Overview of Positive, Person-Centered Organization-Wide ......Overview of Positive, Person-Centered...
Transcript of 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
Person-CenteredPractices&Planning
PositiveBehaviorSupport
UniversalStage• TeachandEncourageCommunication• EncourageandReinforceSocialSkills• Consensus-BasedAndTeamFocus• EmphasisonUsingDataforDecisions• 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• Independence andCommunity
InvolvementEncouraged• MentalHealthandWellnessInterventions
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
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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
TLC-PCP2012 www.learningcommunity.us
• 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
Person-CenteredPractices&Planning
UniversalStage• Person-CenteredThinking• EncourageSelfExpression• Self-DeterminationandChoice
Making• PredictableandProactiveSettings• MeaningfulParticipationinthe
Community
SecondaryStage• MoreIntensiveSupportstoImproveQOL• SimpleInterventionsIntegratedWith
OtherPositiveSupports• IndependenceandCommunity
InvolvementEncouraged• MentalHealthandWellnessInterventions
TertiaryStage• IntegratedPlans(PCP,PBS,Trauma-informedTherapy)• Person-CenteredPlanning• IndividualizedWithPositiveSupports• TeamsMonitorProgress
TLC-PCP2012 www.learningcommunity.us
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?
TLC-PCP2012 www.learningcommunity.us
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.”
L.K.- HennepinCounty
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.”
L.K.- HennepinCounty
“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?)
TLC-PCP2012 www.learningcommunity.us
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
TLC-PCP2012 www.learningcommunity.us
• AnythingYouareHappywithYouWanttoStaytheSame
• YouareOnlyInterestedinChangeWhenThereisDiscontent
ThereAreAre2KindsOfDiscontentØ Cynical
Ø Optimistic
DoWehavetoomuchCynicalandnotenoughOptimistic?
CynicalDiscontent
TLC-PCP2012 www.learningcommunity.us
WhenYouhaveDiscontentwithoutHopeYouGetCynicalDiscontent.
CynicalDiscontentResultsIn:
OptimisticDiscontent
TLC-PCP2012 www.learningcommunity.us
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…
TLC-PCP2012 www.learningcommunity.us
ImplementationofPersonCenteredPracticesRequires:
• APromisetoListen• ToListentoWhatisBeingSaidandtoWhatisMeantby
WhatisBeingSaid• ToKeepListening
• APromisetoActonWhatWeHear• ToAlwaysFindSomethingthatWeCanDoTodayor
Tomorrow• ToKeepActingonWhatweHear
Wrkbk pg 12
TLC-PCP2012 www.learningcommunity.us
ImplementationofPersonCenteredPracticesRequires:
• APromiseToBeHonest• ToLetPeopleKnowWhenWhatTheyareTellingUswilltakeTime
• WhenWedonotKnowhowtoHelpThemGetWhatTheyareAskingfor
• WhenWhatthePersonisTellingUsisinConflictWithStayingHealthyorSafeandWeCan’tFindaGoodBalanceBetweenImportantToandImportantFor
Wrkbk pg 12
MakeSuretoShareOften&KeepNetworking
• Newsletters• PersonalMeetings• InformationSessions• Blogs/Vlogs• StaffMeetings• Committee/BoardMeetings
• CommunityEvents
WorkforceChallenges
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2
3
4
5
6
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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
Organization2KeyContact
Organization3KeyContact
Organization4KeyContact
Cohort2Region2
RegionalTrainer
Organization1KeyContact
Organization3KeyContact
Organization4KeyContact
Organization2KeyContact
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.