Below is a list of the RTC's currently active projects . For more information, see the contact person(s) for each project.

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Assistive technologies can be of enormous value in supporting the abilities of persons with ID/DD to exercise greater control over their personal lives. This study will investigate the use of assistive technology (AT) devices and services by persons with ID/DD. Two projects will be conducted. First, project staff will develop a bibliography summarizing assistive technology devices and potential service use by persons with ID/DD. Second, staff will conduct an in-depth study in five states on the financing of AT devices and services for individuals with ID/DD. This study will provide valuable data on access and financing of AT and will establish the feasibility of mounting a state-by-state analysis investigating resource allocation by the three primary funding sources for assistive technology (Medicaid, public schools, state vocational rehabilitation).

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This study will examine how methods to increase community participation are integrated into a service provider’s on-going operations and what factors affect successful outcomes, including greater duration in relationships and community membership. A matched sample study will be conducted with people with ID/DD who receive support from three state-wide Minnesota provider agencies. Staff from these agencies will be interviewed to determine agency factors affecting successful outcomes of community participation and socially valued roles for individuals with ID/DD. Two agencies will receive training and support in implementing the factors identified as significant predictors, with the third agency serving as control.

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RTC staff will work with the Lewin Group to deliver technical assistance to the 10 grantees who received direct support workforce systems change grants from CMS. The project will include activities such as RTC staff participating in an orientation training event at CMS, participating in an annual systems change conference at CMS and the delivery of telephone, e-mail and written technical assistance activities to the 10 DSW grantees.

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The College of Direct Support (CDS) is a computer-assisted, competency-based, interactive multimedia training curriculum for direct support professionals in community settings.

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This study will provide ongoing evaluation from consumers and will develop programs and products to promote the ideals and support informed decision making in a multi-agency consumer-controlled housing initiative.

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This activity will study access people with ID/DD and their families have to consumer directed community supports (CDCS). It will use a participatory action research model with people using CDCS to learn about their needs and challenges; how staffing needs are addressed and how this compares to staffing patterns in traditional services. Methods will also include: 1) a national survey of state DD Directors, 2) a survey of a sample County Directors of disability services in Minnesota, 3) review of extant data sets in Minnesota, 4) a series of 6-8 individual case studies to gather information about the experiences of CDCS participants; 5) a series of 3-6 focus groups to explore CDCS support and staffing issues that emerged in the case studies; and 6) surveys/interviews with 100-150 sample members to gather information from consumers or family members who direct the supports.

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Numerous approaches have been developed to enhance the self-determination of persons with ID/DD. The majority of these have been targeted at the agency level. Some have been successful in supporting self-determination but relatively less so with persons with more intensive support needs. This investigation will identify and study a set of agencies currently using exemplary practices that effectively support self-determination of persons with a range of ID/DD. Based upon this information, and the results of Study 2.2, a multifaceted self-determination training and technical assistance program will be developed and field-tested in a variety of settings. Evaluation of the program will include consideration of the manner in which a variety of environmental factors and personal characteristics of individuals with ID/DD have an impact upon outcomes in the area of interest.

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This series of studies will document effective strategies to reduce turnover and improve recruitment of DSPs who support people with ID/DD. A comprehensive literature review will examine emerging research on DSP workforce challenges and effective intervention strategies. Case studies and in-depth interviews will be conducted to continue to identify and disseminate information about effective replicable best practices in recruitment, retention and training. Another study will examine policy initiatives and proposals to restructure the DSP workforce. Ongoing technical assistance will be provided and evaluated in 8-10 organizations and a replicable technical assistance model to continue to assist organizations to select, conduct, and document effectiveness of various workforce interventions. A Realistic Job Preview (RJP) intervention will be implemented and evaluated with 150 newly hired DSPs in 4-8 organizations.

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While methods to increase the community participation and social roles of persons with ID/DD have been identified, understanding these outcomes from the perspective of community members who are also part of the intervention is lacking. This study will document outcomes for community members of increased social integration of people with ID/DD, their perspectives and satisfaction about which social inclusion methods are more effective with which types of organizations and activities, and what practices increase duration of membership and social roles. To accomplish this, two different categories of community groups will be examined: community service/civic organizations and faith-based communities. Surveys will be mailed to representatives of civic groups in 4 states and to representatives of three national faith-based initiatives, with additional in-depth phone interviews to identify levels of participation and associated factors. Qualitative case studies of three exemplary civic organizations and three faith-based programs will be conducted as a further follow-up to these studies.

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The National Association of State Directors of Developmental Disabilities Services (NASDDDS), in conjunction with the Research and Training Center, Institute on Community Integration at the University of Minnesota is developing an emergency preparedness self-assessment instrument for state developmental disabilities agencies. The new self-assessment tool is being constructed to assist member state agency officials evaluate the extent to which their existing preparedness plans are able to address the unique characteristics of individuals receiving support through publicly funded developmental disabilities programs.

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The purpose of this project is to learn about the exercise of self-determination among adults with intellectual and/or developmental disabilities (ID/DD) and the specific factors within the environment associated with this outcome. The research activity involves two parts. In the qualitative portion of the study, the experiences and perspectives of 12 individuals with ID/DD served by residential programs engaged in one of three systems level interventions designed to increase consumer self-determination (consumer controlled budgets, person-centered planning, or the Home and Community-Based Waiver) will be investigated using qualitative methodology. One-half of these individuals will be served by organizations whose staff members have received instruction in how to most effectively support self-determination while the other half will be recruited from programs whose staff members have not received such training. In addition, DSPs who support these individuals and family members will serve as sources of information about these experiences. Data collection will consist of semi-structured interviews and participant observation within service settings. The second part of the activity entails a quantitative study of the levels of self-determination experienced by adults with ID/DD being served by residential providers employing one of the aforementioned system-level interventions designed to enhance consumer self-determination. In this part of the activity, 120 adults with ID/DD will be interviewed to ascertain current levels of self-determination and the adequacy of environmental supports. Interviews will be triangulated with a set of scales assessing levels of self-determination completed by a DSP who knows the resident well. All samples for this activity will be drawn in a manner so as to assure diversity within each cell in terms of type and size of residence, extent of intellectual disability, cultural background, and age.

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This project will apply Wilderness Inquiry’s (WI) Universal Program Participation Model to support whole families with young adult members with MR/DD as an alternative to respite support. It will a) assess outcomes in family-efficacy, family empowerment, family cohesion, family and individual’s future participation in outdoor activities, links with other families and community resources, b) identify indicators of high quality, socially integrated family outdoor recreation; c) identify support and training needed by families to use other community recreation resources; and d) identify new ways to improve training and other outdoor and wilderness organizations in supporting families with members with MR/DD.

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This study will provide both summative and formative research to measure the benefits, guide the development and inform the revisions of the College of Direct Support (CDS), its administrative functions and its platform for delivery. The CDS is a comprehensive, national, internet-based, interactive, multi-media training program for Direct Support Professionals (DSPs) (see brochure in Appendix L) and is based on systematic analysis of the knowledge, skills and attitudes needed by DSPs and has been guided by established principles of adult learning. The CDS also incorporates several survey instruments, regarding: 1) satisfaction with employment, 2) intent to stay, and 3) retention rates for DSPs. The CDS Introductory Program of 11 courses (55 instructional hours) became available in June 2003. So far more than 2,300 learners in all 50 states have completed lessons. An introductory program for Frontline Supervisors (FLS) will be added by 2005.

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The report to be completed for this project is an evaluation of the newly implemented model for case management services for persons with developmental disabilities. This report will address the following issues, and include a comparison of the newly implemented model with previous practices and best or alternative practice from literature reviews: 1. How does the new case management model support and encourage client choice and control? 2. How does the new model address county responsibilities? 3. Does the county have any exposures or vulnerabilities under the new model? 4. How does the new model address responsiveness to clients? 5. Will the new model allow the county to meet the needs of growing numbers of clients with fixed case management resources? 6. Will the new model be effective in assuring client health and safety considerations? The report will be based in part on information gathered through focus groups with all case managers and supervisors, a survey of all case managers and supervisors, and interviews with a selected number of consumers.

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This national study was conducted by the Research and Training Center on Community Living in collaboration with state agencies and provider associations to describe the skills and competencies needed by direct support professionals and frontline supervisors who support individuals with developmental disabilities. This study examined organizational workforce outcomes; characteristics of and differences between managers, Frontline Supervisors (FLS) and Direct Support Professionals (DSPs); and workplace competencies, training needs, and timing of training for FLS and DSPs. Participants were selected from 77 organizations providing residential supports to persons with intellectual and developmental disabilities in Oregon, Nebraska, Ohio, Rhode Island and Florida. A total 67 managers, 105 FLS and 49 DSPs participated. Study results were used to identify changes needed in the Minnesota Frontline Supervisor Competencies and Performance Indicators (Hewitt et al., 2004) and a condensed version of the Community Residential Core Competencies (Hewitt, 1998).

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Funded by the Kansas Council on Developmental Disabilities, this project is designed to make systematic, long-term changes in the retention and recruitment of Direct Support Professionals (DSPs) who support people with developmental disabilities in Kansas. The project will assist 12 employers of DSPs (including individuals or families who directly hire DSPs) to put into action proven methods to find and keep high quality employees. In return, the employers will contribute time and people willing to learn new skills, share their expertise, implement changes, and provide feedback to a project advisory committee on how to make these changes work best in Kansas. Each employer will end the project with measurable improvements in their ability to find and/or retain high quality DSPs.

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The Minnesota State Legislature convened a committee, the Quality Assurance Panel, to study the efficacy of establishing regional quality assurance and improvement models in Minnesota. The Department of Human Services asked the Research and Training Center (RTC) on Community Living and the Human Services Research Institute (HSRI) to provide assistance to the Panel. The Quality Assurance Panel recommended that Minnesota establish a State Quality Commission to provide leadership on quality improvement activities and review quality outcomes at the state level, Regional Quality Councils to review quality outcomes at a regional level and to identify and implement initiatives to improve those outcomes. The QA Panel also recommended that Minnesota conduct an annual independent statewide sample of service recipients, an outcome-based quality assessment program, and an updated effective program of incident reporting, investigation and analysis.

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This project is developing a national web-based training program for frontline supervisors in human service agencies to address issues of recruitment, retention and training for direct support professionals.

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The Centers for Medicare and Medicaid Services (CMS) through Medicare and Medicaid reimbursement, regulation, and certification directly and indirectly affects the majority of the long-term care workforce. During FY2003, CMS took on a more prominent leadership role in addressing community-based long-term care workforce shortages through the solicitation of 7 to 10 Direct Service Community Workforce Demonstration projects. The Lewin Group, Institute for the Future of Aging Services (LFAS) and The Center on Community Living/Institute on Community Integration at the University of Minnesota are performing an “Evaluation of Contract Demonstration to Improve the Direct Service Community Workforce.” This project requires a qualitative assessment of implementation readiness and progress to identify and describe Promising Practices, technical assistance to grantees on local evaluation designs, and the development of a quantitative evaluation design to assess demonstration program effectiveness.

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For over 20 years, the National Residential Information Systems Project has been collecting and disseminating annually, national and state statistics on public and private residential services, Medicaid program utilization, expenditures, etc.

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The National Training Institute For Frontline Supervisors and Technical Assistance Project (NTIFFS) is a three year grant program designed to improve recruitment and retention across the country of Direct Support Professionals, who are competent and confident in the skills needed to provide quality supports and services to individuals with developmental and other disabilities.

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Medicaid Home and Community-Based Services (HCBS) is the primary national program to support long-term care for persons with ID/DD. Amidst its rapid growth a recent General Accounting Office report noted reason for national concern about the quality of quality assurance (QA) in community services and what should be expected of system defining in community services. This project will gather and analyze survey, interview, document and focus group data about current systems of states and the federal regions for monitoring, expecting and promoting quality as part of a Participatory Action Research study by the Developmental Disabilities Quality Consortium (8 national ID/DD organizations) evaluate, and offer and advocate for policy and program guidelines for community quality assurance.

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The University of Minnesota, in collaboration with Courage Inc., The Metropolitan Center for Independent Living, and AXIS Health-Care are collaborating on a three-year project designed to demonstrate both the direct and indirect effects of the AXIS approach to health-care on the lives of adults with physical disabilities. During the first year of the project, approximately 200 adults with a variety of physical disabilities will be enrolled in the AHC Program. Over the course of the three-year study, both their health outcomes and satisfaction with the program will monitored on a regular basis. The health outcomes and satisfaction of a comparison group of individuals receiving care through traditional plans will also be monitored during this time. In addition to a variety of traditional health-care outcomes that will be assessed, project staff will evaluate the impact of the AXIS program on the health-care self-determination, social/community inclusion, employment, stress, and the overall quality of life of participants. During the second and third years of the project, a study will be undertaken to determine the extent to which the use of person-centered planning has a direct and/or indirect impact on the health and rehabilitation outcomes, health-care satisfaction and both social and psychological outcomes of participants. During this study, Care-Coordinators (at Courage-Center) and Health Coordinators (at AXIS Health-Care) will be trained to serve as person-centered planning facilitators for the individuals whom they support. A person-centered approach to health-care planning will then be implemented with program enrollees during Year 2 and 3 of the project and the outcomes of these individuals assessed over the remaining two years of funding.

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This project will involve a secondary analysis of the integrated multi-state Community Living Outcomes database to examine the contribution of policy factors (e.g., state, funding source, costs); environmental variables (e.g., home size, staffing patterns, services received); and individual variables (e.g., functional skills, challenging behavior, secondary disabilities and support needs) on community participation, social integration, and independence and other outcomes.

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This project conducts two in-depth case studies of best practices in DSP workforce development in the United States each year. Case studies will focus on programs and initiatives advancing the goals of the National Alliance for Direct Support Professionals (NADSP). Models of best practice will be identified through solicitations in the Frontline Initiative newsletter and through member organizations of the NADSP. The top five nominations each year will be screened for possible inclusion in the case study project. The top two nominations will receive site visits. Up to two Moving Mountains Best Practice Awards will be given each year with the winners honored at the annual Reinventing Quality Conference.

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Quality Mall is a web site that gathers and disseminates information related to or useful in promoting the quality of life for persons with developmental disabilities. It especially focuses on promising person-centered practices and innovations.

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Beginning in 1996, a group of community “stakeholders” in SE Minnesota began to explore community initiatives to improve services. One of these initiatives received Legislative authority and funding to plan, design and implement a new outcome-based quality assurance system for community services. The “Region 10 Quality Commission” was designed to be of the community, by the community and for community members with ID/DD. This study will gather quantitative and qualitative formative and summative evaluation data on this program. It will also develop a documentary film on its development, implementation, engagement of community members and effects on persons with ID/DD and those who support them.

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This project will identify, refine, and establish benchmarks for tools that organizations can use to measure or improve DSP and FLS recruitment, retention and training outcomes. It includes a literature review to identify existing standardized instruments that can improve selection practices, and the refinement and establishment of benchmarks for two instruments that have been developed for RTC/CL research: a set of competencies for DSPs in community residential support settings, and a set of competencies for FLS.

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This project developed a draft of a Report to Congress on the supply and demand of direct support professionals needed to serve people with intellectual and developmental disabilities (ID/DD). The project included reviews of research, data estimates and projections, consultation and interaction with federal government staff, formulation of recommendations and development of an initial draft report. The RTC utilized its expertise in service systems for individuals with ID/DD, current workforce supply and demand and related factors, and data analysis expertise to develop this report in response to a Congressional request.

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This project conducts an extensive review of current knowledge and practice in self-determination and full inclusion. This review will involve all RRTC participants, serve as the background papers to a national "state-of-the-science" conference in Year 4, and be published as a second edition to the RRTC's Challenges for a Service System in Transition: Ensuring Quality Community Experiences for Persons with Developmental Disabilities (Hayden & Abery, Eds., 1994).

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This research and development project will employ systematic analysis of specific web-based technology and learning strategies to accommodate relevant impairments to web use associated with ID. It will use ongoing internal and external assessments and refinements to create and refine a model for maximizing website accessibility for persons with ID and related cognitive disabilities (RCD). A model website will be designed and evaluated to establish, field-test, and exemplify features of website design to accommodate ID/RCD. The model will be employed to design and deliver information of high value to persons with ID/RCD by focusing on “self-advocacy.”

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This study will gather data in two surveys, in 2004 and 2006, on family support services in the 50 states and D.C. Data analyzed will include revenue, spending, and participant data for cash subsidy payments directly to families, and other family supports including respite care, in-home supports, counseling and other services. Data analysis and dissemination activities will address family support spending and numbers of families served in the past decade, family support spending in comparison to total ID/DD long-term care spending, and the level of Medicaid HCBS support for family support services in each state and the US.

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This project integrates Medicaid HCBS (“waiver”), ICF/MR, and Nursing Facility data collection and national data systems of the RTC/CL Minnesota and Colorado programs to maintain a national and state-by-state program of current information on status and trends in Medicaid and related programs that finance and support access to community services. (Activities in this area are co-sponsored by the Administration on Developmental Disabilities and by the Universities of Minnesota and Colorado.)

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This project undertakes various analyses of the National Health Interview Survey on Disability Supplement (NHIS-D) to further knowledge about the lives of persons with developmental disabilities on a range of topics.

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In 2006, the University of Minnesota was asked to conduct a series of interviews and focus groups with staff from two programs of the Volunteers of America (VOA) of Greater New Orleans: Supported Living Services (offering individualized family supports day and night, and semi-independent living supports to adults and children with disabilities) and Community Living Services (offering group homes for adults and children with developmental disabilities).

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This project is a three year workforce systems change initiative funded by The Illinois Council on Developmental Disabilities (ICDD). This project is designed to improve recruitment and retention of Direct Support Professionals in Illinois, who are competent and confident in the skills needed to provide quality supports and services to individuals with developmental disabilities.

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Over the past several years, many important systemic and environmental interventions intended to increase the self-determination of individuals with ID/DD have been implemented. These include: the provision of supports in non-institutional, less tightly regulated settings using the Home and Community-Based (HCBS) waiver; the use of “person-centered” approaches to service planning and delivery; training programs for service staff to enhance their ability to support consumer self-determination, and the use of individualized budgets that allow consumers/family members a voice in deciding on how funding available to support them will be spent. Each of these interventions have particular strengths and drawbacks in supporting self-determination. At this time, however, there is a lack of knowledge as to which of these approaches or combination of approaches best supports self-determination. Using both qualitative and quantitative methodology, this study will evaluate the impact of these each of these for systemic approaches along with a number of micro system level environmental factors on enhancing the self-determination of individuals with ID/DD.

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An interactive website is being developed to provide a “clearinghouse” for leisure, recreation and life opportunities for people with ID/DD. This site will be used to link people with activities of interest and with others who share those interests to improve the quality of people’s social lives, opportunities, choices, and satisfaction. To determine the impact of the website, a pre- and post-test comparison will be conducted on the nature and variety of leisure and recreation activities of a sample of persons from participating sites. Data will be collected through site visits to determine the degree of inter-agency sharing of transportation and staff, and community members’ volunteering of time and resources, and implementation challenges.

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