1. People Are Connected to Natural Support Networks KEY ISSUE: Connections to a network of other people who provide personal support is recognized as important Most often the networks are family and very close friends These relationships are usually lifelong Organizations assist people in maintaining existing and nurturing emerging natural support networks Support networks cannot be created - only nurtured The person chooses the extent and frequency of contact in conjunction with the people in the support network Natural supports may be related to spirituality for some people  CQL | The Council on Quality and Leadership

2. People Have Intimate Relationships KEY ISSUE: Personal desires for intimacy with others are respected and supported The people choose their intimate relationships and their types and scopes Regardless of intensity of support needs, people should have choice and opportunity for developing close personal relationships Desire for intimacy is known and respected The importance and potential for intimacy needs are never denied Relationships with family and close personal friends may meet some people’s needs for intimacy Efforts must be made to understand each person’s intimacy needs

3. People Are Safe KEY ISSUE: Living and working environments (physical and social) meet all expectations for safety The organization assists the person to identify and address safety issues in all environments Specialized assistance is available when required Dangers in the social environment are considered (including self) The support needed to assist the person in emergency situations must be available

4. People Have the Best Possible Health KEY ISSUE: Health care interventions are personalized and effective Best possible health is individually defined by each person Support is provided to the person to manage his/her own situation through education and information Preventive health care is addressed The goal of support is to ensure that health care services are effective in addressing the person’s health related concerns The person must be informed about his/her health situation and treatment options Personal devices such as hearing aids, glasses and dentures must be available to the person and in good repair

5. People Exercise Rights KEY ISSUE: Support is provided to exercise the same rights as all citizens The person is supported to identify and exercise the rights most important to him/her Training and support are provided for people with limited experience or knowledge about exercising their rights People should demonstrate respect for the rights of others as they assert and exercise their rights The exercise of all rights is not limited when a guardian is appointed Some Rights: Free movement in all settings Right to vote Free access to the telephone Time and space for privacy Freedom of religious expression Access to personal possessions, including money

6. People Are Treated Fairly KEY ISSUE: People are afforded the opportunity to contest actions or decisions that he/she believes are not fair or in his/her best interest Any restriction on rights should be treated as a temporary measure Training and support are provided so that restrictions and limitations are removed Independent committees that review personal complaints or restrictions provide a form of due process If there are no complaints to address nor limitations on the person’s exercise of rights, the outcome is present

7. People Are Free From Abuse and Neglect KEY ISSUE: People are not subjected to actions (by anyone) that cause them physical or emotional harm Includes verbal and physical abuse Includes assault from other people served Includes personal distress from a previous occurrence of abuse Neglect occurs in areas such as lack of basic sustenance (food, clothing, shelter), failure to provide needed services, or failure to provide or maintain necessary adaptive equipment A method to correct a situation of abuse and neglect must include provision of support necessary for the person to cope with the situation and take legal action Lack of intervention, when staff have knowledge, can constitute abuse or neglect All allegations are reported and investigated

8. People Experience Continuity and Security KEY ISSUE: People control (to the extent possible) the type and amount of change and disruption that occurs in their lives Disruption is minimized The person has the needed economic and other supports to provide basic security Changes are directed by the person as much as possible Concerns are defined by each person The type and frequency of change is determined by the person The person defines personal requirements for continuity and security Look at changes that are likely to occur in the coming year

9. People Decide When to Share Personal Information KEY ISSUE: Information is not made public or shared with others without the person’s direct consent All information about a person is considered confidential Includes written or verbal information Even with permission, organizations should share only the information that is relevant to services or required to support the person The person’s perspective on the importance of information to be shared is considered in evaluating the presence of this outcome

10. People Choose Where and With Whom They Live KEY ISSUE: People have control of decisions regarding their living situations The person is key to decision-making process Where AND with whom are required Must be presented with an array of options The person’s preferences and unique characteristics are considered Options must be present for the outcome to be considered present Choice is in the present tense

11. People Choose Where They Work KEY ISSUE: Career options and decisions about work are based on each person’s abilities and preferences Must be presented with an array of options Planning for work should begin in high school Options other than work can be considered (retirement, training, volunteer, school) The person is key to decision-making Options must be present for the outcome Choice may require exploring options

12. People Use Their Environments KEY ISSUE: Full access to all parts of the person’s environments are supported to include needed adaptations Environments are modified or adapted to meet each person’s needs Rules and practices can create functional limitations Modifications and adaptations occur to support the person’s autonomy If use of the environment is limited based solely on the person’s limitations or needs, then the outcome can be considered present

13. People Live in Integrated Environments KEY ISSUE: People live and carry out routine activities in the same settings used by other people People with disabilities have the same rights to access environments as all other citizens The environments a person chooses are usually determined by preference and activity Supports enable the person to freely choose Supports must be individualized Choice can be limited by lack of experience and opportunity

14. People Interact with Other Members of the Community KEY ISSUE: Interaction occurs with people outside of the service network in a variety of ways Opportunities are available to have contact with people who do not have disabilities and are not paid to be with the person May occur at work, during leisure activities, or in the person’s home Interactions occur in ways that are consistent with the preferences of the person A broad array of opportunities are available Direct social contact is required Work and supported activities can be considered for this outcome

15. People Perform Different Social Roles KEY ISSUE: People are recognized as capable of assuming different social roles and are supported to carry out responsibilities and activities associated with those roles Examples of some valued roles: volunteer, church member, employee, rotary club member, neighbor, parent, spouse, community association member, team member, voter, etc. Support from the organization should provide access to opportunity, information, technology and skill development The person must be acknowledged and recognized in the particular social role and assume responsibility Greater range of type and complexity of social roles is expected of people with greater capabilities and supports

16. People Choose Services KEY ISSUE: Services are selected from an array of options, and wishes and preferences regarding service selection are respected Services must focus on the pursuit of the person’s goals Array of options Residence and work not an issue OT, PT, speech, case management counseling, staff, grocer, hair stylist, etc. Options must be available for the outcome to be present The person is actively supported to express choice The person is supported when their preferences change over time

17. People Choose Personal Goals KEY ISSUE: Personal goals reflect the person's expressed desires for the future Present and future tense The person directs goal setting Needs/wants must be actively solicited Services and supports must focus on the pursuit of his/her goals The outcome is present if the person is working towards his or her personal goals A formal service planning process is not required for the outcome to be considered present

18. People Realize Personal Goals KEY ISSUE: People experience success in attaining goals or desires Look at past two years Milestone - at least one goal The person experiences a sense of accomplishment Celebration The outcome can be considered present based on the person’s assessment of accomplishment even if the goal is not included in the service plan The significance of an accomplishment is measured by the person

19. People Participate in the Life of the Community KEY ISSUE: People take part in a wide variety of routine and special activities that occur in the community There are opportunities to meet others and broaden experiences Generic community resources are used (doctor, restaurants, retail stores, etc.) Type and variety should match that available to others in the same community when options are limited A generic resource is no longer generic when other members of the community are excluded from using the resource The outcome is present when there is physical presence and engagement in community activities, regardless of who is part of the activity

20. People Have Friends KEY ISSUE: People have voluntary relationships with others that provide emotional support and enjoyment Voluntary (not paid) relationships Services don’t interfere or limit Services offer opportunity to make friends Reciprocal relationships Friends are people apart from family and staff Support to make and keep friends is required for people with no prior experience with friendship

21. People Are Respected KEY ISSUE: People are treated in the same manner as others Interactions that promote respect do not draw undue attention to a person’s disability or differences The person’s options and preferences are honored The person’s capabilities are stressed Expectations for achievement are high Service supports are not intrusive or demeaning An isolated example would not automatically cause the outcome not to be present Support should enhance the person’s self-image and promote a positive image to others