Transition Triangle

The transition triangle talks about the relationship between the High School and Beyond Plan , the IEP transition plan and Agency supports from DDA, DVR and DSB. within that triangle of support is the student asking themselves: Who they are, what is their future and their goals.

The planning process to support a student with disabilities toward their adult life plans requires coordination and organization. This graphic provides a visual overview of the work and who is responsible to help.

The center upside down triangle describes key questions for a student as they move through school and toward adulthood:

  1. Who am I? Answers include what the student is interested in, what they are good at, what they struggle with, and how they see themselves.
  2. What’s my future? Students can begin to imagine where they might work, whether higher education will be part of their future, and how they might live.
  3. How do I reach my goals? The answers are a long-term project. A good planning process ensures that work done today is moving the student toward their vision for adult life.

The three colored triangles on the corners of the graphic represent three tools that help students ask and answer these questions.

The purple triangle on the bottom left represents the High School and Beyond Plan. Washington State requires schools to begin supporting all students with a High School and Beyond Plan before they leave middle school. The plan includes questions to help the student think about where they might work someday and how much education they will need to get that job. The plan is designed to make sure time spent in school is moving the student toward adult goals. The High School and Beyond Plan addresses the same questions that are listed in the center of our triangle and is often managed by staff in a school’s counseling center.

The blue triangle on the bottom right represents the transition plan, which is required in a student’s Individualized Education Program (IEP) by the school year when they turn 16. Goals in the IEP Transition Plan include further education/training, employment, and independent living as parts of a student’s program. A student with disabilities has the right to a Free Appropriate Public Education (FAPE) until they earn a diploma or turn 21. The IEP includes a target graduation date, determined by the IEP team. The state requires the IEP Transition Plan to align with the High School and Beyond Plan. School staff and the family collaborate to make sure these two tools match up to best support a student’s progress.

The teal triangle on top of the pyramid represents agencies that might provide Vocational Rehabilitation (VR) services. The Developmental Disabilities Administration (DDA) has a variety of school-to-work programs for eligible students: A DDA case manager can provide information about options. The Division of Vocational Rehabilitation (DVR) provides Pre-Employment Transition Services (Pre-ETS) for students still in school as well as vocational rehabilitation services for adults with disabilities. As they transition out of school, members of some Native American tribes may access Tribal Vocational Rehabilitation (TVR) services. The Department of Services for the Blind (DSB) is a separate agency providing Pre-ETS for youth and vocational rehabilitation services for individuals who are blind or low vision. Staff from these agencies may work with an IEP team and counselors at school to make sure everyone is working together to support the student in the center.

Ideally a student with disabilities has people supporting all of the features on this transition triangle. Best practice is for all agencies and supporters to collaborate as they help a student move toward a successful adult life.

For direct assistance from PAVE, click Get Help. The Office of Superintendent of Public Instruction (OSPI) provides information about graduation requirements for a student in Washington State

Map Your Future with Person-Centered Planning

A Brief Overview  

  • Person-Centered Planning (PCP) is a method for helping a person map out a future with intention and support.
  • PAVE staff member Michele Lehosky, PCP facilitator, provided a training at PAVE’s Tools 4 Success conference in March 2020. Here’s a YouTube video from that virtual conference: Build Your Dream Map.
  • Read on for more information about what Person-Centered Planning is like.

Full Article  

Everyone dreams about what they might do or become. Individuals with disabilities might need additional support to design the plans, set the goals and recruit help. The Person-Centered Planning (PCP) process is a tool that works like a Global Positioning System (GPS) to help a person figure out where they are starting and how to navigate to a planned destination.   

A PCP session is a gathering that can happen in a specific physical location, such as a school or a community center, or in a virtual space online. The people who get together might include family members, friends, teachers, vocational specialists, coaches—anyone who might help brainstorm ways to plan an enriched, full life for a person of honor.

The first step is to celebrate the gifts, talents, and dreams of the person. Then the group develops action steps to help that person move closer to their dreams and goals.  

Throughout the gathering, the attendees listen, ask questions, and draw pictures or write down words that contribute to the process. Respect for the person’s goals and wishes is a priority, and participants withhold judgment to honor the individual completely.  

Person-Centered Planning explores all areas of a person’s life. All people experience various times in their lives that are transitions. High-school graduation is a major example. Job changes, moving to a new home, entering or leaving a relationship: Those transitions happen for individuals with and without disabilities.

Individuals with disabilities have some additional transitions. For example, when a person leaves the special education system of public education at graduation or after age 21, there is a change in disability protections. A student receiving special education is protected by the Individuals with Disabilities Education Act (IDEA). In adult life, the right to accommodations and non-discrimination is protected solely by the Rehabilitation Act of 1973 (Section 504) and the Americans with Disabilities Act (ADA).

There are specific transitions that occur for individuals who qualify for support from the Developmental Disabilities Administration (DDA), which in Washington is part of the Department of Social and Health Services (DSHS). Employment and workforce training programs often are part of the transition from high school into what happens next.

During major life transitions, many service agencies focus on a person’s inabilities or deficits.  Person-Centered Planning, on the other hand, focuses on what’s positive and possible, based on the dreams and goals of the individual.

A PCP session includes a set of maps where information is collected in words and pictures. Here are some examples:

People in my Life     

This map names important people and their roles in concentric circles. These are people that the individual trusts for help and support and may include paid and unpaid supporters. Those who are closest to the person are in the circles closest to the center of the map.

Who am I?  My Story, My History    

This map is built during the session to describe the person’s story from birth up until the gathering. This map reflects what is most important to the individual. The facilitator might ask:

  • What parts of your life are important for people to know?   
  • What are some stories of your life that would be helpful for a coworker or a friend to know? 
  • Are you a sibling? A spouse? A parent?
  • How old are you? 
  • What activities do you participate in? 
  • Have you had any jobs?
  • Where do you live? Go to school?  
  • Do you have a medical concern that someone spending time with you might need to know about? 

 Likes and Dislikes  

The “Likes” list includes favorites, things that make the person happy. Favorite colors, foods, activities, places, people are listed. 

The “Dislikes” list includes the opposite of all those things and might also list triggers (bright lights, loud noises, angry voices, bullies) or other sensitivities.

What Works/ Doesn’t work 

The first part of this map asks: When learning a new activity or skill, what are steps and learning tools or activities that work for you? Answers might look like these examples: frequent breaks, accommodations, a written schedule, a list of duties, instructions in larger print, a preferred time of day to start something…. 

The second part asks: When learning a new activity or skill what activities do not work for you? Answers might resemble these examples:  waiting in line, too many instructions, too many people barking out orders, standing or sitting for too long, verbal instructions, unclear expectations….  

Gifts, Talents and Strengths  

This map asks several questions: 

  • What are you good at?
  • What can you do that is easy for you? 
  • What are your best qualities? 
  • What do people like about you?   

Examples for answers:  best smile, cleaning, giving, caring, natural dancer, very social, great with computers, good with numbers, great at sports, good listener, good with animals, etc.   

Dreams /Nightmares 

The My Dreams map asks: Where you would like to see yourself in a few years?  Follow-up questions:

  • What will you be doing?
  • What would your dream job be?  
  • Where are you living? 
  • Do you live on your own or with family or a roommate?  
  • How are you keeping in touch with your friends?   
  • What is an action you can take to move toward your dream or goals?    

The Nightmare Map asks:  What do you want to avoid?  Follow-up questions might include this one: Where do you not want to be in a few years? This is not to make the person feel bad but to make an out-loud statement about what the person doesn’t want to happen. This can include actions or thoughts that someone wants to avoid.  

Needs 

The Needs map asks:  What do you need help with to avoid the nightmare?  A follow up question might include: What areas do you need support with? Answers might look like these examples: budgeting money, learning to drive, training to ride the bus, cooking lessons, looking for a job. The goal is to recruit support to help the person stay away from the nightmare and work toward the dream.   

Action Steps  

A map that show Action Steps includes the specific help that will assist the individual in moving toward the dream. This chart typically details what needs to be done, who will do it, and by when. 

Example:    

Goal: To Write a Resume     
Who: Michele 
What: Call Mark to ask for help.  
By When: Next Monday, April 6, 2020 

This process involves many support people in the person’s life and identifies, in a self-directed way, areas where help is needed to meet personal goals. The gathering involves the important people in someone’s life because they can help through the process and step up to offer support for the action steps. 

How to get a Person-Centered Plan  

Here are places that might help you find a PCP facilitator in your area:  

  • Developmental Disabilities Administration (DDA) 
  • Division of Vocational Rehabilitation (DVR)
  • School District 

If you live in Pierce County, Wash., PAVE offers PCP facilitation. Please fill out a Helpline Request Form at wapave.org and ask for PCP support. One of our coordinators will contact you.  

Here are a few additional places to seek information about Person-Centered Planning:  

Inclusion.com: All My Life’s a Circle  

Inclusion.com: The Path Method 

Video from PAVE, Tools 4 Success  

Informing Families.org  

I want the kind with the people and the pictures

By John O’Brien

After a Difficult Start…

Institutionalized from age three to twenty-three in a place where “they treated us like animals”– Mike has composed a good life, taking many valued roles: husband, father, worker, home owner, friend, organizer, advocate, mentor, teacher, neighbor.[1] Anticipating the changes that come with aging, Mike requested funding for a person-centered plan from his case manager (a service option in his state). The case manager said that it was unnecessary for him to spend any of his budget on a plan because a new Federal Rule requires that Mike’s annual plan of care meeting be a person-centered plan. Mike, who has participated in many person-centered plans organized through self-advocacy, asked some questions about the required plan and concluded, “I still want the kind with the people and the pictures.”

Regulations that require a person-centered plan as a condition of receiving Medicaid Waiver funds introduce a distinction between Want-to-plans and Have-to-plans. Each can make a positive contribution; both must creatively respond to constraints. A good Want-to-plan supports discovery of possibilities and life direction and mobilizes a person’s allies at important moments in their lives. A good Have-to plan gives a person effective control of the Medicaid waiver funded assistance they rely on. Committed and skilled facilitators with the time necessary to prepare and follow-up make a difference to the impact of both kinds of plan. How well either process works for a person depends on conditions outside the planning process: the extent, diversity and resourcefulness of the person’s social network; the openness of the person’s community; the flexibility and responsiveness of providers of necessary assistance; the sufficiency of public funds for necessary assistance and the means for people to control those funds. Good plans will identify the current reality of these conditions and consider how to engage them.

Mike’s is a want-to-plan. At his initiative, he and his invited allies (the people) collaborate to create a customized process to address his desire to deal proactively with the new responsibilities and increasing impairments that show up with aging. Mike chose Michele, an experienced facilitator, to guide the process. Their agreement makes it clear that Michele is responsible for facilitating a process of change over time, not just a meeting.[1] A graphic record (the pictures), created by Alex, provides an energizing memory of what emerges, a way to track and update action plans, and a way to orient new people to Mike’s intentions.[2] Occasional check-ins and revisions guide continuing action. One-to-one meetings assist Mike in sorting through all the suggestions and offers of help he receives to assure a good fit with who he is. Mike will bring some the information generated by this work to inform the required annual person-centered support plan, but his Want-to-Plan does not substitute for it.

Mike’s experience unfolds under highly favorable conditions for any person-centered plan. He has a strong desire to assure his wife and himself the best possible old age. Reciprocity for decades of generous neighborliness, concern for co-workers and leadership in advocacy give him a diverse network to call on. He is not inhibited in asking for help when he needs it. The help he needs is largely with navigating the unfamiliar territory of selling and buying property and preparing wills and other necessary documents and demands no change in his current paid services. Hard work and careful management has accumulated equity in family home. Many Want-to-plans will need to include provision for strengthening or establishing the social and material conditions for moving toward a desirable future.

Want-to-plans can also originate in a person’s positive response to an invitation to join a process of organizational change. This sort of plan poses a challenge that an organization must stretch its capacities to meet.

Have-to-plans are a necessary step in determining expenditure of Medicaid funds on services to meet the assessed needs of eligible people. They are the final responsibility of system staff assigned to coordinate services. While the process can vary to accommodate a person’s preferences, the process and resulting plan must comply with detailed standards. The New York OPWDD Person Centered Planning Regulation Checklist enumerates 23 requirements, 21 of which track US Federal Regulations.[3]

Have-to-plans serve a worthy purpose. The rules set conditions for the person to direct the meeting, understand the results and assure that the person-centered service plan documents the person’s needs strengths, preferences, goals and appropriate services.

This checklist item, based on a Federal requirement, identifies the intended result of Have-to plans:

2‐5. The plan documents the necessary and appropriate services and supports that are based on the individual’s preferences and needs and which will assist the person to achieve his/her identified goals. [Complies with CFR 441.301©(2)(v)]

This form of words sets Have-to-plans in the context of publicly funded disability services. Offering increased influence on which available provider(s) will serve a person and how those services will be of assistance is a clear benefit of Have-to-plans when there is a real choice among providers with a capacity to individualize supports.

This standard also locates a tension that constrains Have-to-plans as two impulses struggle with each other within the same sentence. One impulse, energized by commitment to self direction and the development of people’s strengths, expresses the life a person wants to live and the supports that they prefer to live that life. The other, tied to the historical anomaly of funding US disability support as if it were a medical service, aims to select necessary and appropriate services that are clearly linked to professionally assessed need. State policy can bias the struggle toward one impulse or the other. In some states[1] the person centered plan is bracketed between an assessment of need that involves an extensive inventory of a person’s deficiencies and writing an Individualized Service Plan (ISP) that must demonstrate a direct connection between assessed need and specified services and avoid public funding of “wants” or “lifestyle choices”. Without the skillful facilitation of an intentional shift in perspective, a Have-to-plan will be primed by a focus on deficiencies and develop within unconscious boundaries set by judgements of what can realistically be funded.

A Want-to-plan can safeguard a Have-to-plan. A person and those who care can choose to create a space outside the world of disability services for conversation about a person’s identity, gifts and capacities and the circumstances that offer the best life chances. Often, as with Mike, some action will result from this conversation that requires no change in publicly funded services. When the sort of changes in services that require a Have-to-plan are necessary, a person and their allies have a foundation for negotiating what they need from publicly funded services.

____________________________________________________

[1] See for example, NJ Division of Developmental Disabilities (March 2016). Supports Program Policies & Procedures Manual (Version 3.0).

[1] Other agreements might suit other circumstances. A different person might agree to fill the necessary follow up role.

[2] Denigrating graphic records has become a cliche criticism of person-centered planning (“people have colorful pictures on their walls but their lives are unchanged”). Lack of commitment or capacity for creative action seem to me more likely causes of inaction than a vivid record of people’s thinking does.

[3] http://www.opwdd.ny.gov/sites/default/files/documents/PCPChecklist.pdfThe 22nd standard, specific to New York, defines a person-centered planning process as a right and requires written notice of that right. The 23d assures that all relevant attachments are filed with the plan. The rule itself, Medicaid Program; State Plan Home and Community-Based Services, 5-Year Period for Waivers, Provider Payment

Reassignment, and Home and Community-Based Setting Requirements for Community First Choice (Section 1915(k) of the Act) and Home and Community-Based Services (HCBS) Waivers (Section 1915(c) of the Act), was published in the Federal Register on January 16, 2014.

[1] You can view Mike’s witness to growing up in an institution and a snapshot of his life today in this 2015 TV investigation into his state’s continuing operation of institutions: http://www.king5.com/news/local/ investigations/wash-decades-behind-in-serving-developmentally-disabled-1/48265785

 

What is Person Centered Planning?

What it is?

Person Centered Planning is a process focused on celebrating the gifts, talents, and dreams of a person, and on helping that person develop action steps to move closer to their dreams and goals. It involves 4-5 gatherings, usually in the person’s home, where friends, family, and others chosen by the family, brainstorm together about how to enrich the life of the person with special needs.

Gatherings are facilitated by people who listen, ask questions and draw pictures
and words that represent the desires of the focus person.

What makes it special?

Person Centered Planning is deeply personal. It is done specifically to listen to a person’s feelings and goals without judgment. It is done in a sensitive way that truly honors who that person is; Person Centered Planning explores all life domains, and future dreams. It is done to empower a person and his or her family to develop action steps that will support that focus person, and enrich his or her relationships.

How you can find out more about person-centered planning?

Workshops are sponsored yearly by Parent to Parent and local school districts. Anyone is welcome to attend. At the workshops, young people and adults who have experienced Person Centered Planning share their experiences about how
Person Centered Planning has affected their lives.

For more information about workshops, or to learn more about how you can develop a Person Centered Plan for yourself or a loved one,
please call Michele Lehosky 253-565-2266; mlehosky@wapave.org

Sponsored by Pierce County Parent to Parent in partnership with PAVE,
Peninsula, Franklin Pierce and Clover Park, School Districts.

 

Person Centered Planning and Aging Families

At the age of 56, a single parent from the baby boom age, my youngest son is now 26, and at this time in my life I need to plan for my retirement.

In a few years I will be heading toward the twilight of my life, so I need to take into account how that affects the life of my son, Kyle, who experiences Down Syndrome. Just like many families who live with and care for their adult sons and daughters for most of their life, it is my responsibility to share vital information that I might be the only one who knows, such as how, what, when, and where services are to be received. This way all the hard planning that has made his routine and the quality of life possible can continue even when I’m no longer able to care for him or myself as I age.

Up to this point most families don’t plan for such events, thinking that they will outlive their loved one with a developmental disability, brushing aside thoughts of what the future might hold for them. If I don’t think about it won’t happen. So usually what happens is when the parent or care giver has a medical emergency there is no plan of care or support for themselves or for their adult son or daughter with a disability, leaving both in need of a plan of care. It will be important to identify who it is left to sort through the maze of services, or lack of services, to help during this very vulnerable time.

Person Centered Planning is a tool that is used to help people plan for the future. Just as you plan along awaited trip you use a simple guide to help you make the journey comfortable to enjoy your precious time you have set aside. When it is time to plan, bring together the people who will be in the family’s life at that critical time. Usually, it is left up to siblings who have not been very involved in their sibling’s day-to-day care. Their parents did a really good job of caring for their sibling, but most find out the hard way what the daily routine looks like for their sibling.

By using the Person Centered Planning method, you have a document on hand so that you are able to have input into a plan of care before a crises.

Aging parents must start thinking about drafting a will and learning about trusts for your peace of mind. Think about the use of Person Centered Planning as a tool, as it can help relay your wishes and concerns. Share information about their care, like who their doctors are, what their care plan is, and other things like a living will. This is in case the parent loses their ability to share vital information to the people who care and to service providers who need to plan action steps.  What history of care has been provided, what are the needs, who can help, what is the plan of care when you or I are not able to communicate the needs of our adult sons and daughters?  As we age, the plan becomes the family plan, not just for the individual but for the whole family, including the network of support and those who will be left to sort things out.

The process helps pull together all their important information so that people who come in and out of the person’s life have something with which to help plan a positive quietly of life for the  individual and their family.

Pierce County Parent to Parent has also put together a care notebook that helps families keep important information together for when the parent is no longer able to speak for themselves or share information that is important, not just for the individual with the disability, but for the family itself.

For more information on Person Centered Planning contact Michele Lehosky at PAVE by email at mlehosky@wapave.org or by phone at (253)565-2266.

Reunited photo courtesy Jenn Durfey via flickr