Parents and other referral sources often ask me how long their child will need residential services. My standard answer is, “it depends”. The problem with my answer is that many people disagree on what the factors are that make up my answer “it depends”. I have completed many literature reviews on factors related to lengths of stay in residential treatment. This research can be confusing and often contradict previous reviews. Many factors have been examined including ethnicity, age, parental involvement, parental substance abuse, access to aftercare (hours/transportation), social economic status, and child diagnosis to name a few.
I admit it. I gave my seven year old an iPod Touch for Christmas. Although this has resulted in a precipitous increase in dreaded “screen time,” there have been other impacts as well. Last night for example, she showed me an app she was playing with, which seemed to involve some complicated rubric for efficiently operating a small farm. It was bright and engaging, with cute little cows, and tiny helpful farmhands. I briefly attempted to take over the management, and, much to her horror, productivity dropped immediately – the Dustbowl had begun. I simply couldn’t acquire the rules and cause/effect relationships as quickly as she could. Her ability to learn, mediated only by the software, is unbelievable.
I was thinking about my daughter’s experience recently, when Grafton invited representatives of Jason Learning, a nonprofit organization that connects students to real science and exploration, and UrbanTech, a nonprofit educational group, to a full-day symposium.
In March of 2010, President Obama signed the Patient Protection and Affordable Health Care Act (ACA). One of the ACA’s major provisions is Medicaid expansion. Under the law, states can broaden the Medicaid financial eligibility criteria to families and individuals making up to 133% of the federal poverty level ($15,400 per individual or $32,000 per family of four).This could provide access to more of Grafton’s lower income clients and many others across the state, but unfortunately at this time, the Virginia General Assembly has chosen not to expand this important program.
When was the last time you looked at your watch and sped up what you were doing to hurry to another activity? Wouldn’t it be great if you soon realized you have a few extra minutes before a meeting and can run to get coffee! Do you check your bank statements to know how much money you have (or, more likely, how much you can squeeze out for that frivolous purchase!)? Have you been successful losing weight by counting calories and minutes of exercise? We all have experiences like this each day, but we don’t realize we are using data to drive our decision-making. In fact, any time we use information to guide our next steps, we are using data.
When I think about the work Grafton has done over the last decade, two numbers (98 and 12 million), come to mind. Grafton has achieved a remarkable 98% reduction in the use of physical restraints and a total return of more than $12,236,934 through savings in employee lost-time, workers’ compensation costs and employee turnover.
When we talk about how we achieved these outcomes, a key phrase is “Comfort versus Control. It refers to a philosophical and paradigm shift that took place at Grafton and continues to shape and guide our treatment philosophy today.
There is nothing more mind-bending about Grafton than its involvement with the State of Victoria in Australia! It seems strange somehow that a 50-year-old provider based in Virginia would be sending teams 10,000 miles away for the purpose of training and case consultation. This may seem especially strange to those of us embroiled in the day-to-day challenge of providing life changing care to our clients back home during this turbulent era of American healthcare reform.