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VIRGINIA’S OPTIONS COUNSELING STANDARDS TRAINING. MODULE 1 OVERVIEW OF OPTIONS COUNSELING. Embrace Person Centeredness Integrate Options Counseling (OC) Take a Closer Look at OC. Goals for Module 1. Why Options Counseling?.
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VIRGINIA’S OPTIONS COUNSELING STANDARDSTRAINING MODULE 1 OVERVIEW OF OPTIONS COUNSELING
Embrace Person Centeredness Integrate Options Counseling(OC) Take a Closer Look at OC Goals for Module 1
Why Options Counseling? Opens doors to opportunities for wider varieties of community supports Builds on existing practices in multiple agencies and organizations Helps address long term support issues in a systematic way
What is Options Counseling? Options Counseling (OC) is an interactive decision-support process whereby individuals, with support from family members, caregivers, and/or significant others, are supported in their deliberations to make informed long-term support choices in the context of the individual’s preferences, strengths, needs, values, and individual circumstances. Standards Section 1.2 4
Guiding Principles of OC Right to control and choices Relationship building Process, not event 5 Standards Section 1.1
All Individuals… …ARE,…WELL,…INDIVIDUALS!
ALL Individuals… …want choices in their lives.
ALL Individuals... …want control over their lives.
Aging and Disability Don’t Change the Fact… …THAT INDIVIDUALS ARE INDIVIDUALS!
And We All Have UniquePreferences and Routines Morning Ritual
Individual approaches support each person and build relationships
A Few Characteristics of Person-Centered Practices • The person’s voice is encouraged and listened to • The person’s preferences, fears, discomfort, and choices are honored • Information gathered is used to develop an action plan • Others who know and love the person are looked to for support in planning and carrying out the action plan • The person’s uniqueness is celebrated
Individuals are at the Center of Planning Theirchoices, their control
Person-Centered Practices Practices that focus on the preferences and needs of the individual, empower and support the individual in defining the direction for his or her life, and promote self-determination, community involvement, contributing to society and emotional, physical and spiritual health. Standards Section 1.2 15
Language (and labels) Do Make a Difference Not person-centered • Client, case, resident, participant, recipient, beneficiary, consumer, patient • Aged, Elderly, Senior Citizen • The Disabled, Handicapped • Assistance, Care, Services, Supervision Person-centered • Individual, person • Older adult • Individual with a disability • Supports
Person Centered Practices Resources • www.vcu.edu/partnership/cdservices/pcprb.htm • www.ilr.cornell.edu/ped/tsal/pcp • www.pioneernetwork.net • www.participantdirection.org • www.dimagine.com/page27.html • www.inclusion.com • www.learningcommunity.us • www.helensandersonassociates.co.uk • www.disabilityisnatural.com • www.circlesnetwork.org.uk • www.communityworks.info
Integrate Options Counseling Integrate Options Counseling
No Wrong Door/Aging and Disability Resource Connections (NWD/ADRC) Roots grew together from the Federal, State, and local levels Federal AoA and CMS – created grant opportunities Streamline Access to Services Creating a Single Point of Entry System to provide better information, assistance and access Avoid or delay facility-based care Combine populations Virginia Legislature – mandated studies to determine benefits of No Wrong Door and/or Single Point of Entry approaches to long term care Save money by reducing/eliminating duplication of effort Seeking data of unduplicated counts of individuals served Communities – motivated to strengthen local coordination of services* Reduce or eliminate client frustration Leverage technology to increase efficiency within and between agencies Track client progress across providers 20
NWD/ADRC In Virginia Offer a virtual single point of entry for accessing public and private health and human services in Virginia for older adults, adults with disabilities and their families and supporters: By phone On-line Physical locations 21
NWD/ADRC Vision Create partnerships, protocol, and an integrated system that provides assistance to older adults, adults with disabilities and their families and supporters in the environment of their choice regardless of where they originally seek help. 22
NWD/ADRC Vision of System Change TheLong Term Support System is: Person-Centered Consumer-Directed Provides access to all available supports and services Helps people at risk of institutionalization to continue to live at home, in the community or the environment of their choice as long as possible 23
NWD/ADRC The current system is • Fragmented • Institutional bias • Focus on programs • Confusing • Costly Aging and Disability Resource Connections… everycommunity in the nation highly visibleand trusted people of all incomes and ages information on the full rangeof LTS options point of entry forstreamlined accessto services 24
37% of Vets are over 65 years old 40% of older adults have one or more disabilities 28% of people with disabilities are also older adults 13% of Vets have a severe disability Growing number of older adults caring for adult children with a disability NWD/ADRCOverlapping Populations Prompt an Integrated Approach to Coordinated Services 25
NWD/ADRCCore Activities Nationally and in Virginia • Providing Long Term Support Information • Supporting Decision-Making through Options Counseling • Streamlining Access to Supports • Facilitating Transitions • Evaluating Outcomes 26
Individual Services and Supports Available Services Individual NWD/ADRCSupport decision-making through options counseling Culture Shift + Language + Training 27
NWD/ADRC IN VIRGINIAHome to Options Counseling An agency providing Options Counseling shall identify key partners to assure streamlined eligibility and access to federal, state and local supports and work collaboratively with them to develop an overall Options Counseling implementation strategy. Standards Section 2.0D 28
ADRC Resources • ADRC-TAE Issue Brief: Strategies for Building Collaboration. http://www.adrc-tae.org/tiki-index.php?page=StrategicPartnershipsandCollaboration • ADRC-TAE Issue Brief: Public-Private Partnerships Case Studies. http://www.adrc-tae.org/tiki-index.php?page=TAEIssueBriefs • Areas for CIL-AAA Collaboration: http://www.adrc-tae.org/tiki-index.php?page=StrategicPartnershipsandCollaboration 29
Centered on the Individual Preferences Strengths Values Needs Individual Circumstances Our own preferences, values, needs and circumstances have no place in Options Counseling!
Involvement of Supporters Options Counselors shall involve the eligible individual and all others the individual wishes to involve in Options Counseling except as follows: Individual says no Individual has surrogate decision-maker Standards Section 3.2(B) 32
Actively Encourage SUPPORTER PARTICIPATION
Surrogate Decision-Maker A person legally authorized to make decisions on behalf of an individual who has been declared legally incapacitated. Standards Section 1.2 34
Surrogate Decision-Maker • Two types in Virginia: • Guardians • Active Powers of Attorney • Presumption of capacity • Person-centered practices are for surrogate decision-makers, too!
Action Plan The Options Counselor shall work with the individual to develop an action plan for implementing the decisions made as a result of Options Counseling. An Action Plan is not the same thing as a service or support plan! Standards, Section 3.2(G) 38
Who’s Eligible For Options Counseling? Individuals age 18 and over with a disability AND Adults age 60 and over… …regardless of ability to pay Standards Section 1.3 40
Essential Components of Options Counseling Relationship building Focus on the individual Decision support Information Gathering/Sharing Weighing of Options Time controlled by Individual Action planning Tracking/Follow-up over time NOT EVERYTHING WE DO IS OPTIONS COUNSELING!
Options Counseling is not “Assessing” (but it can lead to an assessment) Developing a Service or Support Plan (but it can involve referral to a support coordinator for plan development) Simply providing information (but it definitely involves this!) Simply making a referral (but it certainly can involve this!)
Coordination with Support Systems Agencies shall assure that Options Counseling is coordinated with any applicable points of entry into support systems. • CILs • AAAs • CSBs • Local Screening Teams • Hospitals • Physician practices • MFP Transition Coordination providers Standards Section 3.1(D)(2) 43
Relationship to Other Statewide Initiatives No Wrong Door (ADRC) Money Follows the Person Community Living Program Care Transitions Medicaid Waiver Programs Systems Transformation Other Statewide Programs