Team 4: Profile & Provider Selection Meeting Notes (4-23-14)

Members present

  • Michelle Maxwell
  • Don Henzlik
  • Lisa Humke
  • Christine Myers
  • Jennifer Elders
  • Marissa Kirby
  • Jim Eddings
  • Vicki Stillman-Toomey
  • Dawn Imel (phone)
  • Wanda Sumlar (phone)

Agenda

  • Address recommendations for personal profile and plans.
  • Discuss provider selection process.

Meeting Notes

The Team 4 Liaison is currently Jim Eddings from DDD, but that might change due to the understanding that the liaison needs to be a member of senior management.

Initial Comments

  • People under the ACCT process can choose any provider. Those options should be available to everyone.
  • Don: People tell you nonstop what they won't be able to do. That has to change if anything is going to change.
  • How do you write a plan that captures everyone's dreams?
  • Don: Nothing wrong with profile, but its data, not person-centered planning.
  • Should we have 1 plan:
    • Vicki - all for creating one plan
    • Marissa - concerned about ISC agencies doing the ISP.

ISP Information

  • Provider writes the plan for the individual annually.
  • The initial plan is for 30 days.
  • Everyone who is involved in implementing services receives a copy: guardian, DT, therapist, support coordinators, etc.
  • Plan goes from the Q to ISC agencies for approval.
  • The residential provider has ultimate say and if you are home-based the home-based services provider has ultimate say. 
  • A problem: Some DT providers are writing their own plan that isn't checked by the residential provider and BQM.
  • Providers would say ISP comes down to resources.
  • Don: How do you tap into natural supports?
  • Dawn: Rates should be based on the needs of the individual.
  • ISCs monitor the plan but don't have authority to do anything if it's not followed.
  • Don: Need to look at technology between working with different supports, services.

Personal Profile

  • It's similar to the Ligas transition plan.
  • Profile is the initial overview of the individual.
  • Eligibility is determined differently than the profile.
  • Services are authorized off the Profile.
  • Will the Profile be the defining part of the person's choices, wants, etc.? The document that grows everything else? 
  • Michelle: Likes the profile because it's similar to the Ligas plan. Providers in her service area like the Ligas plan.

Concerns about the Profile

  • Dawn: would like to see prioritizing of dreams and wants at the end.
  • Don: The profile doesn't address hope and dreams.
  • Prefer open-ended questions.

When to do the Profile

  • Everyone's work goes into a single document. If they do the profile when people come in on the PUNS, maybe natural supports that can be used in the meantime will be identified.

How to Implement

  • Should it be implemented during the annual reauthorization?
  • Vicki: I would challenge providers to prioritize people that aren't receiving this now during the roll out. 
  • Dawn: 1st year of implementation, this process replaces one ISSA visit. That would hit all the monitoring requirements.

What each member would like to see out of the process, profile, plan

  • Wanda: Profile is the first part in a tiered service plan. Standard format for plan across the board. Each entity has their part in the plan. Would help reduce loss of information.
  • Don: Wants to see personal gifts included in addition to hopes and dreams. How do you create a situation where the person can employ their gifts?
  • Lisa: Include a family component to identify what parents can continue to contribute even though they aren't still in the house. The profile should be included in the 30-day timeframe. Wants to know how this will be implemented in a crisis situation?
  • Marissa: A document or plan with several components. Each entity would contribute their appropriate part. The provider develops the service plan.
  • Chris: Want it to be a useful snapshot of the individual. Wants the provider to really use it.
  • Jennifer: First opportunity and it is a growing document. It's the way you say to a provider, can you serve this person? The plan is how they know what the individual wants.
  • Dawn: Ultimately, a standardized plan would be beneficial and have different components. It needs to be discussed as a team process.
  • Vicki: We are relatively close to being on the same page.

Next Steps

  1. Develop what the profile will look like - hold a conference call for all who would like to participate in making changes to the document. Marissa will send a Doodle poll.
  2. Following: write up the conceptual outcome of what we are recommending for implementation, inclusion of people already in the system.

Next Meeting

  • Responding to notes drafted, decisions made, and what the subcommittee determines the Profile should include.
  • Recommend tool to the Steering Committee.

***See notes from White Board on following page***

Addendum:  White Board Notes from 4/23 meeting

ISP [current]

  • Provider writes the ISP
  • Person centered training provided
  • Annually - 4 days of meeting [?]
  • Initial ISP within 30 days
  • Revised when need changes
  • Sent to Guardian, individual, therapists, SC's and Day Treatment
  • Sent to ISSA for approval within 21 days
  • For all waiver services - defers to residential provider if multiple providers
  • Issues:
    • If multiple providers, are others writing their own plans?
    • Some are late
    • No standardized format or template
    • Language is person centered, but…
    • Rates not driven by plan
    • ISSA's monitor plan but generally there is no enforcement
    • Need an effective complaint process

Should There be Just One Plan?

  • Need and demand have changed expectations
  • How do you make the change?

Profile

  • Prioritization
  • Data is not about what person wants and needs
  • Open ended questions to customize plan
  • Team include people who know and care
  • Profile as a transition plan or annually?
  • Repository of people's history
  • Recognize people's gifts
  • Build natural supports and family roles into plan
  • How to identify natural supports? [Respond to liability concerns]
  • History of trauma
  • Relationship of Profile to crisis management
  • Is the Profile a component of the ISP or visa versa?
  • Needs to be accessible electronically
  • Is it a snapshot or living document?
  • How to assure it is used?
  • Information to ask providers if they can meet needs
  • Standardize a Person Centered Plan with components:
    • Profile
    • Service & Support implementation plan [Is this the ISP?]
  • Need more focus on team process

Quality of Plan

  • Individuals gifts, abilities and talents are identified
  • Needs to be an annual plan [suggested substitution of 1 ISSA visit for development of plan]