Participants in the Center’s classes make the fundamental conceptual shift from being patients to being students. “Good” patients are all that the word implies: they are patient compliant, deferential to authority, limited in questioning treatment decisions and options, and have given over their personal power and authority to the experts.

Participants in the Center’s classes are students. They have made a voluntary decision to register for classes, set their own rehabilitation goals and become active assertive participants in the learning process. The typical Center student is a stable, mature adult who has survived some of life's most demanding experiences. These students bring to the classroom a special quality of determination and persistence.

Students at the Center typically develop a positive and responsible attitude, an attitude centering more on abilities than on disabilities. They are active in setting their educational goals, suggesting curriculum additions and changes, and above all, providing an unparalleled level of peer interaction and support.

The Center’s rehabilitation services are provided within the context of carefully developed classes utilizing educational methodologies and instructional technologies based on clinical therapeutic strategies. With the exception of a student’s initial evaluation, all therapeutic activities happen in groups ranging in size from 3-20. 

This structure is the fundamental reason for the program’s cost-efficiency. The transformation from patient to student, and then to active member of a group, enhances self-esteem, personal growth, physical improvement, and leads to eventual independence.

At the Center, students register for classes and pay college tuition. There are no medical costs associated with attendance. And, health insurance, MediCARE and/or MediCAL are not impacted in any way, either at the institutional or the individual level.

When compared to similar services throughout the nation's health care system, the Center provides a remarkably low-cost, high-benefit approach to serving its targeted population. Cost is not a barrier to enrollment and students do not have to be concerned with insurance restrictions on length of stay and eligibility. Students pay only for the hours of instruction they receive. There is an open enrollment policy, which means that if a student registers for the program mid-semester, they only pay for the portion of the semester they attend. Students attend from 1⁄2 day a week to four days a week, depending on their educational goals.

Community College fees have been steadily rising. However, they are still far lower than comparable hourly medical costs. The 2006 fees for California Community Colleges is $26.00 per unit. Total tuition and fees cost per semester, if a student attends full time for the full semester in 2006 is $279.00 for 300 hours of instruction.

Board of Governors’ Grants (available at all California Community Colleges) and private scholarships (funded through endowments to Cabrillo’s Center) are available for low income students who cannot afford the current fees.

Ideally, administration and management in not-for-profit settings such as hospitals and colleges provide a strong support system for the professional services offered by an institution. Administrators and managers are charged with keeping the framework of the organization strong and operations working seamlessly. They are also charged with the acquisition and distribution of funds. These are enormously challenging tasks for managers who are dependent on public funding, public policies, and the needs of highly and expensively trained specialists who are committed to a high standard of service and their professional ethics.

There is an added burden placed on college administrators when a program is outside of the mainstream. In the Center’s model, special work is required to accurately account for attendance and to accommodate for added safety and transportation considerations. Center staff are constantly aware of the challenges being a “square peg” always needing to make adaptations to fit into “round holes”. However, it is incumbent upon an educational/healthcare hybrid program to facilitate the work of an already overburdened college administration by integrating and translating functions as seamlessly as possible.

Individualized Educational Plans, known as IEPs, are the standard planning and evaluation method used nationwide for disabled students in public school settings. In some colleges, these are called Student Education Contracts or SECs.

At the Center, upon registration, each student receives a comprehensive multi-disciplinary evaluation culminating in the development of an Individual Educational Plan. Each student's plan outlines a set of educational goals and the methods for their achievement. Educational outcomes similar to medical outcomes are used to measure student progress. Individual outcomes are based on each IEP and program effectiveness can be measured by looking at the aggregate of IEP performance measures.

The length of a student’s allowable stay is not dependent on the student demonstrating daily or weekly progress based on defined quantified medical outcomes as is required by many insurance companies. Outcomes at the Center are instead used to improve curriculum and instruction and to assist students in defining and reaching their rehabilitation goals.

Overview l Mission l Contrast With Medical Model