Person-Centered Consumer HCBS Education & Gathering Representative Names June 2017

AGENDA Learning Objectives HCBS Updates Representative Name(s) Educating Consumers about Limitations Talking to Providers about Limitation Areas

LEARNING OBJECTIVES Participants will: Understand expectations and actions for identifying a representative for future use if an consumer can not longer consent. Have a basic understanding of the new HCBS rights and of the expectations of educating consumers in a person-centered manner about these rights; and begin advocacy on behalf of consumers wishing to exercise their rights. Understand how to get technical assistance and/or get HCBS-related questions answered.

HCBS UPDATES CMS extended timeline three years (to March 2022) for all states. Proposed solution for “Inability to Consent” under construction. Rollout of formal Individually-Based Limitations documentation moved out from July 1, 2017; proposed new date is July 1, 2018. Beginning July 1, 2017, at reassessment: Request “Client Representatives”; and Provide HCBS rights education & advocacy

HCBS TRANSITION PLAN: JULY 2017-JUNE 2018 Today we will cover: Ensuring consumer’s “Client Representative” information is up-to- date; Educating consumers in a person-centered manner about their HCBS rights; Advocating for consumers with their Providers.

HCBS TRANSITION PLAN: STARTING JULY 2018 Next year, we will: Assist consumers that have a health/safety risk, and: May not be able to safely exercise their HCBS rights; or May not understand the consequences of their decisions. Formally document any limitations to a consumer’s HCBS rights.

“CLIENT REPRESENTATIVE” July 2017 At intake and reassessment, request “Client Representative” information for: 1. Guardian 2. Spouse 3. Adult Child(ren) 4. Parent(s) 5. Adult Sibling(s) 6. Other Adult Relative(s) 7. Adult Friend(s) New Policy: Get as many as possible!

“CLIENT REPRESENTATIVE”

“CLIENT REPRESENTATIVE” What if there is no one from the list??? 1. Guardian 2. Spouse 3. Adult Child(ren) 4. Parent(s) 5. Adult Sibling(s) 6. Other Adult Relative(s) 7. Adult Friend(s) Support consumers with developing new relationships

APPOINTED REPRESENTATIVE(S) July 2018 If the consumer: Is no longer able to make LTC decisions; and Does not have a “Client Representative”; and A LTC-related decision has to be made… The State will appoint a representative. We will attempt to locate a rep using the list from the “Client Representative” slides. If none are found, we will appoint someone. OAR 461-115-0090(3)

APPOINTED REPRESENTATIVE(S) JULY 2018

HCBS, IN A NUTSHELL What is the point of HCBS? In-Home Institution To make Home and Community-Based Services, and the settings where they are delivered, as home-like as possible. In-Home Institution HCBS NOT HCBS *As we go over the next few slides, think about whether you have consumers who do not currently have some of these HCBS Rights.

HCBS RIGHTS, FREEDOMS & PROTECTIONS Freedoms, Rights, Protections that may not be limited:   Access to the broader/greater community Services in an integrated setting Accessible setting Control of personal resources Privacy, dignity, respect, freedom from coercion and restraint* Residency agreement Services in a private room if desired Services in a non-disability setting if desired Work, if desired Person-Centered Planning and Plans

HCBS RIGHTS, FREEDOMS & PROTECTIONS 1. Access own food at any time 2. Choice in who roommate is in shared units 3. Control own schedule and activities 4. Decorate/Furnish 5. Freedom from Restraint 6. Locks on bedroom/living unit door 7. Visitors of own choosing at any time

HCBS RIGHTS, FREEDOMS & PROTECTIONS Access own food at any time Explain what it means Assess what is happening Take action/advocate

HCBS RIGHTS, FREEDOMS & PROTECTIONS Choice in who roommate is in shared units Explain what it means Assess what is happening Take action/advocate

HCBS RIGHTS, FREEDOMS & PROTECTIONS Control own schedule and activities Explain what it means Assess what is happening Take action/advocate

HCBS RIGHTS, FREEDOMS & PROTECTIONS Decorate/Furnish Explain what it means Assess what is happening Take action/advocate

HCBS RIGHTS, FREEDOMS & PROTECTIONS Freedom from Restraint Explain what it means Assess what is happening Take action/advocate

HCBS RIGHTS, FREEDOMS & PROTECTIONS Locks on bedroom/living unit door Explain what it means Assess what is happening Take action/advocate

HCBS RIGHTS, FREEDOMS & PROTECTIONS Visitors of own choosing at any time Explain what it means Assess what is happening Take action/advocate

PERSON-CENTERED EDUCATION Does the individual understand? YES: Go over the “HCBS Visual Fact Sheet” handout and leave it with him/her. Talk about his/her goals and how to reach them. NO: (e.g., advanced dementia) May not directly have a conversation May not leave materials May observe the environment May talk to people who are important to the individual

PERSON-CENTERED ADVOCACY When talking to providers about a resident’s HCBS right that is not available at this time, ask: How can we make that happen? Is there a way to make progress in small steps?

LET’S TALK How might you approach the: After going through the slides today, you have already thought about consumers in your caseload who do not currently have all of their HCBS rights. How might you approach the: Consumer who wants to have all their HCBS rights today? Provider who is not fully allowing all HCBS rights at this moment in time?

PUTTING IT ALL TOGETHER Document “Client Representative” in OACCESS Count in-person HCBS education as direct contact Any follow-up with provider or consumer may be a direct or indirect contact, as appropriate

HCBS Q&A CALL-INS We want your questions! We can talk about the tough cases. Call-In Ph# 1-888-204-5984 Participant# 3983866 Dates Times Friday, July 7, 2017 10:00 AM – 12:00 PM PDT Friday, July 14, 2017 Friday, July 21, 2017 Friday, July 28, 2017 Wednesday, August 9, 2017 1:30 PM – 3:30 PM PDT Wednesday, August 23, 2017 Tuesday, September 5, 2017 Tuesday, September 19, 2017

MORE HCBS QUESTIONS? Provider Questions: General: HCBS.Oregon@state.or.us CBC-Related: CBC.Team@state.or.us AFH-Related: APD.AFHTeam@state.or.us AAA/APD Staff Questions: Contact: Bob Weir Chris Angel