PCP version for AR (001).pptx

SUZANNE CRISP JUNE 6, 2023 Person-Centered Thinking, Practice, and Planning Today’s Agenda  Define Person-Centered Thinking, Practice, and Planning.  Provide a brief history.  Compare the traditional approach with the person-centered approach.  Describe how this fits into your other r...

SUZANNE CRISP JUNE 6, 2023 Person-Centered Thinking, Practice, and Planning Today’s Agenda  Define Person-Centered Thinking, Practice, and Planning.  Provide a brief history.  Compare the traditional approach with the person-centered approach.  Describe how this fits into your other responsibilities.  Explore tips for making person-centeredness work.  Wrap-up with the To/For discussion.  Lunch Fun History of Person-Centeredness  1980’s – Medicaid allows persons to return to the community after living in an institution.  1990’s – Self-Determination becomes the mantra.  2002 – Federal government requires person-centeredness to be part of all selfdirected programs.  2014 – Section 1915(i) Final rule mandates that Person-Centered Planning must be present in the development of plans and that they reflect cultural considerations of the individual and reflect what is important to the person with regard to preferences, goals and desired outcomes in all waiver programs.  2016 – CMS Quality Strategy – Programs as part of their Quality Management System, must incorporate the principles of person-centeredness throughout program operations. So What is Person-Centeredness? Person-Centered Thinking – In my day-to-day thoughts, do I think about what my actions mean to the people I support? Am I supporting them to create meaningful life experiences? Person-Centered Practice – In my day-to-day actions, do I help support the person to define their life outcomes and discuss how to achieve these? Person-Centered Planning – Do I facilitate the people I serve to develop a plan to reach their goals and outcomes? The process helps the person make informed choices and the plan reflects those choices. Person-Centered Organization – Does the system I work for focus on supporting me and the persons I serve as I use person-centered approaches? What is Person-Centeredness? The art of discovering what is important to the person A system of ongoing listening, learning, and reacting to the discussion. The influence of program staff is very limited. Creative problemsolving is critical. There may be significant reliance on family and support system. It is facilitating not managing. Approach is personalized to each individual. Power shifts from supports broker to the person. Seeks to develop a shared understanding of the person and their situation. Why Use Person-Centered Skills?  the lives of those you support will improve, services will have meaning to the client  applies to all disability groups regardless of age  you will have new and better and more natural ways to contribute to a person’s plan  you will be better able to use and act on the information in a person’s plan  you will more likely develop the values needed to support people in having positive control over their lives  everyone will feel better! What Skills do I Need to Practice Person-Centeredness?  Ask open ended questions. Avoid yes or no answers. Ask good follow-up questions.  Affirm wherever possible on the strengths and efforts of the person.  Reflect on the conversation. Explore topics. Is there a possibility for a mutual understanding.  Summarize back to the person what you think you heard.  Listen more than talk.  Conversations about health and safety still need to occur.  Risk management is still a reality. PersonCentered Assumption s  People want to be able to decide for themselves how to live their day-to-day lives.  The person’s belief in the possibility of change is an important motivator.  The person is the primary resource in finding answers and solutions. You are there to help them navigate through the possibilities.  Grounded in demonstrating respect for the dignity of all involved.  Seeks to discover, understand and clearly describe the unique characteristics of the person.  The Goal is to provide the person:  With the means to have positive control over the life they desire.  Is recognized and valued for their contributions to their community (past, present, and future)  Is supported in a web of relationships, both natural and paid, within the desired community/neighborhood. Traditional System Person-Centered System  Convenience of staff or program.  Focus on person’s life choices.  What is important for the program?  What is important to the person? Changes made annually.  Changes based on person’s needs and wants.  Expectations are defined by the person.  Decisions and outcomes made by the person.  Present an array of options.  Attention is on person’s strengths and capabilities.    Expectations defined by program. Decisions made by consensus of planning team.  Options defined by waiver services.  Attention is on problem solving & “fixing” things.  Emphasis on desires and meaningful experience.  Emphasis on clinical strategies.  Organized to respond to people.  Organized to please funders.   Goals are specific to negative behaviors or physical deficits. Goals specific to short-term and long-term positive aspects of the person’s life.  Plans are unique and personalized.  Individual plans may be identical. I Started to Make a List of a Support Broker Responsibilities But I Didn’t Have the Room So will PersonCenterednes s be More Work for Me? Additional training will help you adopt this approach as a natural response. Creating policies and protocols about what supervisors expect will help to clarify your role. Peer to Peer conversations will assist with fleshing-out promising practices or bad ideas. Persons you serve will be more satisfied with the activities involving them. You may experience more job satisfaction. What About all the Tools? Path – Using Facilitators Making Action Plans (MAPS) – Planning for the Future The Person-Centered Discovery Process – The Conversation  What is important to you?  What is working? What is not working?  Describe a really good day for you. A bad day?  What would you like to change?  What do you need help with?  What type of supports do you need?  Are there things you wish you could more of? Less of?  What do you need to be happy, healthy, and safe?  What would your situation be like in three months? What would you like to change in the next three months? What would you like not to change in the next three months? Important to: Important for: Tips on How to Use a PersonCentered Approach  Don’t begin creating solutions before fully understanding the problem or the situation.  Be mindful of your own prejudices, values, or biases.  Control your ability to exercise influence on aspects of what is important to the person.  Begin small – short range goals build to larger long-range goals.  Take time to acknowledge improvements.  Resistance by the person is your signal to respond differently.  Support the person’s ability to believe change is possible.  Ask open-ended questions.  Listen, listen, and listen. Another Successful Approach Meaningful Quotes “A plan is not an outcome” – Michael Smull “ I had a dream” – Dr. Martin Luther King – “Not I had an annual plan with 4 quarterly outcome visits” “Person-Centeredness – Helping people get better lives not better plans” – A very smart person. “Person-Centeredness does not mean giving the person everything they want – it’s a balance” – Suzanne Crisp “The more time you spend defining the problem, the better the solution” – University of MN. Overview of the Disability Community • Approximately, 57 million Americans, or 19% of the population have disabilities. • Largest minority group and most inclusive. • Includes persons of all ages, genders, religions, ethnicities, sexual orientations, and socio-economic levels. • A disability is a natural part of the human condition. • In the past, persons with disabilities have been subject to devaluation, marginalization, and prejudice. Advancing the Disability Movement   The Americans with Disabilities Act of 1990: Federal law – equal treatment – equal access.  Federal and state laws must assure people with disabilities have the same basic rights as people without disabilities.  Pushed for recognition as an aspect of identity that influences the experience of an individual, not as the sole-defining feature of a person. Olmstead Act of 1999:  Unjustified segregation of a person with a disability is considered a violation of the ADA. The Power of Language  Use of language significantly shapes perceptions of the world and forms ideological pre-concepts.  A person’s self-image is tied to words that describe him or her.  Inaccurate descriptors = negative stereotypes and attitudinal barriers.  Medical diagnoses do not describe a person’s potential and value.  Medical diagnosis is appropriate for a service system – not community and everyday language.  Our language shapes our attitudes – our attitudes shape our language – attitudes and language drive our actions. “The difference between the right word and the almost right word is the difference between lightening and a lightening bug.” Mark Twain Past Approaches  People with disabilities:  Described as helpless and tragic victims of their medical or behavioral condition.  Assumed they wanted sympathy or pity.  Disabled vehicle implies broken down.  What individuals with disabilities want – respect and acceptance. PeopleFirst First! appeared in 1988 through advocacy groups.   Since that time, has been widely adopted by speech and language pathologist and researches.  Now is a part of modern disability etiquette.  Reflects on you – if you use dated language – you are assumed to know little about the disability community and are an insensitive person.  Demonstrates “good manners.”  Aims to avoid perceived and subconscious dehumanization when discussing people with disabilities The Power of Language  People First puts the person first: He is a person who He is elderly and disabled. has grown older and has a disability. She is mentally retarded.She is a person with an intellectual or cognitive disability. “I am a person first, like everyone else.” What’s In and What’s Out  Disabled  Person with a disability  Handicapped  Accessible  Mentally Retarded  Person with an Intellectual or Developmental Disability  Quadriplegic/crippled  Physical Disability Emotionally Disturbed  Mental Health Diagnosis Birth Defect  Congenital Disability Brain Damaged  Brain Injury Special Needs  He/She Needs  Patient/Case  Person/Individual  Consumer  Participant/Individual     What’s In and What’s Out  Handicapped Parking  Reserved Parking  Dwarf/Midget  Short of Stature  In special Ed  Receives special Ed services  Non-verbal  Uses a device  Confined to, suffers from, afflicted with  Has…..  Blind  Visually Impaired Do not Assume…… "... a person with a disability either wants or requires assistance." "... upon acceptance of your help, that you know, without being told, what service to perform." "... a person who appears to have one kind of disability also has others." "... a disabled person is dissatisfied with his/her quality of life, nd is thus seeking pity." "... a person with a disability is easily offended." "... that a person who does not appear disabled, or who uses assistive devices intermittently instead of all of the time, is faking or imagining their disability." "... companions accompanying a person with a disability are there strictly to render service." "... a person with a disability will be receptive to personal questions, particularly in a public setting." "... that when a person with a disability is in a public place, that they are being escorted by a caretaker, instead of traveling alone." Additional Considerations  Persons with disabilities are entitled to the same courtesy that you extend to anyone else.  Don’t pet guide dogs.  It is appropriate to shake hands.  Don’t lean on a person’s wheelchair.  Talk directly to the person with the disability.  Consider sitting down to talk to a person in a wheelchair.  Never pat a person on the head. An Additional Resource  Present Obama signed into law the Plain Writing Act of 2010.  Mandates the federal government to write clear communications that the public can understand and use:   Must establish a system of transparency, public participation, and collaboration.  Replace complex words with simple ones.  Eliminate jargon Handy tips: www.plainlanguage.gov What this Means to You?  Use good manners and speak in People First language.  Understand persons with disabilities are just like you.  Don’t assume persons with disabilities need your help – ask first.  Become a change agent to promote awareness of the disability movement through language. “ Questions? ”