It is the policy of the Lighthouse, Inc. to admit, provide treatment services, and initiate patient referrals without regard to race, color, religious creed, disability, ancestry, national origin, age, and/or gender.

 

There is no distinction in eligibility for program services, which shall be made accessible to persons with disabilities through modifications and adaptive methods that are both practical and feasible.  This includes, but is not limited to: equipment redesign, assessment and elimination of architectural barriers, the provision of aids to overcome environmental barriers, the use of alternative delivery locations to overcome other barriers, personnel education and ongoing assessment to remove attitudinal barriers, resource coordination and referral to address financial barriers, programming flexibility to address employment barriers, internal transportation services and referral to external transportation services as well as structural modifications as needed to address communication or other barriers to treatment.

 

 

Ensuring program accessibility is the responsibility of every employee of the Lighthouse.  From the first referral of a potential client of the Lighthouse, individual needs and barriers to access are evaluated and necessary modifications are suggested.  The accessibility plan is implemented on a daily basis and reviewed annually by the Lighthouse Management Team.  The key areas addressed are listed below, as well as an example from our accessibility plan for the specific barrier to services for the Lighthouse, Inc.  A specific barrier list for the Lighthouse, Inc. is documented after the list of key areas.

 

Architectural Barriers

 

All physical structures, which comprise the Lighthouse campuses, are designed to meet the evolving and varied needs of individuals who have suffered a Traumatic Brain Injury (hereafter TBI) or other disabling conditions.  Input from the occupational and physical therapists are taken into account in the design, development and modification of all Lighthouse structures. If an architectural barrier is identified by the home manager, direct care staff, resident or other individual, this barrier is reported to the Chief Operating Officer (COO) in written format. The Chief Operating Officer then assesses the reported barrier, seeks input from pertinent staff, and makes the appropriate modifications to the structure in order to accommodate the individual needs of the resident. Budgeting for these modifications is conducted on an ongoing process. 

 

 

Environmental Barriers

 

The Lighthouse physical structures are developed in a manner that accommodates the unique needs of the populations served.  The need for additional environmental accommodations for each individual is assessed during the initial evaluation for each resident and outpatient client by the appropriate speech, occupational and physical therapy staff.  In addition, environmental needs that are identified by appropriate psychology or social work staff, nursing, respiratory therapy, as well as direct care, clients or family members are addressed.  These efforts are designed to encourage and facilitate each individual’s capacity to be independent.  Identified environmental barriers are reported to the Chief Operating Officer or Clinical Director, who implement measures to remove the barriers or refer to the Lighthouse management team for additional support in the removal of identified barriers.  The input of the resident and/or the guardian will be considered foremost in the realization of projects designed to remove barriers to access in any Lighthouse programs for the benefit for the resident.  Environmental barriers can include but not be limited to: lighting, equipment, durable medical equipment and odors.

 

Attitudinal Barriers

 

Attitudes of all staff and stakeholders are assessed on an ongoing basis, informally through team meetings and staff education as well as formally through staff meetings, team reports and performance evaluations.  During professional staff, home managers, or direct care staff meetings, attitudinal barriers to providing treatments are assessed and addressed.  Annual staff surveys are conducted, at the time performance evaluations, to identify any attitudinal barriers which may exist within the Lighthouse staff.  Identified attitudinal barriers are addressed by the Director of Human Resources and/or Clinical Director.  Strategies to remove attitudinal barriers include staff development and educational activities, progressive performance review and possibly removal of staff from the provision of treatments services.

 

Client attitudinal barriers are assessed through inpatient and outpatient surveys and are monitored in therapy sessions.  Continuing to keep therapies fun and motivation is an ongoing process. 

 

Methods to address attitudinal barriers within the community can also include school in-services, staff participation in community organizations and boards, resident community employment, and staff or resident volunteer work. 

 

Financial Barriers

           

The ability of a resident to access care with available financial resources is assessed by the Lighthouse finance department in conjunction with the personnel assigned to facilitate potential admission calls. The Lighthouse Chief Financial Officer (CFO) completes the negotiation of contracts for CMH, DHHS and other payor sources, to remove financial barriers. Barriers to care, which have a financial basis are reported to the finance department and the CFO.  Additional support to address financial barriers may be provided by the social workers and may include assistance in the procurement of Medicaid, Social Security or other related fiscal resources for clients.  If it is determined that all fiscal resources have been exhausted and financial barriers cannot be eliminated, the client will be referred to a provider agency that does not have the same level of financial barriers (i.e. a provider that accepts Medicaid payment) and or a referral agency which may have additional resources such as The Michigan Brain Injury association. The Lighthouse will endeavor to preserve adequate funding for each program of the agency.

 

Employment Barriers

 

Employment barriers are addressed internally or through referral to external agencies.  The Lighthouse has implemented flexibility in services, including varying treatment options, which allow for greater flexibility in employment options for clients. The Lighthouse established KW Industries to provide meaningful, off campus employment options for individuals who have suffered a Traumatic Brain Injury. In addition, The Lighthouse, has an established internal enclave program, to allow residents with more extensive employment limitations the ability to work for a sufficient wage while gaining valuable job skills. Residents who seek outside employment are assisted with this pursuit through the Lighthouse Vocational Department or referred to appropriate external agencies depending on their needs. The Lighthouse Vocation Department is actively involved with local and state groups to promote employment opportunities for clients.

 In order to eliminate employment barriers in Lighthouse staffing positions, job descriptions are evaluated annually.  Physical disabilities and personality characteristics are only taken into considerations if the position specifies a need for accommodation.  Reasonable accommodations are given to employees at the discernment of the Lighthouse management.

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Communications Barriers

 

The Lighthouse recognizes that the inability to communicate leads to increased frustration which is often the precipitant of negative behaviors.  The Lighthouse employs many speech therapists who provide ongoing assessment and treatment to overcome communication barriers.  In addition, the Lighthouse employs therapists fluent in languages other than English to meet the needs of individuals with limited English proficiency.  Picture communication boards for non-verbal individuals, adaptive communication devices, as well as the presence of many staff that are proficient in sign language are all instrumental in the elimination of communication barriers.  There is a designated professional staff member who is responsible for the ongoing provision of communication translation as needed for all staff, clients, and other stakeholders. As with all barriers, the individual communication barriers are addressed in collaboration with the person served, support network and other members of the treatment team; solutions are determined to meet the unique needs of the individuals served.

 

 

Communication Aids & Services

 

 

Aid or Service Key:

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1 – Sign Language Interpreter

2 – Paper and Pen

3 – Foreign Language Interpreter

4 – IPad (Special Programs)

5 – Safety Alarm Strobes

6 – Other Augmentative Communication Devices

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Technology Barriers

 

The concept of accessible technology focuses on individuals with disabilities and creating easy access to a product or device, service, environment/organization, or social life.  Accessible technology allows our disabled population access to information and services by minimizing the barriers of distance/travel and cost.

The Lighthouse supports the growth/expansion of information technology and the realization that technology is a part of our everyday life.  Lighthouse residents can transform their lives, by interacting with technology.  Lighthouse residents may create new opportunities for work, complete their banking/financial transactions, create travel plans, buy concert or activity tickets, send emails, or communicate with friends and family.  Information technology gives everyone especially the disabled the means to participate, build self-esteem, jump-start their rehabilitation, and most importantly inclusion.

 

Transportation Barriers

 

The Lighthouse is located in a rural area with limited public transportation availability and therefore recognizes the importance of adequate transportation services to increase the success of residents and outpatients.  The Lighthouse has a comprehensive transportation program which includes buses, vans, and cars.  The buses and vans are equipped with wheelchair accessibility features.  In addition, The Lighthouse maintains a listing of external transportation providers for referral of clients that report a barrier with their transportation services.  Outpatients who have a transportation barrier to attend therapies are assisted by The Lighthouse transportation program on the same schedule provided for the Day Program clients. The Lighthouse staff collaborate with clients and support systems in the provision of transportation services for clients. 

 

Community Integration

 

            “The consequences if an acquired brain injury (ABI) are profound and debilitating.  People who sustain, these injuries experience alteration to the physical, cognitive, behavioral, and psychosocial aspects of their life.  These changes are often difficult to understand consequently, many of these people are unable to successfully reintegrate into their community.”

(Mahar, C. & Fraser, K. (2012). Barriers to successful community reintegration following acquired brain injury (ABI). International Journal of Disability Management, 6, 49–67. DOI 10.1375/jdmr.6.1.49)

 

While, the list of community integration barriers is endless, the Lighthouse accepts the challenge of identifying community barriers and the responsibility to educate the resident, caregiver, and community on the invisible brain injury.  Barriers associated with successful community integration may include, but are not limited to: 

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• Coronavirus pandemic, health implications in congregate care

• lack of employment opportunities

• lack of affordable housing

• lack of or limitations of community services

• lack of social opportunities

 

Other Barriers

 

The Lighthouse is aware of limitations to community integration for residents in areas such as sports.  The Lighthouse therefore provides basketball, softball, and an accessible pool for clients to use.  Any additional barriers that limit community integration are assessed by the client, guardian, and staff.  Assessments are then brought before the Lighthouse management team for resolution.

 

Barriers to care at the Lighthouse are not limited to the above categories.  All staff members are encouraged to assess any barriers to care for clients and to report the perceived barriers to The Lighthouse staff.  The management team will continue to assess barriers on an ongoing basis with input from clients, guardians and other stakeholders.  Concerted efforts are made to eliminate barriers.  If the barrier cannot be eliminated, appropriate referrals are made to external agencies.

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