PC IS ISP 2015 Presented by Eric Williams, CRC Provider - PowerPoint PPT Presentation

PC IS ISP 2015 Presented by Eric Williams, CRC Provider Development DBHDS Division of Developmental Services June 2015 DBHDS Vision: A life of possibilities for all Virginians

ISP updates supported by… Advocates and providers Person-Centered Practices Settlement Agreement CMS Final Rule DBHDS Slide 2

One Page Descriptions A personal, easy to use summary of the individual’s desired life, talents/contributions, what’s most important to and how to support. Slide 3

Part V Plan for Supports Part IV The first four parts are team documents Agreements finalized and shared by the Support Part III Coordinator. Shared Planning Part II Personal Part V is provider specific and finalized by Profile Part I each provider including the SC. Essential Information Slide 5

Updates emphasize… Comprehensive supports and most integrated settings Measurability Employment First Community participation PC Skill-development ISP Psychotropic medication use Monitoring Choice and control Risk Slide 6

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Part I: The Essential Information Friends & Community Contacts Slide 8

Moving from Service Life to Community Life Community A Good Paid Service Life Life Life ‘ Important to ’ recognized Focus on connecting, building relationships ‘ Important to ’ present and natural supports • To and for present • To and for present • Important for addressed • Closest people are • Active circle of support • No organized effort to paid or family • Included in community life address important to • Few real connections Slide 9 TLC-PCP 2013 www.learningcommunity.us

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Part I: The Essential Information Psychotropic Medication use Slide 11

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Part I: The Essential Information Slide 13

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Part I: The Essential Information Active Medical and Behavioral Support Needs Slide 16

Part V: Plan for Supports Slide 17

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Part I: The Essential Information Steve The Plan for Self-Sufficiency • Considers future plans for inclusion • Replaces discharge plan • Applies to every individual Slide 19

Part II: The Personal Profile How I am best supported to direct my planning process: What I want at my meeting: My meeting location: My date of meeting: My time of meeting: My planning partner: People I want to attend: People I don’t want to attend: Slide 20

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Part I: The Essential Information Slide 22

Part IV Agreements Part III Shared Planning How planning proceeds... Slide 23

Important TO What makes a person happy, content, fulfilled • people, pets • daily routines and rituals, • products and things, • interests and hobbies, • places one likes to go 24 24

Important FOR What we need to stay healthy, safe and valued • physical and emotional health • safety and security • things that make you valued in community 25 25

Do you know what is needed for health and happiness? TO FOR 26

Work Learning Health & Community Safety Transportation & Relationships Travel Money Home Slide 27

Part II: The Personal Profile Before the Annual ISP Meeting Slide 28

Part III: Shared Planning Slide 29

Part III: Shared Planning Traditional Action Planning Planning Separate Shared Goals Outcomes Objectives Action Steps • Instructions Strategies Slide 30

Part III: Shared Planning At the Annual ISP Meeting Slide 31

Part III: Shared Planning Writing outcomes… Name important TO. Writing an outcome based on the heart of each issue provides for a variety of ways to support a person having what he or she wants. Slide 32

Part III: Shared Planning Writing outcomes… Previous outcome example: Steve goes to Pizza Shack in order to eat with his friends. Updated outcome examples: Steve eats dinner with his friends. Steve spends time with his friends. Steve goes out to eat. Slide 33

Part V: Plan for Supports Writing activities/action steps… Name action verb activity. Writing an activity is based on what can be seen when supporting a person to learn or have what he or she wants. Slide 34

Outcome: 1. Steve eats dinner with his friends. Work Learning Health & Community Safety Transportation & Relationships Travel Money Home Personal Profile: Important TO Slide 35

Part III: Shared Planning Outcome: 1. Steve eats dinner with his friends. Who? Steve goes to dinner with his friends. Friend Residential* Steve cooks dinner for his friends. Steve chooses and invites his friends. Day Support* Steve makes dinner plans. Residential* Plan for Supports* Slide 36

Part III: Shared Planning Steve makes dinner plans. Skill-building? Yes No Who? Supports are no longer wanted/needed when… Residential When Steve can use the internet or phone book to locate preferred restaurants and identify, call and invite at least 3 friends to a meal. Can a skill be developed? Can assistive technology be used? Guiding questions Can the condition improve? Can natural supports be introduced? Slide 37

Outcome: 1. Steve has his own business Personal Profile: and makes more money. Important TO Work Learning Health & Community Safety Transportation & Relationships Travel Money Home Slide 38

Part III: Shared Planning Outcome: 2. Steve has his own business and makes more money. Who? Supported Steve obtains a business license. Employment* Supported Steve develops a business plan. Employment* Support Steve obtains an employment evaluation. Coordinator* Steve budgets his money to save $500. Residential* Plan for Supports* Slide 39

Part III: Shared Planning Steve develops a business plan. Who? Skill-building? Yes No Supported Employment Supports are no longer wanted/needed when… When Steve develops a business plan that contains all necessary elements and presents it to the small business development center. Can a skill be developed? Can assistive technology be used? Guiding questions Can the condition improve? Can natural supports be introduced? Slide 40

Part III: Shared Planning Slide 41

Part III: Shared Planning Outcomes needed to complete Shared Planning 1: The 5 required life areas 2: The active medical and behavioral needs outcomes 3: The 3 standard outcome options Slide 42

Part III: Shared Planning The 5 required life areas… Slide 43

Part III: Shared Planning The “Active Needs” outcomes… Medical Behavioral Taking from others Diabetes Heart conditions Psychiatric needs Hurting oneself Communication Fall risk Sensory needs Causing harm Slide 44

Part III: Shared Planning The 3 standard outcome options… Routine health and safety Periodic Supports Support Coordination Steve is healthy, safe and a valued member of his community. Steve has something to do when plans are cancelled. Steve’s outcomes are achieved. Slide 45

Part III: Shared Planning Active 3 standard outcome 5 required life areas? Medical/Behavioral? options? Steve is not tired all the time due to diabetes. Steve has his own business and makes more money. Steve has more friends. Steve explores different ways to enjoy music. Steve is organized. Steve is healthy, safe and a valued member of his community. Steve has something to do when plans are cancelled. Steve’s outcomes are achieved. Slide 46

Agreements and Evaluating Success Slide 47

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Part V: Plan for Supports After the Annual ISP Meeting Slide 49

Part V: Plan for Supports Slide 50

Ongoing Learning and Documentation Slide 51

Ongoing Learning and Documentation A emphasis on what’s working, what’s not working and how to improve. Slide 52

Person-Centered Review Outcome status definitions Met = Outcome was achieved (and ended). Partially Met = O utcome was partially achieved. Not Met = Outcome was not achieved. Slide 53

Obtaining ISP materials ISP templates and videos are available online here: http://www.dbhds.virginia.gov/ Select links in the following order to access the ISP Professionals And Service Providers Developmental Services Provider Development Person-Centered Planning Slide 54

Questions? Contacts and resources: Community Resource Consultants (PC ISP): http://www.dbhds.virginia.gov/professionals-and-service- providers/developmental-disability-services-for-providers/provider-development Person-Centered Thinking Training: http://www.personcenteredpractices.org/ Settlement Agreement information at DBHDS: http://www.dbhds.virginia.gov/individuals-and-families/developmental- disabilities/doj-settlement-agreement CMS Final Rule information at DMAS: http://www.dmas.virginia.gov/Content_pgs/HCBS.aspx Slide 55