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HOME & COMMUNITY BASED SERVICES TRAINING FOR DIRECT SUPPORT PROFESSIONALS

HOME & COMMUNITY BASED SERVICES TRAINING FOR DIRECT SUPPORT PROFESSIONALS. WHAT ARE HOME AND COMMUNITY BASED SERVICES?. H ome and C ommunity B ased S ervices (HCBS) provide opportunities for people to receive services while living in their own home and community.

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HOME & COMMUNITY BASED SERVICES TRAINING FOR DIRECT SUPPORT PROFESSIONALS

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  1. HOME & COMMUNITY BASED SERVICES TRAINING FOR DIRECT SUPPORT PROFESSIONALS

  2. WHAT ARE HOME AND COMMUNITY BASED SERVICES? Home and Community Based Services (HCBS) provide opportunities for people to receive services while living in their own home and community. Being a contributing citizen is essential!

  3. CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) New regulations enhancing the quality of Home and Community Based Services, providing additional protections to people who receive services under Medicaid is called the CMS Final Rule.

  4. CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) The intent of the CMS Final Rule is to ensure that individuals receiving services and supports through Medicaid’s HCBS programs have full access to the benefits of community living and are able to receive services in the most integrated setting.

  5. SPIRIT OF THE RULE People receiving services should have the benefits and freedoms of community living just like all of us!

  6. Services Need To BePERSON CENTERED Through the Person Centered Planning process; peopleshould be making their own choices! Choose where they live; living in a place where anyone else might live Choose their own Direct Support Professional or Direct Service Provider if needed

  7. Who Is In Control? THE PERSON RECEIVING SERVICES Control of where they live, where they work/volunteer and who supports them!

  8. SPIRIT OF THE RULE Services should reflect individual preferences and control of their personal resources with goals and preferences related to: • Community Participation • Employment & Volunteering • Income & Savings • Healthcare & Wellness • Education • Self-directed & personally defined outcomes • Independence in making life choices & optimizing autonomy • Choice of services & supports (both paid and unpaid) as well as who provides them

  9. DIRECT SUPPORT PROFESSIONALS • While providing Staffing Supports your role is important in creating opportunities for growth for people in their Life! • Teach people to be as independent as possible in their own home! • Teach people it’s their choice and you are there to help. They are in control of their own lives!!

  10. DIRECT SUPPORT PROFESSIONALS YOU: Assist people in learning to use community resources & develop meaningful relationships within their community. Support people by helping them access the benefits of community living such as shopping, library, festivals, bus routes, volunteering, working, etc.

  11. ROLE OF DIRECT SUPPORT PROFESSIONAL While providing Staffing Supports your role is important in helping all people to maximize their opportunities in Life! As a Direct Support Professional your job is to assist the people you support in becoming as independent as possible in living their life and achieving their goals! This may consist of hands on assistance as well as reminding, observing or training with the person based on their level of needs! To see Abby’s Story by Developmental Disabilities Institute - Wayne State University Visit: • https://www.youtube.com/watch?v=ELUbi2zhUNk&feature=youtu.be

  12. HOW DOES THE CMS FINAL RULE AFFECT THE PEOPLE WE SUPPORT ? Through this training you will be able to evaluate the way you currently support people and open your mind to ways of helping people to be more independent in their home and their community. People with disabilities should have full access to benefits of community living and be able to receive services in the most integrated setting.

  13. PEOPLE RECEIVING HOME AND COMMUNITY SUPPORTS MUST LIVE IN PLACES THAT MEET THE FOLLOWING CRITERIA: The location is integrated in and supports full access to the greater community and the person is able to engage in community life. The Person is able to control personal resources and receive services in the community to the same degree as other people in the community. The person is able to make their own choices. The location is selected by the person from setting options including non- disability specific settings. The setting options are identified and documented in the Person Centered Plan and are based on the individual’s preferences, needs, and resources available to them.

  14. HCBS FINAL RULE CRITERIA CONTINUED: The Home ensures individual rights of privacy, dignity and respect, and freedom from coercion and restraint. The person has privacy in their room including lockable doors, choice of roommates and freedom to furnish or decorate their room & home. The staffing supports enhance, but do not control, individual creativity, self sufficiency and independence in making life choices. The person chooses their services and supports, and who provides them. The Person chooses with whom they interact.

  15. ADDITIONAL REQUIREMENTS FOR HOME & COMMUNITY BASED SERVICES: The person has a lease or other legally enforceable agreement (this is a Resident Care Agreement in a licensed Home with an additional document available at michigan.gov if the person chooses to live in a Licensed home) providing similar protections; that other tenants would have such as information on eviction process & means to appeal an eviction. The person has freedom and support to choose their own schedule & activities The person can choose where to eat, what to eat and when to eat as long as it does not endanger their safety and they do not have any modifications in their Person Centered Plan. The person can have visitors of their choosing.Any modifications to the individual’s right to have visitors must be identified in their person centered plan and be based upon safety concerns only.

  16. ADDITIONAL REQUIREMENTS FOR HOME & COMMUNITY BASED SERVICES: Information about filing a complaint is in a location where the person can access it and they can understand it. Information is provided to the person on how to request new housing if they so desire. The Person is advised on how to discuss their concerns with their staff.

  17. ADDITIONAL REQUIREMENTS FOR HOME & COMMUNITY BASED SERVICES: The Person knows who to contact to complete an anonymous complaint. The person is addressed in a manner in which they prefer to be addressed. The person has the opportunity to seek employment and work in competitive integrated settings if they choose.

  18. ANY MODIFICATION TO THESE REQUIREMENTS MUST BE SUPPORTED BY A SPECIFIC ASSESSED NEED &EXPLAINED IN THE PERSON CENTERED PLAN In order for a person to have a Modification to these requirements they must have a documented reason for that modification . The Following requirements must be documented in the Person Centered Plan: Any Identified specific and “modified need” for the person – for example: If a person has limited or no safety skills, there may be limitations on being able to come and go from their home at any time due to lack of Safety Skills. This must be documented in the plan and reviewed ongoing along with a goal for making progress towards acquiring safety skills. OR A person who has Prader-Willi Syndrome (People with Prader-Willi syndrome eat constantly because they never feel full ) may need to have limitations on access to food due to health and safety reasons. Again, this must be documented in the PCP and reviewed ongoing making progress towards reducing limits.

  19. MODIFICATIONS DOCUMENTED Documentation must occur of positive interventions & supports used prior to any modifications being put in the Person Centered Plan. For Example – YOU/Direct Support Professionalwork with the person teaching them how to safely cross the street while out in the community. The person continues to cross busy streets without looking; therefore the person may have limitations on being able to go out in the community by themselves due to health and safety reasons until they can learn to safely cross the street.

  20. REQUIREMENTS FOR MODIFICATIONS THAT MUST BE DOCUMENTED IN THE PCP CONTINUED : Must have clear description of the condition that is directly proportionate to the specific assessed need. For example – A Person with Prader-Willi Syndrome may need to have food locked in cabinet due to the inability to stop eating on their own. However, you must try to help them to learn to live with this disability such as providing limited amount of food in a cabinet for them. Modifications must be monitored on a regular basis to determine if they are still necessary. There must be documentation of less intrusive methods that have been tried but did not work. For example : The person previously had limited access to food (person could access pantry where limited amount of food was stored) however they could not be re-directed and continued to eat excessively until they were physically sick. This scenario may require that all food has to be locked up again and a new strategy implemented. This would be documented in the Person Centered Plan. BOTTOM LINE: NEVER GIVE UP! KEEP WORKING TOWARDS INDEPENDENCE!

  21. HCBS REQUIREMENTS People receiving HCBS Services must receive service supports in a setting where there is regular (more than once per week) opportunity for contact with people who do not receiving services; for example, Visits from friends/family, interacting with others in the community, involved in community groups, programs, etc.

  22. HCBS REQUIREMENTS Individuals participate in activities of their choosing in the community such as individual shopping, religious or spiritual services, appointments medical & personal, meals with friends or family, recreational activities, community events, volunteer, community services, community employment, school or education classes/opportunities

  23. HCBS REQUIREMENTS Individuals have a secure place to store their personal belongingssuch as locked bedroom, locked closet, lockbox, etc. Individuals have a way to choose Direct Support Professionals, Providers and choose new ones if not satisfied with services such as a Provider Panel with posted information in video/audio formats, choosing Self-Determination, the Provider having a Grievance Process, the person contacting their Supports Coordinator, etc.

  24. HCBS REQUIREMENTS Individuals should be able to update or change their services and supports that they receive based on their preferences and needs. • Individuals should be participating in adult, legal activities such as voting in public elections, involved in groups, Community Boards, etc.

  25. PROVIDING DIRECT SUPPORTS It is YOUR job to help support and assist people to be able to make choices in their life and community!

  26. HOW CAN WE SUPPORT PRIVACY FOR INDIVIDUALS IN THEIR HOME Individuals can close and lock their bedroom and bathroom door if they choose. The person served has a right to privacy! Any modifications due to health and safety must be addressed in the PCP and reviewed to be moving towards independence. Individuals decide if staff members have a key or keypad access to one’s home, bedroom, bathroom. Again, any modifications due to health and safety must be addressed in the PCP. REMEMBER: You are helping support them in THEIR home

  27. HOW CAN WE SUPPORT PRIVACY FOR INDIVIDUALS IN THEIR HOME Do bedroom and bathroom doors have doorknobs that may be unlocked from the inside with one motion (automatically unlocks with one turn of the knob)? We need to assist/support the person in being as independent as possible. There are many different styles of door knobs, handles and locks that help people to navigate doors and locks easier. Look for equipment and modifications that help people to be as independent as possible.

  28. HOW SUPPORT NEEDS TOBE PROVIDED: If an individual needs assistance with personal care, it is important that we ensure they have privacy when receiving this support and help them to be as independent as possible. A PERSON’S PRIVACY MUST BE RESPECTED!

  29. PERSONAL COMMUNICATION DEVICE / CLOTHING If an individual has access to a communication device (cell phone, landline phone, personal computer, tablet); assist them in connecting to others! Choice is important; their choice! You are coaching and assisting as necessary. Look for ways to teach them to choose.

  30. CHOICE IS IMPORTANT! Individuals need to be allowedto have meals or snacks at the time and place of their choosing. Do individuals have access to food at any time, as appropriate and that is safe? Individuals need to be allowed to choose what they eat; eat alone or with others; and have access to food supporting and coaching them in healthy choices. We need to assist/support the person in achieving these goals! Make sure the PCP addresses it!

  31. SUPPORTING PEOPLE Support Individuals so that they can arrange and control their personal schedule for daily appointments and activities. For example; community events, doctor appointments, shopping, volunteering or work, clubs and classes, etc. SUPPORT CHOICE & INDEPENDENCE!

  32. HOW SUPPORT NEEDS TOBE PROVIDED: Support Individuals to have full access to all areas of their home so they can be as independent as possible! Support the person to be able to physically access household appliances.

  33. HOW SUPPORT NEEDS TOBE PROVIDED CONTINUED: Ensure there is space within the home where individuals may meet with visitors to have private conversations Support individuals to move about the inside and outside space of their home while remaining safe

  34. HOW SUPPORT NEEDS TOBE PROVIDED CONTINUED: Support the person to set up public transportation for desired activities, if they don’t have transportation already, while ensuring they are safe. Support them by advocating for their needs if you are invited to their PCP!

  35. If People Do Not Want to Live Alone OR Can Not Afford to Live Alone: They may need assistance in finding an affordable place to live. They may need assistance in finding roommates. Their home and surroundings may need modified as necessary to help them be independent such as ramps, etc. PERSON CENTERED PLANNING - PCP

  36. HOW YOU CAN SUPPORT PEOPLE RECEIVING HCBS Think about your own life and all of the things you do daily. Are the people we support able to do everything we do?

  37. HOW YOU CAN SUPPORT PEOPLE RECEIVING HCBS Your job is to support people with disabilities to live as independently as possible in their local community; being in control of their own life and making life choices!Supporting them to have a high quality of life and be a positive, contributing citizen in their community!

  38. YOUcan make a positive difference in people’s lives! BY Supporting people in controlling their own lives!!

  39. For Additional Information Wayne State University Resources: http://ddi.wayne.edu/hcbs.php State of Michigan Resources: http://www.michigan.gov/mdhhs/0,5885,7-399-71547_2943-334724--,00.html http://www.michigan.gov/documents/mdch/Final_Rule_474879_7.pdf

  40. for MAKING THE DIFFERENCE in people’s lives by supporting them in living successfully in their local community!

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