Tip: Highlight text to annotate itX
Hello my name is john vogt and i am an rit nutrition management program and this presentation
is for the community nutrition class at RIT and I'm going to be telling you about my experience
with the New York State office for people with developmental disabilities shadowing
their dietitians so the mission that we have here from the OPWDD is to help people with
developmental disabilities live richer lives and this can mean a number of different things
the OPWDD provides many services including housing, nutrition, medical services and their
patient population is very different and we'll get into that later on their vision is to
help people with developmental disabilities enjoy meaningful relationships with friends
family and others in their lives by experiencing personal health and growth and living in the
home of their choice and fully participating in their communities the office for people
with developmental disabilities in new york state was created in 1978 and it was originally
named the office of mental retardation and developmental disabilities this name was removed
in favor of the new name in 2010 the creation of this organization was largely in response
to the discontinuation of large-scale developmental disability institutions in which these individuals
were house in very large groups under questionable living conditions so the OPWDD is really rethinking
care for the developmentally disabled it was created largely also in response to the willowbrook
consent decree in which the residents living at the willowbrook state school which was
the subject of an expose by geraldo rivera in the 70s so that the students living there
could find housing in new york state outside of this large institution so it really facilitated
the creation of group homes for the deinstitutionalized individuals the agency covers 5 regions in
the state and I was lucky enough to participate in the finger lakes regionthe new york state
office for people with developmental disabilities is a government funded organization this means
that it must go through several steps to receive their funding the OPWDD directly bills the
centers for medicare and medicaid services CMS then reimburses the state department of
budgeting for the amount that it is billed albany and the department of budgeting therein
then disburses funding to the OPWDD and the private agencies that then conduct these services
for the developmentally disabled these include heritage christian services and the ARC and
things like this the costs associated with feeding these individuals are covered by SNAP
the supplemental nutrition assistance program and the food and nutrition act of 2008 I found
this very interesting because both of these programs are geared toward low income individuals
and by definition the disabled individuals living in the group homes provided by the
OPWDD really have no income allowing them to qualify for these benefits my community
nutrition rotation was based out of the finger lakes region developmental disabilities service
office this is located on 620 westfall road rochester new york the finger lakes region
DDSO coordinates services for over 128000 new york state residents it maintains 143
group homes within 10 counties serving approximately 1300 individuals each registered dietitian
with the finger lakes region DDSO supervises between 8 and 10 houses each house contains
8 to 10 individuals and therefore they supervise between 80 to 100 individuals and carry a
very large case-loadthe finger lakes DDSO operates under several guiding principles
the first among these is to put the person first the developmentally disabled are at
the heart of every service provied by the OPWDD and their person-centered approach is
embodied in everything that they do among their services and their people next they
seek to maximize opportunities autonomy is a big deal at the OPWDD these residents should
be afforded the same opportunity to direct their lives as any other person it is this
mindset that facilitated the change from institutions to group homes where the patients can undergo
a more personalized and loving care I spent the majority of my time at the finger lakes
region DDSO shadowing 2 registered dietitians Laura Stout and Ohio State Alumnus and Lindsay
Lagon our own RIT alumnus they are supervised by Patty Askloff the nutrition staff at the
fingerlakes DDSO come from a variety of backgrounds there are a number of registered dietitians
like Lindsay and Laura there are some dietetic technicians registered as well and some other
nutrition staff who have under state regulations been required to complete at least a 2 year
degree related to the field of nutrition and 400 hours of supervised practice this staff
conducts screenings and diet orders for all residents that come into their allotted group
homes the role of the RD at the finger lakes DDSO is varied of course they conduct the
nutrition care process which includes screening nutrition assessment nutrition diagnosis intervention
monitoring and outcome management fortunately the patient population at the OPWDD will be
under their care for a very long time so monitoring and evaluation become a very real part of
their management the dietitians are always responsible for calculating the nutrient needs
of their patients because the population varies so greatly some individuals are confined to
wheelchairs or are non-communicative while others walk around just like you or I their
needs vary greatly because so many of these individuals are unable to communicate their
needs monitoring their weight is imperative for keeping them healthy the dietitians at
the finger lakes region DDSO are also heavily involved in enteral nutrition many of the
residents have varying degrees of dysphagia or other ailments that make it difficult for
them to swallow tube feeding is often necessary especially as they progress in age the RD
consults with an interdisciplinary team including primary care physicians speech pathologists
occupational and physical therapists all to determine the best route for coordinated treatment
of the individual registered dietitians at the finger lakes region DDSO is also heavily
involved in the training of incoming home-care staff these staff are involved in the cooking
bathing cleaning and general day to day life of all of these individuals because of this
they need to understand how to prepare food for the varying diet orders of these individuals
this includes pureed and ground diets as well as normal or thin liquid diets sanitation
and safety is also of utmost importance and home-care staff undergo extensive training
to keep all of their patients safe this is especially important in the disabled population
because many of them have altered immune function the RDs also conduct ktichen adutis to make
sure that the home-care staff are doing everything by regulation and of course no healthcare
job would be complete without paperwork the RDs at the fingerlakes region DDSO supervise
lab-work they monitor for weight fluctuations and they read all home-care notes related
to nutrition and cooking to determine if any change is need to be made in the care of their
individual patients my time with the finger lakes region DDSO was overwhelmingly positive
by in large my time was spent shadowing both Laura and Lindsay I was able to observe them
in their day to day functions as registered dietitians and join them to group home and
daycare visits my favorite part of the rotation was meeting and interacting with the residents
I was even able to observe my very first tube feeding administration at one of the day home
facilities both Lindsay and Laura were kind enough to include me in the case management
of several interesting individual cases this experience really helped me to build confidence
and understand that I have been well prepared to conduct medical nutrition therapy for a
wide variety of individuals of course I was never making the decisions for the care of
these people but being able to hold intelligent conversation about their cases is a win in
my book another important aspect of this rotation was menu planning I was challenged to create
special snacks and meals for special diets including pureed ground lactose free and others
some individuals simply didn't like certain foods or refused to eat certain foods or would
only drink overall this was an eye opening and challenging first look into menu planning
in a very difficult and diverse population thank you for listening
