Community Supports

Creative Enterprises
Creative Enterprises is a program operated by Four Rivers Behavioral Health. Our purpose is to provide training in work and daily living skills along with recreation to adults diagnosed with intellectual disabilities and/or other developmental disabilities who live in the surrounding counties. This Adult Day Training program is designed to help individuals become acclimated and self-sufficient in the community and be as independent as possible.

The Adult Day Training program offers participants the opportunity to work and earn a paycheck. Individuals work at their own pace and ability level, while Creative Enterprises staff is present to assist in any way needed. Subcontract work is offered to any individual that is interested in earning a pay check and receiving vocational training.

Everyone in Creative is given an assessment and develops a goal to help them reach their full potential. The goals are chosen by each individual with assistance from their guardians and the support team.


Respite Care
Respite provides short-term rest or relief to families who have the responsibility of caring for a family member with a developmental disability. Respite care may be furnished in the family home, the respite provider’s home, or other residential settings. In some cases vouchers may be given for families to purchase their own respite.

Supported Employment and Work Hablilitation
Four Rivers Behavioral Health contracts with other providers in Graves and McCracken counties to provide job development, job coaches and other support services to assist individuals diagnosed with developmental disabilities in locating and maintaining full or part-time employment in the community. Work Habilitation is provided in Graves, Marshall and McCracken County by Creative Enterprises and subcontractors. This service allows individuals to work and earn a paycheck, attend classes for daily living skills or participate in community individual or group activities. Persons diagnosed with intellectual disabilities are eligible for these supports. Referrals are made by subcontractors or case managers.

HART-Supported Living
HART-Supported Living is a program that provides financial grants to persons with a disability to implement individually designed plans for supports. Applicants may request one time only funding, ongoing funding, or a combination of both. Examples of types of supports that can be requested are: Start-up grants for security deposits, home modifications, accessible equipment, vehicle modifications, personal care attendant, homemaker, and transportation. Applications are due each year by April 1st.

First Steps
First Steps is a statewide early intervention system which provides services to children from birth to age three with developmental disabilities and their families. First Steps is Kentucky’s response to the federal initiative called the Infant-Toddler Program (ITP) established by Public Law 99-457 Part C. First Steps officers’ comprehensive services through coordination with a variety of community agencies and service disciplines.

First Steps provides services for the following reasons:

  • A child with a delay or condition that is likely to cause delay should not go through the critical developmental years without help.
  • Services and support benefit families by reducing stress.
  • Early intervention services often decreases the need for later costly special education programs by remediating problems early in the child’s life.

Anyone can make a referral to the Point of Entry Office as long as the family is aware of the referral. Children are determined eligible by a developmental delay. Evaluation shows that the child is not developing typically in one of the five skill areas: cognition, communication, physical, social and emotional, or self-help. Or a child will have automatic entry by diagnosis of a physical or metal condition which has a high probability of resulting in developmental delay.

All evaluations, assessments, coordination is covered by First Steps funding. There is a family share fee to cover cost of therapy that is based up on the family’s income. Services included physical therapy, occupational therapy, speech therapy, nutrition services, and developmental intervention.

Behavior Supports
A service provided to individuals with a diagnosis of intellectual disabilities or a developmental disability who present with challenging behaviors that effect their health, safety, placement or inclusion into their community. Behavior Supports use positive methods to change negative behaviors. A functional analysis is completed in an effort to identify target behaviors, determine how often and under what circumstances they occur and identify the possible communicative intent of the behaviors. Some behaviors may cease following simple environmental modifications while some may require a formal behavior support plan. The plan functions to teach new skills to the individual in an effort to eliminate target behaviors and replace them with socially acceptable behaviors. The plan is implemented by family and staff members who work with the individual on a daily basis.

Community Living and In-Home Supports
Community Living offers support to individuals needing assistance with daily living skills and community integration. Its main purpose is to provide supports to persons diagnosed withintellectual disabilities or other developmental disabilities so that they can remain in their home and community. Both services are available to persons living in their own home or with family.

Community Living Supports (CLS) is a service provided through the Medicaid waiver programs. In-Home Supports are available to individuals receiving supports from the State General Fund Program. Supports include training in areas of: daily living skills, personal care, recreation and leisure, community integration and socialization. These supports are provided on a one-to-one basis.