What It Means for HCS Participants & Their Families Hill Country Community MHMR Center March 23, 2010 Changing from HCS Case Management to Service Coordination by the Local Authority

Use of Respectful Language Texas law establishes the Mental Retardation Authority (MRA) and describes fundamental MRA responsibilities. In this presentation the following preferred terminology is used: Local Authority replaces MRA. Intellectual disability replaces mental retardation.

What is Changing in HCS? Effective June 1, 2010: People in HCS will have a new Service Coordinator from the Local Authority. A Case Manager will no longer be provided by the HCS Provider. Ongoing Person-Directed Planning, focused on the person’s desired outcomes, is the basis for HCS services. The Service Planning Team is responsible for the Person- Directed Plan (PDP).

Why Is this Change Happening? The Texas Legislature is requiring Reshaping of the System of Services for People with Intellectual and Developmental Disabilities, including: $207 million state funds for community services for 7,800 people on waiting lists (over 20,000 people to be served in HCS by 2011) Change of HCS Case Management from the HCS Provider to Service Coordination by the Local Authority in order to–  Increase quality oversight of community services  Ensure people understand their HCS options  Base necessary services on Person-Directed Planning

Current Service Coordination by the Local Authority Local Authorities have a wide range of Service Coordination responsibilities for people with intellectual and developmental disabilities, including: Single point of access to IDD services Eligibility determination (diagnostic & functional assessment) Explanation of service & support options Identification of individual service goals & preferences Enrollment (ICF, HCS & Texas Home Living waivers) Initial Person-Directed Plan for HCS Ongoing Service Coordination for Community Safety Net Services & TxHmL Community Living Options Information Process (CLOIP) in State Supported Living Centers (SSLCs)

Service Coordination in HCS Partnering with the HCS participant, family/LAR* and Provider, the Service Coordinator has continuing responsibilities while a person is in the HCS program : Person-directed planning to identify the person’s personal goals & outcomes which are the basis for HCS services (and may change over time), and Coordination and monitoring to ensure the person progresses toward desired outcomes, receives necessary non- HCS services and is healthy and safe. *Legally Authorized Representative

Person-Directed Planning: Why Is It Important? The Service Coordinator must learn and develop an understanding about the person’s preferences and goals. This is called the Discovery Process. Person-directed planning values these qualities in a person’s life: Self Determination – freedom to decide and choose what is important, including services Community Inclusion – opportunities to connect with people and participate in ordinary community activities Meaningful Relationships – close relationships beyond staff that are maintained and encouraged Natural Supports – services that do not replace supports provided by family, friends and important others

Services Planning Team Person-Directed Planning is about getting to know the person. It is important that people who know the person best, and who are invited by the person/LAR*, take part in the planning. Most often the person/LAR choose to include their HCS Provider to participate throughout service planning. State rule defines “a planning team consisting of an applicant or individual, LAR*, service coordinator, and other persons chosen by the applicant or individual or LAR on behalf of the applicant or individual (for example, a program provider representative, family member, friend, or teacher).” *Legally Authorized Representative

Planning Tools There are 3 parts of service planning for each person in the HCS program: 1. Person-Directed Plan (PDP) 2. Individual Plan of Care (IPC) 3. Implementation Plan (IP) Every year, and as needed, these planning tools are renewed and adjusted to the person’s individual needs, preferences and situation.

1. Person-Directed Plan (PDP) The Services Planning Team develops and the Service Coordinator completes the PDP. It describes: Discovery of the person’s preferences and desired outcomes The types of HCS & non-HCS services necessary to achieve desired outcomes and ensure health and safety Existing and natural supports available The PDP is updated annually and as necessary.

2. Individual Plan of Care (IPC) The HCS Provider, person/LAR and Service Coordinator work together to develop, and the Provider completes, the IPC. It describes: HCS services to be provided Amount and cost of HCS services Non-HCS services to be provided The IPC is updated annually and as necessary.

3. Implementation Plan (IP) After DADS approves the IPC, the IP is developed by the HCS Provider (unless Consumer Directed Services) with input from the person/LAR. It describes : How services and supports are delivered, including when, where and who will provide services and any related training. Outcomes identified in PDP to be addressed with HCS services. The person/LAR must agree on how services will be delivered and sign the completed IP. The IP is updated annually and revised as needed.

How Are HCS Services Affected? A person’s HCS Services will not change because of the change to Service Coordination by the Local Authority. The HCS Provider is responsible for: Developing services in a person’s IPC & hiring staff Responding to a person’s daily needs, including emergency service needs Coordinating with the Service Coordinator HCS services may be adjusted as the person’s needs change and also if the person/LAR requests different services. The person’s PDP is updated to include changing goals and service needs.

When a Person Changes HCS Providers The Service Coordinator has responsibilities whenever a person changes to a new HCS Provider, including: Providing unbiased assistance to person/LAR in selecting a new provider from all qualified providers in person’s preferred geographic area. Completing transfer records in coordination with current and future providers, submitting to DADS. Activating reassignment to new Local Authority as necessary depending on location of person’s new provider & residence.

How the Service Coordinator Stays Involved The Service Coordinator periodically contacts & visits the person at home and locations where services are received. Visits are at least every 90 days and generally more often. Contacts and visits are important for: Building relationships and communication Monitoring the person’s progress toward goals & personal outcomes in the PDP Awareness of the person’s wellbeing & possible risk to the person’s health and safety Recognizing changing support needs

Who to Contact for What Local Authority Contact Information: Hill Country Community MHMR Center Contact the Service Coordinator at the Local Authority to discuss needed services, options and choices, the PDP, and other questions and concerns. Contact the Local Authority to seek resolution to a complaint related to the role and duties of the Service Coordinator or to request a change of Service Coordinator. Contact the HCS Provider to arrange for services, including emergency service needs and to discuss service delivery and staffing roles and duties.

Again, Reasons for This Change: For Community Service System:  Increase quality oversight of services  Ensure understanding of options  Base services on Person-Directed Planning For HCS Participants:  Self Determination  Community Inclusion  Meaningful Relationships  Natural Supports