Learning Objectives•Key milestones in our history•Working together to impact change•Outcomes and results•Our roles to influence change•Your role to influence change•Challenges faced•Tips for others•Questions

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Tri-Counties Regional Center•One of 21 nonprofit regional centers; contracted by California Department of Developmental Disabilities

•Operate under guidance of Lanterman Act legislation since 1969

•Support 12,300 people in Ventura, Santa Barbara and San Luis Obispo counties

•280 employees in six regional offices

•200+ service providers; more than 1400 programs and services

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Early Efforts (1995-2002)•Focused on person centered plan development.•We were helping some people get better lives… one person at a time.•Effort was usually by those who were Essential Lifestyle Planning (ELP) trainers…there was not broad adoption of the principles.

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• A few naturals identified

• The look of the plans changed

• Not consistent or supported across the agency

• No sustainability plan

• Lack of buy in from leadership: no one person responsible

• No system to support learning

• Slow progress lead to cynical discontent

Early EffortsWhat we learned

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“Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.”

~ MARGARET MEAD

Person Centered Change at Tri-Counties Regional

Center6

Laying a StrongerFoundation

• Omar Noorzad, PhD hired as Executive Director 2003

• Developed competencies as basis for selection and performance management

• Code of Ethics-partnership• Operations (OPS) and Services

Review Committee (SRC)• Universal Service Expectations

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“It’s time for you to !#%@&!

or get off the pot!

~ MICHAEL SMULLThe Catalyst

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Bold Steps at TCRC

1. People First Language

2. Developed Person Centered Thinking Taskforce

3. Pilot Teams - Start Small and Grow

4. Embed in Strategic Plan of organization

5. One Page Profiles

6. Ensure sustained attention of Leadership: Person Centered In All We Do 9

Training & CoachingPeople First LanguageCommunities of PracticePositive & Productive MeetingsPerson Centered Reviews in SchoolsPerson Centered Employee DevelopmentCA Gathering for Person Centered Practices

“Person centered practices help us do our work better and take our good practice to the next level to provide great support.”- LIZ RODGERS, PCT TRAINER, EASTERN LOS ANGELES REGIONAL CENTER

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What has Changed?Six organizations

tell their story

Tri-Counties Regional Center

People Creating Success, Inc.

PathPoint

Channel Island Social Services

Genesis Developmental Services

Eastern Los Angeles Regional Center

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• People who receive services are more involved in planning and conducting their own meetings

• Resulting in better staff matches with the use of Matching Support skill

• Contributing to a decrease in staff turnover and an increase in satisfaction of employees and persons served by the regional center

• Implementing with part-time to full time workforce; additionally with unionized, entry to experienced level workforce

The ImpactWhat has changed as a result of this work.

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• PCT Trainers/Mentors are building capacity in other parts of CA.

• PCT provides a common language, set of standards and set of tools to communicate effectively, create clear goals and plans that actively support those we serve.

• Research confirms PCT is a promising practice.

• Organizations are modifying business practices and procedures to reflect a more person centered philosophy leading to individual, organizational and system level changes.

The ImpactWhat has changed as a result of this work.

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Measuring & Aligning

UCSB Evaluation Project

Annual Services and Supports Survey

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“Not only do the TCRC staff interviewed acknowledge the positive changes resulting from PCT Initiative and practices at the organizational level, they also believe that PCT practices have made changes on a personal level, affecting positively both their professional and personal lives.”~MIAN WANG, PHD, UNIVERSITY OF CALIFORNIA, SANTA BARBARA

Impact on Staff

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“Adults with developmental disabilities, receiving services from providers with a higher level of involvement in Person Centered Thinking practices, report a significantly higher perceived quality of life (QOL) than those served by providers with a lower level of involvement in Person Centered Thinking practices.”~ MIAN WANG, PHD, UNIVERSITY OF CALIFORNIA, SANTA BARBARA

Impact on Adultswe Support

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Annual Services and Supports Survey

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Our Role in Growing Person Centered Practices:

• What is one example of a level 2 change we assisted in to further strengthen our person centered practices?

• How did this level 2 change make a difference?

• Why is it important in our role to continue to move level 2 changes forward?

TCRC Team Shares

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Your Role in Growing Person Centered Practices:

• What is your role or what are the roles you currently have to influence level 2-3 change to strengthen person centered practices?

• What is one example of a level 2-3 change you have contributed to?

• What is one new way you might try to create more level 2-3 changes?

Participants Share

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Ongoing Challenges

• Time• Growing caseloads and

documentation requirements• Capturing and sharing learning• Early resistance to change• Changing legislation in

California• Budget reductions that affect

caseload ratios• Staff turnover• Geography, size and scale

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Our Next Bold Steps

Re-Imagined Person Centered Practices Collaborative

Restored and Expanded Training Initiatives

Technology Accelerators

Influencing Level 2 and Level 3 Changes

Five Levels of Staff Engagement

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2010 Tri-Counties Regional Center in partnership with Channel Islands Social Services, Genesis Developmental Services, Inc., PathPoint Inc., and People Creating

Adapted for electronic editing by United Response

Taking ownership and practice of PCT on their own Contributing to wider effort; serving on committees,

changes to PCT curriculum, tools, making good great! Building a strategic network Identifying new areas of improvement and applications

of the work Facilitating at Communities of Practice or training, Contributing stories to agency newsletter or examples

of their work Facilitating more complex meetings Coaching others how and where to use the PCT

approaches Initiating conversations about level 2 changes Using as a personal standard of practice Generating interest and enthusiasm from others Helping the agency/communities figure things out -

facilitate the "hard discussions" - look at organizational issues in addition to the individual

Opportunities to take a lead at (i.e.: COP, present at SO CA Gathering, become a trainer)

Helping them balance existing work load to what they choose to do

Good coaching Recognition for contribution

Regular participant at Communities of Practice Sharing learning with partners Sharing ideas and learning, modelling PCT tools Facilitating more complex PCT tools Using the tools to plan and resolve differences

with partners Introducing PCT to new partners, families and

individuals; encouraging persons served to become facilitators and/or trainers of PCT

Opportunities for further training and development; (Moving from PCT Description to PCT Plan (IPP), Facilitation Skills, PCT Teams, PCT Approach to Risk- adults, PCT Community Connecting)

PCT Review, PCT Coaching, Positive and Productive Performance Development, One Page Profile Training, attend SO CA Gathering )

Develop capacity to coach others

PCT tools being used at meetings Introducing a PCT tool in a meeting Sharing learning when asked Experience value of a tool Talking about it at meetings Figured out how applies to job, using it

and describe benefit Seeking out opportunities to practice, additional trainings, attend

Communities of Practice

Opportunities to facilitate PCT tools and reflect on learning with others

Provide training; (Suggested trainings: Positive & Productive Meetings, PCT Supervision)

Person Centered Team Training Access to shared learning ( PCT Task Force,

Communities of Practice, On Line list serve for resources)

Recognized for their participation; staff want to feel that it matters

Practice People First Language Trying to figure out how it relates to their job/s Observing or seeking out opportunities to observe; trying to

learn in a way that is safe Seeking opportunities to practice with colleagues Asking questions; acknowledge what we still want to learn Practicing the tools in a supportive environment

Develop a one page profile with manager (with instructional support to managers)

Observe tools being facilitated in staff meeting or in field

Access to coaching to learn how to apply PCT tools in different situations

Provide opportunities to practice (Communities of Practice, Staff In Service, Tool Time, games, etc)

Add’l training options (Oh No Not Another Meeting)

Completed PCT training Have been exposed to the training with no personal

next steps taken May or may not be committed Compliance not commitment Have been introduced to basic PCT concept Shared values

PCT principles introduced at New Hire Orientation Regular coaching in the form of PCT Supervision &

modelling of PCT tools from supervisor Intro to PCT in introductory period Performance goal targeting PCT skill development Provide information about agency’s expectations,

vision, mission, values, purpose, Code of Ethics

Becoming person centered:

What good support looks like:

On the left is a sequence of behaviors that are often observed as a staff member moves from first being introduced to person centered thinking to being fully engaged and actively contributing to a person centered organizational culture. On the right we list what good support would look like along the way.

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PCT Operating Principles – Listen, Be Realistic and Commit, Collaborate and Act

1. Listen for understanding 2. Be honest and realistic about your commitments and about what you can and cannot do 3. Practice collaborative decision making 4. Act on what you hear

PCT Behaviors

Listen for Understanding Assume the positive and possible Demonstrate objectivity Check for understanding before responding/acting Respond in a timely manner Seek input by those affected by a decision Be Realistic Be aware of scope of responsibility and authority Consider what is Positive and Possible Be honest about you can and cannot do Commit Determine what you can do Follow-through on what you have said you will do Practice collaborative decision making Honor and solicit different perspectives before making decisions Create working relationships internally and externally – Create and use a framework of information for collective decision making Act on what you hear Model respectful language Take initiative to act when hearing a need and opportunity Bring closure

Take responsibility for your personal choices and actions

• Highlighting success stories through Spirit of Excellence, TCRC intranet

• One Page Profiles becomes first page of IPP

• Quarterly meetings with specialized providers (SLS, Employment)

• Focused partnership with Family Resource Centers

• Convening PCT Trainers and Mentors across California to share learning and identify needs/trends

• Introducing other curricula and resources to reinforce person centered principles

InfluencingSystem Change

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• Person Centered Collaborative evolving to a regional strategic leadership group

• Two California Gatherings for Person Centered Practices

• Statewide Collaborative Training Group practicing Positive and Productive Meeting Principles

• Self Determination legislation requires training in person centered planning

• DDS educational video regarding TCRC approach to medication error improvement planning

• CMS ruling to include language about person centered planning

• Efforts to secure electronic signature practices

InfluencingSystem Change

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Advice for OthersGetting Started

Secure buy-in

Establish the right leadership

Train all staff

Foster a culture of learning and innovation

Align policies and procedures

Implement together

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Advice for OthersSustaining the Practice

Be strategic

Engage stakeholders

Establish accountability

Develop training infrastructure

Share learning

Focus on outcomes

Seek opportunities to influence

Share success stories

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It’s a Journey not a Destination

“An agency making this journey needs to realize that this is an ongoing process. To achieve excellence one must maintain patience and persistence. Mastery may be elusive, but one must strive to move closer and closer to the target.”~ RON DODGEN, CEO, GENESIS DEVELOPMENTAL SERVICES

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“Greatness is not a function of circumstance. Greatness,

it turns out, is largely a matter of conscious choice,

and discipline.”

~JIM COLLINS

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M

Thank you!

Mary Beth LepkowskyAssistant Director, Training & Organizational Developmentmlepkowsky@tri-counties.org(805) 884-7208

Tina Calderaro-MendozaPerson Centered Thinking Coordinatortinac@tri-counties.org(805) 823-2304

Tri-Counties Regional Centerwww.tri-counties.org

Learning Community for Person Centered Practiceswww.learningcommunity.us

For online viewing of “Building Capacity for Person Centered Practices”http://issuu.com/regionalcenter/docs/building-capacity-for-pct

Start anywhere…but start somewhere•Organization•Community•System

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“Change begins with planning with the person served and supported rather than planning for them.”~ UCSB EVALUATION REPORT

AIM for Change

AwarenessImplementation

Measurement 32

Staff Perspective: • Empowered individuals and families served• Enhanced satisfaction of individuals and

families served• Built better community relations for families

and individuals served

Adult and Family Perspective: • Listened to and treated respectfully• Given choices to share issues that are

important to them• Empowered to make decisions and set their

own desired goals• Satisfied that their message gets fast

response• They commented that communication is less

formalized

The UCSB Evaluation

Impact of Person

Centered Thinking on

lives of adults and families

served33