Transcript Self Directed Supports System Map
DRAFT
Self-Directed Supports System Map
DRAFT
Starts with the person…
Advantages of Website Format
• • •
Non-linear
– Hyperlinked and easily navigable – Friendly, Flexible – Adaptable to all audiences – Responsive, can adapt to group needs mid-flight
Combines Text and Graphics and color
– Easy to visualize and understand – Appeals to all learning styles – User can recollect graphics and link to earlier experiences and material
Serve as foundation for hard copy resources
– Detailed info on specific roles, resources, processes
Starts with the person… • Authority • Control • Responsibility • etc…
Pathways to Community Life
Provider Managed
Self-determination Self-directed Day Community Life
OLMSTEAD SPACER
Olmstead Components Planning
Natural Support Community Life Training Team
Support Team for Olmstead
Support Coordinator Friends & Family
Team
Monitors Guardian Friends & Family Transition Case Manager Family/Peer Mentors Developmental Center Staff
Support Team for Olmstead
Transition Case Manager
Transition Case Managers are the link between the Developmental Center, Support Coordinator Agencies and community agencies. They provide valuable information to the team, and assist in the development of an individual’s plan of care.
Support Team for Olmstead
Developmental Center Staff
Developmental center staff are part of the person’s core team, actively participating in the individual’s planning for their move into the community. They provide important insight and understanding of things that are important to and important for an individual, from their first hand knowledge through working and developing a relationship with the person.
Support Team for Olmstead
Bureau of Guardianship Services
The Bureau of Guardianship Services (BGS), provides guardianship for those determined to be in need. If a person is served through BGS, his or her guardian participates as part of the team. Families of individuals who are under BGS may also choose to be part of the team.
Support Team for Olmstead
Peer Mentor
Peer Mentors are individuals with a developmental disability who have experience living in an institutional setting and can listen with a sensitive ear.
Peer Mentors are available to:
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Offer information from a personal perspective that will help in making choices
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Provide support to people so as to strengthen skills in exercising choice and controlling their resources and their lives Be a general support from the person’s perspective
Support Team for Olmstead
Family Mentor
Family Mentors are people who have a family member with a disability living with them or have some other significant relationship with a person with a disability. Family Mentors are available to:
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Share their personal experience, knowledge or resources, person centered thinking, and problem solving techniques to assist an individual/family and their team to work through any concerns that may arise
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Be encouraging of choices
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Provide support from the family perspective.
Support Team for Olmstead
Monitor
Monitors are DDD employees, and coordinate the self-directed team.
Responsibilities of the Monitor include:
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Providing technical assistance to Support Coordinators, people, families, and the fiscal agent
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Review of the person-centered-plan, ensuring that identified services are waiver eligible and that all health/safety needs are addressed
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Approve the plan of care Ensure services are being provided Ensure that expenditures are within the person’s individual budget
Support Team for Olmstead
Support Coordinator
A Support Coordinator works collaboratively with individuals/families, and their network of supporters, as they navigate the person-centered-planning process, ensuring that supports and services are working for the person.
Responsibilities of a Coordinator include:
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Facilitate planning
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Budgeting
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Helping families to find and connect to services Providing technical assistance in self-direction Making changes to the Essential Lifestyle Plan as needed
Olmstead Budget
Olmstead budgets are based upon the level of support an individual needs.
The “Developmental Disabilities Resource Tool” (DDRT is a Self Care Assessment tool designed to gauge in general “how much” service a person needs. These needs then correlate into an individual budget. The assessment assumes that the less an individual’s ability for self care the more she will need assistance from others.
Individual’s moving from one of the Division’s Developmental Centers are assessed by the DDRT in the following areas:
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Self-care
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Behavioral needs Medical needs When the DDRT is completed, it places the person into one of four distinct levels of need for support. Each level of support has an “up to” budget amount to be utilized to purchase services and supports identified in the person’s ELP.
A major advantage of an individual budget is that if the person or their family becomes dissatisfied with their supports and services, they can purchase those supports elsewhere. In essence, the money follows the person giving them the flexibility and control to create the life they want.
Olmstead Budget
The Olmstead budget grids on the next several pages indicate the maximum “up to” budget for each level based on the results the DDRT Self Care Assessment.
Additional funding is allocated based on an individuals’ behavioral and/or medical needs assessment. For individuals residing on their own, additional funds are provided for housing start up costs.
RLC SPACER
Real Life Choices Components Planning
Natural Support Community Life Training Team
Support Team for Real Life Choices
Need graphics Fancy arrows and people
Team
Support Team for Real Life Choices
Support Coordinator
A Support Coordinator assists individuals, families and supporters through the person-centered-planning process.
They help ensure that supports and services work for the person.
Responsibilities of a Coordinator include: – Facilitating the planning process – Facilitating plan updates as needed – Budgeting – Guiding individuals and families in finding and connecting to services – Helping individuals and families navigate Real Life Choices
Support Team for Real Life Choices
Staff
Individuals and families may be eligible to hire paid supporters who will help to implement the plan.
The plan outcomes must reflect the need for staff assistance. Individuals and families may hire staff directly and pay them using the fiscal intermediary.
Staff can also be hired by contracting with a qualifier provider agency.
Support Team for Real Life Choices
Monitor
Monitors are an individual or family’s first link to self-directed services. The Monitor provides information regarding the Divisions’ Real Life Choices and Self Directed Day service system. This enables individuals and families to make an informed decision as to whether self-direction is for them. Responsibilities of the Monitor include: – Providing technical assistance to Support Coordinators, individuals and families and the fiscal agent – Reviewing the person-centered-plan, ensuring that identified services are waiver eligible and that all health/safety needs are addressed – Approving the plan of care – Ensuring services are being provided – Ensuring expenditures are within the person’s budget limits
Support Team for Real Life Choices
Family Mentor
Family Mentors: – have a family member with a disability living with them or have some other significant relationship with a person with a disability – share their personal experience, knowledge or resources – use problem solving techniques to assist an individual, their family and team to work through any concerns – inform and encourage choices – schedule, organize and coordinate family networking meetings – provide support from the family perspective
Support Team for Real Life Choices
Peer Mentor
Peer Mentors: – are individuals with a developmental disability who are self directing independently or with the help of their family.
– offer information from a personal perspective that will help in making choices – provide support to strengthen a person’s skills in exercising choice and control of their resources and their lives – schedule, organize and facilitate peer networking meetings – provide support from a first hand perspective
Support Team for Real Life Choices
Family & Friends
As with all people, family and friends are the people who love us and who we love. They are there to support and celebrate with us as we travel through life.
In Real Life Choices, they are a key part of the planning team. One of the wonderful aspects of self-directed supports is that the person and his or her family make the final decisions about their life.
They
hold the control and authority.
RLC Budget
Real Life Choices budgets are based upon the level of support an individual needs.
The Developmental Disabilities Resource Tool (DDRT):
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assesses a person’s capacity for self care
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assumes that the greater the person’s capacity for self care the less assistance they will need
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places the person into one of four distinct budget levels of support need based on capacity for self care A major advantage of an individual budget is portability. If services are not satisfactory, they can be purchased elsewhere.
This gives the person the flexibility and control to create the life they want.
RLC Budget Levels
Level I inset links
Lowest Support Time Needed, Highest Self Care Score
Level II
Low Support Time Needed, Medium Self Care Score
Level III
Medium Support Time Needed, Low Self Care Score
Level IV
High Support Time Needed, Lowest Self Care Score
Support Team for Real Life Choices
Level I
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Lowest Support Time Needed, Highest Self Care Score
Description: A majority of people can do all activities of daily living, but may need help with public transportation.
Budget: Up to $23,742
Support Team for Real Life Choices
Level II
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Low Support Time Needed, Medium Self Care Score
Description: A majority of people can eat, drink, toilet, care for clothing, make bed, clean room, use microwave, prepare foods, and wash dishes. Need assistance to shop, count change, or do laundry. Budget: Up to $35,162
Support Team for Real Life Choices
Level III
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Medium Support Time Needed, Low Self Care Score
Description: A majority of people can eat, drink, toilet, and dress. Need help to care for own clothing, use money, or count change. A good deal of time is required from caregivers to provide needed supports.
Budget: Up to $48,822
Support Team for Real Life Choices
Level IV
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High Support Time Needed, Lowest Self Care Score
Description: Many people may require assistance to do all activities of daily living, but a majority can eat and drink. Assistance is required to toilet or dress themselves. Most of caregivers time is spent providing needed supports.
Budget: Up to $67,053
SELF-DETERMINATION SPACER
Self-determination Components Planning
Natural Support Community Life Training Team
Support Team for Self-Determination
Support Broker
Support Brokers work collaboratively with individuals and families, as they navigate the person-centered-planning process, ensuring that the plan, supports, and services are working for the person. Responsibilities of Brokers include:
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Facilitating circles of support
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Facilitating development of the annual support plan
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Creating annual budgets, and providing assistance in budget management
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Connecting to resources, including the hiring of staff
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Troubleshooting and brainstorming
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Providing technical assistance in self-direction
SELF-DIRECTED DAY SPACER
PLANNING SPACER
Planning
Essential Lifestyle Planning
Essential Lifestyle Planning
• is a facilitated person centered planning process that creates a user friendly snapshot of how someone wants to live and be supported • helps discover what is important to a person in everyday life • identifies what support the person requires and any issues of health or safety • describes what you have learned in a way that is positive, respectful and easily understood by those who will support the person to get what is important to them • a way of making sure that the person is heard, regardless of the severity of his or her disability.
• identifies and separates what is important to someone, from what others see as important for them and finds a balance between them
PATH and MAPS
• PATH and MAPS are creative person centered planning tools, designed to identify doable action steps in the direction of desirable futures. Both utilize graphic facilitation. • The heart of the MAPS process is the story of the person at the center of the MAP. • PATH is a sharper planning tool, used to cut through complex situations and and move into action.
• Both tools are excellent for team building, and – are loved by people who actually want to – change the way we currently work.
Planning
Personal Futures Planning
• involves values, ideals, and methods for person centered plan facilitation • challenges us to learn to listen and take direction from people with disabilities • effective facilitators learn to listen with an open mind while shaping the ideals of a person’s dream toward reaching the five accomplishments: – Community Presence – Community Participation – Encouraging Valued Social Roles – Promoting Choice – Supporting Contribution
TRAINING & SUPPORT SPACER
Training & Support Real Life Choices
Pathways Lifeline for the Journey Essential Lifestyle Planning
Training
Life after 21
Family Network
Conference
Self-directed Supports Conference • Purpose • Other information
Conference
Family Networking Meetings • Purpose • Support and Information Sharing • Customized training and technical assistance • Informs conference planning • Helps disseminate shared learning from conference
Person Centered Thinking
• Person Centered Thinking refers to the foundational skills and tools that underlie all person centered assessment, planning and delivery of supports. This workshop teaches structured ways of listening and finding balance between what makes a person happy and what helps them stay healthy and safe. It provides effective facilitation methods for gathering, organizing, powerfully presenting, and continually acting on on-going learning.
Essential Lifestyle Planning
• Essential Lifestyle Planning is a person-centered process intended to change the way we plan, design, and deliver supports. This workshop is intended for those interested in facilitating the Essential Lifestyle Planning process. Participants will learn to gather information to produce powerful and effective support plans.
Families Planning Together
• As parents of children and adults with disabilities you may often find yourself wondering how to make people aware of the great things about your son or daughter and the support s/he needs to be happy and safe. Whether you are a the parent of a toddler, school-aged child, young adult transitioning out of school, or an adult with a disability, person centered thinking and planning is a good start to helping your child reach his/her goals and dreams. • Person Centered Thinking refers to the foundational skills and tools that underlie person-centered planning and supports. This workshop for families teaches structured ways of listening and finding balance between what makes your child happy and what helps him/her stay healthy and safe. It provides effective methods for gathering and organizing information, as well as sharing that information so that other people in your child's life are better able to understand what s/he wants and needs.
Lifeline for the Journey
• Life Line for the Journey is an interactive training session assisting families of children from infancy through age 14. At this stage, families are typically wondering and worrying about what the future holds for their child with a developmental disability. The information presented includes vision building, as well as, the different systems that they may encounter, and the scope of service provision for each including eligibility criteria. Networking time is built into the sessions so that families have an opportunity to connect with other families facing similar concerns.
Pathways to Adult Life
• Pathways to Adult Life is dedicated to the needs of children between the ages of 14 and 19. This session is produced through collaboration between DDD, the Division of Vocational Rehabilitation Services (DVRS), the Department of Education (DOE), the Division of Disability Services (DDS), and the Boggs Center. The purpose of this training is to assist students and their families with making informed choices during the transition process from school to adult life. At these sessions, a representative from each agency provides an overview of responsibilities and their services to transitioning students. Families have an opportunity to meet their local contact representatives and follow-up with individual concerns.
Life after 21
• Life after 21 is a two-part training series designed to specifically address the concerns of students with developmental disabilities ages 19 through 21 and their families as they quickly approach the end of their education entitlement. This training provides detailed information on DDD Traditional Day Programs and Self-Directed Day Services option, DDS programs and services, DVRS resource information, and participants receive information on NJWINS (specifically for SSI/SSDI beneficiaries to make informed decisions about employment). Additionally, these sessions include the “The Provider Marketplace” which is an opportunity for families to become acquainted with agencies providing supports and services in their neighborhoods.
Find, Choose & Keep Great Direct Support Professionals
• When you are directing your own supports (Real Life Choices, Self Determination) finding great support staff within your community to help you or your family member live a good life can be a challenge and requires a wide variety of skills. In this workshop participants will learn strategies for finding direct support professionals (DSPs), making the right choice during the hiring process, teaching DSPs to do the job, and keeping great staff over time. This interactive workshop includes a toolkit with activities and worksheets for you to take home to help you grow the skills you need for the life you want.
Family Forum
The Developmental Disabilities Family Education Project helps families to: envision possibilities for a family member in community living learn about and participate in the transition process and, provide to a family member throughout the transition to community living. Family Forums are held four times per year by the Developmental Disabilities Education Project to provide families with a picture of how community living is working for people who have transitioned from developmental centers. At meetings like the Family Forum, families, provider agencies, and individuals share stories of successes and lessons learned in making the transition.
NEW BEGINNINGS FAMILY MEETINGS
New Beginnings is an introduction to the transition process and opportunities in community living.
Housing Panel
Adults who are living in or are in the process of moving into their own homes, their parents, staff from Real Life Choices, Housing Specialists who assist individuals locate their own homes, and Attorneys skilled in the nuts and bolts of Special Needs Trusts and other legal issues all provide information on the practical and technical aspects of moving into Supportive Housing. Persons with disabilities and their family members also have the opportunity to share information with each other and continue to learn about independent community based housing that people with developmental disabilities are choosing and using with success.
The Self-Directed Classroom
The Self-Directed Classroom are a series of six training session Modules intended to provide education, guidance and information to individuals and families of people with disabilities on how to self-direct. The training modules will provide instruction and give materials on the introduction of Real Life Choices (self-directed supports) how to hire, manage, and discharge direct support professional workers. The workshops will offer detailed, interactive information on how to develop, manage, create and track individual budgets.
ORGANIZATIONS SPACER
DDD
FISCAL INTERMEDIARY
SUPPORT COORDINATION
TRAINING & SUPPORT ENTITIES • Boggs Center • DD Family Education Project • Family Support Center • Neighbours, Inc.
UNIVERSAL COMPONENTS SPACER
Community Life
Each of us has something to offer to those people we are close to as well as to the broader communities in which we live and work. In fact, our connections to community provide us with quality in our lives.
A goal and outcome of self-directed supports is to enable people to: – share their gifts and skills; – to actively participate in groups, clubs, and organizations; – and to be fully participating and contributing members of their local community.
Natural Supports
In addition to the paid services identified in your plan, you may use other unpaid supports. Some examples might be: • a friend who takes you to an activity each week; • or spending Saturday with your family who will provide your support; • or a cousin stopping by to help you manage your staff. These unpaid supports, along with the services you purchase, will enable you to achieve the outcomes in your ELP.
Since these natural supports are so crucial to success, if you currently do not have them in your life, you may choose to develop a circle of support or focus within your plan on developing new connections within your community.