creating a culture of direct support professional competence statewide conference grand island, ne...

Creating a Culture of Direct Support Professional Competence Statewide Conference Grand Island, NE October 15, 2014 Joseph M. Macbeth, Executive Director and John Raffaele, Training Consultant National Alliance for Direct Support Professionals

They got up this morning, early, and left their families on this holiday Monday, to go out and make this thing called 'community living' happen. Their work, done well, doesn't look like labour. Their work, done well, is, however, work. It's the kind of labour that changes lives, changes families and changes communities. It's the kind of labour that requires dedication and self-discipline and determination. It's the kind of labour, done well, that is exhausting". - Dave Hingsburger, 2014 National Alliance for Direct Support Professionals (NADSP) A Thought from a Friend

Quick Introductions National Alliance for Direct Support Professionals (NADSP) Joe Macbeth John Raffaele Executive Director Training Consultant & Facilitator

A Day In the Life of a DSP Not Ready for Apartment Living A DSP with Good Intentions, the absence of a Code of Ethics & the understanding of Skills National Alliance for Direct Support Professionals (NADSP)

Actions To Complete For Compliance 441.301(c) (4) Optimizes, but does not regiment, individual initiative, autonomy, and independence in making life choices, including but not limited to: daily activities, physical environment, and with whom to interact. Proposed State Transition Plan Deliverables: Identify, develop, and distribute training tools and policy updates that are needed for compliance National Alliance for Direct Support Professionals (NADSP) New Federal Requirements Direct Support Professional Must Understand: People will have the freedom and support to control their own schedules and activities, and have access to food at any time. People will be able to have visitors of their choosing at any time. People will have the freedom to furnish and decorate their sleeping or living units ARE THEY PREPARED?

The Emerging Role of Direct Support Professionals Historically. Primarily Seen as Caretaker Focus on Custodial Care Providing Companionship Providing Coverage Primarily Focused on Health & Safety Issues Entry-Level Job Now and in the Future. Ambassador, Mentor & Teacher Culturally Competent Close Interactions with Families - often in Family Settings Supporting Informed Decisions Assessing RISK Possession of Complex Skills National Alliance for Direct Support Professionals (NADSP)

Raising the Expectations of the Direct Support Workforce Now and in the Future. Creating plans with People they support Building meaningful friendships & relationships Inclusion not recreation Advocating WITH not FOR people with disabilities Person-Centered Identification National Alliance for Direct Support Professionals (NADSP) Historically. Follow the Plan Filling shifts Rely on readily available supervision Community Outings System-Centered Identification

Building & Maintaining Friendships National Alliance for Direct Support Professionals (NADSP)

Speaking of Inclusion & Disabilities National Alliance for Direct Support Professionals (NADSP)

The Second Fastest Growing Occupation: Personal Care Aides % change in employment (2012 2022): 48.8% Number employed (2012): 1,190,600 Number employed (2022): 1,771,400 Median annual income: $19,190 ($9.23/hour) Nationwide median of $34,750 The BLS expects that over 580,000 jobs for Personal Care Aides will be created in the decade through 2022 US Department of Labor, Bureau of Labor Statistics, 2014 National Alliance for Direct Support Professionals (NADSP) Recent Trends in Direct Support

The Third Fastest Growing Occupation: Home Health Aides % change in employment (2012 2022): 48.5% Number employed (2012): 875,100 Number employed (2022): 1,299,300 Median annual income: $20,820 ($10.01/hour) Nationwide median of $34,750 The BLS expects that over 424,000 jobs for Home Health Aides will be created in the decade through 2022 US Department of Labor, Bureau of Labor Statistics, 2014 National Alliance for Direct Support Professionals (NADSP) Recent Trends in Direct Support

The Financial Cost of Turnover Cost per hire Long-term Supports and Services(2005): $3,278 (UMN) Long-term Supports and Services(2011): $6,000 (PHI) Good Turnover? Bad Hiring National Alliance for Direct Support Professionals (NADSP) Decreasing turnover is about sustaining quality

The Other Costs of Turnover Impact on People with Disabilities Services are fractured Personal growth is disrupted Activities and events are canceled Trusting relationships are broken Unsafe situations are created impacting health & safety Revolving door of strangers performing the most intimate interactions of daily life Impact on Direct Support Professional Workforce Forced overtime Increased medication errors and other incidents Increased job stress Reduced productivity Deteriorating job satisfaction Burn Out Ultimately.More Turnover National Alliance for Direct Support Professionals (NADSP)

Preparing Direct Support Professionals: How Have We Done? Tell me and I will forget. Teach me and I might remember. Involve me and I will learn. - Chinese Proverb National Alliance for Direct Support Professionals (NADSP)

Invest in Direct Support Professionals National Alliance for Direct Support Professionals (NADSP)

Where is Quality Defined? It is defined at the point of interaction between the staff member and the individual with a developmental disability. John F. Kennedy, Jr. (1995) Chair, Presidents Committee on Mental Retardation Developmental Disabilities National Alliance for Direct Support Professionals (NADSP) Where are those at the point of interaction of service delivery typically found on organizational charts?

Typical Organizational Chart Executive & Admin Staff Clinical, Middle Management & Other Support Staff Direct Support Professionals National Alliance for Direct Support Professionals (NADSP) Direct Support Professionals Clinical, Middle Management & Other Support Staff Executive & Admin Staff Future Organizational Chart

Knowledge SkillsValues Unethical Practice Ineffective Practice Uninformed of Best Practice Quality Support Quality Intersection (Code of Ethics)(Universal Competencies) (Training Based on Research) National Alliance for Direct Support Professionals (NADSP)

Direct Support Professionals and the Media NADSP Monitors the News National Alliance for Direct Support Professionals (NADSP)

In the News. Caregiver who stole from disabled men gets prison time The Chicago Tribune, Illinois January 11, 2013 National Alliance for Direct Support Professionals (NADSP)

In the News. Report: State ignoring abuse at group homes The Seattle Times, Washington December 17, 2012 National Alliance for Direct Support Professionals (NADSP)

In the News. Fragile Lives; Needless Deaths (Multi-Part Series) Hartford Courant, Connecticut March 6, 2013 National Alliance for Direct Support Professionals (NADSP)

In the News. Sex crimes alleged at care facilities The San Francisco Chronicle, California November 29, 2012 National Alliance for Direct Support Professionals (NADSP)

In the News. Caregiver arrested for abusing disabled man in Columbia group home The Baltimore Sun, Maryland. February 5, 2013 National Alliance for Direct Support Professionals (NADSP)

In the News. Senator Seeks Federal Probe Of Group Homes Disability Scoop March 6, 2013 National Alliance for Direct Support Professionals (NADSP)

And finally, the big one At state-run homes, abuse and impunity National Alliance for Direct Support Professionals (NADSP) The New York Times, New York March 13, 2011

Which led to.. Legislation Establishes Justice Center for the Protection of People with Special Needs to Prevent, Investigate and Prosecute Abuse and Neglect of Vulnerable New Yorkers Legislative Leaders Announce Agreement on Legislation to Protect People with Special Needs and Disabilities (New York Times, June 18, 2012) National Alliance for Direct Support Professionals (NADSP)

Which is sort of like Closing the Barn Door after the horse has bolted. Legislation that focuses on Prosecution is NOT considering Prevention & Building Excellence National Alliance for Direct Support Professionals (NADSP)

But it also led to this. National Alliance for Direct Support Professionals The Measure of a Society: Protection of Vulnerable Persons in Residential Facilities Against Abuse & Neglect. Clarence J. Sundram, 2012 Direct Support jobs are compensated poorly, with many workers living at or near the poverty level or forced to work multiple jobs to make ends meet. One might summarize the job description of the direct support worker as requiring the wisdom of Solomon, the patience of Job and the caring of Florence Nightingale While much is said about the value of these direct support jobs, the traditional hallmarks of value are often missing qualifying credentials, adequate pay, career ladders, attention to working conditions, adequate training, managerial and supervisory support and so on National Alliance for Direct Support Professionals (NADSP)

A Day In the Life of a DSP Take Me Out to the Ball Game A Nice Afternoon National Alliance for Direct Support Professionals (NADSP)

The Five Elements of a Profession Code of Ethics Body of Knowledge Universal Skill Standards License, Certificate or Credential Affiliation with Professional Organization 1.35 Million in US Direct Support Professionals Approximately 4 Million Cross-Sector PHI, 2012 National Alliance for Direct Support Professionals (NADSP)

A Body of Knowledge that is based on sound research and provides practitioners with a universally accepted skills base. Kanner & Bettleheim Pediatricians Back in the Day Journals, Studies Evidence-Based Practices College of Direct Support and other curricula Becoming a MD National Alliance for Direct Support Professionals (NADSP)

Becoming a MD (continued) Airplane Pilots The Community Support Skill Standards The NADSP Competency Set US DOL Adopted Universal Skill Standards or Competency Areas for the Consistency of Professional Practice States Developing Core Competencies National Alliance for Direct Support Professionals (NADSP)

NADSP Universal Competency Areas Area 1: Participant Empowerment Area 2: Communication Area 3: Assessment Area 4: Community and Service Networking Area 5: Facilitation of Services Area 6: Community Living Skills & Supports Area 7: Education, Training & Self-Development Area 8: Advocacy Area 9: Vocational, Educational & Career Support Area 10: Crisis Prevention and Intervention Area 11: Organizational Participation Area 12: Documentation Area 13: Building and Maintaining Friendships and Relationships Area 14: Person Centered Supports Area 15: Supporting Health and Wellness National Alliance for Direct Support Professionals (NADSP)

NADSP Competency Area Area 1: Participant Empowerment The Direct Support Professional enhances the ability of the participant to lead a self-determining life by providing the support and information necessary to build self-esteem, and assertiveness; and to make decisions. Skill Statements The competent DSP assists and supports the participant to develop strategies, make informed choices, follow through on responsibilities, and take risks. The competent DSP promotes participant partnership in the design of support services, consulting the person and involving him or her in the support process. The competent DSP provides opportunities for the participant to be a self- advocate by increasing awareness of self-advocacy methods and techniques, encouraging and assisting the participant to speak on his or her own behalf, and providing information on peer support and self-advocacy groups. The competent DSP provides information about human, legal, civil rights and other resources, facilitates access to such information and assists the participant to use information for self-advocacy and decision making about living, work, and social relationships. National Alliance for Direct Support Professionals (NADSP)

Becoming a MD (continued) Nail Techs and Jiffy Lube Guys Using the Knowledge Recognition by an Authority as a Profession Demonstrating the Competencies A License, Certificate or Credential to Practice National Alliance for Direct Support Professionals (NADSP)

Become part of something larger NASW, AMA, ANCOR, AIEJI Participate in Training & Networking Opportunities Professional Empowerment & Status Recognition of the Professions Best Practices Affiliation with a Professional Membership Organization National Alliance for Direct Support Professionals (NADSP)

Promoting Physical & Emotional Well-Being Confidentiality Integrity & Responsibility Justice, Fairness & Equity Person-Centered Supports A Code of Ethics that provides practitioners with a universally accepted values base. Relationships Self-Determination Advocacy Respect National Alliance for Direct Support Professionals (NADSP)

The NADSP Code of Ethics Developed by NADSP in 2001 Adopted by New York in 2012 Adopted by New Hampshire in 2014 Universally Accepted National Alliance for Direct Support Professionals( NADSP)

Code of Ethics Word Cloud National Alliance for Direct Support Professionals (NADSP)

A Day In the Life of a DSP Disney Isnt for Me A Great Life National Alliance for Direct Support Professionals (NADSP)

Disney Isnt For Me Deconstructed with Skills & Values Skills: Participant Empowerment Communication Assessment Community Living & Supports Education, Training & Self Development Advocacy Organizational Participation Documentation Providing Person Centered Supports Values: Person Centered Supports Integrity and Responsibility Respect Self-Determination Advocacy National Alliance for Direct Support Professionals (NADSP)

CHOICE C -Citizen H -Harm/Risk O -Opportunities I -Informed Decision C -Community E -Experience National Alliance for Direct Support Professionals (NADSP)

CHOICE National Alliance for Direct Support Professionals (NADSP)

Ed: Nearly 25 Years Later Working on writing his autobiography Getting tattoos Jumping out of airplanes Living his life, on his terms National Alliance for Direct Support Professionals (NADSP) The System opens the door to community; direct support professionals help people go through that door.

Join Our Membership at www.nadsp.org! Customized Trainings, One-Day Workshops and Culture of Direct Support Competency Technical Assistance Join us on Facebook! YES, Were on YouTube Follow us on Twitter @NADSPINC [email protected] National Alliance for Direct Support Professionals (NADSP)

creating a culture of direct support professional competence statewide conference grand island, ne...

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