GLENWOOD, INC.
Daniel HouseII (UP and DOWN)
Subject: Program DescriptionNumber: 3.00
Effective Date: 12/01/04Reviewed: 03/11/15 Revised: 03/11/15 Page 1 of 7.
Authority Reference: Glenwood Inc. Policies and Procedures Manual
POLICY: Daniel House II(UP and DOWN) PROGRAMS DESCRIPTION
The Daniel House II programs are highly structured intensive residential treatment programs for Severely Emotionally Disturbed (SED) boys. These programs serve children who have been unsuccessful in less restrictive environments. Daniel House IIprograms are nondiscriminatory programs serving children from across the state of Alabama.
Children with a serious emotional disturbance are described as those who are from birth to 18 who have had a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria specified within the Diagnostic and Statistical Manual of Mental Disorders (DSM). For the individual to be deemed emotionally disturbed, it must be determined that the child's condition results in functional impairment, substantially interfering with one or more major life activities, such as the abilities to eat, bathe, and dress oneself, or the abilities to function effectively in social, familial, and educational contexts.
ADMISSIONS CRITERIA AND INDIVIDUALS SERVED
Criteria considered during an initial screening for admission are as follows:
1. Individual served (I-S) is male
2. I-S is between 10 and 14 years old.
3. Borderline, average, or above intellectual functioning, and a psychiatric diagnosis. Final admission determination is based on test results and observation of behavior and the approval of a psychiatrist, licensed psychologist, or the VP of Children’s Residential Services.
4. I-S is experiencing mental, emotional, or behavioral difficulties, which prevent placement at home, school, or in a less restrictive environment. These difficulties must be a combination of at least three of the following criteria:
Impaired contact with reality manifested by hallucinations, delusions, or ideas of reference
Withdrawal, regression, or confusion not warranting inpatient hospitalization
Moderate to severe disabling depression
Moderate to severe disabling anxiety
Disabling somatic symptoms
Poor medication compliance
Inpatient care is not warranted
Poor interpersonal skills or difficulty with social interactions
Inadequate problem solving skills
In need of 24 hour protective supervision in daily living
Poor self-control
Cruelty to animals
Inappropriate aggressive behavior
Angry/Hostile temper tantrums
Hyperactivity
Running away
Destructiveness
Poor school performance
Truancy
Defiance of authority
Manipulative behavior
Sexual maladjustment
Assaultive behavior
Child abuse victim (neglect, physical, and/or sexual)
Homicidal/Suicidal ideation (severity not warranting in-patient care)
Drug experimentation
Irrational fears
Attention seeking behavior
Encopretic/Enuretic
Low frustration tolerance
Dysfunctional family relationships
5. Individuals Served must be willing to participate in daily, structured activities as outlined in the programs protocol and Milieu as well as in their most recent treatment plan.
6. All admissions must be approved by a Licensed Independent Practitioner.
ADDENDUM REGARDING SPECIAL TREATMENT CONSIDERATIONS
The Daniel House II programs can make accommodations for family members who are deaf, hard of hearing, or have limited English proficiency by arranging for the necessary interpretive services. In addition, access to a TTY and closed captioning can be arranged. Facility accessibility for families with mobility impairment is available throughout Glenwood’s campus. The admission of Individuals requiring these accommodations would be subject to Daniel House II’s admission/ exclusionary criteria and initial clinical assessment. This assessment would address the feasibility of providing best practice care to the Individual served given the impact of his impairment upon necessary milieu participation. Upon admission, Individuals served and/or family members who have demonstrated the need for these services will be served through a treatment plan that addresses these needs with agency resources or through collaborative referral.
PROGRAMMING
The Daniel House II programs are divided into two programs: The Daniel House II program (UP) houses 8 individuals who are classified and meet criteria as stated above. The Daniel House II (DOWN) program houses three additional individuals that meet the above stated criteria and also offers an additional (4th) bed that may be utilized for assessment, transitional needs, or a long term bed if needed. This bed availability is contingent on current population. All individuals in treatment at Daniel House II have their own bedroom which provides for their own space/privacy and a quiet place or area when needed or desired. Each program has a homelike environment and contains a living room or common area, kitchen, dining room, game room or play area, bathrooms, individual bedrooms, laundry room, pantry, and office. Individuals are allowed to decorate their rooms in any fashion with consideration to their behavioral concerns and safety of both the Individual and the staff working with him. (Ex. No glass items are allowed). They may bring in their own comforters and bedding, curtains and wall decorations as desired.
The assessment component is for youth with complex behavioral and/or psychiatric issues who would benefit from multidisciplinary evaluations coupled with behavioral/interactional observations afforded by a stay of up to ninety days. This length of stay assists the individual served and parents/guardians in developing management skills regarding the Individual’s age-related emotional and cognitive development, illness, medications, and educational needs. Other benefits include the introduction of, or management of, psychotropic medication tailored to the individual’s needs when indicated.
The transitional component, available for up to ninety days, may be utilized in one of two approaches. For Individuals served nearing discharge, this arrangement allows increased independence, more privacy and increased numbers of home visits while supported by familiar staff and structure. The other approach allows for a youth’s admission into the program when acuity needs or referral agency concerns can be addressed more promptly, knowing that a pending discharge date had been finalized for another resident graduating from the program.
Individuals in the assessment/transition bed participate in the house programs and therapies and attend Lakeview School for their educational needs.
ADMISSION EXCLUSIONARY CRITERIA
Individuals served must be free of physical, medical, or mental impairments that would prevent successful participation in the Daniel House II Programs. Individuals Served must not pose a threat to the safety of themselves or others. They must be able to fully participate in the routines and activities of the Daniel House II programs. They must not have a principle diagnosis of alcohol or substance abuse, intellectual disabilities, Autism, or primary organic disorder.
SERVICE LOCATION
Daniel House II is located on 364 acres of land in a wilderness setting, tucked into the hills of Cahaba Heights/Vestavia Hills. The goal of Daniel House II is to establish a therapeutic setting in a home-like environment. Physical address is 160 Glenwood Lane, Birmingham, Alabama 35242.
SERVICES PROVIDED
Each child in care at Daniel House II participates in a variety of activities including therapeutic games, sporting activities, video games, arts and crafts, music therapy, pet therapy, equine therapy, hiking, fishing, and canoeing. The children also go on outings into the community to spend their allowance money and take field trips to the zoo, museums, historic landmarks, the movies, etc. Daniel House II encourages Individuals served to have connections with the community in order to provide important learning opportunities and help children gain respect for themselves and others. Outings are used to model normalized daily activities and foster positive interactions with their family and community.
To meet individual’s spiritual needs, Individuals can also participate in our Chapel services (nondenominational) or may go to church with their families in the community if desired. A written daily schedule is posted in the house each day. This schedule includes activities, meals, snacks, showers, and bedtimes at the very least.
Daniel House II Individuals served receiveindividualized treatment that includes the opportunity to help in the development of individualized plans of care. Each Individual served receives a minimum of 1hour of individual therapy and 1-3 hours of group therapy per week with the addition of family therapy when necessary or possible. Daily (M-F) groups allow individuals time to meet with their direct care staff for discussion and feedback. The plan of care and modality of therapy is a work in progress that is modified according to the individual’s progress every 30 days. These services include access to medical treatment, the use of prescription psychotropic medication, and medication management. Daniel House II provides transportation for medical appointments, dental appointments, and other community services as needed. The individual served and his parents/guardians are educated regarding the Individual’s age-related emotional and cognitive development, illness, medications, and educational needs. All of the above treatment is provided at the recommendation of a coordinated treatment team which includes Residential Instructors (direct care staff), Program Coordinator, Family/Individual Therapist, Register Nurse (RN), Psychiatrist, Teachers and when appropriate, Speech Therapist, Occupational Therapist, ABA, Director and Vice President. Family /Guardians are also invited to attend when they are able and/or can call in via phone for conference call at these times.
Daniel House II staff assists Individuals Served and their families in applying for social security disability, Medicaid, and any other benefits for which they might be eligible.
Daniel House II understands that some individuals may need a legal guardian while in residence in the program. Therefore, a system has been set in place by which a referral to the appropriate resource (DHR, Probate Court, e.g.) can be made on behalf of the individual served.
Individuals Served receive training in a variety of basic living skill areas, including personal care, communication, behavior education, problem solving, anger management, and social skills, to establish a foundation for a successful return to home and community.
The Daniel House II Programs provides 24 hours of coverage per day/7 days a week. During the program hours, a staff/Individual Served ratio is appropriately 1:4 Additional coverage is provided when certain situations merit. Registered Nurses are available on campus during business house and 24/7 through an on-call system.
EDUCATIONAL/VOCATIONAL SERVICES
Lakeview Day Program is the school located on campus that provides educational/vocational services to the residential and day treatment individuals served in Glenwood, Inc.’s Child and Adolescent Division. The school staff are responsible for the individuals served between 8:30am and 2:30pm on weekdays unless there is other planned and therapeutic events scheduled. Lakeview is a year –round school that follows an individual’s IEP (individualized Education Plan)
FAMILY INVOVLEMENT
At intake, a discharge plan is devised which takes into consideration the permanency plan of the individual being served. When permanency placement involves Parents, relatives, foster care, etc... It is the desire of the Daniel House II program to have family/guardian members involved in the Individual’s treatment. Families are strongly encouraged to participate in treatment through Family Counseling and training, attendance in treatment team meetings (once monthly) and/or through campus visits, day passes and in home visitations. When on campus, the families are encouraged to take advantage of our 364 acres of wilderness. They can visit the lakes, walk on a path or visit within the programs or within the other buildings on the premise. Parent/Guardians must visit in designated areas which take into consideration the confidentiality of the others in the program. This is discussed and a designated area is assigned at the time of the visit.
LENGTH OF STAY
The expected length of stay in the Daniel House IIprograms is 6 to 12 months. The final months of treatment will focus on preparing the individual for a smooth transition to a less restrictive environment. An extension may be requested from the treatment team upon completion of 12 months of stay at Daniel House II. Reasons to merit an extension would be extenuating circumstances prohibiting the child’s return home or return to planned placement post program completion, or it is determined the child’s progress indicates a greater benefit in treatment could be gained by additional time in the program. Extensions are reviewed on a monthly basis.
DISCHARGE CRITERIA
Daniel House II will consult with and offer support to parents/guardians during the discharge process. Daniel House II will make appropriate referrals/recommendations to ensure the Individual’s continued progress.
Discharges may be of two types: successful and unsuccessful. AnIndividual served will be considered for successful discharge upon
- Demonstrated progress toward treatment goals as evidenced by a 70% reduction in presenting problems
- Demonstration of enhanced family, social, academic, and community functioning
AnIndividual served will be considered for unsuccessful discharge if the Individual does not meet the above criteria. In such cases, Daniel House II will make referrals and\or recommendations to a setting that has an appropriate level of restrictiveness.
Lakeview staff will consult with appropriate educational personnel in the Individuals school/school district in order to ensure a smooth transition to the school setting.
TRANSFER CRITERIA
A recommendation for transfer to another treatment facility may be made when an evaluation indicates that
- Additional treatment is needed to ensure optimum functioning
- Individual Served is unable to function in his own home or school
When a recommendation is made for transfer, the Daniel HouseII Treatment Team will meet with all concerned parties to discuss the Individual’s progress and make recommendations. Daniel HouseII will assist in making referrals to appropriate resources (other treatment facilities, group homes, therapeutic foster homes, or regular foster homes).
STAFF QUALIFICATONS
Daniel House II shall be staffed by a Program Coordinator, a Child and Family Therapist, Senior Residential instructors, Lead Residential Instructors, and Residential Instructors (I & II), overseen by the Division Director.
- Division Director: The Division Director shall have an MA/MS in psychology, social work, or counseling from a College/University accredited by one of the six regional accrediting associations of the US. A minimum of 5 years clinical experience with C&A MI Residential Care with at least 2 years with administrative, supervisory duties.
- Program Coordinator: The Program Coordinator shall have a MA/MS in Social Work, Counseling, ABA or related field, 3 years experience in C&A MI residential care with 1 -2 years management experience. Professional licensure or certification preferred. Coordinator will have current certification in CPR, First Aid, MAC and MCS and current Alabama Driver’s license.
- Child and Family Therapist – The Child and Family Therapist shall have a MA/MS degree in Counseling or Social Work with 3 years in a clinical or Mental Health Setting and be licensed (ALC, LGSW, LPC, or LCSW). Therapist will have current certification in CPR, First Aid, MAC and MCS and current Alabama Driver’s license.
- Senior Residential Instructor (Weekend) – The Weekend Senior RI will have a MA/MS in social work or counseling, or related field. Plus, 2 years exp. working with C&A MI and/or SED Residential care. 1-2 years management experience. Will have current certification in CPR, First Aid, MAC and MCS and current Alabama Driver’s license.
- Senior Residential Instructor (Weekday)– The Weekday Senior RI will have a high school diploma - preferred BA/BS in psychology, social work, or other human services field and at least 2-year experience working with C&A MI Residential care within Glenwood, Inc. and/or 3 year of exp. In C&A MI Residential care externally. Will have current certification in CPR, First Aid, MAC and MCS. Has a valid Alabama’s Driver License.
- Lead Residential Instructor – The Lead RI will have a high school diploma or bachelor’s degree in psychology, social work, or other human services field and at least 1-year experience working with C&A MI Residential care within Glenwood, Inc. and/or 2 year of exp. In C&A MI Residential care externally. Will have current certification in CPR, First Aid, MAC and MCS. Has a valid Alabama’s Driver License.
- Residential Instructor II – The Residential Instructor II shall have a high school diploma or bachelor’s degree in psychology, social work, or other human services field and at least 1-year experience working with C&A MI Residential care within Glenwood, Inc. Will have current certification in CPR, First Aid, MAC and MCS. Has a valid Alabama’s Driver License
- Residential Instructor I – The Residential Instructor I shall have a high school diploma, prefer 1 year of exp. In C&A MI Residential care. Will have current certification in CPR, First Aid, MAC and MCS. Has a valid Alabama’s Driver Licenses
DH2 program DescriptionPage 1