Service and Support Administration rule OAC 5123:2-2-11

1. Service and Support Administration rule OAC 5123:2-2-11 Kelly Miller, DODD OACB - SSA Forum August 28, 2013

2. History lesson Background of current rule - HCFA visit, need for increased service coordination, CAFS went away, HB 94… Rule was effective in 2005, reviewed in 2010 with no changes. We have learned a lot since 2005 as a system! QA work group met over the last year and made recommendations to DODD to rescind SL QA rule and replace it with other functions.

3. WHY change? We want to focus less on paper and more on the person. We want to embrace and promote increased self-advocacy efforts. We need to create efficiencies within the system and focus our resources where they are most needed. We believe the culture needs to shift more toward “listening to and learning from” the people we serve.

4. SSA rule revisions • Workgroup met for several months • Stakeholders all agreed on changes needed to improve the rule • Likely will be filed by fall with training after and implemented late 2013 • You are getting the advanced version of the training today

5. SSA rule continued • Deletes the term “single point of accountability” and replace it with “primary point of coordination”….discuss! • Shift focus from one of control to a more person centered approach…language changes throughout rule. • Increase self advocacy at all levels, including requirements in ISPs.

6. SSA rule continued • Redefines the term “team” so it is clear… • Adds new language about “decision making responsibility” and deletes the term “daily representative” in accordance with statute. • Allows an individual to request a different SSA from the county board.

7. Assessment • Assessment language has changed to focus on what is “important TO and FOR” the individual and to promote their desired outcomes. • Annual assessment need not be repeated, a process should include reviews and updates as needed…ask “what is working/not working in the individual’s life’?

8. Assessment • Rights • Self-determination • Physical well- being • Emotional well-being • Material well-being • Personal development • Interpersonal relationships • Social Inclusion

9. ISP • Must use a person centered planning process to develop a plan. • Ensure the achievement of outcomes that are important TO and FOR the individual and balance the the two if there are conflicts. • Address identified risks and prevent or minimize risks.

10. ISP • Secure commitments from providers to support the individual in achievement of his/her goals. • Establish and maintain contact with providers, natural supports and the team to ensure all understand expectations and are working toward meeting desired outcomes. • Revise plans as needed…

11. Monitoring • Deletes the word “monitoring” and replace it with “continuous review process” to change the culture from an event/form to an ongoing process. • Requires an individualized approach whereby the ISP identifies the scope and frequency of reviews…no more “cookie cutter” procedures.

12. Continuous review process • Shift focus from reviewing HPC documentation to helping individuals get a life and outcomes they want. • “Don’t go where you are not invited” but of course still be extremely mindful of health and welfare… • Feedback from reviews must be given to the individual, family and provider to close the loop.

13. Continuous review process • Scope, type and frequency must be stated in ISP and include face to face visits. • Frequency may be increased when individual has intense behavioral or medical needs or under other specified circumstances in the rule. • Areas of non-compliance should be referred for a PC review.

14. Update on Behavior Support Rule

15. Questions?