InterestCurve Global Consulting

1. ORGANIZATION BACKGROUND. For over a century, ABC Hospital [name changed for privacy] has been a pioneer and an innovator in the field of helping those disadvantaged and disabled by disease or catastrophic injury. Our pioneering approach began with namesake Frank ABC. In 1907 he established a tent colony for people afflicted by tuberculosis (TB). Distinct from other TB centers, the ABC colony was not just about convalescence; it required patients to proactively care for themselves and participate in community activities. The Hospital has effectively changed missions twice after the prevalence of TB, and later Polio, ceased to be major community health problems. Beginning in the 1950’s the rehabilitation of patients with spinal cord injury (SCI) became our primary focus, with traumatic brain injury (TBI) added as a second specialty shortly thereafter. Throughout these changes, ABC Hospital has retained its approach to rehabilitation that empowers and educates patients and families to be self-sufficient. 2. GOALS. As one of the first rehabilitation hospitals in the U.S., ABC Hospital is the only freestanding facility in the country that focuses exclusively on SCI and TBI injuries – two of the most devastating and life-changing injuries one can experience. The goal of the Hospital is to be an international leader in the field by: § § § § § Fostering independence and encouraging peer support among patients and families; Developing a family atmosphere where caring for others is contagious; Providing each patient and family individualized care through teamwork; Educating others about all aspects of life with spinal cord or traumatic brain injury; and Making the process of rehabilitation fun for the patients, families and staff. 3. CURRENT PROGRAMS. The Hospital provides the following services: § § § § § Inpatient Care for Spinal Cord Injury (SCI) and Traumatic Brain Injury (TBI). Each year, approximately 500 patients receive comprehensive rehabilitative services. Outpatient Services for People Living with SCI and TBI. ABC Hospital helps over 1,400 outpatients annually with health maintenance, medical-surgical care, education, and preventive care. Patient & Family Housing. Outpatients and family members stay in a 47-suite patient and family housing building, where the first 30 days are free, and additional time is provided at a very low cost. Research. Our research department has worked with national and international partners for four decades to improve the health and quality of life for people living with SCI or TBI. Wellness. The PEAK Wellness Center provides patients and other members of the community who live with neurological impairments with the opportunity to use specialized exercise equipment under the care of trained professionals in order to gain enhanced health, strength and greater well-being. Since 1956, The Hospital has treated more than 29,000 people, including more spinal cord patients than any other facility in the world. The Hospital is designated as a Model System Center for both spinal cord and traumatic brain injury by the US Department of Education's National Institute of Disability and Rehabilitation Research. For 23 years, health care experts polled by US News & World Report have named ABC Hospital one of the Top Ten rehabilitation hospitals in the U.S. © 2010 Colorado State Common Grant Application Page 1 of 5 4. PROGRAM. The Community Reintegration (CR) program at The Hospital is an early intervention model that aims to help as many patients as possible with returning to and achieving success at work, school or community volunteer positions post-injury. Rationale. A permanent disability brought on by a catastrophic injury causes profound economic changes for injured individuals and their families. Beyond functional deficits, a spinal cord injury or traumatic brain injury depletes financial assets and places work and career paths on hold, causing further economic setbacks. Facilitating economic stability has always been a factor for ensuring that our graduates regain as much independence as possible. For these reasons, The Hospital's CR program was created and provides a vital service to many of our patients. Most people assume that individuals who are disabled by catastrophic injury can easily access vocational rehabilitation services, however the reality is that the majority of even our most highfunctioning patients would be unable to return to work without our CR program, instead depending on public benefits for the remainder of their lives. As most insurance carriers do not cover vocational assistance as a part of rehabilitation, 80% of our patients do not have coverage for this essential service. Thus, ABC Hospital needs increased community support in order to ensure that we can continue offering CR services that give newly disabled individuals the skills and opportunity to become economically self-sufficient again. Description. Typical public vocational rehabilitation services begin at a level that is too advanced and it does not offer the support needed for our patients to succeed. CR bridges this gap, preparing patients to be received by their local vocational rehabilitation program and continuing to work closely with a patient's case worker throughout job training and placement, ensuring that the specialized considerations for each patient's situation are being honored. The first step in the CR process begins with staff completing a work readiness assessment. Staff works one-on-one with patients to evaluate their potential to return to an employer or prepare for a new job. Frequently the team utilizes "workstations" within The Hospital, located in departments such as the business office or food service, and in establishments in the local community. At these stations, patients perform work duties so that CR staff can further examine their functional abilities and performance, determining next steps. After this initial step, and whenever possible, CR staff works toward reintegrating patients back into their former work environment because returning to work is most successful when people can retain the job they held prior to injury, capitalizing on pre-injury success and the social relationships from their prior employer. If retaining a previous job is not realistic, then CR staff work to assist patients to obtain new work or volunteer positions. Job Retention: When it is possible for a patient to return to the pre-injury workplace, staff members help patients to develop compensatory strategies. Worksite evaluations provide information on needed skills for the patient and needed workplace accommodations. State vocation rehabilitation counselors rely on The Hospital’s CR staff to assist in job retention and helping to secure external funding resources. Continuing education is given to the employer and job coaching is provided to patients to allow for a smooth transition and prevent future problems or termination. Also, preparing the client to return to work in the first year post-injury helps maintain a client's motivation and takes advantage of the person's past job performance and momentum. Our © 2010 Colorado State Common Grant Application Page 2 of 5 vocational therapists work with patients and employers to determine a pre-employment plan for each patient in the program. New Placement Preparation: When patients cannot return to a job after injury or were previously unemployed, preparations involve a client assessment and possible school or re-training. With these individuals, CR provides more individualized, situational work assessments, work adjustment services, career exploration, interest testing and assistance with returning or applying to a university or trade school. Potential employers with available positions are contacted and educated on the tax benefits of hiring a person with a disability. Sometimes assistance is provided with "job carving," which is when CR staff members help an employer modify job tasks so that a patient can be successful in a position. Patients who can meet demands of a given type of work are given assistance with the application and interview preparation. If a patient cannot secure a job, volunteer positions are identified to help them acquire skills and experience for future employment. Timeline. The Hospital’s CR Program is ongoing. The budgetary and evaluation timeline of the program follows the government fiscal year, beginning on October 1st of every year and ending on September 30th of the following year. 5. EVALUATION. The Hospital has a proactive approach to organizational evaluation. The Hospital is one of 14 SCI rehabilitation facilities and one of 16 TBI rehabilitation facilities to be involved in the National Institute on Disability and Rehabilitation Research’s (NIDRR) “model system” program. Under this program, model system centers provide comprehensive rehabilitation services to individuals with SCI and TBI as well as conduct research, including clinical research, on SCI and TBI related issues. The research and patient outcome data is submitted to and aggregated by NIDRR. Participating facilities can see how they compare to other facilities across the country on a variety of standardized measures. In this way, we are able to track patient outcomes and ensure that we continue to provide the best possible care to our patients. As well, each year we also complete a Comprehensive Annual Statistical and Program Outcome Report, which looks at both standardized measures and internal measures, including a section devoted entirely to outpatient outcomes and patient experience surveys. The Hospital has been a model center and thus has been measuring patient outcomes for many years, enabling us to compare patient outcomes and better assess how the changes to our services benefit patients. Measuring Program Impact. The success of The Hospital’s CR Program is measured by: 1. The percentage of patients who return to work or school. Of the 200 people that the program anticipates serving, staff will aim to help at least 40%, or 80 individuals, to return to a former or new employer.* 2. The percentage of patients who retain the job to which they have returned. Often, patients experience unexpected challenges during the initial months back at work. Community Reintegration staff strives to minimize the barriers a person will face by obtaining adaptive equipment, providing job coaching, educating employers and establishing realistic goals for employment. CR staff aim for at least 10% job retention for program alumni.* © 2010 Colorado State Common Grant Application Page 3 of 5 3. The number of businesses and community organizations providing training to patients. Community education with regard to employing people who live with a disability is a key component of the CR program. Staff tracks the number of employers that have received education and training in order to support a new or returning employee with a disability. Additionally, staff plans to add 1-2 new community workstations where patients can temporarily perform work in order to assess work readiness of a patient. Key Evaluation Results. Within a year of discharge, 40% of ABC patients return to school or work, far exceeding the rate at most rehabilitation facilities. Our CR program is one significant reason for this success because The Hospital is one of the only rehabilitation hospitals that offers this type of early intervention program. By having this program run by the hospital itself, our CR services can begin very early on in the rehabilitation process and will follow a patient long after their inpatient stay is over. Over 30 years ago, ABC Hospital developed the Community Reintegration program. During this time, The Hospital’s CR program has proven its success. For example, over the last five years, aggregated statistics from a federally funded network of state-of-the-art rehabilitation centers across the country have shown that The Hospital’s placement numbers are up to 20% higher than those of programs that serve similar populations. 6. COLLABORATION. CR staff works as needed with other community programs when a patient may benefit from their support. These include GED programs, workforce centers and specialized agencies, like Bayaud Industries. More recent collaborations have occurred with community businesses that serve as workstations or to help a patient acquire work experience. This past year, the department has developed relationships with Home Depot and a local nonprofit restaurant called Café 180. In previous years, the State Division of Vocational Rehabilitation (DVR) was the CR program’s most significant collaborative partner. Unfortunately, due to a budget crisis and furloughs, DVR is unable to fund or partner with The Hospital as closely as they have in the past. Although they will still have a role in providing case management services to ABC patients, their funding of The Hospital’s CR program has been reduced to less than 15% of its previous level for the year, and may continue to be reduced in the years ahead. Thus, The Hospital’s CR program is actively pursuing new partnerships, which may be able to provide funding opportunities as well as new community workstations for our rehabilitating clients. 7. INCLUSIVENESS. “Inclusiveness” at ABC Hospital focuses on including the people affected by any issue in the solution. This translates into including people with disabilities – specifically those with spinal cord and brain injury – into achieving goals. Graduates are important peer role models to newly injured patients and families. By involving them in all levels of the organization – board leadership, as well as a wide range of staff and volunteer positions – patients understand that people with disabilities are contributing and important members of the ABC community. Additionally, The Hospital’s HR department participates in diversity focused job fairs, advertises The Hospital’s employment opportunities in publications that focus on diverse candidates in the market place and adheres to an organization-wide Equal Employment Opportunity Commission (EEOC) policy. 8. BOARD/GOVERNANCE. The ABC Hospital Board of Directors sets and ensures the fulfillment of the Hospital’s mission, values and purpose. The Board of Directors of the ABC © 2010 Colorado State Common Grant Application Page 4 of 5 Hospital Foundation oversees the charitable fundraising activities required to facilitate the best care and outcomes possible for people affected by spinal cord or traumatic brain injury. Annually, a sub-set of Hospital Board members are appointed to serve on the Foundation Board of Directors, along with other community members whose only role is as a Foundation Board member. The Hospital term policy limits community members to serving a maximum of two three-year terms. The same benchmark applies to the Foundation Board. Hospital Board members who serve on the Foundation Board during their tenure can serve for terms of one, two or three years. One hundred percent of the Board members contribute financially to the organization. 9. VOLUNTEERS. ABC Hospital has approximately 180 active volunteers who work in all departments throughout the hospital, as well as additional community service volunteers who work to fulfill court requirements. Some volunteers work weekly. A variety of departments use volunteers including the cafeteria, gift shop, therapeutic recreation department, therapy pool or administration. Each active Hospital volunteer is required to make a minimum six-month commitment, however hours are determined by the volunteer position and department that needs their services. Former patients and family members have long comprised the core of The Hospital’s volunteer base. Recently, The Hospital has also revived a program that brings community volunteers into The Hospital on a monthly basis to cook and serve a free dinner to the patients and family members residing in our Patient and Family Housing facility. This has allowed us to create a new avenue for volunteers to become involved with The Hospital who are not able to make a full six month commitment to volunteering, and it is steadily widening our ability to increase awareness of The Hospital’s services beyond our alumni and family member volunteer base. 10. PLANNING. Planning is of particular importance to The Hospital’s staff and leadership to ensure that The Hospital is meeting the needs of increasing populations of SCI and TBI survivors. Each year, both the hospital and foundation boards and senior staff leadership meet to formulate or revise the organization’s strategic plan. Three years ago, these leaders identified the need to update and expand The Hospital’s facility in order to ensure that The Hospital will be able to keep pace with cutting-edge rehabilitation techniques. In addition, throughout this campaign the Foundation is also dedicated to keeping up with their prior commitment to fundraise for programs that are not covered by insurance – programs such as Therapeutic Recreation, Community Reintegration, Equipment for Quality of Life (EQL), the SCI Nurse Advice Line and many others. It is only with increasing philanthropic support from individuals and foundations that we will be able to meet our commitments in the coming years and ensure that The Hospital’s programs and campus can facilitate the highest levels of independence possible for our patients and graduates. *The injury type and level of the patients as well as pre-injury job types vary significantly from year to year. Each of these factors affects how possible it is for our patients to be able to successfully fulfill the employment positions they held before their injury or even be able to return to work. Thus, it is difficult for CR staff to accurately project how many alumni will be able to return to work or return to previous positions in a given year. These numbers reflect estimates based on averages from previous years. © 2010 Colorado State Common Grant Application Page 5 of 5