1. New Community Opportunities Center at ILRU – Independent Living Research Utilization 0 New Community Opportunities Center at ILRU Presents… Nursing Home Transition 4-Part Webinar Series Part 1: Outreach Connecting with People Who Want to Transition September 6, 2011 Presented by: Bruce Darling 0

2. New Community Opportunities Center at ILRU – Independent Living Research Utilization 1 New Community Opportunities Center at ILRU Presents… Nursing Home Transition 4-Part Webinar Series Part 1: Outreach Connecting with People Who Want to Transition September 6, 2011 Presented by: Bruce Darling 1

3. New Community Opportunities Center at ILRU – Independent Living Research Utilization 2 Purpose of the Project This presentation is part of a series of trainings and other activities provided to the IL field by the New Community Opportunities Center at ILRU. The project’s purpose is to assist CILs in developing self-sustaining programs that support community alternatives to institutionalization for individuals of any age, and youth transition from school to post-secondary education, employment, and community living. 2

4. New Community Opportunities Center at ILRU – Independent Living Research Utilization 3 Community Alternatives Project Team ILRU’s partners and collaborators in the community alternatives activities include Utah State University, Center for Persons with Disabilities National Council on Independent Living Suzanne Crisp, national community alternatives expert Association of Programs for Rural Independent Living Michele Martin, Social Media Consultant

5. New Community Opportunities Center at ILRU – Independent Living Research Utilization Introduction and Contact Information Bruce E. Darling President/CEO Center for Disability Rights, Rochester NY BDarling@CDRNYS.org 585-546-7510 …and an ADAPT Organizer 4 4

6. New Community Opportunities Center at ILRU – Independent Living Research Utilization Setting the Stage There’s a law called the Americans with Disabilities Act. There’s a Supreme Court decision, called Olmstead. It’s a civil rights thing. 5 5

7. New Community Opportunities Center at ILRU – Independent Living Research Utilization Current Issues We live in interesting times. A lot is changing. State Budget Issues States are facing serious budget problems, but that doesn’t eliminate the expectation that they comply with Olmstead. 6 6

8. New Community Opportunities Center at ILRU – Independent Living Research Utilization Current Issues, cont’d. Managed Care Some states are bringing in managed care (others have had it). It’s how states pay for services, but it doesn’t mean folks have lost their rights under Olmstead. Aging and Disability Resource Centers Some states are developing Aging and Disability Resource Centers, but this doesn’t prevent Centers from doing transition work! 7 7

9. New Community Opportunities Center at ILRU – Independent Living Research Utilization Outreach Initial Outreach Strategies Review your consumer lists Ask your consumers Ask other people Ask people who got out 8 8

10. New Community Opportunities Center at ILRU – Independent Living Research Utilization Outreach, cont’d. Additional Outreach Strategies Contact the local nursing home ombudsman program Ask for referrals from a friendly nurse or resident doctor who works at the local hospital or clinic Ask attendants (Many work in nursing facilities!) Write a letter to the editor or editorial Present at support groups 9 9

11. New Community Opportunities Center at ILRU – Independent Living Research Utilization Supporting Successful Transition The Role of the Transition Facilitator 1.SUPPORT the person as they reclaim their life 2.UNDERSTAND what brought the person to the nursing home 3.LISTEN for both words and feelings 4.RECOGNIZE that the individual’s emotions of fear, anger, and anxiety are real 10

12. New Community Opportunities Center at ILRU – Independent Living Research Utilization Supporting Successful Transition, cont’d. The Role of the Transition Facilitator 5.KNOW the types of supports and services available in the community and how to access them 6.PROVIDE accurate information in a timely manner 7.EXPLORE options with the person 11

13. New Community Opportunities Center at ILRU – Independent Living Research Utilization Supporting Successful Transition, cont’d. 2 Components that Contribute to Success Developing a trusting relationship Having a comprehensive assessment that clearly reflects needs, concerns, and priorities Developing and implementing a Transition Plan/Independent Living Plan that addresses the individual’s needs Follow-up and post-transition support 12

14. New Community Opportunities Center at ILRU – Independent Living Research Utilization Transition Planning What We Mean by Transition Planning We work with the individual to: Determine their strengths, abilities, wishes, and the supports needed for life in the community Identify how each of the needed supports can be provided in the community 13

15. New Community Opportunities Center at ILRU – Independent Living Research Utilization Transition Planning, cont’d. What We Mean by Transition Planning It can be easy (and fast) to focus on obtaining needed services, but that approach puts the person in a passive role, like the medical model. We offer the opportunity to help the person envision their life on a daily basis which gives them control, information and better prepares them for community living. 14

16. New Community Opportunities Center at ILRU – Independent Living Research Utilization Transition Planning, cont’d. 2 What We Mean by Transition Planning The planning process can include activities that allow the individual to experience parts of community living prior to making the move, such as taking the bus to meet the transition facilitator in the community. 15

17. New Community Opportunities Center at ILRU – Independent Living Research Utilization Transition Planning, cont’d. 3 Promoting Self Direction Support the individual to remain in charge and have control to the maximum extent possible during the entire transition process! 16

18. New Community Opportunities Center at ILRU – Independent Living Research Utilization Transition Planning, cont’d. 4 Promoting Self Direction Make sure that the individual is not just included in the transition process, but leads the process to the extent possible. Explain each step of the transition process to the person moving. When professionals try to take control, direct questions and decision-making back to the person using questions such as: “what do you think?” 17

19. New Community Opportunities Center at ILRU – Independent Living Research Utilization Transition Planning, cont’d. 5 Promoting Self Direction Assist the individual to clarify goals and personal choices Encourage/expect the person transitioning to do as much of the work as possible Support the person in managing the extensive amount of paperwork that will be created during the transition process 18

20. New Community Opportunities Center at ILRU – Independent Living Research Utilization Transition Planning, cont’d. 6 Person Directed Planning Planning can be person-centered but not person- directed. That’s NOT Independent Living. …and actually that wasn’t the intent of Person Centered Planning. 19

21. New Community Opportunities Center at ILRU – Independent Living Research Utilization Transition Planning, cont’d. 7 Person Directed Planning Being “in charge”, to the extent possible, of the planning process may be difficult Institutions teach us to be passive to make things easier People internalize the idea that they no longer have the ability or the right to be in charge of their own life (learned helplessness) 20

22. New Community Opportunities Center at ILRU – Independent Living Research Utilization Transition Planning, cont’d. 8 Person Directed Planning We SUPPORT the person with a person directed planning process We DON’T EXCLUDE or SCREEN them out 21

23. New Community Opportunities Center at ILRU – Independent Living Research Utilization Questions and Answers 22

24. New Community Opportunities Center at ILRU – Independent Living Research Utilization Building Relationships With the Nursing Facility Start by involving the nursing facility staff from the beginning when possible 23

25. New Community Opportunities Center at ILRU – Independent Living Research Utilization Building Relationships, cont’d. With the Nursing Facility Involving the facility staff helps them buy into the idea of transition and provides much-needed help with the process. Facility staff can: 24 help the individual to fill out required applications switch social security payments to the individual assist with the transition to a community doctor ensure they received their medications and personal belongings from the facility 24

26. New Community Opportunities Center at ILRU – Independent Living Research Utilization Building Relationships, cont’d. 2 With the Nursing Facility When a nursing facility isn’t cooperative… try to figure out why by listening to the staff offer training from your Center and include folks who have successfully transitioned educate facilities on the law (including ADA/Olmstead and CRIPA) contact the Ombudsperson Program 25

27. New Community Opportunities Center at ILRU – Independent Living Research Utilization Building Relationships, cont’d. 3 With Family and Other Supportive People It is important to work as closely as possible with families and friends too Supportive ones can make a successful transition more likely Unsupportive folks can derail the plan 26

28. New Community Opportunities Center at ILRU – Independent Living Research Utilization Building Relationships, cont’d. 4 With Family and Other Supportive People Getting unsupportive folks on board: Start by assuming good will Listen to and acknowledge their concerns Educate them on services that can support community living Explain how the new situation will be different Keep them informed of progress 27

29. New Community Opportunities Center at ILRU – Independent Living Research Utilization Building Relationships, cont’d. 5 With Family and Other Supportive People If unsupportive family and friends don’t change their mind… Move on… but don’t slam the door. 28

30. New Community Opportunities Center at ILRU – Independent Living Research Utilization Nuts and Bolts Confidentiality and Informed Consent An individual must give written consent when you share information between the Center and other organizations or people. The person has the right to limit the release of information. 29

31. New Community Opportunities Center at ILRU – Independent Living Research Utilization Nuts and Bolts, cont’d. Confidentiality and Informed Consent Many people with disabilities or other health conditions are concerned that information about themselves will be used against them, so: Acknowledge the concern Set a high standard for yourself and others Watch your own conduct with regard to confidentiality Explain how you use the information you obtain or why other folks need the information 30

32. New Community Opportunities Center at ILRU – Independent Living Research Utilization Nuts and Bolts, cont’d. 2 Confidentiality and Informed Consent When there are legal guardians or surrogate decision-makers, their consent is necessary 31

33. New Community Opportunities Center at ILRU – Independent Living Research Utilization Nuts and Bolts, cont’d. 3 Confidentiality and Informed Consent Do not allow confidentiality laws to be used as an obstacle to working with an individual in a nursing facility 32

34. New Community Opportunities Center at ILRU – Independent Living Research Utilization Nuts and Bolts, cont’d. 4 Keeping Notes Notes should be complete, but do not have to be extensive Include contact information for relevant people Do not duplicate other information that is easily obtainable Keep track of follow-up actions that are needed Just the facts: do not include personal opinions 33

35. New Community Opportunities Center at ILRU – Independent Living Research Utilization Nuts and Bolts, cont’d. 5 Review Medical Records Every person in a nursing facility has a medical record. These medical records can help the transition facilitator better understand the individual’s needs. Help assure that needed medication and medical treatments will be included in the plan 34

36. New Community Opportunities Center at ILRU – Independent Living Research Utilization Nuts and Bolts, cont’d. 6 Review Medical Records Concentrate on the most current and factual information in the record Important, but only one piece of information; these records don’t tell us about the services needed in the community nor the person’s preferences and desires 35

37. New Community Opportunities Center at ILRU – Independent Living Research Utilization Questions and Answers 36

38. New Community Opportunities Center at ILRU – Independent Living Research Utilization 37 Wrap Up and Evaluation Please complete the evaluation of this program by clicking here: https://vovici.com/wsb.dll/s/12291g4c0fa

39. New Community Opportunities Center at ILRU – Independent Living Research Utilization New Community Opportunities Attribution 38 This webinar is presented by the New Community Opportunities Center, a national training and technical assistance project of ILRU, Independent Living Research Utilization. This webinar was organized and facilitated by the National Council on Independent Living (NCIL). Support for development of this presentation was provided by the U.S. Department of Education, Rehabilitation Services Administration under grant number H400B100003. No official endorsement of the Department of Education should be inferred. Permission is granted for duplication of any portion of this slide presentation, providing that the following credit is given to the project: Developed as part of the New Community Opportunities Center at ILRU.