PERSONCENTERED PLANNING IN NEW MEXICO

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PERSON-CENTERED PLANNING IN NEW MEXICO

• ORIENTATION FOR
• IDT MEMBERS
• AUGUST 2006

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DEVELOPMENT OF NEW ISP PROCESS AND FORM

• Development of the new ISP Form began internally
  within the DDSD more than 2 years ago.
• Case Management Unit and Meaningful Day Staff
  began to make recommendations for change.
• Pilot was held in 2005 in the Northeast and
  Southwest Regions.
• The final form was developed in conjunction with
  stakeholders and in consideration of public
  comments.

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TIMEFRAMES

• PLANS DUE OCTOBER 1, 2006 WILL BE REQUIRED TO BE
  FACILITATED AND WRITTEN IN THE NEW FORMAT
• TEAMS HAVE ALREADY BEGUN MEETING TO DEVELOP PLANS
  DUE OCTOBER 1ST

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CHANGES NEW TERMS TO LEARN

• Vision Live, Work, Fun, Health/Other
• Functional Supports Assessment
• Embedded within entire document
• Goals Desired Outcomes
• Objectives Action Steps
• Strategies Teaching Support Strategies
• Addendum B Individual Specific Training

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VISION (LIVE, WORK, FUN, HEALTH/OTHER)
DESIRED OUTCOMES
TEACHING SUPPORT STRATEGIES
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WHATS DIFFERENT WITH THE NEW PROCESS?

• Pre-meeting work to be accomplished
• Coordination of assessments
• Team members informally meet with the individual
  to identify interests and draft the vision
  statement
• Team members assist the individual to prepare for
  the meeting
• Case Manager meets with the individual/guardian
  to explain and gather signatures on the Addendum
  A and Secondary Freedom of Choice Forms
• Team members send draft Individual Specific
  Training information to the Case Manager to
  compile

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WHATS DIFFERENT? PART 2

• Assessment information coordinated prior to the
  meeting
• The new ISP does not have the assessments page
  (dental, vision, etc.) incorporated into the
  form.
• It is recommended that Case Managers continue to
  use the old assessments page to monitor and
  track completion of assessments but it is not
  considered part of the ISP.
• This information will be coordinated,
  implemented, followed up on documented
  throughout the year
• A worsening condition, a new diagnosis, new
  symptoms, and/or the need to obtain medical tests
  or evaluations will be documented on the ACTION
  PLAN FOR HEALTH AND SAFETY RELATED SUPPORTS
  section of the ISP.

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WHATS DIFFERENT?PART 3

• Additional changes
• Therapy assessments to be completed and
  disseminated prior to Annual Meeting
• Therapy Plans written after the Annual Meeting to
  better enable the individual to achieve success
  toward his/her desired visions
• Six-Month Reviews no longer required after
• 10-01-06
• Teams are recommended to have a meeting to
  finalize the vision statements and desired
  outcomes and a second meeting to develop Action
  Plans

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WHAT IS STAYING THE SAME?

• Staying focused on what it takes to help each
  person achieve their vision of the future
• A person-centered approach to planning
• Services are still budgeted through the Annual
  Resource Allotment system
• Providers will still develop detailed strategies
  (or support plans if a nurse, therapy/behavioral
  consultant) within 14 days after the meeting
• Membership of the interdisciplinary team and the
  importance of everyones participation

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A NEW ROLETHE HEALTHCARE COORDINATOR

• All individuals in services are required to have
  a
• Healthcare Coordinator
• This person is selected by the team to track and
  monitor the completion of healthcare assessments,
  and to compile medically-related information

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MAIN SECTIONS OF THE ISP

• Face Sheet Identification of the individual,
  guardian, and other team members
• Narrative Section - This section includes
• Narrative Information
• Long Term Vision Statements
• Progress Towards Reaching the Long-Term Vision
• Desired Outcomes
• The Individuals Definition Of A Meaningful Day

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MAIN SECTIONS OF THE ISP

• Action Plans For Desired Outcomes Action Plans
  include the Desired Outcomes and the Action
  Steps that will move the individual closer to the
  achievement of their personal Visions for the
  future.
• Action Plan For Basic Health And Safety Related
  Supports This action plan will be used to
  document what the team will do to support the
  individual with health and safety issues that
  have not already been addressed.

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MAIN SECTIONS OF THE ISP

• Individual-Specific Training Requirements -
  This section explains what type of training IDT
  members need in order to support the individual
  successfully.
• ISP Meeting Participant Sign-In Sheet - This is
  used to document who attended the ISP meeting.
• Attachments - Support plans and teaching and
  support strategies are attached to the ISP form.
  The type and number of attachments will vary for
  each individual in services.

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HOW WILL ISP MEETINGS CHANGE?

• The team will discover information about the
  person when discussing the areas of focus within
  the Narrative Section
• Life Experiences
• School, Work, and/or Volunteer History
• Relationships
• Health Safety
• Strengths, Gifts, Preferences, and Hobbies

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DEVELOPING THE VISION

• Using information from the Narrative Section,
  the team will support the person to identify
  themes that paint a picture of what he/she would
  like to have in the future.

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ANALYSIS

• After the vision is developed teams will
• Identify what it would take anyone to achieve the
  vision
• Discuss what progress has been made towards the
  vision
• Analyze what still needs to occur in order for
  the person to achieve his/her vision for the
  future

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DESIRED OUTCOMES

• Using the information from the What Needs To
  Occur discussion, teams will help the person to
  identify outcomes he/she would like to accomplish
  related to vision achievement.
• The timeframe for Desired Outcomes is from 3
  Months to 3 years.

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ACTION STEPS

• Action Steps are the smaller steps that lead to
  achievement of the Desired Outcome.
• Action Steps may be steps the person will take,
  skills the person would like to learn, and/or
  steps that others will complete to provide
  support.
• Action Steps will be developed by the team during
  the ISP meeting.

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ACTION PLANS

• The Desired Outcome and the Action Steps make
  up the Action Plan that the team will follow to
  assist the person to accomplish the Desired
  Outcome that leads to Vision attainment.

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TEACHING SUPPORT STRATEGIES

• Teaching Support Strategies are detailed guides
  for staff to follow when supporting an individual
  through a task or activity.
• Teaching Support Strategies are developed by
  Service Coordinators, Direct Support Staff, and
  Therapists.
• They are due to the Case Manager within 14 days
  of the ISP Meeting.

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THANK YOU!