2. Press the space bar to proceed The Search for Meaning in the World of Community Services Press the space bar to proceed Turning Point Services, Inc. Spring 2006

3. Non-CAP Services Training Use this slide show to develop your understanding about several community services, most needing documentation in the service note format P-I- A/E. Please read through each slide carefully. Complete the Service Note Formula exercise when you have finished.

4. Important Points This training seeks to provide basic understanding of several non-CAP- MR/DD services as provided by Turning Point. Key Success Factors are highlighted throughout the training; they are the most important points to remember. (If you have a color display or copy, Key Success Factors are in blue color.)

5. Service Names Turning Point provides many services that are not part of the CAP waiver. Most of these services use a narrative “service note” or “P-I-E/A note” for documenting the work done. Some of the services are done through a contract with one of the LMEs, so the service names and rates can vary slightly from one area to another.

6. Non-CAP services These services are called by many different names IPRS services Contract services State-funded services Services that Need Written Notes

7. Service Names Here are examples of the non-CAP services: Personal Assistance Developmental Therapy Individual Habilitation IPRS (state-funded) Supported Employment

8. Contract Services Since TPS provides many types of “contract” services. It is important to know exactly what is expected from the service. Please read the official TPS definition of the service; it’s in the policy and procedure manual. Ask the QP helping you to find it or explain it to you.

9. Other Contract Services Each contract or endorsed service has specific requirements for documentation and forms to use. Most of the non-CAP services require a PIE/A type service note, or narrative note. This is very different from the “grids” or “data sheets” used for CAP documentation.

10. Service Note Exercise The Service Note Formula at the end of this training will prepare you to write notes using the P-I-E/A format required for most non-CAP services.

11. Abbreviations DT = Developmental Therapy SE – Supported Employment IH = Individual Habilitation PA = Personal Assistance

12. Intention Most training services, also called habilitative services, are designed to help people develop skills and modify behaviors related to behavioral or DD issues that cause functional deficits.

13. Outcomes for Consumers Outcomes, or purposes, are written into a service plan. The goal is always to increase someone’s ability to be successful and self-reliant, that is, to achieve the greatest possible degree of independence in family, social, school, and community life.

14. Service Planning

15. The Person Centered Plan organizes and directs treatment. The PCP identifies strengths, preferences, and resources that are used to address impairments or deficits. The PCP is a working document, meaning it must change to reflect changes in individual needs over time.

16. Person Centered Planning Case Managers or other Qualified Professionals write plans with assistance from the consumer, and from friends, family, and other professionals who provide treatment or support. This is the treatment team, or support team, or the PCP team.

17. Service Planning The PCP includes specific goals or outcomes that seek to restore, improve, or maintain skills and abilities.

18. Outcomes and Strategies Outcomes are best when stated clearly and in a way that creates a picture of what the consumer will be doing or what their life will be like as a result of the treatment interventions. Outcomes must be observable - anyone can see the difference, and measurable - anyone can see how much difference.

19. Outcomes and Strategies Person-centered Positive Describe performance Realistic Clear Measurable Time specific The outcomes are an important part of the service plan. The support and training given by TPS workers is a powerful part of the treatment someone receives.

20. Outcomes and Strategies “Strategies” or ‘interventions” are used by TPS workers to assist the person to achieve the outcomes that are described in the service plan. You may discover a great strategy to help someone reach an outcome, but may not use that strategy until it is written in the plan.

21. Outcomes and Strategies Strategies MUST be described in the service plan, and include techniques such as skill training, role playing, guidance, teaching, role modeling, practicing, and direct behavioral interventions as written in a behavior plan.

22. Outcomes and Strategies Outcomes are based on a vision of what someone will be doing as a result of assistance and training. Strategies are the types of assistance and training that you as the the support worker will use to help someone achieve an outcome.

23. Outcomes and Strategies Outcomes belong to the person receiving services, and are found in conversations with the client, friends, family, and professionals. Stated clearly and concisely, outcomes describe where we are going. Strategies describe how we are going to get there. The provider agency often enriches the strategies in a plan with more detail, by analyzing a task to be taught or outlining successive steps to an outcome.

24. Types of Strategies: Supportive Counseling Modeling Positive Reinforcement Re-Direction Anticipatory Guidance Mentoring Skill Training Community Integration activities Behavioral interventions Teaching Prompting

25. Connecting the Pieces

26.  TPS worker applies strategies consistently and positively  Interventions and consumer responses are documented by TPS worker  Treatment team reviews service notes and revises plan as needed  Turning Point bills Medicaid or the State – who pays Turning Point - who then pays you

27. Connecting the Pieces o Documentation informs the treatment process and creates the $ that pays 1:1 support o Your good work results in new skills and new experiences for consumers o Consumer is more independent, healthy, and connected to family and community

28. Writing Down the Work

29. Writing down what you do is as important as what you do!

30. Writing Down the Work What you do and what you write down drives the system of treatment. What you write down is important in two ways: Informs the treatment process - Is what we’re doing correct? Did we get the goals right? Are the strategies effective or useless? Creates the evidence of your “work” that results in payment and paychecks

31. What’s “P”, “I” and “E” or “A”? Note includes the Purpose (goal or outcome) Note describes the Interventions you used Your note assesses what the consumer did after your intervention, or the effectiveness of the activity Note reflects the amount of time billed

32. Note Checklist Date of the service delivery Interventions you used are in the treatment plan Note signed by you, including your work title (at TPS, that’s often “Hab Tech”)

33. The Service Note Formula More training for writing service notesa (not grids) is next using the “Service Note Formula”. Ask your QP for a copy of this training now. Your QP Supervisor will make sure you get the started with the “right stuff” for your service and the consumer with whom you have been matched.

34. Individual Training You will also receive training that covers the consumer’s entire service plan. Your supervising QP will complete this consumer specific training with you.

35. Individual Training It is important that each staff person is aware of all aspects of the service plan, especially medical and safety issues. This is the “person- centered” aspect of your training.

36. Key Success Factors What you do is important What you write down is important Remember, you provide a powerful service to people who have significant deficits Never fail to call your “QP” with any questions Be professional: consistent, positive, meet deadlines Create a supportive, therapeutic relationship with consumers

37. Key Success Factors  Your work increases self-reliance, independence, & community connections for consumers.  Use only the interventions identified in the person centered plan.  Review the PCP carefully with your QP.

38. Next Step Proceed to the Service Note Exercise. You will practice writing notes that are much different than CAP data sheets. Getting it right now will save you much time later.