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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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9/21/2017
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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
[email protected]
(630) 620-2222
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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
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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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