4/7/12  

1  

A  Sustainable  Model  for  Adult  Residen8al  Services  

William  Mara,  Chief  Opera8ng  Officer,  TERI  billm@teriinc.org  www.teriinc.org  

TERI  Con)nuum  of  Services  TERI  has  served  individuals  with  au8sm  and  developmental  disabili8es  for  more  than  30  years.    Our  programs—residen8al  homes,  K-­‐12  schools,  and  adult  enrichment—are  award-­‐winning  and  set  na8onal  and  interna8onal  standards  for  quality  of  care.    We  are  moving  our  renowned  programs  to  a  central  loca8on  on  21  acres  in  San  Marcos,  Ca.      We  are  building  a  university-­‐like  Campus  of  Life—a  college  for  life,  a  unique  opportunity  for  individuals  to  learn  and  thrive  

Bressi  Ranch  House  –  Carlsbad,  California  

What  we  know  about…  Residen)al  Supports  

Large,  Developmental  Centers  •  All  but  9  states  con8nue  to  have  and  place  people  in  large  residen8al  

programs  (over  16  people)  •  The  number  of  people  living  in  large,  state-­‐run  developmental  centers  

con8nues  to  fall  at  a  rate  of  about  4%  per  year  (55%  decrease  in  last  10  years).  

•  About  5-­‐10%  of  the  popula8on  live  in  large  facili8es.  •  We  spend  an  average  of  $176,266  per    year  per  person  for  those  living  in  large    developmental  centers  ($482.81/day  average)    Sta8s8cs  are  from  2007.  For  more  detail  go  to  hap://rtc.umn.edu/docs/

risp2007.pdf  

What  we  know  about…  Residen)al  Services  

Small,  state  run  or  funded  residences  •  Most  small  residen8al  programs  run  by  non-­‐state  agencies/persons.  95%  house  6  or  fewer  people.  

•  About  72%  of  people  with  ID  in  placement  live  in  6  bed  homes  and  the  balance  in  homes  

 with  3  or  less  residents.  •  Most  residences  follow  the    “congregate  care”  model,    but  foster  care  is  increasing  

What  we  know  about…  Residen)al  Services  

Individualized/Other  Residen8al  •  About  26%  of  people  with  ID  live  in  their  own  home  (rented  

or  owned)(Missouri  &  Wisconsin  greatest  numbers)  •  Host  families:  About  24,000  na8onally  (Idaho,  New  York,  

Wisconsin)  •  About  half  of  all  people  with  ID  live  in  the  family  home  

((Alaska,  Arizona,  Florida,  Idaho  and  South  Carolina)  •  In  2007,  there  were  over  88,000  people    on  wai8ng  lists  for  residen8al  supports.  It  would  require  an  

es)mated  20.2%  growth  in  available  residen8al  service  capacity  to  provide  residen8al  services  to  all  of  the  persons  currently  wai8ng.      States  report  from  0-­‐179%  increase  in    residen8al  care  op8ons  

Residential Options Independent  Living  

Natural  or  Adop8ve  Homes  Inten8onal  Communi8es  (L’Arche;  Camp  Hill)  

Adult  Foster  Care  Board  and  Care  Group  Homes  

   Semi-­‐Independent  Living  ICFs    

Nursing  Homes  Co-­‐ops  

Family  Ini)ated  Residence    

4/7/12  

2  

McNealy  Residen)al  Model:  Families  Joining  Together  

TERI’s  McNealy  House,  Oceanside,  CA.  

   

TERI  McNealy  House  Program  Model  

•  Group  of  4  parents  approached  the  agency  •  Agency  facilitated  Life  Quality  Planning  •  Families  given  op8ons  on  types  of  residen8al  supports  •  Families  chose  to  involve  an  addi8onal  2  families  to  reduce  

costs  and  increase  staff  •  Agency  and  families  designed  the  model  

Neighborhood/Home  Preferences  

•  Quiet  and  safe  neighborhood  near  families  •  4000  square  foot  home  •  Separate  bedrooms  for      4  of  the  6  residents  

•  Away  from  busy  streets  with  high      wall  around  back  yard  for  man  who  runs  

•  Pool,  jacuzzi,  barbecue,  outdoor      recrea8on  and  ea8ng  space  

•  Private  areas-­‐2  living  rooms      plus  game  room  

•  High  quality  materials  and  furnishings  •  Close  to  community  recrea8on  and  shopping      

Staffing  •  Live-­‐in  staffing  paaern;  1:2  ra8o  during  week  •  Awake  night  8me  staff  •  Experienced  staff  only  •  Stable,  dedicated  staff,      trained  in  au8sm  

•  Compe88ve  benefits  and  salary  – Staff  salaries:  $14-­‐18/hour  –   (30%+  above  norm)  plus  medical,  –   dental,  3  weeks  PTO  

•                 Parents  support  weekend  relief  

A  Quality  Life  •     Community  ac8vi8es  each  weekend  •     Lessons  and  planned  ac8vi8es  weekly  •     Regular  events  that  include  families  (dinners,  par8es,  holidays)  •     Vaca8ons    •     Animals:Therapeu8c  Equestrian  Program  and  Companion  Dog  •     Music  Therapy;  Music  apprecia8on    •     Chiropractor/Massage/Pampering  weekly  •     Personal  fitness  trainer-­‐daily  fitness  program  •     Sensory  based  ac8vi8es  daily  •     Ac8ve  involvement  in  cooking,  gardening,  home    •     Swimming/Jacuzzi  daily,  if  desired  •     Weekly  e-­‐mail  updates  to  families  and  rela8ves  •     Community  volunteerism:  replan8ng  burn  areas;    •     Helping  neighbors  •     Sibling  specific  ac8vi8es  planned  by  house  •     Friendship  development  and  maintenance  •     Medical  support  •     Personal  Safety  

Model Residential Start-Up Start Up Revenue:

HUD 550,000 CDBG Grant 250,000 Regional Center 50,000 Parent Contribution 150,000

$ 1,000,000 Ongoing Parents pay sustaining funds monthly of up to $1,500 to support “extras” not funded through traditional sources.

4/7/12  

3  

Residen)al  Sustainability=Urban  Farms  What  is  an  Urban  Farm?  

The  prac8ce  of  cul8va8ng,  processing,  and  distribu8ng  food  in  or  around  urban  areas.  

           

50%  of  the  world’s  popula8on  lives  in  ci8es  800  million  people  are  involved  in  urban  

agriculture  world-­‐wide.  

Urban  Farm  Facts  •  Low  income  urban  dwellers  spend  between  40-­‐60%  of  their  

income  on  food  each  year.  •  By  2015,  about  26  ci8es  in  the  world  are  expected  to  have  a  

popula8on  of  10  million  or  more.    To  feed  a  city  of  this  size,  at  least  6,600  tons  of  food  must  be  imported  daily  

•  250  million  hungry  people  in  the  world  live  in  ci8es.    

TERI  Urban  Farms:  Our  Goals  •  To  convert  12  residences  to  urban  farms  that  are  an  extension  

of  our  4  acre  farm  on  the  Campus  of  Life.    •  To  generate  organic  produce  to  feed  residents  and  staff  •  To  provide  lifespan  voca8onal  opportuni8es  to  individuals  

with  au8sm  and  developmental  disabili8es  •  To  expand  revenue  base  by  becoming  organic  farmers  

 

TERI  Urban  Farms  To  convert  12  residences  to  urban  farms  that  are  an  

extension  of  our  4  acre  farm  on  the    Campus  of  Life.    

1.  Design  garden  plan  for  each  site  2.  Clear  space,  install  irriga8on,  compost,  build  growing  

beds,  plant  crops  (some  transplanted  from  Campus  of  Life)  

3.  Prepare  garden  business  plan  to  track  garden  assets  4.  Secure  donors/gixs  in  kind  5.  Annual  plan8ng  plan  6.  Track  investments  and                            yields  produced  7.        Garden  Management  plan  8.        Marke8ng  Plan  

TERI  Urban  Farms    To  generate  organic  produce  to  feed  

 residents  and  staff  •  Healthy  menus  (view  at  

hap://www.teriinc.org/programs-­‐and-­‐services/culinary-­‐ins8tute.html  

•  500  pounds  lost  in  18  months  •  Serve  300  meals  a  day  •  CSA  (for  Staff)  

TERI  Urban  Farms  

 •  Cer8fica8on  in  organic  gardening  methods,  

gardening  assistant,  grounds  maintenance  through  Kilmer  College  

•  Par8cipa8on  through  Lifespan  Ins8tute  •  Microenterprise=Heirloom  

   produce  •  Farmer’s  market  •  Coopera8ves  

To  provide  lifespan  voca)onal  opportuni)es  to  individuals  with  au)sm  and  developmental  disabili)es  

                         

4/7/12  

4  

TERI  Urban  Farms  To  expand  revenue  base  to  become  sustainable  

       

Other  Markets  •  Local  Restaurants  •  CSA  •  Farmer’s  Markets  •  Health  Food  Stores  •  Contractors  •  Staff  and  Families  

 

Projected  Revenues  Per  Acre  Per  Year  Based  on  3  harvest  cycles  per  year  

Revenue  projec8ons  provided  by  expert  consultant      

   Gross  Per  Acre    Net  Per  Acre            $108,300            $45,763  

 

Impact  of  Urban  Farms  •  Economic:    Creates  jobs;  reduces  food  cost  •  Social:  Beaer  health/nutri8on;  increased  income;  employment;  food  security  all  within  household  

•  Energy  Efficiency  •  Quality  of  Food  •  Economy  of  Scale  

   Follow  our  WebLog  about  the  process  of  establishing  urban  farms  in  our  residences  at  www.teriinc.org  

Sustainability  Summary  •  Families  must  prepare  to  par8cipate  financially  in  the  development  and  ongoing  opera8on  of  programs  for  their  sons/daughters.  

•  Agencies  must  develop    revenue  producing  businesses    and  decrease  reliance  on    dona8ons,  grants,    government  funds.