The Art of Options Counseling: Person-Centered, Decision Support

1. The Art of Options Counseling: Person-Centered, Decision Support Thea Griffin, LMSW

2. Prerequsite for Options Counselors • Complete the NY Connects Information and Assistance Training that provides the necessary core competencies and communication skills instruction. • This includes active listening and interviewing techniques, empowering callers and handling difficult situations.

3. Learning Objectives • Define Options Counseling • Distinguish Options Counseling from Information and Assistance • Apply Person-centered interviewing techniques • Empower individuals to make decisions • Track Options Counseling

4. NY Connects: Choices for Long Term Care • An essential part of NYS’ effort to rebalance the long term care system • A central component of federal long term care reform initiatives for both the AOA and CMS, and functions as NYS’ Aging and Disability Resource Center (ADRC) • Streamlines access to information and assistance about long term care services, reduces fragmentation and empowers individuals to make informed choices

5. Information and Assistance Public Education Long Term Care Councils Key Functions of NY Connects

6. Aging and Disability Resource Center Grant • Two NY Connects programs awarded the federal ADRC grant award in 2009. • Improving access to long term care and improving transitions in care aimed at reducing preventable re-hospitalizations.

7. Defining Options Counseling • An interactive and individualized process whereby consumers are assisted in evaluating all of their long term care options and are supported in making a decision based on their values, needs and preferences and cost. • A distinct and specialized service offered by Aging and Disability Resource Centers

8. Options Counseling is…. Information and Assistance + Decision Support/Counseling = Enhanced Information & Assistance!

9. Goals of Options Counseling • To provide people with the information they need to make informed choices • To provide guidance by matching people’s needs and preferences with available services and supports • To help plan for the future • To help improve the quality of life of people receiving long term care services

10. An approach that generated from the Disabilities Rights Movement Consistent with direction of NY Connects Focuses on the individual, not on fitting the person into available services Highlights strengths, capacities, preferences, and desired goals of individual Person-Centered Planning: The Foundation of Options Counseling

11. Each person determines what is necessary and desirable to create a meaningful life. Options Counselors give individuals control to create the results they want. “What do you need to help you make this decision?” “What will help you make this decision better?” Counselors letting go of the need to “resolve the problem”. Importance of Self-Determination

12. Identifying consumer and family needs, values, and preferences Providing information on public and private resources Connecting consumers with resources Assisting consumers in deciding course of action and allowing for self-determination Counseling and support through the process Following up Elements of Options Counseling

13. Takes more time than I & A Is a process, not an event Involves multiple conversations Occurs in person and involves the family, as appropriate and feasible Encourages future planning Provides decision support, including action steps Requires documentation and tracking Distinguishing Features of Options Counseling

14. Prioritize the individual’s needs and wants Identify their preferences and values Identify options available Help individuals weigh the pros and cons of different choices “What might happen if you decide not to take any action?” Defining Decision Support

15. Decision Support Continued…. • Helps anticipate and plan for future needs • “What would you like to do when your daughter (caregiver) goes back to work full time?” • Develop an Action Plan

16. Getting the Information Needed to Provide Options Counseling • Ask individual to tell their personal story • Ask open-ended up questions: • “What type of assistance are you looking for?” • “How would you describe your current situation?” • Listen for cues that the person is at the point of decision making: • “Maybe I… I don’t know…Someone told me I need… I can’t…” • Ask if she/he would like support evaluating the options and making decisions

17. Individuals Who Would Benefit from Options Counseling Individuals with immediate long term care needs (e.g. after major life changing event) Individuals who are planning for future needs Caregivers who need help in caring for their loved one Individuals who are transitioning from one setting to another, such as from the hospital to their homes.

18. When Might Options Counseling Not Be Helpful? • During a crisis • When individual does not have the capacity to make decisions • When individual only wants a referral or telephone number

19. Examples of Components of an Optional Counseling Session • Individual/Family Needs and Preferences • Personal history and preferred lifestyle • Functional limitations and capacities • Support system • Financial situation • Exploration of Choices and Options

20. AoA Distinctions • Benefits Counseling Provides accurate and objective information on public benefits and entitlements, such as that provided by the HIICAP coordinator. • Futures Planning Focuses on planning for anticipated long term care needs.

21. Received I&A training Understanding of person centered planning Respect for self-determination Ability to provide counseling and support Knowledge of all available resources, public and private, and their cost Active listening skills Ability to work with families Skills of an Options Counselor

22. Key Questions for Options Counselors

23. Tools to Guide the Delivery of Decision Support • Importance and Readiness Rulers • Preferences Map • Relationship Map • Options Counseling Action Plan

24. Importance and Readiness RulersHelps with future planning

25. Preferences MapAssess values, needs and preferences

26. Relationship MapAssesses values, needs and preferences

27. LTC Options Counseling Action PlanChallenges and Preferences

28. Strengths and Possibilities

29. Options, Next Steps and Follow Up

30. Challenges Faced by Options Counselors • Dealing with family dynamics and handling conflicts • Helping individuals who have limited “options” • Working with individuals who do not qualify for public programs and have limited resources • Repeat callers who refuse to accept services • Letting individuals take risks.

31. What will you bring back with you? What was most/least useful? What would you like more information about? Discussion

32. Programmatic Requirements for Implementing Options Counseling • Track and document • Create methods for continued staff competence • Develop and implement operational protocols, including referral procedures with hospital discharge planners

33. Tracking Options Counseling

34. Additional Resources • Technical Assistance Exchange www.adrc-tae.org • Thea Griffin T_griffin@ofa.state.ny.us