August 3, 2020

Dr. Gwen:         Welcome to my channel. I'm Dr. Gwen, I'm a clinical psychologist who's obsessed with empowering disabled individuals, their families, and the systems that support them. If you haven't already, please consider subscribing to my channel where I curate tips and tricks to helping neurodiverse individuals thrive. In this video, I interview Rhonda Daniels, Executive Director of Moving Forward Towards Independence.

                        Moving Forward is a residential program in Napa, California that provides transitional and independent living support to adults with developmental disabilities, learning disabilities, and autism spectrum disorders. We learn about Moving Forward to graduated support levels or three-tier program and get a clear sense of their mission, which is to help each individual achieve their personal potential across all areas of life. What's so cool about Moving Forward is that the program supports a wide range of abilities and is considered a lifelong program for non-college-bound individuals. As you take this interview in with Rhonda, I want to encourage you to think about what it means to be embraced, and to have a lifelong community.

                        Hi, Rhonda. Thanks so much for joining me today.

Rhonda:           Oh, it's great to be here. Thank you, Gwen.

Dr. Gwen:         Yeah, I have wanted to really dive into Moving Forward Towards Independence for a while, so, this is really, really fantastic that we're going to get to talk and get more into the program. But maybe we can start by you telling us about yourself.

Rhonda:           Sure. I've been with Moving Forward for 15 years, done every job there is to do and I've been the Executive Director for the past five. And, prior to that, I had a 26-year career as a vocational counselor in the Workers Comp system. So, I had an opportunity to work with people in a variety of situations and help them identify new career choices when they physically couldn't do their own choices. So, when an opportunity came up as a Community Resource Specialist with Moving Forward, I thought it fit my skills perfectly and that's where I jumped in.

Dr. Gwen:         Yeah, and that background is so informative.

Rhonda:           Yeah.

Dr. Gwen:         Based on what you're doing now. That's fantastic. And, let's get into Moving Forward, talk to us about your program or describe it for people who don't know it.

Rhonda:           Okay. So, we're a post-secondary residential program started 22 years ago by a group of six families who were looking for a place for their non-college-bound 22-year-olds to go. They started the program as an independent living skills program and 22 years later, we've grown into a three-tiered program. The first tier is called Transitional Living 1. Many folks who come to that program have never lived away from home before, some have, some been in other programs. But the young men and women live together in a home and they operate as a family, they learn how to cook, and clean, and do their laundry, they learn to bank and budget, follow a schedule. Hopefully, they learn how to make a friend and keep a friend, how to get a job, and keep a job. But, it's 24/7 teaching independent living skills and social skills. And, during that period of time, often about a year, we have very close contact with the family, telephone conferences weekly, a lot of give and take with the parents. And, at some point, the team including our staff, and the family, realize the resident is ready to move to the second tier.

                        So, we have an apartment building next door that we don't own but we occupy all four two-bedroom apartments. So, this gives our residents a chance to graduate if you will into their own apartment with a roommate, their own bedroom. And, this is where they begin to learn how to shop, make healthy choices, budget, buy household goods, share with a roommate. And, all the time, our expectations of them are the same as it was from day one that they participate in our program, that they go to work if they're working.

                        And, eventually, when the team feels that they're ready, they join what we call our Community Living Program, our third tier. For many, this is a lifelong program, it doesn't have to be. But, right now, we have about 30 folks who live in the community which means it could be as close as next door or across the street, or within five or six blocks of us. And, they live in their own rental or a family-owned home with roommates, and we serve them in their homes.

                        And, I think the beauty of Moving Forward is the wide range of abilities. Folks range in age from 18 to mid-50s now. And, we have folks in our Community Living Program who are married, who both drive, who care for animals, live in a family-owned home. And, we have others who will always need to be administered meds, and help cleaning their place, and help structuring their social calendar. So, we have a wide variety of abilities. But our mission, in whatever phase of the program the resident is in, is that they achieve their highest level of independence in both work and living.

Dr. Gwen:         Yeah, I mean, that's always the thing that's always attracted me to your program is this kind of tiered model. And, this nod, even through your tiered model, that even when they get to that third tier, that they may always need some level of support to live a healthy and safe life.

Rhonda:           Right.

Dr. Gwen:         But that they can. They can do that.

Rhonda:           They sure can.

Dr. Gwen:         So, I've always loved that about your program that it is really taking into account the reality of the situation. And that you really can serve a lot of different individuals.

Rhonda:           Right.

Dr. Gwen:         And then, it's not time-limited, which is great. It doesn't sound like it's time-limited, anyway, to me.

Rhonda:           It's not time-limited at all on our part. As I said, for many it's become a lifelong program. And, for those who isn't, they're welcome to come and stay for a year or two or three or four. And, some go back to their home communities, some move on to a different kind of program. But, it is not time-limited for us.

Dr. Gwen:         Yeah. Rhonda, in your first tier, in they're living kind of as a family together in a home, what are your staff ratios at that level?

Rhonda:           So, we have one person who sleeps over at night in one of the houses that serves all 44 residents. So, we're not a program that has a person sleeping in each area. Our folks are really high functioning, very independent, safe. And, for 22 years, it's worked that we've had one person sleepover. During the day, we have all kinds of staff coming and going. And again, though, you might come to our program 1:00 in the afternoon and not see any staff at all because they may be taking someone shopping, or to a doctor's appointment, or to a variety of things. So, you might not see staff which means clients have to occupy themselves at times.

                        But for every-- for example, for the woman's house, there's the case manager and she is the resident's go-to person. She only works 40 hours a week, so we pride ourselves on being very deep with support staff so that the resident and the family always have someone to contact. But, that person is responsible to make sure that all of the residents' needs are met. So, if that person works 12:00 pm to 8:00 pm, and their resident needs a fasting blood test, we're not going to make the resident wait until noon. So, another staff would take them at 8:00 am. So, we work as a team and we're very deep that way.

Dr. Gwen:         Yeah, that's great. And, I think that we're going to get into, and maybe we get into this now, which is who's that ideal client or resident for you? When someone comes to us with this general set of skills or profile, they really can thrive at Moving Forward. What kind of resident or client would that be?

Rhonda:           So, there's a million-dollar question. I think, that a person who's motivated, someone who is ready and wants to leave home, someone who's motivated to become as independent as possible, and someone who is somewhat of a rule follower, enough of a rule follower to be safe because we promote independence. And, from Day 1, pre-COVID, when residents come to us, they can be with staff 24/7 if they need to be. But, our goal in both the world of work and in independent living is that they become as independent as possible, that they foster friendships, and they're able to go to downtown Napa on their own, take a class at Napa Valley College with support, but that they don't have to be with staff at all times.

                        And, sometimes, that takes a month until someone who's very tech-savvy and who's used to being independent learns their way around the small town of Napa. And, it can literally take a couple years for those who really need support and aren't safe in the community. But, I would think, to reiterate the answer, someone who's motivated, someone who wants to be here, and has the same goals as their family has, and as we have that they want to be able to set goals for themselves which might be to get a job, might be to take meds independently, might be to follow a schedule, that's one of the hardest things for our folks.

                        With such a wide age range, 18 to mid-50s, the labels of our clients are going to vary based on when they were born, high-functioning autism, Asperger's, developmental disabilities, Down syndrome. But really, what our folks have in common is that they are all pretty slow processors. And, I often say they can run circles around me with technology, pop culture, fashion, but, making plans for the weekend and following through when their peers cancel out on them can be the biggest disaster of their lives. And it's that executive functioning and processing that we try to support our folks with. And, we have disappointments in our lives, they have disappointments in their lives and we'll help them navigate that.

Dr. Gwen:         Yeah, that's lovely that there's that commonality there. Isn't that funny, I can relate to this, where I'm like, "I don't know how to this tech-wise." But boy, my client can tell me all the different ways to solve that problem." But now, we need to back up and figure out when we should go to sleep.

Rhonda:           Right.

Dr. Gwen:         And, give it a whole another situation. Yeah, got it. So, that first phase which it sounds, or tier, where you've got adults that are just transitioning to trying independent living maybe for their first time, no matter what age they are.

Rhonda:           Right.

Dr. Gwen:         Moving out of their family home, and this-- Do you find, Rhonda, that your clients are able to set reasonable goals? I mean, goal setting is really interesting, but how do you approach that? Sometimes, the goal-setting can be interesting.

Rhonda:           Well, most people's goal is to move to the next step, that they want their own apartment, they want to move into the community living. So, most of their goals are just foreseeing the future when they can be as independent as possible. So, it's our staff who helps them break down what they need to be able to do to move to that next step.

                        And, often initially, it's just, "Can you follow your schedule?" "We'll make your schedule together." "We'll list the Moving Forward classes." "We'll list whatever else in your life in Napa that you need to keep a schedule for." And, your only goal is to stick to your schedule and that's very hard for a lot of our folks.

                        For others, it's take your meds independently and we'll go through steps doing that. Like I said, getting a job because the vocational part is of our program is huge which I'm sure we'll get to. But, we try to break down the goals with them and make them very realistic, set our folks up for success, celebrate each achievement, and just keep setting more goals.

Dr. Gwen:         Yeah, that's great. Let's get into the vocational program and the types of classes you guys offer. Because that's different than like going down to Napa Community College.

Rhonda:           Right.

Dr. Gwen:         So, let's talk about the focus of your classes.

Rhonda:           So, what I call classes could be a group of four people, six people, could be 12 or 20. But, they're usually all social skill development classes, support group classes, they teach independent living skills. So, of course, we have the usual job readiness, and budgeting, and banking, and decision making. And now, our monthly safety class is now weekly safety class with COVID. But, we also try to match our client's interest with our staff's skill. So, last year, prior to COVID, we added a book group. We had a group of happen to be young women who were really interested in reading a book together, staff who was willing to meet with them weekly to discuss it.

                        We formed a book group; we had a group of gals and guys who wanted to do Pokémon Go and I don't even know what that is to this day. But, we had a staff who loved Pokémon Go and he got a group of folks together, and every Wednesday, 3:30 pm to 5:00 pm, they went walking in Napa to catch Pokémon on their phones.

                        But, it's such a perfect example of how when we start out with a class that's driven by our client's interest and our staff's skill. We get a group of people together who normally wouldn't give each other a second look. And, they start catching Pokémon together, and pretty soon, the group has dispersed into, instead of meeting Wednesday, 3:30 pm to 5:00 pm, you want to go Thursday night and walk around downtown Napa and catch Pokémon. So, these splinter groups splinter off, and we have these in these folks exercising independent living skills, being social with peers they wouldn't have spoken to had they not had some common interest, and it's just the most beautiful thing to see that from a client-driven interest group, people become independent and do things together.

                        Some of our other classes, social skills classes, we have many staff who are very artistic. So, we're lucky to have an art room and we have three different art classes a week. Right now, we have a gratitude committee that I want to show gratitude to the people in Napa who are supporting us through this time. We have sing-alongs, we have psychologists who come in and do real support groups, we've had grief groups, we've had communication groups. We have a wonderful retired speech therapist who has worked individually with some of our folks. And, I got the idea that she could work with the folks who don't express themselves freely, and she's been doing this communication class with a group. And, we hear from all outside sources, "Wow, someone's really opened up and communicated," and they have no idea that they're in this group.

                        And then, we have the people who have no boundaries and don't know when to stop talking and she's working with them on listening. So, those are a sampling of our social skills classes that we offer.

Dr. Gwen:         Yeah.

Rhonda:           I think, one of our best programs that we offer in the community, people can't wait to move into the third tier and live on their own in the community. They're no sooner moved out and they think, "Oh, my goodness, what do I do now? I'm living alone." Or, "I only have one or two roommates but they're working." So, we've developed our dinner group program, and that's for folks in the community. And, if you and me and two other folks were residents at Moving Forward and we were doing a Monday night dinner group tonight, it would be my turn to, with my case manager, plan, shop for, and prepare dinner. And then, you and the other two folks would come to my apartment or house, and you'd be learning how to be a good guest, and I'd be learning how to be a good host.

                        And, out of those dinner groups have developed all kinds of unlikely friendships, and it's staff-led, the conversation is staff-led. And, depending on the time of year, they might watch the Warriors or watch the 49ers, and go for a walk. So, it's just a wonderful part of our program that gets people together who normally wouldn't. And, it helps with not having a frozen dinner for a seventh night, and eating healthy, and sharing food with other people. So, it's been a wonderful program.

Dr. Gwen:         Yeah, and one of your missions that I've always seen whenever I hop on your website, is this kind of development of a lifelong community? This idea of having a community of peers, and people, that I can see myself living happily with for the rest of my life. Not saying that there are not any bumps in the road, but how wonderful it is to have the support, to even have the experience to host a dinner party.

Rhonda:           Right.

Dr. Gwen:         Or, to be a guest at a dinner party. And that everyone's learning. So, it really allows everyone to give it a try without too much risk anyway which is so great. It's so great. I love those dinner parties.

Rhonda:           Yeah, so we have men's group, and we have women's group, and one of the funniest things that happened, I think, right before COVID, January or February, is one of our male case managers took a group of guys to a bar to play pool. And, some of these guys, guys in their 20s and 30s, had never been able to walk up to a bar, and order a drink, and pay for a drink, tip. And then, just come back and shoot pool and most of them ordered soda, one or two ordered a beer. But, it was just such an appropriate thing for 20 to 30-year-olds to be doing. So, we tried to really get them out doing the kinds of things they want to do.

Dr. Gwen:         Yeah, and, I think, that's right that they want to do. Rhonda, how do you guys handle dating? I know that with lots of programs, it's a real tricky situation sometimes to handle dating, but that's just a part of adult life.

Rhonda:           Yeah, no, it's never been tricky for us. In the men's house and the women's house after move-in day, no men or women can go upstairs in the other person's house. We encourage dating, we teach about-- These folks, just like any other middle school kids, learn about dating and sex through movies, and that's not always reality. So, we spend a lot of time trying to teach whether it's the gal or the guy, what a date would look like, and what's appropriate for a first and second and third date, and encouraging them to do what we think is appropriate. Once they move into their own apartment, they can certainly have their boyfriends or girlfriends stay over and go into their rooms with them, just not in the community houses. But, we really encourage dating, we encourage double dating, we've got a lot of couples who go out together which is just so nice, lovely friendships. But, it's never been something that was hard for us, we just saw it as natural.

                        I think, the hardest thing for some of our staff and some of our parents is because most of our folks have never really had a boyfriend or girlfriend before they came, that once they have one, the family seem to think that's going to last forever. So, when the first breakup happens, it's heartbreaking, worse for the parents and the staff than the resident. But, we always remind the families that, "Hey, you and I had plenty of heartbreak before we found our mate, and isn't this a great problem to have that your son or daughter did have love in their life, and now they'll have to move on." So, we really just treat it as part of life.

Dr. Gwen:         Yeah, and maybe we can touch upon that point of parent involvement. You were saying that there's some parent meetings especially in the first phase or first-tier when someone comes. Maybe, can you talk a little bit more about how parents are involved in that first tier?

Rhonda:           So, Moving Forward is really unique in many ways. But, I think we're very unique in how we partner with the families that we encourage the family's involvement. Most live far away so that they're not in Napa. But, when a person first comes to the program, prior to entering, we've had many conversations, we've had a tour with the family, we've had a sleepover with the potential residents. So, we've already built some kind of rapport. Once the family drops off the resident, we try to have a formal meeting at the 90- to 120-day mark. Because we think that it takes that long to acclimate to a new program whether it's a first-time away-from-home program, or it's the fifth program they've tried. A good three or four months will tell them a lot about Moving Forward and tell us a lot about the resident. So, we'll have a formal meeting at that point. But, up until that point, the case managers had weekly telephone conferences with the family and we learn more about the resident by talking to the family, and the family knows what's going on at Moving Forward. We're also available 24/7 if they need us, but there is a definitely a weekly conference.

                        After that third or fourth month, if it's decided this looks like it's going to work and we set some goals, then we formally meet at the year anniversary and every year after that. But, we're totally in contact with the resident's family on a weekly basis.

Dr. Gwen:         Yeah, that's so great because I see that in so many times, transition is also difficult for the parent or for the parents, who've spent a significant part of their adult child's life advocating for them and organizing support, and coordinating and scheduling and transporting. And now, they're gone.

Rhonda:           Right. It can be very hard for some people. Our case managers do everything that a parent would do, and they don't have to worry about that anymore. They also don't have to have tug of wars with their adult children anymore because we do that. And, they can come to Napa and take their son or daughter out to dinner and enjoy the time together and not that role of disciplinarian and financial issues. So, they get to see the upside pretty quickly.

                        And then, lastly, I think, Moving Forward is really unique in that we're not just a community for our residents, we really are a community for our families. And, we only formally meet three times a year for lunch. But, out of those three times a year meetings, incredible friendships have been developed where families have ended up traveling to Europe together and really relying on each other. So, it's a lovely community of families.

Dr. Gwen:         That's awesome. So, it's not only building lifelong communities for your residents but also for their families, which that's such a beautiful thing that's happening there. Rhonda: Yeah. Dr. Gwen: Hey, Rhonda, can we get into the vocational piece of Moving Forward? Let's talk about that and how you guys are helping the vocational development of your residents.

Rhonda:           It's a very strong part of our program. So, everything I'm saying now is pre-COVID and I'm sure we'll talk about post-COVID, but from day 1, our residents start volunteering. So, anybody who's not working but participates and volunteer, we'll volunteer at the food bank, the library, we've gone to convalescent hospitals, we've gone to farmers' markets, but they're developing pre-vocational skill training from day 1. And, I think, that's so valuable that if I have to pitch in and staff the food bank volunteer and someone says to me, "Well, that's not the way someone else does it", and I said, "You know what? Today, I'm the boss, and we're doing it my way and this is what's going to happen in real life." So, they really learn from Day 1, start developing good pre-vocational skills.

                        Some of our folks qualify for the Regional Center System. All of our folks qualify for the Department of Rehabilitation system. So, during the first month, we get them enrolled with the Department of Rehabilitation which supports our folks in finding employment. And, through the Department of Rehab, our folks get an opportunity to try real-work situations. So, they might do a one or two-week, 20-hour a week vocational assessment, they might do a three or six-month work hardening program, they could do several of these until we find the right match. So, initially, we're trying to find barriers to employment, what's going to work best for this resident. Once we think we find a niche for our resident, then, if they appear to be job-ready, then we start the looking for work process.

                        And, interestingly for most people, it's usually easier to match our folks with a job they can do than to teach our folks what I call the soft skills. Because if somebody's going to be a bagger at a grocery store and they're very well qualified and skilled for that very difficult job, they usually do very well on the job. But, if it's a union shop and they're working eight hours and they have to take an hour break in the break room, often, our folks haven't a clue of how to navigate a break room and make small talk with other people, and what to do when they're finished eating their lunch in five minutes. So, it's the soft skills of supporting our clients through employment that I think is the most important thing we do once they find a job.

                        Right before, say March 15th, we had 44 residents in the program, we try to stick right around 40 to 45 residents. And, on March 15th before COVID started, we had 19 who were competitively employed. Meaning, they were working in a variety of settings with or without a job coach. Some had been in jobs literally 14 years, some have been in jobs 14 days, but on March 15th, we had 19 folks competitively employed that we were supporting, we had about 10 folks who were in Regional Center supported day work programs, and we had about 10 folks who were in some phase of looking for work, one was in a culinary program, one was taking classes at Napa Valley College, a couple are not going to be working and they were volunteering in their own special volunteer position. So, that's typical for us at any one time that we have a good amount of people working.

                        Napa is a hospitality area, so most of our folks are working in the hospitality field, they're working in hotels, they're working in restaurants, grocery stores, we have folks who are self-employed doing bookkeeping out of their home, we have a good handful who are always wanting to work with animals, and we have people who have jobs working with animals, we've had people working in retail. So, we have a really great track record with helping place our folks in jobs and supporting them and helping them keep their jobs.

Dr. Gwen:         Yeah, and, I mean, it sounds like you've also developed relationships with your community businesses as well.

Rhonda:           Yeah, that's the key because Napa really is a small town. It's a great big tourist area but it really is a small town. And, our Community Resource Specialist who's our liaison for our residents to all things, volunteer, school, and work, does a great job of developing and keeping up with those relationships.

Dr. Gwen:         Yeah, that's so fantastic. That's great. There's this real eye on daily living vocational training and placement, and then with this kind of ultimate goal of getting you as independent as possible. But, whatever that looks like for you and what you got.

Rhonda:           Right.

Dr. Gwen:         Yeah. Hey, Rhonda, what would you say your desired outcomes are for your clients? I know that can change, obviously, for each of your residents. But, when can you be, "Ah, that really worked for this person, that what we did, that's good."

Rhonda:           That's an interesting question because part of me wants to say never, and part of me wants to say-- It's interesting, people assume that the folks in Tier 1 are going to need more support than the folks in Tier 3. And, I think what happens as our resident's age, their families are aging. So, somebody who's really independent, just goes through our program from the house to the apartment, and they're living independently in their own place, sometimes those who are the most safe, the most independent, the most happy, sometimes life happens to them just like it happens to you and me. First, we see the beloved family pet pass away and that's a big loss. Then, we start seeing the grandparents pass away and that is a big loss. And, eventually, one or both parents start passing away. So, even though our residents are independent and living alone or with others, and, like I said, some who drive, some who care for pets, some who are married, but life happens. And, as their family experience trauma, there are setbacks. There's always going to be setbacks just like there would be for you and me.

                        The other thing that happens as our folks age is their bodies deteriorate. And, we have residents who have medical issues that have nothing to do with their intellectual disability. We've had knee replacements, we've had cancer surgeries, we've had trips to the emergency room, life happens. And so, the most independent person is probably going to have a setback at some point, whether it's a death in the family, or something to their own health.

                        So, that's why I said, my first thought is, it never ends.

Dr. Gwen:         Yup. yup. Well, and what's so comforting is that because there isn't this kind of time limit to your program, and because there is this graduated kind of support that you can access, what's so nice is that when someone comes into Moving Forward as a resident, if it's a good fit and everything's working, that they could be supported by Moving Forward forever for them on some level.

Rhonda:           Right.

Dr. Gwen:         And that's unusual, I think, in a transition program. Well, I don't want to necessarily call you a transition program. But, this idea of like, there isn't that pressure of, "Okay, well, you better produce."

Rhonda:           No, I just don't think that's realistic. We have a couple of residents for whom we are their fifth program. And things are working out really well and their families have said, "Oh, we should have come to you first." Well, the resident probably wasn't ready for our program 10 or 15 years ago. I try to tell families that they really need to find the best program for their son or daughter for now. Because none of us, when we all went to college, we may have had two or three roommates before things worked out and we found the right roommate. Some of us went to more than one college before we found out where our niche was. And, I don't think that parents of an 18-year-old or a 22-year-old can necessarily predict that Moving Forward is the place for their son or daughter for the rest of their life. But, if it fits now, then, I think that's where they need to focus.

                        And, I always tell parents that I really believe there's a program out there for everybody. And, might not be Moving Forward, but there is something out there that's right for their son or daughter. So, I think, that's the thing to focus on is where's the best place for them to be at now.

Dr. Gwen:         Yeah, and that's so lovely because then you don't kind of get caught up in the anxiety of things. And then, maybe it really nudges a parent or the system to look at who the adult is now. What are the pain points-- I kind of talk about pain points or pressure points that that programs or services or interventions ease. And so, really looking at the fact that what we all change and evolve. And so, that's just such a realistic and reasonable, practical way of looking at needs.

Rhonda:           Right. Gwen, I always like to talk about what we're not because we are not a therapeutic program. Most of our clients do see a therapist and psychiatrist and we are very involved in working with them, and many of our folks experience anxiety and depression, but we are not a therapeutic program. We're also not an educational program. We'll support our folks in going to Napa Valley College or Napa Adult School, we'll do whatever it takes to help them be successful there, but we are not an educational program. And we're not a medical program. So, if people need medical support, we will, in conjunction with their family, find the best medical support for them, but that's not what we do. So, I think that's important also.

Dr. Gwen:         That is really important, Rhonda, because when people are really clear about your program, that's when your program really can work its magic. When those factors line up, it's important. I think sometimes people have a difficult time understanding what a therapeutic program is. I think, especially here in California because a lot of times, when you talk about residential programs that are not in California, they're typically therapeutic residential programs. But maybe what you can do, can you just kind of define what a therapeutic program is and how that's different from Moving Forward?

Rhonda:           Yeah, I'm not sure I can define what a therapeutic program is but I can tell you that what we do is teach independent living skills and teach social skills. So we don't do behavior modification, and the reason we don't do that is our staff isn't skilled and trained in that type of activity. And, we have so many different staff coming and going. That's not what we do. We're here to help our residents set goals and achieve those goals in in small steps. But, like I said, we're not here to do behavior modification, we're certainly not here to deal with substance abuse, because the type of staff that we hire doesn't have that kind of background. Our staff has background in teaching, our staff has background in social work, our staff often has experience working with this population in a variety of settings. But we aren't licensed clinicians, and that's what I think of when I think of a therapeutic program.

Dr. Gwen:         Yeah, where there's a real main focus on mental health and that kind of emotional support. You're really talking about filling the gap with the actual skill-building of-- the skills that you need as an adult.

Rhonda:           Right. And, as I said, that doesn't mean that the majority of our folks don't have a psychiatrist and a therapist that we're very involved with, but it's that we're not providing that.

Dr. Gwen:         Yeah, I think that's important. It's an important distinction because a lot of times with therapeutic residential programs, all of those services are provided in-house and comprehensively provided in-house. So, it's not unusual then for your residents to access that on their own, obviously, with support from you. But, that it is an important distinction. And, I think, the more that people understand that the better that is. But, part of these interviews are really are trying to pull apart the weeds and to actually figure these things out because I think there's a lot of misunderstanding or misinformation out there about transition programs. When you talk about transition programs, you and I both know, there are lots of them.

Rhonda:           Yes.

Dr. Gwen:         They're all very-- Some of them are very common, but they're all very different. They have a different personality in and about themselves.

Rhonda:           Right.

Dr. Gwen:         So, that's a great thing to distinguish. Rhonda, how do people typically pay for Moving Forward?

Rhonda:           So, it is private pay. The first step of our program, one, cannot access their Regional Center funding if they have it. So, it's straight private pay, it's a fee for service. Once the person lives in an apartment where they're paying a third-party rent, then they can access their Regional Center funding if they have it, and the Regional Center will defray the cost of Moving Forward by about $1,300 a month, because we're vendorized for ILS which is Independent Living Skills, then that's different than SLS, Supported Living Skills. Supported Living Skills could be 24/7 and certainly more than the 35 that we're authorized for. The reason we're vendorized at a max of 35 hours a month from Regional Center is because the folks that benefit from our program are higher-functioning and wouldn't need the 24/7 kind of support.

                        Many of our folks do not qualify for regional centers, so they pay privately throughout the program. And, I typically tell families that whether they're paying fees to Moving Forward in the first phase which are almost $5,000 a month, or they're paying fees in the second and third phase which are less to Moving Forward, but then they're paying for rent, household expenses, utilities, food. I always tell folks that it's probably going to be between $4,000 and $5,000 a month to support their adult for the rest of their lives living in Napa. And, that's based on rent and it's based on needs.

                        Now, that doesn't mean they can't use the Social Security money that might come in, they can't use part of the income that their family member would earn by working, but I think it's a fair estimate that wherever the money is going, it's going to be between $4,000 and $5,000 a month to support this individual.

Dr. Gwen:         Yeah, that's good. And, to be quite honest, it's actually, I had to say this, quite reasonable. Only because I've spoken to programs who are $200,000 to $300,000 a year. And, I mean, this is part of the reason why I wanted to do some of these interviews as well which is how do we try to offset some things, in regards to just accessing high-quality good information for free. How do we start doing that for families in our community? Because it does take a village...

Rhonda:           Yeah, it's for sure.

Dr. Gwen:         ...to raise our tribe. And so, this is a realistic thing. And, I talk about funding in all of my interviews and programs because it's a part of the reality of a program. And, being in California, because there's a lot of people coming from out of state, I imagine, that don't have the regional center...

Rhonda:           Correct.

Dr. Gwen:         ...kind of understanding. When someone comes from out of state and becomes a resident at Moving Forward, are they then eligible for regionals? And that's if they qualify, obviously, but would they be eligible?

Rhonda:           They're eligible to apply, and if they qualify, then they begin to receive services.

Dr. Gwen:         Yeah, cool, that's good to know. That's really good to know. Awesome, Rhonda. Okay, so, I always end off my interviews with this question which is--

Rhonda:           Uh-oh.

Dr. Gwen:         Yeah, if you could only choose one skill to empower in one of your residents or a client, what would that be and why?

Rhonda:           I think it would be to follow a schedule that was developed by themselves and the people who support them. Because if they trust themselves and the people who support them, and they can stick to the schedule, I think everything else will fall into place. The financial aspects of living their life will fall into place, the social aspects will fall into place, the emotional support, the nutrition, everything will fall into place if they trust that they can follow the schedule they help develop for themselves.

Dr. Gwen:         It's almost like that lever, it's the one or the first domino in the whole sequence of things when you can get that in place. Well, and, you and I both know the importance of the schedule, and predictability, and routine, and these are for any of us for that matter.

Rhonda:           Right.

Dr. Gwen:         But, that's awesome. Awesome. Well, Rhonda, if anyone's listening to this interview or seeing this interview, what's the best way for people to find out more about you or to get in touch with you?

Rhonda:           Well, I'm really proud of our website Moving-Forward.org, and that's the first place they should go. And then, they can call me directly at 415-302-4614.

Dr. Gwen:         Yes, and I'm here to attest for the fact that that is her number and she does respond. So, it's so awesome. Thank you so much, Rhonda, for doing this interview with me.

Rhonda:           My pleasure, thank you.

Dr. Gwen:         Thanks.

                        Hey, thanks so much for watching. If you're interested in finding out more about Moving Forward Towards Independence, contact Rhonda. Her contact information is in the description below. Additional information about Moving Forward and this interview can also be found on my website, which I'll also link in the description below. If you got any value from this interview, please hit that Like button and subscribe. Doing so helps to get this information to others just like you. See you in the next video and thanks for watching.