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ADVANCING A RESEARCH AGENDA FOR ICF10th North American Collaborating Center Conference on ICF
June 1 to 4, 2004
An ICF based Tool to Identify Services and Supports Needs for Inmates with Developmental DisabilitiesS. Antonio Ruiz-Quintanilla,
S. Bruyère, T. Golden, and C. Blessing
Employment and Disability Institute
Cornell University
Ruiz-Quintanilla, EDI, Cornell University 2
The Project
Integrating Person-Centered Planning Practices into Program Development, Rehabilitation Treatment and Release Planning for Inmates with Developmental Disabilities.
Ruiz-Quintanilla, EDI, Cornell University 3
Project Goals
Enhance the current classification and evaluation system for inmates with special needs
Refine and enhance services to inmates with developmental disabilities
Improve the rehabilitation treatment process
Integrate treatment and release planning
Better prepare this group for integrated community living, learning and employment upon release.
Ruiz-Quintanilla, EDI, Cornell University 4
Outcome: Classification System
Enhance the State of New York Department of Correctional Services’ (NYDOC) system of classification and evaluation of offenders with developmental disabilities
To increase the breadth and depth of information that is gathered and used for identifying services and supports that inmates with developmental disabilities will receive during their incarceration.
Ruiz-Quintanilla, EDI, Cornell University 5
Outcome: Person Centered Planning
Introduce Special Needs Units (SNUs) staff to person-centered planning and support approaches
To refine and enhance services to inmates with developmental disabilities during their incarceration in the SNUs.
Ruiz-Quintanilla, EDI, Cornell University 6
The Project Partners
New York State Department of Correctional Services
New York State Division of Parole
New York State Developmental Disabilities Planning Council
Mental health service providers
Community providers
Volunteers
Employment and Disability Institute (EDI), Cornell University
Ruiz-Quintanilla, EDI, Cornell University 7
Person-Centered Planning
Person-centered planning is a collection of methods and resources that enable a person to choose their own paths to success. The tools of person-centered planning help to…
understand the interests and desired life conditions of the person who is at the focus of the planning process
discover the inherent gifts and capacities of the person
explore the connection between a person’s interests and capacities and opportunities within the community
facilitate transition planning and increase the probability of finding value and success as a community member
Ruiz-Quintanilla, EDI, Cornell University 8
Research Data
SYSTEM DATA
To evaluate the outcomes of the intervention, we identified data elements from the current NYDOC and NYDOP data systems which can be used to monitor ongoing processes and help establish measures of success and benchmarks.
QUESTIONNAIRE DATA
A questionnaire will be used to collect additional information from security officers, treatment staff, service providers, community providers, parole personnel, and other collaborating partners.
Ruiz-Quintanilla, EDI, Cornell University 9
Research and Evaluation Design
OVER TIME
A pre- and post-data design will be applied to compare SNU units among each other and across time.
ACROSS SNUs
Comparison among the SNU units will be used to estimate effects of characteristics like security level, or other organizational and cultural aspects of the facilities.
MATCHED SAMPLES CONTROL
A comparison of SNU data with matched samples from the general population of inmates (GPOP) (control group) allows the estimation of the influence of time, as well as the influence ofother factors/variables proven to predict successful reintegration into the community (such as age, education, time in custody, family relations, region of residence).
Ruiz-Quintanilla, EDI, Cornell University 10
Research Design
T1
SNU 1
SNU 2
SNU 3
GPOP 1
GPOP 2
GPOP 3
Ti+1 TnTi+2
IntervDk,1
Interv
Interv
Dk, Dk,i+1 Dk,n
Dk,1 Dk,i Dk,i+1 Dk,n
Dk,1Dk,i Dk,i+1 Dk,n
Dk,1 Dk,i Dk,i+1 Dk,n
Dk,1 Dk,i Dk,i+1 Dk,n
Dk,1 Dk,i Dk,i+1 Dk,n
5 years back 5 yearsProject
start
Dk Dk DkDk
Dk Dk DkDk
Dk Dk DkDk
Dk
Dk
Dk
Dk
Dk
Dk
Exp Groups
Matched Control
The ICF Checklist: Activities & Participation Domains
Ruiz-Quintanilla, EDI, Cornell University 12
Instrument: General Requirements
ICF-based tool to assess services and supports needs of inmates with developmental disabilities on a group level (survey questionnaire)
ICF-based tool to assess services, individual progress and supports needs of inmates with developmental disabilities on an individual level (institutional folder)
ICF-based research instrument to evaluate the program implementation (training impact)
Ruiz-Quintanilla, EDI, Cornell University 13
Instrument: Additional Requirements
A classification and evaluation system was developed based on the ICF’s Activity Limitation and Participation Restriction domains with the following criteria in mind:
1. SIMPLE
2. USEFUL
3. ALLOW MONITORING of progress
4. QUALITY STANDARDS
Ruiz-Quintanilla, EDI, Cornell University 14
Instrument: Additional Requirements
A classification and evaluation system was developed based on the ICF’s Activity Limitation and Participation Restriction domains with the following criteria in mind:
1. SIMPLE
The instrument needs to be simple and clear enough so that service providers from a diversity of occupational backgrounds and educational levels can fill it out without the need for extensive instruction
Ruiz-Quintanilla, EDI, Cornell University 15
Instrument: Additional Requirements
A classification and evaluation system was developed based on the ICF’s Activity Limitation and Participation Restriction domains with the following criteria in mind:
2. USEFUL
The collected information needs to be useful to allow staff to identify services and supports the inmates need and should receive during their stay in the SNUs.
Ruiz-Quintanilla, EDI, Cornell University 16
Instrument: Additional Requirements
A classification and evaluation system was developed based on the ICF’s Activity Limitation and Participation Restriction domains with the following criteria in mind:
3. ALLOW MONITORING
The recorded information should allow monitoring progress towards the goal of community integration capacity achieved by inmates as a consequence of services provided.
Ruiz-Quintanilla, EDI, Cornell University 17
Instrument: Additional Requirements
A classification and evaluation system was developed based on the ICF’sActivity Limitation and Participation Restriction domains with the following criteria in mind:
4. QUALITY STANDARDS
The instrument needs to fulfill quality standards commonly required by similar instruments, including for example inter-rater reliability.
Ruiz-Quintanilla, EDI, Cornell University 18
Group Level Services and Supports Needs Assessment
ICF-based tool to assess services and supports needs of inmates with developmental disabilities on a group level(survey questionnaire)
Ruiz-Quintanilla, EDI
A & P SNU Inmates Support Needs and Importance
Ruiz-Quintanilla, EDI, Cornell University 20
ACTIVITY LIMITATIONS & PARTICIPATION RESTRICTION
For the group of inmates with developmental disabilities (SNU inmates) you work with please indicate their frequency of support needs in general for each of the following activities.
Then use the Importance Scale to indicate the relevance of each activity for successful community integration of inmates with mental disabilities after release IN GENERAL.
Ruiz-Quintanilla, EDI, Cornell University 21
Support Needs
Frequency of Support Needs
0 No inmate needs support (0-4%)
1 Few inmates need support (5-24%)
2 Some inmates need support (25-49%)
3 Many inmates need support (50-75%)
4 Most inmates need support (76- 100%)
9 Not applicable
Ruiz-Quintanilla, EDI, Cornell University 22
Importance
Degree of Importance
0 Not important
1 Of little importance
2 Moderately important
3 Important
4 Very important
9 Not applicable
Ruiz-Quintanilla, EDI, Cornell University 23
A & P SNU Inmates Support Needs and Importance
Ruiz-Quintanilla, EDI, Cornell University 24
Initial Results: Support Needs
50-75% (mean 3.71 – 3.00)School education, economic self-sufficiency, higher education, solving problems, calculate, employment, political life, writing, multiple tasks, complex interactions, driving, reading, intimate relations, human rights, formal relations
0 – 4% (< 1.00)Lifting and carrying, drinking, eating, walking
Ruiz-Quintanilla, EDI, Cornell University 25
Initial Results: Importance for Successful Community Integration
IMPORTANT (mean 3.82 – 3.00):Solving problems, writing, reading, multiple tasks, economic self-sufficiency, listening, economic transactions, calculating, single task, spoken communication, employment, school education, health, grooming, washing, stranger relations, human rights, family relations, basic interactions, community life, intimate relations, formal relations, acquisition of goods, using transportation, complex interaction, non-verbal communications, speaking, informal education, meal preparation, toileting, housework
Of little importance (mean < 2.0)Walking, fine hand use, lifting and carrying
Ruiz-Quintanilla, EDI, Cornell University 26
Initial Results: Scale Reliabilities “Support Needs”
N-items Cronbach alpha If item deleted SUPPORT NEEDS Learning and applying knowledge
6 .331 (Calculate) .448
General tasks and demands 7 .895 Mobility 6 .892 Self-Care 7 .892 Domestic Life 4 .832 Interpersonal Interactions and Relationships
7 .879
Major Life Areas 6 .266 (Higher education) .636 Community and Social Life 5 .810 Total Scale 48 .950
Ruiz-Quintanilla, EDI, Cornell University 27
Initial Results:Scale Reliabilities “Importance”
N-items Cronbach alpha If item deleted IMPORTANCE Learning and applying knowledge
6 .445 (Watching) .578
General tasks and demands 7 .888 Mobility 6 .782 Self-Care 7 .932 Domestic Life 4 .813 Interpersonal Interactions and Relationships
7 .951
Major Life Areas 6 .717 Community and Social Life 5 .804 Total Scale 48 .936
Ruiz-Quintanilla, EDI, Cornell University 28
Individual Level Capacity Classification
ICF-based tool to assess individual progress, service and supports needs for inmates with developmental disabilities on an individual level (institutional folder)
Ruiz-Quintanilla, EDI, Cornell University 29
Capacity
1. For each activity please use the scales below to indicate your assessment of the SNU inmates’ capacity (the inmates current potential to master the activity).
2. Please rate the capacity as it applies to the SNU inmate IN GENERAL. We like you to help us identify the limitations and support needs that apply to this SNU inmate based on your experience working with him.
Ruiz-Quintanilla, EDI, Cornell University 30
Capacity (without assistance)
Extent of Activity limitation
0 No difficulty
1 Mild difficulty
2 Moderate difficulty
3 Severe difficulty
4 Complete difficulty
9 Not applicable
Ruiz-Quintanilla, EDI, Cornell University 31
Next Steps
Distribute questionnaire and collect data and feedback
Analyze data
Revise questionnaire
Draft checklist for individual level
Test checklist
Revise checklist
Ruiz-Quintanilla, EDI, Cornell University 32
Special Thanks to …
John Culkin (Director of Mental Health Services), Stanley Garman (Assistant Director of Mental Health Services), and Heather Kasowski (Psychologist II) New York State Department of Correctional Services
Ed Fraley (Assistant Parole Services Program Specialist)New York State Division of Parole
Officers and Support Staff from the Special Needs Units at Sullivan, Arthur Kill & Wende
New York Developmental Disabilities Planning Council
Ruiz-Quintanilla, EDI, Cornell University 33
Contact Information
S. Antonio Ruiz-Quintanilla, PhDEmployment and Disability
Institute
School of Industrial and Labor Relations CORNELL UNIVERSITY 305 ILR Extension Building
Ithaca, New York 14853-3901 USATelephone: (607)255-2132 * Fax: (607) 255-2763
e-mail: Tony_Ruiz@cornell.edu
Disability Statistics Web http://www.disabilitystatistics.org
EDI Web http://www.edi.cornell.edu
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