The individual who has a Waiver Slot and natural family and/or the authorized representatives of the individual makes the decision on what support the individual will receive. You are the “customer” who can take your business where your needs are most effectively met. The individual and the natural family are the “Directors” of the support team. Feel free to ask lots of
questions and continue to look until you are satisfied with the response. The Support Coordinator from the local Community
Services Board or Behavioral Health Authority will assist in this process by providing information on the licensed provider agencies available in your region. Often the community Services Board is also a provider of residential services. There is no requirement to receive support from the CSB programs, but it may be one of the agencies you will wish to consider.

To begin:

• Check out the web site of the agencies you are considering (from the list of providers given to you from the support coordinator or your own research) and review the mission statement of each agency to see if they reflect your own values. Check on the reputation of the agencies by talking with people in the field or with people who have used the service.

• How long has the agency been in operation and what experience and education do the owners/directors have?

• Does the agency have openings in the area that the individual chooses to live?

• Do the proposed support providers have expertise in the areas of concern for the individual, for example, ability to communicate with sign language, positive behavioral support training, autism expertise, etc?

• Check out the Virginia Department of Behavioral Health and Developmental Services web site, under Office of Licensure – “provider search” - you can checkthe licensure status of providers. Providers who have licensure authorization for less than three years may mean that they are a new provider agency or have experienced problems which require more frequent review by the state.

When you meet the agency representatives:

• Discuss how often each service is visited by Program Managers or other supervisory personnel from within the agency and what occurs on these supervision visits.

• Ask about training provided to family providers and other direct support staff.

• What are the policies and procedures regarding problem events? How are natural families notified? Are natural family members included in important decisions before they are made or immediately after when major changes occur?

• Discuss with the potential provider and the agency representative the level of involvement you wish to have in the development and updates of the support plan for the individual who receives support. How do you want medical care decisions handled, and what are the agency’s procedures for keeping you informed about issues as they arise?

• How does the agency propose to get to know the person? Is the individual interviewed by the people who are offering a
  service about preferences before the service starts? Do they listen well to the person who will receive support? Is the provider willing to offer a day visit and then an overnight visit before a decision is made?

• Is the provider and the agency open to including the natural family in the development of the personal profile and the typical daily schedule for the person?

• How does the particular provider accommodate social activities of individuals, visits and vacations away from the residence?

• Ask the provider about their personal philosophy of delivering support. Are they professionals or are they tied into a more custodial idea of care giving?

• What practices does the agency follow to assure good health for the people receiving support? Medication administration,
  physical exams, emergency medical care, dental care, psychiatric care, etc.

• What is the agency policy related to handling the personal finances of the people they support? How is this communicated
  to the individual and family members?

• What steps are taken to ensure personal choice in development and implementation of the support plan and in making choices of activities, meals, community activities, church involvement and leisure activities?

• Are there staff available with the knowledge, skills and abilities to create Positive Behavioral Support Plans when needed?

Physical Environment

• Is the appearance of the residence well kept, free of hazards, inside and out?

• Is there a private bedroom available for each person who receives support?

• Is there opportunity for the individual who will receive support in the home to decorate his/her bedroom to her/his personal taste?

• Do the bathroom facilities meet the needs of the people residing in the home? If environmental modifications are needed, can they be authorized?

• Is there a policy regarding the personal items for individuals such as CD players, radios and TVs?

• Are you comfortable with the condition of the kitchen appliances, and the amount of food available?

• How are meals planned? Is there monitoring of nutrition? Are the people being supported assisted to participate in meal preparation and choosing favorite foods?

• During the visit - what was the attitude of the family providers? Do people appear to get along well and treat each other with respect?

• Did things appear to run smoothly? Were the staff able to attend to the people supported in the environment?

• What were others who receive support doing at the time of your visit? Did they appear comfortable andwell cared for?

• Are there pets in the home if the people there want them?

• Where medications are stored and are they locked? Who in the home is authorized to assist in medication administration?

• Is it okay for family and friends to visit the home? 

These guidelines are only one tool to help your decision-making regarding residential support services for the individual who needs services. There may be other questions specific to the persons unique support needs. The Arc of Virginia is a great source of support and help, as well.

Compiled by: Kamala Bauers, LCSW & Jack Wall, MA. Ed.

kbauers@www.wallresidences.com
jwall@www.wallresidences.com

Wall Residences
PO Box 235
Floyd, VA 24091
(540) 745-4216