Hassel House was a personal care home that provided residential and day services to 18 elderly individuals with serious mental illness. JEVS transformed Hassel House into the JEVS’ Wellness Initiative (JWI), an independent living program where participants reside in apartments with their own lease and integrate into their community by learning to engage and share. JEVS provides multiple services including: Mobile Psychiatric Rehabilitation services to support participants and teach them independent living skills based upon their needs; Certified Peer Specialist services to help people practice new skills; and what is most unique—JEVS also provides Wellness services that address 7 dimensions of wellness: medical, psychiatric, spiritual, social, nutritional, relational, and recreational. In addition, JWI connects each person to waivers through the Office of Long Term Living, providing attendant care or technology services so that the person can remain at home.
JWI breaks down segregation for elderly disabled people and supports each individual in pursuing his/her integrated path into the community while receiving proper supports to grow older within the comfort of home. When residents live in the community, they can make choices regarding health care, staffing, meal planning, activities, and setting their schedules. JWI is operated by a Nurse who—along with Health Mentors—monitors and supports each person to secure health and psychiatric services, address medication management, nutrition, physical fitness, and smoking cessation, and facilitate the flow of communication between all healthcare related providers. Each person has integrated wellness plan and recovery plans that promotes recovery and resilience through a holistic asset-based approach. Services are based on personal priorities, resources and safety factors in each person’s home and community as well as identified personal barriers.
JWI is designed to assist individuals to achieve and maintain independence in the communities in which they live. JWI provides people with choices and control in their everyday lives because we believe that they are experts in their own needs and barriers, and thus can and should help design and create solutions that fit those needs. This approach promotes self-determination and self-respect as the path toward the best quality of life. Skill building is offered in the participant’s home as well as at relevant sites in the community. Services promote participant choice and are provided on a one-to-one basis by trained Recovery Educators. Health Mentors provide wellness and health care supports so that each person seeks proper medical and behavioral intervention. Certified Peer Specialists are available to help each person progress through his/her recovery journey. Each person is touched by at least one of these services daily, based on individualized planning.
In a community setting, “round the clock” care is not necessary, thus reducing costs. People can also secure additional resources including: Aging Waiver funding – personal assistance service, meals, transportation; technology supports - environmental monitoring for safety; SNAP, LIHEAP and other benefits; mobile psychiatric rehabilitation, skills training, recovery supports, peer supports; and ongoing wellness activities. Individuals can call staff on a “warm” line should they have a concern short of a crisis-to talk through an issue or get advice on handling a situation. This intervention deflects situations that can become more serious and lead to hospitalization, thus promoting cost savings. JEVS staff utilizes technology to increase the efficiency of data collection. Staff in the field use smart phones, tablets and laptops to manage information from our electronic health records thus freeing them up to provide more direct support to individuals.
JEVS’ transformation of a group-based behavioral health program into an independent living wellness one is innovative and creative. JWI includes 7 dimensions of wellness that integrate the physical, mental, and spiritual well-being of people and provides a holistic approach to their needs, leading to a better quality of life. To ensure that individuals actively pursue wellness, Recovery Educators develop wellness action plans that include skills development and goal setting. Health Mentors connect them to community wellness activities. Certified Peer Specialists help people practice skills, engage their community, and support them while modeling success. Since these individuals are over 60, they are at greater risk of isolation, manipulation, and health crises. Because we connect them to other resources and services, they can stay at home with additional supports and avoid being placed in a nursing home. This approach also allows them to maintain independence and control.
The design of the staffing team is something that other organizations can easily replicate. JEVS staff also actively participates in the Mobile Psychiatric Rehabilitation Services Collaborative with other practitioners where we share and learn about best practices. JEVS has also taught the behavioral health system to connect an individual to other supports in the State system to meet their needs (such as aging waiver or attendant care services).
Current funding is contracted with Philadelphia Department of Behavioral Health so that JEVS can provide services and supports for independent living. Rents are paid by bridge subsidies that are administered by PMHCC. JEVS works with Iron Stone, a housing provider to provide living space for individuals and accepts JEVS services and offerings as a benefit for the entire residential community. JEVS hosts yoga and cooking classes and walking clubs in which all members of the housing complex are welcome to participate. Other partner agencies include: Mt. Airy Learning Tree (to expand social leisure offerings), Meals on Wheels, Aid for Friends, and the Philadelphia University Social Work & Occupational Therapy depts., which provide interns and field work students to work with clients. PCA conducts assessments to identify potential waiver services to supplement services that are paid by Philadelphia DBH with personal care or other supports.
This program is eminently replicable and scalable as the Department of Behavioral Health is interested in seeing expansion of these programs. DBH has initiated many residential transformation initiatives, but this is the first transformation that focuses on the elderly population. JEVS’ program has the capability to grow beyond the current number of residents served through City referrals. The components of JEVS Wellness Initiative are replicable in other locations as well.
To develop effective recovery planning we will collaborate with each individual to establish goals with specific, measurable time lines and action steps. Wellness plans will also correspond to the recovery plan and goals will reflect both plans. Every 90 days, we will evaluate the plan and modify it with participation of the individual based on his or her choice and progress toward recovery goals. We will educate each person on service options to choose appropriate levels of services and community supports. Data will be collected to show each person’s satisfaction with services, health status, and progress on wellness and recovery plans. We hope to demonstrate the importance of maintaining a focus on wellness initiatives that weave physical health with behavioral health to better round out recovery planning.