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People's PCPs lead to Person-Centered and Person-Directed Services and Supports
AHH Provides Continuous and Consistent Services and Supports for each Person.
AHH Provides Positive Behavioral Supports to People
AHH Treats People w/psychoactive Meds for Mental Health needs Consistent w/National Standards of Care.
Personal Outcomes
100
People achieve their personal and PCP goals.
Do people realize their personal goals?
100
Email amongst staff, incident reporting protocols, reports to TASC, Drug Court, DSS, Primary Care Doctors, Lawyers, etc.
Does AHH have a system for ensuring that important events impacting people are effectively communicated to other staff, and to referring community partners where appropriate?
100
AHH does not allow restrictive interventions. The term “behavior support plan” is typically used for I/DD population. AHH supports people by teaching them positive coping skills and behaviors to use as alternatives to destructive behaviors.
Do policies and procedures reflect AHH’s commitment to positive behavioral approaches?
100
Psychoactive medication is never used to sedate clients or control their behavior, rather is used to assist with the amelioration of symptoms related to actual psychiatric diagnoses.
Is the use of psychoactive medication based on specific psychiatric diagnoses resulting from a thorough psychiatric evaluation, by a licensed clinician using a thorough assessment tool?
100
• The community offers a rich array of activities and experiences where we find and develop interests, take care of our personal needs and enjoy leisure activities. • When we go out into the community, we meet other people, learn and broaden our experiences. • The less experience a person has with life in the community, the more likely he or she is to need support and opportunities to try different activities.
What is REVIEW!!!! PERSONAL OUTCOMES People participate in the Life of the Community?
200
Clinician conducts Person Centered planning process with client during the CCA.
Do people direct the development of PCPs, or are they supported to do so?
200
Documentation occurs with 24 hours in the Alphaflex system and is written in the PIE format. (purpose, intervention, effectiveness).
Do staff document that they have provided services and supports in accordance with the PCP and AHH policies and procedures?
200
AHH has trained all staff in Emergency Procedures. All AHH staff can competently handle medical and behavioral emergencies.
Does the organization implement policies and procedures that ensure a rapid, effective and appropriate response to behavioral emergencies?
200
All clinicians work in a coordinated effort across services to monitor the well being of the people we support and to report side effects and unusual behavioral occurrences to each other.
Are people monitored for drug side effects on a regular, systematic basis using a standardized tool or other accepted standard of care?
200
• People interact with a variety of other people who do not receive services, or who are not staff of AHH or paid to be with them. This interaction is critical to obtaining and using meaningful social capital. • Some contacts are casual (greeting a neighbor, chatting with a clerk in a store); some are more formal (seeing the dentist, working with others on the job). Sometimes these contacts develop into closer relationships over time. • Through family members, friends, and co-workers connections to even more people within the community become possible.
What is REVIEW!!!! PERSONAL OUTCOMES People Interact with other members of the Community?
300
CCAs assess both strengths and risks in the biopsychosocial dimensions of their lives.
Do assessments focus on the skills and supports present, those preferred and desired by the person, and those needed to realize personal goals?
300
PCP progress is monitored continually, the frequency requirement under each service is different due to rules regarding authorizations, but generally a minimum of every 3 months.
Does AHH have a system for monitoring implementation of PCPs?
300
The term “behavior support plan” is typically used for I/DD population. However, AHH staff know that all behavior is communication. Anger management, positive coping skills, problem-solving, and conflict resolution are taught to people as alternatives to negative behaviors.
Do behavior support plans include teaching alternative communication strategies?
300
Once clients are under the care of our medication providers they are seen for follow up appointments with the frequency necessary to effectively monitor the health, safety, and well-being of clients and the effectiveness of medications.
Does AHH have a system to ensure regular review of the effectiveness of psychoactive meds by licensed health care provider at intervals that meet all laws, regulations, and are consistent with national standards of care?
300
• We do not prejudge what people say they want as “unrealistic” or “unachievable”. Rather we respect what we learn is important to each individual and why. • People’s goals serve as the basis for interacting with them and providing supports. • Biggest Challenge: How do we honor people’s goals and work within what the MCO will pay for us to assist them with?
What is Related Personal Outcomes: People choose personal goals?
400
People make choices about goals and services but only within the parameters of what the MCO Benefit Plan will pay for. They are free to make choices in their personal life.
Do people choose their goals and services, including where they work and where and with whom they live?
400
Motivational Interviewing, CBT, Service Definition Training, CQL Basic Assurances, CQL Personal Outcomes, Crisis Response, Documentation, Basic Competencies (Special Populations) Training, Cultural Competency, Confidentiality and more
Do staff receive training in skills and abilities needed to implement people’s plans?
400
All AHH staff are trained in NCI-A and Crisis Response. At AHH “behavioral supports” are identified as de-escalation and calming strategies which can be provided by anyone trained at AHH, followed by coping skill development with primary clinicians.
Do only support staff with prior training and demonstrated competency provide the behavioral supports people need?
400
Yes. Our medication providers are not working in isolation they are a part of a treatment team of clinicians who are aware of what medications are typically used to assist people with what symptoms. This assists with a system of checks and balances.
Does the medication prescribed correspond to known standards for effectiveness related to the specific diagnosis, symptom or behavior?
400
• AHH does not for the convenience of the organization, require people to accept services that do not match their needs. • AHH considers individual preferences when making decisions about the type, intensity, location and provider of service. • AHH supports people if they change their minds about choices they have made.
What is Related Personal Outcomes: People choose services?
500
PCPs are modified upon achievement of goals, when goals are not being achieved, and upon change in need and desire.
Are PCPs modified by people with their individual support teams as goals and objectives are or are not realized.
500
People are in charge of their daily routines in their lives. Preferences for when and how services are provided is assessed during CCA and ongoing by clinicians supporting clients.
Do people choose their daily routines including where and how services are provided?
500
REVIEW!!! Name six Basic Assurances we have covered so far.
What is Rights Protection and Promotion; Dignity and Respect; Natural Support Networks; Protection from abuse, neglect, mistreatment, and exploitation; Best Possible Health; and Safe Environments?
500
Yes. It is the culture of this agency to treat people with therapeutic clinical treatment interventions and coping skill development, first and foremost. Medications are used only as an adjunct to treatment not the sole focus of treatment and are prescribed as conservatively as possible while still being effective.
Do people receive the fewest psychoactive meds possible, at the lowest effective dosage possible?
500
• Achieving goals give people a sense of accomplishment and enhances personal image. • Personal goals, directions, dreams, and aspirations add meaning and value to life. • People may need to learn new skills and competencies to achieve personal goals. • Assisting each person to reach his or her goals is the focus of services and supports.
What is Related Personal Outcomes: People realize personal goals?