overview of positive, person-centered organization-wide ......overview of positive, person-centered...

OverviewofPositive,Person-CenteredOrganization-WidePlanning

Day1-TeamTraining

MinnesotaDepartmentofHumanServicesResearchandTrainingCenteronCommunityLiving

InstituteonCommunityIntegration

MainTopicsforDay1• OverviewofPositivePerson-CenteredPractices

– Person-CenteredPractices– BuildingaStableWorkforce– PositiveBehaviorSupport– OtherPositiveSupports

• GettingStarted!– TeamMeetings– AssessReadiness&Buy-In

• PreparingforTeamSelf-Assessment

ActivityOrganizationalIntroductions

RolesShareIdeasforGroundRules

MakingOurVisionReality

“Visionwithoutsystemsthinkingendsuppaintinglovelypicturesofthefuturewithnodeepunderstandingoftheforcesthatmustbemasteredtomovefromheretothere.”

- PeterM.Senge,TheFifthDiscipline:TheArt&PracticeofTheLearningOrganization

Year-OneTeamActivities• FormaTeam• ConfirmReadiness• TeamSelf-Assessment• ActionPlanandLong-termVision• Data-BasedDecisionMaking• MonitoringCapacityBuilding• PreparingforYearTwo

KeyElementsIncludedinCurrentInfrastructure

• Person-CenteredThinkingandPlanning• OrganizationalWorkforceDevelopment• CulturalCompetence• PositiveBehaviorSupport

TrainingDays:May,2016ThruFeb.,2017

• 5DaysForAgencyTeams- OverviewandKickOffofTeamTraining- 2DaysofSelf-Assessment- 1DayofMonitoringPractices- 1DayofSustainability

• 6TrainingDaysforCoaches• 2DaysforKeyContacts+3ConferenceCalls

Overview

CreatingtheFoundation

PositiveSupportsDefined

ReferstoAllPracticesthatIncludetheseCharacteristics:1) Person-CenteredInterventionsthatDemonstrateCultural

CompetenceandRespectforHumanDignity2) Evidence-BasedandPromisingPractices3) StrategiesforOngoingAssessmentandMonitoringat

IndividualandOrganizationalLevels4) OftenImplementedinCombinationwithMorethanOne

Practice

PositiveSupportExamples• Person-CenteredThinking/Planning– Foundational• PositiveBehaviorSupport• AppliedBehaviorAnalysis• AssertiveCommunityTreatment• CognitiveBehaviorTherapy• MotivationalInterviewing• SystemsofCare• WraparoundPlanning• TraumaInformedPractices• School-LinkedMentalHealth

All People

Some People

Few

ImplementingMorethanOnePositiveSupportPracticewithinanOrganization

Person-CenteredPractices&Planning

PositiveBehaviorSupport

UniversalStage• TeachandEncourageCommunication• EncourageandReinforceSocialSkills• Consensus-BasedAndTeamFocus• EmphasisonUsingDataFor

Decisions• IntegratedwithOtherPositive

SupportPractices(PBS,Trauma-InformedCare,Etc.)

UniversalStage• Person-CenteredThinking• EncourageSelfExpression• Self-DeterminationandChoice

Making• PredictableandProactiveSettings• MeaningfulParticipationinthe

Community

SecondaryStage• UseDatatoIdentifyIndividualsAtRisk• AdditionalSupportsforKeySocialSkills• GroupandIndividualInterventions• Function-BasedDecisions• SimpleInterventionsIntegratedwith

OtherPositiveSupports• MentalHealthandWellnessInterventions

TertiaryStage• IndividualizedPBSPlans• IntegratedwithOtherPositiveSupports(PCP,

Trauma-InformedCare,DBT,Etc.)• PlansAreEvaluatedtoEnsurePlansAre

ImplementedwithFidelity• OutcomeMeasures• TeamsMonitorProgressofEachPerson

SecondaryStage• MoreIntensiveSupportstoImproveQOL• SimpleInterventionsIntegratedWith

OtherPositiveSupports• IndependenceandCommunity

InvolvementEncouraged• MentalHealthandWellnessInterventions

TertiaryStage• IntegratedPlans(PCP,PBS,Trauma-informedTherapy)• Person-CenteredPlans• IndividualizedwithPositiveSupports• TeamsMonitorProgress

All People

Some People

Few

Multi-TierSystemsofSupport


PositiveBehaviorSupport

UniversalStage• TeachandEncourageCommunication• EncourageandReinforceSocialSkills• Consensus-BasedAndTeamFocus• EmphasisonUsingDataforDecisions• IntegratedwithOtherPositive

SupportPractices(PBS,Trauma-informedCare,Etc.)



Community

SecondaryStage• UseDatatoIdentifyIndividualsAtRisk• AdditionalSupportsforKeySocialSkills• GroupandIndividualInterventions• Function-BasedDecisions• SimpleInterventionsIntegratedwith

OtherPositiveSupports• MentalHealthandWellnessInterventions

TertiaryStage• IndividualizedPBSPlans• IntegratedwithOtherPositiveSupports(PCP,

Trauma-InformedCare,DBT,Etc.)• PlansAreEvaluatedtoEnsurePlansAre

ImplementedwithFidelity• OutcomeMeasures• TeamsMonitorProgressofEachPerson


OtherPositiveSupports• Independence andCommunity


TertiaryStage• IntegratedPlans(PCP,PBS,Trauma-informedTherapy)• Person-CenteredPlanning• IndividualizedwithPositiveSupports• TeamsMonitorProgress

Year1

“Implementationfactorsareuniversal(likegravity)andapplyequallytoanyhuman

servicesector.”

-DeanFixsen,APBS,2016

PRACTICES

SupportingStaffBehavior

SupportingAll People

OUTCOMES

ImprovingQualityofLife

SupportingDecisionMaking

14

AssumptionsforMovingForward

• BuildonOrganizationalStrengths• Identifya“Doable”ListofTasksthatcanbeAchievedthisYear

• SettingthePace– MarathonnotaSprint– ChangingEvery-DayWorkRoutines– WorkSmarternotHarder– CelebrateSuccesses

Overview:UniversalPerson-centeredPractices

“Wemustimproveourpracticestobuildaculturethatoffersandsupportsrealchoiceandcommunityinclusion.”

Minnesota Department of Human Services · PO Box 64238 · St. Paul, MN 55164-0238

Bulletin NUMBER #16-56-01

DATE February 11, 2016

OF INTEREST TO Lead agencies

Social services supervisors and staff

Public health supervisors and staff

Mental Health Supervisors and staff

Case managers

Other interested parties

ACTION/DUE DATE Please read the bulletin and prepare for implementation.

EXPIRATION DATE February 11, 2018

Lead Agency Requirements for Person-Centered Principles and Practices – Part 1 TOPIC Lead agency requirements for person-centered principles and practices for people who receive publicly funded services in Minnesota.

PURPOSE To provide a comprehensive introduction to the requirements for person-centered principles and practices, as required by federal and state rule, state statute, Minnesota’s Olmstead Plan, and a court settlement agreement.

CONTACT Send questions to [email protected]

SIGNED

CHARLES E. JOHNSON Deputy Commissioner Minnesota Department of Human Services

TERMINOLOGY NOTICE The terminology used to describe people we serve has changed over time. The Minnesota Department of Human Services (DHS) supports the use of "People First" language.

RequirementsforPerson-CenteredPractices

• OlmsteadPlan• JensenSettlementAgreements• HCBSRules• 245D• PositiveSupportsRule

WhatDoes“Person-Centered”Mean?

• TreatEachPersonwithDignityandRespect• BuildonPerson’sStrengthsandTalents• HelpPeopleConnectwithTheirCommunityandDevelopRelationships

• ListentoandActoneachPerson’sCommunication• MakeaSincereEffortOveralltoUnderstandEachUniquePerson

FiveKeyAreas

• ShareOrdinaryPlacesandActivities• MakeChoices• Contribute• BeTreatedwithRespectandHaveValuedSocialRoles

• GrowinRelationships

TLC-PCP2012 www.learningcommunity.us

ServiceLife

CommunityLife

AGoodPaidLife

MovingfromServiceLifetoCommunityLife

• Importantforaddressed• Noorganizedefforttoaddressimportantto

• Toandforpresent• Activecircleofsupport• Includedincommunitylife

• Toandforpresent• Closestpeoplearepaidorfamily• Fewrealconnections


• Importantforaddressed

• Noorganizedeffort toaddressimportantto

• Toandforpresent• Activecircleofsupport• Includedincommunitylife

• Toandforpresent

• Closestpeoplearepaidorfamily• Fewrealconnections

Focusonconnecting,buildingrelationshipsandnaturalsupports‘Importantto’ present

‘Importantto’ recognized

MovingfromServiceLifetoCommunityLife

ServiceLife

CommunityLife

AGoodPaidLife

All People

Some People

Few

CreatingaPerson-CenteredFoundationforImprovingQualityofLife




Community


OtherPositiveSupports• IndependenceandCommunity


TertiaryStage• IntegratedPlans(PCP,PBS,Trauma-informedTherapy)• Person-CenteredPlanning• IndividualizedWithPositiveSupports• TeamsMonitorProgress


Any changes an organization makes to its practices, structure or rules that result in positive differences in the lives of people. (Organization Level/Managers/Supervisors/CEO/Administrative Support).

Level1

Level2

Level3

Any changes that results in a positive difference in the lives of people who use services or in your own work life.

Any change in practice, structure and rules made at the system level. These changes have an effect on many organizations, and therefore many peoples’ lives. (Larger State Level or National Organizational or Leadership Level Issues).

LevelsofChange

GoalsFor…..

• PeoplewhoReceiveServices

• StaffatAllLevels

• Organization– AllLevels

• Community

ImportantToImportantFor&TheBalanceBetween

Discovery/ListeningTools

ManagementTools

EverydayLearningTools TLC-PCP2012 www.learningcommunity.us

Wrkbk pg 9

ACoreConcept

Importantto /ImportantforandtheBalanceBetweenThem

TLC-PCP 2012 www.learningcommunity.us Wrkbk pg 5

ImportantTOWhatisImportanttoaPersonIncludesThoseThingsinLifeWhichHelpUstoBeSatisfied,Content,Comforted,Fulfilled,andHappy.ItIncludes:

• PeopletoBewith/Relationships

• StatusandControl

• ThingstoDoandPlacestoGo

• RitualsorRoutines

• RhythmorPaceofLife

• ThingstoHaveWrkbk pg 5

ImportantFORIssuesofHealth

• PreventionofIllness• TreatmentofIllness/MedicalConditions• PromotionofWellness(e.g.Diet,Exercise)

IssuesofSafety• Environment• WellBeing---- PhysicalandEmotional• FreedomfromFear

And…whatOthersSeeasNecessarytoHelpthePersonbeValuedandbeaContributingMemberofTheirCommunity

Wrkbk pg 5

ImportantTo andFor AreConnected

• TheyInfluenceEachOther• NoOneDoesAnythingthatIs“ImportantFor”Them(Willingly)UnlessaPieceofItIs“Important”toThem

BalanceIsDynamic(Changing)andAlwaysInvolvesTradeoffsamong:• theThingsthatare“ImportantTo”• andBetweenImportant“To”&“For”

7QuestionsQuestionsYouShouldbeAbletoAnswerforEachPersonYouSupport:1. WhatisImportantTothePerson?

2. WhatisImportantForthePerson?

3. HowisImportantForAddressedintheContextOfWhatisImportantTo?

4. IsThereaGood Balance betweenImportantToandImportantFor?

5. WhatDoesthePersonWanttoLearn;WhatDoWeNeedtoLearn?

IfThePersonistoGettheBalanceDescribedandWearetoLearn:6. WhatNeedstoStaytheSame(beMaintainedorEnhanced)?

7. WhatNeedstoChange?


Cohort1Experiences

FromRecordedCommentsFebruary2,2016

ExperiencedTeamMembersShareTheirPerspective:WhatHaveYouLearnedFromTheTraining?

“WehavelearnedhowtobeaPerson-CenteredOrganization.WecameinwiththeassumptionthatwewerealreadyaPerson-CenteredOrganization.Thishasgivenuslottothinkabout.”B.H.- RSI

“This[training]allowedthesupervisorstonotfeelresponsibletofix…tohelppeoplewesupportinabetterway.”

A.M.- Rise,Inc.

“Ihavelearnedthiswayofthinkingisfarmoreoverarchingofhowwesupportaparticularpopulation…itisawayofthinkingaboutourservicesandstaff.”

R.R.- Rise,Inc.

“Itisawaytopracticecreativity,discoveryandlistening.Thosearekey.Theconceptandtoolsseemedtomakesensetome.Ihavegainedappreciationforhowthingscouldbemorecreative,howthetoolscouldbemorethree-dimensional.Thathasbeenthepowerofit—theartofthetools.“

L.K.- HennepinCounty

“WhatIhavelearnedisthat,themoretrainingIgoto,themoreimmersedIam,themoreitbecomesmorenatural.Employeesaremoreengaged.Whentheyseehowitaffectstheirlives.Thatiswonderful.”N.H.- HennepinCounty

ExperiencedTeamMembersShareTheirPerspective:WhatHaveYouChangedAboutYourOrganization?

“WehadalotofchangesatRSI.Changesabouthowwedotheplanningprocessofthepeoplewesupport.Wearereallylisteningandengagingpeoplewesupport.Previously,wehadpeopleinvolvedinplanningbutnottrulylistening.Manychangeswehaveimplementedhavebeenaboutemployees. (Thatis)Oneofthekeytransformations.Wehavefoundtheemployeeslearnedhowtheycanassistthepeopletheysupportandmakesomeofthosechangesintheirlives.Usingthetoolsandskillstoproblemsolve.Changinghiring,evaluationforouremployees.Themorewepractice,themoreweengrainedineverydayproblemsolving.”B.H.- RSI

“Foruswehavechangedmanythingsabouthowwesupportourstaff.Wehavechangedperformanceadvancementandhowwethinkaboutteammembers.Itgoesbeyondhowweplanservices,itisanumbrellaratherthanprogram.”

R.R.- Rise,Inc.

“Inannualemployeereviews,weareusingwhatisworkingandwhatisnotworkingwherebothemployeeandsupervisorgetatwhatchangeswecanmakeforthatemployee.Settinggoalsforstaffsothattheycanexcelintheirposition.”

A.M.- Rise,Inc.

ExperiencedTeamMembersShareTheirPerspective:WhatHaveYouChangedAboutYourOrganization?

“InmonthlysupervisionwiththepeopleIsupport,IusedWorking/NotWorking...Ihavebeenabletore-assignsomepeopleandofferthemnewresponsibilitiestokeepthingsfresh.Changingwords—wordsthatidentifypeoplebydiagnosis.(We)workonhowtoimprovecommunicationstylebetweendifferentdepartmentssothinkscouldbeimproved.”

N.H.- HennepinCounty

“Changednamesevenjobpostings.Beingintentional.Havingconversationsabouthowweincorporatelanguagethattalksaboutpeople.…Wehavecoreleadershipthatislookingatintegratingotherthingsaswell...Wehavesolidactionplan.….Lookingatlastyear,wewerereadybutwemovedforwardfaster.”


ExperiencedTeamMembersShareTheirPerspective:WhatHaveYouLikedTheMostAboutTheTraining?

“Differentapproach,onestructuredtohavestayingpower.Wehavedoneothertrainings—welearnedalotbutIdon’tthinkitwasstructured.Thisissetupwelltodothat.Ialsolikehowthepeoplewhoareinchargeoflevel3wereinvolved.Someofthosestrugglescouldbethingsthatmightleadtopolicychange.” B.H.- RSI

“Workingwithpeopleinmyorganization.Ireallylikedtheopportunitytogettoknowmyco-workers.Ididknowwhotheywerebutnotatthislevel.Co-training– allofthecoaches.Workingacrossoursilos.”A.M.- Rise,Inc.

“Beinginvolvedwithotherdiversegroupsofpeople- UofM,DHS,andfolksthatserveresidential,employmentandhowitfosterscreativity.”


“Iamabigpictureperson.IappreciatedthespiritofPCTandhowitcanchangehowyoudothings.ItissomethingItalkaboutallofthetime.Ithasbeenthedrivingforceofalotofdifferentthings.Allofthesethingsaredonebetterwhenwedoitinapersoncenteredway.Acommonlanguage…” R.R.- Rise,Inc.

ExperiencedTeamMembersShareTheirPerspective:WhatAdviceWouldYouGive?

“…Reallybeingstrategic.Whatcanwekeepdoingthatisnaturalwithwhatwearealreadydoing?Wherearestretchopportunities?”L.K.- HennepinCounty

“Bethoughtfulaboutwhoisinyourleadership.Besureyouaregivingyourcoachesthetimetheyneed.Theyaregoingtobethekey.”B.H.- RSI

“Makeitnatural—whenusingthetoolsjustdoitnaturally.Whenemployeesseethat,theyaremoreopentodoitthemselves.”N.H.- HennepinCounty

“Don’ttoonarrowlydefinehowitmightbeused.Iencourageyoutothinkaboutsomethingthathasthepotential.Beopentoyourentireorganizationbeingimpacted.Irecommendyouincludeyourleadership.”R.R.- Rise,Inc.

“Embracethechange.Changecanbehard.Addthetoolsnaturally.Bethoughtfulofhowyouincludeyourcoaches.Includethosewhoalreadyconsideredtheywerepersoncentered-itisokaytohave“aha”moments.…wegotbiggerrealizations.”

A.M.- Rise,Inc.

Person-Centered Organizational Development Tool

Assessment,Discovery,Exploration

1. Wehelpindividualsidentifyandachievetheirdesiresanddreams,notjudgethem.

2. Weusestrategiesandtoolstodeterminewhatisimportanttopeopleandwhatisimportantforthem.

3. Aperson’sexpectationsanddesiresdirectservicegoalsandpriorities.

PlanningPractices4. Individualsdirecttheplanningprocessandinvolveanyother

supporterstheychoose.5. Weprovidesupportstoensureindividualsareabletomake

informeddecisions.6. Wecommunicateinformationinplainlanguageandrespondto

anindividual’scommunicationneedsandpreferences.7. Weensuretheindividual’sserviceplanisresponsivetoand

respectfulofanindividual’shistory,needs,interests,culture,preferences,desiresanddreams.

8. OurplanningprocessensuresthatwhatisimportantTOpeoplewillbesupportedandthatwhatisimportantFORpeoplewillbeaddressedinsideofwhatisimportantTOthem.

9. Weeffectivelymanageriskandincorporateitintotheplanningprocess,honoringthedignityofrisk.

10. Plansareflexible;theyarereviewedandupdatedasanindividual’sdesiresandgoalschange.

CommunityParticipationandInclusion

11. Weensureourservicesandsupportsprovideopportunitiestoenhancecommunityparticipation.

12. Weactivelyworkwithourcommunitymembersandwesupporttheminconnectingwith,including,andvaluingthepeoplewesupport.

13. Peoplearesupportedtomaintainanddevelopvaluedsocialroleswithintheircommunities.

14. Wepromoteandprovideappropriateopportunitiesforcommunity-basededucation,employment,andvolunteeringtothepeoplewesupport.

CurrentLevelofSupportsandServices

15. Informedchoicesshapeaperson’splanandhowservicesareprovided.

16.Wearecreativeinfindingwaystohelpindividualsachievetheirgoalsandworkwithotherorganizationstoaddressservicegaps.

17. Weprovidesupportsandservicesthathelpindividualsliveandstayinthecommunity.

18. Thedesiresanddreamsoftheindividualswesupportareactedupon.

19. Weprovidesupportsandservicescustomizedtothecurrentneedsanddesiresoftheindividual.

20. TheservicesandsupportsweofferensurethatwhatisimportantFORpeopleisaddressedinsideofwhatisimportantTOthem;ourservicesandsupportshonorwhatisimportanttopeople.

21. Weofferawidevarietyofsupportoptionswhenpossibleandcollaboratewithcommunitypartners.

OrganizationalDesignAndProcesses

22. Ourmission,vision,andvaluesreflectperson-centeredandpositivesupportsandservicesthroughouttheorganization.

23. Staffhavethetrainingandskillstoofferperson-centeredandpositivesupportsandservices.

24. Staffhavetheresourcestoofferperson-centeredandpositivesupportsandservices.

25. Wearewillingtochangepoliciesandpractices(includingjobdescriptions,resources,expectationsandstaffrecognitionprocesses)toensureindividualsreceiveperson-centeredsupportsandservicesthatmaximizechoice,control,anddirection.

26. Staffaretrainedinandareusingpositivesupportpracticesandinterventions.

27. Weprovideopportunitiesforindividualsandtheirfamiliestoengageinleadershiprolesandshapeourstrategicplaninmeaningfulways.

28. Weprovideresources(time,money,criticalstaff,etc.)toinitiativesdesignedtoenhanceourorganization’sabilitytoprovideperson-centeredandpositivesupports.

EvaluationofPersonCenteredPractices

29. Thequalityofsupportsandservicesisroutinelymeasuredandresultingdataisusedinorganizationalplanning.

30. Staffisregularlyengagedinassessingandimprovingprogramsandservices.

31. Weengageparticipants,theirfamilies,andtheiradvocatesinevaluatingoursupportsandservices.

32. Wecollaboratewithotheragenciesandstakeholdersasamechanismforqualityimprovement.

33. Weusefeedbackfromstaffandparticipantstoinformdecisionsaboutserviceimprovements.

Activity1

SplitYourAgencyGroupinHalf• OneHalfCompletesAreas1,4,5• OneHalfCompletesAreas2,3,6• WhenBothGroupsareDone,SharewithOneAnother

Overview:PreparingforImplementation

AssessingOrganizationalDesignStrengths&WorkforceRelatedNeeds

WhatisOrganizationalDesign?

• ALookatAll ProcessesandPracticeswithinanOrganizationfor:– AlignmentwithMission/Vision/ValuesandPurpose– AlignmentwithEfficientandEffectiveUseofResources(Creativity,Technology,Streamlined,etc.)andOngoingViability(Surplus,Etc.)

– AlignmentwithGrowthandDevelopment(Visioning,BuildingTowardtheFutureWhileAttendingtoToday,StrategicRisk)

– IntheContextAvailable(Laws,Regulations,Demographics,ResourceCostandAvailability,etc.)andAnticipated(WhatcanwePredict?)


Any changes an organization makes to its practices, structure or rules that result in positive differences in the lives of people. (Organization Level/Managers/ Supervisors/CEO/Administrative Support).

Level1

Level2

Level3

Any changes that results in a positive difference in the lives of people who use services or in your own work life.

Any change in practice, structure and rules made at the system level. These changes have an effect on many organizations, and therefore many peoples’lives. (Larger State or National Organizational or Leadership Issues)..

LevelsofChange

Wrkbk pg 8

AligningthePCPSOrganization• StartattheBeginning:Mission,Vision,Values-DotheyFully

AlignwithPerson-Centered/PositiveSupportpractices?• Enrollmentofcriticalstakeholders

• ClarifywhoWeServe(“Specialty/Niche”or“AnyonewhoNeedsServices”)

• NeedsAssessment(WhataretheGapsBetweentheMission,Vision&ValuesandCurrentProcesses).Lookat:• Whowehire?Aretheytherightfit?• Howwetrainandsupport• Howwealignresources• Policiesandpracticesinallpartsoftheorganization(notjustdirect

support)• Structures(funding,buildings,locations,job

descriptions/expectations,etc.)• Whatwemeasure/Howwemeasure(QualityofLife,satisfaction

withservices,achievementofgoals)

Time,Effort,AndCommitmentMustMatchGoals

LeadingandManagingThroughChange

DiscontentistheEngineofChange


• AnythingYouareHappywithYouWanttoStaytheSame

• YouareOnlyInterestedinChangeWhenThereisDiscontent

ThereAreAre2KindsOfDiscontentØ Cynical

Ø Optimistic

DoWehavetoomuchCynicalandnotenoughOptimistic?

CynicalDiscontent


WhenYouhaveDiscontentwithoutHopeYouGetCynicalDiscontent.

CynicalDiscontentResultsIn:

OptimisticDiscontent


RequiresHopeandisBasedonTrustthatisCreatedwhenthereIs:

• AHistoryofActingonThingsthatcanbeChanged

• HonestyaboutThoseThingsthatwillTakeTimetoChange

• ProgressinActingontheThingsThatTakeTime

WhereCynicalDiscontentisDominant…TrustmustbeCreated

WhoareOurPotentialStakeholders?

• PeopleSupported• PeoplewhoCouldBeSupported

(IfWeDidaBetterJobwithMeetingRealNeeds)

• Families• OrganizationBoard• Employees• PotentialEmployees• AffiliatedServicesand

Organizations• CommunityMembers(All

Types)• CMS/ACL- HCBS• DHS

• Licensing• LeadAgency• CaseManagers• TheLearningCommunity/SDA• OtherFederalAgencies

(SAMHSA)• ADRCs• UofM• AdvocacyGroups• CourtandStaffingAroundthe

JensenSettlement/MNOlmsteadPlan

• NADSP• Others…


ImplementationofPersonCenteredPracticesRequires:

• APromisetoListen• ToListentoWhatisBeingSaidandtoWhatisMeantby

WhatisBeingSaid• ToKeepListening

• APromisetoActonWhatWeHear• ToAlwaysFindSomethingthatWeCanDoTodayor

Tomorrow• ToKeepActingonWhatweHear

Wrkbk pg 12


ImplementationofPersonCenteredPracticesRequires:

• APromiseToBeHonest• ToLetPeopleKnowWhenWhatTheyareTellingUswilltakeTime

• WhenWedonotKnowhowtoHelpThemGetWhatTheyareAskingfor

• WhenWhatthePersonisTellingUsisinConflictWithStayingHealthyorSafeandWeCan’tFindaGoodBalanceBetweenImportantToandImportantFor

Wrkbk pg 12

MakeSuretoShareOften&KeepNetworking

• Newsletters• PersonalMeetings• InformationSessions• Blogs/Vlogs• StaffMeetings• Committee/BoardMeetings

• CommunityEvents

WorkforceChallenges

0

1

2

3

4

5

6

7

BackintheDay! Yesteryear Today Tomorrow

MismatchBetweenPoolofWorkersandNeedForWorkers

Poolofworkers Peopleneedingsupport

RiskManagement&SupportedDecision-Making

Data-DrivenDecision-Making

• DecidehowYouwillKnowYouareSucceeding

• FindtheRightMeasure:– FocusedontheRightThings

– Reliable/Helpful– Doable(NotTooComplex-JustEnough)

• UseIt toGuideNextSteps

Overview:PositiveBehaviorSupport

BuildingAPositiveSocialClimate

PositiveBehaviorSupportProvidesaFrameworkforPrevention

Intensive,IndividualInterventions• IndividualswithIntenseNeeds• Assessment-Based• HighIntensity• AppropriateforProfessionalsAcross

AgenciesandSystems

MostPBSEffortsonlyRespondWhenTertiarySupportsAreNeeded

“It’sawholeshiftinparadigmoffightingfirestobuildingcapacitywithintheorganizations--whetheritisacontractedserviceproviderorresidentialordaytreatmentprogram....Iseeourroleas...helpingpeoplebuildcapacity...”

H.M.- HumanServicesProfessional

FocusonPrevention

MajorGoalsOfUniversalPBS

1. PromotePositiveSocialInteractions2. DesignPositive,Proactive,Predictable

Environments3. EstablishData-BasedDecision-Making

Systems

Practices

Simple Strategies

Plans

Primary TierUniversal Intervention Strategies

Organization-WideFrameworktoImproveQualityofLife

YEAR1FOCUSFORTEAMS

PositiveSupportsareImplementedinManyTypesofOrganizations

• ResidentialSupports• Employment• ChildrenandFamilyServices• MentalHealth:Center-WidePositiveBehaviorSupport

• NursingHomes/ElderCare• Facility-widePositiveBehaviorSupport• SchoolandDistricts• EarlyChildhood

67

PBSAssumptions

• WeareInterdependent– WeAllHelpEachOthertobeOurBetterSelves

• EveryoneCanImproveHis/Her SocialSkills• EvenWhenWeKnowtheRightWaytoModelGoodSocialBehavior,Wedon’tAlwaysChooseto

“AlmosteverybodyIworkwithhas‘behavior’,includingstaff,thatisproblematictothemonadailybasis.Imeanweneedtonotthinkofitas[problembehavior]”

--PersonSupportingPeopleWithTraumaticBrainInjuryinKansas

“Youcan’tchangeanyoneelsebutpeopledochangeinrelationshiptoyourchange.Allrelationshipsareasystem,andwhenanyonepartofasystemchanges,itaffectstheotherpart.”

- JackCanfield

“Peopledon'tresistchange.Theyresistbeingchanged.”

- PeterM.Senge

Function-BasedThinkingIdentifyWhyWeEngageinBehaviors– EscapeorAvoid

• People• Situations• Things• InternalPhysiologicalResponse

– ObtainAccessto• People• Situations• Things• InternalPhysiologicalResponse

ReplaceProblemBehaviorwithAPositiveAlternative

“Peoplemustbehavetheirwayintonewideasandskills,notjustthinktheirwayinto

them.”

- MichaelFullan

PeopleInvolvedinImprovingSocialInteractionsTogether

• PeopleReceivingServices• StaffMembers• Family• Guardians• CaseManagers• CommunityMembers

UniversalPBSMeansBuildingaPositiveSocialExperience

EveryoneWorksTogetherTo:• List KeyPerson-centeredValues• Identify theSocialBehaviorsthatReflectTheseValues

• Create aPlanforIncreasingSocialInteractions

• Support andRecognizeEachOther,HelpEncourageandPrompt

• Celebrate Success

SocialBehaviorsthatarePerson-Centered

• EmpowerPersontoLeadMeetings• ProvideOpportunitiestoMakeChoices• UseActiveListeningSkillsWhenSpeaking• AskaboutUniqueCulturalCharacteristicsthatDefineaPerson

• RepeatWhatSomeonehasSaidtoConfirmUnderstanding

ReinforcingthePositive!• BeClearWhenYouAreReinforcingSomeone

“ThankYouforHelpingAnnePuttheGroceriesAway.”

• WatchforOpportunitiestoPromotePositiveSocialInteractions

• Give4PositiveStatementsforEveryDemand/Correction

FocusonOurValuesinAction• CelebrateSuccesses!• ModelandPracticeSocialInteractions• EmphasizetheValueofSocialInteractions

“Mindfulnessmakesitpossibletoseeconnectionsthatmaynothavebeenvisiblebefore.Butseeingtheseconnectionsdoesn’thappenasaresultoftrying—itsimplycomesoutofthestillness.”

- PeterM.Senge,Presence:AnExplorationofProfoundChangeinPeople,

Organizations,andSociety

WeAllPerceiveBehaviorDifferently• LoudArgumentscanbePunishingtoSomePeoplebutConsideredEntertainingbyOthers

WeAllRespondToBehaviorDifferently• PeopleWhoEnjoyArguingandDebatingGoOutfor

DrinksAfterward• PeopleWhoareInsultedbyArgumentsWillAvoid

GoingOutforDrinks

Data-BasedDecisionMaking• AssesstheEnvironmentforPerson-Centeredness• Organization-wideMeasures

– Retention/Attrition– Climate– StaffInjury

• ChangesinOurBehavior– UseofPerson-CenteredThinkingTools– IncreaseinPositiveSocialBehavior

• Self-AssessmentChecklist• OnsiteEvaluationTool• DecreasesinSeriousIncidents

ImprovingOurDataSystems

• UseDataWeAlreadyCollect• MakeSureDataareCollectedinanAccurateManner

• ImproveConsistencyofOurResponsestoProblems/Crises

• WhenisaProblemReallyaProblem?

TheRoleofthePBSFacilitator• 1-2PeopleinEachOrganization• ExperienceFacilitatingPBS• ProvideSupportforUniversalStrategies• ProvideGuidance/MonitoringforPBSPlans

• IntroducePBSViaOrientationandIn-serviceTraining

• MentorNewStaffLearningtoFacilitatePBS

WhyisitHelpfultoInvestinPBSFacilitatorTraining?

• SupportsOngoingTraininginUniversalPositiveBehaviorSupport– Orientation– In-service

• AssistinMonitoringandEarlyIdentificationofPeopleinNeedOfAdditionalSupport(Year2)

• SupportTeam-BasedMonitoringofProgressAcrossBehaviorSupportPlans(Years2/3)

• FacilitateIndividualPBSPlans• MentorNewStaffMembersinIndividualizedPBS

GettingStarted

BuildingtheTeam

Leadership Team

Visibility

Training Mentoring Evaluation

Active Coordination

Start Small And Build On Success

OrganizationandCountyPlanning

Interagency & Natural Supports

PCT, PBS (Other PS) Expertise

FundingPoliticalSupport&Policy

GettingStarted

• FormanOrganization-WideTeamthatRepresentsAllStakeholders

• AssessReadinessandBuyIn• CompleteaSelf-Assessment• CreateanActionPlan• UseDataforDecisionMaking• MakeChangestoImproveOutcomes

GettingStarted

• FormAnOrganization-wideTeamthatRepresentsAllStakeholders

• AssessReadinessandBuyIn• CompleteaSelf-Assessment• CreateanActionPlan• UseDataforDecisionMaking• MakeChangestoImproveOutcomes

RoleoftheTeam

• CreateaPilot– StartwithPartoftheOrganization– IdentifyWhoCoachesandKeyContactsInteractwith

– SharePlanwithStaffandConfirmInterest

• ConductaSelf-AssessmentofStrengthsandNeeds

• Developa3-YearVisionandanAnnualPlan• ShareResponsibilitiesandTasks• EstablishEffectiveTeamProcess

TeamMembers

CoreTeamRepresentation(PlanningAndCoordination)• Administration• Management• Coaches• KeyContact• DirectSupport

ExpandingInputMeeting2-3Timesa Year• PeopleReceivingServices• FamilyMembers• Guardians• CaseManagers• Community• Administration• Management• Coaches• KeyContact• DirectSupport

BuildingInternalCapacity

• ApplytoOrientationandIn-serviceTraining

• Person-CenteredThinkingTrainers• PictureofaLifePlanningFacilitatorsandTrainers(orOtherPerson-CenteredPlanning)

• PositiveBehaviorSupportFacilitator• CoachTraining

Coaches

• IdentifyPlanswithStaffforUsingToolsAcrossPilotArea

• EncourageUseofPCTTools• CoachMeetingsandTrainingsforSharingIdeas• HelpKeyContactsCollectInformation

Key Contact Roles

• Prompt Team to Meet Regularly• Bring Team Additional Information • Share Questions and Issues with Trainers • Work with Team to Gather Data• Collaborate with Coaches

WorkingTogether:CoachesandKeyContacts....

• Aren’tExpectedtoHaveAlltheAnswers• ShouldbeAbletoDescribeBasicsofPositivePerson-CenteredPractices

• MakesSureMeetingsareScheduledandRemindsPeopletoAttend

• “PositiveNag”toEncourageActionPlanActivitiesareCompleted

• TroubleshootswithOtherCoachesandKeyContacts

Organization/ County Teams

BuildingEffectiveSupportNetwork

StateTeam

ICIAndRegionalTrainers

Team

KeyContact Coaches

SupportNetworkAndDataCollection

StatewideTeam

Cohort2Region1

RegionalTrainer

Organization1KeyContact




Cohort2Region2

RegionalTrainer





MinnesotaTrainingInfrastructureCommunicationPathway

ReviewOfFidelityTool

Freeman, R, Amado, A., O’Nell, S., Reichle, J. & Julien, H. M. (2015). Minnesota Organization self-assessment and action planning tool for positive supports. Minneapolis, MN: Institute on Community Integration. University of Minnesota.

1

Minnesota Team Implementation Checklist: Planning Tool for Integrating Person-centered and Positive Support Practices

Organization: ______________________________________ Date: ____________________________

Region: _______________________________________ County: __________________________

INSTRUCTIONS: The organization-wide team should complete checklists quarterly to monitor activities for implementation of positive supports selected by the organization. Please complete as a team and submit quarterly to: _________________________________________

Team Members: ______________________________________________________________________

Person(s) Completing Report: __________________________________________________________

Checklist #1: Start Up Activity

Put an “X” in the column that fits where the team is in the planning process for each numbered item on the checklist.

Not Started (0 points)

In Progress (1 point)

Achieved (2 points)

Team 1. Team established (administration, management, direct support staff, county staff, etc.).

2. Team has regular meeting schedule. 3. Plan is completed for including feedback in planning process from people living and/or working in setting, and families, guardians, case managers, etc.

3. Team has clear purpose and vision that aligns with the person-centered values identified.

4. Team has an effective meeting process. 5. Team has Key Contact.

6. Administrator’s support & active involvement (attendance in meetings, support for systems change, etc.).

Staff Commitment

7. Staff members are aware that the organization is implementing person-centered and positive support practice(s).

8. Team assesses readiness of people to participate in each person-centered and positive support practice(s).

9. Staff members are directly involved in organization-wide planning.

ScoringtheMNTeamChecklist• ImplementationPoints

– Achieved =2– Inprogress =1– NotStarted=0

• PercentageofItemsImplemented– Total

ü NumberofItemsScoredas“Achieved” DividedbyTotal#ofitems

– SubscaleScoresü NumberofItemsinEachSubscaleAreaScoredas“Achieved”DividedbythenumberofItemsinThatSubscaleArea

• PercentageOfPointsImplemented– Total

ü TotalNumberofPointsAchievedDividedbyTotalPossible– Subscalescores

ü TotalNumberofPointsinEachSubscaleDividedbyTotalNumberofItemsMultipliedby2

WhathastheTeamAccomplished?

WhatAreasshouldtheTeamWorkonNext?

0102030405060708090

100

%im

plem

ented

MNTeamImplementationChecklist

PreYear1

SubscaleItemsontheChecklist

ResultsOfTheMNTeamChecklist

0

10

20

30

40

50

60

70

80

90

100

Team Commitment SelfAssessment

ActionPlanning

StaffDevelopment

Evaluation Visibility Overall

Pre

Year1

%Im

plem

ented

SubscaleItemsontheChecklist

WhathastheTeamAccomplished?

WhataretheTeam’sStrengths?

0

10

20

30

40

50

60

70

80

90

100

May

-08

Oct

-08

Dec

-08

Mar

-09

May

-09

Dec

-09

Oct

-07

Oct

-08

Dec

-08

Mar

-09

May

-09

Sep

-08

Dec

-08

Feb-

09M

ay-0

9O

ct-0

9D

ec-0

9

Feb-

09M

ay-0

9O

ct-0

9D

ec-0

9

Oct

-08

Dec

-08

Feb-

09M

ar-0

9M

ay-0

9O

ct-0

9

Sep

-08

Dec

-08

Feb-

09M

ar-0

9M

ay-0

9O

ct-0

9

Sep

-08

Dec

-08

Mar

-09

May

-09

Oct

-09

Dec

-09

Oct

-09

Oct

-09

Oct

-09

Oct

-09

Oct

-09

1 2 3 4 5 6 7 8 9 10 11 12

In-P

lace

Sta

tus

n= 7 Active Organizations by Checklist Date

MN Team Implementation ChecklistExample of Summary Data

% Partial Implementation% Full Implementation

BreakoutActivity2

• PleaseCompleteItems1- 7• ConsiderHowYouWill:

– InvolveAllStakeholdersinMeetingProcesses

– DiscusstheTypesofStrategiesthatMightWorktoHelpYourTeamCommunicatewithStaff

SystemsChange

• ChangeOccursWhenEveryoneIsActivelyInvolvedinDecisionMaking

• ChangeisaPersonalExperience• MandatesandDirectivesCanHaveNegativeImpactonMorale

BuildingConsensus

• IdentifyAreatoStartConsensusBuilding• ReadinessandStaffCommitment

– Share– Vote

• InvolvingPeopleinDecisionMakingIncreasesLikelihoodofRealChange

• CreativityofOurPeopleisImpressive

AssessingInterest&Commitment

• 80%StaffSupportforImplementation• 3-YearActionPlan,ProgressOccursOverTime• BehaviorisOneofTop3GoalswithinOrganization• AllStaffAgreetoParticipateinImplementation

– EncouragingandModelingSocialInteractions– BuildingPerson-CenteredValuesintoEverydayActions– ParticipatinginDecisionMaking– ReinforcingandRecognizingPositiveSocialInteractions

WebinarOpportunityForStaff

• Purpose:IntroducePerson-CenteredandPositivePractices

• Date:June23,2016,9:00-10:00a.m.• RecordedEvent:ViewDuringMeetingorIndependentViewing

IdentifyWaysToCommunicate

• TeamMeetings• StaffMeetings• Trainings• CoachMeetings• OtherEvents• Newsletters• WebsiteBuildintoExistingCommunicationWheneverPossible

BreakoutActivity3

• PleaseCompleteItems8-12• ConsiderhowYouwill:

– InvolveAllStakeholdersinMeetingProcesses

– DiscusstheTypesofStrategiesthatMightWorktoHelpYourTeamCommunicatewithStaff

TeamSelf-AssessmentPreparingforTeamTrainingDays2and3

ImplementingtheVision

“Whenthereisagenuinevision(asopposedtotheall-too-familiar‘visionstatement’),peopleexcelandlearn,notbecausetheyaretoldto,butbecausetheywantto…”

- PeterM.SengeTheFifthDiscipline:TheArt&PracticeofTheLearningOrganization

TeamTrainingDays2&3

• FormAnOrganization-WideTeamThatRepresentsAllStakeholders

• AssessReadinessandBuyIn• CompleteASelf-Assessment• CreateAnActionPlan• UseDataForDecisionMaking• MakeChangesToImproveOutcomes

KeyElementsofSelf-assessment

• Person-CenteredandPositiveSupportsUsedinOrganization

• AlignmentofOrganizationalPolicies• OrientationandIn-serviceTrainingSystems• OrganizationalData

– QualityofLifeEvaluation– BehaviorInterventionReportForm– Attrition,SickDays,Etc.

Self-Assessment:Person-CenteredPractices

• Person-CenteredThinkingTrainings• Person-CenteredPlanners• IntroducingPerson-CenteredPracticestoNewStaff

• TypesofOngoingStaffDevelopment• NumberofPCTTrainersNeeded• Coaching

Self-Assessment:PositiveBehaviorSupport

• PositiveEnvironmentAssessment• SocialClimateandValuesinAction• StrategiesforReinforcement• StaffAwarenessofPBS• NumberofPBSPlansNeeded

BringTheFollowingToNextTraining!

• OrganizationMissionandVision• PoliciesforPromotingQualityofLife,

PreventionofProblemBehavior,CrisisResponse,etc.

• OrganizationalToolCompletedToday• FidelityAssessmentTools

BringTheFollowingtoNextTraining!

• InformationRelatedtoOrientationandIn-serviceTraining

• OrganizationalSurveys(Climate,Other)

• SurveysandOtherDocumentationRelatedtoQualityofLife

• InformationaboutOtherPositiveSupportsUsedinOrganization

BringTheFollowingToNextTraining!

• EvaluationDataAlreadyCollected• ExamplesInclude:

– BIRFSummaryofData– IncidentReportPatterns– QualityofLifeSummaryData– SurveysofStaff– InformationRelatedtoRetention,WorkersCompensation,StaffInjury,Climate,etc.

BreakoutActivityDiscussSelf-AssessmentListinActivityNotebook• PleaseCompleteItem13• QuicklyReview14-36(MostAreNotStartedandWillBeCoveredinLaterTrainingDays)

• KeyContacts:PleaseTurnintheTeamChecklistBeforeLeavingToday

• WeWillSendYouGraphstoShowYourProgress!!!

Sample Annual Action PlanActivity Person(s)

Responsible Date Completed

1. Policy and Procedure Assessment Meetings Set With Review of Action Plan

Admin Coach

September

2. Dedicate 15 Minutes to PBS in Staff Meeting Establish Agenda Prior to Each Meeting

Key Contact Coach

October

3. Work With Pilot Group to Identify Person-centered Values and Social Behaviors

Team November

4. Create Plan for Pilot Group to Celebrate Success Together at Weekly Roommate Meetings

Team September -October

5. Expand team membership and Set Larger Community Meeting Twice a Year - Recruit Family Member and Guardians - Invite Self-advocates - Identify Community Members

Team Members & Staff Delegated to Work on Task

December

6. Share Information About Progress on Agency Website Team November

7. Develop and pilot acknowledgement system for Staff Team November

8. Review use of PCT Tools in Coaches Meeting and Assess Progress

Coaches

January

CalendarReminders

ReviewofCalendarTableforRegion

ThreePost-itNotes

• WhatdidyouLIKEabouttoday?

• WhatdidyouLEARNtoday?

• WhatwouldyouCHANGEabouttoday?

Preparationofthis[presentation/report]wassupported,inpart,bycooperativeagreementJPK%50470fromtheMinnesotaDepartmentofHumanServices.TheUniversityofMinnesotaundertakingprojectsundergovernmentsponsorshipareencouragedtoexpressfreelytheirfindingsandconclusions. Pointsofvieworopinionsdonot,thereforenecessarilyrepresentofficialMNDHSpolicy.

overview of positive, person-centered organization-wide ......overview of positive, person-centered...

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