The Search for Meaning in the World of Community

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Turning Point Services, Inc.Spring 2006

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.

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.)

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.

Non-CAP services

• These services are called by many different names

• IPRS services• Contract services • State-funded services• Services that Need Written Notes

Service Names

Here are examples of the non-CAP services:

• Personal Assistance• Developmental Therapy• Individual Habilitation• IPRS (state-funded) Supported

Employment

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.

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.

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.

Abbreviations

DT = Developmental Therapy

SE – Supported Employment

IH = Individual Habilitation

PA = Personal Assistance

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.

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.

Service Planning

Service Planning

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.

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.

Service Planning

The PCP includes specific goals or outcomes that seek

to restore, improve, or maintain skills and abilities.

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.

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.

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.

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.

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.

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.

Types of Strategies:

• Supportive Counseling

• Modeling• Positive

Reinforcement• Re-Direction• Anticipatory

Guidance

• Mentoring• Skill Training• Community

Integration activities

• Behavioral interventions

• Teaching• Prompting

Connecting the Pieces

Connecting the Pieces

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

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

Writing Down the Work

Writing Down the Work

Writing down what you do is as

important as what you do!

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

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

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”)

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.

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.

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.

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

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.

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.