Many years ago two salesmen were sent to Africa by a British shoe manufacturer. The goal of their trip was to investigate this new market, and to report their findings back to headquarters on the potential of the market.

• The first salesman came back with a rather dismal report, “There’s no potential at all here, because nobody wears shoes.”
• The second salesman came back with a rather different reply, “There’s massive potential in Africa, because nobody wears shoes.”

It’s our choice as to how we interpret any situation, whether we are looking at it positively with optimism, or as a challenge full of negativity.  Today is the last day of HOPE's fiscal year and we are thrilled to report that through this past year of changes and challenges, HOPE is stronger than ever.  Thanks to everyone that has supported HOPE this past year and kept the optimism and belief in HOPE's mission and vision.  I am so grateful. 

Amy Wallman Madden

Hello Summer!   Since we live in Iowa, we have the great opportunity to experience the extreme weather conditions of bitter cold winter days and hot, humid summer days.  This year has been no exception so far.  Here is some general information and signs for when visiting with others these summer days. 

​Call 911 if someone you know/work with have any of the following symptoms:

• Lack of sweating
• Flushed skin
• Racing heart
• Unconsciousness
• Dizziness or lightheaded
• Skin that feels cool and moist
• Body temperature over 104F
• Nausea and vomiting
• Confusion
• Rapid breathing
• Headache
• Muscle cramps

 
Remember certain medications make you more sensitive to summer heat!
 
Medications, Heat and You
Some medication may make you more sensitive to summer heat! When it gets really hot, it can be dangerous for our health! Extreme heat can cause heat-related illness, injury and even death, especially in young children and older adults. People with chronic health conditions are also at risk during hot weather. Some medications we take to help manage chronic health conditions can sometimes affect how well our bodies can tolerate extreme heat.
 
If you take medications for the following conditions, you may be at risk for injury due to heat:

• Bladder issues such as overactive bladder
• Medications for nausea, motion sickness, or irritable bowel syndrome
• Cognitive and psychiatric disorders
• Parkinson’s disease
• Alzheimer’s disease
• Blood pressure, heart attack, heart failure, or other cardiovascular disease
• Colds or allergies
• Pain, seizures, or trouble sleeping
• Diabetes
• Kidney, liver, or lung disease

 
What can I do to make sure my medications are safe for me when it is hot?
1. Talk to your doctor or pharmacist. They know exactly what medications you are taking and can talk to you about how summer heat might affect you. Ask about hot summer weather and your medicine.
2. Drink plenty of water to stay hydrated, especially if you are taking diuretics.
3. Use air conditioning while inside.

Take good care and be safe!

​I was reacquainted with this story recently in "The Art of Possibilities".  A three sentence summary shares this about possibilities:  Everything in life is an invention. If you choose to look at your life in a new way, then suddenly your problems fade away. One of the best ways to do this is to focus on the possibilities surrounding you in any situation rather than slipping into the default mode of measuring and comparing your life to others.

Once upon a time, there was an old man who used to go to the ocean to do his writing. He had a habit of walking on the beach every morning before he began his work. Early one morning, he was walking along the shore after a big storm had passed and found the vast beach littered with starfish as far as the eye could see, stretching in both directions. 

Off in the distance, the old man noticed a small boy approaching.  As the boy walked, he paused every so often and as he grew closer, the man could see that he was occasionally bending down to pick up an object and throw it into the sea.  The boy came closer still and the man called out, “Good morning!  May I ask what it is that you are doing?”

The young boy paused, looked up, and replied “Throwing starfish into the ocean. The tide has washed them up onto the beach and they can’t return to the sea by themselves,” the youth replied. “When the sun gets high, they will die, unless I throw them back into the water.”

The old man replied, “But there must be tens of thousands of starfish on this beach. I’m afraid you won’t really be able to make much of a difference.”
​
The boy bent down, picked up yet another starfish and threw it as far as he could into the ocean. Then he turned, smiled and said, “It made a difference to that one!”

adapted from The Star Thrower, by Loren Eiseley (1907 – 1977)

Thank you personally to the entire HOPE team (all 52 of you!) for embracing the values of this small boy. You all make a difference every day. 

The last year has been a year of changes as Iowa has moved to Managed Care.  As we navigate through these changes, we are continually looking for (and finding!) ways to improve upon our service delivery as well as employment engagement which we feel is progress.
 
One of the changes being constructed through HOPE is that of a mobile application to complete employee’s time card.  HOPE has implemented a new payroll application, Paylocity, that allows clocking in and out from an employee’s phone.  The Center for Medicare and Medicaid Services has been pushing the use of “Electronic Visit Verification”.  And though Iowa has not yet implemented, we feel that by being proactive, we can help shape the implementation of this which is slated for the fall of 2017. 
 
Another change HOPE is driving to further develop is the opportunity to complete documentation throughout service delivery.  By fusing the capabilities of Paylocity with Salesforce, this ideal application will minimize indirect time,  allowing for tracking outcomes, monitoring goal progress and providing real time updates.  There have been a few legislative updates that were signed in May by Governor Branstad that would further simplify documentation, but the actual implementation date and scope of those changes remain unknown.  Due to this most recent development, our implementation has been delayed until August when the details of this legislation are revealed.  Stay tuned as this exciting news develops!
 
“You can’t change the direction of the wind, but you can adjust the sails to reach your destination…”

​It is that time to start thinking about severe weather, what it looks like and what to do if there are severe weather warnings. A few suggestions are as follows:

• Listen to NOAA Weather Radio or to commercial radio or television newscasts for the latest information.
• Be alert to changing weather conditions.
• Look for the following danger signs:
  • Dark, often greenish sky
  • Large hail
  • A large, dark, low-lying cloud (particularly if rotating)
  • Loud roar, similar to a freight train.
  • If you see approaching storms or any of the danger signs, be prepared to take shelter immediately.
  • Know the difference between a watch and a warning.
    • Tornado Watch - Tornadoes are possible. Remain alert for approaching storms. Watch the sky and stay tuned to NOAA Weather Radio, commercial radio or television for information.
    • Tornado Warning - A tornado has been sighted or indicated by weather radar. Take shelter immediately.

 
What to do in the case of a tornado in various locations:

A structure (e.g. residence, small building, school, nursing home, hospital, factory, shopping center, high-rise building)

• Go to a pre-designated area such as a safe room, basement, storm cellar, or the lowest building level. If there is no basement, go to the center of a small interior room on the lowest level (closet, interior hallway) away from corners, windows, doors, and outside walls. Put as many walls as possible between you and the outside. Get under a sturdy table and use your arms to protect your head and neck.
• In a high-rise building, go to a small interior room or hallway on the lowest floor possible.
• Put on sturdy shoes.
• Do not open windows.

A manufactured home or office

• Get out immediately and go to a pre-identified location such as the lowest floor of a sturdy, nearby building or a storm shelter. Mobile homes, even if tied down, offer little protection from tornadoes.

The outside with no shelter
If you are not in a sturdy building, there is no single research-based recommendation for what last-resort action to take because many factors can affect your decision. Possible actions include:

• Immediately get into a vehicle, buckle your seat belt and try to drive to the closest sturdy shelter. If your vehicle is hit by flying debris while you are driving, pull over and park.
• Take cover in a stationary vehicle. Put the seat belt on and cover your head with your arms and a blanket, coat or other cushion if possible.
• Lie in an area noticeably lower than the level of the roadway and cover your head with your arms and a blanket, coat or other cushion if possible.

In all situations:

• Do not get under an overpass or bridge. You are safer in a low, flat location.
• Never try to outrun a tornado in urban or congested areas in a car or truck. Instead, leave the vehicle immediately for safe shelter.
• Watch out for flying debris. Flying debris from tornadoes causes most fatalities and injuries.

Feel free to check out this website for more information about severe weather:  https://www.ready.gov/tornadoes

As a parent who has watched our daughter's self-esteem, confidence, joy and happiness soar with the critical SCL (Supported Community Living) services she receives,  my husband and I have been feeling increasingly  frightened as huge cuts to the Medicaid budget are being considered.  So, when her case manager and agency staff invited us to advocate for her in specific ways, we signed on to do whatever we could.  We made calls to federal and state senators and representatives, and had surprisingly  positive experiences telling a bit of our story to staffers, who were kind and responsive.

The bigger leap for me, was deciding to participate in the IDaction Day at the Capitol, Advocating for Change in the Iowa General Assembly, on April 5th.  I do not enjoy public speaking, and have no experience with meeting lawmakers, so went off to the Capitol feeling a swarm of butterflies and teary energy stirring around in my gut.  Now, a couple of days later, I am SO glad I moved past my fears to hear my voice introducing our beautiful daughter to legislators who are in the midst of deliberations that will effect her quality of life.

The IDaction training session before seeking out legislators was very helpful and went a long way in helping to calm my fears about how to be part of the process.  Getting to the Capitol and seeing Amy and Jodi was enormously encouraging as I decided to try to speak with legislators in our daughter's county, who may support big budget cuts. Beginning with gratitude for the Medicaid funding that makes SCL services possible and connecting the gratitude to specific successes like no hospitalizations, or group home, or sheltered workshop, but because of the funding, a first independent apartment with just a few SCL hours a week,  competitive employment at her local HyVee with SE (Supported Employment) support only as needed,  and our daughter's new mantra, "I'm happy mom, and I feel like a real adult,"  was the story that tumbled out, and was received by each legislator with kindness and compassion.  

I have no illusions about the funding challenges ahead, and what that will mean to our families.  I do have great hopefulness in the power of stories over time, to change hearts and make a difference for good in the world.  I will choose this challenge again, and stand ready to pay forward the gift of mentoring to any who would like to join me. 

Larry and Linda Christensen have graciously given us permission to share this sincere and genuine letter to Legislators which eloquently conveys the importance of supports for individuals with diagnosis of mental health or intellectual disabilities.  Many thanks to Larry and Linda for advocating for your daughter, and all who would be affected by funding cuts. 

I am writing with regard to proposed changes and cuts in Medicaid. My wife and I know that changes are necessary to preserve this valuable program. We are supportive of eliminating waste and duplication in every part of government and its programs. We also have fears and concerns. We are old enough to remember when facilities for the mentally ill were closed – for good reasons – before there was an adequate system in place to receive those patients displaced.

We are parents of an adult daughter who is both developmentally delayed and afflicted with complicated mental illness issues. Her teen years through her late twenties were a nightmare as she engaged in dangerous and self-destructive behaviors.

The last decade has seen a remarkable turnaround due to the help and support she receives from workers and agencies that receive most of their funding from Medicaid. Our daughter has moved beyond group homes and 24 hour Waiver Homes to living in her first apartment where she receives help with medication management, cooking, cleaning, meal preparation, exercise, and other living skills through Supported Community Living staff (SCL) who visit her a few hours a week, in her community of Atlantic, Iowa.

In earlier years our daughter could not hold a job and lost confidence that she would ever be employable. In the past few years she has moved from a sheltered workshop to part time, competitive, community employment at her local HyVee with Supported Employment coaching and monitoring.

After years of hospitalizations and repeated failures our daughter is happy, feels proud of herself, and is a contributing and valued member of her community. Even we as her parents could not have done for our daughter what a community of informed, dedicated, trained, and organized professionals who know her well and are able to help her accomplish her goals. We have seen and know well, how each of the pieces that support our daughter is a building block that makes successful independent living possible for her.

We fear for our daughter’s future if changes and cuts are made in the wrong way, or if an impersonal, distant process is substituted for trusted relationships.
​
We ask that you keep the people of Iowa who depend on Medicaid in your mind and heart as you vote on our daughter’s future. 

​Early in March, HOPE Agency put on a conference for all employees to attend free of charge.   Asking employees to give up a Friday night and Saturday morning seemed payment enough!  In preparation, we look at feedback given throughout the year as to what topics and areas of focus our employees would like additional training and support. Then the search for outside speakers and experts to come and share on the various topics begins.  A few of the topics covered this year were oral health care, taking care of oneself, the changing tide in supported employment and a personality assessment.  The event was attended by over 70% of all employees and the energy generated at the event was and is contagious.  And, the ripple effects are still being felt.  Here is yet another example of the dedication of HOPE employees.  A HUGE thanks to all that helped make the event a success as well as to all those who attended!  

Every year ID Action sponsors Advocating Change Day at the Capitol. This year’s date is Wednesday, April 5. The following link gives a bit more information about this day, and how to register.
 
http://www.cvent.com/d/2vqbvs?lang=en&sms=7&cn=0Gcx3oBu5UKv_k2nc_EQOw
 
Given the current climate of change, this would be a great opportunity to share your voice and stories.  If you are working with a participant during this time, I strongly encourage to attend the event together.  The best facilitators of change are stories directly from those that receive services.  

We are so excited to be adding another member to our team! Molly will be starting with HOPE Agency February 27 and will be filling the role of Opportunities Coordinator.  In addition to her years of experience in the field of human services (specifically disability services), Molly also has familiarity in human resources, specifically in recruitment and retention.  When you see and meet Molly, please give her a friendly welcome!  We are thrilled to have her be a part of HOPE, and sharing HOPE with others.

​
“Hello all! I am Molly Camp. I grew up and still live in a small town in Iowa. My husband, 2 teenage daughters, and our animals keep us busy. I have worked in this field for about 7 years and love to see the growth of it all. I am excited to join the Hope team and help continue this great service!”