VIRGINIA’S OPTIONS COUNSELING

STANDARDSTRAINING

MODULE 1OVERVIEW OF OPTIONS

COUNSELING1

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GOALS FOR MODULE 1

Embrace Person Centeredness

Integrate Options Counseling (OC)

Take a Closer Look at OC

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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

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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

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GUIDING PRINCIPLES OF OC

Right to controland choices

Relationship building

Process, not event 5Standards Section 1.1

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Embrace Person Centeredness

7…ARE,…WELL,…INDIVIDUALS!

ALL INDIVIDUALS…

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ALL INDIVIDUALS…

…want choices in their lives.

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ALL INDIVIDUALS...

…want control over their lives.

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AGING AND DISABILITY DON’T CHANGE THE FACT…

…THAT INDIVIDUALS ARE INDIVIDUALS!

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AND WE ALL HAVE UNIQUEPREFERENCES AND

ROUTINES

Morning Ritual

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INDIVIDUAL APPROACHES SUPPORT EACH PERSON AND

BUILD RELATIONSHIPS

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A FEW CHARACTERISTICS OF PERSON-CENTERED

PRACTICESThe person’s voice is encouraged and

listened toThe person’s preferences, fears,

discomfort, and choices are honored Information gathered is used to

develop an action planOthers 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

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INDIVIDUALS ARE AT THE CENTER OF PLANNING

Their choices, their control

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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

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ONE WORD CAN MAKE A BIG DIFFERENCE!

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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

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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

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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

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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 phoneOn-linePhysical locations

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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.

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NWD/ADRC VISION OF SYSTEM CHANGE

The Long Term Support System is: Person-CenteredConsumer-DirectedProvides access to all available supports and servicesHelps people at risk of institutionalization to continue to live at home, in the community or the environment of their choice as long as possible

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NWD/ADRCThe current system is Fragmented Institutional bias Focus on programs Confusing Costly

Aging and Disability Resource Connections…

every community in the nation highly visible and trusted people of all incomes and ages information on the full range of LTS options point of entry for streamlined access to services 24

NWD/ADRCOVERLAPPING POPULATIONS PROMPT AN

INTEGRATED APPROACH TO COORDINATED SERVICES

Growing number of older adults caring for adult

children with a disability

40% of older adults have one or more disabilities

28% of people with disabilities

are also older adults

37% of Vets are over 65

years old

13% of Vets have a severe

disability

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NWD/ADRCCORE ACTIVITIES NATIONALLY AND IN VIRGINIA

Providing Long Term Support InformationSupporting Decision-Making through

Options CounselingStreamlining Access to SupportsFacilitating Transitions Evaluating Outcomes

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NWD/ADRCSUPPORT DECISION-MAKING THROUGH OPTIONS COUNSELING

Available Services

Individual

Individual

Services and Supports

Culture Shift + Language + Training27

NWD/ADRC IN VIRGINIA

HOME TO OPTIONS COUNSELINGAn 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

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Take a Closer Look at OC

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CENTERED ON THE INDIVIDUAL

Individual Circumstances

Our own preferences, values, needs and circumstances have no place in Options Counseling!

Preferences Strengths

Values Needs

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INVOLVEMENT OF SUPPORTERSOptions 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)

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ACTIVELY ENCOURAGE

SUPPORTER PARTICIPATION

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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

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SURROGATE DECISION-MAKER Two types in Virginia:

Guardians Active Powers of Attorney

Presumption of capacity

Person-centered practices are for surrogate decision-makers, too!

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IMPORTANT CONCEPT

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DECISION-MAKING

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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)

ACTION PLAN

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GOAL #___ ACTION STEP/S

RESOURCESNEEDED

TIME RESPONSIBLEPARTY

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Individuals age 18 and over with a disability

AND

Adults age 60 and over…

…regardless of ability to pay

Standards Section 1.3

WHO’S ELIGIBLE FOR OPTIONS COUNSELING?

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ESSENTIAL COMPONENTS OF OPTIONS COUNSELING

Relationship building Decision supportFocus on the individual

Time controlled by IndividualWeighing of OptionsInformation Gathering/Sharing

Action planning Tracking/Follow-up over time

NOT EVERYTHING WE DO IS OPTIONS COUNSELING!

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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!)

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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

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No Wrong Door (ADRC)Money Follows the PersonCommunity Living Program

Care TransitionsMedicaid Waiver Programs

Systems TransformationOther Statewide Programs

RELATIONSHIP TO OTHER STATEWIDE INITIATIVES

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THE END

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