Person-Centered Planning Updates in EIS Training for Providers
Discover the latest updates in Person-Centered Planning (PCP) as of November 15, 2021, including best practices, reasons for updates, service descriptions, community connections, valued roles, and resources for agencies and providers. Learn about the purpose of planning, key accomplishments, and how services relate to personal goals and development.
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PCP Updates in EIS November 15, 2021 Training for Provider Agencies
Agenda Person-Centered Best Practices Reasons for the Updates Overview of the Updates Provider Pages Updates to Service Descriptions and Narratives Next Steps Resources and Questions 23
Purpose of Planning & What to Remember It s about discovering a Person s capacities creating a vision for a future developing the supports building meaningful community connections and relationships increasing valued roles PRESENCE, CHOICE, COMPETENCE, RESPECT, COMMUNITY PARTICIPATION
Person-Centered Planning Best Practices Maine Department of Health and Human Services 4
The Five Accomplishments by John O Brien and Connie Lyle O Brien Community Presence How can we increase the presence of a person in local community life? Community Participation How can we expand and deepen people s relationships? Encouraging Valued Social How can we enhance the reputation people have and increase the number of valued ways people can contribute? Roles Promoting Choice How can we help people have more control and choice in life? Supporting Contribution How can we assist people to develop more competencies?
Services Relate to Goals and help the Person . Make and sustain meaningful connections, memberships and friendships. Increase their active involvement in the life of communities. Increase valued social roles in communities Develop and invest their gifts and capacities. Increase choice and control in their lives.
Person-Centered Resources OADS Person Centered Planning Manual and Resources Maine College of Direct Support Dr. Beth Mount Person Centered Services Video A Manual For PCP Facilitators Maine Department of Health and Human Services 7
Reasons for the Updates Person Centered Best Practices To strengthen the connection of best practices when planning with people Ensure informed choice, most integrated settings, access to explore and maintain jobs, support to build relationships and be free from coercion and restraint Federal Department of Justice Settlement and Centers for Medicare and Medicaid Services Members choose services and supports that provide them opportunities to live in the most integrated setting appropriate to their needs, consistent with their informed choice and health and safety. Choosing services and where they happen should always be based on the needs and preferences of the person receiving services. Add Community Membership service and goal pages See Nuts and Bolts of Community Membership PowerPoint on Community Involvement page Maine Department of Health and Human Services 8
Overview of the Changes Made Overview of Updates Made Updated service domains Service Descriptions for Home Support Work Support Community Support Updated Service Planning Narratives/more text options Home Support Work Support Community Support Added NEW Community Membership Service Planning/Goal Community Involvement Page OADS Updated Case Management pages PCP guiding text to better align with PCP Manual, PCP QA Tool, and HCBS Requirements Maine Department of Health and Human Services 9
Provider Pages Overview of Narratives Ensure that it is understandable to the person and family- it describes what will happen, when and what staff will be doing to support the person Who got together and when What happened last year and what s the plan for this year Guiding Prompts are more explicit to capture all needed information 2 Text Boxes- NEW Other tips: What Services in the Program will be provided- connect the narrative to the above identified services Example: I am interested in learning about photography this year (discovery) Service Domains: Community Supports and Personal Development Narrative then covers what will staff do with and for the person
Provider Pages - Service Planning Completing Service Planning 1.Information about the person 1. Interests and Likes 2. Strengths and Gifts 3. When are they at their best what makes things good? 4. What do they want to learn? 2.Tools you can use 1. Relationships who is in their life? 2. Community Maps where do they belong, places to go, explore? 3. Personal Profile in PCP what s already known? Maine Department of Health and Human Services 11
Provider Pages - Service Planning, cont. Service Planning, Continued 3. What is a narrative? 1. Describes what will happen, when, and what staff will be doing to support the person 2. Connects what will happen to the service identified 3. Written in plain language so the person and their family can understand 4. What is a goal? 1. An outcome the person wishes to achieve 2. Something the person wants to do and/or is important to them 3. Is observable 4. Written in plain language balanced between detail and open-ended 5. What it is not: a service description, a habilitation plan, a service-related activity, nor is it measured in percentages of success or number of trials Maine Department of Health and Human Services 12
Provider Pages - MaineCare Service Description Changes Updated Service Descriptions for Home, Work, & Community Support Added service descriptions to align with HCBS Changed Employment to Competitive Integrated Employment (CIE) Activities related to access and obtaining CIE Financial Literacy Valued Social Roles ( relationships/connections) Transportation access Changed Narrative text boxes Changed guiding text to reflect person-centered philosophy and HCBS Settings rule Added a second text box (4000 characters) to provide ample space for documentation Maine Department of Health and Human Services 13
Provider Pages - Service Description - Home Support Click here for the paper form on the OADS website Maine Department of Health and Human Services 14
Provider Pages Service Description Work/Employment Support Click here for the paper form on the OADS Website Maine Department of Health and Human Services 15
Provider Pages Service Description Community Support Click here for the paper form on the OADS website Maine Department of Health and Human Services 16
Provider Pages Service Description Community Support Click here for the paper form on the OADS Website Maine Department of Health and Human Services 17
Provider Pages Narratives in Detail All Provider Pages - First Narrative Box, first box of prompts Service Planning Narrative: Using the persons communication preferences and learning style during Service Planning develop the following: 1)Summary that includes when service planning occurred, who talked with the person (and guardian, if applicable) to review previous plan and learn/determine the persons current goals including planning for and discussing how to: i) Strengthen community involvement and participation based on the persons unique interests, strengths, skill and goals; ii) Sustain and increase natural support relationships and their involvement in the person s life, based on the persons unique interests, strengths, skills and goals; iii) Explore, seek, obtain, maintain or advance in competitive integrated employment, based on the persons current employment status. [Applies to all working-age persons (or retirement age persons with a goal to work in CIE); iv) Pursue supported retirement, based on the persons unique interests, strengths, skill and goals [Applies to all persons age 65 and over that have identified this]; v)Increase and maintain maximum control over personal resources; vi) Access transportation options necessary for pursuing and achieving all goals identified with the person. Maine Department of Health and Human Services 18
Provider Pages Narratives in Detail All Provider Pages - First Narrative Box, 2nd box of prompts 2. How will schedules and activities be developed by the person, with support to meet their identified goals and desired outcomes. 3. Specific tasks, strategies and support that will be used to implement individualized schedules (days per week, hours per day), activities and goals. 4. Where services are implemented based on the persons choice (including non-disability specific settings). 5. Specific staff responsible to support the person to achieve their identified goals. ( Role of staff providing services- DSP, Program Manager, other roles of support staff) Maine Department of Health and Human Services 19
Provider Pages Narratives in Detail All Provider Pages - Second Narrative Box, first box of prompts 6. Overall, how services are connected to the persons identified goals, strengths, preferences, support needs, and risks (health, behavioral, and personal safety). 7. How and when will progress toward goals and outcomes be tracked and used to inform Service Planning. All Provider Pages - Second Narrative Box, second box of prompts 8. What staff will do to promote individualized positive supports (communication support, teaching of skills, verbal re-direction or prompting, environmental modifications, voluntary timeout, etc.) including any Positive Support Plans. Include a review of Reportable Events, Individual Support Teams (ISTs), Safety Device Plans, HCBS Right Modifications Addendums, or Behavior Management Plans (as applicable). Maine Department of Health and Human Services 20
Next Steps 1. All PCPs were locked down on 11/15/2021. The next time the Case Manager creates a new version for updates, all existing information in the PCP will be carried forward. PCPs will be updated based on annual Plan date or as needed to document changes in the person s life, services, or support needs. Between now and May 31, 2022, all PCPs must have a new version in the current format. 1. There are no timelines related to HCBS that require an immediate change to the persons PCP 2. HCBS Updates should be made at the next team meeting on or before May 31, 2022. 3. If there is no need to update a plan for the next annual plan or to document changes, the Case Manager will work with the team to update the plan into the current format. 2. 3. 21 Maine Department of Health and Human Services
Ask Yourself In Person-Centered Planning am I assisting people to... Make and sustain meaningful connections, memberships and friendships? Increase their social value roles? Increase their active involvement in the life of communities? Develop and invest their gifts and capacities? Increase choice and control in their lives? Remember it s all about the Person!
Resources 42 C.F.R. 441.301(c)(1),2 regarding Section 1915(c) Home and Community-Based Waiver Services (HCBS), including the person-centered planning process Maine Statute: 34-B, Chapter 5 Community Involvement webpage with new resources and information, including the Resources Box added recently (right side of page). Person Centered Planning Tools (free) https://helensandersonassociates.co.uk/person-centred- practice/person-centred-thinking-tools/ OADS Person-Centered Planning webpage includes paper forms for Home Support, Community Support, Work/Employment, and Career Planning Service Plans and Goals https://www.maine.gov/dhhs/oads/providers/adults- with-intellectual-disability-and-autism/person-centered- planning 23 Maine Department of Health and Human Services
Questions? For more Information and Individual Support around Service Planning Email: ResourceCoordinator-OADS@maine.gov In Subject Line PCP/Service Plan Question 24 Maine Department of Health and Human Services
Questions? For more Information around HCBS Support Email:HCBS.DHHS@maine.gov In Subject Line HCBS Service Plan Question 25 Maine Department of Health and Human Services
