Clinical Operations

The Clinical Operations Department includes the following services:

• Medical
• Nursing
• Psychology
• Social Work Counseling
• Speech and Language
• Nutrition
• Occupational Therapy
• Therapeutic Recreation

Once the service has been identified as a need through the Person-Centered Planning process, a clinical assessment is completed. If treatment is deemed medically necessary, the plan is developed. Family/caregiver training and monitoring of progress is provided. Clinical treatment plans are developed based on the following principles and goals:

• The individual needs to feel safe, loved, loving, and engaged.
• The establishment of meaningful personal relationships.
• The ability to make meaningful choices based on life experiences.
• The opportunity to acquire and practice new skills.

Medical:
The role of the Medical Director is to provide direction and to serve as a resource to the individuals served by MORC, as well as the MORC clinical, administrative, and contractual staff.

Psychiatric evaluation and medication monitoring for individuals with severe, persistent, or complicated symptoms of mental illness combined with a development disability are provided by MORC. The psychiatrists provide the services at either their office or one of MORC’s office locations.

Nursing:
The role of the Nursing staff is to augment the health care services individuals receive from other community resources. The MORC nurse assists in the coordination of care, health promotion and preventative services, hospitalization aftercare, and education.

Conditions that would warrant nursing intervention may include the following:

• Diabetes management.
• Wound care.
• Feeding tubes.
• Polyphamarcy.
• Multiple/competing health issues.

Psychology:
The role of the Psychology staff is to provide cognitive/adaptive/emotional assessment; positive behavioral support; family/caregiver training; coordination with psychiatry and other disciplines; and individual, group, and family therapy.

Conditions that would warrant psychological intervention may include the following:

• Guardianship testing.
• Eligibility determination.
• Co-occurring mental illness (e.g., symptoms of an adjustment disorder, anxiety disorder, hallucinations and/or delusions; depression; eating disorder; impulse control disorder; mood disorder; obsessive compulsive disorder; psychosis; substance abuse; sleeping disorder).
• Behavioral challenges that result in the potential for injury to self or others or significant property destruction.
• Sudden deteriorating change in behavior/skills.

Social Work Counseling:
The role of the Social Work Counselor is to provide therapy to individuals, groups, and families. The Social Work Counselors will sometimes work together with the Psychologists to provide therapeutic intervention.

Conditions that would warrant counseling intervention may include the following:

• Grief and loss.
• Dysfunctional relationships.
• Sexuality issues.
• Trauma of sexual, physical, or emotional abuse.

Speech and Language:
The role of the Speech and Language Therapist is to assess and provide treatment to individuals with speech, language, audiological, and/or swallowing disorders.

Conditions that would warrant speech and language intervention may include the following:

• Problems with articulation, resonance, or prosody (the person is unintelligible – speaks too loud, too soft, too fast to be understood and/or has problems with fluency).
• The need for alternative or Augmentative Alternative Communication (ACC) devices due to individuals being nonverbal or having other neurological pathologies, such as cerebral palsy.
• Apraxia (usually severe articulation problems with mostly unintelligible speech productions).
• Closed head injuries, aphasia (traumatic brain injury), or any of the dementias.
• Swallowing disorders.

Nutrition:
The role of the Registered Dietitian is to assess and treat complex nutritional needs of individuals. Dietitians assist in coordination of care, health promotion, preventative services, hospitalization aftercare, and education. The MORC dietitians coordinate the Eli Lilly Solutions for Wellness educational program that focuses on nutrition, exercise, stress management and sleep improvement, and support for improving overall wellness.

Conditions that would warrant dietary intervention may include the following:

• Obesity.
• Malnutrition.
• Diabetes or renal disease.
• Swallowing disorders.
• Tube feeding.
• Cardiac issues (i.e., congestive heart failure, hypertension, hyperlipidemia).
• GI tract disorders (i.e., gastroesophageal reflux disease, bowel obstruction, severe chronic diarrhea, irritable bowel syndrome, ulcerative colitis).
• Pressure ulcers.

Occupational Therapy:
The role of the Occupational Therapist is to assist individuals in establishing, restoring, or maintaining as much independence as possible. Occupational Therapists evaluate the ability to perform daily living skills and the presence of environmental barriers.

Conditions that would warrant occupational therapy intervention may include the following:

• Physical disabilities.
• Swallowing disorders.
• Change in health status as the result of a stroke, injury, disease such as Parkinson’s or osteoporosis, or an amputation where the individual’s fine and/or gross motor skills are affected.
• Behavioral challenges that result in the potential for injury to self or others or significant property destruction where the behavioral support plan is not effective.

Therapeutic Recreation:
The role of the Therapeutic Recreation Specialist is to provide therapeutic relaxation treatment, education, and opportunities for participation. They offer classes that accomplish these goals, in addition to coordinating services through community resources. The MORC Therapeutic Recreation Department offers individuals the opportunity to participate in the Recreational Empowerment Committee, which is a consumer-driven group whose purpose is to connect with community agencies to advocate for additional recreational opportunities for persons with disabilities.

Conditions that would warrant therapeutic recreation intervention may include the following:

• Individuals needing assistance in developing or managing leisure time.
• The need for education about quality leisure functioning.
• Individuals needing improved social skills training and participation in physical activities.

For more information about MORC Clinical Operations, please call (586) 263-8919.