1. Where do your dreams take you? Come with CFS to a place where Person-Centered Thinking is the way to do business…

2. Becoming Person Centered Organizations

3. Service Life Community Life Important for addressed No organized effort to address important to To and for present Active circle of support Included in community life To and for present Closest people are paid or family Few real connections Moving from Service Life to Community Life A Good Paid Life Focus on connecting, building relationships and natural supports ‘Important to’ present ‘Important to’ recognized © The Learning Community for Essential Lifestyle Planning, Inc. 2006

4. Learning about what isn’t working for system change Best practice models don’t infect all of typical practice and cause change Best practice models don’t infect all of typical practice and cause change Pilot efforts work but become another program Pilot efforts work but become another program The “tick box” approach to person centered planning improves the quality of the paper more than the quality of lives The “tick box” approach to person centered planning improves the quality of the paper more than the quality of lives Change by memo has no effect Change by memo has no effect

5. Learning about things that work You have to change how people think You have to change how people think - It has to be everyone - top to bottom, side to side - New ways of thinking have to become habits Organizational culture has to reflect the values and support the skills Organizational culture has to reflect the values and support the skills All of the efforts have to be integrated All of the efforts have to be integrated Changing structures and policies have to arise from and reflect the learning Changing structures and policies have to arise from and reflect the learning

6. Introduce and apply person centered thinking skills Formal training for – All managers – senior, middle, front line All managers – senior, middle, front line Selected direct support staff Selected direct support staff Key players, the “opinion molders” among the Key players, the “opinion molders” among the - self-advocates, family members, board members, funders, inspectors, service coordinators, etc.

7. But there has to be more than training Training introduces skills Training introduces skills Without more than training the impact diminishes over time Without more than training the impact diminishes over time Skills are learned but not regularly applied and then largely forgotten Skills are learned but not regularly applied and then largely forgotten The remnants of the skills are in the forms that have become empty rituals The remnants of the skills are in the forms that have become empty rituals

8. Two Errors Just training plan facilitators Just training plan facilitators Thinking that training without structured practice is enough Thinking that training without structured practice is enough

9. Not just better plans… Help people get better lives © The Learning Community for Essential Lifestyle Planning, Inc. 2006

10. There has to be an effort that takes the skills from training to habit Skill becomes habit Formal training Informal training Structured practice with feedback Reinforce

11. Those who take skills from training to habit are coaches, person centered thinking coaches

12. Coaches help the skills become habits Support the pervasive and routine use of the skills Support the pervasive and routine use of the skills - In day to day work - In problem solving Use the skills to develop “living descriptions” of how people want to live through partnerships with – Use the skills to develop “living descriptions” of how people want to live through partnerships with – - Those who use the services - Family members - Those closest to the person Make and celebrate level 1 changes Make and celebrate level 1 changes Create optimistic discontent Create optimistic discontent

13. Supporting Dreams Being “Mindful” & Recording Learning Recognizing and Sorting Important To and Important For & Finding the Balance Between Them Defining Staff Roles and Responsibilities Matching Staff and Those Using Services Learning, Using and Recording Communication Supporting Relationships, Community Connecting Learning Log The 4 Questions Working/Not Working What are the skills needed to support people? © The Learning Community for Essential Lifestyle Planning, Inc. 2006

14. Sorting Important to from Important for (and finding a better balance between them) © The Learning Community for Essential Lifestyle Planning, Inc. 2006 Important toImportant for

15. 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. Important to © The Learning Community for Essential Lifestyle Planning, Inc. 2006

16. What is important for people, includes only those things that we need to keep in mind regarding– Issues of health or safety What others see as important to help the person be a valued member of their community Important for © The Learning Community for Essential Lifestyle Planning, Inc. 2006

17. Importan t to Importan t for Importan t to Importan t for Importan t to Importan t for Balance © The Learning Community for Essential Lifestyle Planning, Inc. 2006

18. USE JUDGEMENT & CREATIVITY CORE RESPONSIBILITIES NOT OUR PAID RESPONSIBILITY The Donut Sort Defining Staff Roles and Responsibilities © The Learning Community for Person Centered Practices, Inc. 2008, adapted from the work of Charles Handy

19. Supports wanted and needed Skills needed Personality Characteristics (Present/Absent) Shared interests (nice to have) Matching Staff © The Learning Community for Essential Lifestyle Planning, Inc. 2006 for each person what are the:

20. Communication Chart Learning, using, and recording communication Communication Chart Learning, using, and recording communication What is happeningPerson does thisWe think it meansWe should © The Learning Community for Essential Lifestyle Planning, Inc. 2006

22. 4 + 1 Questions (focus on learning and act on it) 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 have learned?

23. What works/makes senseWhat doesn’t work/make sense Person’s perspective Family’s perspective Staff’s perspective

24. What works/makes senseWhat doesn’t work/make sense Person’s perspective Staff’s perspective USE THIS INFORMATION TO BUILD THE A G E N D A FOR THINGS THAT ARE TO STAY THE SAME USE THIS INFORMATION TO BUILD THE A G E N D A FOR THINGS THAT NEED TO CHANGE Disagreements

25. © The Learning Community for Essential Lifestyle Planning, Inc. 2006

26. If I had an hour to save the world, I’d spend 55 minutes defining the problem. -Albert Einstein

28. www.learningcommunity.uswww.learningcommunity.us for more information go to: Michael Steinbruck steinbmp@umdnj.edu 732.235.9308 or contact:

29. How we weaved Person Centered Thinking into the Rounds Process in our Residential Department

30. Clinical Meetings  What we did then - focus on compliance issues  What we are doing now - moving towards helping consumers achieve a more meaningful life

31. Person Centered Thinking Approach  Working/Not Working Tool which we renamed to Team Meeting/Consumer Rounds Worksheet (page1)  Records information in a more person centered way

32. TEAM MEETING/ CONSUMER ROUNDS WORKSHEET page 1 Consumer Name: Date: Presenting issue: From the Consumer’s Perspective What Is Working Right Now? 1.Enjoys working at Pathmark 2.Likes having control over his money 3. Likes being able to refuse to go on his appt for Drug counseling. 4.Taking his Viagra when he wants it What Is NOT Working Right Now? 1.Doesn’t like to have team meetings all the time 2.Doesn’t like getting positive drug test results 3. Everyone pressuring him to go to see his counselor From Staff Perspective 1. Team meetings gain only temporary cooperation 2. He remains employed. 1. Has high blood pressure and not knowing his drug or alcohol level 2. Concerned about mixing Viagra with high blood pressure and drugs.

33. Team Meeting/ CONSUMER ROUNDS WORKSHEET page 1 Consumer Name: Date: Presenting issue: From the Consumer’s Perspective What Is Working Right Now? What Is NOT Working Right Now? From Staff Perspective

34. Developing a Person Centered Thinking Plan  Utilizing the “4 + 1” Questions Tool which we renamed the Team Meeting/Consumer Rounds Worksheet (page 2)  Based upon What’s Working/Not Working Tool, we began to use this tool to answer the questions in order to formulate a plan

35. TEAM MEETING/ CONSUMER ROUNDS WORKSHEET page 2 Consumer Name: Date: What have we tried: 1. Restricted his independence in the community 2. A relapse protocol was put in place 3. Transporting him to and from work. 4. Driving him to Counseling sessions What have we learned? 1. He has access to drugs and alcohol at work during breaks. 2. Pathmark will not intervene unless it interferes with his work performance. 3. Doesn’t like to be in group with other “slow” people. What are we pleased about? 1. He tries to respond, he wants to stay sober. 2. His employment has not yet been effected. What are we concerned about? 1. Effects on his health What should we do now? 1. MSC will look into a residential drug program for him 2. Talk to MD about discussing the dangers of mixing drugs with high blood pressure. 3. Explore finding educational video for him to watch 4. Explore having attend regular AA meetings. 5. Meet again in one month.

36. Team Meeting/ CONSUMER ROUNDS WORKSHEET page 2 Consumer Name: Date: What have we tried: What have we learned? What are we pleased about? What are we concerned about? What should we do now?

37. Results  The tools became a living document  We moved away from a focus on compliance and towards meeting the real life needs of the consumers  We have more successful paper  We have eliminated obstacles to creating happier lives

38. Day Hab Overview  Day Habilitation Without Walls (DHWOW) is a community based one to one program. The program is geared towards individuals who were in traditional day programs that were unsuccessful in helping them achieve their goals and need one to one support. DHWOW is not site based and focuses on volunteer and recreational opportunities in the community. As a result the program participants are able to work on their goals hands on and in real time.

39. Problem Areas 1.Differences between desires of the consumer and advocate 2.Continuation of the same goals that did not result in much change in the consumer’s life 3.Ways to record learned information

40. What we were doing before… Planning for the consumer instead of with the consumer

41. Tool Used  Before we would bring something to the table and have the consumer/ advocate choose from our options  Important To/ Important For – helped develop more meaningful goals for the consumers, during planning meetings  Important To – what the person is saying in their words or behavior  Important For – issues of health or safety, “what others see as important for the person to be a valued member of their community”

42. Important To/ Important For  Important To Important For

43. Oscar’s Story  Problems – discrepancy in how goals are addressed  Helping Agent – important to/ important for tool  Positive Outcome – Oscar currently volunteers twice a week at a senior center

44. Oscar’s Important To/ Important For What is important to Oscar  To help others  Having a “regular” job (like people without a disability)  Working at one site  Working indoors  Same daily routine What is important for Oscar  To gain work experience  Healthy and safety environment

45. A PERSON CENTERED DESCRIPTION ABOUT ______________________ I. What are some great things about the consumer?  (What do people like and admire about the consumer? How does the consumer like to be introduced? What does the consumer like to do? Where does the consumer like to go? Whom does the consumer like to spend time with?)  II. What are things about the consumer that is important for others to know or do in order to best support them?  (What does the consumer dislike? What are things that the consumer has to do (or have) to keep him/her happy? How does the consumer need to be supported at home, at work, or out in the community?) III. What do you and other do that makes the consumer happy?  (What qualities and traits do you possess that the consumer likes? What qualities and traits do other people possess that the consumer likes?)  IV. Is there anything else that you can share that we would want to know about the consumer? Written by: __________________Relationship to consumer:_________________________

46. Person Centered Description Tool  Compilation of several PCT Tools  Tool is completed by staff, family, consumer or other involved parties  Supervisor then utilizes this information to create a person centered description with graphics as a background  Future goal is to utilize this description as the cover of all of our habilitation plans

47. A person centered description about Oscar Oscar enjoys being around other people and helping them if possible. He enjoys watching Wrestling and his favorite wrestler is Stone Cold Steve Austin. Oscar also collects Wrestling DVD, games, posters, and other memorabilia. Oscar’s favorite places are Nintendo World, Sony Wonders, and the Circus. Oscar also enjoys going on group trips with his peers, and talking to them about his favorite wrestlers. Oscar loves spending time with people he went to school with, friends from his Day Program, and his mother. Although usually shy at first, Oscar freely expresses himself once he gets to know a person. Oscar does not like it when people use curse words, walking long distances, or being outside for long periods of time. Oscar prefers to have a routing schedule and be around friendly people. Oscar needs to know about an event before participating in it and map out his bus route before traveling because he gets anxious. He is unable to travel in the community independently, but is learning how to with help from his DHS. Oscar needs to contact his mother when he makes changes to his schedule. To best support Oscar a person needs to know that Oscar is quiet when upset and has a hard time verbalizing his feelings. Oscar’s mother is his biggest support and it is important for him to call her when he gets home from program each day.

48. Results  Way to record information learned so all new staff can access meaningful information in a more timely fashion  Less paper, more information  More meaningful goals for the consumers that result in better lives