Home and Community Based Services Supports: Living Well with a Disability

Home and Community Based Services and Supports
Living Well with a Disability

What is Living Well with a Disability?

Living Well with a Disability is an eight-week health promotion workshop for people with disabilities and chronic illnesses. It is based on research designed to reduce the occurrence of secondary conditions -- those health related conditions that develop as a result of a person's original disability or chronic illness. Secondary conditions can vary from pressure sores or physical deconditioning, to isolation due to lack of accessibility or depression. Learning to manage one's secondary conditions can lead to greater independence and desired levels of participation.

Living Well with a Disability is an evidence-based practice, which means that research has shown it is effective. Specifically, participants report a decrease in health related limitations and reductions in health care costs. As a result, participants report they are able to meet a variety of important life goals like developing relationships, recreation opportunities and for some, even employment.

How will HCBS support Living Well?

Beginning in 2006, Senior and Long Term Care and the Montana Disability and Health Program coordinated with Centers for Independent Living to provide Living Well workshops to consumers who are on the 1115 waiver. Importantly, the cost of this service for waiver consumers does not have to come from the waiver team budget. Options include

• Teams may allocate dollars for consumers who participate in Living Well.

• In the event Living Well costs cause teams to be over budget, Senior and Long Term Care will hold the waiver teams harmless for the amount they are over due to Living Well costs. This special initiative is limited to 20 waiver clients statewide.

• Year-end monies can be applied to the cost of providing the Living Well to waiver recipients.

Does Living Well mesh with the goals of the HCBS waiver?

Much of the information and potential outcomes from Living Well can enhance the work of case managers and waiver consumers by supporting desired independence. In fact, independence and engagement in desired activities is a cornerstone of the program. As you know, sometimes consumers feel stuck. We have found that as people increase participation in desired activities, they also become open to learning about improving their health. This is a positive cycle that people use to meet future goals and gain independence.

How does Living Well benefit waiver consumers?

Living Well facilitates effective goal setting in a step-by-step process that includes planning how each individual can reach an important life goal. These quality of life goals are developed by the consumer. In developing a “pathway” for reaching the goal, the individuals consider healthy lifestyle behaviors to facilitate goal achievement. For example, an individual who sets a goal to make new friends might develop a weight loss objective toward meeting that goal. In other words, health is a means to an end. Further, when a goal is self-selected and meaningful, consumers are motivated to make healthy lifestyle behavior changes, using solution oriented thinking, rather than focusing on problems and barriers.

The Living Well workshop encourages peer input which fosters an atmosphere of mutual aid and mutual accountability. As one Living Well participant stated, "The best part of Living Well was classmates asking what I did over the past week to meet my goal. I feel more personal satisfaction. Setting goals gave me some motivation to hope, work, think towards a future -- a positive, worthwhile, much needed experience." For many participants, Living Well produces possibility thinking, empowerment, and hope.

What does the curriculum look like?

Here's a sample! You will need Acrobat reader to see these files. If you don’t have Acrobat reader, you can download it for free by clicking on the logo at right.

Introduction to the Living Well Curriculum

Goal-Setting Chapters

How does the program work?

The Living Well workshop is provided by the Montana Centers for Independent Living (CIL). A workshop is usually scheduled for eight weekly two-hour meetings either at the CIL itself or another designated location. Participants attend as many of the sessions as possible and work through the curriculum with facilitators and a group of eight to ten participants. At the first session, each participant receives a copy of the Living Well curriculum that is theirs to keep. Facilitators guide participants through the program encouraging discussion, answering questions and helping participants complete program exercises.

The workshops are held in accessible meeting space with accessible restrooms. When needed, personal assistants and family are welcome to attend with the participant; however, the individual is encouraged to be the main participant in the program. The Living Well curriculum is available in a variety of formats including large print, Braille and text disks.

The cost of the program is $37.50 per workshop session which can be paid with HCBS funds as outlined above. Private pay is also accepted.

How can I get my clients into a Living Well with a Disability workshop?

You can contact the Center for Independent Living in your area to find out when the next workshop is scheduled. Then, simply reserve a slot with the consumer making sure he or she understands the purpose of the program and participation requirements. Contact information for the CILs is listed below.

• Billings: Living Independently for Today and Tomorrow (LIFTT) Sue Davidson, (406)259-5181, sued@liftt.org

• Bozeman: Montana Independent Living Project (MILP) Deb Ledo, (406)599-0192, doodlydoo@earthlink.net

• Butte: Montana Independent Living Project (MILP) Cheryl Beirne, (406)728-4834, milpcheryl@qwest.net

• Fort Belknap: North Central Independent Living Services (NCILS) Margaret Keener, (406)452-9834, ncilskeener@sofast.net

• Glasgow: North Central Independent Living Services (NCILS) Colleen Forrester, (406)228-2075, ncils2@nemontel.net

• Glendive: Living Independently for Today and Tomorrow (LIFTT) Kathie Bach, (406)377-4062, liftt@midrivers.com

• Great Falls/Black Eagle: North Central Independent Living Services (NCILS) Kris Kleindschmidt,(406) 452-9834, ncilskleinschmidt@sofast.net

• Helena: Montana Independent Living Project (MILP) Les Clark, (406)442-5755, milples@qwest.net

• Kalispell: Summit Independent Living Center (Summit) Flo Kiewel, (406)257-0048, fkiewel@summitilc.org

• Missoula: Summit Independent Living Center (Summit) Jude Monson, (406)728-1630, jmonson@summitilc.org

• Poplar/Wolf Point: North Central Independent Living Services (NCILS) Debra Mason, (406)768-3040, ncils3@nemontel.net

For more information, contact:

Craig Ravesloot, Health Projects Director
Research and Training Center on Disability in Rural Communities
The University of Montana Rural Institute: Center for Excellence in
Disability Education, Research and Services
52 Corbin Hall, Missoula, MT 59812-7056
406-243-2460 or 888-268-2743
cravesloot@comcast.net