HCBS Training

Everyone receiving services is unique and needs different types of supports and practices. As a result, many HCBS providers are learning about and training staff to use person-centered and positive support practices. Examples of these types of practices were shared in earlier modules. The challenge for most teams is to introduce key information about the many different types of practices that can be used to improve quality of life.

The challenge many organizations face is that there is a need for a number of different person-centered and positive support practices. For instance, a provider may feel that LifeCourse for Families is an important practice but also want to use PATH for people who will benefit from this model. In fact, an understanding of different person-centered planning methods is considered an important part of becoming a really effective person-centered plan Facilitator. Experts in person-centered plan Facilitation often blend different models to create meet the needs of each person.

Most organizations also use a number of different types of positive support practices. Organizations working with families may choose Applied Behavior Analysis or Positive Behavior Support in addition to using person-centered practices. Organizations that support people with behavioral health related issues are familiear with Motivational Interviewing and Systems of Care.  

It can be challenging for organizations to integrate multiple practices into the everyday work of HCBS. Minnesota teams are addressing this issue by using the action-planning process outlined in these modules to use more than on practice.  The goal of this effort is to avoid fragmented trainings and help staff see the connections across different practices. Most teams problem solve by looking for similarities and differences across practices.

Different Types of Person-Centered Practices:

• LifeCourse
• Person-Centered Thinking
• PATH
• Picture of a Life

Examples of Positive Support Practices:

• Applied Behavior Analysis
• Dialectical Behavior Therapy
• Positive Behavior Support
• Response to Intervention
• Trauma focused cognitive behavior therapy
• Wraparound Planning

Minnesota Team Integrating Multiple Practices:

A team in Minnesota providing HCBS trained coaches in the organization to support staff members learning about both Person-Centered Thinking (PCT) and Positive Behavior Support (PBS).  The team worked with trainers to make sure coaches felt confident in introducing both practices by:

• Asking PCT and PBS trainers to work together to train coaches
• Teaching coaches to introduce tools from both PCT and PBS
• Designing awareness-level training for new staff to introduce practices

In addition, the nurses attending worked on a plan to monitor health data for possible changes in quality of life. The goal was to monitor potential emotional and health-related challenges that might impact quality of life for each person receiving services. This information was used to intervene as soon as possible before quality of life or other challenges became more of a problem.

Example of a Minnesota County Organizations Collaboration:

One community group held listening sessions with other organizations, the police department, advocates, family and community members, county leaders, and providers. The listening sessions were about the frequency of 911 calls that were happening at adult foster care homes. This community used person-centered strategies to discuss concerns people had about the increasing number of 911 calls. Some people believed that too many 911 calls were being made. Others voiced concern about the availability of resources to help people before an emergency call was needed. Facilitators used person-centered strategies to encourage professionals across different agencies to share what types of positive supports were considered important. The following practices were included in this brainstorming session:

• Person-Centered Thinking
• Psychological First Aid
• Trauma Informed Care
• Positive Behavior Support

Based on these listening sessions, the team worked with community members to create a resource manual to help people think through difficult situations. A flow chart was created to help staff assess whether a challenging event was considered an emergency or not. The manual introduced person-centered strategies and positive support practices, including Psychological First Aid and trauma-informed care. The manual contained resources and contacts to use when a situation didn't require a 911 call but when supports were needed as soon as possible. This Person-Centered Incident Matrix (PCIM) manual is an example of a collaborative problem-solving effort that helped improve communication within a community. Visit the Module 8 Resource Page to learn more about the PCIM Manual.