Attachment H - Historical and Mission Vision.docx

Location and Facility Design

The Outwood campus is in the northwestern corner of Christian County, approximately three (3) miles south of Dawson Springs and 24 miles north of Hopkinsville on State Highway 109. The facility occupies approximately 185 acres of land. The old campus property impacts approximately 75 to 80 acres of the total tract at its highest point of elevation. The remaining acreage is moderately sloped and landscaped. This portion of the property, which spans approximately 60-65 acres, is the site of the new facility.

There are sixteen (16) units within five (5) buildings, a resident life center, a chapel, a sheltered workshop, a water tower, three (3) old storage buildings, a maintenance shop storage building, a facility storage building, and a pavilion. The Chapel is currently unusable, and improvements are not budgeted for during this biennium. Please see Attachment C – Outwood Site Map for the campus layout.

The 80 bed, five (5) cottage facility design creates a residential care facility with functionality, future needs, ease of administration, individual mobility, safety, and security in mind. The five (5) cottages allow the housing of a maximum of sixteen (16) individuals per cottage. Each apartment has four (4) bedrooms with two (2) shared baths. All cottages are carpeted in the living areas.

There is a dining/recreation room, as well as a separate living room, kitchen, and record station. The two (2) apartments share a staff locker room, a clean and soiled linen room, a medication room, a laundry room, a room for personal clothing, and an observation room with a bath (for medical isolation). This room may be used as a private bedroom.

All the cottages have fully equipped kitchens. Each cottage has a small outdoor patio and grill. Food services are provided in the apartments, including preparation with paraprofessional staff, who eat some meals with individuals in the apartments. All other employee meals are prepared in a central kitchen. The cottages have separate electric heating and cooling units. Cottages are connected to a transfer switch, which can provide electricity via a generator during a power outage.

Service Groups

The Residential Services Office houses staff responsible for the programmatic administration of the residential areas. It consists of three (3) offices, open office space, and storage areas.

The hub of the facility is the Resident Life Center with its eight (8) satellite units. The Resident Life Center incorporates essential programmatic and support services. The Center has space for administrative offices, therapy workrooms (including occupational and physical therapy), a communications coordinator for speech and hearing, and support services (psychology, medical, dental, laboratory, and pharmacy), as well as a Central Supply area.

Behavioral health services are provided on campus or off campus under contract with the Community Mental Health Center (CMHC). Dental services are performed both on-site and off-site. Laboratory and Pharmacy services are being provided under contract. All individual support services, such as dietary and health records, are contained within the individual’s primary record at the cottage. Linen services are contracted out.

The core of the Resident Life Center is the multi-purpose room, which is designed to serve as a gymnasium/recreation room, dining area for special occasions, and community center. Additionally, the building features a hobby room and a dining/break room that serves meals to the individuals providing services, as well as vending machines.

The Resident Life Center's basement contains essential linen, dry, cold, and frozen food storage areas, mechanical/boiler rooms, and maintenance rooms.

The sixteen (16) work/training rooms are spaced in three (3) buildings of six (6), eight (8), and two (2) units each. All are similar in design, except that between two groupings of rooms, additional space has been allocated for one-way observation rooms of the units. Removing a folding partition can enlarge three (3) of the rooms. If necessary, this will then provide sufficient square footage to meet federal and state educational classroom size specifications, should these units ever be needed for providing mandatory public education. This use, however, would be subject to the approval of the DBHDID.

The work/training units are designed to allow for flexibility in their utilization, depending upon individual needs. They provide the space essential for modular training, vocational skill development, and/or other therapy training programs.

A new sheltered workshop building became operational. The building is approximately 7,600 square feet and resembles an industrial work setting. In addition to the work floor, there are offices, a meeting room, a break room, and a lunchroom. Shipping and receiving capabilities (loading dock) are incorporated into the design.

Other buildings on the grounds include a chapel, which is not being used at this time, three (3) storage buildings from the old facility (Quonset hut is the only old storage building that is utilized), a new maintenance shop/tractor shed, and new facility storage building that contains a storage area for each cottage and for administrative storage needs, and a pavilion.

Physical Plant and Utilities

The Resident Life Center and work/training units are heated with natural gas and can use fuel oil as an alternative energy source. An emergency generator system, which provides emergency lighting in the event of a power outage, is also incorporated into the design.

The buildings are primarily of protected ordinary construction consisting of wood trusses or truss joints on masonry bearing walls of concrete block with brick exteriors. All combustible framing material is protected with fire-code drywall. There is sprinkler protection throughout, with smoke detection where required by codes. All the state’s requirements for insulation are met with a combination of batts and rigid insulation. All roofs with a slope equal to 1:4 are covered with Class “A” asphalt shingles. All roofs with a slope of less than 1:4 is of lightweight insulating concrete with a gravel-protected built-up roof. Interior partitions in living areas are of concrete block.

The facility currently receives its water from the Christian County Water District. The pump house and small water tank located on the grounds at the entrance to the facility are the property of the Water District. There is an elevated water tower located on the grounds of the old facility, which was renovated in 1988-1989 and most recently worked on in December 2019 – January 2020. The elevated tank is strictly used for fire suppression only. The new meter installed by the Christian County Water District is to feed domestic water to the facility.

Kentucky Utilities presently services the Outwood campus through its offices and substations located in Dawson Springs. Atmos Energy supplies natural gas to the site, and the facility is connected to the city of Dawson Springs sewer system.

The facility shall maintain a fire control and evacuation plan to be practiced at least quarterly for each shift of personnel, with all staff and individuals participating. Drills shall be held at different times of the day. The fire alarm must have an inspection deadline or claim form posted. The facility shall have agreements with the Dawson Springs Fire Department for fire protection. A $500 retainer fee is involved, as well as a “per call” fee, which varies depending on the time involved.

Community Involvement

Dawson Springs is a small community of approximately 3,500 people with limited economic and industrial resources. The community is a valuable resource for the facility, offering shopping, recreation, spiritual growth, and entertainment opportunities. Additionally, numerous community integration activities are held in the surrounding areas. Therefore, the Contractor must provide transportation resources to enable community participation, medical and home visits, supported community work activities, and activities of personal interest. Currently, one (1) truck, five (5) mini vans, one (1) accessible van, one (1) SUV, and three (3) cars are leased to meet the transportation needs of individuals living at Outwood ICF/IID.

It is expected that the facility will continue to operate and expand its involvement in the community, collaborating with local school districts, CMHC, social, religious, and recreational groups, as well as supporting community activities and initiatives. The facility also has Community Advisory Committees, which serve as advisory bodies to the facility and provide input on its operations.

Department of Justice (DOJ)

On September 21, 2004, the Commonwealth of Kentucky entered a Memorandum of Understanding (MOU) with the United States Department of Justice (DOJ) to implement and maintain a strategic plan for Facilities serving individuals with intellectual and developmental disabilities. In 2006, a Settlement Agreement was reached between the DOJ and the Cabinet for Health and Family Services.

The MOU and subsequent Settlement Agreement are the result of an investigation performed by the DOJ on November 5-9, 2001, which resulted in allegations by the United States Assistant Attorney General, Civil Rights Division, that persons residing in or confined to Oakwood were being subjected to conditions that deprived them of rights, privileges and immunities secured by the Constitution or laws of the United States, further clarified by a Settlement Agreement between the Commonwealth and the DOJ and filed in Federal court on August 31, 2006 (Attachment D). Specific allegations by the DOJ against Oakwood included:

1. The failure to protect residents from harm.

2. The failure to provide residents adequate care from treatment teams by providing inadequate individual support plans, behavioral support plans, and behavioral and psychological services.

3. The provision of psychiatric services, general medical care, nursing care, nutritional management, and physical therapy that fell substantially below generally accepted professional standards of care.

4. The provision of inadequate quality improvement programs to address appropriate care, and

5. The failure to accommodate persons who desire to live in the community.

The investigation was performed pursuant to the Civil Rights of Institutionalized Persons Act (“CRIPA”), 42 U.S.C. § 1997.

The Commonwealth, through the Cabinet, is committed to ensuring its most vulnerable citizens have the freedom to live a life of dignity and respect. As a result, the Commonwealth, in collaboration with DOJ, created a Strategic Action Plan (“SAP”) for Oakwood.

A national consultant assisted in drafting and implementing the SAP. Implementation of the Strategic Action Plan developed for Oakwood is required for all state-owned and operated facilities serving persons with intellectual disabilities. The goal is to ensure collaboration, coordination, cooperation, and continued implementation of the DOJ agreement and current SAP, as well as any future actions deemed necessary by the DOJ.

Mission, Values, and Goals

A. Mission

Outwood, owned by the Kentucky Cabinet for Health and Family Services, was established with a primary mission of providing a residential environment for care and development. The homes’ role in the State Comprehensive Intellectual Disability Program is to provide living and training for individuals who do not have lesser restrictive community options available. Outwood is expected to provide the type of enriching environment needed to maximize the intellectual, social, and physical development of each person. Outwood shall accept individuals for services without regard to religion, ethnic origin, sex, degree of disability, or ability to pay.

The long-range objective of Outwood is to provide residential supports and training to persons with intellectual disabilities to enable them to transition to less restrictive community homes when ready. Treatment is expected to focus on skills training to address barriers and enable individuals to attain a level of self-sufficiency consistent with their capabilities, while being supported in the least restrictive environment possible. This objective is achieved through adherence to stated values and a commitment to delivering quality services.

B. Values

1. Each individual has the capacity for growth and development.

2. Each individual is expected to have access to services and opportunities that enhance his or her development, autonomy, independence, productivity, well-being, and capacities for social interactions with others, including those without disabilities.

3. Each person is expected to have access to the most culturally normative and least restrictive social and physical environments possible.

4. Each individual’s services and supports should be provided, as much as possible, in settings that are integrated into the community and that promote interaction with family members, friends, and other persons without disabilities; and

5. Each person’s services and supports should be delivered in accordance with an individual plan that is developed from an approved assessment of support needs, monitored, coordinated, and revised by members of a person-centered team of people who are important in the life of the person served.

C. Goals and Objectives

1. Provision of the highest possible level of care to the individuals who reside at Outwood, in a manner that ensures these individuals are afforded genuine choice, treatment, and training in the least restrictive environment possible. Individuals residing at Outwood are expected to be provided a safe environment and protected from abuse, neglect, or exploitation.

a. Each person’s rights shall be protected, and assistance provided to exercise those rights.

b. Persons served, their families/guardians, and community agencies are expected to be involved in the delivery of services as determined by the individual and the person-centered planning team.

c. Services and supports are expected to be person-centered, based on each person’s vision and dreams for the future. They are expected to be tailored to each person's unique needs, wants, and strengths.

d. All support and training are expected to be geared to increasing the individual’s control over the environment and making personal choices.

2. Significantly improve the quality of care and treatment services for the individuals who reside at Outwood in accordance with Federal and State ICF/IID standards and regulations, the 2006 Settlement Agreement between the Cabinet and the DOJ, and the associated Strategic Action Plan (Attachment A), in a manner acceptable to the Cabinet.

3. Implementation of a Community Transition Plan that provides training necessary to remove barriers to community involvement and placement; educates individuals, families, and guardians regarding community support options; and allows for any resident who seeks and is appropriate for community placement to transition to the community. Transition planning and implementation are expected to begin upon admission, be ongoing, and be consistent with the Department Facility Transition Process to ensure safe and successful transitions.

4. Cooperation and effective working relationships with the parents/guardians of residents.

5. Assurance of timely communication and cooperation with individual parents/guardians and the Parent/Guardian organization, the Outwood Family Group. The Outwood Family Group is a vital entity that supports the administration of the Facility, communicates concerns, and promotes the enhancement of the quality of life for all residents. It also communicates with parents and legal guardians to ensure a unified effort in supporting the operation of Outwood. The Contractor is expected to utilize the Outwood Family Group in an advisory capacity, have a representative on the Facility Advisory Board, and hold regularly scheduled monthly meetings with the Outwood Family Group, as requested by the Family Group or the Department.