Designing opportunities and providing choices to the people we serve.


Home and Community Based Services

Design the methods, materials and settings used to provide ILS training to meet the following outcomes:

1. Increase the person’s independence by teaching skills so tasks and activities may be performed with decreased dependence on caregivers.
2. Increase the person’s opportunities to interact with people without disabilities who are not paid caregivers.
3. Provide daily schedules, routines, environments and interactions similar to those of people without disabilities of the same chronological age.
4. Provide skill training in an environment where the skill will be used.
5. Support development of decision-making skills and informed choices in all aspects of daily living including selection of service providers, goals and methods, location and decor of residence, roommates, daily routines, leisure activities and personal possessions.

  • Engage in activities that make it possible for an adult with developmental disabilities or related condition(s) to live in the community
  • Exercise social, recreation and transportation skills, including appropriate social behavior
  • Learn and exercise the rights and responsibilities of community living
  • Maintain personal appearance and hygiene
  • Manage money, prepare meals and shop
  • Obtain and maintain a home
  • Perform first aid and obtain assistance in an emergency
  • Self-administer medication
  • Use the phone and other utilities

This includes assistance with acquisition, retention and improvement in skills such as:

  • Bed making and household chores
  • Eating and the preparation of food
  • Personal grooming and cleanliness
  • Social and adaptive skills necessary to enable the individual to reside in a non-institutional setting.

Examples of services include:

  • Communication
  • Community participation and mobility
  • Health care, leisure and recreation
  • Household chores
  • Interpersonal skills
  • Money management
  • Reduction or elimination of maladaptive behavior
  • Sensory and motor development.

Overview of “Housing with Services”
Some housing sites in Minnesota offer services to the people that live there. They are called “Housing with Services” (HWS). HWS settings include:

  • Apartments.
  • Board and lodging. In these sites tenants might have a private bedroom or bathroom.
  • Or, they might share these rooms. The common areas are shared with other tenants.
  • Corporate adult foster care. In these homes up to five people.

Services are often supplied by staff in eight hour shifts. HWS offer health services such as nursing care. They also help with grooming and medicines. Support services may include help with laundry, paying bills, making doctor appointments and arrangements for rides. Often meals, social activities, a hair salon, exercise room, and emergency call systems are offered, too. Some services are called “assisted living”. These are a mixture of health and support services. The state Department of Health ensures that HWS sites meet certain care standards. Some HWS sites have their own home care license. Some hire a licensed home care agency. The HWS home care license is called either Class A or Class F. The class depends on the way services are offered. Not all housing for seniors is a registered HWS site. Only those that offer the right mix of health and support care need to be registered.

Choices by Design LLC is moving toward person-centered practices in all areas of service delivery. As a company, Choices by Design LLC strives to make sure everyone who receives long-term services and supports and mental health services can live, learn, work and enjoy life in the most integrated setting. The goal is for people to lead lives that are meaningful to them. To do this, we must have a person-centered support system that helps people:

  • Build or maintain relationships with their families and friends
  • Live as independently as possible
  • Engage in productive activities, such as employment
  • Participate in community life.

Our support system must reflect that we understand, respect and honor the things each person thinks are important. Person-centered practices are essential to this effort. Person-centered practices are flexible and adaptable. They encourage informed choice and creativity. We use person-centered practices because they increase people’s quality of life.

Our transition to this person-centered approach reflects one of our core values: We focus on people, not programs. However, the person-centered approach is not unique to Minnesota. It is a practice that is emerging across a wide variety of fields that work with different people in different settings. Many state and federal policies now mandate person-centered delivery of long-term services and supports.

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