View source for The Hughes Center for Exceptional Children/Residential Treatment Program Handbook

==About==
This text was transcribed from a Word document dated 2009-12-08. It includes only the main content, and has been re-formatted for legibility. As far as I know, it is not available on the Hughes Center web site. --[[User:Woozle|Woozle]] 01:20, 24 April 2010 (UTC)
==Content==
===Our Mission===
The mission of the Hughes Center for Exceptional Children is to encourage and facilitate the continued physical, emotional, social, and psychological growth and development of young people ages 13-22 in a positive, nurturing, caring, and structured environment.

Often young people such as you come to us with multiple backgrounds and problems, including numerous placements. We believe in the power of the individual to make positive choices to achieve a successful and productive life.

The goal of all staff members at The Hughes Center is to help you overcome the struggles that have, to this point, been the focus of your recent life. We will teach you the tools to resolve conflicts, develop healthy coping strategies, and deal with the issues that led to your admission here. Together we will work to identify your strengths so that we can build from them. We are here to help you better manage the challenges faced both day to day and over the long term, and we will work with you individually in the belief that you are the center of everything we do. Our program is based on the belief that the path to success utilizes the strengths that each individual owns to build their future.
  
===Our Vision===
At The Hughes Center we are dedicated to building happier and healthier lives in the residents we serve.  Our program embraces the core values of:

* Safety
* Respect
* Compassion
* Honesty

We believe in the power of the helping relationship through which each person is empowered to develop to their maximum potential.

===Program Goals===
While at The Hughes Center we will encourage you to develop respect for yourself, others, and the community.  While you are with us, we will help you identify your unique strengths and learn how to use them consistently in your life to achieve happiness in your relationships with others.  We pledge to help you learn how to make choices that will best meet your needs and encourage you toward 100% self management.  You will learn how to resolve conflicts with peers and authority figures, build healthy relationships with people at The Hughes Center as well as family members and people in the community, deal with problems constructively and develop healthy coping strategies that you can carry with you beyond this placement.

===Program Description===
You will be assigned to a cottage and become a part of a campus community.  You will have individual therapy three times per week; family therapy, expressive therapy, goals groups three times a day, social skills groups, life skills groups, and vocational, recreational, and structured leisure activities. You will also receive up to three therapeutic groups a week facilitated by a licensed or graduate level staff member. The groups will consist of anger management, social skills, self esteem building, and psycho educational. A Hughes Center nurse will provide medical treatment and give medications as ordered by doctors.  A psychiatrist will meet with you every week.

Treatment plans are written within the first 14 days following admission and reviewed every 30 days thereafter, and as needed.  The Treatment Team includes you, your family members, the psychiatrist, nurse, teacher, direct care staff, your therapist, and case manager.  Your parent/guardian also helps develop and signs your treatment plan. Your therapist will make phone calls with you each week to your family. The Treatment Team will make changes to your program as necessary to meet your individual needs.

===Program Staff===
You will have numerous people available to assist you in reaching your goals while at The Hughes Center:

* '''Mental Health Specialists (MHS) and Residential Supervisors''': All staff in the program have many experiences and a great deal of knowledge in helping others. They will work closely with you in your cottage and throughout your day. Although they will require you to put forth your best effort, they will also offer you a great deal of support and guidance in helping you manage your behavioral/emotional issues. Your goals and objectives, along with your progress on each, will be discussed with you daily and at the monthly Treatment Team by the Mental Health Specialist.  Your Residential Supervisor will be the person responsible for the day to day management of your cottage.  They provide supervision and leadership to the MHS’s that will be working with you.  
* '''Individual Therapist''': You will be assigned an individual therapist and see your therapist three times per week. You will also have group therapy at least two times per week with your therapist and peers in your cottage. With your therapist, you will understand how needs, choices, and the problem areas identified in your treatment plan fit together. Your therapist will review your individual, family and group therapy goals and objectives, along with your progress on each, at the monthly Treatment Team.
* '''Psychiatrist/Physician''': Your psychiatrist will prescribe medication based on your individual behavioral and emotional concerns. He/she will meet with you at least once per week and will assist you in understanding your medications. You and your parent/guardian must agree with the recommendations of the psychiatrist.Your psychiatrist/physician will review your goals and objectives, along with your progress on each, at the monthly Treatment Team. 
* '''Teacher''': While at The Hughes Center, you will attend school year round at the on-campus school. School operates from 9:00 a.m. until 3:00 p.m., Monday-Friday. Your teachers will assess your academic skill levels and work with you toward improving them. Your teachers want you to feel more confident about your ability to do well in school, and develop a love of learning that will continue long after your stay at The Hughes Center. Your teacher will review your educational goals and objectives, along with your progress on each, at the monthly Treatment Team. 
* '''Case Manager''': Your case manager assists the therapist, nurses and psychiatrist with your treatment planning.  He/she will obtain reports from the Mental Health Specialist, Therapist, Psychiatrist, Teacher and Nurses on your behavior to ensure that you are working toward your goals in treatment.  Your goals and objectives, along with your progress on each, will be discussed with you daily by the Nurses and Mental Health Specialist and monthly with the Treatment Team.  Your case manager will be the primary contact between you and your families/guardians and social workers/case workers.
* '''Nursing Staff''': The nurses at The Hughes Center will provide medical treatment and give medications as ordered by the doctors. It will be important for you to ask questions about any medications you receive, and you should also inform them of any concerns you may have so that they can communicate them to the psychiatrist. Your goals and objectives, along with your progress on each, will be discussed with you daily and at the monthly Treatment Team by the Nurses.
* '''Treatment Team''': Your treatment team consists of your MHS staff, your therapist and case manager, teacher, your psychiatrist, nursing staff, you, and your parent/guardian. Treatment plans are written and reviewed every 30 days and as needed by your treatment team. The treatment team may make changes to your program at any time to meet your individual needs.

===Program Services and Activities===
You will participate in numerous services and activities throughout the week that are designed to help you achieve your goals and successfully complete treatment at The Hughes Center:

* Education, On-Campus, Year Round School
* Individual Therapy
* Group Therapy
* Family Therapy
* Recreational Therapy
* Expressive Therapy
* Social Skills
* Goals Group
* Health/Wellness 
* Medication Training
* 24-hour Nursing Care
* Vocational Activities
* Structured Leisure Activities
* Spiritual Opportunities
* Off-Campus Activities
* Community Involvement

===ON-CAMPUS VOCATIONAL WORK PROGRAM===
When a Resident expresses interest in the on-campus vocational work program:

* The Resident must be 15 years old to apply for the program.
* The Resident’s IEP should include vocational goals as part of their standard curriculum
* An application should be completed with a specific job request.
* An interview should be conducted with the Resident, Superintendent of Schools, Program Director, and THC employee that will be involved in supervising the resident.
* The Resident must be on Level II for at least 30 consecutive days to seek an on-campus job and must maintain at least Level II to continue working.
* The Resident must agree to and sign a vocational work program contract.

When a resident begins working an on-campus job:

The vocational work program will be completed in graduated steps:

* '''Level I''': The Resident will first begin working one-two hours per day learning basic skills and tasks related to their specific job. The Resident will have direct supervision at all times.

* '''Level II''': After the Resident has mastered tasks on the First Level, he/she will work three hours per day learning more difficult skills and tasks related to their specific job. The Resident will have direct supervision at all times.

* '''Level III''': After the Resident has mastered tasks on the Second Level, he/she will work four hours per day mastering all aspects of their specific job. The Resident will have direct supervision at all times. (The Resident will also experience working inside the gate as well as outside the gate with direct staff supervision).

* '''Level IV''': After the Resident has mastered their specific on-campus job responsibilities, the Resident will be allowed to apply for an off-campus job.

At the end of each level, the Resident will be evaluated before being promoted to the next level. It is the resident's responsibility to request the next level.

* While working on-campus, the Resident will be paid $1.00/hour or $2.00/hour, depending on the job.
* The Resident will be responsible for completing their time sheet daily.
* The Resident will be paid every two weeks.
* The Resident will open a savings account and the money earned will be deposited into his/her account.
* Eligible Residents will receive Work Experience credits (in school) while working in the on-campus vocational work program.

===A typical day at The Hughes Center===
{|
|-
! width=20% | Time
!Activity
!Description of Activity
|-
|6:30 – 7:30 a.m.
|Showers/Activities of Daily Living
|Hygiene, clean room, clean unit & showers for upper levels
|-
|7:30 – 8:00 a.m.
|Goals Group
|Goals Groups are for discussing earned levels and planning and setting daily goals for the next shift
|-
|8:00 – 8:15 a.m.
|Transition to Cafeteria
|Walk to Cafeteria from Cottage
|-
|8:00 – 8:45 a.m.
|Breakfast
|-
|8:45 – 9:00 a.m.
|Transition to School
|Walk to School from Cafeteria
|-
|9:00 – 3:00 p.m. 
|SCHOOL
|-
|3:00 – 3:15 p.m.
|Transition to Cottage
|Walk to Cottage from School
|-
|3:15 – 3:45 p.m.
|Goals Group/After School Snack
|Goals Groups are for discussing earned levels and planning and setting daily goals for the next shift
|-
|3:45 – 4:15 p.m.
|Social Skills Group
|Led by various staff
|-
|4:15 – 5:00 p.m.
|Process Groups: M, T, W or Th<br>Off Days: Expressive/Art
|Process Group: Led by therapist 3x weekly<br>Expressive/Art: Led by various staff
|-
|4:15 – 5:00 p.m.
|Vocation Group Activity
|Led by various staff
|-
|5:00 – 5:30 p.m.
|Dinner
|-
|5:30 – 5:45 p.m.
|Transition to Cottage
|Walk to Cottage from Cafeteria
|-
|5:45 – 6:30 p.m.
|Therapeutic/Recreational Activities
|Activities Director
|-
|6:30 – 7:30 p.m.
|Structured leisure, phone calls, TV, unit activity
|-
|7:30 – 8:00 p.m.
|Goal Group/Evening Snack
|Goals Groups are for discussing earned levels and planning and setting daily goals for the next shift
|-
|8:15 – 9:00 p.m.
|ADL Group/Prepare for Bedtime 
|Includes basic hygiene and showers 
|-
|9:00 p.m.
|Bedtime/Lights Out
|}

===Your Rights and Responsibilities===
[[Virginia]] Law and Regulations of the Department of Behavioral Health and Developmental Services provide for a system of client rights while you are at The Hughes Center. As a resident, it is important for you to know your rights.  For your information we are including a copy of Your Rights in DBHDS Operated, Funded or Licensed Programs along with a copy of this handbook.   We encourage you to talk with staff listed on the front of this handbook or with your personal advocate here at The Hughes Center if you have questions about your rights.  

As a resident, it is important for you to know your rights.  It is equally important for you to understand that with any right comes responsibility.  These are also included in your rights copy as mentioned above.

===Our Responsibilities===
Every staff member at The Hughes Center has the responsibility to insure that you receive the best possible care designed to meet your individual needs.  We are responsible for providing an environment that is safe and clean as well as providing active treatment targeting your individual needs. 

===General Responsibilities of Residents===

* You are responsible for keeping your bedroom neat, picking up after yourself in common areas, doing your laundry, and completing assigned chores.
* You are responsible for treating yourself, peers, and staff with respect.
* You are responsible for being on time for school, groups, and activities.
* You will be held responsible for all property damage.
* You are responsible for getting what you need out of your treatment by:
*: a. asking for help when you need it
*: b. sharing your feelings with staff and peers
*: c. not participating in unhealthy behaviors that may be initiated or encouraged by peers
*: d. telling the truth
*: e. attending school daily and on time
*: f. showing respect for yourself, peers, and staff
*: g. participating in all therapy sessions, goals groups, and activities
*: h. following the dress code
*: i. observing wake-up time and bedtime

===Therapeutic Program===
You will be assigned to an individual therapist.  You will see that therapist three times a week and you will also have group therapy with peers in your cottage up to three times per week. Your therapist will help you understand your specific needs and how to make positive choices in an effort to meet those needs. You will work very closely with your therapist to understand the choices you make and how to get your needs met in healthy, productive ways. Family Therapy will be conducted at least once a month.

Discharge is not decided on "doing" behavior alone &ndash; it is a combination of your progress in therapy, attitude, behavior and choices.  Discharge is determined by your Treatment Team. Every month the staff in your cottage will report to the Treatment Team about your participation, effort, and quality of work in school, therapy, and in the cottage. How quickly you work through the program depends upon your attitude, behavior, choices, and progress in therapy. You will successfully complete the program at The Hughes Center when you have reached Level III participation, effort, and quality of work in all areas of your treatment for a consistent period of time. The average length of stay is 9-12 months. Some residents will finish the program in less time and others will need longer. The Hughes Center is planning your discharge from the day of admission, so discharge is in all aspects of your treatment.

===Orientation===
Every resident that enters the facility will be on orientation for 30 days. On this level, the resident will learn the rules and structure of the program and may complete various assessments. Residents will participate in activities within the cottage and designated activities on facility grounds. Off campus activities will not be permitted during this time. 

===The Level System===
Levels will be reviewed three times during the day at the Goals Group; once in the morning, afternoon and evening.  You, along with your staff, will discuss the progress you have made towards the goals listed in your treatment plan.  After the discussion, a level will be determined based on your behavior and participation in the program.  The descriptions below list the types of behaviors for each level.  For example, your behavior and participation in getting ready for school, going to breakfast, attending school and transitioning back to the cottage will be reviewed at the afternoon Goals Group.  Once you have received your level, you now work towards the next Goals Group.  You may have a bad day at school in which you receive a level 1 but have great afternoon/evening.  You may then go up to a level 3.  Each level gives you the opportunity to start over.  Your level can change three times per day based on your behavior and participation.  

* '''REFLECTION''' - On this level, the resident has had significant difficulty maintaining appropriate behavior and has demonstrated extreme defiance, destruction of property, non-compliance, self-abusive behavior, physical aggression towards others, and/or verbal abuse. The resident must be directly supervised at all times. A resident specific behavior modification plan may be developed. On this level the resident will not participate in any off campus activities or specific designated activities within the facility.

* '''LEVEL I''' - On this level, the resident needs several prompts, redirection, and direct supervision to complete tasks within their cottage and at school. Inappropriate behavior continues to be evident (temper outbursts, cursing, defiance, etc.) and the resident has not responded to program reinforcements. Close supervision of the resident is required on this level due to the residents’ inability to self-regulate behavior and actions. Off campus and specific designated activities within the facility will not be permitted on this level.

* '''LEVEL II''' - On this level, the resident is responding positively to program reinforcements, however, there continue to be instances of inappropriate behavior. The resident is able to complete tasks with prompts and redirection although direct supervision is required to ensure the tasks are completed correctly. The resident will begin to demonstrate self-regulation of behavior and actions on this level and will request a time-out, sensory time, or individual time with staff when needed. Off campus and facility activities are permitted on this level at the discretion of program staff when a resident has been on Level II for three consecutive days or more.

* '''LEVEL III''' - On this level, the resident is responding consistently to program reinforcements and completes all tasks in the cottage and at school with minimal prompts, redirection, and direct supervision. The resident is able to demonstrate self-regulation of behavior and actions and will request needs/wants appropriately to staff. Off campus and facility activities are permitted on this level at the discretion of program staff when a resident has been on Level III for two consecutive days or more.
 
===Visitation===
The Hughes Center supports family contact.  The Treatment Team will work with your parent/legal guardian to develop an Approved Visitor List of people who may visit you. Your guardian will have final approval of each person on the list.  The guardian may add or remove people from the list at any time by calling your therapist.

You are expected to have good behavior during all visits and passes.  Any visit that is becoming inappropriate or unhealthy may be stopped immediately by staff.  Any scheduled visit or pass may be cancelled if there is any dangerous or noncompliant behavior.  Visits on facility grounds may last two hours.  More time may be allowed for families traveling long distances as approved by the Treatment Team.  Two visitors are allowed at a time.  All visitors over the age of 18 must show a photo identification card.  No children under the age of 13 will be permitted to visit. 

Visiting Hours: 
{|
|-
| Wednesday ||	 5:00 p.m. – 7:00 p.m.
|-
| Saturday  ||	 1:00 p.m. – 4:00 p.m.
|-
| Sunday    ||	 1:00 p.m. – 4:00 p.m.
|}
Families and/or approved visitors may bring food items to you during visits and passes.  Because of health codes, all leftover food must be thrown away at the end of the visit.  No food will be brought back to the cottage to save for later.  This includes food purchased during outings as well.

'''Request for On-Campus Visit''':  Please notify the case manager or therapist of all requests for on-campus visits no less than 48 hours prior to scheduled visiting days.

'''Off Campus Passes''': All requests for off-campus passes will be discussed, considered, and either approved or denied during the residents monthly Treatment Team Meeting ONLY. Passes will increase in length based on successful completion of shorter passes.

===Outings===
If you are on the appropriate level and there is a scheduled outing for your cottage or class you will be permitted to participate in the scheduled off campus outing. You must be on Level II for three consecutive days or Level III for two consecutive days to be eligible for off campus outings. All outings are at the discretion of program staff; the Administrator on Call, Therapist, and/or Psychiatrist has the right to restrict any outing if there is suspicion of dangerous behavior or acting out prior to the outing. There will be no off campus activities for residents on Orientation, Level I, or Reflection.

===Telephone calls===

The Hughes Center supports family contact.  The Treatment Team will work with the parent/guardian to develop a Call List of people you may call.  You may add or remove people from the list at any time by calling your therapist.

# You may make ONE ten minute phone call from the cottage phone EVERY DAY OF THE WEEK.
# Therapists will help you make phone calls to social workers, lawyers and guardians ad litem.  These calls will not be counted as your call for that day.
# You may call the Human Rights Advocate (1-434-947-6214) when you feel that your rights have been violated.  This will not count as your daily phone call.
# Staff members will dial phone numbers using the Call List.
# After two phone call attempts, the next person in line uses the phone.

===Mail===
You will be provided materials/postage to send one letter per day.  You may receive mail and send mail without restriction, unless ordered by a physician or court order.  All mail will be opened in front of staff to ensure contraband is not received.  Care packages are limited to clothing, pictures, reading and writing materials.  Food and personal care items are not allowed.
  
===Resident/Family Resolution of Complaints===
Residents, their families, and LAR or legal guardian may freely voice complaints and recommend changes without being subject to coercion, discrimination, reprisal, or unreasonable interruption of care, treatment, and services.

Residents will be encouraged to submit complaints directly to the locked complaints box located in the cafeteria. Complaint forms will be available to all residents who wish to file complaints in writing. Complaint forms will be placed in the locked box and will be checked daily, Monday through Friday. Residents or parents/guardians may call the CAO or human rights advocate directly if they wish to file a verbal complaint.

All formal complaints will be investigated immediately and conducted by the CAO/designee.

===Personal Items===
The Hughes Center discourages you from bringing items of value to the facility and is NOT RESPONSIBLE for lost, stolen or broken items.  Items such as radios or electronic game devices will NOT be replaced if damage or theft occurs.  Your belongings are your sole responsibility.  Receiving this handbook and your signature shows your understanding of this policy.

===Resident Rooms===
Your room is expected to be kept clean. Beds should be made in the morning before breakfast. No personal items or litter should be on the floor. Clothes should be neatly folded on closet shelves. NO HANGERS ARE ALLOWED. Food is not allowed in rooms. Room checks will take place in the morning and the evening. To make your room feel more comfortable, you are encouraged to bring personal items from home such as a blanket or posters, as long as they are appropriate and in good taste. There will be a 4x6 poster board for each resident to tape pictures and posters. No pictures or posters are allowed on the walls of the bedrooms.

===Self-Care===
Our program includes a curriculum that teaches personal hygiene, how to appropriately use hygiene products, how to care for your clothing, and how to care for the space in which you live. All residents are expected to:

* Bathe daily
* Wash hands prior to eating
* Put on clean clothes and underwear after bathing
* Have clean and combed hair
* Brush teeth each morning and each night
* Keep personal care items in the locked office
* Do laundry on assigned laundry day (In the cottages are washing machines, dryers, and other laundry essentials. Staff will demonstrate the correct procedure for doing laundry, and will be available to assist when needed.)

===Management of Inappropriate Physical Behaviors===
The Hughes Center for Exceptional Children strives to provide a positive, therapeutic environment. We recognize that all residents have the right to considerate, respectful care in the least restrictive treatment environment. It is our philosophy that the resident’s behavior must be managed in such a way as to prevent or defuse situations that may require intrusive interventions such as physical holds. 

It is our commitment to use a physical hold only when there is imminent risk of harm to the resident or others. We are committed to educating our staff regarding the inherent risks of physical holds. More importantly, we emphasize the use of non-physical interventions as the preferred method for managing behavior. When it is absolutely necessary for staff to perform a physical hold, they are required to communicate clear expectations to the resident, attempt to discontinue the physical hold as soon as possible, and include the resident in the debriefing process; we do not use physical restraints as a treatment option.

===What to bring to The Hughes Center===
* 7-9 sets of washable, comfortable clothing
* Storage space is limited so any amount of clothing exceeding 7-9 sets will be sent back with the your parent/legal guardian
* Coat or jacket appropriate for the season
* Two pairs of comfortable walking shoes or sneakers
* Books, reading material, tablets, or notebooks without metal or wire bindings
* Walkman tape/CD player with THREE CDs 
* You are not allowed to bring game systems that require hooking up to a TV

===Other Reminders===
* Glass mirrors, nail polish/remover, or other similar products will be maintained by staff and only allowed use with direct supervision.
* Medicated creams, washes, acne products, or other special items may only be used with a physician’s agreement as some of these items may interact with prescribed medications.
* Medications are prescribed, ordered, and dispensed via The Hughes Center or its outside resources. No outside medications will be allowed or dispensed without physician’s approval.
* Residents are responsible for their own personal belongings. The Hughes Center will not accept responsibility for lost or damaged items. We recommend you do not bring expensive clothing or electronic equipment.