people's whereabouts tied into the camera system at a cost of $23,000.
Major Agency revisions to substance abuse policy where clients are required to be sober for six months before a plan is written.
Dissertation from employee of residential services titled
Predictors of Success in a Comprehensive Rehabilitation Center.
Barry will share this document with members as a possible topic at a future meeting.

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HSRC - Barbara Lewis

Barbara reported that HSRC hosted an Open House on the 19th of October which was a great success. Tours of the grounds were provided, students manned displays portraying work in their training areas, which included participation from our local senator. As a result of the open house, the local newspaper started publishing articles pertaining to our various training areas periodically in the newspaper.
The Center has the opportunity of acquiring the lease of the Army Reserve Center which is directly across the street from our main building consisting of 35,000 square feet. We have submitted our proposal to the City of Hot Springs and the Department of Education in Washington. Proposed plans include moving certain training areas across the street, expand our driver's ed program, implementing a hospitality services/café, etc. Our ABE/GED training area may be relocated there also since it is now housed in the outside training areas.
We are requesting approval for a revision in our drug policy where we can test new students arriving at the Center and random test at any time. If a client is found dirty, they are sent home for 45 days and tested again upon return, and if dirty, the client is discharged.
A new employee has been hired to do satisfaction surveys and other types of follow-up services. Barbara reported that regular census along with the hospital census is on the upswing.

Michigan Career & Tech Institute - Dennis Hart

Dennis reported his center was recently audited with minimal discrepancies. An additional nursing assistant instructor has been hired.
Traumatic brain injury clients are requiring more training for his staff to improve knowledge and expertise.
The newly elected governor had visited his facility before the election which hopefully will produce more monies to expand programs at the Center with one of his staff serving as liaison in the governor's office.

Roosevelt Warm Springs - Greg Schmieg

Greg has been at his facility for six months and he works under an elected Commissioner. He reports that his financial deficit has been reduced down tremendously in the past few months.
The hospital census is up around 40 and is still awaiting certification as a Medicare provider.
Blanchard Hall will be completed in September 07 which will house the orthotics section.
Both the medical and vocational areas are working on strategic goals. He has had some recent retirees.
Revisiting the CRP program due to past legal issues.
Census is about 180 with the vocational unit looking at serving more deaf and blind clients.
They are intending on opening two cottages for independent living training.
One of his psychologists, Dr. Kim Lawson, has done extensive work on mirror feedback and working with attention deficit disorders and Greg will copy members on this information.
His people are looking for additional revenue prospects and have worked up a package deal for the workers comp and veterans cases. In meeting with the local Fort Benning officers, it seems the need for rehabilitation surrounds injuries such as amputation, burns, and brain injuries. They are looking at a model in the San Antonio area.
Their recent Camp Dream activities brought in some 1,000 guest.
They will host the women's wheelchair basketball games this year along with celebrating their 80th birthday in July. The usual gala ball was cancelled due to planning the birthday celebration.
The Commissioner requested that every budget person in the governor's office visit the center prior to attending to the capital improvement budget requests which should gain more positive support from legislative group.
The Smithsonian has had a polio exhibit and the curators are now looking for relocation of this exhibit, possibly at Roosevelt.
He is implementing a servant leadership training similar to one back in 1999 for his staff. Along with this leadership scope, each supervisor is expected to poll his section, find the lowest paying job in their department and work one shift in this type job. He finds an amazing changed opinion of most supervisors who complete this procedure, along with staff morale.

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Tennessee Rehab Center - David Holmes

Continue in Order of Selection Priority Category 1 for VR Agency and not likely this will change.
Utilization is running 80-85%.
Traumatic Brain Injury program referrals are up after considerable marketing efforts have boosted referrals and are back on track.
A major rehab hospital in Nashville who provided the majority of SCI referrals recently changed over to a geriatric hospital. Contacts with Shepherds Rehab Hospital and meetings with the discharge planners hopefully will produce new SCI referral sources.
New vocational training program of Hospitality Worker was implemented and program enrolled first two students this month. Looking at a retail clerk program that could place graduates in local Dollar General stores.
Exploring feasibility of developing a Personal Care Attendant training program that could be approved for college credit. Hoping to partner with a local university that serves a high number of SCI clients. Assistant Commissioner wants this program operational for SCI college students as requirement for continued payment by VR for personal care attendant services.
New Assistant Commissioner presented new philosophy of values driven management at a recent retreat for all management/supervisory staff with the central office taking more of a support role versus authority. Decisions are to be made at the lowest level with mutual accountability between employees and clients. Provides greater authority to regional and front line supervisors to obtain maximum positive results by reclassifying positions, reallocating staff, with less emphasis on individual counselor production goals and more on unit and regional production.
As a result of Baltimore training conference developed an energy management proposal and has submitted it for capital maintenance project approval.
Capital improvement projects are moving forward but slowly; dormitory renovation of $6.5 million; security upgrade of $650,000; campus lighting project of $110,000; and elevator upgrade of $275,000.

West Virginia Rehab Center - Laine Wilder

National conference spurred them to address security issues, emergency response manual, etc.
Census down, 125-130 clients.
Application for designation as a CORF is in process with review being made for Medicare & Medicaid Services.
Insurance carrier who took over Workers Compensation making referrals to the facility. The process for becoming a privatized Workers Compensation Insurance carrier is almost final.
A future date for an open house is in planning stages.
Community Reintegration Services are being expanded with more efforts to include the blind and visually impaired.
Client of the Year ceremony held in October.
TANIF grant will allow them to perform comprehensive vocational evaluations for clients of DHHR.

Woodrow Wilson Rehab Center - Richard Luck/Rick Sizemore

New video was shown.
Creating a new unit, program evaluation and staff development.
Searching for a new Vocational Services Division Director and the unit will be renamed to Workforce Development Unit.
New Director's search is ongoing with three candidates.
New acute care unit dealing with substance abuse in spinal cord injury which includes detox.
Medical renovation will consist of 36 new beds.
Switzer Building renovation will require estimated two million dollars.
Will celebrate 60th anniversary in 2007.
Staff are being routinely surveyed for their ten most critical themes which should provide employee ownership and better communication down the lines.
Census is about 250 with goal around 300, serving 500-550 persons annually.
Commissioner interested in servant leadership.

GWU for Rehab Counseling - Dr. Dew

Due to his upcoming retirement, search for his position and a second faculty position is in the works. He will leave his grant work in February.
A new president has been hired out of John Hopkins.
Center will continue focusing on international work and research; Korea, China, Singapore.
He will continue with SOCRC after retirement.
Sees Autism as the new category receiving notice.
Qualified Rehabilitation Counselor
may be allowed to be determined by each individual state.

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Tuesday, December 12, 2006

Review of National Conference Track Discussions

Chairman Holmes opened the meeting with discussions of the National Training Conference Track Session Recommendations. The first session report discussed was Protecting Clients, Staff, and Property Through Security Assessment and Prevention. Consensus was reached on the following bulleted points.

Security Issues:

Everyone seems to have a crisis response plan but training for security personnel needs to be implemented.
The developing guidelines for security training could be a consortium project.
Centers with police coverage and centers with only security will be looked at differently when developing training.
Consensus for development of a standard of best practices for Center security and conduct a mini institute for training.
Suggested that this be done via a video conference and then could be pulled and viewed when new hires come on board.
Center Directors will share their information with other Centers such as security who are tested prior to offering a job, security with guns versus no guns; use of pepper spray.
Need for all to acquire a copy of the CERMUSA manual. David offered to supply manuals to directors.

The following was decided as strategic planning items.

Directors agreed to review and utilize the Effective Practices listed in the track session report pertaining to the safety and security of students, staff, and property where such practices do not exist and are feasible to implement.
Directors agreed to carefully canvas the extended community, assessing potential dangers and formulating contingency plans for meeting emergency situations resulting from these assessments (see examples in D. Recommendations # 2 under Track Session Report Protecting Clients, Staff, and Property…)
Directors agreed to identify individuals to assume the responsibility of developing multi-agency minimum security training guidelines. (#3 under Recommendations).
Directors agreed to the establishment of video-conferencing among centers for purposes of discussing implementation of best security practices and review pertinent security issues.
Directors agreed that Centers who have Police Departments connect with those who are interested in exploring the possibility of having a sworn Police Department (Recommendation #5) for technical guidance.
Directors agreed that a communications study should be completed at each Center to insure adequate communications system are in place and functional. (Recommendation #6)
Directors agreed that Centers should ensure that frequent and specific training is provided to staff and students, as well as specific emergency response procedures incorporated into Center Crisis Response and Emergency Preparedness Plans concerning specific emergency situations. (See Recommendation #7 for specific situations)

It was decided to include specifically in the 2007-2008 NC-SOCRC Strategic Plan the following regarding Security:

A NC-SOCRC security team will be established with identified team leaders from each Center which will serve as a focus group to establish Standards of Excellence in providing security assessment and staff training guidelines. The focus group is to utilize recommendations from the Security Track Session Report in establishing these Standards of Excellence.
The identified NC-SOCRC security team will form a security training institute to provide a training component to review current security practices and disaster preparedness guidelines. This security team will focus on #3 and #7 recommendations concerning training in developing the multi-agency security training guidelines and a training outline to be utilized in training staff and students on a frequent basis as to Center Crisis Response procedures and Emergency Preparedness Plans.

The second Track Session Report discussed was Pandemic Influenza and Personal Disaster Preparedness. Howard Rutenberg, Medical Director at the HSRC joined the group for these discussions. The following bulleted points were discussed:

Pandemic Flu Issues:

Howard Rutenberg will provide copies of his report.

Decision making in the face of a pandemic flu.

Need to cooperate with local health departments in each state.

Command Center discussed.

Need to identify essential versus non-essential duties, such as payroll.

Rate of mortality, standard post mortem policies sufficient or where do we go from here.

Discussion as to getting clients home and staff dispersed. Probably mandated by Governor to close due to epidemic.

Assume no new client would be accepted during this timeframe.

If epidemic strikes, and people start to die, a plan should be in place for the disabled population and emphasis for explanation to lower functioning population needs addressing. Greg, Dennis and Barry stated they have a plan. Post a 1-800 number for people to call.
Need for stock piling of supplies.

Barry's contact in Wisconsin will provide him information for training and will copy to each member.

Dick has a video he would like to share with everyone also.

Suggested someone at each center needs to be on the committee to work on a detailed strategic plan.

Discussion about who would remain on staff to complete payroll, command center personnel, etc. This would depend on each individual circumstance.

Howard will continue with development of a standard and report back to this group in the future.

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The following was decided as Strategic Planning items for Pandemic Flu after reviewing recommendations from the National Conference:

Center Directors agreed that each Center will establish a specific Pandemic Flu Plan utilizing the critical components identified under the D. Recommendations Section of the Track Session Report. Howard Rutenberg has already done this for HSRC and shared a copy of this plan with the group.
Once the Pandemic Flu Plan is developed each Center DON and identified physician will be responsible for implementing the plan and training staff.
Center Directors agreed that each center should immediately implement preparedness activities to lessen the spread of Infectious Diseases. A list of the activities is identified under Recommendation #2 in the Track Session Report.
Center Directors agreed that Personal Emergency Training Guidelines for Persons with Disabilities should be developed and implemented.

It was decided to include specifically in the 2007-2008 NC-SOCRC Strategic Plan the following regarding Pandemic Flu Preparation:

Each NC-SOCRC member center will develop a specific and workable Pandemic Flu Plan consistent with each Center's existing disaster plan to include identified components recommended from the National Training Conference Pandemic Influenza and Personal Disaster Preparedness Track Session. These components involve Clinical Management/Infection Control, Social Distancing, Isolation and Quarantine, Criteria for Admission, Decision Making for Partial Center Operations and Decision Making for Resuming Center Operations.

Once the Flu Plan is developed, the DON and identified Physician at each center will be responsible for implementing the plan and training center staff.
Personal Emergency Training Guidelines for Persons with Disabilities will be developed and distributed to each member Center to make available to all students served. Howard Rutenberg, Medical Director at HSRC, will facilitate this and work with a designated team of NC-SOCRC medical representatives to develop these guidelines.

The third Track Session Report discussed was Cost Containment through Effective Preventative Maintenance and Strategies. The following bulleted points were discussed:

Cost Containment Issues:

Develop individual management center plans, energy czars.
WW has energy savings contests; certifications for physical maintenance staff.
Primary goal is cost containment as to not drain our budgets for utilities.
Discussion on environment standards; computer climate controls, standard and degree of comfort.
Handout from Rick Sizemore reviewed and discussed.
Global statement recommends the Center Directors along with plant administrators to have the decision making authority.
Identify unique needs of comprehensive rehabilitation centers relating to specialized type of disabilities served.
Continue discussion of future maintenance plans with core staff to collectively save dollars at all nine centers due to collaborative expertise.
Collectively develop specific strategic information resulting in measurable reductions in energy usage, energy savings, and effective preventative maintenance activities.

The following was decided as Strategic Planning items for Cost Containment Through Effective Preventative Maintenance and Strategies after reviewing recommendations from the National Conference:

Individual NC-SOCRC Directors will discuss individual action plans with Physical Plant Administrators as to pursuing cost containment plans. (See recommendation section individual commitments).
Center Directors agreed that the Consortium should collectively develop specific strategies resulting in measurable reductions in energy usage, energy savings, and effective preventative maintenance activities.

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It was decided to include specifically in the 2007-2008 NC-SOCRC Strategic Plan the following regarding Cost Containment.

Physical Plant Administrators (PPA's) from the Consortium Centers work together via video-conferencing/consortium quarterly meeting to collectively develop specific strategies resulting in measurable reductions in energy usage, energy savings, and effective preventative maintenance activities.

The PPA's will organize a team of PPA's to collectively develop and refine these measurable energy savings and preventative maintenance strategies to share, discuss, and assist consortium member centers in cost containment and preventative maintenance practices.

The fourth Track Session Report discussed was Developing Standards of Excellence in Vocational Evaluation. The following bulleted points were discussed.

Standards of Excellence Issues:

Dick commented to accomplish this global work there will be a need for some financial support to bring our people together perhaps by videoconferencing. Voc evaluation is one of the things that comprehensive rehab centers do well and have set standards for accomplishments.
Do we want to establish peer reviews of what each center is doing according to established protocol?
Due to Dick's retirement, he suggests Steve Kirby to fill his shoes.
Suggests book that Jeanne Miller (AR) be contacted for her publication, etc.
Evaluators continue to identify all factors when evaluating clients (such as clients not agreeable to leaving their home area for work elsewhere); as this is a problem at all centers and should be addressed in the evaluation process.
Broaden evaluations identifying life skills, etc.

The following was decided as a Strategic Planning item for Standards of Excellence in Vocational Evaluation to be specifically included in the 2007-2008 NC-SOCRC Strategic Plan:

A Steering Committee identified by the Consortium will evaluate other existing Standards of Excellence for Vocational Evaluation and develop a position paper containing specific Standards of Excellence in Vocational Evaluation to present to the NC-SOCRC Directors for review.

The fifth Track Session Report discussed was Models for Job Readiness and Successful Job Placement for Vocational Training Graduates. The following bulleted points were discussed:

Job Readiness Issues:

Agreement with strategic measurement with review of research/practice done at every center.
Development of tools per outcome measurements and continue to tweak to establish long term effective practices for centers to follow.
Addition center staff will be recruited to work on this review.
Soft skills Training should be shared among group.
Dr. Dew suggested a flow chart be established for visual effect.
Barbara to provide copy of their revised training program report which includes portion on life skills.
Dennis has a career readiness program where clients are
washed out
before entering a training program.
Established need for revisiting this area among participants.
Three centers agreed to customize training programs.
Prescription training and partnerships discussed.
WW works with Hardee restaurants to develop a model with them to train clients to their job expectations.
The materials management training discussed as an upcoming program.

The following was decided as Strategic Planning items for Job Readiness and Successful Job Placement for Vocational Training Graduates after reviewing recommendations from the National Conference:

Center Directors agreed that there should be a review of current research/practices for assessing pre-vocational and/or life skills and development of an outcome measurement evaluation program for pre-vocational and/or life skills programs to share with Consortium Centers.
Center Directors agreed that there should be a review of current inventories of core soft skills training and development of a comprehensive model for integrating soft skills training into existing training programs.
Center Directors agreed that strategies should be reviewed and developed for capitalizing on meeting the needs of employers through developing customized vocational training programs.

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It was decided to include specifically in the 2007-2008 NC-SOCRC Strategic Plan the following regarding Models for Job Readiness and Successful Job Placement for Vocational Training Graduates.

A focus group will be developed to review research pertaining to outcome measurements establishing criteria for assessing life skills/pre-vocational skills and develop an evaluation program/outcome measurement guidelines for pre-vocational and/or life skills programs to present to the Consortium Directors.
Directors of the Michigan, Pennsylvania, and West Virginia Consortium Centers will work with identified staff at their respective Centers on strategies for developing customized vocational training programs in meeting the needs of employers. Developed strategies/guidelines will be reviewed by NC-SOCRC Directors to share with strategic center staff.

Demonstration of KMC

David Holmes demonstrated accessing the European Platform of Rehabilitation (EPR's) Knowledge Management Center. This electronic information sharing system is a work in progress and the NC-SOCRC will further determine the feasibility of using this system and sharing NC-SOCRC information with European partners.

Tour of HSRC

A tour of the Hot Springs Rehabilitation Center was provided to the NC-SOCRC Directors by Barbara Lewis and staff which was thoroughly enjoyed by all.

Planning Discussion NC-SOCRC Directors & EPR Directors Workshop - Washington D.C.

Dr. Donald Dew identified an interest by the European Platform as to a workshop to bring together the EPR and NC-SOCRC Directors for a symposium in Washington, D.C. to address key issues identified by both organizations. The following issues were briefly discussed concerning the workshop:

Dr. Dew has met with appropriate persons involved with the European platform and is considering a spring symposium in Washington.

Available support of lodging for meeting.

Cost of symposium for the SOCRC.

Need for electronic system or sharing information with our European centers.

Sister center visits, i.e. Greg's visitor from England

Wednesday, December 13, 2006

Barbara Lewis introduced Robert Treviño, Commissioner of Arkansas Rehabilitation Services who addressed the NC-SOCRC Directors as to some initiatives being pursued in Arkansas. A period of discussion between Commissioner Treviño and the Directors took place and the importance of the Comprehensive Rehabilitation Centers to people with Disabilities. Commissioner Treviño was very complimentary of the Hot Springs Rehabilitation Center and appreciative of the services provided to individuals with disabilities in Arkansas. He stated he will be participating in the graduation ceremonies that will be held that morning for which the NCSOCRC Directors will attend and invited the Consortium to hold its next National Conference in Hot Springs Arkansas.

BUSINESS MEETING

Secretary's Report - Laine Wilder

There have been no minutes since our National Conference in September of 2006. The minutes from the June 7-9, 2006 meeting were approved as written.

Treasurer's Report - Dennis Hart for Don Rullman

The current financial report was presented and is attached. The Treasurer's report was approved.

New Business

Due to the Directors attending the HSRC student graduation exercises, no new business was discussed.

Meeting Adjourned to attend 10:00 a.m. Graduation Exercises.

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