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EUROPEAN MODELS ON SERVICE PROVISSION: THE GAUTENA NETWORK Joaquin Fuentes MD Cardiff,19th May 2004

EUROPEAN MODELS ON SERVICE PROVISSION: THE GAUTENA NETWORK Joaquin Fuentes MD Cardiff,19th May 2004. MONMOUTH. MONMOUTH. RIVER WYE. RIVER WYE. GAUTENA (Gipuzkoa Autism Society). Kingdom of Spain. THE BASQUE COUNTRY. Inhabitants 2,098,000. Gipuzkoa County. 50 x 60 Km 676.00 inhabi.

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EUROPEAN MODELS ON SERVICE PROVISSION: THE GAUTENA NETWORK Joaquin Fuentes MD Cardiff,19th May 2004

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  1. EUROPEAN MODELS ON SERVICE PROVISSION: THE GAUTENA NETWORK Joaquin Fuentes MD Cardiff,19th May 2004

  2. MONMOUTH

  3. MONMOUTH

  4. RIVER WYE

  5. RIVER WYE

  6. GAUTENA (Gipuzkoa Autism Society)

  7. Kingdom of Spain THE BASQUE COUNTRY Inhabitants 2,098,000 Gipuzkoa County 50 x 60 Km 676.00 inhabi.

  8. ALL WALES BASQUE COUNTRY

  9. GENERAL INFORMATION ABOUT THE BASQUE COUNTRY • The Basque Autonomous Community • Inhabitants 2,062.000 • Social Serv. expenditures per person / per year: +/- 160 Euro • Full “competences” in the fields of: Education, Health and Social Services (among others) • County Council Authority is responsible for taxation

  10. GAUTENA: HISTORICAL BACKGROUND First Parents Societies in Mental Retardation Services development Social awareness and informal support Support from private institutions GAUTENA was created Creation of a new Basque Autonomous Administration Full competences in Education, Health and Soc. Services Tax sovereignty / Autonomous tax collecting The new Administration choose to support Societies..... 1960 1978 1980

  11. GIPUZKOA IN THE BASQUE COUNTRY CANTABRIC SEA FRANCE GIPUZKOA 50 x 60 km 676,000 inhabit.

  12. San Sebastian

  13. Donostia - San Sebastian

  14. GAUTENA (Gipuzkoa Autism Society) and Dpts. of Health, Education and Social Services

  15. Population: 676,000 < 20 Kms. Outpatient clinic (129 clients) GAUTENA (Gipuzkoa Autism Society) and Dpts. of Health, Education and Social Services

  16. GAUTENA: PSYCHIATRIC PROGRAMME • TOTAL NUMBER OF CASES 280 • OUTPATIENT TREATMENT 129 • SPECIALIZED TEAM 1 Medical Director • 1 Psychiat. and 3 Psychol. • FREQUENCY • Up to 11 contacts / year 31% • 12 - 22 contacts / year 13% • More than 22 23% • FINANCING Health Department • 144.243 Euro • Free for the families

  17. Population: 676,000 50 x 60 Kms. Classroom (64 students in 14 classrooms) Outpatient clinic GAUTENA (Gipuzkoa Autism Society) and Dpts. of Health, Education and Social Services

  18. GAUTENA: EDUCATIONAL PROGRAMME STUDENTS 64 in our classrooms (+70) CLASSROOMS14 (inordinary schools) RATIO 2/5 LIMIT OF AGE 20 YEAR COST PER PLACE 19.833 Euro FINANCING Education Department, Basque Government

  19. Population: 676,000 50 x 60 Kms. Classroom Home (49 clients in 6 homes) Outpatient clinic GAUTENA (Gipuzkoa Autism Society) and Dpts. of Health, Education and Social Services

  20. GAUTENA: COMMUNITY LIVING PROGRAMME CLIENTS 49 6 PLACEMENTS: Clients Ratio Cost per place Oriamendi Group Homes 8+6 2/6 30.050 Euro Urnieta Group Homes 7+7 2/7 30.050 Euro Txara Residential Unit 12 1/4 24.040 Euro Zarategi Sheltered Flat 8 1/4 19.232 Euro RATIO 1/4 1/3 AGE From 18 FINANCING Social Services Depart., County Council

  21. Population: 676,000 50 x 60 Kms. Classroom Home Outpatient clinic WE Home (30 fam / year) GAUTENA (Gipuzkoa Autism Society) and Dpts. of Health, Education and Social Services

  22. Population: 676,000 50 x 60 Kms. Classroom Home Day Center (69 in 3 DCs) Outpatient clinic WE Home GAUTENA (Gipuzkoa Autism Society) and Dpts. of Health, Education and Social Services

  23. GAUTENA: DAY PROGRAMME CLIENTS 69 adults PLACEMENTS 3 (Ategorrieta, Aiete and Oriamendi) RATIO 1/5 1/3.5 AGE From 20 years of age YEAR COST PER PLACE 10.220 Euro FINANCING Social Services Department, County Council

  24. Population: 676,000 50 x 60 Kms. Classroom Home Day Center Outpatient clinic WE Home Leisure (212) GAUTENA (Gipuzkoa Autism Society) and Dpts. of Health, Education and Social Services

  25. GAUTENA: LEISURE PROGRAMME CLIENTS INVOLVED212 RESPITE CARE 30 Weekend and short stays SUMMER CAMPS 150 clients (6 camps) WALKS 21 SPORTS 54 (swimming, pelota, aerobic, adapted sport, ...) FINANCING Social Services Department, County Council Based on volunteers collaboration

  26. ABALANCED VIEW CLIENTS AND FAMILIES PROFESSIONALS PUBLIC ADMINISTRATION & SOCIETY

  27. 2003 Medal of Citizenship Merit of the City of San Sebastian

  28. DESIGNING A SPECTRUM OF COMMUNITY SERVICES FOR PERSONS WITH AUTISM: OVERCOMING SIX CHALLENGES

  29. First Challenge: Identifying autism

  30. Identifying existing community initiatives Informing professionals & authorities Using local systems of communication Conferences & seminars Brochures, books Haizea – Llevant program Public medial campaigns First Challenge: Identifying autism

  31. HAIZEA – LLEVANT PROGRAM Catalonia: 1200 (0-2), Basque Area: 800 (2-6) Basic developmental skills acquisition + Alerting signals Standard materials 1. Checking developmental progress 2. Blindness, Deafness, Autism, Mental Retardation & Cerebral Palsy Distribution in Basque Area, Rioja, Aragón...

  32. 10 11 12 14 16 18 20 22 24 Name recognition 17. Feeds the doll 33. Understands words 34. Follows orders given by gestures SA-10 Loss of babling 14. Imitates homew. 31. Imitates gestures 50% 75% 95% 64. Points with his / her finger

  33. 10 11 12 14 16 18 20 22 24 Name recognition HAIZEA-LLEVANT & Autism 97 items and 21 alerting signals Items - 11, 14, 17, 32, 50, 64, AS - 5, 8, 12 and 13 17. Alimenta a la muñ 33. Comprende palabras 34. Sigue órdenes gestuales SA-10 pérdida del balbuceo 14. Imita labores domésticas 31. Imita gestos 50% 75% 95% 64. Points with his / her finger

  34. Second Challenge: Choosing an adequate model of service

  35. Second Challenge: Choosing an adequate model of service Compliance with social models and values International credibility Pursue the “state of the science” Define approach with clarity Guarantee basic needs and human rights “Thinking big, acting small” Positive discrimination policy

  36. ACTION IN THE FIELD OF DISABILITIES Integrative education and Community based rehabilitation (Declaration of Salamanca - UNESCO)

  37. TEACCH Understanding Autism Spectrum Goal of Optimum Adaptation Parent – Professional Collaboration Assessment for Individualization Priority for Cognitive and Behavior Theory Structured Teaching Skill Enhancement & Deficit Acceptance Lifelong Community-Based services Holistic Orientation GAUTENA

  38. Comparison between North Carolina & Gipuzkoa, Spain

  39. Comparison between TEACCH & Gautena, Spain

  40. Comparison between TEACCH & Gautena, Spain

  41. Third Challenge: Parents – professionals collaboration

  42. Third Challenge: Parents – professionals collaboration Parents´society (non-lucrative public interest) Professionalized management Board and committes Orientation towards the client / family Clear and revisable procedures Agreement of the personal support plan

  43. INDIVIDUALIZED SUPPORT PROGRAM SERVICE 1 SERVICE 2 KEY WORKER CLIENT FAMILY PROGRAM FOR NEXT YEAR

  44. QUALITY COMMITMENTS Satisfaction Human rights Discharge Training plan Quality system Assessment Service plan Incorporation Annual plan Confidentiality Quality Improvement Committe

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