Feature Issue on Crisis Management for People with Intellectual, Developmental, and Other Disabilities

Prior to the COVID-19 pandemic, Ardmore Enterprises had been working on transforming its day program and employment service models that support people with intellectual and developmental disabilities (IDD).  These transformation efforts included investing in training for staff and leadership, closing a sheltered workshop, and shifting focus to supporting competitive jobs and integrated, community-based options.     

Those transformation efforts were interrupted when Ardmore found itself having to abruptly close in-person, facility-based service delivery in March of 2020.  Emergency provisions in federal and state funding allowed us to offer telehealth and virtual supports, strategic in-person job coaching, and small-group community participation. In addition, family members became staff members to support people with IDD in their own homes.

Virtual 

Virtual supports were new to Ardmore, so staff, families, and leadership had to work together to quickly assess who wanted this type of support and what equipment would be needed. People who had the necessary equipment began to connect daily with staff to engage in exercise, music, cooking, virtual tours, self-advocacy, and small group discussions, and other activities. This immediately provided a way to keep people connected and engaged during a time of uncertainty, and minimized the risk of social isolation.

Employment  

Shortly after the pandemic began, many of the people Ardmore had supported to gain competitive, integrated employment were furloughed, let go from their jobs, or stopped working due to safety concerns. There are some people who have remained employed as essential workers, however. This happened through strong support from their employers, use of personal protective equipment, other safety protocols, and continued in-person job supports.

For people who lost their employment, or were in the midst of a job search prior to the pandemic, Ardmore’s employment team has continued engagement by helping people to stay in touch with their employers and participate weekly in Job Club, a virtual experience designed to maintain and strengthen employment skills that has been a lifeline for isolated families. People also receive telehealth supports and are offered virtual non-work activities. 

One person was scheduled to begin working at a restaurant in Maryland the same week the lockdown began there. The day before his first day on the job, he was notified the restaurant would be closing due to the pandemic and he no longer had a job. The disappointment was immense, but he continued to participate virtually in Job Club. His mother, who supports him to fully engage in the activities, shared her thoughts in a letter:

“Since we are all isolated from each other right now, we look forward to Job Club because we know we will see our friends and learn something new each time,” she wrote. “These weekly meetings where we see each other and can talk, learn, and have fun together mean so much to us.”

Future Model  

Once it became clear that the public health emergency would be lasting longer than previously thought, we began taking a closer look at what service delivery could or should look like in the future. It became clear that use of technology and virtual supports, as well as flexibility and small-group supports were going to be critical. Ultimately, the decision was made to begin the process of selling the building and re-envision what day services would look like post-COVID.

We are now assessing what will need to be in place to support people in integrated community settings, without the use of a provider owned and operated site.

Staff and leadership are engaged in learning and training initiatives that focus on employment outcomes, use of person-centered planning tools and teaching strategies. Our priorities are:

• Supporting competitive employment outcomes  
• Community exploration and building connections  
• Employment exploration, time-limited internships, and soft-skill building 
• Learning and maintaining skills of daily living  
• Expanding social roles and experiences  
• Learning and encouraging self-advocacy  
• Skill-building, including: travel training, money management etc.    
• Day supports when a person is not working 
• Activities of retirement for older adults 

Ardmore also receives technical assistance from subject-matter experts with the Institute for Community Inclusion, with a focus on increasing employment outcomes and community-based supports. This assistance is helping us focus on identifying what organizational systems, structures, and resources need to be adjusted to support this new business model long term.  All levels of the organization are part of the process, which helps provide internal continuity and collaboration.  

Challenges  

Changing both a business and service-delivery model in the best of times is challenging. Doing the same during a public health crisis adds additional challenges.  There are a lot of uncertainties that make planning for future service delivery difficult, including an unknown timeline for when it will be safe to spend full days in the community. What type of technology will we need to provide flexible services on a long-term basis and how can we best support our front-line staff? Will long-term funding support these changing service delivery models?

In the face of these uncertainties, we remain focused on providing transparent communication and planning with people, families, coordinators of community services, staff, and our funding sources. The organization is committed to learning and working together to create a path forward, both in the current crisis and beyond. 

Related Content