OPTIONS COUNSELING & TRAINING UPDATE ADRC Advisory Committee Meeting April 9, 2013 Ed Ahern ADRC Options Counseling Program Manager

Agenda Options Counseling History Options Counseling Vision Spirit of MI in Options Counseling Training Revision Training Priorities Content Clusters

Options Counseling History In 2006 – as Options Counseling discussions begun, the purpose was clear Offering someone the full range of options Helping individuals know their options so they can remain in the community Empowering individuals to make their own choices Counseling individuals on the range of public and private options Increasing the choices that a person can make Working with the person through the decision making process Helping individuals to plan Options counseling is a full service for consumers Starts with traditional Information and Referral but goes further Getting the know the consumer/person An ongoing service for consumers which could include multiple follow ups

Options Counseling History in CA 9/2011 – OC Workgroup formed to develop CA Draft Standards 10/2011 – AoA Releases Federal Draft OC Standards 12/1/11 – CA Completes Draft OC Standards, Action Plan 12/9/11 – Options Counseling Training 1 1/3/12 – Options Counseling Pilot Begins in 7 locations 2/2012 – Options Counseling Training 2 4/15/12 – Refined OC Action Plan and Guidance 6/2012 – ACL releases latest Federal Draft OC Standards 12/2012 – Workgroup releases revised version of CA Draft OC Standards

ADRC Options Counseling Definition ADRC Options Counseling is an interactive process where individuals receive guidance in their deliberations to make informed choices about long-term supports. The process is directed by the individual and may include others that the person chooses or those that are legally authorized to represent the individual.

Options Counseling Includes: A personal interview to discover strengths, values, and preferences of the individual and the utilization of screenings for public programs A facilitated decision support process which explores resources and service options and supports the individual in weighing pros and cons Developing action steps toward a goal or a long term support plan and assistance in applying for and accessing support options when requested Quality assurance and follow-up to ensure supports and decisions are working for the individual.

Options Counseling: The cornerstone of ADRC partnerships ACL views Options Counseling as both a philosophy underpinning how ADRCs interact with individuals, as well as a process that ADRC staff will follow to support individuals and families to consider their options and access the right services and supports at the right time. 7

ACL Vision for Role of Options Counseling Veterans Administration Medicaid Money Follows Person Managed Care MDS Section Q

Veterans & Options Counseling The VHA recognizes the ADRC Options Counseling Program as the front door to LTSS 9

National Options Counseling Training & Certification Vision Create shared vision for a national workforce of Options Counselors using person centered practice skills to support all individuals to get the right services at the right time in the right place Build consensus on core components of a national Options Counseling Training Program Develop, test, and finalize national training program Develop a certification program 10

Motivational Interviewing...a collaborative, person-centered form of guiding to elicit and strengthen motivation for change." 11

MI Skills in Options Counseling The Spirit of Motivational Interviewing Starts with an attitude, frame of reference or philosophy of extreme respect Respect clients wisdom, knowledge and ability to make decisions See things from client perspective Bring an attitude of partnership and collaboration MI role not to motivate or fix the problem – Evoke Spirit of MI: Partnership – Acceptance – Compassion – Evocation 12

Training Revision: Why There were a number of important factors to consider as we revised our training. Some of these factors include: Feedback from previous training participants (12/2011, 2/2012) Options Counseling pilot/evaluation (Jan – June, 2012) Options Counseling Workgroup Changing significance of the Options Counseling service as a gateway to long-term services and supports (LTSS) Continued implementation of state initiatives surrounding LTSS including the Coordinated Care Initiative (Duals Demonstration and Medicaid managed LTSS) Updated guidance from Administration on Community Living Revised CA Draft Options Counseling Standards (12/2012)

Revised Training The Options Counseling training consists of three self-paced online modules as a primer for a two-day face to face training.

Training Structure Section 1. About ADRCs & Options Counseling: A history and vision 1.Introduction 2.Section Instructions 3.Pre Test 4.ADRCs and Options Counseling – an Overview 5.California ADRC Components 6.Post Test 7.Forum 8.Resources

Training Structure Section 2. Options Counseling: The Basics 1.Section Instructions 2.Pre Test 3.Introduction to Options Counseling 4.California Draft Options Counseling Draft Standards 5.Core Competencies of Options Counseling 6.Crosswalk of CA and Federal Draft Standards 7.Post Test 8.Forum 9.Resources

Training Structure Section 3. Preparing for, Getting to and Through Options Counseling 1. Introduction/Instructions 2. Training Activity 3. Pre Test 4. What is and isnt Options Counseling? 5. OC vs. STSC vs. Care Management 6. From I&A to Short Term Service Coordination 7. Triggers to Options Counseling

Training Structure Section 3. Preparing for, Getting to and Through Options Counseling (continued) 8. Scripts That Move You (into, through and out of Options Counseling) 9. Preparing Your Mind/Spirit of Motivational Interviewing in Options Counseling 10. The Art of Active Listening Using an Action Plan 11. Post Test 12. Forum 13. Resources

Training Structure Sections 4 and 5. Face to Face Training (2 days) Involves hands-on role play. 1. Welcome, Introduction, Housekeeping 2. Warm Up Exercises 3. Getting to Know You 4. Summary of Pre-training Materials 5. Preparing Your Mind for OC 6. Motivational Interviewing as a tool in Options Counseling 7. Personal Responsibility/Choice 8. Medical vs. Social Model of Disability

Training Structure Sections 4 and 5. Face to Face Training (2 days) (continued) 9. Choice: Right to Fail 10. Special Topics –Role Play 11. Open Discussion 12. Post Training Quiz 13. Face to Face Training Evaluation 14. Resources 15. Technical Assistance

Video & Voice PowerPoint Presentations: Because theres a great deal of information to be learned as part of the training, we are working to make the training as interactive and easy for all Tools Used in the Training

Training Sneak Peek Options Counseling Training

Training Priorities Alameda County ADRC Partnership Agencies: Recipient of ADRC funding under the Hospital Discharge Planning grant San Diego ADRC Partners: San Diego will launch a VD HCBS program in July, (ACL Part B Grant) Existing ADRC Partner Agencies Newly forming ADRC partnership agencies with demonstrated commitment Money Follows the Person (MFP) Lead Organizations and Minimum Data Set (MDS) Section Q Local Contact Agencies

Content Clusters A number of topics require additional discussion, information or clarification. Content clusters will serve has a hub for comprehensive information on subjects such as: Caregivers, Decision Making, Legal Surrogacy, Veterans, Youth, Managed Care Engaging Subject Matter Experts Not part of Options Counseling training (beyond basic information) but will be available as a resource for all

Realizing that there are many existing and new ADRC partnership agencies that want to have qualified staff trained in Options Counseling, we are working to leverage other resources in order to maximize the number of training opportunities available.

Feedback Feedback from the ADRC Advisory Committee is always welcome (either directly or through the Options Counseling Workgroup) Choices – Options Counseling (CA) Technical Assistance Exchange