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Client and Family Handbook

 

Welcome to Next Step Ministries!  We are glad you are a part of our family!  Our staff is here to work with you and your family in providing the best services we can.  We take seriously our calling to provide each client and family member with the love and respect due each of God’s children, and hope you see the Light of Christ shine through us.  As you become more familiar with us, it is our desire that you come to understand that we are a ministry first, and a service provider second. Please take a few moments and review the following information.  Each of the programs are summarized so you know the scope and goals of our services.  Following that are policies and procedures that we have found are helpful in answering questions as well as assuring a safe and smooth day for all concerned.  Please check here periodically as these will be updated as needed.


 

Table of Contents

Programs Overview.. 3

Job Skills Program.. 3

Therapeutic Day Program.. 3

After School Program.. 4

Saturday Respite Program.. 4

Camp Program.. 4

Drop – In Services. 5

General Information and Policies. 5

Appropriate Clients. 5

Attendance. 6

Illness. 6

Medications. 7

Medical Information Changes/Updates. 8

Special Requests Form.. 8

Lunches and Snacks. 8

Impaired Driver. 9

Inclement Weather. 9

Payment. 9

Non-Smoking Policy. 9

Volunteers. 9

Extra Personal Hygiene Supplies and Clothing. 10

Concerns, Issues, Conflicts and Complaints. 10

Annual Family Meetings. 10

Fund Raising Events. 10

Annual Friends and Family Picnic. 11

Monthly Prayer Meeting. 11

Special Interest and Educational Offerings. 11

Client Rights. 11

 


 

Programs Overview

Job Skills Program

This program is designed to provide clients with an ongoing experience of meaningful work and positive interaction with the community.  Projects may include packaging, collating, sorting, preparing bulk mailers, budgeting, shopping and preparing dog biscuits (Hope Bones) to be distributed to local shops, as well as providing some offsite work activities.

In addition to work skills, clients are placed in social situations and taught the value of teamwork.  The Job Skills Program provides clients with social and community opportunities such as dining at local restaurants, attending local theater, enjoying local parks and recreation spots, and various other activities.  Art (led by a professional artist) and music therapy are provided weekly in house.

Job Skills:  Although many areas will be addressed throughout the various activities, emphasis will be on:

1.       Appropriate interpersonal skills                                         7.   Personal appearance

2.       Following directions - written and/or verbal                                8.   Communication

3.       Time management skills                                                       9.   Cleaning

4.       Working cooperatively with others                                  10. Organizing

5.       Fine motor skills                                                                       11. Hand/eye coordination

6.       Money management                                                             12. Basic Math skills

Program Details:  The Job Skills Program runs Monday – Friday from 8:00AM – 4:00PM (additional after program care hours are available).  Daily schedules vary from week to week and will be distributed in advance.  Next Step will provide transportation to all off-site activities.  The Job Skills staff will supervise this group, drive off-site, and lead clients to develop skills.  The Job Skills staff may be accompanied by volunteers to ensure the success and safety of this program. 

Qualifications:  For all clients to benefit from the Program, each client should:

1.       Plan on attending at least twice a week.

2.       Demonstrate a willingness to participate in the Program activities.

3.       Be independently mobile – with or without assistive devices.

Therapeutic Day Program

This program is geared towards those special needs clients who have aged out of school, need a supportive and structured day environment, and are generally in the severely/profoundly developmentally delayed range.  The goal for the client is to maintain or improve the functional skills learned at school and home, while providing the day care component needed by families as they continue their daily activities.  This program also provides for much needed socialization, mental stimulation, and community interaction that is often lacking when a client remains at home during the day.

Professional staff and experienced assistants provide a structured day of gross motor, fine motor, communication, activities of daily living, socialization, recreational, and community activities.  An artists’ groupand music therapist come weekly to share their gifts. Additional guests come in as well on a periodic basis.

The program operates year round, Monday through Friday, 9am – 5pm, with additional care hours available from 8am to 9am, and from 5pm to 6pm. 

After School Program

This is available for middle and high school students on Cherokee County school days who can arrange transportation from school to Next Step, and can be picked up by 6:00 pm.

Saturday Respite Program

Available the 1st and 3rd Saturday of the month from 10 - 3, this program is for older children, teens, and young adults with special needs who are looking for a fun day of activities and socialization.  For parents and caregivers, this time provides a break from care giving responsibilities, time to spend with other family members and friends, or simply a chance to run errands unaccompanied.

Activities vary depending on the interests of each client, with crafts, movies, and games always available.  On the 3rd Saturday, Happy Tails Therapy Pets come for a visit.  Everyone enjoys pizza and soda for lunch.

Next Step Ministries staff and volunteers supervise the day’s activities and assist clients.  The emphasis is on socialization.  Clients look forward to seeing their friends on Saturdays.

Reservations are required in advance.   

Camp Program

The Day Camp program is geared toward middle and high school students with special needs.  This is offered during the summer months and weeklong school breaks, as space is available.Campers join the program that is most developmentally appropriate (Job Skills or Therapeutic Day Program), and the “fun factor” is increased for all during Camp sessions through extra special activities and field trips.

The camp day may include crafts, cooking, music, Bible stories and other fun activities. An artists’ group and music therapist come weekly to share their gifts.  Functional and academic activities based on clients’ skills and abilities are offered.  Opportunities for socialization occur daily.  Weekly community outings (bowling, restaurants, theatre, aquatic center, etc.) round out the program.  Campers will be exposed to non-denominational Christian beliefs through media, weekly themes, and prayer.

Our staff is experienced in working with special needs.  We welcome all levels of developmental disabilities, including those who need assistance with personal hygiene, feeding, and mobility skills.  An R.N. is here to monitor health conditions and dispense medication.  Volunteers from the community provide extra love and attention.  And one never knows when a special guest may come….

Register early (space is limited), and come join the fun!

Drop – In Services

These services are designed for those who need occasional care or who wish to participate with one of our programs on a limited basis.  All drop-in services are subject to space availability. Some examples of this type of care include:

1.        Teacher Work Days

2.       Unexpected School Closings

3.       A family member with special needs is visiting from out-of-town and needs a fun place to go while you work or spend time with other relatives.

4.       One-on-One situations – If a clientrequires one-on-one assistance, due to health reasons, they can attend Next Step with their caregiver at a reduced hourly rate.  This can be scheduled on a regular basis, or for special activities (field trips, special music) as desired,and the caregiver is expected to provide all care needed.  This is a great option for those who are looking for fun socialization and enrichment opportunities.

If we can customize scheduling for your specific situation we will – let’s talk!

 

General Information and Policies

Appropriate ClientsThe majority of our clients have developmental delays in the moderate to profound range. Many are in wheelchairs, are non-verbal, have seizure disorders, are tube-fed, and/or require assistance with personal hygiene.  Others are quite mobile, verbal, and function fairly independently. We have an R.N. on staff to manage and supervise many medical issues, with staff cross-trained to cover in her absence.

We are, however, unable to accept clients who:

1.       Require one-on-one care for medical reasons such as:

a.       Ventilator dependent

b.      Requiring deep suctioning

c.       Life threatening seizure disorder

d.      Severely medically fragile

2.       Demonstrate a frequent behavior that is harmful to themselves or others such as:

a.       Hitting or biting self, other clients or staff

b.      Throwing objects with apparent intent to be harmful

c.       Aggressive/confrontative/combative behaviors

d.      Leaving the premises unattended

3.       Demonstrate disruptive behavior disturbing to others such as frequent loud and/or high pitched noises.

4.       We feel we cannot safely and appropriately serve given our staff availability and training, as well as the current client mix.

Each potential client will be assessed prior to admission.  If there is a question about the appropriateness of the client, a trial basis may be suggested.  If a client starts to display unacceptable behavior while attending, the staff will work with the family to resolve the behavior in a timely manner.  If a client has a “bad day” which is out of the ordinary, the parent/caregiver may be required to immediately pick up the client to avoid harm to the client, other clients, or staff.  Safety for all clients and staff is a top priority.

Attendance- When you enroll at Next Step, you will arrange your schedule with the Office Manager.  We work on being as flexible as possible with your needs and our existing clients.  Once your day(s) have been established, please communicate with us if a change (permanent or temporary) is desired. These requests will be honored as space becomes available.

                Sick Days – Please let us know by phone or email by 10:00am if you need to be absent for the day.  If you are out sick, and let us know by 10:00, there will be no charge for the day.  If you bring your client in and they are ill and need to be sent home, the day will be charged as usual (see policy under “Illness” to review this).  Many of our clients have difficulty fighting off germs and can become very ill even when exposed to germs, and we are trying to prevent illness.

                Vacation – Family time is very important, and we recognize the value of vacation.  We are closed every year for the week between Christmas and New Year’s Day.  In addition, every family may take up to 2 weeks of vacation (prorated for those not full time) with written notice given 1 week in advance.  These two weeks are not charged to your family, and your spot at Next Step will be held.  This will allow others on a waiting list to attend during that time (especially important over the summer).  Additional absences (excluding illness) or vacation time will be charged as usual.  We staff based on our planned attendance, and have those expenses to cover.  Forms to notify us of your planned absence are available at the front desk.  These need to be completed and turned in to the front desk a week ahead of the planned absence.  Exceptions for Medicaid waiver clients as per prevailing guidelines.

                Late Pick-Up- There will be a late pick-up charge of $1/minute for time after 6:00pm Monday – Friday, and after 3:00 on Saturday.  If you will be late, please call and give us an estimated time of your arrival.  Late payment is expected at the time of pick-up.  Unpaid fees will incur an additional $10 charge for invoicing expense.

                Sign In/ Sign Out Sheets – All clients are required to sign in and sign out daily.  This can be done by the client, parent, or caregiver.  The sheets are centrally located.  The information requested is client name, driver name, time in and time out.  After schoolers brought by the school bus will be signed in by the staff, and parent/caregiver should sign them out.

 

Illness- .  You may find us stricter than schools.  We have a large number of clients with compromised immune systems.  That means that even minor colds and illnesses oftenbecome serious and require hospitalization.  It is therefore vital that everyone assist inminimizing the spread of germs within our facility.

We must ask that any client who is exhibiting symptoms of possible illness be kept at home.  Those exhibiting fever, discolored mucus, diarrhea or vomiting should not return until they have been symptom and fever-free for 24 hours, without the use of medication.   Even if they appear to be feeling better, the illness can remain in their system and be contagiousfor this time.  If your child has documented allergies, please let us know.  It is sometimes difficult to tell the difference between colds (contagious) and allergies (not- contagious).   Discolored nasal drainage is infectious.  Clients who are not able to manage secretions (coughing and sneezing) and are not on antibiotics may be sent home if there is concern about spreading germs to others.  Any clientwho develops these symptoms while in our care will be sent home to protect clients and staff from potential infection.

If the nurse determines that the client may have a contagious illness, the client will be isolated from the other clients, and the caregiver will be contacted about the illness and requested to come and pick up the client.

If a client requires antibiotics, please note that they need to be on the antibiotic for 24 hours before returning to Next Step.

If laxatives are used as part of a bowel program, please do not administer the laxative when results are expected at Next Step.  This is embarrassing to the client, requires a great deal of staff time for hygiene, and we are not able to determine the cause of the diarrhea.  Caregivers will be contacted and expected to pick up the client even if laxatives are the source of diarrhea.

Please know that our clients’ health and safety is of the utmost importance to us, and we are doing everything in our power to maintain a safe and germ-free environment.  Thank you for your assistance and support in keeping everyone healthy and well.

 

Medications–Many times our clients are required to receive medications during the day.  All medications are kept locked in the Nurse’s Office, and require specific written instructions for administration.  Medications are administered by the nurse.  In the event of her absence, meds will be dispensed by the person covering for the nurse.  This person has received specific training on the procedures.  If you have any questions or concerns about the medications, please discuss these with the nurse.  If she is not at the facility when you arrive or leave, feel free to call during the day to speak with her, or leave her a note to contact you.

Please avoid leaving medication that is not for use at Next Step in client bags. In the event that you need to do so (for example, a paid caregiver or non-custodial parent will be picking the client up), please let the staff know so that the medication can be locked in the nurse’s office. Also, let the person picking the client up know that they will need to get the medication from staff. Your cooperation in this helps us to avoid any dangerous situations that could be created if another client were to gain access to the bag.

                Prescription MedicationsThe Release to Dispense Medication Form(available at the front desk) must be completed and signed by the parent/legal guardian before any medication will be dispensed.  All medication should be in the original container, with the client’s name and detailedinstructions for administering the same.  Also please note that the medication will be administered only as indicated on the container.  Any changes or additions will require a new form to be completed and signed.

                Over The Counter MedicationThe Release to Dispense Medication Form(available at the front desk) must be completed by the parent/guardian prior to the medication being dispensed.  The medication must be supplied in the original package with the directions on the package, and the client’s name written on the package.

                First Aid Medications- These will be given/dispensed as indicated on the Medical Consent Form that was completed at enrollment.  If your preferences change, please ask to revise the form.

Medical Information Changes/Updates – Over the course of time, there will probably be changes and/or updates in client medical information, medication changes, etc.  Please communicate this directly to the nurse, either verbally, by phone call, or in writing.  She is available from 9am – 4pm Monday thru Friday.  

Special Requests Form- There may be some “special requests” needed (other than medication) on an ongoing basis.  Examples may include AFOs that need to be taken off at a specific time, seizures documented in a certain way, etc.  So that everyone understands the request, the request can be honored, and things don’t get miss-communicated between people, we are asking that the information gets put down in writing, signed by the parent, and approved by staff.  This will ensure that the request is followed through on a consistent basis.

Lunches and Snacks- To accommodate each client’s nutritional needs as well as their individual likes and dislikes, clients bring their own lunches, snacks and drinks.  For a full day, one lunch and two snacks are recommended.  Water is always available and will be served if the client does not bring another drink.  Special outings and/or certain special days may require different preparations, so watch for notices on calendars for changes.

1.       When sending in frozen lunches, consider the length of time to heat – please keep microwave cooking times to less than 7-8 minutes.

2.       Daily “Brown Bag” lunches should have an ice pack if needed to keep lunch cold.

3.       Lunches and snacks should be as prepared as possible due to the number of lunches the staff has to fix.  Please do the cutting and texturizing at home as much as possible.

4.       Clients in the Job Skills Program will, as able, prepare their own lunch brought in from home.

5.       Snacks should fit in client’s cubbie, and may be provided in bulk as long as it fits.  Refrigerated snacks should be limited to a 1-day supply.

6.       If a special lunch (such as a pizza party) or a trip is planned, the client may need to bring their own money to cover the expense.  If it is a special lunch at Next Step and the client does not like or is unable to eat the meal, the client should bring their own lunch as usual.

7.       If a picnic is planned, parent/caregivers should pack an appropriate lunch with all needed items (including drinks, napkins, special cups or straws, utensils, etc).  Microwaves, choppers, and specialized feeding equipment will not be available.  Please watch your calendars for picnic dates!

8.       If the client’s lunch needs to be refrigerated, please hand the lunch to a staff person rather than put it in the refrigerator.  The refrigerator is full, and organized, and lunches have been “lost” when parents have re-arranged to fit in another lunch.  An ice pack in the lunch bag is preferred!

Impaired Driver– Safety is a primary concern and responsibility, and Next Step Ministries has a legal and ethical obligation to protect all clients.  For this reason, a client will not be released to a driver who appears to be impaired to drive.  Apparent impairments may include, but are not limited to, slurred speech, motor control/balance issues, impaired thought processes, or extreme emotional lability.

If the driver appears to be impaired, the driver will be informed that they appear to not be capable to safely drive the client at that time, and asked if there is another family member who can drive.  The client will remain at Next Step until an appropriate driver arrives.  If the impaired driver refuses to allow the client to remain until another driver can come pick up, and insists on leaving with the client, the authorities will be contacted and apprised of the situation.

Dress Code- Clients should dress in comfortable and appropriate clothing to participate in the various activities at Next Step as well as field trips.  In general, clothes should be loose fitting and machine wash-able.  Female clients should dress modestly, avoid tight fitting or low cut tops, and consider whether a dress, skirt, or short shorts is appropriate.  All clients should consider easy fasteners for pants to allow for independent/easy toileting.  Comfortable and safe footwear should also be considered, and this will vary between clients depending on their mobility skills. 

If a field trip is planned, please dress appropriately for the weather and activity.

Inclement Weather- Please note that we do not automatically follow area school systems. We base decisions on expected conditions at our opening time(s). We understand the difficulty of making alternate care arrangements, and will strive to make a decision as early as feasible.

Closings will be posted on our Facebook Page and Website (www.nextstepministries.net) as soon as a decision is made. We also utilize a mass texting service. If you would like to receive text notifications of closings, please text this message (@nsmweather) to this number (81010) to add yourself to this list. You will need to reply to a confirmation text to complete the process. If you are unable to get information from any of the above sources during a snow or ice storm, you may call (678)480-0021 before 11PM or after 6AM for clarification.

If we close early due to deteriorating weather conditions, we will post to the above, and begin notifying caregivers of those present by phone.  If Cherokee County Schools are closing early, be aware that we will likely follow suit. If you do not hear from us, please contact us at (770)592-1227 to verify our status. Please leave a voicemail as we may be trying to reach other caregivers during this time.

Payment- Upon enrollment, you will be provided with a payment agreement form. This form will outline the agreed-upon tuition schedule for your client, and will also provide you with an opportunity to select your preferred billing schedule. Please address questions and/or issues with payments, billing or Medicaid Waivers to the Office Manager.

Non-Smoking Policy- No smoking or use of tobacco products is allowed on the premise or on Next Step sponsored field trips.  This includes clients, staff, and volunteers.

Volunteers- Next Step uses many different individual volunteers and organizations to help.  This provides more individual attention for clients with activities and socialization, help for the staff with routine cleaning and yard maintenance, and a great way for the community to learn about our special clients. All volunteers are cleared with a background check before interacting with clients.  No one with a history of sexual abuse or molestation is allowed to volunteer.  All volunteers are under the supervision of staff at all times.

Extra Personal Hygiene Supplies and Clothing  Every client should come with at least one change of clothes (labelled).  Please also send in additional personal hygiene items (attends, pads) as needed.  Packages should be labelled with client name.  The staff will make every attempt to let you know when supplies are running low, but please take responsibility to check and resupply.  If a change of clothes is needed and you have not supplied the change, we will find what we can.  The Next Step clothes are labelled.  Please wash and return the following day so they are available for future use.

Concerns, Issues, Conflicts and Complaints- We understand that there will be times when parents/caregivers have an issue or concern with a staff member or procedure.  If the issue is a personal one with a staff member, please talk with that staff member individually first to try and resolve the concern (Matthew 18:15-16).  If this is not possible, arrange an appointment to discuss the issue with the Executive Director.  The staff member may be a part of the meeting as well.  We want to resolve any issues or misunderstandings. 

If there is an issue or question about a procedure, please arrange a time through the Office Manager to discuss this with the appropriate person.

If you feel the issue is not resolved satisfactorily, you may bring the issue to a Board of Directors committee for a hearing.  Let the Executive Director know and she will arrange a mutually agreeable time for all parties.

Annual Family Meetings- When a client starts at Next Step, several goals will be developed in the initial intake session based on family input and services/activities available.   We will schedule an annual meeting with the family (around the client’s birthday) to revisit the goals and programs related to the client’s needs.  This is a great time to touch base and determine the direction for the following year.  If you have concerns or want to meet prior to that time, please schedule a meeting through the Office Manager. 

For Medicaid Waiver clients, the annual ISP meeting will take the place of this annual meeting. Dates and times for these meetings are usually booked about two months prior to the client’s birthday. Please advise your Support Coordinator of Next Step’s desire to participate in these meetings. As we are responsible for implementing ISP goals, it is important that we be involved in creating ISP goals. We have a conference room available for this purpose. Also, please allow a few minutes at the beginning or end of your scheduled meeting time to update NSM paperwork and records.

Fund Raising Events- Next Step Ministries is a 501(c)3 non-profit organization.  That means we do fund raising activities to help with scholarships, equipment purchases, organizational expenses, etc.  We hope each family will commit to participating in at least 1 activity/event per year in support of Next Step.  The more participation we get, the better results we will have, and the better services we can offer.  In the past, events have included the Belk Charity Day Sale, the Run, Walk or Roll 5K, Christmas and Greeting Card sales, and Hope Bone sales.  Participation can take many forms, and is also a great way to meet others in the process.  Please let the Office Manager know if you are interested in volunteering for any of these projects.

Annual Friends and Family Picnic- Every year (late summer/early fall) we have a pot-luck Picnic for clients, families, staff, Board members and volunteers.  This is a great time to meet everyone involved at many different levels in the Next Step Program.  Please plan to come and enjoy the time! 

Monthly Prayer Meeting- We have a monthly prayer meeting at Next Step, to pray for Next Step, the clients, families, staff and other needs.  Everyone is welcome to come.  We meet the second Saturday of the month, 8:30am – 10:00am.  No reservations needed – the coffee pot is on!

Special Interest and Educational Offerings – On occasion there may be topics of interest to our families that either we bring to Next Step or let you know about.  Past offerings have included speakers on Special Needs Trusts and Wills, dates for school transition fairs, and other activities specifically geared towards the special needs population.  Please watch for these notes – posted on our doors, noted in the e-newsletter, sent home on fliers, or via special emails.  If you have ideas for topics you would like to see addressed, please let us know. If you are not currently receiving our e-newsletter, please visit our website, www.nextstepministries.net, to sign up.

Client Rights- It is the purpose of Next Step Ministries to treat each client and caregiver with dignity and respect reflective of Christian values.  As such, the following rights are accorded to each program participant and their caregiver:

1.       The right to be treated with respect and dignity;

2.       The right to be free from physical or verbal abuse or mistreatment

3.       The right to participate in the development of one’s service plan, with support from staff or caregiver, as needed;

4.       The right to refuse to participate in any particular activity;

5.       The right to privacy and confidentiality;

6.       The right to be fully informed of all the services provided or available and the charges, if any, of each service;

7.       The right to be informed of the reason for discharge and the procedure for appealing that decision;

8.       The right to initiate a complaint and be informed of the complaint resolution process;

9.       The right to a clean and safe environment while at the program facility.

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