1. Today’s Vision…Tomorrow’s Reality
Office of Developmental Programs
Today’s Vision…Tomorrow’s Reality
Futures Planning Implementation Proposal
December 17, 2013

2. Perspectives

3. Today’s Vision

4. ODP Mission and Vision
Futures Planning is founded on the Mission and Vision of the Office of Developmental Programs (ODP):
Mission
The mission of the Office of Developmental Programs is to support Pennsylvanians with developmental disabilities to achieve greater independence, choice and opportunity in their lives.
Vision
Our vision is to continuously improve an effective system of accessible services and supports that are flexible, innovative and person-centered.

5. Futures Planning Purpose
Enrich chances for meaningful lives for Pennsylvanians with developmental disabilities
Ensure the service system achieves quality outcomes for individuals and families
Reduce service system complexity to simplify access to services
Develop a service delivery system that is more fair and carefully manages taxpayer resources

6. Planning Structure Extended Team/Action Plan Teams ODP Core Team
Source of exchange between staff and Core & Extended Teams
Provided input
Provided Subject Matter Expertise as needed to Core and Extended Teams
ODP Team members acted as Action Plan Team Co-Leads
All stakeholders had multiple and varied opportunities to offer suggestions and give feedback
Everyone was encouraged to get involved and spread the word
ODP Leadership Staff
Participated in Extended Team
Used feedback from community & staff in draft recommendations
ODP and Stakeholders worked together through consensus
Drafted recommendations on service system redesign based on existing mission and vision statements
Incorporated feedback from community & staff into final recommendations
Extended Team/Action Plan Teams
ODP Core Team
ODP Team
Broader Engagement: Community & Staff

7. Statewide Stakeholder Representation
Individuals and Families
Providers
County/Administrative Entity Staff
Advocacy Organizations
University Partners
State Agency Partners

8. Futures Planning Time Line
Futures Planning Began
Jan 2013
First Extended Team Meeting
Long Range Goals Developed
First Public Comment
Mar 2013
Objectives Developed
May 2013
Action Plan Teams Formed
Jun 2013
Second Public Comment
Aug 2013
Final Public Comment
Self-Advocate and Family Open Forums
Oct 2013
Action Plans Finalized
Nov 2013

9. Public comment periods advertised through the website
Stakeholder Outreach
Expectation of Extended Team to be a link or liaison with their respective community groups
Website for all Futures Planning materials
Public comment periods advertised through the website
Statewide listening tours throughout the year by the Deputy Secretary
Two open forums at the PA Disability Employment and Empowerment Summit (PADES)
Five regional self-advocate and family forums hosted by ODP

10. Tomorrow’s Reality

11. Tomorrow’s Reality - Long Range Goals
Each person is supported to:
1. Live and lead a productive, self-determined and safe life.
2. Make informed choices.
3. Enjoy real opportunities for a variety of relationships in which they are accepted, valued, and included.
4. Access services and supports throughout life that are creative and flexible.
5. Have their family and/or circles of support respected and assisted as needed with the understanding that the needs of the individual come first.
6. Receive well-coordinated quality supports and services from natural, public and private sectors.
7. Receive high quality services and supports in inclusive community settings.
8. Choose to self-direct paid services and supports within a defined budget based on assessed need.
9. Access the full range of technology to promote independence, inclusion, productivity and self-determination.
10. Experience seamless transitions throughout the life span.
11. Have the services and supports for their desired work, vocation and/or education.
12. Access unique, innovative, non-traditional services and supports.

12. ODP Futures Planning Objectives
Each person’s budget is based upon assessed needs, and the individual will know and be able to control the services within their budget.
Review and revise qualifications so that people will be supported by professionals who are appropriately qualified and trained to their individuals’ needs, including a focus on people with complex physical or behavioral health needs.
Define a process to support creation of and funding for newer, better, reduced-cost ways to provide services.
Integrate flexible models of service that can support peoples’ changing needs in their home communities, including supporting people through a physical or behavioral health crisis.
Determine the best and simplest system to manage services to improve outcomes.
Develop steps to define quality measures. The results of the measures then can be used to develop an action plan to improve quality of life for those supported by the ODP system. ODP will work with individuals, families, providers and others to develop meaningful measures that go beyond the minimum standards.
Develop design options for a pilot program for managed care of developmental disability services.
Pennsylvania will be an Employment First state. Employment is the first priority for people with disabilities.

13. Action Plan Development
The eight work groups of the Extended Team developed action plans for each objective to move ODP toward the overall Long Range Goals. These plans included:
Action items that will achieve the overall objective
Action steps required to achieve the action item
For ease of understanding, each action plan was summarized for the final public comment period and public forums
All comments from public input and open forums were considered in the development of the Action Plans

14. Action Plan Prioritization
The Core Team brought together the eight separate Action Plans and prioritized activities in a first phase implementation proposal for Consideration was given to:
DPW Strategic Plan
ODP Mission and Vision
Themes across action plans
Action items that needed to occur before other action items
Action items that are realistic and doable
Staff and financial resources

15. Implementation Proposal
Based on the prioritization process, selected activities from all eight objective action plans are proposed
Expected outcomes and resource needs are considered
Necessary first steps for the long term success of the Futures Plan fall into the following areas:
Using a Person-Centered Assessment
Identifying Service Needs and Gaps
Improving Provider Qualifications
Ensuring and Enhancing Quality
Designing Broad System Change

16. Implementation Proposal Structure
Implementation proposals are structured as follows:
Objective Number Reference
Selected Action Items
Expected Outcomes
Time Line

17. Using a Person-Centered
Assessment

18. Implementation Proposal – Person Centered Assessment
Person-Centered Needs Assessment and Budget Process (Objective #1)
SELECTED ACTION ITEMS
Evaluation of current assessment process through interviews with individuals, families and other stakeholders
Evaluation of available tools
Finalize tool(s) to be used
Create exception and appeals processes
Explore establishing all service rates based on the cost to serve people with similar needs
Explore relationship between assessment scores and budget ranges
Develop operational process, including waiver, regulation, fiscal and other changes
Create measures and begin monitoring to establish baselines

19. Implementation Proposal – Person Centered Assessment
Person-Centered Needs Assessment and Budget Process
EXPECTED OUTCOMES
Provides more evidence-based understanding of services and supports that are focused on individual needs
Provides individuals the opportunity to control their services and budget
Offers consistency of practice
Anticipated savings due to simpler process, allowing for the expansion of the number of people served
Provides chance to more accurately connect needs to the budget
Long range impact will be determined after development of the assessment and link to budget
TIME LINE
Selected action items will be done over 12 months
2-3 years to complete the full needs assessment and budgeting process

20. Identifying Service
Needs and Gaps

21. Implementation Proposal - Service Needs and Gaps
Innovative Services and Supports (Objective #3)
SELECTED ACTION ITEMS
Develop and implement the standards and process for the introduction of new/different ways that address services and supports
Identify resources that aren’t currently used or that are not used enough
EXPECTED OUTCOMES
Encourages creativity and innovation in program development and service delivery
Allows ODP to know what else can be provided in a more efficient way than what is currently being offered
Anticipated savings at an individual level
Overall, provides data that shows gaps and how changes can be made
May identify resources that aren’t currently used
TIME LINE
12 months
Ongoing assessment and evaluation of new process and standards

22. Implementation Proposal – Service Needs and Gaps
Supports for Changing Needs in Times of Crisis
and Transition (Objective #4)
SELECTED ACTION ITEMS
Conduct gap analysis with a cross-system team to determine what currently exists, what is working, and activities that can be easily replicated
Continue implementation of Dual Diagnosis Initiative focusing on regional stabilization teams
EXPECTED OUTCOMES
Reduction in costs for people by providing support before a crisis occurs and before issues happen during a key transition period
Use of supports that improve quality of life and avoid more intensive or higher cost services
TIME LINE
6-9 months; some things already in process

23. Implementation Proposal – Service Needs and Gaps
Employment First (Objective #8)
SELECTED ACTION ITEMS
Implementation of this Action Plan along with the Governor’s employment initiative and work among agencies including the State Employment Leadership Network (SELN)
EXPECTED OUTCOMES
Improved quality of life for individuals through gainful employment as a respected member of their community
Long term savings in improved outcomes by people working and being less dependent on public supports
TIME LINE
12+ months

24. Improving Provider
Qualifications

25. Implementation Proposal – Provider Qualifications
Provider Qualifications (Objective #2)
SELECTED ACTION ITEMS
Conduct a review of service definitions (current and proposed) and provider qualifications to identify necessary changes
Align and improve training with current and proposed provider qualifications; identify training gaps; complete development of pre-enrollment training; create a record of current ODP training offerings
Explore workforce development activities through higher education and vocational education
Create a training curriculum about intellectual disability and autism for Certified Nursing Assistants

26. Implementation Proposal – Provider Qualifications
Provider Qualifications (Objective #2)
EXPECTED OUTCOMES
Enhanced quality of life for people
Increased provider capacity
Improved staff expertise in supporting people with intellectual disabilities and autism
Workforce having proper training results in less time to learn the job and improved length of time on the job
Proper training creates better management for individual behavioral challenges and physical health reducing the need for increased staffing
TIME LINE
12-18 months

27. Ensuring and Enhancing
Quality

28. Implementation Proposal – Ensuring and Enhancing Quality
Quality (Objective #6)
SELECTED ACTION ITEMS
Identify quality of life and outcome measures
Collect data on existing quality measures and data sources and gaps
Publish first list of selected quality measures
Create provider profiles and determine whether providers or ODP will collect and display the profile information
Build structure for quality improvement projects
EXPECTED OUTCOMES
Remove data and reports that are currently being collected and developed but not used
Anticipated savings because of quality monitoring and improved outcomes
Long term reduction in services that don’t achieve individual outcomes
Improved individual outcomes due to better options over time
TIME LINE
18-24 months

29. Designing Broad
System Change

30. Implementation Proposal – Broad System Change
Create the Best and Simplest System of Services
and Supports (Objective #5)
SELECTED ACTION ITEMS
Review current and new support and system options
Improve the Individual Support Plan (ISP)
Reevaluate required duties of Administrative Entities and the Operating Agreement
Reevaluate required duties of Supports Coordination Agencies and the Provider Agreement and related policies
Train Supports Coordinators about ISP monitoring (already happening)

31. Implementation Proposal – Broad System Change
Create the Best and Simplest System of Services and Supports
EXPECTED OUTCOMES
Improves focus on outcomes for people in the ISP process
Improves Supports Coordination focus on identifying risk factors and addressing them early
Maximize and strengthen chances for community inclusion and use of natural supports
Improvements to ISP monitoring for intended outcomes
TIME LINE
9-12 months

32. Implementation Proposal – Broad System Change
Integrated, Coordinated Support (Objective #7)
SELECTED ACTION ITEMS
Design an integrated, coordinated model of support that addresses the needs of individuals with developmental disabilities and can lead to a pilot after Year 1
EXPECTED OUTCOMES
Improved individual outcomes and quality of life if supports are coordinated
Anticipated savings will be measured through the pilot model
TIME LINE
12 months

33. Support Implementation
Activities to
Support Implementation

34. Activities to Support Implementation
Stakeholder Input/Data Collection
Assess the current ODP service system through data collection and stakeholder interviews, surveys, focus groups, etc.
Resources
Evaluate internal resources that can be realigned and redeployed
Evaluate new resources required, some of which may be flexible, short-term or specific to a single task
Communication
Implement a communication strategy that continually informs and engages stakeholders, both internally and externally
Policy Revisions
Assess current policies for relevance, clarity and the need for new and changed policies (including changes to Medicaid Waivers)
Information Technology
Assess current information technology needs

35. Proposed Implementation Structure
Implementation of all proposals will require a great deal of effort and coordination
A proposed structure will guide implementation:
Deputy Secretary Executive Leadership Team
Project Manager Steering Committee
Implementation Teams
Extended Team
Stakeholders

36. Staffed by members of the ODP Executive Leadership Team
Steering Committee
Charged with oversight and coordination of integrated Action Plan implementation
Staffed by members of the ODP Executive Leadership Team
Reports to the ODP Executive Leadership Team and DPW Leadership
Led by the ODP Project Manager
Guided by a project work plan
Gives regular reports to ODP and DPW Leadership and the Extended Team that include:
Project status
Major milestones
Anticipated challenges
Updates on communication with stakeholders
Suggested changes to project work plan
Acts as a liaison between the ODP Executive Leadership Team and Implementation Team leads

37. Initial Implementation Time Line
Start ODP Steering Committee
Form Implementation Teams
Continue evaluation of internal resources that can be realigned
Develop and start using communication strategy
Jan 2014
Begin stakeholder input activities
Collect data from other states
Implementation teams begin work
Feb 2014
Extended Team update meeting
Finish stakeholder input activities for initial assessments
Evaluate other work supporting all objectives– policy, regulation, waiver amendments, IT changes, training/ education; strategy
Mar 2014

38. Planning for 2015 will revisit these suggestions
Next Steps
These proposals are meant to create the foundation for full realization of the ODP Futures Plan
The Extended Team worked in partnership with ODP to determine additional short term objectives and parking lot issues
Planning for 2015 will revisit these suggestions

39. Tomorrow – A Story
Perspectives

40. Today’s Vision…Tomorrow’s Reality
Thank you to everyone who took part in and gave input to
The Office of Developmental Program’s
Today’s Vision…Tomorrow’s Reality