Agency Setting and Market Scan

Agency Setting Summary:

1. Agency/Setting name and description (brief explanation of the agency type, services provided, populations served, location).

The Lewinsville Adult Day Health Care Center a provides a fun and safe environment catered to older adults. They provide services such as memory care, exercise programs, outings, health care monitoring, psychosocial services, transportation and much more. This is a place where participants can come to socialize and enjoy activities personalized to their interests or learn new hobbies! The population served is older adults with dementia or those who require more assistance and modification to perform activities of daily living. The center is located on 1611 Great Falls Street, McLean, Virginia.

2. Etiology & History- when was the agency founded and how has it changed/grown over time?

According to Forbush (2017), Before it was known as the Lewinsville Senior Center, it was formally known as the Lewinsville Elementary School which was built in 1961. In 1994 Fairfax County approved a permit that allowed for an independent living facility, senior center, adult day care center, child care center, and a field for recreational activities to be built. Now the campus includes two privately operated child-care centers. The child-care centers are now used to help facilitate intergenerational programs for the participants at the Lewinsville Adult Day Health Care Center and Senior Center. There have been a few renovations made throughout the years, with the most recent project finished in 2019. They continue to serve a large population of individuals from the Northern Virginia area.

3. Mission/Vision/Core Values- List these. Not every agency has all of these elements, which is fine.

Mission Statement:

“To provide quality community-based Adult Day Health Care, in a safe and positive environment, to individuals who need supervision during the day, due to the changes in their cognitive and/or functional abilities” (M. Combs, personal communication, June 14, 2020).

4. Agency continuum of services and intended goals/outcomes for those services.

The Lewinsville Senior Center offers a variety of services for their participants based on their needs and abilities. For adults who are more independent and do not require any assistance or modification, the senior center is the ideal placement. They provide services focused on increasing socialization, and maintaining cognitive functioning and physical health (R. Robinson, personal communication, June 9, 2020).

For participants who have physical or cognitive impairments, receive a dementia diagnosis, or begin to show a lack of orientation and alertness, the Adult Day Health Care Center is a more appropriate fit. Here the focus is on memory care, assistance with activities of daily living, and activities that help improve or maintain physical, cognitive, social, and emotional functioning (M. Combs, personal communication, June 9, 2020).

5. Stakeholders- identify the internal/external stakeholders of RT services- examples of internal stakeholders are treatment team members, allied professionals, supervisors, volunteers, administrators, any employees or internal agents that are elemental to the provision in RT services. Examples of external stakeholders include customers, families, vendors, partners, any entity or person external to the agency.

The internal stakeholders are the Director of Health Services, the Long-Term Care Coordinators, Center Nurse Coordinators, Center Nurses, Recreation Therapists, Office Managers, Senior Program Assistants, Program Assistants, Staff Volunteers, Volunteers, and Interns.

The external stakeholders are the clients served and their families.

6. Organizational chart- describe the chain of management/supervision within the agency beginning with yourself as the intern.

According to Combs (personal communication, June 14, 2020). The Interns are directly supervised by the Recreation Therapists. The Recreation Therapist also supervises and evaluates the Senior Program Assistant, Program Assistants, Staff Volunteers, and Volunteers. The Recreation Therapists are supervised by the Center Nurse Coordinator. The Center Nurse Coordinator also supervises the Center Nurse and Office Manager.The Center Nurse Coordinator is supervised by the Long-Term Care Coordinator who also oversees the four Adult Day Health Care Centers in the area. The Long-Term Care Coordinator is supervised by the Director of Health Services who also oversees the Adult Day Health Care Centers and the clinics in the area.

7. Agency Policies and Procedures (2)- applicable to all agency employees. List the name and a one-sentence explanation of the purpose of the policy.

According to Combs (personal communication, June 14, 2020). The following are agency policies and procedures applicable to all agency employees:

Tuberculosis Test – Every employee is required to obtain an annual TB test to determine if they have been exposed to the bacteria. This helps ensure the safety of the clients they serve, as older adults are more susceptible to becoming gravely ill if they contract tuberculosis.

Limited Food Handlers Test – All staff serving food is required to pass the Limited Food Handlers Test, which is good for five years. This is a requirement because staff is expected to learn food safety because they often help serve breakfast, lunch and snacks to participants.

8. RT Policies and Procedures (3)- applicable to RT services only. List the name and a one-sentence explanation of the purpose of the policy.

According to Combs (personal communication, June 14, 2020). The following are Recreation Therapy policies and procedures applicable only to recreation therapy services:

Ratio – At all times, there needs to be a ratio of one staff member for every six participants to help ensure the safety of the clients. This is so that every participant can be monitored in case they need assistance.

NCTRC Exam – All Recreation Therapist must either be certified upon getting hired or pass the exam within a year of being hired. This policy is in place to ensure that all participants are receiving the most appropriate level of care and that the Recreation Therapist is competent in delivering the best services possible.

Assessments – All participants must be assessed by a Recreation Therapist within one month of their start date. The assessment is then updated annually or if any significant health concerns arise. The purpose of assessing the participants is to determine their needs, abilities, interests and goals.

9. Accreditation/Licensing/Regulation- identify what agencies regulate the agencies and RT services. For each regulating body, give an example of a regulation impacting RT services.

Adult Day Health Care Centers in Virginia are accredited by the Virginia Department of Social Services. They provide accreditation and licensure for three years. The Virginia Department of Social Services also provides the regulations required of all licensed Adult Day Health Care Centers.

A regulation that impacts RT services is: 22VAC40-61-30 Program of Care

There shall be a program of care that:

1. Meets the participants’ physical, intellectual, emotional, psychological, and spiritual needs;

2. Promotes the participants’ highest level of functioning;

3. Provides protection, guidance, and supervision;

4. Promotes a sense of security, self-worth, and independence;

5. Promotes the participants’ involvement with activities and services; and

6. Reduces risk in the caregiving environment.

This impacts Recreation Therapists because it means our services must be relevant to the needs and abilities of the clients served. Our programs should have a purpose that satisfies at least one of the domains listed above according to The Virginia Department of Social Services (2019).

Market Scan:

1. Who are the customers of RT services at this agency?

The population served is older adults who have physical and/or cognitive impairments who may require more assistance with their activities of daily living. They also serve the families of these clients by hosting support groups and special events where friends and family are invited to participate.

2. What is the cost and how are RT services paid for (membership fees, billable services, bundled fees, grants, etc.)?

The cost for a membership to the Adult Day Health Care Center is based on household income as well as number of dependents. For example, a single-person household with zero dependents whose annual income is between $20,032-$26,708 would pay a daily fee of $30 to attend Adult Day Health Care and pay $1.00 for daily transportation if they are using the Fastran. Other forms of acceptable payment are long-term care insurance and Medicaid Elderly or Disabled with Consumer Direction Waivers. Scholarships programs are available for participants to apply for as well (Fairfax County Health Department, n.d.).

3. What is the product/service provided to the customers?

The services provided to participants include therapeutic recreation activities, assistance in activities of daily living, meals, transportation, health monitoring, and field trips.

4. Are the customers satisfied with the RT services provided? How do you know?

Yes, Recreation Therapist and staff constantly evaluate their programs and client satisfaction. They establish rapport with the clients and their family and ask for their feedback on the programs and services provided.

5. Are there competitors to your agency?

Competitors would include at-home services provided to older adults by in-home assistants, nurses, or therapists.

6. Are there untapped/potential markets which RT services could be expanded to? If so, who are they and what services?

An untapped potential market in Virginia that recreation therapy services could be expanded to is public schools. In states such as California, Maryland, and New Hampshire they have already integrated recreation therapy into the school systems (Northeast Passage, n.d.; Baltimore County Government, 2019; Los Angeles Unified School District Human Resources Division, 2003). Recreation therapy services could be provided to children with disabilities or impairments. Recreation therapy can also help in the enhancement of social skills and other skills needed to successfully participate in an academic setting. By creating treatment plans for the students and using purposeful leisure interventions they can help the student function as independently as possible and provide a better quality of life (American Therapeutic Recreation Association, n.d.)

RUBRIC:

 

References

American Therapeutic Recreation Association. (n.d.). Recreational therapy and school systems. American Therapeutic Recreation Association. https://cdn.ymaws.com/www.atra-online.com/resource/resmgr/sections/atra_info_schools_08.30.17__.pdf

Baltimore County Government. (2019, December 10). Therapeutic recreation programs. Baltimore County Therapeutic Recreation Programs. https://www.baltimorecountymd.gov/Agencies/recreation/programdivision/therapeutic/programstherapeutic.html

Forbush, F. (2017, October 24). Mclean’s Lewinsville Center Reimagined. Connection Newspaper. http://www.connectionnewspapers.com/news/2017/oct/24/mcleans-lewinsville-center-reimagined/

Fairfax County Health Department. (n.d.). Adult day health care fees and affordability. Fairfax County Adult Day Health Care. https://www.fairfaxcounty.gov/health/adult-day-health-care/fees

Los Angeles Unified School District Human Resources Division. (2003, September). School recreation therapist, special education. Los Angeles Unified School District. https://ca01000043.schoolwires.net/cms/lib/CA01000043/Centricity/Domain/280/Class%20Descriptions/0526%20SchlRecTherapistSpEd.pdf

Northeast Passage (n.d.). School based recreational therapy. Northeast Passage. https://www.nepassage.org/recreational-therapy/school-based-recreational-therapy

Virginia Department of Social Services. (2019, December 29). Standards and regulations for licensed adult day care centers. Virginia Department of Social Services. https://www.dss.virginia.gov/files/division/licensing/adcc/intro_page/code_regulations/regulations/final_adcc.pdf