Housing Best Practices Forum Welcome!

Housing Options Best Practices Forum 4/20/2015 Agenda Welcome and Logistics Person-Centered Thinking and the Search for Housing – Anne Roehl Success Story – Geoff Meyer Questions Program and policy updates Closing JULIA

Logistics (boring yet necessary) Housing Options Best Practices Forum 4/20/2015 Logistics (boring yet necessary) Hosts: Nichole Meyer, Wright County Sarah Tripple, Washington County Heidi Sandberg, DHS Alison Niemi, DHS Lots of Sites! Keep microphones muted, but let us know if you can’t hear! No questions during presentation Questions during and after presentation to DHS Housing Options email: dhs.housingoptions@state.mn.us Follow up evaluation JULIA

Housing Options Best Practices Forum 4/20/2015 Format of Forums Every other month (evens), third Monday, 1:30-3:30 Taped presentation and materials available post- session on mn.HB101.org (partners tab) Steering Committee to oversee agenda and topics ALI

What are we hoping to achieve? Housing Options Best Practices Forum 4/20/2015 What are we hoping to achieve? More choices and control for people over their housing and services Leverage resources as best we can Collaboration between counties, tribes and providers to develop creative housing options for individuals Share success stories and best practices used in your community Forward identified policy/resource barriers to decision- makers Ultimate goal: Everyone has the opportunity to live in integrated housing of their choice. HEIDI

“Best Practices” Review CSH Dimensions of Quality Building the capacity of supportive housing HCBS Settings Rule Ties best practices to funding Housing First Housing first without a requirement for "housing readiness" Individualized Housing Options Creative use of existing resources to design housing options centered around the person Olmstead Supreme Court requires opportunities for integration for people with disabilities PSH Evidence-Based Practice Ensuring quality housing for people with Serious Mental Illness Person-Centered Thinking Concrete, easy to use tools that can be accessed by anyone

Institute on Community Integration An Introduction to Person Centered Planning …a key to housing that works! Anne Roehl Institute on Community Integration

Institute on Community Integration An Introduction to Person Centered Planning …a key to housing that works! Anne Roehl Institute on Community Integration

Seven “Person Centered” Myths “We’re already doing it” Person-centered planning means asking the person, “What do you want?” A good plan means a good life Person-Centeredness applies only to people who use services

Seven “Person Centered” Myths Person-Centeredness applies to only one type of disability Person-Centeredness only applies to those working with people who receive services Person-centered planning is a planning process that can be done separate from more significant organizational change

5 Foundational Beliefs Common to all Person Centered approaches: Essential questions are: Who is this person? What is important to him/her? Person-Centeredness aims to change common patterns of community life Stimulate community hospitality Enlist community members in assisting focus people to define and work toward a desirable future

5 Foundational Beliefs, continued Person-Centeredness fundamentally challenges practices that separate people and perpetuate controlling relationships Honest Person-Centered Planning can only come from respect for the dignity and completeness of the focus person Assisting people to define and pursue a desirable future tests one’s clarity, commitment and courage

It’s NOT the setting A community LIFE and a HOME is more than a “community residence”

Critical Boundary

We want a system where - The people who use the service (with the support of their families) Tell us how they want to live Make use of public resources to have the life they want (or as close as we can determine) Get the support they need to make the first two happen

We want a system where - The people who provide the service Are empowered to make a difference Use public resources wisely Get the support they need to make the first two happen!

We want a system where - Everyone feels heard Change is possible for people and for the systems that serve them Should we drop slides 18-20??

Where do we start?

About Person Centered Methods Person Centered Planning Approaches Focused on events Action Planning Long Term Goals Person Centered Thinking Everyday ways of thinking A foundation for Action Planning Focus on the “now” and shorter term goals

Person Centered Planning The term “Person-Centered Planning” refers to: A family of approaches to organizing and guiding community change in alliance with people with disabilities and their families and friends John O’Brien and Herbert Lovett Finding a Way Toward Everyday Lives

How is Person Centered Thinking different? Focus on the “now” Powerful tools for discovery: seeing the whole person, their gifts and desired life Keep focused on the person, not system’s offerings or agency turf issues Also acknowledges we can’t provide person centered support without engaging in person centered processes ourselves

TLC-PCP 2012 www.learningcommunity.us This work is about – Helping people get better lives Not just better plans… TLC-PCP 2012  www.learningcommunity.us 

Person Centered Thinking The Core Concept

TLC-PCP 2012 www.learningcommunity.us Core Concept Important to and Important for TLC-PCP 2012  www.learningcommunity.us 

TLC-PCP 2012 www.learningcommunity.us Important to – Those things in life which help us be satisfied, content, comforted and happy. It includes: People to be with/relationships Things to do Places to go Rituals or routines Rhythm or pace of life Things to have TLC-PCP 2012  www.learningcommunity.us 

TLC-PCP 2012 www.learningcommunity.us Important to – What is important to a person includes only what people are “saying” with their words with their behavior When words and behavior are in conflict, listen to the behavior Includes what matters most, by the person’s definition TLC-PCP 2012  www.learningcommunity.us 

TLC-PCP 2012 www.learningcommunity.us Important for – This includes only those things that we need to keep in mind regarding: Issues of health or safety Physical health and safety, including wellness and prevention Emotional health and safety, including support needed 2. What others see as important to help the person be a valued member of their community TLC-PCP 2012  www.learningcommunity.us 

Health and Safety Dictate Lifestyle Important to for Provide a quick refresher using an example that crosses these three slides: Ex: Who here loves pizza? Ok, imagine you had high cholesterol and lived someplace where health and safety dictates your lifestyle. We would never let you have pizza again. Who here would be happy with that? TLC-PCP 2012  www.learningcommunity.us 

All Choice No Responsibility Important to for Ok, pizza lovers, you now life in a place where that myth of person centeredness is to give people everything they want (which is actually neglect on our part!). We would let you have all the pizza you want, have a heart attack and die! It’s your choice!! Happy and dead is unacceptable! TLC-PCP 2012  www.learningcommunity.us 

TLC-PCP 2012 www.learningcommunity.us Balance Important to for Using the example of pizza lovers with high cholesterol, get people to come up with ideas of how to create a balance. Point out that the solutions were easy to come up with because we identified the important TO first and then put the important FOR into context – it created the balance. This is explained in greater detail in the next few slides. TLC-PCP 2012  www.learningcommunity.us 

TLC-PCP 2012 www.learningcommunity.us Finding a Balance If something is important for us and is also important to us, we will do it If something important for us is not important to us, we have no interest in doing it If we want people to attend to what is important for them there has to be an aspect of it that is important to them Avoiding triggers is also included in moderation - how many of you have had, at some point in their life, a weight loss issue? Was it because your doctor showed you your BMI or was it because pants didn’t fit, you had an event TLC-PCP 2012  www.learningcommunity.us 

Balancing Important TO and FOR Sequence matters: learning about what matters the most to the person first (a critical aspect) It is not about either/or: paying attention to health, safety and valued social roles is critical, but alone it is insufficient if not in the context of “important TO” TLC-PCP 2012  www.learningcommunity.us 

Balancing Important TO and FOR Risk management techniques currently often focus on assuring safety or health at the cost of what creates satisfaction for the person We need to change our frame of reference to believe that both can co-exist TLC-PCP 2012  www.learningcommunity.us 

TLC-PCP 2012 www.learningcommunity.us Finding the Balance We all make tradeoffs between the many different things that are important to us. Some people may love living in a particular place. And are willing to make the tradeoff when living there means a longer commute to the work they love. PURPOSE: to support people to think thru specifically what is meant by “finding the balance” SCRIPT You can use these examples to support a brief conversation with the group about finding the balance… TIPS: TIME: 5 minutes NOTES: TLC-PCP 2012  www.learningcommunity.us  TLC-PCP www.learningcommunityus.com

TLC-PCP 2012 www.learningcommunity.us Finding the Balance We also make tradeoffs between what is important to us and what is important for us. These tradeoffs can be temporary OR long term solutions. Expressing personal opinions and speaking my mind is important to me, but not swearing in front of my neighbors is important for me PURPOSE: to support people to think thru specifically what is meant by “finding the balance” SCRIPT You can use these examples to support a brief conversation with the group about finding the balance… TIPS: TIME: 5 minutes NOTES: TLC-PCP 2012  www.learningcommunity.us  TLC-PCP www.learningcommunityus.com

Finding the Balance So what does this mean for housing when Resources are scarce? Not everyone can have their perfect “vision” or their first “choice?” The same thing it means for you!

Knowing a “good balance” A good description of what’s important to and for a person – developed through a process of actively listening and discovering with the person – allows us to understand what a good balance means for the person It creates a vivid snapshot The “must haves” and the “deal breakers” and everything in between impacts the balance too!

Knowing a “good balance” When it comes time to choose, we can see what option is the best fit to that snapshot Are the items that are most important to the person retained or enhanced? How does each option impact a good balance? How can we address the “trade offs” or those things that are less ideal?

Creating a Picture

tools to help find balance Person Centered Thinking Skills tools to help find balance

Tools for asking “What do we know?” Before jumping to “What do we do?” If I had an hour to save the world, I’d spend 55 minutes defining the problem. -Albert Einstein

Defining the problem (or goal) The more time you spend defining the problem… the better the solution

Important To Important For & The Balance Between Management Skills Relationship Map Routines & Rituals Good Day Bad Day 2-Minute Drill Reputation Communication Donut Important To Important For & The Balance Between Matching Learning Logs Working Not Working PURPOSE: Providing participants with a visual reminder of the skills as overviewed in Day 1. This slide helps to transition from Day 1 training to Day 2. It is here to provide a very very brief summary of yesterday and foreshadow todays work. SCRIPT Remember yesterdays overview of the skills we promised to cover in these 2 days of training. Recall we will be learning and practicing skills that can be divided into 3 categories. All of the skills in all of the categories support an intentional approach to developing positive relationships and keeping the person and those who care most at the center of decision making. Discovery/Listening- collects important information which leads to understanding the desired balance between important to/for – we will be practicing all these skills today Everyday Learning- organizes the evaluation of everyday situations in order to learn and identify next steps. We covered these yesterday Management- assists in allocation of and support for staff -We practiced developing the donut yesterday –today we will learn how to gather information and organize it to create good matches between the people we hire and the people we support. Today we will also add two facilitation skills that underpin –help to ensure success –when using all of core skills we are helping you to practice. TIPS: The main thing here is to say “ This is what we did yesterday and this is what we will do today”. Don’t get tied up trying to explain the skills or how facilitation skills work with the other skills. Slide is animated. TIME: 1 minute for this slide Discovery/ Listening Skills 4 + 1 ?s Everyday Learning Skills © TLC-PCP 2012 www.learningcommunity.us TLC-PCP www.learningcommunityus.com

Getting a picture of “Important to” Good Day/Bad Day Rituals and Routines What’s working (what makes sense)/What’s not working (what doesn’t make sense) 4+1 Questions TLC-PCP 2012 www.learningcommunity.us

Good Day/Bad Day A really good day A really challenging day What happened that contributed to your good day? What do you look forward to doing? Who do you look forward to seeing? What happens that gives you energy to deal with difficult situations? What motivates and interests you at work OR on a work day? What threw your day off? Made the day bad for you? Made you frustrated? Bored? Took the fun out of it? Be sure to include those daily frustrations TLC-PCP 2012 www.learningcommunity.us

Rituals and Routines Rituals guide us through our days and bring consistency, comfort and control Morning Going to bed Mealtimes Transition Birthday Cultural/Holiday Spiritual Vacation Comfort Celebration Grief/Loss TLC-PCP 2012 www.learningcommunity.us

4 + 1 Questions Great for getting “unstuck” Using the “4 questions” to focus on learning What have we tried? What have we learned? What are we pleased about? What are we concerned about? And then What should we try/do based on what we learned? TLC-PCP 2012 www.learningcommunity.us

What’s working/What’s not working Focus in on a specific issue or area of life Helps you dig deeper Negotiation tool All must feel listened to – accurately reflect perspectives, engage everyone Start with common ground Remain unconditionally constructive Bridge to action planning What needs to be maintained/enhanced? What needs to change? TLC-PCP 2012 www.learningcommunity.us

What’s Not/What Could Improve Use to organize perspectives about a specific Issue or to get a snapshot description of NOW What’s Working What’s Not/What Could Improve What does the person say is working? What does the person say is not working or could be better? What does the family say is working? What does the family say is not working or could be better? What does the staff person/teacher/therapist (etc) say is working? What do they say is not working or could be better? PURPOSE: Give people a visual of what the work/not working form looks like. As well as written instructions for how to use the form. To teach people how to use working/not working to organize information to prepare for action planning. SCRIPT Review what to put in each section. TIPS: Hints : where ever possible use the person’s own words or your best guess TIME: NOTES: TLC-PCP 2012  www.learningcommunity.us  TLC-PCP www.learningcommunityus.com

Disagreements perspective Person’s USE THIS INFORMATION TO BUILD THE A G E N D A FOR THINGS THAT NEED TO CHANGE perspective Person’s USE THIS INFORMATION TO BUILD THE A G E N D A FOR THINGS THAT ARE TO STAY THE SAME PURPOSE: To illustrate how the working/not working analysis can be used SCRIPT Use this slide to illustrate how this can be used to develop goals and objectives that help people move toward the lives that they want and to assist with negotiation where there are disagreements To help with action/goal planning - The left hand column helps with identifying those things that you wish to maintain or enhance. The right hand column shows things that need to change. A way to help people create meaningful goals or plans and not “stupid goals” – can give an example. Point out that disagreements often turn up on the diagonals. Let people know that this has 2 of the core principles of negotiation built into it – If you have carefully written down everyone’s perspective they feel listened to. If you point out where the same items appear in the same column but different perspectives you have started with common ground. TIPS:  A recent article reported a study that claimed accurately reflecting perspectives in mediation was more important than empathy.   Apr 22, 2008 ... Perspective-takers created more value and earned significantly more points for themselves than those from the empathy group or the control ... www.sciencedaily.com/releases/2008/04/080422115014.htm TIME: 5 Minutes Disagreements perspective Staff’s Wrkbk pg 32 TLC-PCP 2012  www.learningcommunity.us  TLC-PCP www.learningcommunityus.com

Finding Roommates Matching Profiles One Page Profiles Introduce critical supports & skills needed Focus on Personality characteristics, common interests One Page Profiles Introduce who someone is TLC-PCP 2012 www.learningcommunity.us

Person Centered Thinking is a 2-day, interactive training Learning the skills and practice using them in scenarios and on yourself Registration at rtc.umn.edu/pctp/training/

Person Centered Planning Approaches Personal Futures Planning PATH Essential Lifestyle Planning A Picture of a Life

Personal Futures Planning: Maps for the Journey: Personal Profile

PATH Planning Alternative Tomorrows with Hope Steps: Situate yourself in a very positive future, Picture it clearly, Then think backwards

PATH Graphics

Essential Lifestyle Planning Originally developed for people with “challenging reputations” by Michael Smull and colleagues Discover CORE VALUES and preferences vs. superficial choices about how the person really wants to live Good plans are easily accessible and reflect what is important to the person and what others think is important for them

A Picture of a Life This Person Centered Planning Format Is aimed at moving to a new home Asking what needs to be present in A new home A meaningful and productive day The community to support what’s important to the person Professional Services

A Picture of a Life: Visual Sparks creativity Includes a written description

A Picture of a Life: Visual Sparks creativity Includes a written description

Picture of a Life (PoL) is a 2-day, interactive training Hands on practice using the skills to develop a plan for a co-trainer (a person who uses services him/herself) Registration at rtc.umn.edu/pctp/training/

The Pitfall ANY “person-centered” approach can be used in an agency-centered or system- centered way It’s not the approach as much as the values and the thinking driving us to understand the person at the center of planning

Quality Person Centered Planning There is no “right planning method” for all people and all situations. A quality plan is: a promise to listen a promise to act on what is heard a promise to be honest a promise to KEEP discovering and honoring what’s important to people. TLC-PCP 2012  www.learningcommunity.us 

Thank You! If you want to know more about us or our trainings, feel free to contact me! Anne Roehl Research and Training Center on Community Living Institute on Community Integration University of Minnesota 612-624-7558 vand0202@umn.edu

Housing Options Best Practices Forum 4/20/2015 Success story Geoff Meyer, People Inc.

Program and policy updates Housing Options Best Practices Forum 4/20/2015 Program and policy updates Mental Health updates – Gary Travis Thursday, December 17, 2015 – Homeless Memorial March and Service: http://www.simpsonhousing.org/events/2015- memorial-march/ HCBS Rule Transition Plan March starts at 5 PM at HC govt center

Wrap-up Comments or questions? DHS Housing Options email: dhs.housingoptions@state.mn.us Presentation and materials available: http://mn.hb101.org/ Complete evaluation Future sessions Take some time to network!

Additional materials and resources Individualized Housing Options Resource Guide: http://mn.hb101.org/documents/Individualized%2 0Housing%20Options%20Resource%20Guide%20 JANUARY%202014.pdf Housing Benefits 101: “My Situation” => “Start Here” Moving Home Minnesota Housing Transitions Worksheet: eDoc on DHS public web, #67593

Steering Committee Members Housing Options Best Practices Forum 4/20/2015 Steering Committee Members Kate Erickson, Department of Corrections Heidi Sandberg*, DHS (Section 811) Vicki Farden, Minnesota Housing Finance Agency (Supportive Housing) Alicia Smith, DHS (Indian Policy) Ed Sootsman, Hennepin County Colleen Fodness, Dakota County Nan Stubenvoll, DHS (Alternatives to Foster Care) Julie Grothe, Guild, Inc. Mari Moen, DHS (Direct Care and Treatment) Lynette Studer, DHS (Transition to Community) Jeannie Nelson, DHS (Moving Home Minnesota) Gary Travis, DHS (PATH, PSH) Sarah Tripple*, Washington County Becky Melang, CSH Julia Welle Ayres,* DHS (Housing) Nichole Meyer, Wright County Dianne Wilson, DHS (Alcohol and Drug Abuse Division) Alison Niemi*, DHS (Housing) Kelsey Nyline, Fraser Leah Zoladkiewicz, Department of Human Services (DHS) (HCBS) Stacey Ray, Catholic Charities Thank you! *Planning Committee Members