slide 2 (of 64) welcome to the training partnership housekeeping notes for the day: cell phones...
TRANSCRIPT
Slide 2 (of 64)
Welcome to the Training Partnership
Housekeeping notes for the day: • Cell Phones• Elevators are located…• Ramps & automatic doors are located…• Schedule including breaks…• Act 48 Credits…• Certificates of Completion…• Follow-up Surveys and Evaluations…• Reimbursement…• Questions
Slide 4 (of 64)
The Pennsylvania Training Partnership for People with Disabilities and Families
• Achieva
• Institute on Disabilities at Temple University
• Mentors for Self Determination
• Self-Advocates United as 1
• Vision for Equality
Five organizations across the state are working in unison
to bring trainings on the Mental Retardation system to
people who receive supports through this system. They
are:
Slide 6 (of 64)
The Partnership is funded by theOffice of Developmental Programs (formerly
the Office of Mental Retardation), Department of Public Welfare.
This presentation has been reviewed and approved by the
Office of Developmental Programs (ODP).
Slide 7 (of 64)
What Will You Learn Today?• What is an Individual Support Plan (ISP)?
• How is the ISP used?
• What kind of information is included in a plan?
• What is an outcome?
• How do I write outcomes that will lead to the life I want?
™ Supports Intensity Scale 2004 AAIDD
When We Think About What is Important to Us in Life, We May Think of:
Everyday Lives
CommunicationCommunity Inclusion
Source: Everyday Lives, Making It Happen Booklet, November 2001, Pennsylvania Department of Public Welfare, Office of Developmental Programs
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What Is An Individual Support Plan (ISP)?
• The ISP is a planning document.
• In collecting rich and vital information about a person, the ISP can be a supportive document.
• The ISP is a tool to outline supports and services to drive a good quality of life.
The ISP outlines, through outcome statements, the actions people need to take to ensure a safe, healthy and happy life for a person.
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Why is an Individual Support Plan Important?
Because:• It is a plan to support the goals and dreams of a person.• It is a plan to make sure all of your needs are met.
• It is the contract between the person and the Administrative Entity/county for the supports and services.
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What Should Happen at Individual Support Plan Meetings?
• People come together with the person to talk about what is important to the person and what he or she wants his/her life to look like.
• All important aspects of life should be discussed; all the person’s needs, health, safety, medical, etc.
• Identifying services and supports that will help support a person’s choices.
• Most importantly, the team will make commitments to action, so that the plan will actually happen.
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who have information that
will help reach the person’s goal who are willing to teach
the person a new skill
who support the person
who are willing to take action on the person’s
behalf
who can help the person make his or her vision for the
future happen
whose opinions the person valuesPeople:
Who Should Be at the ISP Meeting?
who may share a common
interest
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Can People Who Don’t Use Words To Talk Participate in their
Individual Support Plan?
?
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“Nothing About Me Without Me!”
Team members must honor and expect that:
• ALL people for whom ISPs are completed can contribute to their meeting and ISP development.
• ALL people for whom ISPs are completed can drive their ISP meetings.
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Promoting Full Participation and Leadership at the Meeting
• Self-advocacy – start young with membership on teams.
• Communication tools – systems, devices, therapies to assist with communication.
• Communication chart – tool to help us understand what is being said.
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Promoting Full Participation and Leadership at the Meeting (cont.)• Essential Lifestyle Planning (ELP)
tools – many tools to help us learn about a person and what is important and meaningful to a person.
• Decision-making tools and systems – to help people make choices about their lives.
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An Individual Support Plan (ISP) is a plan developed by the person and his or her team to assist in gaining the support the person needs to live the life he or she envisions.
Vision of the Future
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Exercise: Vision for the Future
Think about what is important to you or your
family member. Think about the values you or
your family member holds. With those in the
back of your mind, imagine what life looks like
5 years from now.
Slide 21 (of 64)
Creating a Good Plan• People who are involved in the
planning process need to really know the person.
• The person’s plan addresses all his or her identified needs.
• The person’s plan for the future must be clear and respected by all.
• Think creatively about all of the ways someone could be supported to live the life of his/her choosing.
The Planning ProcessGATHERING
INFORMATION
PUNS IM4Q
SIS and PA Plus
Person-Centered Plan
Other assessments
PUTTING ISP INFORMATION TOGETHER—
Team input
Outcomes/goals
Identify supports
FUNDING FOR ISP
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Some Things to Think About For the Plan• Home living • Community living • Employment• Health and Safety• Teaching and Education• Behavior• Social• Protection and Advocacy
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Let’s Look at the Individual Support Plan
• Individual preferences• Medical• Health and Safety• Functional Info• Financial• Services and Supports• Monitoring
Slide 25 (of 64)
Individual Preferences
What makes sense
Desired activities
Know and Do
Like and Admire
Important TO
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Like and Admire
• Include what other people think!– What qualities do we
admire about the person?– What personality traits do
we like?– What makes this person
unique and valuable?
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Know and Do• Details about what we KNOW about the person.• Details about how what we know influences
what we DO.• Make sure the DO section of the plan is strong.• If done right…
• Helps prevent people from teaching the same things over and over.
• Can really help ensure that people get support the way that works best for them.
• Important that it is written in plain language.
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Desired Activities• The person’s interests and vision should lead the
discussion.• Should reflect the person’s likes.• Never include what other people think!
– What does the person enjoy? – How does he/she like to spend his time? – Where would they like to live or work?
NEXT STEP: Ask how can we increase opportunity for desired activities that will enrich his/her life?
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Important TO• Consider all areas of life:
– Friendships and relationships – Living arrangement– Employment opportunities or current job situation– Spiritual or faith community
• Could include information about what kinds of people I need to support me.
• Never include what other people think should be important!
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• All people balance what is important TO them and what is important FOR them.
• Important TO are things that really matter to someone.
• Important FOR are things to keep someone healthy and safe.
Balance of Important TO and Important FOR
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What Makes Sense• Gathers information from different perspectives
about what is currently working in a person’s life.– Use individual’s perspective– Use the family’s viewpoint– Use the support staff’s or friend’s viewpoint
• Also gives insight into things that are not working or don’t make sense.
• This will help inform outcomes later on in the planning process.
Slide 33 (of 64)
Medical• Names of various doctors and their
contact information
• Prescription/medication information
• Do you take your medicine independently?
• Allergies
• Track appointments and frequency of doctor visits.
• Brief Medical History
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General risks and safety precautions
• Fire safety• Traffic safety• Kitchen safety
Water safety (including
temperature regulation)
Outdoor appliances
(for example, lawn mower)
Self-identifying information
Health and Safety
Sensory Concerns
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Supervision: intensity and
staffing
Behavior support plan
Stranger awareness
Meals/eating
Who is designated to support the person in making health care
decisions?
Health promotion
Health and Safety
• Learning conflict resolution skills
• Learning about social expectations and social boundaries
• Knowing how to act in different places
• Accessing and obtaining mental health support like counseling and therapy
• Knowing when to get support if things are not going well
• Controlling anger and aggression
How Will the ISP Help the Individual If There Are Behavioral Concerns?
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Functional Information• Physical development
• Adaptive/self help
• Learning/Cognition
• Communication
• Social Emotional information
• Educational/vocational information
• Employment
• Understanding Communication
Slide 38 (of 64)
Understanding Communication
It is essential that everyone understands what someone says and how they say it. This section should be clear, concise, and detailed!
Communication ChartWhen this is happening (or just happened)…
I do this…. It usually means…. And I want you to…
#3• In the environment
• What’s just gone on
•The “trigger”
#1 (or 2)• The behavior
• What others notice
• Can be seen, heard, and felt by others
#2 (or 1)• Meaning of the behavior
• What the emotions and feelings are
• What’s going on inside
#4• What other people should do in response
• Or not do…..
Slide 40 (of 64)
Exercise: Understanding Communication
• Use the chart from the ISP section called “Understanding Communication” to write out a couple of ways that either you, a family member or someone you know communicates without words.
Slide 41 (of 64)
Financial Information
• This section describes a person’s income and any financial management issues.
• It also looks at available resources, such as bank accounts.
• People with disabilities need to be aware of the limits on income and resources that may affect their eligibility.
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What is an Outcome?
Outcomes shouldreflect the priorities,dreams and hopes of the person.
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Use phrases that link the needed service to the goals or desires of the individual:
“…in order to…”
“…so that…”
“…to ensure that…”
“…to enable her to…”
Developing Outcome Statements
What are examples of outcomes important to you or your family member?
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Supports and Services: Outcome Actions
OUTCOMES… SERVICES and
SUPPORTS……are used by your
Supports Coordinator,
based on your input, to
determine which
services and supports
are needed and funded!
…are directly tied to
one or more of the
outcomes and should
promote the outcomes!
Slide 45 (of 64)
The Outcome Actions section is where you talk about what needs to be done.– What are the needs?– What steps need to be taken to achieve the outcome?– Who is responsible?– How often and for how long will the action be needed?– How will we measure progress?
Supports and Services: Outcome Actions
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How Do Outcomes Relate to Services and Supports?
• Using outcomes as the guide, the team determines what services and supports are needed.
• Remember services and supports are directly connected to one or more of the outcomes.
• Services and supports must outline the actions needed to promote the outcomes.
• “Outcomes supported by MR funding must be within the context of the health and safety of the person and assuring their continued life in the community.”
Slide 47 (of 64)
After the ISP is written, with
outcomes and the supports and
services needed to achieve
them, the budget is drafted and
attached.
Slide 48 (of 64)
Your Budget Should Be:• Developed with the Supports
Coordinator; • Submitted to the Administrative Entity
(AE)/county;• Once approved by the AE/county,
returned for your records.
Once your plan is AUTHORIZED and APPROVED, you can
start making contact with qualified Medicaid waiver
providers to secure the supports and services outlined in
your ISP.
Slide 49 (of 64)
If You Have A Waiver…
• The ISP is your plan for services and supports and must be approved by the AE/county.
• Authorized services in the ISP must be provided.
• If they are not provided, you can request dispute resolution, and/or Fair Hearing.
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Remember Tips for Creating a Good Plan
• People who are involved in the planning process need to really know the person.
• The person’s plan addresses all his or her identified needs.
• The person’s plan for the future must be clear and respected by all.
• Think creatively about all of the ways someone could be supported to live the life of his/her choosing.
Slide 55 (of 64)
A Good Plan Should Help Us Answer These Questions:
• Can we describe the person to a stranger so the stranger might say I would like to meet that person?
• Can we name 5 of the most important things TO that person?
• Does everyone close to that person know what the person’s vision is for his/her life in 6 months, 1 year…5 years?
• Does everyone know his/her role in helping that person to live the life that s/he wants to live?
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Your Plan Should Be A Life Story…
YOUR life story!
Everyone should have a
plan whether or not
there is funding
available.
Slide 57 (of 64)
What If I have Questions About the Individual’s ISP?
• Contact the Supports Coordinator.
• If something needs to change, gather the team and have a new meeting to address the issue.
• ISPs should change with the changes in a person’s life.
Slide 60 (of 64)
The Learning Community for Person-Centered
Practices for all the tools they continue to give us
and the use of some of their concepts and graphics
for this presentation.
The Picture Communication Symbols™ ©Mayer-
Johnson LLC. All rights reserved worldwide. Used
with permission.
Special Thanks To:
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Resources
• ODP Customer Service 1-888-565-9435.
• Community Advocates working out of the regional Disability Rights Network offices – #1.800.692.7443 or www.ppainc.org
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ResourcesPerson-Centered Planning Resources• www.elpnet.net• www.inclusion.com • www.allenshea.com/friendsCircles of Support
www.circlesnetwork.org