Granite Bay Care
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Granite Bay Care (CARE) was founded upon the belief that an individual’s quality of life can be measured in no small part by his or hers experience of relationships. Securing and maintaining paid employment, participating in activities of daily living, and enjoying local opportunities for recreation, all individuals are encouraged to become active members of the communities within which they reside. While careful not to promise permanence, CARE has developed innovative models specifically designed to cultivate meaningful connections between supported individuals and caregivers often not possible in more traditional support models.

GBC’s focus on relationships and the unique challenges that each supported person faces has resulted in the development of a variety of innovative service models, allowing individuals to enter into and move through CARE along a continuum of care.

For individuals accustomed to a chaotic and hostile world, this can prove to be a formidable task. However, with patient understanding and consistent application of support strategies, the “CARE wrap-around” team (consisting of operational, nursing, and clinical consultants working interdepartmentally with person-centered teams) has a demonstrated track record of success in creating a climate of mutual acceptance and appreciation between individuals and CARE-givers. In the majority of cases, the quality of this bond has had a profound therapeutic impact on consumers, providing a means to achieve first emotional/behavioral stability/regulation, then normality/ routine, and finally community investment/integration.

 

Continuum of CARE

Rather than forcing individuals to change, GBC encourages a culture of mutual understanding and respect. Offering active assistance in the long-term maintenance of life challenges, GBC diverts energies once expended on counterproductive maladaptive responses to anxiety, guilt, and frustration; freeing the individual to address more productive goals associated with “active treatment”. It should be noted that CARE has never discharged an individual, for any reason. CARE will continue its tradition of seeking outside consultative resources to meet any and all challenges arising from this moral and ethical decision as it builds an internal capacity to responsibly and effectively manage its commitment to CARE. Within this Continuum of CARE, Granite Bay Care employs an array of program models tailored to each individual's needs and strengths.

• To reduce power struggles, the modifying environment establishes a culture for both individuals and staff that encourages mutual respect and interdependence.
• A cognitive-behavioral is used to process behavioral incidents, fostering an appreciation of the connection between "thoughts, feelings, and behaviors".
• Feedback tools are woven into daily programming, empowering the individual to begin the process of taking positive control over his or her goals and future.
• Progress toward community integration is supported and assessed through contributions to the welfare of others in the home, resource sharing, negotiation, conflict resolution, and opportunities for staff and peer validation.

Live-In Provider CARE

The Live-in Provider CARE is the most intensive level of support offered within GBC’s Continuum of CARE. This “hybrid” model of care is unique to GBC in the State of Maine and has been proven to be particularly effective in supporting the needs of individuals who exhibit high risk, challenging behaviors. The core element of this approach focuses CARE through a singular lens, the Adult Foster Care (AFC) “Provider” or professional roommate. This dedicated individual agrees to commit themselves to providing a unified therapeutic approach, in a home atmosphere free from the institutional trappings normally associated with group home models. This model has demonstrated considerable success in engaging those individuals who have historically co-opted traditional programming.

Within this model of care, Granite Bay Care employs a program design that is easily tailored to each individual's needs and strengths.

This model is by design flexible, permitting the addition of a second layer of staffing to ensure stability during periods of significant behavioral upheaval or transition. This second layer of support can be reduced and even eliminated over time without jeopardizing the consistency afforded through the core layer of support, the Live-In Provider. GBC’s Residential Support Services are provided under the MaineCare Section 21 Waiver.

In-Home Care

Granite Bay Care offers in-Home CARE support to adults with developmental disabilities who are living with family or on their own, in communities where they have established a sense of permanency. Our services extend CARE into existing environments and contexts offering assistance within a reassuring framework. With an emphasis on autonomy and self-determination, person-centered CARE is flexible, intended to work with and around the changing demands and schedules of the supported person and their personal circumstances.

Because In-Home Care is rendered in the home of the consumer, or their family, the selection criteria for staff must adjust according to the circumstances. Recognizing the importance of personality fit, supported persons and their families are invited to participate in the interview, selection, and evaluation of CARE and their CARE staff. Owing to the intimate nature of the work, the use of relief staff to cover sickness or vacation will be considered an intrinsic element to all In-Home Care arrangements. To minimize disruption due to planned or unforeseen occurrence, the Agency will develop a provisional pool of staff available to each specific home. As a courtesy to all involved, the Agency will provide opportunities for introductions and cross-training in a manner agreeable to the supported person and their circle of support.

GBC’s In-Home CARE supports are provided through the MaineCare Section 21 & 29 Waiver

CARE Across-Shift

Granite Bay Care offers a residential or shift-staffed 24/7 model of CARE providing professional, trained staff and individualized supports within community-based homes. These small two-person (unlicensed) or three to four person (licensed) homes can be designed to meet a wide range of person-centered needs from teaching independent living skills to providing medically intensive levels of CARE. While the shift staff model is not unique to the Agency, Granite Bay Care employs an Across-Shift design. This CARE Across-Shift ensures continuity in communication and service delivery between staff teams avoiding the “ships passing in the night” phenomena that invariably work against teamwork and team-consistency.

Through person-centered plans, individuals are encouraged to express and exert the fullest range of choice possible in their daily lives, and in doing so, are able to develop a genuine sense of self-determination. This autonomy is not to be confused with isolation. To promote an expanding circle of natural supports, the Agency offers a sense of community and belonging for every person receiving CARE, allowing them to live with dignity, safety, and hope.

GBC’s Residential Support Services are provided under the MaineCare Section 21 Waiver.

Emergancy Respite CARE

On occasion, persons can find themselves displaced from their home, or temporarily in need of additional supports to insure their safety and the safety of those around them. Without judging the circumstances leading to this critical predicament, Granite Bay Care offers short-term CARE for persons in crisis with nowhere else to turn. During this period of emergency respite CARE, the Agency offers the capacity to perform intensive functional, behavioral, psychological and nursing assessments to assist those teams requiring suitable after-CARE alternatives.

Because Granite Bay Care provides respite CARE within existing home-environments, these opportunities are limited based upon availability and the consent of the person (and guardian/case manager) already living and receiving CARE in the home. Should the team anticipate any respite CARE to exceed thirty (30) days, or the respite period continues open-ended for a thirty (30) period, the Agency will invite the person and their circle of support to participate in a formal evaluation of received Emergency Respite-Care services and identify a plan of CARE (Person-Centered Plan addendum) moving forward. At this time, the Agency will also seek feedback from other person living in their home and their circle of support.

GBC’s Emergency-Respite CARE Support Services are provided under the MaineCare Section 21 Waiver, State contracted Respite/Crisis CARE, or through private-pay arrangements.

CARE Clinical Consultation

Persons with Cognitive and Physical Disabilities frequently find themselves marginalized, underestimated with regard to either, or both, their personal strengths or struggles. For persons experiencing a world of misunderstanding, a psychological “evaluation” can be a useful tool helpful in helping teams better appreciate this person’s unique experience of the world and the kind of CARE most likely to foster success. It can also serve a number of other significant functions.

Specifically, these evaluations can reinforce the quality of CARE rendered, and verify to CARE teams that there are no other unidentified factors otherwise thwarting progress. Moreover, because mental health issues can be missed or misattributed in persons with developmental disabilities, an evaluation can assess if there are any mental health challenges inhibiting, even derailing progress, and can recommend strategies to help the supported person and CARE team manage and overcome those obstacles. Finally, when behavioral issues have become a persistent problem threatening to undermine community integration, an evaluation can help a CARE team understand the underlying issues and processes involved. Objective measures assessing level of supports can ensure a CARE team neither underestimates nor overestimates the capabilities of the person in need of CARE.

GBC’s Clinical Consultation Services are provided to GBC consumers in our Live-In Provider, Residential, and In-Home Support programs for no additional cost, at the request of the consumer’s team. Clinical Consultation Services are also available to consumers utilizing Emergency or Respite Services, as well as non-GBC consumers on a fee-for-service basis.