S Antonio Ruiz Quintanilla

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.


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.


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.


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.


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


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


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.


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).


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




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


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)


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




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




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.




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.



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.


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


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.


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


Importance

Degree of Importance

0 Not important

1 Of little importance

2 Moderately important

3 Important

4 Very important

9 Not applicable


A & P SNU Inmates Support Needs and Importance


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


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


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


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


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)


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.


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


Next Steps

Distribute questionnaire and collect data and feedback

Analyze data

Revise questionnaire

Draft checklist for individual level

Test checklist

Revise checklist


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


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: [email protected]

Disability Statistics Web http://www.disabilitystatistics.org

EDI Web http://www.edi.cornell.edu

S Antonio Ruiz Quintanilla

Education

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