Ask the Scholar

Document scope · 1 page
doc
Scholar
Ask about this object, its catalog metadata, its source description, or the page inventory. For page-specific OCR and visual context, open one of the page chats.

Scholar Source Context

Document identity
localId
348806777
label
[TIRR] New Options Reports [1976-1978] [2]
core
doc
dtoType
document
pageCount
1
Source metadata
Source extras
naId
348806777
levelOfDescription
fileUnit
recordType
description
ocrSource
nara-archive
Single page context
seq
1
pageIndex
0
type
document
mediaId
9a8e5f1b29967dfa
ocrText
Originally Processed With FOIA(s): FOIA Number: S S FOIA MARKER This is not a textual record. This is used as an administrative marker by the George Bush Presidential Library Staff. Record Group/Collection: Donated Historical Materials Collection/Office of Origin: Frieden, Lex, Collection Series: Disability Rights Organizations Subseries: OA/ID Number: 52065 Folder ID Number: 52065-002 Folder Title: [TIRR] New Options Reports [1976-1978] [2] Stack: Row: Section: Shelf: Position: OMB Approval No. 29-RO218 a. NUMBER FEDERAL ASSISTANCE 2. APPLI- 3. STATE a. NUMBER APPLICA. CANT'S TION 1. TYPE PREAPPLICATION APPLI. b. DATE IDENTI- b. DATE Year month day OF Year month day CATION FIER 19 ASSIGNED 19 ACTION APPLICATION (Mark ap- NOTIFICATION OF INTENT (Opt.) Leave propriate box) REPORT OF FEDERAL ACTION Blank 4. LEGAL APPLICANT/RECIPIENT 5. FEDERAL EMPLOYER IDENTIFICATION NO. 74-1334678 a. Applicant Name Texas Institute for Rehabilita- b. Organization Unit : tion and Research 6. 1333 Moursund Avenue a. NUMBER c. Street/P.O. Box : PRO. GRAM b. TITLE d. City : Houston e. County : Harris (From Rehabilitation f. State : Texas g. ZIP Code: 77030 Federal Catalog) Research and Demon- h. Contact Person (Name Jean A Cole Ph D. & telephone No.) : 797-1440 ext. 504 stration 7. TITLE AND DESCRIPTION OF APPLICANT'S PROJECT 8. TYPE OF APPLICANT/RECIPIENT A-State H-Community Action Agency Transitional Living: A Model for B-Interstate I- Higher Educational Institution C-Substate Indian Tribe the Severely Physically Handicapped District K-Other (Specify) D-County E-City non-profit reha- This live-in transitional training program F-School District G-Special Purpose bilitation center prepares handicapped individuals for active District Enter appropriate letter community involvement including independent 9. TYPE OF ASSISTANCE A-Basic Grant D-Insurance living, vocational or educational planning, B-Supplemental Grant E-Other Enter appro- & increased social participation. C-Loan priate letter(s) A 10. AREA OF PROJECT IMPACT (Names of cities, counties, 11. ESTIMATED NUM- 12. TYPE OF APPLICATION States, etc.) BER OF PERSONS A-New C-Revision E-Augmentation BENEFITING B-Renewal D-Continuation national 250 Enter appropriate letter D 13. PROPOSED FUNDING 14. CONGRESSIONAL DISTRICTS OF: 15. TYPE OF CHANGE (For 12c or 12e) A-Increase Dollars F-Other (Specify) a. FEDERAL $ 144,155 .00 a. APPLICANT b. PROJECT B-Decrease Dollars C-Increase Duration b. APPLICANT 7,208 .00 22 22 D-Decrease Duration E-Cancellation 17. PROJECT c. STATE .00 16. PROJECT START DURATION Enter appro- DATE Year month day d. LOCAL 10/1 30-60 priate letter(s) .00 1977 Months 6. OTHER 18. ESTIMATED DATE TO Year month day 19. EXISTING FEDERAL IDENTIFICATION NUMBER .00 BE SUBMITTED TO FEDERAL AGENCY 19 77 8 1 $ 151,363 .00 RSA 13P57889/6-01 f. TOTAL Wash D.C. 21. REMARKS ADDED 20. FEDERAL AGENCY TO RECEIVE REQUEST (Name, City, State, ZIP code) Rehabilitation Services Administration; 330C. Street SW; Yes No 22. a. To the best of my knowledge and belief, b. If required by OMB Circular A-95 this application was submitted, pursuant to in- No re- Response structions therein, to appropriate clearinghouses and all responses are attached: sponse attached data in this preapplication/application are THE true and correct, the document has been APPLICANT duly authorized by the governing body of (1) NA CERTIFIES the applicant and the applicant will comply THAT with the attached assurances if the assist- (2) ance is approved. (3) 23. a. TYPED NAME AND TITLE b. SIGNATURE c. DATE SIGNED Year month day CERTIFYING William A. Spencer, M.D. REPRE- 19 SENTATIVE President 77 7 29 25. APPLICA. Year month day 24. AGENCY NAME TION RECEIVED 19 27. ADMINISTRATIVE OFFICE 28. FEDERAL APPLICATION 26. ORGANIZATIONAL UNIT IDENTIFICATION 30. FEDERAL GRANT 29. ADDRESS IDENTIFICATION 31. ACTION TAKEN 32. FUNDING Year month day 34. Year month day STARTING a. AWARDED a. FEDERAL $ .00 33. ACTION DATE 19 DATE 19 .00 35. CONTACT FOR ADDITIONAL INFORMA- 36. Year month day b. REJECTED b. APPLICANT TION (Name and telephone number) ENDING c. RETURNED FOR c. STATE .00 DATE 19 AMENDMENT d. LOCAL .00 37. REMARKS ADDED d. DEFERRED e. OTHER .00 Yes No 8. WITHDRAWN f. TOTAL $ .00 38. a. In taking above action, any comments received from clearinghouses were con- b. FEDERAL AGENCY A-95 OFFICIAL sidered. If agency response is due under provisions of Part 1, OMB Circular A-95, (Name and telephone no.) FEDERAL AGENCY it has been or is being made. A-95 ACTION STANDARD FORM 424 PAGE 1 (10-75) 424-101 Prescribed by GSA, Federal Management Circular 74-7 OMB NO. 80-RO 186 PART II PROJECT APPROVAL INFORMATION Item 1. Does this assistance request require State, local, Name of Governing Body regional, or other priority rating? Priority Rating Yes No Item 2. Does this assistance request require State, or local Name of Agency or advisory, educational or health clearances? Board Yes X No (Attach Documentation) Item 3. Does this assistance request require clearinghouse (Attach Comments) review in accordance with OMB Circular A-95? Yes X No Item 4. Does this assistance request require State, local, Name of Approving Agency regional or other planning approval? Date Yes X No Item 5. Is the proposed project covered by an approved compre- Check one: State hensive plan? Local Regional Yes X No Location of Plan Item 6. Will the assistance requested serve a Federal Name of Federal Installation installation? Yes X No Federal Population benefiting from Project Item 7. Will the assistance requested be on Federal land or Name of Federal Installation installation? Location of Federal Land X Yes No Percent of Project Item 8. Will the assistance requested have an impact or effect See instructions for additional information to be on the environment? provided. X Yes No Item 9. Number of: Will the assistance requested cause the displacement Individuals of individuals, families, businesses, or farms? Families Businesses Yes X No Farms Item 10, Is there other related assistance on this project previous, See instructions for additional information to be pending, or anticipated? provided. X Yes No OMB NO. 80-R0186 PART III - BUDGET INFORMATION SECTION A - BUDGET SUMMARY Grant Program, Estimated Unobligated Funds New or Revised Budget Function Federal or Catalog No. Federal Non-Federal Federal Non-Federal Total Activity (a) (b) (c) (d) (e) (f) (g) 1. Rehab. R&D 13.627 $ -0- $ -0- $ 144,155 $ 7,208 $151,363 2. 3. 4. 5. TOTALS $ $ $144,155 $ 7,208 $151,363 SECTION B - BUDGET CATEGORIES - Grant Program, Function or Activity Total 6. Object Class Categories (1) (2) (3) (4) (5) a. Personnel $ 80,115 $ $ $ $ b. Fringe Benefits C. Travel 2,500 d. Equipment 12,500 e. Supplies 500 f. Contractual 10,000 g. Construction h. Other 10,500 i. Total Direct Charges 116,115 28,040 j. Indirect Charges k. TOTALS $ 144,155 $ $ $ $ est. 7. Program Income $ 100,000 $ $ $ $ OMB NO. 80-R0186 SECTION C - NON-FEDERAL RESOURCES (a) Grant Program (b) APPLICANT (c) STATE (d) OTHER SOURCES (e) TOTALS 8. Rehabilitation R&D $ 7,208 $ $ $ 7,208 9. 10. 11. 12. TOTALS $ 7,208 $ $ $ 7,208 SECTION D - FORECASTED CASH NEEDS Total for 1st Year 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter 13. Federal $ 144,155 $ 45,039 $ 33,039 $ 33,039 $ 33,038 1,802 1,802 1,802 14. Non-Federal 7,208 1,802 15. TOTAL $ 151,363 $ 46,841 $ 34,841 $ 34,841 $ 34,840 SECTION E - BUDGET ESTIMATES OF FEDERAL FUNDS NEEDED FOR BALANCE OF THE PROJECT FUTURE FUNDING PERIODS (YEARS) (a) Grant Program (b) FIRST (c) SECOND (d) THIRD (e) FOURTH 16. Rehabilitation R&D $ 144,155 $ 158,300 $ 151,550 $ 139,000 17. 18. 19. $ 144,155 $ 158,300 $ 151,550 $ 139,000 20. TOTALS SECTION F - OTHER BUDGET INFORMATION (Attach additional Sheets If Necessary) 21. Direct Charges: (please see attached sheets) 22. Indirect Charges: 23. Remarks: PART IV PROGRAM NARRATIVE (Attach per instruction) SECTION F OTHER BUDGET INFORMATION 21. Direct Charges PERSONNEL project director (50%) * 10,500 research director (15%) * 4,000 functional skills adviser 16,000 social worker 15,000 vocational counselor (30%) 4,800 follow-up specialist (50%) 7,500 research assistant 8,000 coordinator of staff 3,815 associates (50%) attendant manager 8,000 care attendants** 2,500 80,115 TRAVEL travel for staff to disseminate materials on project 2,500 EQUIPMENT van to transport project participants on fieldtrips 12,500 SUPPLIES office supplies 500 CONTRACTUAL production of audio-visual materials for use by handi- capped persons 10,000 OTHER audio-visual consultation 2,000 consultation from handi- capped staff associates 5,000 duplicating expense 3,000 computer time for research data 500 TOTAL DIRECT COSTS 116,115 * Remaining portion of these salaries to be paid by RT-4 funds. Remaining portion of these salaries to be paid by per diem revenue. 22. Indirect Charges 35% of salaries and wages 28,040 TOTALS 144,155 PART V ASSURANCES The Applicant hereby assures and certifies that he will comply with the regulations, policies, guidelines, and requirements including OMB Circulars Nos. A-87, A-95, and A-102, as they relate to the application, acceptance and use of Federal funds for this Federally assisted project. Also the Applicant assures and certifies with respect to the grant that: 1. It possesses legal authority to apply for the grant; that a 4. It will comply with requirements of the provisions resolution, motion or similar action has been duly of the Uniform Relocation Assistance and Real Property adopted or passed as an official act of the applicant's Acquisitions Act of 1970 (P.L. 91-646) which provides governing body, authorizing the filing of the application, for fair and equitable treatment of persons displaced as a including all understandings and assurances contained result of Federal and federally assisted programs. therein, and directing and authorizing the person identi- 5. It will comply with the provisions of the Hatch Act fied as the official representative of the applicant to act which limit the political activity of employees. in connection with the application and to provide such 6. It will comply with the minimum wage and maximum additional information as may be required. hours provisions of the Federal Fair Labor Standards Act, as they apply to hospital and educational institu- 2. It will comply with Title VI of the Civil Rights Act of tion employees of State and local governments. 1964 (P.L. 88-352) and in accordance with Title VI of 7. It will establish safeguards to prohibit employees from that Act, no person in the United States shall, on the using their positions for a purpose that is or gives the ground of race, color, or national origin, be excluded appearance of being motivated by a desire for private from participation in, be denied the benefits of, or be gain for themselves or others, particularly those with otherwise subjected to discrimination under any pro- whom they have family, business, or other ties. gram or activity for which the applicant receives Federal 8. It will give the grantor agency or the Comptroller Gen- financial assistance and will immediately take any mea- eral through any authorized representative the access to sures necessary to effectuate this agreement. and the right to examine all records, books, papers, or 3. It will comply with Title VI of the Civil Rights Act of documents related to the grant. 1964 (42 USC 2000d) prohibiting employment discrimi- 9. It will comply with all requirements imposed by the nation where (1) the primary purpose of a grant is to Federal grantor agency concerning special requirements provide employment or (2) discriminatory employment of law, program requirements, and other administrative practices will result in unequal treatment of persons who requirements approved in accordance with Office of are or should be benefiting from the grant-aided activity. Management and Budget Circular No. A-102. 1 PROJECT NARRATIVE A. TITLE Transitional Living: A Model for the Severely Physically Handicapped B. PROGRESS REPORT 1. Changes in Plan The New Options Transitional Living Project opened in June of 1976 with seed money from Rehabilitation Research and Training Center 4 (RT-4). In October of 1976 an R&D grant was funded for which continuation is sought in this request. The R&D funding has substantially increased the project capability to conduct service demonstrations and evaluation research. (Residential costs for each participant in the project are sponsored on a per diem basis by the Texas Rehabilitation Commission.) Implementation of the New Options project has departed very little from the model as set forth in the original grant request submitted in April of 1975. A few minor changes are summarized below. Length of Stay for Each Participant It was originally intended that each participant would live in the project for a period that was individually determined, up to a maximum stay of six months The average period of stay was estimated to be four months. In planning implemen- tation of the project with the. Texas Rehabilitation Commission, this agency agreed to sponsor each client for a maximum stay of six weeks, with the understanding that at the end of a year the policy on length of stay would be re-examined. As a result of this agreement with TRC; the project has operated to date on the basis of a six-week program cycle. Plans for experimenting with other lengths of stay are outlined in Section C-2 (proposed changes). Use of a Nurse Clinician Initial planning specified that New Options would share the time of a nurse clinician with other programs of the Texas Institute for Rehabilitation and Research. The role of this part-time staff member included consultation with participants about their medical status and implementation of a training module on medical needs. Because of a shortage of nursing personnel, this plan was not feasible. Instead, medical consultation with participants has been donated to the project by TIRR physicians, particularly by Dr. William A. Spencer, Director 2 of the Institute. Staff physicians and other medical personnel of TIRR have also contributed their time to provide a weekly medical training module. Use of Practice Apartment The original grant request specified that a practice apartment would be established by the project so that participants could experiment with living in this community setting. To date, a practice apartment has not been logistically feasible. The project is currently considering a possible move of the entire program to a community apartment location. Issues surrounding the exploration of this alternative are discussed in Section C-2 (proposed changes). Follow-Up Services To date follow-up services have not been extensively developed in New Options, though some assistance to former participants has been provided. This is due to a great extent to the fact that a larger proportion of participants than expected have re- turned to locations at some distance from Houston. Exploration of follow-up needs and capabilities is a major objective for the second grant year (see Section C-1, work plan for the next grant period) . There are several areas in which the project is ahead of schedule as originally set forth in the timetable (see Appendix A) . These are summarized below. Task 11 Diversify Participant Population The project began in cycle 5 (January, 1977) to include a few participants with disabilities other than spinal cord injury. To date, the participant population has included one person with polio residuals, one with muscular dystrophy, two with head injuries, and four with cerebral palsy. Information is being collected on particular needs of various disability groups. The effects of this diversity are discussed in Section B-2 (progress during current grant period). Task 12 Diversify Program Content Efforts have begun to diversify program content in order to acco- modate differences in needs of various types of participants. These developments are also discussed in Section B-2. Task 14 Develop Modules for Replication Work has begun on the production of written program materials and videotapes. Materials produced to date are listed in Section C3 (research utilization plan). Expansion in this area will be a major objective in the second and subsequent program years. 3 2. Progress During Current Grant Period During the project's first year, major tasks were planning program content, assembling a staff, putting the basic transitional program into operation, and planning and im- plementing research procedures. In planning the project, core staff members traced the experiences of residents of the previous Cooperative Living Project and talked with them about how they initiated changes in their lives. There seem to be several important prerequisites for be- coming actively involved in the community. One of these is having information about what opportunities are avail- able and the knowledge of how to get needed information. The second prerequisite is the possession of certain per- sonal skills that are needed in order to take advantage of available opportunities. These skills may include social assertiveness, diplomacy, an ability to budget energy well, or an ability to manage financial affairs. A third important prerequisite is a more general skill that may be termed problem-solving capability. This involves the ability to analyze a situation, to obtain new information, to make decisions, and to formulate sequential plans. It involves being able to anticipate consequences and to take action before crises develop. New Options is intended to assist handicapped individuals in each of these areas. a. Accomplishments and Findings Objectives of the first grant year as stated in the initial grant request are as follows: (1) to define a system of services required to meet the needs of severely physically handicapped persons engaging in a transitional living experience (2) to refine criteria for selection of persons who can benefit from a transitional living program (3) to develop basic transitional program content (4) to develop a research design to evaluate the program and pre-test research methodology (5) to develop a practice apartment that will allow individuals to gain experience in independent living in a protected environment (6) to establish functional training programs that prepare the individual to maximize his functional abilities in non-institutional environments 4 Objectives 1,2,3,5, and 6 which relate to the development of a service delivery demonstration will be reviewed below in this section. Objective 4 which deals with research aspects of the program will be reviewed in section b which follows on Research Developments and Problems Encountered. Objective 1: Development of a Service System The New Options project is housed in TIRR's Maximum Indepen- dence Center, a dormitory-style building located four miles from the main Institute building in the Texas Medical Center. Each project participant has a private room. Meals, trans- portation, and non-professional attendant assistance are provided on a shared basis. This residential system using shared supportive services has been borrowed directly from TIRR's earlier Cooperative Living residential project (SRS R&D 13-P-55487/6-01) Experience has shown that living for six weeks in a dormitory-style setting with a non-profes- sional attendant staff is an important element at New Options. Participants frequently interact with each other informally on a one-to-one basis, and there seem to be some important effects of this close interaction with peers. Many parti- cipants have never been away from this personal care of family members or a nursing staff, and learning to manage the interaction with attendants and direct their own care is an important skill to be acquired. The New Options program staff includes a project director (anthropologist), a research director (psychologist), a social worker, a functional skills adviser with a background in physical therapy, and a part-time vocational counselor. In addition to organizing group activities, each of these persons is involved in goal-setting and problem-solving with participants on a one-to-one basis. The purpose of this counseling is to help the individual learn to solve problems on his own. This approach often involves departures from traditional professional roles in which staff members tend to solve problems for clients rather than letting them devise their own solutions. Many outside resource persons are also involved, including physicians, agency personnel, and other persons encountered by handicapped persons in the community. The staff also includes a category of individuals called staff associates. These are handicapped persons who are actively involved in the community and who are paid to provide extensive information to participants and serve as behavior models. The staff has tried to choose a variety of associates who represent differing lifestyles and diverse values and viewpoints. The extensive use of staff associates is based on observation of the importance of modeling in the previous residential project. To date the project has had a total of 66 associates who meet with participants an average of 39 times in each six-week program cycle. 5 In general, the staffing planned for the project has been effective, though some changes have been made. The most difficult role to define and fill has been that of personal counselor which is held by a social worker. It has been hard to achieve a good balance between therapy on the one hand and more concrete planning and problem-solving with individuals on the other. The staff has also learned that more time is needed from the part-time vocational counselor, and this position has been changed from 20% to 30% time effort. A new part-time staff position has been created for a Coordinator of Staff Associates. This individual is responsible for making logistical arrangements and for supervising the active handicapped persons from the community who conduct various program activities. Objective 2: Refinement of Selection Criteria Staff members and the project DVR courtesy counselor largely agree on the following characteristics as important traits in persons who seem to have benefitted most from the project: readiness to face life as a severely disabled individual; desire to make changes in lifestyle; willingness to set and work on goals; willingness to risk experimenting with new ways of doing things and new kinds of behaviors; average intellectual capacity (comprehension of verbal input, no major memory deficits, reasonable attention span) ability to read; ability to speak well enough to be generally under- stood; ability to hear; no severe emotional pathology; and physical endurance for program (sitting tolerance, bowel control that is predictable, suitable urinary management). Experience has demonstrated that the program seems to be most effective when participants in a given cycle do not differ too widely in intellectual level. The program can be altered to accomodate persons at different intellectual levels from cycle to cycle, but it is an advantage if persons within any one group are relatively similar in this respect. Other types of diversity such as differences in rural or urban background, length of time since onset of disability, and general direction of future plans, can frequently be utilized to advantage in promoting group interaction. One of the most significant problems in choosing participants is assessing the individual's degree of medical stability through reports from referring DVR counselors and physicians. Professionals who have not worked previously with severely physically disabled individuals may provide misleading in- formation. In some cases participants have needed more medical care than the project was designed to provide. A few project participants and referring DVR counselors seem to have held unreasonable expectations of what the program can provide, and it has proven important to be aware of possible problems in this area when selecting participants. Such ex- pectations are attached not only to the New Options project but to the notion of moving to Houston in general. Many persons 6 hold an exaggerated view of the number of residential facilities, jobs, and supportive services available in the city. The staff has made an effort to define reasonable expectations and to communicate these be- fore individuals enter the project. The following list represents the views of project staff and of the DVR courtesy counselor about what participants can expect to accomplish in New Options : gaining in- formation on what opportunities are available in the community (living arrangements, educational training programs, vocational availability, transportation availability) learning the skills to go about getting information; learning to manage financial affairs; learning to relate with attendants to get needs taken care of; learning to budget energy; learning to adapt oneself to new environment; learning to be more com- fortable in public (being visible, asking for help) ; learning to examine how individuals interact with other persons and ways this might be changed; having the opportunity to be among other handicapped persons and learning how they cope with problems; examining feelings about issues important to each individual (their identity, family relationships, sexuality, ability to control their life course); learning to define goals and direc- tions; becoming more comfortable in experimenting with alternative ways of doing things; learning how to solve problems and having actual experiences where such learning can be practiced; learning sequential planning; and learn- ing to anticipate problems and make plans on how to handle them before a crisis develops. Objective 3: Development of Program Content Previous research and experience have indicated a number of subject areas that are important for handicapped individuals who are beginning active involvement in the community. A series of training modules has been developed to address these areas. The modules include: independent living arrangements vocational and educational opportunities financial management consumer affairs mobility functional skills attendant management problem-solving social skills sexuality leisure time medical needs Outlines of the content of each module can be found in Appendix C. Teaching methods used include classroom instruction, group discussions, and numerous fieldtrips into the community. The modules are usually co-lead by a regular staff member and a staff associate. Each module