Rutgers, The State University of New Jersey Liberty Plaza, 335 George Street, New Brunswick, NJ 08901

rwjms.rutgers.edu/boggscenter p. 732-235-9300 f. 732-235-9330

Kim Zoeller, MPA President and CEO

Ray Graham Association Lisle, IL

Implementing Personalized Supports

September 28, 2017 APA Hotel Woodbridge, Iselin, NJ

The attached handouts are provided as part of The Boggs Center’s continuing education and dissemination activities. Please note that these items are reprinted by permission from the author. If you desire to reproduce them, please obtain permission from the originator.

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Implementing Personalized SupportsThe Boggs Center on Developmental Disabilities

KIM ZOELLER, PRESIDENT AND CEO

RAY GRAHAM ASSOCIATION

Today’s Discussion

Culture and Person-Centered Practices

Discovery to Planning – Using Personal Outcome Measures©

Implementing Personalized Supports

Practical Solutions

Success Stories

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A little about RGA…

Providing services and supports since 1950 – located in the western suburbs of Chicago.

Accredited by CQL for more than 20 years - First organization in the world to achieve accreditation using the Person-Centered Excellence format.

October 2003 – Workshop was closed! Created the Community Learning Center model.

Completely phased out any subminimum wage work – Micro-business development.

Support more than 100 people gainfully employed each year.

A focus on customized residential supports.

Monarch Services – Academy, Life Coaching.

Family support options – Recreation – Therapeutic Horseback Riding

We are on a journey…we want to raise people’s

expectations!

Organizational culture is key…

Invisible, but it is the driving force that reflects the values and behavior of everyone within the organization.

Nothing derails person-centered practices more than a conflicting organizational culture.

Leaders must conscientiously take an active role in positively influencing the culture…actions speak louder than words.

Flexible and willing to change.

Language is important. A strong value for everyone’s time. Measure and celebrate the right things. Productive, empowered, energized, and

respected team members best know how to “pay it forward”.

Leadership holds themselves accountable to those they serve.

Remember that everyone leads…make sure they are trending in the right direction.

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The Truth is….

It does not cost a dime to live by a set of values that prioritizes listening to people and a

commitment to truly striving to focus on what’s most important to them.

Telling it like it is…

Simply declaring your organization “person-centered” is not enough.

We spend way too much time thinking about paper and forget to engage with people about their lives.

We let rules and regulations define our reality. We keep people’s lives small by our lack of creativity

and fear of change. We waste people’s time doing “activities” that have

no real purpose or meaning for working age adults. We overcomplicate just about everything.

We listen to the “Yea-But” people…You know the

type of person I am talking about…every time you bring up an idea you get “yea, but” we cannot do that because…blah,

blah, blah!!!!

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My Security

My Relationships

My CommunityMy Goals

My ChoicesMy

FocusGuide to person-centered thinking,

practices, and planning.

Using Personal Outcome Measures©

Outcome Interview Person Centered Planning

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Personal Outcome

Measure Data

Measuring success of the organization based on the outcomes that people achieve.

Can quickly identify trends…both positive and negative.

Use to determine training needs of your staff.

This data can be used to re-direct resources.

A great source of information for grant writing and development efforts.

Drill down to service/program specific to determine effectiveness – Strategic planning.

How can this data help my organization?

Planning with Personal Outcome Measures®

The 21 POMs are the basis of conversations with people about their life priorities.

Planning is not an event, it is a process.

Always remember that the person owns their own outcomes!

The person’s team owns the supports.

There are no “prerequisites”…it is life, not school!

Confirm each person’s safety, security, and health related POMs. Adjust supports, as needed.

Support people to identify important life priorities – ASK and ACT! Sometimes you cannot tackle everything at once, but be sure to take the person’s lead on what’s most important.

Always include those most needed to support the person to succeed.

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More on planning…

Navigating rules and regulations. Do what you got to do, but don’t let the tail wag the dog.

Yes, sometimes you have to focus on the next best thing…

Keep it simple!

Consider a “roll out” to get buy in!

Documenting people’s life stories and journey can be creative and fun!

Stop! Do not over think this!

Person-centered practices are not something else you add to your plate, it becomes what you do. It is not a

policy or procedure. It becomes your way of life at your organization. And, remember that it is a marathon and

not a sprint! You have to be in it for the long haul.

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Stop… Do not recreate the wheel!

Look for those sensible opportunities to change the conversation during existing gatherings…instead of recognizing your staff for years of services, recognize them for their role in supporting people to achieve important life goals and outcomes.

You do not want to have competing systems. As you shift, replace and not add to. Consistency and persistence is key.

A few practical ideas!

Training your staff about POMs without them knowing! Month long campaigns that focus on

fun activities for people you serve (“Quality Campaigns”).

Contests… healthy food cook-offs, create your own game show, do an “amazing race”, etc.

Start every meeting in every department by sharing the real life successes and achievements of the people you serve.

Breakdown silos during the discovery process! Day and residential share in the

process of learning about people (“All about Me”).

Use technology and make it fun to learn about people…videos, pictures, etc. about home, work, fun… How many times do day staff visit people’s homes? How many times do residential staff get to learn work/day?

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Everyone should have something to celebrate!!

Annual Meetings… Who’s meeting is it really? Celebrate the past year…how full

is your “poster board”? Take care of the “boring” stuff

outside the meeting! Build excitement for the upcoming

year!

Embrace change!

Change comes in all shapes and sizes! Small changes can lead to much larger changes.

Change applies to everyone in your organization…not just your “program staff”. Don’t forget your finance, development, human resources, maintenance, and other support teams.

Change is healthy, but sometimes it feels like the process might kill you!

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A story about change…

Prior to 1999, RGA operated a large traditional workshop program.

In 1999, the first “Community Learning Center” (CLC) opened and the CLC concept was initially developed.

October 2003 – Workshop was closed!

Opened 7 CLCs, then closed 3 of them.

Completely phased out any subminimum wage work.

Micro-businesses.

Created Monarch Services.

Support more than 100 people to be gainfully employed each year.

I know exactly what you are thinking!!!!!

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Life (as we thought we knew it) before 2003

People loved the workshop because they saw their friends everyday.

People served and families loved the safety and security of the workshop.

People loved the work they were doing and did not want to or they couldn’t find a job outside the workshop.

Staff knew best about what people wanted and needed. The “yea-but” people ruled!

Staff were resistant to change…it is not broken, why fix it?

The roles and functions of our staff NEVER changed from year to year.

Everyone loves a paycheck, even if it is for 25-cents.

People and

Values

Families

Staff

Budget

Design

Person-Directed Approach

Goal was not to save money, but rather try to be

cost neutral! Better use of resources.

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Design… Community Learning Center

RelationshipBuilding

Health and Fitness

PersonalEnrichment

LeisureEducation

and Recreation

Creative Arts

Community Life EconomicDevelopment

Monthly Theme Focus Area

A little side by side…

Workshop Community Learning Center

40,000 square foot building 6 Buildings – approximately 4,500 square feet each

Facility Operations Cost = $403,000 annually

Facilities (all) Operations Cost = $405,000

Employment: One majorcontract … lots of downtime

Employment: Micro-Business Development, Community Jobs (>100 relationships)

Volunteerism = 0 More than 20 partnerships supporting social roles

Transportation centralized Transportation decentralized

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Positive Impact on People

Outcome Measure Before After – 3 Yr Percent IncreasePeople choose services 47% 87% +40%People realize personal goals 63% 100% +37%People are connected to natural supports

62% 81% +29%

People perform different social roles

21% 50% +29%

People have friends 58% 81% +23%People use their environments 78% 100% +22%

Success story - Chris

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Success Story - Ann

Success Story - Tom

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Suggested Reading and Resources

O’Brien, J., & Lyle O’Brien, C. A Little Book About Person Centered Planning. (1998) Toronto, ONT: Inclusion Press.

Seligman, Martin E.P., Flourish: A Visionary New Understanding of Happiness and Well-being. (2011) New York, NY: Atria

CQL Publications What Really Matters: A Guide to Person-Centered Excellence Personal Outcome Measures Shared Values Basic Assurances

Contact information

Kim Zoeller, President and CEO

Ray Graham Association

901 Warrenville Road, Suite 500

Lisle, IL 60532

www.raygraham.org

kimz@raygraham.org

(630) 620-2222

Organizational Culture and Person Centeredness

Kim Zoeller, Ray Graham Association February 2014

Nothing can derail the good intentions of Person-Centered Planning more than a conflicting culture within the organization. It is the culture of an organization that determines what is important. Although invisible to the eye, it is ultimately the driving force that reflects the values and behavior of everyone associated with the organization. Simply declaring that your organization is “person-centered” is not enough. Actions speak much louder than words. The actions or inactions of leadership can either set the tone for a culture that embodies the spirit of “person-centeredness” or just the opposite. Leaders must conscientiously and deliberately take an active role in influencing the culture of their organization; otherwise they will end up being shaped by the culture itself and the status quo will continue. In a person-centered culture, all people feel welcome, listened to, and supported in their decisions. This includes employees of the organization, families, people with disabilities, and other stakeholders. It is a common understanding that people are experts when it comes to their own lives and they expect their opinions to be heard, respected, and acted upon. Person-centered organizations value creating a culture that gives people the authority to pursue their own vision, and equally allowing team members to have the autonomy and flexibility to support people moving forward. A culture that truly embraces person-centeredness does not confuse hearing people with listening to them. Listening requires us to open up our minds and set aside our bias and opinions. While it may seem like a minor issue, language and vocabulary must be in alignment with the organization’s mission and tenants of person-centeredness. The field of disability related services has been very successful in creating a language that only we understand and often times defines people with disabilities as being different from everyone else. A person-centered culture uses the same language and vocabulary for all people. These organizations pay attention to the details and understand that how we refer to people and what’s happening or not happening in their lives reflects how we really feel and how we prioritize what’s important. In a system where services and supports have traditionally been delivered to people with disabilities based on what professionals recommend, truly listening and building a culture based on person centered values can be challenging. Cultures that are most successful tend to highly value spending time with people served and truly listening to their priorities. Sometimes key organizational leaders will spend hours, days, and months perfecting a document, refining the font, margins, and spacing. Yet, spend so little time truly listening to people and taking action. Leadership must be extremely tuned into where they choose to focus attention. Although systems and processes are important for structure and follow through, rewarding efforts as it relates to the successes of people served is paramount and speaks volumes about what’s really important.

All organizations have the “yea-but” people. You know the type of person…every time an idea is brought up they say “yea-but” we cannot do that or that will not work. However, a person-centered culture quickly neutralizes “yea-but” people and prevents them from influencing priorities for people served and/or the organization. In fact, the “yea-but” personality has a difficult time surviving in a person-centered organization. They are viewed as obstructionists and not promoted

to positions of leadership and authority because a “yea-but” in a leadership role can totally derail the ability of an organization to be responsive to people’s ever changing priorities. Person-centered organizations and leadership teams keep steady and on course despite the many rules and regulations that must be navigated. Person-centered organizations do not use rules and regulations as excuses. As humans we do what is measured and unfortunately in our field the timeliness of completing documents is mostly the key success indicator for regulatory entities. Often this has no bearing on quality, but it is where our most important team resources spend their time. Person-centered leaders always imagine and consider if people with disabilities created the system how it would look and they focus their energy in that direction, while doing what must be done. When organizations value everyone’s time great things happen! But, too often organizations waste people’s time. Leading up to a person-centered planning meeting and throughout the meeting we ask a lot of questions and many times people get very excited to move ahead with some new life adventures. But, we fail to act, and we do it over and over again, having practically the same meeting from year to year. Can you think of few things more bothersome and disrespectful than wasting your time? Person-centered organizations truly believe that lack of forward movement in people’s lives is reflective of the quality of their services so they devote much time and energy in finding new solutions, seeking innovative initiatives, and charging forward with the next best thing to creatively influence progress. Applying the same level of responsiveness when it comes to employees is absolutely critical to creating a culture that embraces person-centeredness. Productive, empowered, energized, and respected staff best understand how to “pay it forward” when it comes to providing person-centered services. Recognizing that all staff members are leaders and they have important insight and opinions has to be a common denominator within the organization. It is all about developing teams that ask questions, listen, and act! Teams that encourage creativity, forward thinking, and focus on the positives and the possibilities are the priority for development and recognition. Organizations that excel at being person-centered also tend to be learning organizations. Learning organization refers to a culture that facilitates learning of its team members and continuously transforms itself. Learning organizations constantly evaluate the ongoing dialogue of its stakeholders and external pressures, thus not to fight to maintain the status quo, but rather bucking the system and creating opportunities that are responsive to people’s changing priorities. Learning organizations become more like communities that employees can feel a commitment to. These are cultures where each and every employee sees their role clearly linked to the organization’s mission and values. Finally, at the end of the day, what we measure and celebrate is what we do. Person-Centered organizations measure their success based on the successes of the people it serves. Leadership teams hold themselves accountable to people and they are willing to be flexible and change. Person-centered cultures understand that their efforts are an on-going journey, not a destination. The journey never ends. The path just changes!

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