Kelly Miller, DODD Service and Support Administration rule OAC 5123: OACB - SSA Forum August 28, 2013

History lesson  Background of current rule - HCFA visit, need for increased service coordination, CAFS went away, HB 94…  Rule was effective in 2005, reviewed in 2010 with no changes.  We have learned a lot since 2005 as a system!  QA work group met over the last year and made recommendations to DODD to rescind SL QA rule and replace it with other functions.

WHY change?  We want to focus less on paper and more on the person.  We want to embrace and promote increased self-advocacy efforts.  We need to create efficiencies within the system and focus our resources where they are most needed.  We believe the culture needs to shift more toward “listening to and learning from” the people we serve.

SSA rule revisions  Workgroup met for several months  Stakeholders all agreed on changes needed to improve the rule  Likely will be filed by fall with training after and implemented late 2013  You are getting the advanced version of the training today

SSA rule continued  Deletes the term “single point of accountability” and replace it with “primary point of coordination”….discuss!  Shift focus from one of control to a more person centered approach…language changes throughout rule.  Increase self advocacy at all levels, including requirements in ISPs.

SSA rule continued  Redefines the term “team” so it is clear…  Adds new language about “decision making responsibility” and deletes the term “daily representative” in accordance with statute.  Allows an individual to request a different SSA from the county board.

Assessment  Assessment language has changed to focus on what is “important TO and FOR” the individual and to promote their desired outcomes.  Annual assessment need not be repeated, a process should include reviews and updates as needed…ask “what is working/not working in the individual’s life’?

Assessment  Rights  Self-determination  Physical well- being  Emotional well-being  Material well-being  Personal development  Interpersonal relationships  Social Inclusion

ISP  Must use a person centered planning process to develop a plan.  Ensure the achievement of outcomes that are important TO and FOR the individual and balance the the two if there are conflicts.  Address identified risks and prevent or minimize risks.

ISP  Secure commitments from providers to support the individual in achievement of his/her goals.  Establish and maintain contact with providers, natural supports and the team to ensure all understand expectations and are working toward meeting desired outcomes.  Revise plans as needed…

Monitoring  Deletes the word “monitoring” and replace it with “continuous review process” to change the culture from an event/form to an ongoing process.  Requires an individualized approach whereby the ISP identifies the scope and frequency of reviews…no more “cookie cutter” procedures.

Continuous review process  Shift focus from reviewing HPC documentation to helping individuals get a life and outcomes they want.  “Don’t go where you are not invited” but of course still be extremely mindful of health and welfare…  Feedback from reviews must be given to the individual, family and provider to close the loop.

Continuous review process  Scope, type and frequency must be stated in ISP and include face to face visits.  Frequency may be increased when individual has intense behavioral or medical needs or under other specified circumstances in the rule.  Areas of non-compliance should be referred for a PC review.

Update on Behavior Support Rule

Questions?