Friendship Initiative​

​A high quality of life usually involves friendship as an important piece of the puzzle and now Cardinal Innovations has a new initiative aimed at helping members find opportunities to develop friendships.

The effort began in 2013 when Cardinal Innovations started reviewing personal outcomes for individuals served to determine which efforts worked and where there may be room for improvement. Cardinal Innovations partnered with The Council on Quality and Leadership, CQL, to use its Personal Outcome Measures® (POM) assessment to identify areas of strengths and weaknesses for the individuals with intellectual and developmental disabilities that receive managed care services through the NC Innovations Waiver.

A representative sample of adults 18 and older was selected in all counties served. The sample was reflective of the percentage of individuals in each area of the same race, sex, and services received (i.e. Day Supports, Community Networking, Community Guide, and Residential Supports). Of the 300 identified individuals, 250 were assessed using the POM and 50 were not assessed due to natural attrition.

​"We know that without friends, all people, regardless of whether or not one has a disability, are at risk for isolation, loneliness and vulnerability."

-Dr. Barbara Agnello

Cardinal Innovations Clinical Director​
The Personal Outcome Measures® assessment identifies 21 outcome areas proven to be the most significant factors in the quality of life for individuals with intellectual and developmental disabilities. The assessment not only looks at the 21 outcomes, but also whether or not the supports are in place to achieve those outcomes, as defined by the individual. Once all assessments were completed, the results were analyzed and coded for similarity of responses for qualitative and quantitative themes.

One area of concern based on the data was the lack of friendships for those assessed. Because of the importance to quality of life that friendship plays, Cardinal Innovations is now working to identify ways to build and increase friendships for those supported on the NC Innovations Waiver. To reach Cardinal Innovations’ vision of a community in which each person is welcomed, respected and valued, they must engage one of the core values: partnership.

“The concept of community integration has been considered a best practice for decades in the field of intellectual and developmental disabilities. The importance of community integration includes the development of friendships, interests, and support,” said Cardinal Innovations Clinical Director Dr. Barbara Agnello. “We know that without friends, all people, regardless of whether or not one has a disability, are at risk for isolation, loneliness, and vulnerability. While family often plays an important support role for many individuals, friends also play a very important support role that is different from the role of family. For example, individuals may feel more comfortable talking about certain topics with a friend than rather than talking about the topic with their mother or their father.”

Members of Cardinal Innovations’ Community Programs management team recognize that they cannot increase opportunities for individuals to build friendships through outreach to frontline staff, individuals/families​ served, and waiver services alone. The outreach also must reach providers, as well as to the community, to accomplish this task. Cardinal Innovations will partner with all available resources (Care Coordinators, Providers, Communications staff, Community Partners staff, Schools, Churches, local organizations, and local businesses) to make a difference.

To increase friendships and opportunities for friendships for those on the NC Innovations Waiver, Cardinal Innovations will assess all individuals on the waiver to determine how an impact can be made. A friendship questionnaire was given to all by the end of April. Those results are being analyzed. During this time, the Community Programs management team will begin working with the Community Partners team to address this need and identify places in all of the local communities served where opportunities for educational sessions could be held, reaching groups that would be eager to partner in this initiative.

In the coming months, the Community Programs management team also will discuss this importance with internal staff. The discussion can be facilitated by Care Coordinators with the families served to encourage opportunities to build friendships, while discussing the importance of having friends in regards to having a better quality of life.

Once the results of the initial friendship questionnaire are analyzed, they will be used to develop strategic talking points for the Care Coordinators, providers, stakeholders, communications team and Community Partners team to educate the community. After a year of strategic intervention, an additional friendship questionnaire will be completed with all individuals receiving waiver services to determine if the outcome of having friends, and the supports involved to achieve that outcome have improved over time.​​​