Person-Centered HCBS Education & Gathering Representative Names June 2017

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Explore learning objectives, updates, and transition plan for a person-centered approach in HCBS education, including identifying representatives, educating consumers about their rights, and advocating for them with providers. The plan covers extending timelines, solutions for inability to consent, and documenting limitations to consumers' HCBS rights from July 2017 to June 2018.


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  1. Person Person- -Centered Centered Consumer HCBS Education Consumer HCBS Education & & Gathering Representative Names Gathering Representative Names June 2017 June 2017 1

  2. AGENDA AGENDA o Learning Objectives o HCBS Updates o Representative Name(s) o Educating Consumers about Limitations o Talking to Providers about Limitation Areas 2

  3. LEARNING OBJECTIVES LEARNING OBJECTIVES Participants will: oUnderstandexpectations and actions for identifying a representative for future use if an consumer can not longer consent. oHave a basic understanding of the new HCBS rights and of the expectations of educating consumers in a person-centered manner about these rights; and beginadvocacy on behalf of consumers wishing to exercise their rights. oUnderstandhow to get technical assistance and/or get HCBS-related questions answered. 3

  4. HCBS UPDATES HCBS UPDATES o CMS extended timeline three years (to March 2022) for all states. oProposed solution for Inability to Consent under construction. o Rollout of formal Individually-Based Limitations documentation moved out from July 1, 2017; proposed new date is July 1, 2018. o Beginning July 1, 2017, at reassessment: Request Client Representatives ; and Provide HCBS rights education & advocacy 4

  5. HCBS TRANSITION PLAN: JULY 2017 HCBS TRANSITION PLAN: JULY 2017- -JUNE 2018 JUNE 2018 Today we will cover: oEnsuring consumer s Client Representative information is up-to- date; o Educating consumers in a person-centered manner about their HCBS rights; o Advocating for consumers with their Providers. 5

  6. HCBS TRANSITION PLAN: STARTING JULY 2018 HCBS TRANSITION PLAN: STARTING JULY 2018 Next year, we will: Assist consumers that have a health/safety risk, and: o May not be able to safely exercise their HCBS rights; or o May not understand the consequences of their decisions. Formally document any limitations to a consumer s HCBS rights. 6

  7. CLIENT REPRESENTATIVE CLIENT REPRESENTATIVE July 2017 At intake and reassessment, request Client Representative information for: 1. Guardian 2. Spouse 3. Adult Child(ren) 4. Parent(s) 5. Adult Sibling(s) 6. Other Adult Relative(s) 7. Adult Friend(s) New Policy: Get as many as possible! 7

  8. CLIENT REPRESENTATIVE CLIENT REPRESENTATIVE 8

  9. CLIENT REPRESENTATIVE CLIENT REPRESENTATIVE What if there is no one from the list??? 1. Guardian 2. Spouse 3. Adult Child(ren) 4. Parent(s) 5. Adult Sibling(s) 6. Other Adult Relative(s) 7. Adult Friend(s) Support consumers with developing new relationships 9

  10. APPOINTED REPRESENTATIVE(S) APPOINTED REPRESENTATIVE(S) July 2018 If the consumer: a) Is no longer able to make LTC decisions; and b) Does not have a Client Representative ; and c) A LTC-related decision has to be made The State will appoint a representative. We will attempt to locate a rep using the list from the Client Representative slides. If none are found, we will appoint someone. OAR 461-115-0090(3) 10

  11. APPOINTED REPRESENTATIVE(S) APPOINTED REPRESENTATIVE(S) JULY 2018 11

  12. HCBS, IN A NUTSHELL HCBS, IN A NUTSHELL What is the point of HCBS? To make Home and Community-Based Services, and the settings where they are delivered, as home-like as possible. In-Home HCBS Institution NOT HCBS *As we go over the next few slides, think about whether you have consumers who do not currently have some of these HCBS Rights. 12

  13. HCBS RIGHTS, FREEDOMS & PROTECTIONS HCBS RIGHTS, FREEDOMS & PROTECTIONS Freedoms, Rights, Protections that may not be limited: Access to the broader/greater community Services in an integrated setting Accessible setting Control of personal resources Privacy, dignity, respect, freedom from coercion and restraint* Residency agreement Services in a private room if desired Services in a non-disability setting if desired Work, if desired Person-Centered Planning and Plans 13

  14. HCBS RIGHTS, FREEDOMS & PROTECTIONS HCBS RIGHTS, FREEDOMS & PROTECTIONS 1. Access own food at any time 2. Choice in who roommate is in shared units 3. Control own schedule and activities 4. Decorate/Furnish 5. Freedom from Restraint 6. Locks on bedroom/living unit door 7. Visitors of own choosing at any time 14

  15. HCBS RIGHTS, FREEDOMS & PROTECTIONS HCBS RIGHTS, FREEDOMS & PROTECTIONS Access own food at any time Explain what it means Assess what is happening Take action/advocate 15

  16. HCBS RIGHTS, FREEDOMS & PROTECTIONS HCBS RIGHTS, FREEDOMS & PROTECTIONS Choice in who roommate is in shared units Explain what it means Assess what is happening Take action/advocate 16

  17. HCBS RIGHTS, FREEDOMS & PROTECTIONS HCBS RIGHTS, FREEDOMS & PROTECTIONS Control own schedule and activities Explain what it means Assess what is happening Take action/advocate 17

  18. HCBS RIGHTS, FREEDOMS & PROTECTIONS HCBS RIGHTS, FREEDOMS & PROTECTIONS Decorate/Furnish Explain what it means Assess what is happening Take action/advocate 18

  19. HCBS RIGHTS, FREEDOMS & PROTECTIONS HCBS RIGHTS, FREEDOMS & PROTECTIONS Freedom from Restraint Explain what it means Assess what is happening Take action/advocate 19

  20. HCBS RIGHTS, FREEDOMS & PROTECTIONS HCBS RIGHTS, FREEDOMS & PROTECTIONS Locks on bedroom/living unit door Explain what it means Assess what is happening Take action/advocate 20

  21. HCBS RIGHTS, FREEDOMS & PROTECTIONS HCBS RIGHTS, FREEDOMS & PROTECTIONS Visitors of own choosing at any time Explain what it means Assess what is happening Take action/advocate 21

  22. PERSON PERSON- -CENTERED EDUCATION CENTERED EDUCATION Does the individual understand? o YES: Go over the HCBS Visual Fact Sheet handout and leave it with him/her. Talk about his/her goals and how to reach them. o NO: (e.g., advanced dementia) o May not directly have a conversation o May not leave materials o May observe the environment o May talk to people who are important to the individual 22

  23. PERSON PERSON- -CENTERED ADVOCACY CENTERED ADVOCACY When talking to providers about a resident s HCBS right that is not available at this time, ask: o How can we make that happen? o Is there a way to make progress in small steps? 23

  24. LETS TALK LET S TALK After going through the slides today, you have already thought about consumers in your caseload who do not currently have all of their HCBS rights. How might you approach the: oConsumer who wants to have all their HCBS rights today? oProvider who is not fully allowing all HCBS rights at this moment in time? 24

  25. PUTTING IT ALL TOGETHER PUTTING IT ALL TOGETHER oDocument Client Representative in OACCESS o Count in-person HCBS education as direct contact o Any follow-up with provider or consumer may be a direct or indirect contact, as appropriate 25

  26. HCBS Q&A CALL HCBS Q&A CALL- -INS INS We want your questions! We can talk about the tough cases. Dates Times Call-In Ph# 1-888-204-5984 Friday, July 7, 2017 Friday, July 14, 2017 Friday, July 21, 2017 Friday, July 28, 2017 Wednesday, August 9, 2017 Wednesday, August 23, 2017 Tuesday, September 5, 2017 Tuesday, September 19, 2017 1:30 PM 3:30 PM PDT 10:00 AM 12:00 PM PDT 10:00 AM 12:00 PM PDT 10:00 AM 12:00 PM PDT 10:00 AM 12:00 PM PDT 1:30 PM 3:30 PM PDT 1:30 PM 3:30 PM PDT 1:30 PM 3:30 PM PDT Participant# 3983866 26

  27. MORE HCBS QUESTIONS? MORE HCBS QUESTIONS? Provider Questions: General: CBC-Related: CBC.Team@state.or.us AFH-Related: APD.AFHTeam@state.or.us HCBS.Oregon@state.or.us AAA/APD Staff Questions: Contact: Bob Weir Chris Angel 27

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