Running head: COMPETENCY-BUILDING ACTIVITY-PEER EVALUATION
Competency-Building Activity
Concordia University
HS 550 Issues in Human Service Administration
Brittany Serpico
21 October 2013
Knowing the Environment
When viewing the political, economic, social, and technological factors most likely to affect the clients in the new program Generation Connection, one needs to focus on both the elders and the students. I’ve interviewed Brad Berens, the Executive Director of AVCOA (Antelope Valley Committee on Aging), with whom I’m helping form this new program. The first question I asked was “what does he think are the political, economic, social, and technological factors that would be most likely to affect the clients?” The second question I asked was “how can we assess the needs and strengths of the program’s community?” Thirdly, I asked, “what factors of culture and diversity would have the greatest effect on our clients and the program?” Berens gave a thorough explanation, which is summarized in the body of this paper.
In regards to political factors, the program will be considered a model worthy of expanding and duplication. While the program will be small to begin with, its impact would not be lost on local and county governments and departments, most notably Adult Protective Services who receive referrals on self-neglect cases which in some cases could be addressed by this program (Berens, 2013). Community volunteerism is something that local governments discuss and like to brag about. “School Districts too, would want duplication in each high school” (Berens, 2013). Brad continues the topic of political factors in regards to the students:
The program breaks down stereotypes of ageism commonly held by young people, consider the resentment of some young people thinking the oldsters are using up their “social security”. As the boomers (and later Baby boomers “echo”) continue to age, societal issues will surround issues like the resource management of health care, (i.e. expense of a transplant for an older person vs. life expectancy).
When referring to economic factors, seventy-five percent of our clients live at or below the federal poverty line with the remaining twenty-five percent living at or below the California Economic Security Index for Seniors (Berens, 2013). The clients benefit from in-home help that they could not otherwise afford. Not only will the elder clients benefit, but also the students would be helping gain experience and knowledge to help them advance in their future careers.
In regards to social factors, the clients we are focusing on are homebound, isolated, and without social networks. The social component, especially intergenerational, positively will affect the well-being of the clients and students. “The interaction improves overall health, eliminating to a degree depression in the client which improves overall health” (Berens, 2013). In regards to the students, they learn the value of life well-lived, which becomes motivational to them and expands their knowledge, first-hand, of altruism. “The values of older people are inculcated and as a group, the students will dialogue on the difference the program has impacted them” (Berens, 2013).
In regards to technological factors, the only thing we could think of is that students could bring laptops for life history documentation of the elder. Also, use documentation to record “results in the phenomenal aspects of the electronic age as they teach the elder the wonder of the net and social media” (Berens, 2013). Often times when I am out in the field working with clients, the elders often have questions about their computer at home and I am able to give them advice and assistance if needed.
Assessing the needs of the client is pre-determined by a formal assessment performed by the professional staff, including myself, a Case Manager. We already have a wait list of clientele from the Home Delivered Meals (HDM) program and soon to be a wait list on the Family Caregiver Support Program (FCSP). The strength of the program will be formally determined by the re-assessments of our clients with the client being stabilized according to activities of daily life (not witnessing a further decline) (Berens, 2013). “In a more formal sense, I anticipate targeting joint clientele of AVCOA and Hi Desert Medical Group where the medical component is tracked for stability too” (Berens, 2013). Another indicator may also be the reduction of hospital readmissions per client (Berens, 2013).
Culture and diversity challenges would include the recruitment of students who are culturally appropriate to the client in terms of language, shared culture for ease of being able to relate to the elder (Berens, 2013). Final life histories would have to be written in the client’s primary language in addition to English to satisfy the living document for client and family as well as the scholastic aspect of a final paper to the student’s instructor (Berens, 2013). In terms of culture and diversity, the act of serving rural areas where typically no resources are available should also be considered. “There are inherent issues of culture and diversity simply in play because of geographic isolation over and above the common issues of ethnicity” (Berens, 2013). The issue of economics (generally lower income people in rural areas) also lends itself to the culture of the area (Berens, 2013).
Interviewee’s Information:
Monday, September 9, 2013
Brad Berens (Executive Director)
Antelope Valley Committee on Aging (AVCOA)
(661) 942-6244
Planning
The answers to this week’s assignment seemed a little repetitive, but I referred back to previous conversations with Brad Berens, the Executive Director of Antelope Valley Committee on Aging (AVCOA). To recap, the program will address a specific population with multiple issues. The focus is on the advanced elderly, who are living alone without a family support system, oftentimes due to family members living a too great a distance that personal contact is more difficult. The targeted elderly are very frail, chronically ill, some with disabilities and unable to attend to activities of daily life without support or assistance.
Most of the new program’s clientele will include elders that are already on the Home Delivered Meals program or on the wait list due to funding shortages. The problem for these elders is that they desperately want to remain in their own homes, in the least restrictive environment possible and avoid institutionalization. However, due to insufficient income, they cannot afford the extra help they desperately need.
In most of these cases, the elder has needs beyond the nutritional aspects of Home delivered meals. Due to frailty, illness and disability they can no longer sufficiently keep up their home and need assistance with housekeeping and heavy chores. In addition to needing assistance, these elders are often plagued by loneliness and isolation that coupled with their individual challenges leads to profound states of depression, further cascading their issues of illness.
The program involves working with local High Schools, academic counselors, key clubs, and many other groups that are normally focused on good students on a scholastic path to college. Many of these noble students are enrolling themselves in community service to enhance their college applications.
This program will have students making a commitment to Generation Connection program for an entire school year where weekly (one day a week for several hours) they will go in groups of 5 to 6 to initially provide heavy chores around the elder’s home to make it more livable. Anecdotally, as an example say the elder’s favorite thing was having a garden to keeping their yard nice. The students would spend time enhancing the appearance and maintenance of the yard and home. Heavy cleaning, anything the elder has difficulty doing.
Concurrently, the students will spend time conversing with the elder (who is inherently lonely) questioning them of their life history. Several dynamics take place here, the obvious (keeping the home maintenance up, perhaps cooking additional meals to be stored in the fridge for a couple of days etc.) it has a profound effect on both the student and the elder. For the high school student, at that age, they are inherently nervous, insecure and wary of the very old. This comes from an age-based egocentric point of view from the teenager where the center of their universe is focused on themselves.
The students will be required to spend several weeks of doing chores and listening, where the element of trust and friendship build into meaningful relationship between the young and old. The academic portion of this program will have the students documenting and writing a paper documenting the elder’s life. In the end it will serve as a life history of the elder that can be passed down to their generational off spring, including adult kids, and grandkids and further down the family line as it develops. One would be surprised that most families lose their family history of the generation - one or two above them. In regards to the students’ academics, the final product is a written history of their lives that they can revisit and pass on to following generations.
The high school students are supervised by agency staff, always with the same staff person for continuity and bonding with the elder and staff in addition to the students. Staff will guide the process from introduction of the student group to the elder, facilitate communication until the students are comfortable, and be a role model for the students. Depression is addressed in the senior and overall health is improved.
In conclusion, the mission of Generation Connection is to address the needs of the isolated and homebound elders in the community. The specific goal of the program are to prevent self-neglect among elders in the community. According to Berens (September 2013), “Antelope Valley has the highest incidence of Adult Protective service referrals in LA County. Most of these referrals are for self-neglect amongst the elderly.
Interviewee’s Information:
Monday, September 9, 2013
Brad Berens (Executive Director)
Antelope Valley Committee on Aging (AVCOA)
Phone: (661) 942-6244 / Email:
Organizational Theory and Design
First, I will clarify the process of the new Generation Connection program. The process to choose the High School students who will participate begins with the School's Guidance Counselor with an overview of the program. Once they agree to the many positive aspects of the program, they will arrange meetings between staff and key clubs in the school to make a presentation to the students, explaining the concepts, process, educational activities and the expectation of positive outcomes for the elder client and intrinsic rewards for the students. While the program will eventually spread to several schools (including private schools) it will begin with just two. The two schools will be picked for logistics. One school will be chosen based on proximity for less travel time, allowing the students to work in their own community in some cases and in others for proximity to rural areas where generally the elder clients are in the highest need due to isolation. The students will be given a brief orientation on the needs of the elders as they reach advanced elderly status. The idea is to familiarize the students with self awareness and awareness of the elderly as a learned personal experience. According to Berens (Sept. 2013), part of the orientation is to put the young people through an hour or so lecture/presentation ‘walking in the shoes of the elderly’ where certain techniques are employed like smearing petroleum jelly on glasses mimic opticdegeneration, binding legs to mimic physical disability and the like.” Remember, the skilled and professional staff members are always with them to gently guide and teach.
The older adults of course will have to consent to the visitation brought into their home with the students. Social workers will match students based on mutual interests as much as possible. Social workers, as a routine of their visitation and follow-ups will know the issues and challenges faced by the elder and will match accordingly. Goal measurement is both objective and subjective. Allowing for an elder to remain in their home and avoid institutionalization is a measurement that is objective in and of itself. Changes in mood in the elder, dress, and demeanor are expected changes related to the elimination of depression so commonly affecting the mental and physical aspects of health. Berens continues (Sept. 2013), “the stabilization of chronic health problems will further be ascertained as the elders will be chosen from the client list shared with High Desert Medical Group so all aspects of health are measured.” “Our relationship with HDMG allows for the "triage" of mutual clients where closely coordinated service delivery, both medical and social service has the best possible outcomes” (Berens, 2013).
For my new Generation Connection program, I’ve had some additional assistance from Brad Berens, the Executive Director of AVCOA, in designing an organizational chart. I emailed him the following questions: Which theory do we plan to implement? How is the organization departmentalized? How will work be divided among departments and individuals? How would you make sure that the work of various individuals and groups was effectively coordinated? In his response, he explained how AVCOA currently is organized, which will be the model for the Generation Connection program.
Berens replied to the first question in his email (Sept. 26, 2013), “In an organization like AVCOA, particularly as a mid-size agency, 1.3 million dollar budget, we do and would apply a participatory management style theory. Often other leaders might choose a more rigid approach (bureaucratic, top down) but in social services participatory style is much more advantageous to staff and clientele.” Client services are best delivered when decision making is pushed to the lowest competent level within the parameters of each staff's job description. This expedites service delivery while allowing each staff member to develop at a much quicker pace. “From a personal point of view, I like each position to have two other members on the organizational chart ready to assume more responsibility” (Berens, Sept. 26, 2013). With a participatory style of management all resources of the agency can be considered for the well-being of the client.
In most organizations, I would assume that there is a need for departmentalization. Berens responded in the email (Sept. 26, 2013) “The new program would be departmentalized with the Case Managers (supportive services department) as the Lead, allowing for first hand professional knowledge of the client we are seeking to support through the intergenerational program.” Another department would fall under the Volunteers Coordinator, who would be the supervisor of the students during their visitation and provision of services to the homebound and isolated senior.
Case managers will determine which elder clients would be best serviced by the program; generally this will depend on conditions of isolation, depression, sociability limitations of activities of daily life and willingness to work with the students. “For both the Case managers and the program coordinator, it will be a sales pitch to both client and students until the students and client begin meeting” (Berens, Sept. 26, 2013). The student program coordinator will be instrumental in giving feedback to the Case Manager in charge of each elder client who is chosen to be provided with such assistance. “Program coordinator and Case Managers will be routinely as a part of the case conferencing meetings (and general staff meetings) ensuring optimal service delivery and positive outcomes” (Berens, Sept. 26, 2013).
Interviewee’s Information:
Thursday, September 26, 2013
Brad Berens (Executive Director)
Antelope Valley Committee on Aging (AVCOA)
(661) 942-6244
Budgeting and Information Systems
The biggest challenge in developing a program budget is finding the funding to cover the costs. The Management Information System that AVCOA uses is called Get Care, a computerized database where we input every client’s demographics and case monitoring information. Each client will be re-evaluated every 3 months. There is an example of the intake form in this paper, which will be used for all intakes and re-evaluations. This form is used to evaluate client needs and risks in order to determine what care plan is best for the client. Units are used for billing purposes in this organization. 0.1 units is the equivalent of six minutes and therefore 60 minutes or one hour is equal to one unit. There is a list of the billing units for the Generation Connection program in this document. The following is the line item budget for Generation Connection program: