1. CROSSWALK PCP Comps Ethics HCBS POMs

2. Today’s Discussion  About the presenters….  Purpose of Crosswalk of Transformation Initiatives  What the Initiatives have in common  The organization of the Crosswalk  Why all this change / transformation  How do we get there  What does transformation look like when we succeed

3. A Crosswalk: What is it? “A marked part of the road where pedestrians have the right away … Crossing to the other side, safely.” “Comparing information from two or more sources to determine agreement.”

4. Sorting Through Information: Essential and Time-Sensitive  Getting information often and in pieces  Urgent  Disconnected  Overwhelming  Trying to make sense of it all  Important but not urgent  Connected yet distinct  Reasonable and related

5. A Crosswalk to Common Sense  This Crosswalk was created by the RCWT because providers told us  Ethics and Comps were just ONE MORE THING  ALL the transformation stuff was too much, too fast, too disconnected  The Regional Centers for Workforce Transformation (RCWT) “Crosswalk”  Inter-relationship of purpose  Practical steps leading to service transformation  Similar expectations  Unique applications

6. “It’s Really All The Same Stuff”  CQL Personal Outcome Measures  OPWDD’s DSP Core Competencies  NADSP Code of Ethics  HCBS Federal Regulations  Person-Centered Planning

7. “It’s Really the Same Stuff”… Because Each One  Is highly person-centered  Values respect and self-determination  Shifts control from the professional to the individual  Demands enhancement of organizational culture  Requires entire workforce to be knowledgeable, skillful and ethical

8. A Page from the Crosswalk: CQL Personal Outcome Measures OPWDD’s DSP Core Competencies NADSP Code of Ethics HCBS Federal Regulations Person-Centered Planning People are connected to natural support networks B: Getting to know the person through assessment and discovery; F: Building and Maintaining Relationships 1: Person-Centered Supports—first allegiance is to the person being supported and all functions flow from this. Supporting full access to the community that any other person not receiving services can enjoy. Person invites to all planning those whom s/he chooses. People have intimate relationships F: building and maintaining positive relationships; O: promoting positive behavior and supports H: developing professional relationships 7: Relationships recognizing importance of friends and family, assisting with informed choices in self- expression, separating professional’s personal beliefs Honoring a person’s priorities; right to have visitors of one choice; provider ensuring dignity of risk. Person communicates desired personal relationships and exercises informed decisions/choices. People are safe S: supporting safety; R: supporting crisis prevention, intervention and resolution; T: ensuring safety during environmental emergencies Promoting physical and emotional well- being; encouraging growth, recognizing autonomy; reducing risk from harm. Protects persons from coercion and restraints; Right to personal space and privacy with the ability to lock one’s room and control access; ensures reasonable dignity of risk. Person has key to lockable front door of residence and bedroom door. People have the best possible health P: Supporting Health and Wellness 2. Promoting Physical and Emotional Well- Being Person-centered planning and outcomes; honoring a person’s priorities. Choice in functional, health, clinical supports f

9. Crosswalk: From Left to Right  Personal Outcome Measures (POMs)  the oldest (>20yrs)  widest (international)  most practiced habilitative measures that look simple yet challenge everything

10. Crosswalk: From Left to Right  NADSP Code of Ethics  NYS Core Competencies and  Like the POMs  depth of principle  constant commitment to the individual  intentionality

11. Crosswalk: From Left to Right  Federal Home and Community Based Services (HCBS) standards  Tells us what individual self-directed outcomes should look like by March 2019 to continue qualifying for Federal funds  Defined by personal autonomy and choice!  Scheduling  Food  Visitors  Daily activities  Physical environment  Who he/she interacts with  Bending systems to human rights, self-defined outcomes within natural community

12. Crosswalk: From Left to Right  Person Centered Planning (PCP)  To maximum extent possible, the person directs his/her life plan  Exercises informed choices about services  Involves parties chosen by the person

13. My Self  Who am I?  Am I the result of the impact of family and friends? Close relationships?  Am I my experiences?  Am I my decisions? Are they mine? Are they conditioned responses? Informed?  Knowing myself better will help me explore tomorrow

14. My World  Where do I live? How did I get here?  Where do I express myself? Home? Work? Social places?  Where do I belong? One place? Many places? No place?  Where can I build new relationships? New possibilities?

15. My Dreams  How do I want my life to be?  How can I express myself more fully?  How can I participate more in life around me…in the life of my community?  How can I gain a respected social role?  How can I be of service?

16. My Self CQL Personal Outcome Measures OPWDD’s DSP Core Competencies NADSP Code of Ethics HCBS Federal Regulations Person-Centered Planning People are connected to natural support networks B: Getting to know the person through assessment and discovery; F: Building and Maintaining Relationships 1: Person-Centered Supports—first allegiance is to the person being supported and all functions flow from this. Supporting full access to the community that any other person not receiving services can enjoy. Person invites to all planning those whom s/he chooses. People have intimate relationships F: building and maintaining positive relationships; O: promoting positive behavior and supports H: developing professional relationships 7: Relationships recognizing importance of friends and family, assisting with informed choices in self- expression, separating professional’s personal beliefs Honoring a person’s priorities; right to have visitors of one choice; provider ensuring dignity of risk. Person communicates desired personal relationships and exercises informed decisions/choices.

17. My World CQL Personal Outcome Measures OPWDD’s DSP Core Competencies NADSP Code of Ethics HCBS Federal Regulations Person-Centered Planning People interact with other members of the community. V: supporting active participation in the community; D: Facilitating personal growth and development: I: Exhibiting professional behavior. 7. Relationships; 9. Advocacy Respect people’s observance of cultural, religious, and spiritual preferences; right to choose friends and associates; access to phone and internet at all times. Planning reflects person’s meaningful activity in general community. People perform different social roles. A: Supporting a person’s unique capabilities, personality, and potential skills; V: supporting active participation in the community. 1. Person-centered supports. 6. Respect 9. Advocacy Encourage spontaneity of choice of activities; ensure reasonable dignity of risk; respect people’s cultural, religious, and spiritual preferences. Planning reflects the person’s preferences expressed through informed decision- making.

18. My Dreams CQL Personal Outcome Measures OPWDD’s DSP Core Competencies NADSP Code of EthicsHCBS Federal RegulationsPerson-Centered Planning People choose personal goals. B: Getting to know the person through assessment and discovery of skills; D: Facilitating personal growth and development; K: creating meaningful documentation 6. Respect. 1. Person-centered supports 3. Integrity and responsibility Service plan reflects risks and minimizes it through supports; plan documents inform decisions and allied supports; plan honors personal priorities and ensures satisfaction with supports and addresses dissatisfaction in a timely manner. Person with assistance, if necessary, communicates preferences, strengths, capacities, needs…. People realize personal goals. A. Supporting a person’s unique capacities, personality and potentials. 8. Self-determination 6. Respect 1. person-centered supports Person-centered plans must focus on specific outcomes; plan reflects cultural considerations; facilitating informed choice and protecting rights Person is satisfied with the supports and services in which s/he is participating

19. Why all this Change? New Services = New Workforce From……………………………………….....To  Old Funding Rates…...New Funding Rates  Congregate…………………..Individualized  Workshops………...................Employment  Group homes………………………At-home  Program plans………….Self-determination  Program compliance……Individual metrics  Status quo………….Struggle for relevancy  State contracts……………..MCO contracts

20. Why? DSP Transformation  There is no service transformation without workforce transformation.  DSPs are 80% of the workforce  DSPs are a shrinking resource and still not fully prepared  DSP work requires more than following instructions  DSPs require professional ethics and professional skills  Managed care will evaluate DSP service deliverables

21. How? Organizational Culture Improvement  POMs, Comps, Ethics, HCBS, PCP are culture initiatives  Cascading commitment to respect and competence  Culture is not morale, but the environment we work-in / live-in  Culture is unwritten rules for getting along  Culture is personality of organization  Culture is everyone’s responsibility

22. How? Cascading Steps to Take Throughout the Organization: Executive Leadership Team Middle Managers Frontline Supervisors (FLS) DSPs Face-to-face learning on the Code of Ethics and Core Competencies Instructional videos with manuals Orientation, Transformation, FLS skills, Families

23. What Workforce Transformation Looks Like

24. What Do Transformed DSPs Look Like? Custodians task workers Care-givers human potential feels personal bring your heart & your values to work “love my guys” Support Professionals Caring, professional ethics & competencies

25. Quality & System Transformation  Individualized supports requires more than just  showing up & following instructions  being a nice person  Rather, Individualized supports requires  effective independent judgment  high ethical commitment  skills to affect personal outcome measures

26. What Does Service Transformation Look Like? 1. a life valued by the person with IDD 2. determining choices through informed decision-making 3. friendships & community participation 4. learning skills for valued social roles 5. enjoying self-esteem due to positive relationships & realizing abilities.

27. What Does a Transformed Organization Look Like?  Cascading commitment to personal outcomes  Takes steps toward a preferred culture  Embraces Ethics, Comps & their metrics  Valorizes person with IDD as #1 purpose of the organization  Values, develops DSPs as #2 in importance and key to defining quality  Values, develops FLS as the key to DSPs success

28. CROSSWALK PCP Comps Ethics HCBS POMs

29. www.workforcetransformation.org  Contact: Kirsten Sanchirico at Kirstens@nysacra.orgKirstens@nysacra.org  Presenters: Kathleen Brown at kbrown01@familyres.orgkbrown01@familyres.org Regis Obijiski at regis.m.obijiski@opwdd.ny.govregis.m.obijiski@opwdd.ny.gov Code of Ethics & Core Competencies for Direct Support Professionals