Anderson Center for Autism - New York Nonprofit Press

12 New York Nonprofit Press www.nynp.biz September 2012
agency of the Month
Anderson Center for Autism
A Focus on LifeLong Learning
by Fred Scaglione
In 2001, Anderson Center for Autism in
Staatsburg effectively began the new millennium
with a new name, a new Executive Director
and a new focus on providing specialized services
for a targeted group of consumers. Initially
founded in 1924 by Dr. Victor Anderson, Anderson
School, as it was known, had shared many
of the challenges facing numerous other large
campus-based programs – declining utilization,
anemic reimbursement, high staff turnover, and a
seriously aging physical plant. In response, the
board chose to move Anderson’s concentration
away from its traditionally broad base of individuals
with an array of developmental disabilities
and begin admitting only young people who
were diagnosed on the autism spectrum. Over
the next decade, Executive Director Neil Pollack
and his management team undertook an aggressive
program to completely remake Anderson
Center, both programmatically and physically.
As a result, Anderson Center for Autism is today
exactly what its name implies – a high quality
provider of autism-related services, not only to
those young people and adults in its school and
residential programs, but for the community as
a whole.
Pollack sees Anderson Center’s transformation
as a three-pronged effort to develop 1) a new
agency approach to serving people with autism,
2) a new management and governance structure,
and 3) a comprehensive site plan for reconstructing
the agency’s physical campus.
A Center for Autism
“The first thing we needed was a 21st century
program,” he explains. “We received a grant
from the State Education Department to begin
working with the University of Rochester for the
implementation of Applied Behavior Analysis
(ABA).”
ABA is an evidence-based approach which
has proven particularly effective in working
with individuals on the autism spectrum. ABA
involves teaching individuals to change socially
unacceptable and/or potentially dangerous behaviors
by reinforcing alternative behaviors that
are positive and appropriate through a variety of
rewards. “We try to look at why a person is doing
what they are doing,” says Eliza V. Bozenski,
Director of Agency Affairs who had served
as Clinical Director during implementation of
ABA and still oversees that department. “They
are communicating with us. We try to give them
an alternative, so they can replace a challenging
behavior with something that reaches the same
goal but in way that is more appropriate.”
Picture Exchange Communication Systems
(PECS), for example, provides nonverbal individuals
with autism an alternative way to communicate
with staff, family and friends. “Many
individuals with autism are visual learners,” says
Bozenski. “PECS strips are a way that they can
tell us what they want by putting together a series
of pictures or images into a whole sentence, for
example, ‘I want a hamburger.’ As we implemented
PECS we saw a huge reduction in challenging
behaviors.”
Bozenski points to the history of Jon, a student
whose extraordinarily challenging behaviors
had sent several staff members to the hospital,
as an example of how ABA can improve life
for individuals with autism… and those who care
for them. “By tracking his behaviors, our Multi-
Disciplinary Team noted that whenever Jon was
on the swing in the Physical Therapy (PT) room,
he would be calm,” she explains. The Team
began bringing the young man to the PT room
whenever a challenging behavior seemed imminent.
Then, they taught him to show a “break
card” to his teachers whenever he felt a challenging
behavior coming on. “Everyone would clear
the hall and Jon would head for the PT room,”
says Bozenski. “He learned that this was an alternative
he could use. No one went to the hospital
again.”
The staff at Anderson Center work hard to
help students learn the best way to meet their
needs while managing behaviors. It is not uncommon
to see students wearing yellow noisecancelling
headsets. “Many of our students are
noise sensitive,” says Bozenski. “Going through
the hallways and particularly into a crowded cafeteria
during lunch can be too much for them.
Teachers will suggest that they wear headsets to
reduce the extra stimulation. Gradually, they will
learn to take a headset themselves when they are
going to lunch.”
The program utilizes a variety of other techniques
that have been proven to work well with
individuals on the autism spectrum. The staff
teaches students the concept of “First/Then,”
e.g. “First we will clean up; then we will have
ice cream” – often using PECS picture exchange
strips to convey and reinforce the ideas. A Personal
Boundaries curriculum, featuring color
coded images depicting family, friends, staff,
strangers, etc., helps students understand “Who
do I Hug?”, “Who do I shake hands with?”,
“Who do I wave to?” – a particularly challenging
series of personal issues for individuals with
autism.
Anderson Center began by applying ABA in
its school program. “We changed our curriculum
and trained all our teachers,” says Pollack.
However, the agency wanted to go further. “We
wanted a program that was going to have an impact
and could be utilized in all of our settings, a
single program that we could apply around
the clock, 24/7, 365 days a year,” says Pollack.
“We started in the classrooms, but then
rolled it out into our residential program. After
that, we moved into our adult residences
and our LifeLong Learning Centers.”
There is close coordination between the
school and residential program staff. “If a
student has an issue or a behavior in school,
the staff in the homes will know about it
right away and vice versa,” says Bozenski.
The program works, says Pollack. “Parents
see their child learn toilet training, symbol recognition
and speech. They become calmer and
are able to interact with others and begin doing
things with their families. It’s amazing for parents
who never thought this type of progress was
possible.”
And, the agency helps students learn skills
necessary for basic activities in the community.
“Parents want to be able to take their child to a
movie,” says Pollack as one example. “We have
an auditorium here on campus where we hold
movie nights and students get a chance to learn
and practice. What is it like sitting in this type of
seating? What do I do if I need to go to the bathroom?
How do I talk to staff and parents without
disturbing everyone else? Then, they can transfer
these skills into the community.”
Putting the Anderson Center for Autism program
into practice required additional resources,
however. The agency now receives State Education
Department (SED) funding that supports
an enhanced staffing ratio in all 23 classrooms.
Pollack also sought and won a “hard-to-place”
residential program model featuring a higher
reimbursement rate from the Office of Children
and Family Services (OCFS).
Rebuilding the Campus
Anderson Center accepts students ages 5
to 21 into its residential school program. A total
of 124 students live on campus. “We accept
some of the most challenging students in New
York State,” says Pollack. Despite the narrow-
Neil Pollack
er programmatic focus, Anderson Center’s utilization
is up substantially. “When I got here,
we had an average vacancy rate of 25%,” says
Pollack. “Now we are almost always full.”
In order to accommodate these residential
students, however, Anderson Center has had to
effectively rebuild its entire campus. Most of
the original brick and stone “cottages” had to
be been torn down and replaced by brand new
state-of-the-art homes, specifically designed to
serve the agency’s population. “The students
live in 15 houses,” says Pollack.
Each home is divided into two mirror-image
sides with four “permanent” beds and one
“swing” bed – accommodating 8-10 students
in total. The structures are clean, modern,
Spreading the Word about Mandated Autism Insurance Coverage
Anderson Center for Autism prides itself on being a resource and service provider to families and
individuals in the broader community.
No recent news has been more important to the
community at large than the passage of a New York State
law which now mandates insurance coverage for autism
services, says Chief Operating Officer Patrick D. Paul.
“The new autism legislation in New York State is
very good news for individuals with Autism Spectrum
Disorders (ASD) and their families,” says Paul. “It provides
for increased access to treatments that offer the greatest
opportunity for positive life outcomes: Applied Behavioral
Analysis (ABA) and other evidence-based therapies.”
The law, which was signed by Governor Andrew Cuomo
last year goes into effect on November 1st. Nationally,
31 other states have passed similar legislation. The law
requires that NYS regulated health insurance plans cover
“medically necessary” services for the diagnosis and treatment
of Autism Spectrum Disorders (ASD) as defined by
Patrick D. Paul
the Diagnostic and Statistical Manual of Mental Disorders (DSM IV-TR). Children or adults of any age
are covered if they have been diagnosed with ASD -- including Asperger’s Disorder, Rett Syndrome,
Childhood Dis-integrative Disorder and Pervasive Developmental Disorders Not Otherwise Specified
(PPD-NOS) – and have a medical need for services.
There are a couple of caveats, however, explains Paul. “The law only applies to State-regulated
insurance companies,” he says. “If your employer is self-insured, then the law doesn’t apply. Many
large corporations in New York are self-insured.” Families should check with their insurer to find out if
they are covered.
And, while the law goes into effect on November 1st, individual policies will be affected when they
are issued or renewed. Once again, employers or insurers have more information.
Finally, there are caps. The total amount of reimbursement for ABA services annually is $45,000.
Individuals with a diagnosis of an Autism Spectrum Disorder will require an assessment by an
appropriate professional who can then prescribe a treatment plan. Board Certified Applied Behavior
Analysts are among those professionals eligible to provide assessments and Anderson Center is
planning to make these services available to the community. Final state regulations outlining how the
process will work are still under development, however.
“A lot of people don’t know about this. We want to make sure we get the word out,” says Paul.

September 2012 New York Nonprofit Press www.nynp.biz 13
agency of the Month
bright and comfortable, while also offering a
range of technical and structural supports for
students and staff. Discrete alarms alert staff
whenever someone enters or leaves the building.
Exhaust fans turn on automatically when
students use the kitchen and bathrooms. “They
prevent our fire alarm system from generating
false alarms,” says Pollack, noting how these
can be a major source of friction between residential
campuses and the local community.
The reconstruction of Anderson Center’s
100-acre campus has been a major undertaking,
taking almost ten years and over $30 million
so far, with several projects still underway.
In addition to the 15 student houses, the
agency has constructed a lake-side recreation
facility with an outdoor pavilion and a Village
Center with outdoor pool, program and meeting
space, apartments where families can enjoy
private day visits with their children, and support
facilities including a supply storehouse.
Several original buildings have been retained
and are being incorporated into a new
administrative headquarters, program space
and housing for visiting student interns and
“fellows.”
“Unless you knew the old Anderson
School, it is hard to understand how different
the campus is now,” says Maria Espie, Director
of Business Affairs, who has managed logistical
issues involved with completely rebuilding
a 124-student residential school while still in
operation.
LifeLong Learning
While Anderson Center’s residential
school can serve young people up to the age
of 21, most students require intensive supports
as they enter adulthood. The agency currently
serves approximately 80 adults with autism
and other developmental disabilities who live
in16 homes licensed as Individual Residential
Alternatives (IRAs) by the NYS Office for
People with Developmental Disabilities (OP-
WDD). Many of these individuals lived at
Anderson School prior to its change of focus.
However, most still have a diagnosis of autism
in addition to other disabilities, says Mary
Doyle, Director of Adult Services.
When Doyle first took over Adult Services
in 2001, the agency had only six homes. Most
of the subsequent growth came in response to
demand for places in Anderson Center’s programs.
“Parents want their children to stay
with Anderson Center after they graduate,”
says Pollack. “They recognize that we have a
good system.”
Anderson Center has extended its use of
ABA to Adult Services and has adopted “Life-
Long Learning” as the guiding principle of
its programming in this area. “We don’t stop
learning when we leave school,” says Pollack.
“The same should be true for our students.”
To this end, Anderson Center has designated
its three day programs in Poughkeepsie,
Pleasant Valley and Saugerties as LifeLong
Learning Centers. The 25-30
participants in each program
work on developing new life
and vocational skills, while
also having opportunities for
recreation and socialization.
Anderson Center has
created many opportunities
for both students and adults to
find fulfillment through work
in the community. It begins
by preparing students with
the kinds of vocational skills
needed for many volunteer
jobs or competitive employment.
The school features a
“Vocational Training Room”
where students practice a
range of skills, including sorting items by size
and color; folding and stacking clothing; picking,
packing and delivering supplies, etc.
“We have partnered with a large number
of great companies and organizations in the
community around opportunities for volunteer
and paid employment,” says Pollack. “One of
our individuals won Employee of the Month
at Best Buy. We have a group of students
who work in the ‘dish room’ at the Culinary
Institute of America. That’s a pretty busy and
important part of their operation. We have another
group that goes to the Baptist Home to do
cleaning, although they tell us that their most
important role is engaging with the senior resi-
Over the past decade, Anderson Center has rebuilt virtually
its entire campus.
dents there.” In all, Anderson Center’s adults
engage in volunteer work at approximately 20
community organizations.
The agency also creates alternative employment
opportunities for those who are still not
ready to go out into the community. “We’ve developed
a ‘cross cleaning’ program where individuals
from one LifeLong Learning Center will
go to one of the other centers and do the cleaning
there,” says Doyle. “It’s a satisfying work experience
for them. They travel to a different location
and perform the tasks that they’ve learned.”
Anderson Center recently rolled out a new
initiative titled “What’s the Next Step?” which is
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14 New York Nonprofit Press www.nynp.biz September 2012
agency of the month
Anderson continued from page 13
designed to encourage residents and staff to identify
another important goal that would give them
added fulfillment and satisfaction. “We want to
make sure that our staff never think about individuals
as if they can only go so far,” says Pollack.
“There is always something more.”
Over the next several years, Anderson
Center is planning to offer residential opportunities
for an increasing number of individuals
with disabilities. The agency has opened
one new IRA and plans to open three more this
year and has a goal of opening two more each
year going forward.
A Community Resource
In recent years, Anderson Center has
extended its scope of autism-related services
beyond the campus and its Adult Services division
and into the community as a whole.
While Anderson Center offers only a
limited number of slots for day-students in
the campus school, it provides autism-related
technical assistance and consulting services to
ten local school districts. “They pay us to provide
supports that are helpful in keeping their
students in school and living at home,” says
Pollack. “We began this when we realized that
we were receiving referrals from children who
didn’t really need our level of services. We
want local schools to be successful in serving
children wherever appropriate.”
Anderson Center also offers educational
sessions on autism for first responders and
others. “We recently did one for a local Sheriff’s
department to help them better understand
what autism is and how to deal with individuals
with autism and their families in the course
of their work,” says Pollack.
Another interesting initiative is a program
that trains – and certifies – local restaurants
and businesses to be “Autism Friendly.”
“Families want to know that they are going to
an establishment where they are welcome and
respected,” says Pollack. “And, businesses
want to be responsive to their customers.”
The program provides training in all aspects
of autism and ways to make their environment
as friendly and comfortable as possible. Coppola’s
Restaurant in Hyde Park, a long time
Anderson Center supporter, was the first business
to receive the new “Autism Friendly” certification
and window-logo.
Anderson Center has also taken on the
mission of ensuring that local community
members fully understand the importance and
value of a new law requiring New York Statelicensed
health insurers to provide coverage
for autism services. (See box on page 12.)
Management & Governance
Anderson Center’s programmatic and
physical transformation would not have been
possible without a new approach to management
and governance, says Pollack.
The original six-member Board of Directors
has been expanded to become two
Boards – a “Center” Board which oversees
the operation of Anderson Center for Autism,
and a separate “Foundation” Board which is
largely responsible for raising funds which
will support the Center – with 15 members
each. “While these are separate organizations,
the two boards meet together twice a
year for strategic planning so their efforts
are always coordinated,” says Pollack. Individual
executive team members also play an
active role as liaison and support to various
board committees.
Anderson Center has implemented an
“Earn and Learn” program through which
staff members receive enhanced compensation
based on their completion of relevant
college credits. “We hire staff at a base salary
which is below many of our competitors
because we believe that if you are coming to
us with just a high school diploma, you are
really looking to find a career,” says Pollack.
“We provide tuition support and predetermined
raises as you go through school. By
the time you have 60 college credits, your
salary will be well above what you would be
making anywhere else.” As a result of this
policy, says Pollack, Anderson Center has
seen its turnover rate drop sharply, ending
2011 at 13.1%, and its average Direct Support
Professional (DSP) has 45 college credits.
“I believe U.S. employment policy
for direct care is wrong,” Pollack explains.
“Staff in agencies like ours should have bachelor’s
degrees and should be compensated as
such.” He points to European program models
in countries like Denmark as an example.
He also notes that Anderson Center’s J-1 visa
program regularly brings in Social Pedagogue
students and other professionals from these
countries as interns in a mutually-beneficial
exchange of experience.
Lastly, Anderson Center has taken a proactive
approach to succession planning. “I
believe that too many nonprofit boards put
themselves in the position of having to do
unnecessary national searches for new leadership,”
says Pollack. “The corporate model
of identifying an appropriate successor inhouse
and grooming that individual as your
next Executive Director works very well.”
Consequently, Anderson Center has designated
Chief Operating Officer Patrick Paul to
succeed Pollack as Executive Director at the
appropriate point in time.
Looking ahead, given the extraordinarily
high incidence of autism spectrum disorders
among young people, it is clear that Anderson
Center will have an increasingly important
role to play in the Hudson Valley through
its residential school, adult services and expanding
community involvement in the years
ahead.