April 18, 2017
On Friday, April 21, 2017, the Community TIES program at the Waisman Center will be celebrating 30 years of helping Dane County children, adolescents and adults with developmental disabilities live with their families and in their communities.
Working with the Dane County Department of Human Services (DCHS), the mission of Community TIES is to address the behavioral, psychological, and emotional needs of individuals with disabilities, using therapeutic approaches that assure continued participation in supported community life.
To discuss this milestone, we sat down with Josh Lapin, director of the TIES program, to talk about three decades of memories and successes, and hopes and goals for many decades to come.
Waisman Center (WC): Tell us about how the Community TIES program supports individuals with disabilities?
Josh Lapin (JL): It's hard to overemphasize how important it is for individuals with disabilities to remain a part of their communities. We do a lot of training around best practices and evidence-based approaches to help the people we work with remain in their communities, with their families and friends.
For that to happen, I think the most important thing that we do is build relationships. We build relationships with the individuals we support, and we build relationships with their families.
Having these meaningful relationships with the people we serve really allows us to recognize when they are doing well, and also why they are doing well. Then, when things get a little difficult or intense, we try to recognize those signs and subtleties and figure out how to respond and address those issues.
Again, none of what we do would be possible without relationship-building. I think of the opportunities we have to meet and work with individuals and families, and based on those long-term relationships, being able to say, "If you try this, it might help this person be more successful in the community, or this might help this person be more adaptive with their behavior."
WC: Thirty years is quite a long time. How did Community TIES get started?
| Josh Lapin, director of Community TIES
JL: We began in 1986. At that time many individuals with disabilities were leaving institutions, and they needed support to successfully integrate and live within their own communities.
Paul White, the first director of the Community TIES program, started with a caseload of four individuals. Today, we manage an active caseload of more than 300, which makes it more challenging to build and maintain one-on-one relationships. So we have more team meetings, for example, but our blueprint is still the same: we are dedicated to building these relationships with the individuals and families we work with.
A number of individuals that we support, I started seeing them when I started working at TIES back in the early 1990s.
WC: You mention changes that have happened over the years. What are some of the ways Community TIES has grown?
JL: Obviously, one of the changes has been the number of people we serve. But we have also expanded the services we offer.
Fairly soon after TIES was started, a psychiatry clinic—now called the TIES Clinic—was established to assist individuals with disabilities who had co-occurring mental health issues.
We also have a Crisis Response program, managed by Axel Junker and RaeAnn Fahey, for individuals who might be at risk of being taken to an inappropriate mental health hospital or even prison, when it would be better for this person to go somewhere else where they can cool off for a day or two or three.
The Crisis Response program coordinates a Safe House as a way to keep people in the community when it is appropriate to do so. If it wasn't safe for someone to stay at their home, yet their behaviors didn't require them to go to an institution, the Safe House serves as kind of a middle step. There can be up to two people at the house at any time.
Through our Rhythms Program we look at how mindfulness and technology can enhance the lives of individuals who experience complex sensory and movement differences and those who support them.
WC: What are your thoughts on TIES’ 30th anniversary and for the future?
JL: I think our longevity is crucial for the individuals we serve. Our work is from pediatrics to geriatrics; we work with people of all ages and you do not age out of our program.
That really fits with our model of relationship-building. As people get older, as families pass on or move away, sometimes we are the only constant for some individuals, and it’s something we take very seriously. I think this long-term relationship component is a central legacy of TIES.
I also want to say that our partnership with DCHS has been vital. A number of the programs at Community TIES were developed through discussions with DCHS about the needs of county citizens and how we could provide effective services.
As Dane County transitions to the Family Care program, we will need to contract with a managed care organization to continue our services. There will undoubtedly be changes in the long-term care for individuals with disabilities in our county and state.
Our programs are intricately tied together; if some of them were to be discontinued after the transition to Family Care, I think it would directly impact people's quality of life. We really want to be able to keep these programs together as much as possible.
But we have also been preparing to adapt to the coming changes, and we hope to continue to build the relationships and provide the services that we do now for many years to come.