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Todd Costello is Executive Director of Community Living Alliance, a Wisconsin-based independent living center that provides personal care, behavioral health services and service design and coordination for individuals with disabilities. He has a master’s degree in nursing and has worked in inpatient psychological and physical rehabilitation. He also serves on the Adoption and Implementation Council for the Research and Rehabilitation Training Center on Home and Community-Based Services at Shirley Ryan AbilityLab.
Costello has been with Community Living Alliance for more than 23 years, and says the organization’s goal is to collaborate with their clients to help them achieve their goals.
“Self-determination and choice are so essential for practicing whole-person care,” he said. “But how do you measure it? How do you promote it? How do you train staff to be able to provide it? It’s an ongoing journey. Being in a place where the choice is the consumer’s is a good space to be.”
Community Living Alliance is in the process of becoming a trauma-informed care organization. Costello says training the entire staff in trauma-informed care is essential to serving the community. When he accompanies staff to clients’ homes, he asks them what their best day looks like. Then, he helps staff to recreate that best day using the principles of self-determination.
“We are very sound in wanting to promote choice, but sometimes, there is judgement involved in whether or not it’s a good choice or a bad choice,” said Costello. “It’s not about the organization’s comfort; it’s about what the consumer needs.” Honest conversations in meetings with patients go a long way toward addressing the dignity of risk, he said. “Sometimes, people want to take the risk because the trade-offs are more important to them,” Costello said. “You have to be willing to honor that and come up with a plan that has components of safety.”
Even when a consumer might not get exactly what he or she wants, Costello and his staff try to honor the person’s original goal. The end result, he said, is promoting each individual’s freedom.