PROGRAM DESCRIPTION

Mission Statement

Our mission at MARC is to use actual work activities as therapy in the belief that having an occupation is a basic human activity essential for health and the healing process. Therapeutic work activity must embody the characteristics of purposefulness, challenge, accomplishment, and the satisfaction that makes up every occupation.

 

Scope of Care

We provide a comprehensive range of therapeutic vocational day treatment specialized in outpatient rehabilitative services to people recovering from brain injury, spinal cord injury, severe orthopedic injury and limb loss, neurological disorders, or neuropsychiatric conditions, in a community integrated model of care.  We primarily serve adults but may occasionally serve older adolescents or minors who are at least 16 years of age and who may not have access to a specialty pediatric rehabilitation program best suited to their specific service needs.

 

Vocational Associates (VA’s) are served within a specialized facility structured to accommodate their individual needs.  VAs are assisted to maintain health and safety, and to develop a productive structured daily routine designed to improve functional participation in a vocational setting. Therapeutic and habilitative activities vary in scope and focus, but may include educational, pre-vocational, vocational, enclave, cognitive remediation, recreational, artistic, participative groups, and physical exercise.

 

Spinal Cord Injury

In most instances etiology is related to impact trauma (i.e., MVA). Medical need impacts admission and level of care related to the level of a spinal cord injury. For example, individuals requiring a Tracheotomy or Mechanical Ventilation are outside of our scope of care. Care needs for Persons Served with spinal cord dysfunction is reviewed prior to admission to determine level of care and required resources to provide that care.

 

The purpose of this program is to be able to provide individuals, who have sustained a traumatic brain injury, the following skills designed to foster; independence, appropriate social skills, interaction with peers, family members as well as others in the community; cognitive ability, quality of life, development of skills necessary for competitive employment, and participate in purposeful activities.

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Services Offered

• Transitional Services

• Occupational Therapy                                           

• Physical Therapy

• Therapeutic Exercise Programs

• Medical and Therapy Services Coordination

• Individualized fitness programs

• Job Coaching

• Family Education & Training

• Vocational & Pre-Vocational Training

• Supported Employment

• Structured Workshop

• Art Activities and Groups

• Training in Community Living Skills, Domestic Skills, Life Skills, and Social Skills

• Structured Day Program

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Hours of Operation

MARC maintains standard business hours, Monday – Friday from 8:30 a.m. to 4:00 p.m. Administrative and key clinical staff are available 24 hours per day for emergencies.  During the times when an administrator is not within the environment of the program and an emergency arises, an on-call system is in place.  Staff are trained on emergency protocol and procedures during new hire orientation and annually.

 

Staffing

Clinical staff are licensed and certified to provide services in each specialty service area.  Job Coach Staff provide supervision, assist with daily activities and functional skill development, provide specialized treatment and rehabilitation services according to individualized programs.  Job Coach Staff must have a high school diploma and successfully complete established MARC training.  Job Coach Staff also complete training related to the individual participant’s service needs. 

 

MARC is an equal employment opportunity employer. Employment decisions are based on merit, qualifications, abilities, and business needs, and not on race, color, citizenship status, national origin, ancestry, gender, sexual orientation, age, religion, creed, physical or mental disability, marital status, veteran status, political affiliation, or any other factor protected by law. MARC complies with the law regarding reasonable accommodation for employees with disabilities.

 

Administrative and program management personnel ensure consistency and quality of services and efficiency of support operations.  All staff must pass criminal background checks prior to employment. Job Descriptions, including performance, experience, and training requirements, are available for all positions within MARC and provided to staff at time of application.

 

Staff Titles

• Executive Director

• Vocational Program Manager

• Physical Therapist

• Occupational Therapist

• Recreational Therapist

• Art Therapist

• Music Therapist

• Vocational Job Coach

• Administrative Assistant

• Human Resource Generalist

• Quality Improvement Manager

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Training

MARC elicits feedback from all stakeholders (VA’s, families, agencies, employees, externals) to refine ongoing staff education and training priorities and to improve training regimens.  Additional training needs often emerge during clinical team meetings, continuous quality improvement or other administrative meetings.

 

All staff are expected to complete a new hire orientation with additional trainings provided via the New Hire Orientation binder. Clinical and professional, or staff with special certifications or licenses, are required to maintain on-going continuing education credit requirements.

All staff receives a minimum of 40 hours employee orientation that includes a mentoring process and formal training in:

• MARC Fundamentals Training including individual rights, and person-centered treatment planning

• Abuse and Neglect Training

• OSHA training including Infection Control/Universal Precautions/Blood Borne Pathogens

• Safety and Hazard Communication

• Emergency Procedures (fire, disaster, etc.)

• CPI (Crisis Prevention Institute) or NAPPI (Non-Averse Physical and Psychological Intervention) which includes prevention of and management of disruptive behaviors

• CPR & First Aid

• Health and Medical Issues - including seizure disorder, skin integrity, swallowing disorders, diabetes overview, spinal cord dysfunction, oxygen use, etc.

• Transfer/Body Mechanics Training

• HIPPA/Confidentiality

• Code of Conduct

• Person Served Rights/Responsibilities

• EE Injury Accident and Incident Reporting

• Person Served Incident Reporting

• Medication Administration Training – simulated med pass training

• Workplace Violence Prevention Training

• Employee Harassment Training

• Suicide Prevention

• Professional Boundaries

• Basic Brain Injury 101

• Cultural Diversity

• Safe Handling Techniques

• Safe Food Handling

• Safe Drivers Training

 

Admission Criteria and Guidelines

1. Adults who are aged 18 years or older with a diagnosis of an acquired brain injury, spinal cord injury or other severe orthopedic injury, neurological disorder, or neuropsychiatric condition. 

2. Adolescents 16 yrs. or older, may be considered for admission with appropriate waiver from Michigan Adult Foster Care Licensing.  Admission will only be considered if the candidate does not have access to a specialty pediatric rehabilitation program best suited to their specific service needs, or to preserve proximity to critical family and / or community support.

3. Potential to benefit from MARC services and to meet the functional outcomes established.

4. Submission of pre-admission documentation or information to adequately conduct intake assessment and determine suitability for admission.

5. Completion of all admission documentation.

6. Behaviors that may be dangerous to self or others are able to be managed with behavioral interventions, and do not represent a serious risk to health and safety of others.

7. Medical condition is stable and medical needs can be managed within context of vocational environments.

8. Documented evidence of funding.

9. We cannot accept or retain a person who requires continuous nursing care. We cannot accept or retain a person who requires isolation or restraint.

10. Admission is contingent on the prospective compatibility with other VA’s.

11. At the time of admission and at least annually, an outcome measurement assessment is completed. A copy will remain on file.

12. The VA and VA representative allow the program to contact physicians and to utilize all information to assist the residents. 

13. The amount of personal care, supervision, and protection that is required by the VA is available in the therapy space.

14. The kinds of service, skills and physical accommodations that are required of the therapy space to meet the VA’s needs are available – barrier free.

15. Physician prescription specifying what services are needed.

16. While attending the program the VA’s rights are protected by the following:

    1. Shall not be discriminated against based on race, religion, color, national origin, sex, age, handicap, marital status, or source of payment.

    2. Shall not be denied or restricted in exercise of his or her constitutional rights, including the right to vote, the freedom to practice the religion of his or her choice, the right to freedom of movement and freedom of association.

17. The program will maintain a current license and/or accreditation as applicable and abide by all administrative rules.

 

Estimated Length of Stay/Admission:

Estimated length of stay/admission is determined by the treatment team evaluation of therapy process and goal outcomes. This is reviewed at least annually and documented by an updated prescription.

 

Transition Criteria

1. VA meets the outcome goals as specified in their vocational therapy plan and has improved skills to a degree sufficient to be able to be served in alternate community environment. Typical outcome goals include sufficient improvements in workplace tolerance, behavioral self-management, ability to maintain personal health and safety, managing one’s personal and business affairs, making effective use of strategies to compensate for cognitive and behavioral impairments, or becoming competitively employed or otherwise engaged in volunteer work, sheltered work, school, or other meaningful, productive day activity.

2. Behavioral sequelae are sufficiently self-managed to not present a danger to self or others and/or successful community placement.

3. Discharge/follow-up plan is in place prior to exit from the program.

4. VA is not capable of maintaining entry criteria.  An alternative placement site/service provider will be identified prior to exit from the program.

5. Completion of all discharge planning and documentation.

 

Discharge Criteria and Guidelines

 

1. MARC will maintain the VA in program if the following criteria are met or the VA requests discharge:

   1. The amount of personal care, supervision and protection required by the VA is available in the facility.

   2. The kinds of services and skills required of the facility to meet the VA’s needs are available in the facility.

   3. The VA’s needs are compatible with other members of the facility.

   4. The program determines placement to be inappropriate.

2. A 30-day written notice will be given prior to discharge from the facility. The notice shall state the reason for discharge. A copy of the written notice will be provided to the VA and the VA’s designated representative. Exceptions to the 30-day written notice are:

   1. Substantial risk or an occurrence of self-destructive behavior.

   2. Substantial risk or an occurrence of serious physical assault or destruction of property.

      1. When such basis or a discharge exists, 24-hour prior verbal notice followed by a written notification will be given.

      2. The reason for the proposed discharge, including the specific nature of the substantial risk.

      3. The alternatives to discharge that have been attempted.

      4. The location to which the resident will be discharged, if known.

 

The program will try to plan a discharge planning meeting and provide the necessary documentation to ensure for an appropriate transition. There may be a cost for making copies of records outside of the discharge planning process.