Principles and Practices of PersonCentered Planning: Detroit Area Agency on Aging November 30, 2005

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Principles and Practices of Person-Centered
PlanningDetroit Area Agency on
AgingNovember 30, 2005

• Pam Werner
• Specialist
• Michigan Department of Community Health
• 320 S. Walnut
• Lansing, MI 48913
• E-mail wernerp_at_michigan.gov
• Phone [phone]

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Introductions
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Independence Plus Initiative

• Goal 4 To introduce into the MI Choice 1915 c
  Waiver for Elders and persons with physical
  disabilities the concepts, principles and
  practices for supporting arrangements that
  provide consumers/beneficiaries choice and
  control over defining, selecting, directing and
  purchasing needed services and supports.

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History of Person-Centered Planning

• Documented by Canadian advocates and Judith Snow
• Adopted by national advocates service delivery
  systems
• 1976 Lanterman Act requires an IPP, becoming law
  in California
• 1994 Howell Group of Michigan publishes
  definitions
• 1995 advocates lobby for inclusion in the
  technical amendments of the Michigan Mental
  Health Code
• April 1996 person-centered planning process is
  required when developing a plan of service
  (330.1712)
• 2005 Michigan Medicaid Long Term Care Talk Force
  recommends and requires the implementation of
  person-centered practices

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What is Person-Centered Planning?

• process
• relationships
• responsibility
• shifting power
• choice
• trust
• respect
• partnerships

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Preplanning FundamentalsThe Person Chooses

• who is invited to their meeting
• where the meeting is held
• when the meeting is held
• what is and is not discussed
• who assists in the facilitation
• who will assist in carrying out activities in the
  plan

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FundamentalsWe Need to

• Listen to what the person is telling us
• Understand what the person wants
• Know what we can and cant do
• Provide choices, flexible services and supports
• Develop a group of champions/support network to
  support the persons desires and preferences
• Assist the person in developing partnerships and
  community connections

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Person-Centered Planning is not

• Doing whatever anyone wants without looking at
• Health Safety
• When addressing health and safety
• The individual must be a partner in discussing
  their concerns
• Supports to address health and safety need to be
  documented

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Medical/Behavioral Framework

• Start with what is wrong with the person
• Assess issues of health and safety
• Determine what the person can/cannot do
• Assessments of adaptive behavior
• Strengths and needs list
• Plans that describe how to keep the person
  healthy and safe and that make them more
  independent

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An alternative approach

• Start with how the person wants to live
• Learn what is important to the person in everyday
  life
• Assess issues of health and safety
• Assess what the person might want to learn to get
  more of what is important

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An alternative approach

• Plan with the person
• Describe what is important to the person
• Describe what others need to know or do to
  support the person
• Addressing any issues of health or safety in the
  context of how the person wants to live
• Offer opportunities for learning that help the
  person get more of what the person wants

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An alternative approach

• As the person is getting more of what is
  important in everyday life
• Look for opportunities for them to spend time in
  places and doing things where they are welcomed
  by the others there
• As you build connections look for opportunities
  to establish and nurture relationships
• Seek to discover what the person might like in
  the future and help them move in that direction

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Principles and Values ofPerson-Centered Planning

• Every person has strengths, gifts, and
  contributions to offer.
• Every person has hopes, dreams and desires.
• Each person, and those who love the person, are
  the primary authorities on his or her life.
• Every person has the ability to express
  preferences and to make choices.
• A persons choices and preferences shall always
  be respected.

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Ten Points to Listening

• Believe that the person has something to give and
  is of value
• Help people discover their gifts
• Listen with an open mind
• Listen to dreams and visions, not just to what is
  in the present
• Listen without hurrying

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Listening (continued)

• Listen to fears and pain
• With no intent to fix or control anyone
• For words that actions may not reveal
• Listen to recognize opportunities
• Knowing that things take time
• From Ten Points to Listening by Pat Beeman, taken
  from A guide to community Membership for Older
  Adults with Disabilities, University Affiliated
  Program of Indiana, Training Resource Network,
  St. Augustine, FL

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What about people who dont use words to talk?
We must listen creatively

• What makes the person happy or sad?
• What comforts the person?
• Ask those who know the person best
• Share knowledge ask questions

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People Map
Home Supports
Friends
Family
Community Participation
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Important Qualities of a Facilitator

• Non-Judgmental
• Respectful
• Supports Values of the Person
• Warm and Friendly
• Team Builder
• Flexible
• Well Prepared
• Creative
• Good Listener
• Shares Power
• Assertive

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A Facilitator

• Clarifies What is Important to and What is
  Important For the Person
• Synthesizes Information
• Keeps the Focus on the Person and What They Want
  and Need
• Brings People Together to Support the Person
• Encourages Creativity
• Works as a Partner with Others
• Summarizes Discussion

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A Facilitator(continued)

• Encourages Trust Building
• Seeks input From People Who Know and Care
• Checks With the Person Before Making Assumptions
• Assists in Resolving Conflict
• Places the Focus on the Persons Dreams Making
  Things Happen
• Provides Timely Feedback to Others
• Assists in Developing/Strengthening Natural
  Supports/Friendships

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What is a Natural Support?

• Natural Support is someone who is involved in a
  persons life, other than just for pay
• Natural supports are built person by person
• Natural supports must be reciprocal with both
  individuals benefiting
• Natural supports can be family, friends,
  neighbors, co-workers, club members, and anyone
  the person chooses to spend time with

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Current Opportunities to Document Person-Centered
Info into The MI Choice Waiver Forms

• Care Plan
• Contact Log
• Assessment
• Re-Assessment
• Other?

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Gathering Person-Centered Information

• Start with a conversation
• Using a people map discuss who is important to
  the person and who is in their circle of support
• If family, friends circle members are not present
  discuss with the person if others need to be
  contacted and how information from chosen people
  will be gathered
• Ask the person how they want to spend their day.
  What is working and what is not working from
  their perspective
• Ask what the person feels they need. Ask
  questions to clarify if what they said is what
  they really want

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Gathering Person-Centered Information (cont.,)

• Keep the focus on the person!
• When others answer for the person, check to see
  if the individual agrees, direct non-verbal
  behavior and questions to the person
• Document the persons preferences and indicate
  when they are honored
• Discuss and document strengths, abilities and
  gifts the person has to offer

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Gathering Person-Centered Information (cont.,)

• When assessing/addressing the 30 targeted areas
  document what the persons routines and rituals
  are
• To assist with developing and strengthening
  community connections area(s) of Social Function
  and Brittle Support System can be targeted

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Person-Centered Stories
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Seeking Advice from the Experts

• Your Thoughts.
• Is this information new?
• Is this information redundant?
• Is this information helpful?
• How do you see person-centered planning and
  person-centered processes provided in the MI
  Choice Waiver?
• What is the role of the person receiving services?

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Some Thoughts..

• Quality Person-Centered Planning takes time
• People who spend the most time with the person
  need to receive adequate amount of training,
  mentoring and coaching
• Subcontract agencies need training, mentoring and
  contract requirements to support person-centered
  planning
• Discussion of consumer choice and control needs
  to be kept in the forefront with consumers
  leading as equal partners

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More Thoughts

• All documentation requirements need to be
  examined.
• Paper must have a purpose
• We need to strive for a balance between paper and
  delivering valued chosen services
• To truly implement person-centered processes
  agencies must operate as team

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Quality cannot be inspected into a product
Inspection to improve quality is too late, too
costly, and too ineffective. Quality must be
designed in. Deming, 1991
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Organizational Elements Necessary to Promote
Person-Centered Processes

• Vision
• Leadership
• Organizational culture rooted in trust and
  respect
• Team development, participation, and support
  provided throughout the organization
• Viewing all problems and issues through the lens
  of helping people get the lives they want
• Developing/strengthening consumer, family and
  advocacy partnerships
• Developing/strengthening community alliances

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Improving Effectivenessin Self-Advocacy

• Consumers as Equal Partners
• Board membership
• Committee membership
• Part of the selection team for hiring staff
• Paid for their participation
• Employed in the organization at all levels
• Directing and leading the process as equal
  partners
• Connected to the community through active
  membership

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