ADMINISTRATIVE ISSUES

Track, horse & trailer, exercise stations

When it comes to administering the program, business and political practicality dictate that the Director and the Board of Trustees see Bittersweet Farms' services as an a la carte service system. While they offer lots of services, including a vocational day program and supported living services, the county offers families vouchers for their choice of services, along with a list of a network of providers. After considering what is offered in each setting, families select what best matches their needs. They can interview different providers to see which best fits their needs.

In reality however, choices are limited in residential services, as there are very few openings anywhere in the system, and there is little or no money to develop additional ones. Providers can offer a little help with less extensive and less expensive services to families, such as respite care, recreational activities, options and in-home supports.

It has been much easier to create an array of service options, each with its own funding capabilities, than it has been to secure institutional funding for a one-stop, comprehensive program.

Current concerns

Bittersweet's most serious challenge is its rate of growth. The demands upon Bittersweet Farms have become tremendous, for it is often the only option with autism expertise, available to families. There seems to be an endless number who need its services, and it's hard for Bittersweet to say, "No," when the choices are so limited. On the other hand, there is much concern that growth, if poorly handled, may result in compromised quality for those currently in the program. The pressure is enormous.

Plans are underway to renovate the existing facilities in order to separate residential and non-residential activities. This new organizational effort may relieve growth problems such as the competition for space among administrative, residential and community components of the program. The Board and staff continually reach out to meet existing needs in a way that guarantees the quality characteristic of Bittersweet Farms.

To create some kind of balance, Bittersweet Farms' staff are actively training many service providers in a variety of settings, rather than offering satellites, themselves. But the demand continues to grow, and as Bittersweet becomes more stable financially, and in quality of service, there is the expectation that there will be increasing pressure to create a satellite, or to help other people accomplish that.

A disappointment is that this demonstration project, with all its successes, has not been emulated in outlying areas where there is great need. Calls for these services still come in from everywhere in the country. Although ventures in various places, near and far, have tried, many have failed to succeed.

Several program efforts in other states have faded away, largely because they have not received support from developmental disabilities agencies that fund services. In many areas, specialized services to persons with autism are not on the priority list for program development. In contrast, Bittersweet Farms has had local support as well as strong connections in the state capitol.

Supported Living Arrangements

Bittersweet Farms serves some individuals in supportive living. Staff provide 24-hour supervision in homes rented by individuals with autism, within a twelve-mile radius of the main facility. In most cases, individuals who live in their own homes, commute to the farm for vocational services, although it is not required. This community-based alternative has some advantages. Residences and their locations can be selected based on such factors as family, interests, church affiliations, and familiarity with a community. Families feel more comfortable in these settings, as they are equal partners in assuring positive features and dþcor. Finally, the supported living option has no limit with regard to the total numbers of people served, for bed do not need to be licensed.

The distance between Whitehouse, where Bittersweet is located, and the supported living homes, poses some challenges, however. It becomes difficult to create the same sense of community, characteristic of the farmstead, when people live so far away. It also can be problematic to provide encouragement and back-up to staff living of-site. Thus, they may feel disconnected from their colleagues and the farmstead environment. These issues are important as the discussion continues about farmstead concepts and how to adjust in the years after 2000, in the face of trends towards non-group living facilities.

Commitments to supportive living arrangements will require intensive energies toward making participants feel a strong community connection. Administratively, managing supported living homes would be easier if they were in close proximity to the farm base.

There are efforts throughout Ohio, and in other states, to streamline the flow of funds to follow individuals instead of providers. Through a person-centered planning process, funds could be individualized. If a person's needs required a place with more intensive supports, then the funds would pay for a setting that offered them. If there were strong needs to reside in a certain neighborhood, then the funds would be spent securing a home and services in that location. Once priorities are established, a list of issues and solutions can be created, determining how funds will be used.

Such a personalized system would help programs that specialize in autism, because in most cases, those would be the choice of families. Currently, most funding mechanisms throughout the system, support models like sheltered workshops or residential institutions. A person-centered system would encourage entrepreneurial efforts to meet the demand.

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