VIRGINIA’S OPTIONS COUNSELING STANDARDS TRAINING

1. VIRGINIA’S OPTIONS COUNSELING STANDARDS TRAINING MODULE 5 ADMINISTRATION of Options Counseling August 11, 2011

2. OPTIONS COUNSELING STANDARDS TRAINING AGENDAMODULE 5 Administration of Options Counseling 1:00 p.m. Welcome and Introductions The Basics Staffing an Options Counseling Program Documentation, Data Collection and Reporting 2:15 p.m. Break 2:30 p.m. Evaluation Marketing, Education and Awareness Next Steps 3:30 p.m. Qs & As 4:00 p.m. Adjourn

3. Operate successfully Adjust business practices Commit to Training Goals for Module 5

4. Definition Philosophy Eligibility Essential Components Agency Bill of Rights/ Grievance Procedure Partnerships The basics

5. 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 5

6. Guiding Principles of OC Right to control and choices Relationship building Process, not event 6 Standards Section 1.1

7. Eligibility Individuals age 18 and over with a disability AND adults age 60 and over… …regardless of ability to pay Standards Section 1.3

8. Bill of rights and Grievance procedure Agencies shall assure that individuals receive and have access to the agency’s existing bill of rights and grievance procedures. Standards Section 3.1(D)(3)

9. 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!

10. 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) 10

11. Relationship to Other Statewide Initiatives No Wrong Door (ADRC) Money Follows the Person Community Living Program Veteran’s-Directed Home and Community-Based Supports Program Care Transitions Medicaid Waiver Programs Other Statewide Programs

12. Staff roles Core competencies/ credentials Training Monitoring and supervision Staffing ratios Staffing an options counseling program

13. OPTIONS COUNSELING STAFFING: ESSENTIAL COMPONENTS and ROLES DETERMINE THE NEED + PROVIDE OPTIONS COUNSELING AND FOLLOW UP + MONITORING/SUPERVISION

14. CORE COMPETENCIES: staff who determine the need for options counseling • Training in statewide protocol • Do you understand the information I have given you? (if “no,” refer to OC; if “yes,” ask next question) • Do you need additional information? (if “yes,” refer to OC; if “no,” ask next question) • Do you know what your next steps are? (if “no,” refer to OC; if “yes,” do not refer to OC) (Section 3.1.B.) • Demonstrated accurate use of the protocol Standards Section 4.1(A)

15. CORE COMPETENCIES: staff who determine the need for options counseling

16. CREDENTIALS: staff who determine the need for options counseling Good listening/interviewing/communication skills Knowledge of issues confronting older adults and individuals with disabilities Successful completion of statewide training module in determining the need for Options Counseling. Standards Section 4.3(A)

17. CORE COMPETENCIES: staff who deliver and follow up from options counseling • Training in statewide Options Counseling curriculum • Ability to: • Understand the individual • Understand/educate about public/private resources • Facilitate knowledge of informal supports and self-direction • Encourage future orientation and goal-setting • Follow up • Communicate in a manner that leads to informed choices Standards Section 4.1(B)

18. CREDENTIALS: staff who deliver and follow up from options counseling Bachelor’s degree/equivalent experience Minimum one year experience Knowledge of long term supports/funding systems Knowledge of the issues confronting older adults and individuals with disabilities Good listening/interviewing/communication skills Successful completion of the statewide Options Counseling training curriculum Standards Section 4.3(B)

19. CONTINUING TRAINING: staff who deliver and follow up from options counseling Agencies providing Options Counseling shall require successful completion of an annual statewide Options Counseling best practices training to ensure that staff who deliver Options Counseling have appropriate decision-support skills and knowledge about available resources. Standards, Section 4.4

20. CONTINUING TRAINING: staff who deliver and follow up from options counseling

21. CORE COMPETENCIES: supervisors Training in the Options Counseling administration curriculum Standards Section 4.5(C)

22. CREDENTIALS: supervisors Experience or educational training to oversee staff development, program management, program planning, policy/procedural maintenance, and program evaluation. Standards Section 4.5(C)

23. ADEQUACY OF STAFFING (A) Agencies providing Options Counseling shall assure that staff who determine the need for and who deliver Options Counseling have sufficient time to devote to their Options Counseling duties. (B) Agencies providing Options Counseling shall establish staffing ratios that assure compliance with 4.6(A). Standards Section 4.6

24. Documentation, reporting and evaluation

25. Unit of Service A unit of service is defined as the number of contacts, and the time spent in hours or portions thereof, with and on behalf of each individual. The hours shall be recorded in 15-minute increments. Standards Section 5.1(E)

26. The Individual Support Record Individual support records shall be maintained for each individual receiving Options Counseling. Standards Section 5.1 (A) 26

27. ITEMS FOR THE INDIVIDUAL SUPPORT RECORD: STAFF DETERMING THE NEED Original contact Reason Trigger Demographic profile person/relationship Individual’s contact Authorization to OC referral date Progress notes information share information Standards Section 5.1(B)

28. ITEMS FOR THE INDIVIDUAL SUPPORT RECORD: options counselor Initial contact date New? Reengaging? Why? Environment and Participants communication preferences Standards Section 5.1(C)(1-4)

29. ITEMS FOR THE INDIVIDUAL SUPPORT RECORD: options counselor Individual Circumstances Standards Section 5.1(C)(5)

30. ITEMS FOR THE INDIVIDUAL SUPPORT RECORD: options counselor Preferences, needs, Options, alternatives Action Plan: Goals/ values, definition risks, benefits discussed decisions, steps, of success resources, timeline, responsible party Referrals made Action plan implemented Progress Notes Future Needs Standards Section 5.1(B) (6)-(13)

31. ITEMS FOR THE INDIVIDUAL SUPPORT RECORD: options counselor in follow up Date and time spent Follow up Decisions purpose/outcome implemented? Supports received Goal status Satisfaction Plan followed? Termination Reengaged? date/reason Why? Standards Section 5.1(D)

32. Data Reporting The agency shall collect the following data on an individual basis and report it on an aggregate level: • Demographics • Individual Satisfaction Data (process and choices/decisions made) • # individuals living in community—6 and 12 months • # individuals offered, provided, terminated from and re-engaged in Options Counseling • Time spent per individual • # referrals made • # individuals achieving goals • # staff trained in Options Counseling/roles/titles Standards Section 5.2

33. Assessing individuals’ satisfaction

34. THE IMPORTANCE OF DATA:IS OPTIONS COUNSELING WORKING? Standards Section 3.3(D)

35. Agencies shall also follow up using a uniform instrument, administered in the method or mode of communication that the individual uses and prefers, to measure individuals’ satisfaction with the Options Counseling process and the choices the individual has made. Standards Section 3.3(C)(2)

36. Individual satisfaction domains CHOICE HEARD SUPPORTS INFORMED AUTONOMY Standards Section 3.3(D)(3)

37. HONOR PREFERENCES Sign language? Talking? What language? COMMUNICATION Special device? In writing?

38. HONOR PREFERENCES Home? In person?And where?Options Counselor’s Office? Neutral Environmentallocation? Telephone?Computer?

39. Options counseling Marketing, education, and awareness

40. Raise Awareness • Provide Education and/or • Actively Market Standards Section 2.0(A)

41. audiences • Adults 60 and older, and adults 18 and older who have a disability • Individuals residing in hospitals and other institutional settings • Family members, caregivers and supporters • The general public • The medical community, including hospitals • Administrators and staff of long-term support facilities • Long-term support ombudsmen Standards Section 2.0(A) • Providers of long-term community supports and other local agencies having regular contact with older adults and/or individuals with disabilities • Social workers • Health and human services agencies • Local government officials and policy makers • Advocates and advocacy organizations

42. Awareness and education activities = Outreach + Response to inquiries for information Standards Section 2.0(B)

43. Awareness, education and marketing activities shall be directed both to individuals who pay privately, and to individuals who cannot pay. Standards, Section 2.0(C)

44. Marketing Resources • TAE Issue Brief: Marketing to External Audiences http://www.adrc-tae.org/tiki-index.php?page=OutreachandMarketing • ADRC-TAE Issue Brief: Private Industry Lessons – Branding http://www.adrc-tae.org/tiki-index.php?page=OutreachandMarketing • Centers for Disease Control and Prevention Social Marketing http://www.cdc.gov/healthmarketing/ • Social Marketing Institute http://www.social-marketing.org/sm.html • Social Marketing Place http://social-marketing.com/ • Turning Point Foundation http://www.turningpointprogram.org/Pages/socialmkt.html • AARP publications http://www.aarp.org/states/ • Idaho Performance Measures http://www.adrc-tae.org/tiki-download_file.php?fileId=26826

45. Marketing Resources • National Clearinghouse on Long Term Care Information http://www.longtermcare.gov/LTC/Main_Site/index.aspx • Own Your Future Campaign http://www.longtermcare.gov/LTC/Main_Site/Planning_LTC/Campaign/index.aspx • Assessing Your Long-Term Care Planning Quotienthttp://www.adrc-tae.org/tiki-download_file.php?fileId=1962 • A House in Order: How Planning for Your Aging Brings Peace of Mind: http://www.adrc-tae.org/tiki-download_file.php?fileId=26901 • National Council On Aging: Use Your Home to Stay at Home Program http://www.ncoa.org/content.cfm?sectionid=250 • American Institute of Certified Public Accountants (AICPA)http://www.360financialliteracy.org/

46. What happens now?

47. TRAINING THAT MUST OCCUR BEFORE SEPTEMBER 30! • OCCs train all agency staff who determine the need for Options Counseling • Determining the Need – Modules 1 and 2 • OCCs coordinate (with EDs) a training for local team AAA and CIL staff: Working with individuals with disabilities and older adults (Module 6) • VDA will provide training on the NWD technology for the use of CRIA in OC documentation, tracking and reporting. • Any staff who missed August 10-11 training and who will be providing OC or supervising OC, must receive training in the applicable Module/s: • Providing OC – Modules 1, 2, 3, 4, and 5 • Supervising OC – Modules 1 and 5

48. NEXT STEPS • Begin offering OC according to the statewide standards • Provide quarterly reports to VDA • Develop a plan for local outreach and marketing • Integrate talking points into local outreach • Train new staff members who will be determining the need, providing OC or supervising OC, as they join the agency • Determining the Need – Modules 1 and 2 • Providing OC – Modules 1, 2, 3, 4, and 5 • Supervising OC – Modules 1 and 5

49. The end