Workforce Transformation My First Allegiance is to the

Workforce Transformation “My First Allegiance is to the Person I Support. ” 08/26/2015

Not Just a Training Workforce Transformation The goal of OPWDD’s Workforce Transformation agenda is to help staff transform from caregivers to professionals through a Workforce Development Program including: • Part 1: Overview & Orientation • Part 2: Redefining the Role of the DSP from Caregiver to Support Professional • Part 3: Person Centered Planning • Part 4: Observation & Evaluation

Part 1: Overview & Orientation The “Why” of Workforce Transformation and Orientation to The Code of Ethics and Core Competencies

Not Just a Training Workforce Transformation In order to assist the individuals we support to achieve a more fulfilled life that is in line with our mission of Living, Loving, Working and Learning, YAI is committed to developing a workforce that is knowledgeable, skilled and ethical. This is achieved by ensuring that staff develop an understanding of: • The National Alliance for Direct Support Professionals (NADSP) CODE OF ETHICS • OPWDD’S DSP CORE COMPETENCIES • PERSON CENTERED PLANNING (including CQL’s Personal Outcome Measures POMS) • Home and Community-Based Services (HCBS) Waiver Rule

Workforce Transformation This is a cultural shift/improvement initiative that starts with Leadership and requires buy in from CEO, HR, QI, Training Director, and Administration.

YAI is a person-centered, person-directed organization Staff’s “first allegiance is to the person. ” (Code of Ethics) Staff demonstrate competence in the areas of putting people first, building relationships, demonstrating professionalism and supporting health and safety. (Core Competencies) My Life Living Loving Working Learning Staff create plans and deliver services directed by the person in integrated community settings that lead to outcomes that are important to the person. (HCBS Waiver Rule & POMS)

POMs (Personal Outcome Measures)

Why were Home and Community-Based Settings (HCBS) Rules developed? • CMS (Center for Medicaid Services) wants the individuals we support to have REAL LIVES. • As a field, we try, but we don’t do enough. • States must apply to CMS for permission to provide HCBS Waiver services every 5 years. • In order to get permission, we have to comply with the rules.

What are the HCBS Rules? In a nutshell: Independence, Autonomy and Integration • People have the ability to make real choices. • People understand their rights and exercise them to the fullest extent possible. • People have the ability to participate in the community; in the manner they wish, at the time they wish and with whom they wish. • People have the right to live, work and receive services in integrated settings. • People who live in agency owned apartments or houses have a written occupancy agreements. • People have access to all parts of their environments.

HCBS Waiver-Community Rule What more can we do? Meal planning/access to food Home and environment Having leases, keys and more privacy Making personal connections to people in the community Having visitors in their own home Being able to make decisions Going places when they want to Choosing which staff they want to work with Person Centered Planning

Key Elements: The Why! • Staff are the cornerstone of operations. They work with individuals with IDD and have a great impact upon the quality of life for the individuals they support. • Staff are faced with ethical challenges daily. • Staff often work independent of direct supervision and therefore must exercise good judgment. • A code of ethics can serve as a tool for direction and support. • Knowing how to resolve ethical dilemmas in the workplace can increase your decision-making effectiveness while keeping you and your organization on the right side of the law and public sentiment.

Code of Ethics for Direct Support Professionals • While supporting people as they direct the course of his or her own life, you will face ethical decisions. You may feel conflicted when the person has set goals for themselves then make choices and decisions that are not in line with those goals. • When this occurs, you must remember your promise of partnership and ensure that your first allegiance is to the person that you support. • The National Alliance for Direct Support Professionals (NADSP) Code of Ethics outlines standards of conduct and professionalism that guide your everyday work.

Code of Ethics for Direct Support Professionals

Our Code The NYS Direct Support Professionals’ Code of Ethics Person-Centered Supports As a DSP, my first allegiance is to the person I support; all other activities and functions I perform flow from this allegiance. Promoting Physical and Emotional Well-Being As a DSP, I am responsible for supporting the emotional, physical, and personal well-being of the individuals receiving support. I will encourage growth and recognize the autonomy of the individuals receiving support while being attentive and energetic in reducing their risk of harm. Integrity and Responsibility As a DSP, I will support the mission and vitality of my profession to assist people in leading self-directed lives and to foster a spirit of partnership with the people I support, other professionals, and the community. Confidentiality As a DSP, I will safeguard and respect the confidentiality and privacy of the people I support. Justice, Fairness and Equity As a DSP, I will promote and practice justice, fairness, and equity for the people I support and the community as a whole. I will affirm the human rights, civil rights and responsibilities of the people I support. Respect As a DSP, I will respect the human dignity and uniqueness of the people I support, I will recognize each person I support as valuable and help others understand their value. Relationships As a DSP, I will assist the people I support to develop and maintain relationships. Self-Determination As a DSP, I will assist the people I support to direct the course of their own lives. Advocacy As a DSP, I will advocate with the people I support for justice, inclusion, and full community participat ion.

National Alliance Direct Support Professionals (DSP’s) Code of Ethics for Direct Support Professionals 1) As a DSP, my first allegiance is to the person I support, all other activities I Will……. . and functions I perform flow from this allegiance. 2) As a DSP, I am responsible for supporting the emotional, physical, and I Will……. . personal well-being of the individuals receiving support. I will encourage growth and recognize the autonomy of the individual’s while being attentive and energetic and reducing their risk of harm. 3) As a DSP, I will support the mission and vitality of my profession to assist people I Will……. . in leading self-directed lives and to foster a spirit of partnership with the people I support, other professionals, and the community. 4) As a DSP, I will safeguard and respect the confidentiality and privacy of the I Will……. . people I support. 5) As a DSP, I will promote and practice justice, fairness, and treat all people equally. I will affirm the human rights, civil rights and responsibilities of people I support. I Will……. . 6) As a DSP, I will respect the human dignity and uniqueness of the people I I Will……. . support. I will recognize each person as valuable and help others understand their value. 7) As a DSP, I will assist the people I support to develop and maintain relationships. 8) As a DSP, I will assist the people I support to direct the course of lives. I Will……. . their own I Will……. . 9) As a DSP, I will advocate with the people I support for justice, inclusion, and I Will……. . full community participation. 8

Weaving the Code of Ethics into your Programs 1. Incorporate The Code into hiring and interviewing practice. 2. Establish a strong presence of The Code into your pre-service and orientation programs. 3. Use The Code at your team meetings. 4. Use The Code to create plans that support individuals. 5. Create a way for the individuals you support to learn about and use The Code in their relationships with the people who support them.

Direct Support Professionals Who are the most important staff in the field of developmental disabilities? Why? DSP’s assume all of these roles each and every day: • Custodial Task Workers • Care Givers • Support Professionals Therefore, they must be competent!

Remember: • Competence is – Knowledge, – Skills, and – Ethics • Competence + Interactions = Empowerment • DSPs should be empowering the individual at all times.

Core Competencies: 7 Goals Areas The job of a DSP requires technical and values-based skills that make life-changing differences in the lives of the individuals they support. Goal 1: Putting People First Goal 2: Building and Maintaining Positive Relationships Goal 3: Demonstrating Professionalism Goal 4: Supporting Good Health Goal 5: Supporting Safety Goal 6: Having a Home Goal 7: Being Active and Productive in Society 19

Core Competency Survey

Part 2: Redefining The Role Of The DSP From Caregiver to Direct Support Professional

Empowerment Strategies Transforming from a Caregiver to a Support Professional A support professional empowers individuals to: 1. Live a life that is valued by the person as defined by their Personal Outcome Measures (POMs) and not the personal values of the staff. 2. Have more opportunities for desired community involvement. 3. Think and problem solve, helping them to figure out what they want to do. 4. Learn new skills that increases their independence and decreases dependency on staff. 5. Have increased self-esteem through positive interactions focusing on their abilities and not their disabilities.

Part 3: Person-Centered Planning An Introduction to the Basics of Person Centered Planning. Content was adapted from OPWDD, Centers for Medicare & Medicaid Services, and The Learning Community.

Centers for Medicare & Medicaid Services’ Final Rule The final rule addresses several sections of Medicaid law under which states may use federal Medicaid funds to pay for home and community-based services (HCBS). The rule supports enhanced quality in HCBS programs, adds protections for people receiving services.

The Final Rule & Person Centered Planning CMS specifies that service planning for participants in Medicaid HCBS programs must be developed through a person centered planning process, directed by the person, that addresses health and long-term services and support needs in a manner that reflects individual preferences and goals.

What is Person Centered Planning? “Planning from a person-centered perspective seeks to listen, discover and understand the individual. It is a process directed by the person that helps us to learn how they want to live and describes what supports are needed to help them move toward a life they consider meaningful and productive. ”

“Important To” & “Important For” Person Centered Planning works to discover what is important to the person and what is important for the person, while determining what the desired balance between the two is according to the person.

“Important To” What is important to a person includes those things in life which help us to be satisfied, content, comforted, and happy. It is a person’s own definition of quality of life.

“Important For” What is important for a person includes issues of health and safety and what the person and others see as necessary to help the person be valued and a contributing member of his or her community.

Finding the Balance is always changing and involves tradeoffs. We make tradeoffs because many different things are important to us. In addition, we make tradeoffs between what is important to us and what is important for us.

Purpose of Planning A planning process and a plan of support guide the delivery of supports to a person in a way that leads to outcomes or results that are important to him or her.

Focus on Outcomes • Outcomes are not goals. • Outcomes help determine whether a person’s goals are achieved and if the planning and the supports provided are successful.

Person Centered Implementation must include: • A promise to listen to what is being said, what is meant by what is being said, and to keep listening. • A promise to act on what we hear, always find something we can do today or tomorrow, and keep acting on what we hear. • A promise to be honest that what they are telling us will take time, when we do not know how to help them get what they are asking for, and when there is not a good balance between their important to and important for.

Person First Language Person Centered Planning includes using Person First Language emphasizes the person, not the disability. People are not possessions. “My guys” or “my individuals” implies ownership. People who receive services are people you support.

Person First Language • Puts people before their disability. • Describes what a person HAS, not what a person IS. • The words used about a person has an impact ON the person. RESPECT=SELF ESTEEM=SELF DETERMINATION

Person First Language Instead of…. Use…. Disabled or special needs Person with a disability Autistic A person who has autism My guys/individuals People I support Nonverbal Does not use words to communicate High/Low functioning Person who needs more/less support Normal or Typical People without disabilities

National Alliance Direct Service Professionals (DSP’s) Code of Ethics for Direct Support Professionals 1) As a DSP, my first allegiance is to the person I support, all other activities I Want……. . and functions I perform flow from this allegiance. 2) As a DSP, I am responsible for supporting the emotional, physical, and I Want……. . personal well-being of the individuals receiving support. I will encourage growth and recognize the autonomy of the individual’s while being attentive and energetic and reducing their risk of harm. 3) As a DSP, I will support the mission and vitality of my profession to assist people I Want……. . in leading self-directed lives and to foster a spirit of partnership with the people I support, other professionals, and the community. 4) As a DSP, I will safeguard and respect the confidentiality and privacy of the I Want……. . people I support. 5) As a DSP, I will promote and practice justice, fairness, and treat all people equally. I will affirm the human rights, civil rights and responsibilities of people I support. I Want……. . 6) As a DSP, I will respect the human dignity and uniqueness of the people I I Want……. . support. I will recognize each person as valuable and help others understand their value. 7) As a DSP, I will assist the people I support to develop and maintain relationships. I Want……. . 8) As a DSP, I will assist the people I support to direct the course of their own lives. I Want……. . 9) As a DSP, I will advocate with the people I support for justice, inclusion, and I Want……. . full community participation. 8

Part 4: Observation & Evaluation

National Alliance Direct Service Professionals (DSP’s) Code of Ethics for Direct Support Professionals 1) As a DSP, my first allegiance is to the person I support, all other activities I Observed……. . and functions I perform flow from this allegiance. 2) As a DSP, I am responsible for supporting the emotional, physical, and I Observed……. . personal well-being of the individuals receiving support. I will encourage growth and recognize the autonomy of the individual’s while being attentive and energetic and reducing their risk of harm. 3) As a DSP, I will support the mission and vitality of my profession to assist people I Observed……. . in leading self-directed lives and to foster a spirit of partnership with the people I support, other professionals, and the community. 4) As a DSP, I will safeguard and respect the confidentiality and privacy of the I Observed……. . people I support. 5) As a DSP, I will promote and practice justice, fairness, and treat all people equally. I will affirm the human rights, civil rights and responsibilities of people I support. I Observed……. . 6) As a DSP, I will respect the human dignity and uniqueness of the people I I Observed……. . support. I will recognize each person as valuable and help others understand their value. 7) As a DSP, I will assist the people I support to develop and maintain relationships. 8) As a DSP, I will assist the people I support to direct the course of lives. I Observed……. . their own I Observed……. . 9) As a DSP, I will advocate with the people I support for justice, inclusion, and I Observed……. . full community participation. 8

Conclusion As of 2016, all agencies will be mandated by OPWDD to begin the use of the Core Competencies Evaluation Tools with their new and veteran DSP staff.