SEEC Fading Supports

Jennifer Sulewski

Background

SEEC (Seeking Equality, Empowerment, and Community) is a Maryland-based provider of employment, community living, and community development supports to people with intellectual and developmental disabilities (IDD). Originally established in 1987, SEEC started converting from facility-based to exclusively community-based supports in 2005, and closed down its center-based program completely in 2009. Currently all of SEEC’s supports are individualized and community-based, in keeping with the organization’s mission “to support people with intellectual and developmental disabilities to direct their lives with dignity, choice, authority, and responsibility.” SEEC provides supports to over 200 people with IDD throughout Montgomery County and the District of Columbia.

Like many providers of individualized supports, SEEC has had to find creative ways to individualize supports even though its funding structures do not support 1:1 staffing. One way they do this is by deliberately building both human capital (community living skills) and social capital (relationships in the community). As skills and relationships are built, paid supports can be faded, thus making more efficient use of resources in the longer term.

Implementation

SEEC uses two strategies to enable fading. The first is building human capital or skills to reduce support needs. This may require an up-front investment of more intensive supports, as described by executive director Karen Lee: “If there’s somebody who we believe will be able to do a part of their day without any support, we will put one to one support to give them the training they need to get there. So [for example] travel training is done one to one.” By finding the resources to invest in this 1:1 training for a limited time, the overall need for staff support is reduced, providing more freedom to develop an individualized day for the individual.

The second strategy is to build connections in the community, so that “their community that they’re now a part of begins to embrace them and play that role that staff often has done.” Community members, such as instructors or fellow participants in a class or club, are often happy to serve as natural supports, in the same way a supervisor or coworker may provide natural supports on the job. If the relationship is deliberately set up, the natural support can also have a contact to call at SEEC if there is a problem. This strategy enables a shift in mindset from focusing on how independent the individual is capable of being to “creating an intentional community around somebody.”

Impact

Most people supported by SEEC still require at least some level of staff support. Of the 90 people receiving Community Life Engagement supports from SEEC, only about 10% go through their whole day without staff involvement. However, staff supports can be tailored to individual support needs, changing throughout the week as needed by the individual. Natural supports enable staggering of staff supports. For example, let’s say that José and Bianca are both receiving CLE supports from SEEC. A staff member might drop José off at a job or activity where he doesn’t need support, and go to the gym with Bianca at the same time.

The success of this strategy is best exemplified in individual success stories, such as these two examples:

Success Story #1: LA Fitness

For Joe, the closure of SEEC’s facility-based program gave him a chance to re-think the structure of his days. Previously, Joe had spent his days in and out of the center, doing some community-based work and other activities, and spending some time at the center. During this time he was almost always with a staff member.

After the center closed, Joe was supported to create a more individualized, more independent structure to his days. Support staff helped him to join a local LA Fitness center and connect with a trainer there. They trained him how to access the fitness center on his own, and how to use public transportation to get there from his home.

Now Joe takes the bus to the fitness center on his own, goes swimming, exercises, and then walks to a pizza shop for lunch. In the afternoons he goes to work or volunteers at a local food pantry. As described by Karen Lee, Joe “no longer is with groups ever. He’s always just kind of got his daily schedule worked out.”

In addition to being more independent, Joe has developed relationships with community members at his job and volunteer job. He “has a real presence in the community as well as a job that all resulted from him not being in a segregated center doing his fitness or going to a separate class, a disability aerobics class or something like that, but from being a part of his community.”

Success Story #2: Chess Club

Mike’s support staff thought he might enjoy learning chess. The staff found a local chess club and went with him to the chess club for a few weeks to get him started. They also provided him travel training on how to get there on his own.

Once Mike had started to learn the routine, was comfortable with the culture of the chess club, and knew how to get there on his own, staff pulled back from attending regularly with him. At the same time, they established contacts at the rec center that hosted the club. Mike’s support staff opened a line of communication so the rec center staff would know who to call at SEEC if there were a problem or if Mike didn’t arrive at his usual time.

“We made sure the people at the rec center knew who to call if he doesn’t show up or if there was a problem. We also had to create a nearby back up staff to call if something did happen. So this process takes a lot of steps to ensure it is set up correctly.”

Now Mike participates regularly in the chess club on his own, with limited need for staff support.

Suggestions for Replication

• Commit to providing exclusively community-based supports. Closing its facility-based day program and selling the building was an important turning point for SEEC. It forced staff to think creatively about how to build individual lives fully in the community, without relying on the center as a fallback or base of operations. The additional resources used to support a building now support things like technology and increased staff supports.

• Deliberately build relationships in the community. On the individual level, this involves creating ongoing opportunities for interaction, such as Joe’s regular schedule at the fitness center or Mike’s consistent participation in the chess club. On the organizational level, SEEC also builds relationships with community resources such as local recreation centers, art centers, and community colleges. Based on these relationships, people at these community resources are comfortable supporting individuals and contacting SEEC if there is a problem.

• Always start with one person at a time. This strategy requires a change in mindset from thinking of staffing as a fixed ratio or groups. An individual’s support needs are unique and can change with time as new skills are built and relationships formed.

• Invest up front in order to fade in the long term. An initial investment in setting up a good situation can pay off in the ability to fade supports and reallocate those resources to the next person. This enables each person to have a more individualized schedule, even without ongoing 1:1 supports.

For more information

Jennifer Sulewski, [e-mail]

Karen Lee, [e-mail]

SEEC website: http://www.seeconline.org/