Why the confusion, King 5?

We often hear varying opinions about what the cost of care for people with intellectual disabilities really is.  This  should not be so difficult to figure out given that there are resources upon resources to use.  For some reason though, several of the resources which could give us the best information are not used.  This makes no sense to me unless the goal is to keep the public and legislators confused and to keep pretending that there is no real way to make a comparison of cost for community and institutional care.

In the most recent airing of “Last of the Institutions” by investigative reporter Susannah Frame of King 5 News, she did refer to the cost of care for one young man with high support needs.  He lives in a home supported by Alpha Supported Living.  Ms. Frame also interviewed Scott Livengood, CEO of Alpha Supported Living and referenced the “average” cost of care for those in dispersed community housing.  This young man’s daily care cost is $370.00 – far higher than the “average” cost reported to legislators and the public.

Using this “average” cost is a tactic that is used to hide the truth of the issue.  Those in DDA and the agencies know full well what the cost of care of each individual in a community setting is.  Each agency has negotiated with DDA the exact number of hours and supports that each of their clients will need.  It is no mystery.  Pretending that those with high support needs can be cared for at the “average” cost is nothing but a lie.

For instance, a couple of years ago I was given the daily rates for the cost of care of the 30 residents with the highest support needs and cost.  The daily range was $497 to $969 with an average direct care cost of $598.  If there was an “average” to use for the cost of care for residents in the shared community if they were to move to dispersed housing, this would be the average to use.  See this link for the chart with the costs and the support needs assessments of these clients. Highest 30 Residential Clients by Cost and acuity

I spoke with Russ Walker, Executive Producer for King 5 Investigators.  I brought up the issue of the dispersed community costs not including medical, dental, nursing care, prescription medications, and food – just to highlight a few cost centers.  Mr. Walker assured me that the costs did include these and they knew since Mr. Livengood had showed them the accounting for Alpha Supported Living. It’s interesting to note that the Certified Cost Report for Alpha Supported Living does not include these costs.  Certified Cost Report for Alpha Supported Living 2014

When looking at the actual data,  the calculations and cost accounts are very different than what is provided to our legislators and public.  When I have presented these differences to some legislators, Disability Rights Washington, the Developmental Disabilities Council and The Arc Chapters – the common response is refusal to communicate.    They have not been able to prove me wrong even when given the opportunity to do so.  I believe this means they are not able to prove me wrong.

Take a look for yourself and decide – what costs are missing from the community support side of the equation?  Do the costs add up as equal in your judgement and calculations?   Click the link for a table of the daily cost per resident.

Shared Community RHC and Alpha Supported Living Cost Comparison

I am using Alpha Supported Living as the example since this is the agency that Susannah Frame used in her investigation.  Alpha Supported Living is one of the better agencies yet the reimbursement from the state barely covers the cost.  Alpha has major fundraising campaigns to raise money to provide quality services to their residents.

Alpha Supported Living 990 2014

DDA Account Descriptions

It’s not Scientific Research – part 2

The Policy Report that Susanna Frame refers to as “scientific research” is not scientific research but a literature review looking at one aspect of life. The Policy Brief she shares is not a scientific research and the authors note that for those with severe intellectual disabilities with complex support needs there has been a huge gap in the research.

Promoting choice and person centered supports comes with an added responsibility to ensure that individuals and families are given the opportunity to have accurate information about the many complexities involved with their care.

While the deinstitutionalization movement started with great intentions – this movement has gotten out of hand without a grip on the reality of the situation.

Wolf Wolfensberger (1934-2011) was instrumental in the formulation of the concept of personal value and meaningful integration and inclusion of people with intellectual disabilities.

“Wolfensberger (2003) has indicated that the advent of the ideologies of radical individualism coupled with radical self-determination and the derivative constructs of ‘choice’, self-advocacy and empowerment has resulted in many people with ID being turned loose without any, or without sufficient, supports, guidance, tutelage or outright controls.  Wolfensberger singles out for particular criticism the kind of assertiveness training promoted by People First and other collective advocacy groups. “(Jackson, 2011)

There are several groups that are supported by public funds that partake in this radical advocacy movement.  They refuse to collaborate with others who are more holistic, take a strident tone and alienate those who may question their tactics or ideology.   The Arc, SAW (Self-Advocates Washington), SAIL (Self Advocates in Leadership), Parent to Parent, Washington State Parent Coalitions for Developmental Disabilities are several of these organizations which have become wedded to this radical agenda of black/white choices.

These groups are working with for-profit vendors to polarize advocates to “community” or “institutionalization” to the complete exclusion of true choice and alternatives.  The politicization of the research agenda which is dictated by external bodies is doing our citizens a great disservice.

This so-called “investigation” by Susannah Frame from King 5 plays right into this agenda.  It has been clear from the start of the biases and lack of research and facts.  The complexities of the issues have not been addressed nor has there been any information given as to why advocates may not agree with the “choice” that they are told is the “right” choice.   Many question the credibility and ethics of the authors of the reports and the so-called “scientific” research.

While it seems that community cost is less by the limited data that is provided, it is not really about cost – nor is it really about choice – it is about something else – it’s about an ideology that is going to lead to disaster if no one is allowed to question it.

Paradoxically, instead of being genuinely enabling, empowering and liberalizing, ideology is being deployed to support policies which benefit the for-profit vendors.  This is big business and many community vendors are making a large profit from the care of vulnerable people.

Scott Livengood, CEO of Alpha Supported Living, would be able to tell you that his company cannot accommodate many residents with the high support needs of Yusuf – the young man portrayed in the recent segment.

Alpha Supported Living does a great job of supporting Yusef and others but some of these agencies are not so well staffed or managed well.   Records indicate that Yusef’s daily personal care comes to about $370.00 a day – yes that is less expensive than the daily care rate at the RHC but what is missing from this information is the cost of all the other aspects of care – food, shelter, health care, transportation – just to highlight a few costs that can add up rather quickly.

Any Supported Living Provider will say that they cannot afford to care for people with this level of care with the low rate of reimbursement that they receive from our state.  The funding for this care comes from the Home and Community Based Service Waiver (HCBS) and each state has a different program for funding.

While it has been stated that Washington is decades behind – the facts show otherwise.  There are 12 states that do not have any large State-Operated ICFs but that does not mean that they do no not have private ICFs or nursing homes or utilize those services from an ICF in another state.  In order to move people from the ICF to a dispersed community setting, it would be critical to know what the resources are in the community and if there is funding available to provide the specialized services and to sustain them.

The chart below has data taken from The State of the States (the same resource that Susannah Frame used for her information).  One can see that every state has some residents in an ICF/ID or nursing home.  It is also important to note the HCBS per capita spending for those who live in dispersed community settings.  The states with fewer people in larger facilities spend much more per capita on the HCBS waivers.

Washington, with a HCBS cost of $87.00 is below the national average of $129.00.  Those states with no large state-operated facilities spend an average of $175.00 per capita on HCBS waivers.  This care also comes with a cost. It needs to be noted that the HCBS costs do not include cost of living expenses such as rent, food, medical care which are all included in the ICF/ID costs.

If this was all about cost we would not be having these discussions.

Data taken from “The State of the States in Developmental Disabilities” Fiscal Year 2013 and Centers for Medicaid and Medicare Home and Community Based Spending FY 2013

Graph sorted by percent of ID residents in /ID and Nursing Facilities

HCBS spending per capita and ID residents 2013

 

Graph sorted by State spending on HCBS waivers FY 2013

HCBS spending with ID Residents

 

King 5 “Last of the Institutions” Part 4

 

Resources used:

 

Ailey, Sarah H., et al. “Factors related to complications among adult patients with intellectual disabilities hospitalized at an academic medical center.” Intellectual And Developmental Disabilities 53, no. 2 (April 2015): 114-119.

Arnold, Samuel R. C., Vivienne C. Riches, and Roger J. Stancliffe. 2014. “I-CAN: The Classification and Prediction of Support Needs.” Journal Of Applied Research In Intellectual Disabilities 27, no. 2: 97.

Bershadsky, Julie, Sarah Taub, Joshua Engler, Charles R. Moseley, K. Charlie Lakin, Roger J. Stancliffe, Sheryl Larson, Renata Ticha, Caitlin Bailey, and Valerie Bradley. 2012. “Place of Residence and Preventive Health Care for Intellectual and Developmental Disabilities Services Recipients in 20 States.” Public Health Reports 127, no. 5: 475-485

Bigby, Christine. “Known well by no-one: Trends in the informal social networks of middle-aged and older people with intellectual disability five years after moving to the community.” Journal Of Intellectual & Developmental Disability 33, no. 2 (June 2008): 148-157.

Centers for Medicaid and Medicare, 2015. Medicaid Expenditures for Long-Term Services and Supports (LTSS) in FY 2013: Home and Community-Based Services were a Majority of LTSS Spending June 30, 2015, s.l.: Centers for Medicaid and Medicare.

Cooper, Sally-Ann, et al. “Multiple physical and mental health comorbidity in adults with intellectual disabilities: population-based cross-sectional analysis.” BMC Family Practice 16, no. 1 (August 2015): 1.

Erickson S, LeRoy B. Health literacy and medication administration performance by caregivers of adults with developmental disabilities. Journal Of The American Pharmacists Association: Japha [serial online]. March 2015;55(2):169

Felce, David. “Costs, Quality And Staffing In Services For People With Severe Learning Disabilities.” Journal Of Mental Health 3.4 (1994): 495-506.

Friedman, Carli, Amie Lulinski, and Mary C. Rizzolo. “Mental/behavioral health services: Medicaid home and community-based services 1915(c) waiver allocation for people with intellectual and developmental disabilities.” Intellectual And Developmental Disabilities 53, no. 4 (August 2015): 257-270.

Hamden, AnnNewton, RichardMcCauley-Elsom, KayCross, Wendy. “Is Deinstitutionalization Working In Our Community?.” International Journal Of Mental Health Nursing 20.4 (2011): 274-283.

Hamelin, Jeffery P., et al. “Meta-Analysis Of Deinstitutionalisation Adaptive Behaviour Outcomes: Research And Clinical Implications.” Journal Of Intellectual And Developmental Disability 36.1 (2011): 61-72.

Hewitt, Amy. “Presidential Address, 2014—Embracing complexity: Community inclusion, participation, and citizenship.” Intellectual And Developmental Disabilities 52, no. 6 (December 2014): 475-495.

Jackson, R. “Invited review: Challenges of residential and community care: ‘the times they are a‐changin’.” Journal Of Intellectual Disability Research 55, no. 9 (September 2011): 933-944.

Kelly, Susan, and Yani Su. “Psychotropic and anticonvulsant medication: Individuals with intellectual and developmental disabilities who transitioned to the community from an institution.” Intellectual And Developmental Disabilities 53, no. 4 (August 2015): 289-300.

Lakin K, Prouty R, Polister B, Coucouvanis K. Data Briefs: Change in Residential Placements for Persons with Intellectual and Developmental Disabilities in the USA in the Last Two Decades. Journal Of Intellectual And Developmental Disability [serial online]. June 1, 2003;28(2):205-10.

Larson S, Lakin C, Hill S. Behavioral Outcomes of Moving From Institutional to Community Living for People With Intellectual and Developmental Disabilities: U.S. Studies From 1977 to 2010. Research & Practice For Persons With Severe Disabilities [serial online]. Winter2012 2012;37(4):235-246.

Luckasson, Ruth, and Robert L. Schalock. “Standards to guide the use of clinical judgment in the field of intellectual disability.” Intellectual And Developmental Disabilities 53, no. 3 (June 2015): 240-251.PsycINFO, EBSCOhost (accessed November 28, 2015).

Mansell, Jim, and Julie Beadle-Brown. “Deinstitutionalisation and community living: Position statement of the Comparative Policy and Practice Special Interest Research Group of the International Association for the Scientific Study of Intellectual Disabilities.” Journal Of Intellectual Disability Research 54, no. 2 (February 2010): 104-112

Martinez-Leal, R., et al. “The Impact Of Living Arrangements And Deinstitutionalisation In The Health Status Of Persons With Intellectual Disability In Europe.” Journal Of Intellectual Disability Research 55.9 (2011): 858-872

Nøttestad, Jim Aa., and O. M. Linaker. “Psychotropic Drug Use Among People With Intellectual Disability Before And After Deinstitutionalization.” Journal Of Intellectual Disability Research 47.6 (2003): 464-471.  2015.

Snell, Martha E., et al. “Characteristics and needs of people with intellectual disability who have higher IQs.” Intellectual And Developmental Disabilities 47, no. 3 (June 2009): 220-233.

Stancliffe, Roger J, Eric Emerson, and K Charlie Lakin. “Community living and people with intellectual disability: Introduction to Part I.” Journal Of Intellectual & Developmental Disability 25, no. 4 (December 2000): 1-4.

Stancliffe, Roger J, and Sian Keane. “Outcomes And Costs Of Community Living: A Matched Comparison Of Group Homes And Semi-Independent Living.” Journal Of Intellectual & Developmental Disability25.4 (2000): 281-305.

Swenson S, Lakin C. A wicked problem: Can governments be fair to families living with disabilities?. Family Relations: An Interdisciplinary Journal Of Applied Family Studies [serial online]. February 2014;63(1):185-191

Ticha R, Hewitt A, Nord D, Larson S. System and Individual Outcomes and Their Predictors in Services and Support for People With IDD. Intellectual And Developmental Disabilities [serial on the Internet]. (2013), [cited November 27, 2015]; 51(5): 298-315.

It’s not science!

This post will provide some additional information to help clarify some of the mis-information that is being reported by Susannah Frame in her “Last of the Institutions” series on King 5 in Seattle, WA

  • The reports referenced by Susannah Frame are not “scientific research” but social research with many variables that cannot be generalized. The Policy Brief she shares is not a scientific research and the authors note that for those with severe ID with complex support needs, there has been a huge gap in the research.

From Charlie Lakin Research Article: (Susannah refers him as one of the countries foremost researchers)
“The higher level of support needed by people with more severe disabilities provides a greater challenge in assisting them to live in personal housing. The per-person cost of providing paid supports is one important such challenge.”


“They concluded that no economies of scale could be established in the existing research, except in very small residential settings, in which the decreased number of people in the home necessitated an increased staffing ratio. The critical point is reached at which there is a need for one staff member at all times, so that if the number of people in the home further decreased, the ratio of staff to residents necessarily increases. Unless nonpaid or differently paid supports are introduced, the per-person cost of support increases. ‘‘Such diseconomies of very small scale apply only in residential services when the service model or the residents’ support needs require continuous paid staff presence’’ [Lakin and Stancliffe, 2005, p. 324]. This is most often the case for persons with severe disabilities.


Lakin, K., & Roger, S. (2007). Residential Supports for Persons with Intellectual and Developmental Disabilities. Mental Retardation and Developmental Disabilities Research News, 151-159.

  • Susanna Frame reports that Washington is decades behind other states yet the most recent data (which she has also looked at and referenced) shows a different story:This is what Susannah Frame says” Washington state has a larger population of developmentally disabled adults living in state-run institutions than nearly every other state in the union.” Look at the data – I don’t see how Susannah Frame came to her conclusion – someone must have just told her that and she believed it.

    Data taken from “The State of the States in Developmental Disabilities” Fiscal Year 2013
    http://www.stateofthestates.org/…/intell…/state-profiles

Percent of IDD in state ICF ID and Nursing facilitiesPercent of IDD in private ICF ID and other facilities

Scott Livengood, CEO of the supported living agency Alpha Supported Living, weighs in with his comments about the cost of care.  Mr. Livengood knows full well what the cost of care for people with complex, high support needs are.  His agency needs to negotiate with DDA for hours to ensure that the residents have the support needs.  He also knows that those with higher support needs require more personal care and their care is more expensive.

I do not understand the extreme reaction that Mr. Livengood had with regards to maintaining safe building structures for those at the RHC.  One of the reasons that the costs are so high now is that the state has allowed the buildings to dilapidate and go into dis-repair.  Is it wrong to provide safe living conditions?  It is time that some efforts were put forth to maintain the residences.

And just like union workers at the RHC who have jobs and make a meager living, Mr. Livengood’s job is also tied to caring for this population.  One major difference is he has a hefty salary with annual bonuses and has had raises of 12 and 10 percent in the years 2012 and 2013.  His 2013 reported base salary (IRS Form 990) was $248,950 with bonuses and benefits bringing his full earnings to over $290,000.

This post refers to the King 5 Series “Last of the Institutions

 

“Last of the Institutions” – part 3

“Last of the Institutions” – Part 3 will air tomorrow (Wednesday, November 18, 2015) on King 5 in Seattle.  Susannah Frame, the investigator on this story has promised this segment will have the stories and view points of families, guardians, professionals and community members who support a full continuum of care for our most vulnerable.

I have been hard on Susannah Frame for the impressions that she has given with regards these issues.  I am hard on her since she has been given some information that contradicts much of what she has reported yet has not addressed the issues.  I thought that was what an investigation was intended to do and maybe I’m just impatient.

From my perspective and the perspective of many advocates for people with intellectual and developmental disabilities, Susannah Frame has only regurgitated the rhetoric we have heard for years without looking into why advocates claim the reports (which she terms “scientific research”) are misinterpreted and fall very short of addressing the diversity of the population.

Yes, it is true that MOST people with intellectual/developmental disabilities can live in small community homes and settings but we are not talking about MOST in this situation.  We are talking about those who have the very highest support needs and we are talking about safe, appropriate and integrative care.

It is also true that there are some people with these extremely high support needs who do live in small community family homes and settings.  No one disputes that fact either.

What we need to understand is that for these people who have extremely high support needs, their care is expensive – no matter where they live.  In fact, the cost of their daily personal care alone in a small community home is greater than full, comprehensive care in a therapeutic community.

We only have so many resources to go around and share with a diverse population.  What is disturbing to me is this so-called advocacy that wants to evict people from their homes only to push them into another community that will not be able to accommodate their needs.  This will then create a much larger crisis for those on the other end of the spectrum who only need a little support – they will go without.  Is this advocacy?

 

 

 

 

Is Washington State “decades” behind the times?

This has been an interesting week for TV Investigations into issues of care for our citizens with Intellectual Disabilities.

One deserves to be heard and is a real investigation into real and current issues of abuse and death of an innocent man who happened to live with an intellectual disability.  Well, the other report, is not really an investigation – at least not yet – but looking into what happened in the institutions over 40 years ago with video of the horrible conditions in bygone years.

Kudos to Tracy Vedder from KOMO News for her investigation into the death of Jessy  Hamilton and the total mistreatment of him while under the care of the court system.  Jessy’s death is a tragedy and could have been prevented if the judge, lawyer, Cetralia Police Department and the Developmental Disabilities Administration were capable of doing their jobs.

lhttp://www.komonews.com/news/investigations/AutismDeath.html

On another station, Susannah Frame of King 5 News has started her investigation series titled “The Last of the Institutions” with this video.

http://www.king5.com/story/news/local/investigations/2015/11/03/washington-state-developmentally-disabled-residential-habilitation-center/75065984/

Unfortunately, the information that Ms. Frame has shared is decades behind and not factual.  She has gathered her information from biased reports and has chosen to use video which does not depict our state’s therapeutic communities as they are today.  She has chosen to show one campus from a back gate separating the campus from a neighboring park – the only fence she could find on the campus.  When questioned about this blatant misrepresentation of what the campus looked like she wrote “it was the only public space they could find”.  Ms. Frame ought to know better – the campus itself is public property – no gates or fences – she could very well have chosen a setting to show what the campus actually looked like.

Washington STate DSHS did make a clarification of this shot on a comment on the King 5 Website:

DSHS Clarification of Fircrest Video by Susannah Frame

Ms. Frame states that there will be more coming in which she will delve into the various issues more thoroughly.  My hope is that she has facts – not just wishful thinking.

I will be following the “investigation” closely and adding comments here and on King 5 Facebook and website.  I will provide facts and resources.

The issue is not “community” vs “institution” but about how are state can provide quality care to those who need it bases on their support needs and their choice.

We are way ahead of other states but we do need to have better quality of care, better oversight in the community, better pay for caregivers and better training and support.  Continuing to keep the “community” vs “institution” issue as a focus will only detract from what we really need to look at and investigate.  This is irresponsible reporting.

It’s a Wonderful Lie

WA Action Alert

 

Once again, The ARC – Washington State has issued an Action Alert to advocates with inaccurate and unfounded information.  Is this another attempt to rile up advocates for those who have intellectual or developmental disabilities to go against one another rather than working together for the good of the whole? It is a wonderful lie, but it’s a lie.  That is not wonderful – it’s deceptive and harmful.

Please see this link for accurate information from both the Office of Financial Management and Memo from DDA Asst Secretary Perez re 2014 Proposed Supp Budget.  It is clear from both these documents that The ARC-Washington State is misleading our citizens.  I have written to both Sue Elliott, Executive Director and Diana Stadden, Policy and Advocacy Coordinator to indicate the source of their information for the extremely misleading Action Alert.  They have not been able to produce any evidence to support their claim.

 

Alert

Below is the text of The ARC – Washington State Action Alert

Arc action Alert for posting

Comparing the misleading information above which was sent out in a media blitz on December 19, 2013, the real information is below:

In light of these facts, Governor Inslee is proposing modest adjustments to the 2013 Supplemental Budget.  There is a very slight .7% overall increase in the DDA budget to meet these changes, which include:

  • An expansion of eligibility to Medicaid to individuals between the ages of 19 and 64, with income below 138% of the federal poverty level;
  • Funding for full time staff to perform preadmission screening, resident review, and specialized services (when needed) to Nursing Home clients in the Residential Habilitation Centers.
  • Reimbursement for developmental and autism screening will be added to the Medicaid plan to assure that children with developmental delays are identified as soon as possible.
  • Hiring of additional Residential and Community Services investigators of supported living providers in order to improve the timeliness of investigations, which will be funded through a certification fee.
  • The Vulnerable Adults Incident Tracking system (TIVA) which will be  funded through the Roads to Community Living grant.
  • Development of the Community First Choice option Medicaid waiver which would result in the state receiving an additional 6% federal match for services provided to individuals with developmental disabilities and the elderly.  The savings could be re-invested in additional client services.
  • Capital Budget—Funding added to the Capital budget to make infrastructure repairs at Lakeland Village and Fircrest School.

It certainly appears to me that there is support from our Governor to ALL people with intellectual and developmental disabilities – from the young children to the elderly, from those at home to those in supported communities.

Please, encourage The ARC chapters to support a continuum of care, support ALL people with ID/DD and do not pit advocates against each other by spreading false information.  In order to improve the situation, we need to work TOGETHER!

Please do write, call, email, fax Governor Inslee to indicate your support for working together for the benefit of ALL

Call the Governor’s office at (360) 902-4111

Send an email to the Governor at https://fortress.wa.gov/es/governor/

Post a response on Governor Inslee’s Facebook page at https://www.facebook.com/WaStateGov

(You must have a Facebook account. Be sure to tag your legislators.)

Send a tweet (text message of 140 characters or less) to Governor Inslee’s Twitter at https://twitter.com/govinslee

College In Residence Volunteer Program

This program has been very successful and I believe it would be a wonderful enhancement to our other Residential Habilitation Center Campus.  We certainly have the space for college students to live – why not put it to good use and give these students an educational opportunity which will also enhance the quality of life of our residents?

I love this idea and believe it could be part of a healthcare professional’s training to spend at least a quarter doing this.  We need to pursue this opportunity.

Contact: John Wiley, (509) 363-4797, john.wiley@dshs.wa.gov
Contact: Thomas Shapley, (360) 902-8007, thomas.shapley@dshs.wa.gov
August 26, 2010
Student volunteer program at Lakeland Village has served developmentally disabled residents for 40 years

SPOKANE – For the past 40 years, students at Eastern Washington University and other area colleges have formed a unique bond with Lakeland Village through the College in Residence Volunteer program, or CIRV.

CIRV is pronounced “serve,” and the volunteers help staff with the hundreds of daily chores a residential habilitation center requires.

The program, which started in 1970, provides an apartment and board at nominal cost in former staff quarters to about 40 students. In exchange, the students each volunteer 15 hours a week on the Lakeland Village campus, just across the street.

Recently, administrators from the Department of Social and Health Services Division of Developmental Disabilities presented plaques to EWU officials recognizing the Cheney School’s contributions to the program over the decades. Current and past CIRV volunteers also were recognized.

The majority of CIRV students attend EWU, but the program also has been home to students from Whitworth University, the Community Colleges of Spokane, Gonzaga University and even Apollo College.

Ronni Coleman, entering her senior year at EWU, is a CIRV who lives in one of the two-bedroom apartments while pursuing a degree in radiology. Coleman said volunteers frequently provide “another pair of eyes” and interact with clients, freeing Lakeland Village staffers for other duties.

“They’re the neatest people to work with,” she said of the cottage residents. “The more you get to know them, the more you know what you can do.”

“People like Ronni bring youth and lots of energy to our clients,” said Leroy LeMaster, CIRV program coordinator. “I think the kids learn a lot about themselves. And when these kids leave here, they become spokespeople for Developmental Disabilities.”

Without the volunteers, Lakeland Village residents might not be able to participate in popular programs such as Special Olympics, recreational dances and movie nights, LeMaster said.

Lakeland Village, opened in 1915 in a rural area near Medical Lake, is one of five Department of Social and Health Services residential habilitation centers that provide training, work skills, programs, supportive living and around-the-clock care for eligible clients under the state’s Division of Developmental Disabilities, within the Department’s Aging and Disability Services Administration. The centers also provide short-term respite stays for eligible community members.

The CIRV program offers students a real-life opportunity to “test the waters” in a potential career, such as recreational, physical, or speech therapy.

“It was a good experience. I loved it,” Nora McKinney said of her two quarters in CIRV. “The CIRV students would carpool to save money. You do what you can to get through college.”

McKinney, now a Lakeland Village habilitation plan administrator, joined the CIRV program as a therapeutic recreation major in the early 1970s at the start of her career. In September, she will celebrate 35 years with DSHS, all of them at Lakeland Village.

Sharlene Gentry wanted to be a teacher when she transferred to EWU from North Idaho College in 1980. “I didn’t know I wanted to get into Developmental Disabilities,” she said. “CIRV was my way to go to college in Washington from Idaho. It helped me to be able to pay the bills.”

She eventually got her teaching degree and worked in public schools for a bit, but later returned to teach at Interlake School before it closed, later becoming a habilitation plan manager at Lakeland Village.

She’s now a supervisor at the Division of Developmental Disability Region 1 headquarters in Spokane. If not for two years spent in CIRV housing and the volunteer work that went with it, her path might have been much different, Gentry said.

“CIRV determined the course of my career,” she said. “The Lakeland Village staff was very welcoming and friendly, she said, “So much so that I often spent more than 15 hours a week there because I enjoyed the persons with disabilities who lived there as well.” Gentry said one of her cherished memories of Lakeland Village is of helping a 22-year-old woman learn to tie shoelaces.

“We sat down night after night” to practice the skill, she said. “Finally, she was able to tie her shoes. To a lot of people, that doesn’t mean a thing, but for her, it meant a lot.”

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