Implementing Person-Centered Practices and Positive

TwoDifferentModelsforImplementingPBSinOrganizationsSupportingPeopleWithDisabilities

ImplementingPerson-CenteredPracticesandPositiveBehaviorSupportinMinnesota

RachelFreeman,Ph.D.InstituteonCommunityIntegration

UniversityofMinnesota

Purpose

• StatewidePositiveSupportPlanning• Minnesota’sInfrastructureforImplementingPerson-CenteredPractices&PositiveBehaviorSupport

• EvaluationQuestions,DataCollectionSystems,andStories

StatewidePlanningTeamMeetsQuarterly(CoordinationIntraandInteragency)

OlmsteadSub-cabinet

DHSOlmsteadSteering

Committee

OlmsteadAgencyLeads

InteragencyCommittees

Data Systems Workgroup

Workgroup: Marketing & Communication

Workgroup: Preservice/Inservice

TA Workgroup Workgroup:

Inventory & Definitions Workgroup:

Crisis Prevention

Original Organization of Statewide Positive Support Plan 2015 -2016

ExamplesofAccomplishmentsFromStatewidePlanning

• StatewidePlanIncludedinOlmsteadPlan• ParallelDevelopmentofTrainingInfrastructure

• MinnesotaDepartmentofEducationPBIS• Organization-widePerson-CenteredPracticesandPBS

• FidelityofImplementationforPerson-CenteredPractices• StandardsofPracticeforPerson-CenteredPlanning• FidelityofImplementationToolsandTraining

• TrainingInfrastructureandLaunchforDiverseHumanServiceOrganizations

• Counties• PublicHealth• MentalHealth• ProvidersSupportingPeoplewithIntellectualandDevelopmentalDisabilities

ExamplesofAccomplishmentsFromStatewidePlanning(Continued)

• InventoryMeetingsStatewideonPoliciesandProceduresRelatedtoRestraint

• PositiveSupportsWebsite(MNPSP.ORG)• ParallelDevelopmentofEvaluationSystemsAcrossDHSandMDETrainingInfrastructures(Starting)

• PositiveBehaviorSupportNetwork• LedbyDepartmentofHumanServices,MinnesotaDepartmentofEducation&UniversityProfessionals

• PATHCompleted• FocusonInservice PreserviceRelatedIssues• PBSStateConference

StatewidePlanningTeamMeetsQuarterlyCoordinator:CarolAnthony

DataSystemsWorkgroup

Workgroup:Marketing&Communication

MNPBSNetworkMNPBSGathering

TAWorkgroupCoordinatorCA/RF

Workgroup:Inventory&Definitions

MDEPBIS

Revision to Statewide Communication Systems (2016 – 2019)

Person-CenteredPracticeWorkgroupCoordinator- SD

PositiveBehaviorSupportDHSCoordinator-AM

PositiveSupportExpansionWorkgroupCoordinator-CA

InfrastructureWorkgroup–CA/RF

MNGathering

NextStepsforStatewidePlanning:PositiveSupportStatewidePlanning

• LaunchNewTeams• UpdatetheLogicModel• ReviseActionPlan• ChairsFacilitateSelf-AssessmentandRecommendationsforChangesandSubmittoInfrastructureWorkgroup

• InfrastructureSummarizedChangestoLogicModelandSubmitstoTAWorkgroupforReview

• OversightGroupSubmitstoOlmsteadSubcabinet• FocusonAreasThatNeedAttention

Organization-WidePerson-CenteredPracticesandPositiveBehaviorSupport

PositiveBehaviorSupport

UniversalStage• TeachandEncourageCommunication• PredictableandProactiveSettings• EncourageandReinforceSocialSkills• Consensus-BasedTeamFocus• EmphasisonUsingDataForDecisions

SecondaryStage• EarlyInterventionandDataMonitoring• AdditionalSupportsforKeySocialSkills• Function-BasedDecisions• SimpleInterventions• MentalHealthandWellnessInterventions

TertiaryStage• IndividualizedPBSPlans• IntegratedwithOtherPositiveSupports(PCP,Trauma-InformedCare,DBT,Etc.)

• PlansAreMonitored- Data-BasedDecisionMaking• TeamsMonitorProgressofEachPerson

OrganizationalWorkforceDevelopment

PersonCenteredPractices&Planning


ImplementingMulti-TieredSystemsofSupport

Person-CenteredPractices&Planning

OrganizationalWorkforce


OrganizationalWorkforceDevelopment


PositiveBehaviorSupportTertiaryStage• InDepthPerson-CenteredPlans• IntegratedPlans(PCP,PBS,Trauma-informedTherapy)

• TeamsMonitorPlanProgress

PrimaryStage• UniversalPerson-CenteredStrategies• EncourageSelfExpression• Self-DeterminationandChoiceMaking• MeaningfulParticipationintheCommunity

SecondaryStage• MonitorPCTActionPlans• AdditionalQualityofLifeStrategies• IncreaseStrategiesforSupportingIndependenceandCommunityInvolvement

• MentalHealthandWellnessInterventions



OrganizationalWorkforce

Organizational WorkforceDevelopmentPositiveBehaviorSupport

UniversalStage• AlignPoliciestoPerson-CenteredPractices• ReviseJobDescriptions,andPerformanceEvaluations• IntegratePerson-CenteredPracticesandPBSWithNewOrientationandOngoingInstruction

• UseDataforDecisionMaking

SecondaryStage• MonitoringandEarlyIntervention• TrainingTargetedforGroups• TargetedStrategiestoImproveSpecificSettings• SimpleProblemSolvingforChallengingSituationsThatOccurinMoreThanOneSituation

TertiaryStage• TailorProblemSolvingforSpecificProblematicSituations• IndividualizeTrainingandMentoringtoAddressUniqueSettingsWhereProblemsOccur

• ImproveSupervisionandMentoringforLocationsExperiencingChallenges

• EstablishMatching/HiringTailoredtoIndividualizedPlans OrganizationalWorkforce



Person-CenteredPractices&PBSInstituteonCommunityIntegration(https://mnpsp.org/training-materials/)• Team-BasedActionPlanning&DataSystems• PBSMulti-TieredCurriculum• KeyContactTraining• Person-CenteredPlanning&PBSFacilitatorTraining• RegionalTrainerMentoring

SupportDevelopmentAssociates(SDA)(http://sdaus.com/resources)• UniversalPerson-CenteredPractices• CoachesTrainingSystem• Person-CenteredThinkingTraining• PictureofaLifePlanningTraining

PRACTICES

SupportingStaff Behavior

SupportingAll People

OUTCOMES

Improving Quality of Life

SupportingDecisionMaking

14

TeamsInvolvedinSystemsChangeAcrosstheLifespan(ChildrenandAdults)Including:

ProviderOrganizationsResidentialHomeSettingsEmploymentSettings

PublicHealthOrganizationCountyTeamsMentalHealth

Cohort2ASt.LouisCountyRegion(County&3Organizations)IntegratedModelCohort2B

WestCentral(5Counties,PublicHealthDept.,2Organizations)IntegratedModel

Cohort1SupportDevelopmentAssociatesPerson-centeredPracticesModel1County,3Organizations

MinnesotaStatewidePlanforBuildingRegionalCapacity

TrainingLayers• TeamTraining• RegionalTrainers• Person-centeredThinkingTrainers/CoachTraining

• PictureofaLifePlanners/Trainers

• PBSFacilitators

StatewideTeam

Cohort2Region1

RegionalTrainer

Organization1KeyContact




Cohort2Region2

RegionalTrainer





MinnesotaTrainingInfrastructureCommunicationPathway

Leadership Team

Visibility

Training Mentoring Evaluation

Active Coordination

Start Small and Build on Success

Organization and County Model for Planning

Interagency & Natural Supports

PCP, PBS (Other PS)

Expertise

FundingPoliticalSupport&Policy

StatewideEvaluationQuestionsOrganization-WideImplementation

AssessingOrganizationalData• AlignmentofOrganizationalPolicies• OrientationStaffDevelopment&Performance• SurveysandOtherDocumentationRelatedto

– QualityofLife– Climate– Stress

• InformationaboutOtherPositiveSupportsUsedinOrganization

• QualityofLifeEvaluation• IncidentReports(PreparationinYear1)• Injuries,SickDays• InformationRelatedtoRetention,WorkersCompensation,StaffInjury

Evaluation&DataSystemsOrganization-WideEvaluation RelatedEvaluationData/ToolsWhatimpactdidthetraininghaveoncapacitybuilding?

Numberofcoaches,keycontactsNumberofstaffinvolvedinimplementationNumberofpeoplesupported

Whatarethestrengthsandneedsoftheorganization?

Person-centeredorganizationaldevelopmenttoolQualityofsocialandphysicalenvironment

Howwellarethepracticesimplemented? Fidelityofimplementationchecklist(Quarterly)Onsiteevaluation

Aretheimprovementsinconceptualknowledgeofstaff?

Pre/posttestsforstaffusingDC/CDS

AretherechangesinbehaviorofStaffandPeopleLivingandWorkinginaSetting?

Directobservationofstaffperson-centeredpractices(Quarterly)Directobservationofpeoplesupported(Quarterly)Incidentreports,restraint,911calls,etc.(Quarterly)Organizationaldata(retention/tenure,etc.)

Aretherechangesinuniversalqualityoflife? Qualityofsocialandphysicalenvironmentinterviews

ExpansionofOrganization-WideImplementationinMinnesota:Person-CenteredPractices&PositiveBehaviorSupport

2015 2016 2017- Estimates

Regions 1 3 3-4

Teams 4 16 20

TotalCoaches 44 167 207

KeyContacts 6 24 34

PBSFacilitators 0 6 12

PCTTrainersByRegion

4 14 18

TotalActive PCTTrainersinMN

46 66 86

DescriptiveDataforOrganization-wideImplementation

0

5

10

15

20

25

30

35

40

Teams KeyContacts PBSFacilitators PCTTrainersbyRegion

Num

ber

TypeofRoleinImplementation

StatewideOrganization-wideImplementationGrowthPatternOverTime

2015

2016

2017

DescriptiveDataforCoachesbyRegionandPCTTrainersAcrosstheState

0

50

100

150

200

250

TotalCoachesbyRegion MNPCTTrainers

Num

ber

TypeofRoleinImplementation

OverallNumberofCoachesbyRegionandTotalPCTTrainersAcrossMN

2015

2016

2017

FidelityofImplementation:MNTeamChecklist

WhiteFormTeamImplementationAcrossPositiveSupports

BlueFormPBSSubscaleItems

PinkFormPerson-centeredPracticeItems

DomainsforOverallFidelity• Team• StaffCommitment• Self-Assessment• ActionPlanning• StaffDevelopment• Evaluation• Visibility

State-WideMinnesotaTeamChecklist– Overall

0%

10%

20%

30%

40%

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100%

Agency1 Agency2 Agency3 Agency4 Agency5 Agency6 Agency7 Agency8 Agency9 Agency10 Agency11 Agency12

State-WideMinnesotaTeamChecklist– Overall2016-2017

Baseline

1stfollow-up

Percen

tCom

plete

Agencies

State-WideMinnesotaTeamChecklistPerson-CenteredPracticesSubscale

Percen

tCom

plete

OrganizationsInvolved

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MinnesotaTeamImplementationChecklistPerson-CenteredPracticesSubscale– Cohort2

Baseline

5Months

State-WideSummaryofMinnesotaTeamChecklist–PositiveBehaviorSupportSubscale

0%

10%

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MNTeamImplementationChecklistPositiveBehaviorSupportSubscale

Cohort2byAgencyBaseline

5months

Percen

tCom

plete

OrganizationsInvolved

Cohort2TeamBaselineDataPerson-CenteredPositiveOnsiteEvaluationTool

Percen

tCom

plete

OrganizationsCompletingtheOnsiteEvaluation

0%

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Agency1 Agency2 Agency3 Agency4 Agency5 Agency6 Agency7 Agency8

Cohort2BaselineDataforOnsiteEvaluations2016-2017

BaselineOnsiteEvaluation

Person-CenteredPracticesSocialEngagement

PositiveSocialBehaviors

FinalStagesofDirectObservationMeasure

Person-CenteredValuesinaMentalHealthClubhouse

Times of Day

Free Time Outside

Activities Before Lunch During Lunch After Lunch End of the Day

Pers

on-C

ente

red

Val

ues

Respect Each Other

Respect Each Person’s Personal Space

Smoke in Designated Areas, Tip Your Servers

Move Out of the Way for Someone Trying to Get Through,

Allow People Time to Finish Lunch Peacefully

Check if Others are Finished Before Starting to Clean Up

Jump In and Offer to Help!

Take Care of our Space

Pick Things Up That Are on the Ground

Throw Garbage in Can, Clean up After Yourself

Pushing in Chairs Keep a Clean Table Clean up your Dishes, Push in your Chairs

Tidy Up and Organize

Work Together

Share Information and Ideas

Help Carry Things for Other People

Offer to Help to Finish Tasks

Help Each Other get Stuff Done!

Offer to Help People Who May Need It

Share the Tasks so People Don’t Always Have to do the Same Thing

Appreciate Diversity Learn About

Each Other’s Uniqueness

Be Sensitive to What Other People Would Like to Do

Know That We all do Things |Differently!

Everybody Moves at Their Own Pace

Be Aware that Others Have Different Eating and Clean-Up Rituals and Routines Than You

Be Sensitive to People’s Routines as We Clean up

StatusofState-WideOutcomeData• ObservationSystemsinPlacefor2Outof12Teams• BehaviorIncidentReportingSystemDatabyRegion• StateandRegionalQualityCouncilsareWorkingonQualityofLifeMeasurement

• IndividualPerson-CenteredPlansandPBSPlansareImplementedWithinTrainingContext

• TeamsareWorkingonOrganization-WideDataCollectionSystems• ProviderOrganizationsPreparingtoImproveIncidentReportingSystems• Retention-TenureDataareAssessed• SurveysandQualityofLifeDataareAssessed

ContactInformationRachelFreemanEmail:[email protected]

RachelFreeman,Ph.D.InstituteOnCommunityIntegration,UniversityOfMinnesota,Pattee Hall,Room110A,150PillsburyDr.S.E.MinneapolisMN55455

ThanksforYourTime!!!

PresentationandAdditionalToolsAreAvailable!

Presentationhttps://new.apbs.org/conference

AdditionalToolsandResourceshttps://mnpsp.org/training-materials/

Preparationofthis[presentation/report]wassupported,inpart,bycooperativeagreementJPK%50470fromtheMinnesotaDepartmentofHumanServices.TheUniversityofMinnesotaundertakingprojectsundergovernmentsponsorshipareencouragedtoexpressfreelytheirfindingsandconclusions. Pointsofvieworopinionsdonot,thereforenecessarilyrepresentofficialMNDHSpolicy.

Documents

Implementing Person-Centered Practices and Positive