Cedar Paulson Mueller was married last October. She met her future husband when she was in high school and working part-time at Fleet Farm. “I don’t know how he fell for me when I was wearing that orange shirt!” Cedar jokes.

Originally from Cochrane, Wisconsin, Cedar grew up attending Cochrane-Fountain City Schools but graduated from Winona Senior High School. She later went on to attend Winona State University and majored in Social Work.

Her introduction to Home and Community Options came while she was taking a service learning class in high school. Her teacher suggested choosing a field that would be challenging and out of her area of experience, so Cedar chose the Developmental Achievement Center (DAC). The DAC provides coaching and job support to people with disabilities, and while there, Cedar heard a lot about HCO from the people there. Cedar thought, “Gee, how fun would it be to work with people all day long instead of just while they are at work!” so she applied to HCO in 2014 and has been here ever since.

When she began working for HCO, she provided support to four gentlemen. “It was super fun,” she shared. In her years with the agency, she has supported people living in their own homes/apartments or with family and has also worked with young children. Cedar thinks that Winona seems to be unique in the fact that there are so many agencies that serve individuals with special needs. She says she talks to people from other towns and they are amazed, because they don’t have such resources. One of her favorite parts of the job is getting to know the individuals and their loved ones. “What you can learn from them is so important,” she says.

Cedar is currently the Primary Counselor at a program supporting a group of women with ages ranging from 23 to 91. Cedar emphasizes that the job is primarily a teaching job. Early on in her career with HCO, a coworker told Cedar, “Work yourself out of a job. Teach them so well that they don’t need you anymore.” Cedar teaches not only the individuals she supports, but also the new staff who come in to help. And, she says, she teaches staff how to teach, too.

When Cedar is training new staff, she always tells them to treat the individuals the way staff would like to be treated, or how they would want a family member to be treated and cared for. “Clean as if you were cleaning for your family,” she tells them. If a new staff member makes a mistake, it is often because they have no experience in keeping someone else safe. It’s not always super tough, she tells new staff. “It’s usually smooth sailing, but there are hiccups sometimes!” Cedar says it’s all about teaching, and she encourages staff to “use your resources.”

Cedar feels that having empathy is an extremely important part of the job. “If you don’t have empathy to start, you’ll definitely gain it after working at HCO!” It’s also important as a staff to find a balance between doing things for someone when they need it and encouraging them to do what they are capable of doing. “They should be allowed to do everything they can for themselves – even the kids. When you let go of control, you allow someone else to be your teacher.”

Patience is helpful too – both with the people you support but also with yourself. There are times when Cedar remembers coming home frustrated. “It is something you constantly work on,” Cedar says. Some days are a struggle. “Other days, I come home from work and say, ‘I did really well today!’”

COVID has made life for those she supports very different. Since they have a few people at a higher risk if they were to contract COVID-19, it is essential to be cautious and take extensive measures to ensure their safety. The staff understand that the ladies’ safety is important and are doing as much as they can to reduce the risk. They eat meals at different times, sanitize high touch surfaces often, frequently wash their hands, and they all wear masks – even the ladies. “It has been a challenge at times.”

Everyone is currently home and trying to stay busy. The women Cedar supports are not currently working, so they do a lot of crafts in their spare time. Some ladies enjoy their alone time watching TV, playing games, or being on their computers. They talk to friends on the phone and participate in zoom activities. Like everyone, the ladies are sometimes bummed that so many events and activities are cancelled. While they aren’t going out and doing as many things like they used to, they understand the importance of being safe and healthy.

Cedar emphasizes that they are all part of a team and that part of the job is making sure everyone is safe – both individuals and coworkers. Cedar has been exposed to coworkers that have tested positive twice. “Both times I freaked out a bit,” she says. “I am pregnant, so I am considered high risk because they are not sure how the virus can (or if it does) affect the baby. The first time I was exposed, I was only about 10 weeks. More recently, I have been 30+ weeks, so the stress for me hasn’t gotten any better,” she shared. “Overall, HCO has handled the positive cases well. Each time, I received a phone call from our Executive Director explaining the situation and assessing my exposure level.” Data surrounding COVID-19 is constantly changing as more information is being learned about the virus, so HCO works closely with the Minnesota Department of Health to interview and assess exposures of staff and the individuals HCO supports. This enables HCO to continually assess the infection control practices at their residential sites, develop improved protocols, and provide additional staff training if needed.

Adequate staffing was an ongoing challenge for HCO before the pandemic, and the struggle has only been exacerbated by COVID-19. When someone is being tested and they have symptoms, they are not able to work until their test results come back. The care needs of those HCO serves haven’t lessened and it can be a struggle for many HCO programs to find alternative support when a scheduled staff cannot come in to work due to illness or a potential exposure. Luckily, current employees have been very understanding, flexible, and willing to pick up additional shifts to help – often at the last minute. “Our house has done well and staff have been more than willing to pick up their co-workers’ hours, Cedar shares. “We are so grateful for our fantastic bunch of staff we have.”

For staff, getting to know the people you support is the key to providing high quality care. Knowing people’s interests is important to helping them enjoy life, but knowing what they struggle with or dislike can be just as important. “Sometimes jokes and a good laugh will improve everyone’s mood, but other times, it might take having some one-on-one time with an individual who is struggling.” Cedar will often spend time with an individual one-on-one to chat and provide encouragement, or offer a bubble bath. The house has a big walk-in tub, and all the women love a bubble bath. “We all have cranky days,” Cedar says. “Usually everything can be fixed or talked out. Everyone is different.”

Despite all the changes because of COVID-19, Cedar shares that the best part of the job is working with the individuals day-to-day and seeing what brings them joy or makes them laugh. “I wish more people knew about HCO,” she says. “We do a lot of amazing things. The world would look very different if more people understood just how much we are all capable of.”

 

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HCO warmly congratulates Cedar and her husband, Dylan, on the recent birth of their baby girl, Birdie!

Crystal Pagel joined Home and Community Options as a part-time employee about six years ago.

Crystal came to HCO from the Developmental Achievement Center (DAC). Crystal had previously worked in various manufacturing jobs and was looking for something more engaging. In her four years at DAC, she had become familiar with HCO and thought it sounded like a job she would enjoy. Now she can’t imagine working anywhere else. Finding DAC and HCO helped her discover her own talents and enabled her to help others hone theirs. When the pandemic hit, she was working at DAC between her HCO shifts, and also worked for Global Home Health. Now, she continues at Global and is also working at Cardinal of Minnesota in addition to her work with HCO.

Crystal grew up in Winona and has a lot of extended family living here. She has two children, a son, 17, and a daughter, 22. Her daughter lives on her own in Winona and her son goes to Winona Senior High. When schools closed due to the pandemic, he began studying online from home and did quite well. At home, Crystal and her family care for a menagerie of exotic pets: a rabbit, a leopard gecko, frog, parakeet, and two aquariums: one 70 gallons, and the other 20 gallons. Luckily, she has been able to pursue her outdoor interests during the pandemic. In her spare time Crystal likes to kayak, bike, take the boat out, go tubing, camping, fishing, hiking, walking, and running.

When she first started at HCO, Crystal was also on call at HCO’s first remote-monitoring home, so when the position of Program Coordinator at the remote-monitoring program opened up, Crystal moved there. Conversations about creating a remote monitoring program began in 2008 or 2009. While not perhaps prepared to live entirely independently, HCO believed that there were individuals at a few of the homes who had built strong skills and may no longer need support 24 hours a day. They would be able to spend the night at home without constant staff on-site, and HCO wanted to find a system that would support these individuals from afar to enable them to be more independent. As one individual living in the home said at the time, “I don’t need to be babysat!”

When searching for the right system, HCO discovered that one did not exist with the features that they needed, so they decided to develop it themselves. If a person living at one site calls for help over the system, help is provided by staff at another site. All of the individuals living in the home, as well as their guardians, must agree to using the system. They are required to learn how the system works, when to use it, and when not to.

Remote monitoring technology is now being used in three HCO homes. The system is specific to the needs of the individuals in the home and is implemented in locations where HCO finds the additional technology to be safe and beneficial to those living there. It is rare for anyone to push the button to call for help, but Crystal says that the men she supports like the system. They feel that they are being trusted with extra responsibility and are proud that they have developed the skills that enable them to use it.

Staff used to come in early in the morning to get everyone ready for work, then come back mid-afternoon when the men arrived home to provide support into the evening hours. Due to the pandemic, the schedule has changed and the four men that Crystal supports have not been working during the day. The program supervisor is currently on-site full time (instead of also splitting time at another site), and additional staff have been added as well. With people home most of the day, Crystal has been helping the men in the house cook, clean, and create menus, as well as assisting them with many other aspects of their lives. Crystal’s job also includes training staff to complete required paperwork and data-tracking, helping the men with personal hygiene, household chores, budgeting, and planning activities. She enjoys watching them grow in their abilities, and she sees constant improvement as they build independence and create new relationships.

Before COVID-19, staff would take the men to events in the community like church on Sundays, COMPASS bowling, dances, and trips to the YMCA. Now, the men can still attend church on ZOOM, as well as ZOOM with friends and family, and take advantage of the virtual programs and activities offered by HCO, such as exercising and games.

All of the gentleman that Crystal supports are currently in the process of returning to work and are eager to get back to their former routine. “They would like to have more things to do in the community,” she shares, “but they realize that they are not alone in wishing that the pandemic would go away and businesses would open up again.” Until then, the men are keeping busy with crafts, sidewalk chalk art, rides in the house van, campfires at the house and at the HCO campsite at Prairie Island, or playing cards and games in their spare time. They also mow the lawn, go golfing, grill out, and are enjoying the warm summer days.

Crystal loves both the staff she works with and the individuals she supports. “HCO is a great place to work with caring, hardworking people who take their jobs seriously,” Crystal says, “and with individuals who can always make you smile – even when you’ve had a bad day.”

 

When an enormous portion of your job centers around coordinating large scale events and legislative advocacy groups, what do you do when a pandemic limits people’s ability to safely come together in groups? If you are Lynette Johnson, Events Coordinator for Home and Community Options, you create virtual events and leverage technology to involve all the individuals and staff throughout the agency in various interests from afar.

COVID-19 has had a substantial impact on people with disabilities. In the spring, many of the individuals HCO supports were suddenly unable to work. Staff were quickly rerouted from other worksites to provide more care and support for people who were now at home during the day and were looking for ways to stay active and engaged. Lynette loves to travel, so back in March, she began creating daily themed activities as learning opportunities. Want to go to France or Australia? You can, with Lynette’s travel packets sent to each house. They include something for everyone, including coloring pages, word finds, and interesting facts about these faraway places. Through June, there has been more than 100 straight days of different themed activities shared with HCO houses.

When HCO first procured iPads for the individuals in the organization to use to stay connected with friends and loved ones, there was some apprehension. However, it didn’t take long before everyone was merrily joining in during the daily and weekly virtual events. “Technology has enabled us all to still come together. During this time of uncertainty, I have heard a lot more laughing together than I imagined I would,” Lynette comments. “Now that everyone has gotten more comfortable with seeing their friends virtually, we can continue to help them build on those independent skills and find ways for them to take on more ownership and help more with planning, leading, and engaging with each other.”

One thing Lynette has always loved about her job is her work with the Grassroots Advocacy Task Force, which follows legislative issues impacting disability services. She enjoys supporting people as they build confidence and skills to advocate for things they are passionate about. During COVID-19, she has been able to help people continue to grow and take on leadership roles in other ways. Lynette has frequent calls with individuals to see how they are doing, brainstorm fun activities, or talk about ways that they would like to get involved. “I ask them what they’d like to do, and then I try to find a way to help them make it happen.” Individuals began sharing new talents, building different skills, and showing more independence. Several people have taken on planning specific activities, or assisting with leading parts of events like being a timekeeper, or hosting. “One individual I was talking with recently played the piano for me beautifully. I never knew they even played because they had never shared that before. Out of that, we came up with the idea to have a Talent Show for our individuals to showcase their many different skills to all of their friends.”

The variety of games and other remote activities has continued to expand. “We try to find popular activities or brainstorm new ideas of various things people would be able to do together normally. Then we try to find ways to adapt these ideas for a large virtual group or make them more interactive,” Lynette shares. One favorite is virtual birthday parties. They include crafting of birthday cards, singing, and seeing all your friends from other programs. Fitness activities like Chair Yoga, Adaptive Dance, and recreational competitions like toss tournaments help to get people up and moving while getting to compete with friends, cheer each other on, and provide a feeling of being right alongside one another. There have been scavenger hunts, Bingo games, crafts, contests, and trips around the world – all without leaving home. They’ve had virtual bake-offs, a virtual BBQ, and a cooking show.  “As time has gone on and the length of time people are staying at home grows, we are trying to provide even more activities to help people stay positive and to feel mentally and socially fulfilled.”

One of Lynette’s roles at HCO is to coordinate various internships and volunteers across the agency. This spring, fast moving COVID-19 restrictions had Lynette unexpectedly recreating new internships from scratch for prospective interns. For four Therapeutic Recreation Majors interning during their spring and summer semesters, technology is being used as a resource to communicate remotely with those HCO serves. Instead of providing musical support on stage, each of these interns have a caseload of calls to individuals to make and activities to lead. “It’s fun for the individuals to make new friends. They like spending time with each other,” Lynette says, “and it’s fun for the interns to stretch their creative and leadership abilities within the new Zoom format.” One of the interns found out an individual she calls likes to play Farkle, so now they have some pretty competitive contests together over the computer. The pandemic has pushed HCO to utilize volunteers in different ways too, like providing socializing video calls to residents or sewing face masks for HCO’s programs. “It is important for us to be able to follow through with our commitments to our interns and volunteers, and find new ways to still provide quality experiences for them and our programs.”

Any other year, the middle of June marks the culmination of at least a year’s worth of work when the HCO musical opens on stage at Saint Mary’s Page Theatre. Without the musical this year, Lynette’s first thought was how much she was going to miss seeing individuals every night during rehearsals, but she has been pleasantly surprised to find that she’s seeing more of them now than ever before. Time away from the production has provided Lynette with a unique opportunity to get creative and develop activities that provide new ways to interact and engage with those HCO supports. Some individuals who were uninterested or unable to attend events in the past are now becoming involved through the computer. Inclusion is a vital part of HCO’s work, and Lynette believes that a number of virtual events will continue beyond the effects of COVID-19 due to the opportunities it has provided to engage new participants.

Lynette says that she has learned a lot through this new way of doing things. “I have known some of the individuals HCO serves for years, but I have been able to really build a deeper relationship with them during COVID-19. I love that I’m still able to make an impact on their lives.  That’s why I have the job I have,” she says.

Everyone at HCO has experienced a huge change since the initial Stay-At-Home order in reaction to COVID-19. It has been Dan Milian’s job over the past few months to help HCO maximize the technology it has available to safely operate during the pandemic.

Dan acts as the IT Desk for the agency. His role used to have him in and out of HCO’s various houses numerous times on a weekly basis, fixing computers or rotating out equipment. While he continues to help out staff at the programs work on faxing or scanning important files and papers, visits to the houses in person are now only occurring in an emergency. These days he is office-bound, walking people through computer problems on the phone.

At the beginning of March, the agency was already talking through various phases of their pandemic plan, assessing critical agency functions and the roles of its main office employees. Who was cross-trained and would be able to step in should someone become ill? Who would be able to take on new roles? Who could provide additional support to program staff and their supervisors in the event of positive COVID cases?

At times, it feels like almost business as usual at the Central Office – with a few exceptions. Bottles of hand sanitizer and disinfectant cleaner are stationed throughout the building. Symptom and temperature screenings are completed by staff in masks when they arrive. The main office is used to seeing staff and individuals HCO supports stop by regularly to drop off paperwork or pick up supplies, head downstairs into the office kitchen to work on cooking skills, make art in the resource area, or just pop their head in for a quick hello to catch up. Now, doors to offices are closed up, and traffic throughout the building has been restricted. Central Office staff rarely have face-to-face interactions with each other, and in their place is an abundance of communication through phone and video.

About a week before the mid-March Stay-At-Home order, Dan already had a pretty good idea of how much things were likely to change. “I started thinking about what could be done to mitigate the problems a quarantine would present,” he shared. One of his first projects was to make sure that the needed technology and equipment was in place so HCO’s management personnel and office staff could function without coming into contact with each other. Would they need to quarantine? What would a worst-case scenario look like? After careful consideration, their team at the main office was able to make a number of adjustments to processes that put safety, social distancing, and infection control systems in place, which enabled minimal disruption to the building’s staff and duties.

A number of the adjustments HCO had to take were made easier by steps that were already being worked on since last year. In HCO’s homes, being able to stay connected through Zoom has been a life changer. Through it, multiple people can attend a virtual face-to-face meeting. HCO had already begun introducing Zoom for Healthcare last fall as a way to deal with reducing costs in areas that have consistently been a challenge for agencies like HCO: underfunded mileage expenses, additional staffing support needs at program sites, and the potential for growing training capacity utilizing the new technology. Implementation was scheduled to roll out slowly, with limited programs piloting the software for use before expanding to encompass the whole agency. When the pandemic hit, as Dan described it, “instead of tip-toeing down the hill, we got pushed over the cliff.” Everyone had to get up to speed on how to use video communication – very quickly.

In another stroke of luck, HCO was in the process of purchasing iPads for its residential programs when the first cases of COVID-19 began appearing throughout the country. While originally acquired for the purposes of supporting nursing, documentation, and training needs at HCO’s various sites, the iPads have found multiple other uses in the wake of the pandemic. They are providing a critical doorway for friends and family to stay connected with their loved ones in HCO’s care. It’s also been an engaging way for HCO’s individuals – many of whom lead very active and productive social lives before the pandemic – to participate in various types of events and activities. Classes in chair yoga and adaptive dance, bingo games, scavenger hunts, and craft projects like window and door decorating for Easter or Mother’s Day are providing fun throughout the day while HCO residents are at home and unable to work. The most fun of all are the birthday parties, where HCO individuals across all houses get together through Zoom to sing happy birthday to one another.

COVID-19 has been likened as people having to “fly the plane while its being built,” but the experience has provided a number of opportunities for innovation and creativity. Dan has been active in finding ways to help other departments leverage technology to implement new ideas. A recent project involved working with Amazon to get HCO registered as an essential business providing health care. The designation, an idea he credits to coworker Ashly Bissen, enabled HCO to get prioritized access to additional sources of PPE (personal protective equipment), such as gloves, masks, and hazardous waste bags.

It has been a struggle on and off for HCO to secure more than just PPE. Dan’s work to procure technology equipment to enable teams to do their jobs without risking their own health and safety was also a challenge early on. With the state’s move to distance learning for children in school, families and friends using video software to stay in touch with loved ones, and other businesses doing their best to continue working where they can, he had to get creative in finding sources for purchasing things like video cables, webcams and audio headsets. “Technology equipment was really hard to come by for a while,” Dan shared. “Third party sellers have been charging 3-4 times what they would have for a webcam 6 months ago. A lot of electronics stores have been sold out or have very limited quantities. We had some difficulty in the beginning finding what we needed, but it’s gotten better.”

Dan thinks that in the future we can expect to see a continuation of more virtual meetings and less in-person gathering. “We’re all here for the individuals,” he says, “so it’s been a struggle. People are really missing each other!” For that reason, he hopes that at some point HCO will be able to resume some level of in-person meetings and visits in the future.

For Ashly Bissen, the job of Communication Coordinator for Home and Community Options has undertaken a number of changes in the wake of COVID-19. What was once a role geared towards marketing, promotion, artistic design, and fundraising has shifted from a primarily external focus to an internal one.

Ashly is working closely with Executive Director, Suzanne Horstman, and HCO’s Management Team as they develop new plans and implement best practices based on directives from the CDC, Minnesota Department of Health, Department of Human Services, and local healthcare providers. As more information is learned about COVID-19, agency processes can change almost daily, and at times it can be a challenge to keep up. “One part of my job that I’ve always enjoyed has been taking complicated concepts and developing ways to share them with others in a simple, engaging, and understandable way.” How she does this now looks a little different, and with A LOT more people. “With COVID-19, I’ve had the opportunity to learn so many new things about the inner workings of our agency and the disability services industry as a whole. Being able to put that knowledge into context with the medical, economic, and social impacts we are seeing in our community has been eye-opening,” she shared. “While I’ve always known that HCO takes a proactive and innovative approach to providing services, it’s been fascinating to see that approach in action firsthand with something like this.”

Staff members, individuals, families, and case managers are turning to the communication office as an information hub, and Ashly has become a one-stop-shop for those seeking information about HCO’s services as it relates to the virus. While she’s still doing some of her typical work, much of what she now handles is managing and routing correspondence across various departments and helping to field questions. What is HCO is doing to protect my loved one? Is anyone ill? How can I communicate with my loved one safely? What does HCO need? What can I do to help?

As directives surrounding COVID-19 change, she is tasked with opening up a dialogue with all of HCO’s stakeholders to convey these changes and make sure everyone in the agency is on the same page. “There will always be nuances to each specific situation as we roll out something new, but it’s helped us provide a bit of consistency where we can in an increasingly inconsistent time,” she said. The temporary change has also helped HCO supervisors keep their focus on the care needs of those HCO serves and implementing critical changes as quickly as possible rather than fielding questions. “If a staff member has a question, they typically go directly to their supervisor with that question. With COVID-19, it’s likely we have a number of staff members across all of our programs who have the same question as well.” HCO’s efforts to centralize where their information comes from has ensured that communication has been consistent and helped them get a better idea of where people are at with processing through that information. “I’ve been able to look for trends in what people want to know, which helps us determine where we as an agency need to provide more information. And because things are moving so fast, we don’t always have the answers right away. We sometimes have to say: That’s a very good question and I don’t know the answer – but we’re going to go and find out.”

The agency’s annual musical (which accounts for a huge percentage of the donations that HCO receives annually) is typically a large part of Ashly’s job. With this year’s musical postponed to 2021, HCO’s approach to fundraising looks very different as well. Many non-profits like HCO are now tasked with exploring other avenues for fundraising and are all vying for the same dollars at the same time. “We want to be sensitive to the fact that many of the families and businesses that have been so generous with HCO in the past may not be in a financial position to support us on the same level this year. There are so many new needs we are facing with COVID-19: PPE shortages, the increased need for service hours with less staff to provide care, and countless new costs without funding sources to pay for them. We’ve had a number of people who would typically contribute to our musical that have still chosen to give to our organization, and we are exploring ideas for other ways that the community can continue to help us meet our mission. Our families and the community as a whole have always been so supportive of HCO, and we are so lucky to have them. I’m optimistic that those who can support us will continue to do so.”

Where she would normally be making musical flyers or calling sponsors about their ticket reservations, much of Ashly’s time these days is spent in conversations with families and staff, helping establish communication surrounding new agency protocols, or talking through future challenges and potential solutions during the pandemic. “I’ve been able to provide a lot of support with the implementation of technology and video conferencing software in a way that we as an agency haven’t used before, which has been really interesting for me to watch play out,” she said. “We were lucky to have been already in the process of establishing these systems shortly before COVID-19 started, and we were able to pivot this project quite quickly to meet very different needs from what was originally intended. Seeing this technology now being used to help our staff hold remote meetings or provide the ability for those we serve to stay connected to each other and their loved ones from afar has been amazing.”

While some of these changes have been easy to see coming, others have come as a surprise. “Professionally speaking, I’ve learned that while being able to help our stakeholders understand what steps we are taking as an agency is extremely important, helping them also understand WHY we are taking those steps has been just as critical. It’s been the catalyst to helping people work through some of their fears and feel confident that we are doing the very best that we can to protect and care for our individuals and our staff,” Ashly said. “There’s been a definitive shift in how I connect with others. The conversations I’m having with people now feel much more real – more authentic,” she shared, “both personally and professionally. By its very nature, this pandemic has taken a lot of control and feelings of safety away from all of us over the past few months. Everyone is at a very different level of understanding, processing, and responding to COVID-19. I’ve enjoyed being able to listen to other people’s concerns and help them work through those feelings. I’ve gotten to know some new people and have also built deeper relationships with others in ways that I wasn’t expecting.”

Who knows when the medical and economic climate will return to some semblance of normal, but in the meantime, HCO staff such as Ashly are proving to be flexible and resilient in these unprecedented times.