Informed Decision Making Direct Support Professional Roles & - - PowerPoint PPT Presentation

Informed Decision Making

Direct Support Professional Roles & Responsibilities

Raleigh, N. Carolina 6.10.2019 Presented by

National Alliance for Direct Support Professionals

John Raffaele, MSW Director of Education

Introduction

John Raffaele MSW, Director of Educational Services NADSP

Introductions

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

THE NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS

What is The NADSP?

Understanding Our Past & How Far We’ve Come

“We have a situation that borders on a snake pit, children live in filth, our fellow citizens are suffering tremendously because of a lack of attention, lack of imagination, lack of adequate manpower”. Senator Robert M. Kennedy, 1968

Changing Long-Term Supports and Services Landscape

HCBS Settings Rule Olmstead Act Department of Justice Litigation and Settlement Agreements Transitions to Managed Care Budget Implications Growth in demand and and Shift to Individualized Supports Focus on Recovery and Community Inclusion Supported Decision Making

Where is Quality Defined?

THE NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS

“It is defined at the point of interaction between the staff member and the individual with a developmental disability.”

John F. Kennedy, Jr. (1995) Chair, President’s Committee for People with Intellectual Disabilities

THE NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS

Also at the Point of Interaction: Abuse & Neglect

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

What is Informed Decision Making?

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

What is Informed Decision Making?

(A comprehensive definition for Direct Support Professionals)

• Informed decision making is a process where a person supported has obtained

information and knowledge about a situation or problem

• With the assistance of a direct support professional or other person, the

person supported understands the choices available to them and the

• utcomes possible
• When they make a final choice it reflects their personal values, not those of

the people assisting or supporting them

• Finally, it is the acceptance of the associated responsibility and risk of the
• decision. This decision is their decision alone and non-coerced by the

professional.

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

Some Context…

• We all use informed decision-making!

So why do we need a training on it?!

Because people with disabilities have historically and systematically been denied the right to make decisions, take risks, and experience life in the way that those without the label of disability have.

Changing Context…

• The way Centers for Medicare and Medicaid

Services defines home and community-based settings changed in 2014.

–Defined by personal autonomy and choice!

• Scheduling
• Food
• Visitors
• Daily activities
• Physical environment
• Who he/she interacts with

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

Supported and Informed Decision Making

When people are supported to make decisions for themselves, they are seen as more capable by others. When we are not allowed to make our own decisions

• r when someone else makes our decisions for us, we

are seen as less capable and as having less value in community.

2014 INDEPENDENT BUT NOT ALONE: A GLOBAL REPORT ON THE RIGHT TO DECIDE Page 65

Actions To Complete For Compliance 441.301(c) (4) – Optimizes, but does not regiment, individual initiative, autonomy, and independence in making life choices, including but not limited to: daily activities, physical environment, and with whom to interact. Proposed State Transition Plan Deliverables: “Identify, develop, and distribute training tools and policy updates that are needed for compliance”

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

New Federal Requirements

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

Providers must ensure that services are furnished:

(i)Under a written person-centered service plan (also called plan of care) that is based on a person-centered approach:

• Reflect risk factors and measures in place to minimize them, including individualized back-up

plans and strategies when needed.

• The individual will lead the person-centered planning process where possible
• Includes people chosen by the individual.
• Individual directs the process to the maximum extent possible
• Reflects cultural considerations of the individual

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

New Federal Requirements

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

Informed Decision-Making

1. 2. 3. 4. 5.

Understand the decision/issue/situation The NADSP 5 Step Process Gather information Explore options & consider outcomes Decide, act & empower Evaluate the decision

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

Home and Community Based Settings Community Settings Rule

Direct Support Professionals Must Understand: People will have the freedom and support to control their own schedules and activities, and have access to food at any time. People will be able to have visitors of their choosing at any time. People will have the freedom to furnish and decorate their sleeping or living units

Are Direct Support Professionals Prepared?

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

Step 1

Understanding the;

Decision/Issue/Situation

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

1

Step 2

Gathering Information

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

2

Step 3

Explore Options and Consider Outcomes

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

3

Step 4

Decide, Act and Empower

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

4

Step 5

Evaluate the Decision

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

5

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

Informed Decision-Making

1. 2. 3. 4. 5.

Understand the decision/issue/situation The NADSP 5 Step Process Gather information Explore options & consider outcomes Decide, act & empower Evaluate the decision

Vital Questions to ask…..

What kind of decision is being made? Has the person made a decision like this before? Has the person been assisted to understand the risks and benefits? How big is the impact of this decision in the person's life? How long would the person live with the decision? How hard would it be to undo? Most important: What is the least restrictive level of support that might work.

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS

EXPERIENCE

Something we get just after we needed it… We all learn by experience-usually, its bad experience… People we support need

• pportunities to EXPERIENCE

different options in order to establish a preference. Those options may and will include some degree of risk!

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

PROVIDE CHOICE & ENSURE SAFETY?

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

States & Providers must find the balance between choice and risk

PROVIDE CHOICE & ENSURE SAFETY?

NATIONAL ALLIANCE FOR DIRECT SUPPORT PROFESSIONALS (NADSP)

States & Providers must find the balance between choice and risk