1. Person-Centered Consumer HCBS Education & Gathering Representative Names June 2017

2. AGENDA Learning Objectives HCBS Updates Representative Name(s)
Educating Consumers about Limitations
Talking to Providers about Limitation Areas

3. LEARNING OBJECTIVES Participants will:
Understand expectations and actions for identifying a representative for future use if an consumer can not longer consent.
Have a basic understanding of the new HCBS rights and of the
expectations of educating consumers in a person-centered manner
about these rights; and begin advocacy on behalf of consumers
wishing to exercise their rights.
Understand how to get technical assistance and/or get HCBS-related
questions answered.

4. HCBS UPDATES
CMS extended timeline three years (to March 2022) for all states.
Proposed solution for “Inability to Consent” under construction.
Rollout of formal Individually-Based Limitations documentation
moved out from July 1, 2017; proposed new date is July 1, 2018.
Beginning July 1, 2017, at reassessment:
Request “Client Representatives”; and
Provide HCBS rights education & advocacy

5. HCBS TRANSITION PLAN: JULY 2017-JUNE 2018
Today we will cover:
Ensuring consumer’s “Client Representative” information is up-to- date;
Educating consumers in a person-centered manner about their HCBS rights;
Advocating for consumers with their Providers.

6. HCBS TRANSITION PLAN: STARTING JULY 2018
Next year, we will:
Assist consumers that have a health/safety risk, and:
May not be able to safely exercise their HCBS rights; or
May not understand the consequences of their decisions.
Formally document any limitations to a consumer’s HCBS rights.

7. “CLIENT REPRESENTATIVE”
July 2017
At intake and reassessment, request “Client Representative” information for:
1. Guardian
2. Spouse
3. Adult Child(ren)
4. Parent(s)
5. Adult Sibling(s)
6. Other Adult Relative(s)
7. Adult Friend(s)
New Policy: Get as many as possible!

8. “CLIENT REPRESENTATIVE”

9. “CLIENT REPRESENTATIVE”
What if there is no one from the list??? 1. Guardian 2. Spouse 3. Adult Child(ren) 4. Parent(s) 5. Adult Sibling(s) 6. Other Adult Relative(s) 7. Adult Friend(s)
Support consumers with developing new relationships

10. APPOINTED REPRESENTATIVE(S)
July 2018
If the consumer:
Is no longer able to make LTC decisions; and
Does not have a “Client Representative”; and
A LTC-related decision has to be made…
The State will appoint a representative.
We will attempt to locate a rep using the list from the “Client Representative” slides. If none are found, we will appoint someone.
OAR (3)

11. APPOINTED REPRESENTATIVE(S)
JULY 2018

12. HCBS, IN A NUTSHELL What is the point of HCBS? In-Home Institution
To make Home and Community-Based Services, and the settings where they are delivered, as home-like as possible.
In-Home Institution
HCBS NOT HCBS
*As we go over the next few slides, think about whether you have consumers who do not currently have some of these HCBS Rights.

13. HCBS RIGHTS, FREEDOMS & PROTECTIONS
Freedoms, Rights, Protections that may not be limited:
Access to the broader/greater community
Services in an integrated setting
Accessible setting
Control of personal resources
Privacy, dignity, respect, freedom from coercion and restraint*
Residency agreement
Services in a private room if desired
Services in a non-disability setting if desired
Work, if desired
Person-Centered Planning and Plans

14. HCBS RIGHTS, FREEDOMS & PROTECTIONS
1. Access own food at any time 2. Choice in who roommate is in shared units 3. Control own schedule and activities 4. Decorate/Furnish 5. Freedom from Restraint 6. Locks on bedroom/living unit door 7. Visitors of own choosing at any time

15. HCBS RIGHTS, FREEDOMS & PROTECTIONS
Access own food at any time
Explain what it means
Assess what is happening
Take action/advocate

16. HCBS RIGHTS, FREEDOMS & PROTECTIONS
Choice in who roommate is in shared units
Explain what it means
Assess what is happening
Take action/advocate

17. HCBS RIGHTS, FREEDOMS & PROTECTIONS
Control own schedule and activities
Explain what it means
Assess what is happening
Take action/advocate

18. HCBS RIGHTS, FREEDOMS & PROTECTIONS
Decorate/Furnish
Explain what it means
Assess what is happening
Take action/advocate

19. HCBS RIGHTS, FREEDOMS & PROTECTIONS
Freedom from Restraint
Explain what it means
Assess what is happening
Take action/advocate

20. HCBS RIGHTS, FREEDOMS & PROTECTIONS
Locks on bedroom/living unit door
Explain what it means
Assess what is happening
Take action/advocate

21. HCBS RIGHTS, FREEDOMS & PROTECTIONS
Visitors of own choosing at any time
Explain what it means
Assess what is happening
Take action/advocate

22. PERSON-CENTERED EDUCATION
Does the individual understand?
YES: Go over the “HCBS Visual Fact Sheet” handout and leave it with him/her. Talk about his/her goals and how to reach them.
NO: (e.g., advanced dementia)
May not directly have a conversation
May not leave materials
May observe the environment
May talk to people who are important to the individual

23. PERSON-CENTERED ADVOCACY
When talking to providers about a resident’s HCBS right that is not available at this time, ask:
How can we make that happen?
Is there a way to make progress in small steps?

24. LET’S TALK How might you approach the:
After going through the slides today, you have already thought about consumers in your caseload who do not currently have all of their HCBS rights.
How might you approach the:
Consumer who wants to have all their HCBS rights today?
Provider who is not fully allowing all HCBS rights at this moment in time?

25. PUTTING IT ALL TOGETHER
Document “Client Representative” in OACCESS
Count in-person HCBS education as direct contact
Any follow-up with provider or consumer may
be a direct or indirect contact, as appropriate

26. HCBS Q&A CALL-INS
We want your questions! We can talk about the tough cases.
Call-In Ph#
Participant#
Dates
Times
Friday, July 7, 2017
10:00 AM – 12:00 PM PDT
Friday, July 14, 2017
Friday, July 21, 2017
Friday, July 28, 2017
Wednesday, August 9, 2017
1:30 PM – 3:30 PM PDT
Wednesday, August 23, 2017
Tuesday, September 5, 2017
Tuesday, September 19, 2017

27. MORE HCBS QUESTIONS?
Provider Questions: General: CBC-Related: AFH-Related: AAA/APD Staff Questions: Contact: Bob Weir Chris Angel