NYS Self-Determination Consolidated Supports & Services Project

Circle of Support (COS) Training

Circle of Support (COS)

An Introduction and Overview* The Start of Circles

* Building an Effective Circles

* Definition/Purpose/Function/Operation

* Role & Responsibilities/Effectiveness of Circles -- What Circles members do!

* Safeguards/ Risk Consequences/Challenges

* How to Keep Circles Alive and Well

Circle Elements

The Beginning

Forming Circles

Getting and Keeping

Members

Roles of Circles

Effective Circles Challenges Evaluating

Circles Living the Life

Introductions

Primary Trainer

Lou Rossi

OMRDD Mission Statement

We help people with developmental Disabilities live richer lives.

Principles of Self Determination

Freedom AuthoritySupportResponsibilitySelf advocacy

OMRDD’s Vision Statement

People with developmental disabilities enjoy meaningful relationships with friends,

family and others in their lives, experience personal health and growth and live in the home of their choice and fully participate in their communities.

OMRDD’s Mission

Is to assist people to lead richer lives in the areas of:– Home– Community Participation– Relationships– Health

OMRDD’s Values

Compassion - The capacity to appreciate what others think and feel

Dignity - The recognition of the work of each person and the treatment of individual rights and preferences with respect, honor and fairness

Diversity - The celebration, respect and embracing of the differences among us because these differences strengthen and define us

OMRDD Values

Excellence - The continual emphasis on innovation, increasing knowledge, and delivering the highest quality supports and services

Honesty - The foundation on which trust is built and truth is communicated

The Beginning of Circle of Support

Circle of Support concept was first developed by Judith Snow and Marsha Forest in Toronto, Canada in 1980.Circles have been part of society forever? Everyone needs to have a Circle?Do you have enough Circles?

What is a Circle of Support?

A Circle of Support is a group of people, family members, friends and support staff, who have come together to assist a person with a disability to visualize, express and accomplish his or her life’s dream.

A Circle of Support assists the person to make choices/decisions; to take charge of his or her life. To have their voice heard! To gain personal identity.

A Circle of Support members are freely chosen by the person to help them achieve his or her dream

What is a Circle of Support?

A Circle of Support is a requirement of the Self Determination/Consolidated Supports and Services Project in New York State

In the Self-Determination/Consolidated Supports and Services (CSS) Project, the Circle of Support is the “key” decision making group. How they perform their role is very important to the person and to his/her participation in a Self-Directed lifestyle

ITT/Circle of Support Comparison

Inter disciplinary Treatment Team is the traditional planning group, made up of usually para-professional andprofessional staff to provide and coordinate mostly clinical type services to helppeople fit preexisting availableprogram options

Circles of Support is a groupof people freely chosen by a person including family and friends who come together tosupport a person to achievea more self-directedpersonal lifestyledirection. Circle members assist the person to make informed choices, to attainpersonal responsibility and tomanage resources effectively

What we have learned about Circles so far?

A facilitator is important to Circle Operation

Circles operate best with consensus and partnership

You can not force a circle on someone who is content with his or her life or unwilling to make a change

Who Needs a Circle of Support?

Everyone (size of the circle is not so important) Participants in Self-Determination Consolidated Supports and Services Project must have oneEspecially people in lifestyle transition (s) and dissatisfied with current life situation

Where Do I Discover People to Join my Circle of Support?

The DDSO

Other Provider Agencies

Spiritual Leaders

Members Of Your Church,Synagogue or Mosque.

Cultural Organizations

Continuing Ed.Progs

Health Clubs

A Favorite Staff Person

The Library

The Internet

Communities at large

Family,friends, Community and Work Map (Circle Map)

Circle Formation E.G.

Circles Are Not New - Circle Map Exercise Instructions– Select 3-4 participant member groups – Instruct group members to each complete their personal

circles diagram ( handout #1Circles Relationship Map)– Have group members compare their circle maps and to

designate a group member to report out outcomes – Allow 10-15 minutes for group reporters to deliver information

concerning distinctions of Circle Map

– Reconvene group - discuss group responses

Circle Membership Map

Family Members

Friends

Community Connections

Work Relationships

LRossi-01/2007

Steps to build a Circle of Support

1. Reference your Circle Membership Map2. Select names to join your Circle of Support

3. Plan an informal gathering -- Make it fun! share your future goals and ask who will join

you 4. Next, send out invitations/call people personally, invite selected individuals to your Person-Centered Planning session

- Congratulations - Congratulations -

Characteristics of CIRCLES

The person leads/controls circle processesCircle members are usually selected from 3 principal groups ( Family - Friends - Support Staff)Remember: there are 3 general types of people that serve on circles:

- Those that make things happen !- Those who watch things happen !- Those who wonder what happens !

Group Survival Decision Exercise

Scenario: in route to Europe on an overseas flight your plane suddenly has to crash land in open sea. After a fragile landing you discover five other survivors with limited provisions remaining. You must decide what provisions you need to select to promote your chance of rescue.

Available items: a flashlight, gallons of H20, cereal boxes, several long narrow pieces of plane fuselage, jackets, fish pole, blankets, a radio, a computer, emergency kit, cigarettes, a large piece of the fuselage, lifejackets with inflatable cushions, personal luggage, sun glasses, sun tan lotion, several seat cushions, a sewing kit with needle, a mirror, fresh fruit, coffee, cable wire & cutter, a watch. (Pick only 5)

Who Should NOT be in a CIRCLE

People, organizations or groups that present a conflict of interest to the individual’s future

People who lack time and/or commitment

People who try to dominate circle control

People not trust worthy

People who are not going to stay around

Lead, follow or get out of the way.

What CIRCLE members do?

Ensure the Principles of Self-Determination are followed and assist the person to achieve valued outcomes and independenceRecognizes the person’s capacities and makes possible his/her full use of these talents/gifts Assist the person with planning, managing and budgeting their life goalsMonitors and ensures required documentation is complete; satisfactorily and done on a timely basis

Roles and Responsibilities in Circles

Circle members are freely chosen membersAn MSC must be on the Circle of SupportA CSS participant Rights, freedom of Choice are respected and valuedThe person is free to communicate their fears, preferences and not to fear any reprisalsA Support Broker serves at the discretion of the CSS Participant

Roles and Responsibilities for Circles

The Circle must meet at least quarterlyCircle members share the responsibility for development of least restrictive safeguardsExplores the use of durable power of authority and health care proxiesCircle and participant must manage fiscal resources and honor prudent buyer standards

Roles and Responsibilities for Circles

Circle members, MSC and DDSO liaison are responsible for reporting CSS Plan issuesThe Participant/designee complete and submit required documentation to the FEA on timeEnsures that the participant/designee receives and manages monthly fiscal reports from the FEA

Roles and Responsibilities for Circles

Ensures the Memo of Understanding between the FEA and Participant is signed and outlines each parties responsibility A circle member may serve as a designee to the FEAEnsures that the SUB/SB contract details term, compensation and deliverables of the CSS PlanReports dysfunction circle or CSS issues to the CSS liaison

What CIRCLE members do?

Meets regularly; especially early on but afterwards at least quarterly (required)Supports what the person wants to do, provide knowledge,education and risk consequence infoAssist the person to make informed life choicesHelps to ensure health, identify risks, develops safeguards and conducts risk assessment practices

What CIRCLE members do?

Promotes healthy lifestyle choices Explores with the person the advantages and disadvantages of designating durable power of attorney to a trusted relative or friendExplains considerations/consequences regarding having a health proxyHonors, and respects the person as an equal individual Keeps the DDSO liaison and MSC apprised of relevant issues

Expectations of CIRCLE members

A circle member is expected to support/assist the person to find his/her voice and move the circle ahead effectively Set aside titles,power, and position to focus on the individual - Give active versus intermittent involvementComplete assignments, responsibilities on time Bring and share capacities

What CIRCLE members do?

Advocates/Supports and Respects the individual

Ensures focus person understands his/her responsibilities within the CSS program

Responsibly monitors prudent use of personal & public dollars ( timesheets, monthly service notes, CSS plan updates and renewals, Start-Up /Support Broker contracts

A Circle of Support has responsibility obligations to the person who has chosen to be self-determined. Essentially, this is why circles have come together.

Circle Exercise (Joanna)

Divide participants into 3-4 member groupsHave each group designate a recorder and reporterDistribute Joanna Exercise ProfileAllow groups 10-15 minutes to complete E.GHave each group report findingsDiscuss group consensus to problem

Effective Circles

Have a facilitator (not the MSC), but typically the Start-up Broker or Support BrokerIdeal circles have natural leaders come forward.Effective circles are self-sustaining. Have a keeper of the circle.Do not depend on one person. Or else, what if that person can longer serve?

Once a CIRCLE is formed, then what?

Explore, discover, help person develop a dream.

Develop wants/need attainment strategies.

Identify actions to get to where to go next.

Participate in making thing happen.

Take action - watch outcomes.

What else can Circle members do?

Assist the individual to manage his/her budget/resourcesGive the individual opportunity and hope, allow the person to utilize their own capacities and talentsAssist the individual to be safe from harm Keep meetings simple, with a posted start and end timeMake sure all members know the individual and each otherMake sure all members know how to contact each otherMake sure all members know the ground rulesAssist in the formation of new relationships, new capacities and more control over everyday life experiences

Where and When to Meet?

Meet in a natural environment, at home in a restaurant, or at a friends house Where everyone feels welcome and comfortableWhere the meeting agenda can be metMeet at a time that is agreeable to everyoneMeet frequently enough to make things happenFocus on the dream/ vision that the person has

The Ground Rules

Be courteous to each otherEqual respect should be given to all membersNo titles or positions No interrupting when someone is speakingAll input is welcomed, valued and encouragedSidebar conversations during your meetings are not allowedStay on topicEveryone adheres to the ground rules

Circle Exercise ( John )

Distribute John Exercise profile and allow each participant 5-10 minutes to answerDivide participants into 3-4 member groupsAsk each group to designate a recorder and reporterAllow groups 10-15 minutes to reach consensus Discuss individual vs consensus results (WHY?)

CIRCLE Challenges

Keeping circles sustained over time. Keeping Circles on task - active, interested, invigorated.Membership Who’s in, who’s not.Staff resources.

Gatherings - where - location, time, food, Transportation, confidentiality.

CIRCLE Challenges

Varied Role and Responsibilities Conflict of interest regarding persons decisions and choices Conflicts between circle members (i.e.,person/parents/friends/self-hires)Control issues (resource expenditures, friends, interests, health, risk management, etc)Training

Dealing with a Problem Self-Hire EG

You are a Circle member who is asked to attend a meeting where the person you support is going to fire their self-hire staff. What responsibilities do you have to the person you support and to the self-hire staff member?List responsibilities from participants on newsprint - seek consensus of final list

Circle Evaluation Questions

Is the person free from abuse, neglect, intimidation and exploitation?Are there MSC, Start-Up/Support Broker IssuesWhat are Circle and Focus Person RelationshipsDo Circle members understand their Role/Responsibilities/Safeguarding obligationsAre meetings occurring at least 4 times/year

Circle Evaluation Questions

Has Circle members been freely selected?Does the person exercise authority and control their personal resource account?Is the person satisfied with the ISE, FEA, MSC and supports and services?Does the circle functioning effectively?Does the FEA meet their responsibilities?

What does the MSC do when a Circle is Dysfunctional

1.The MSC Informs the individual, members of the circle, and the DDSO Liaison and offers to help address the concern/issue

2. Next, the DDSO Liaison talks to the person and the Circle about steps to reform the circle or, if necessary, use of other program model services

3. If the issue remains unresolved, the liaison reports the matter to the DDSO Director or Designee for action which may include termination of C.S.S enrollment

Guardianship and Circles

The circle assists in exploring the advantages and disadvantages to designating durable power of attorney to a trusted relative or friendThe circle helps in the understanding of having or not having a health proxy If the person has a legal guardian, he/she must participate in Circle of Support operations

Facilitator/Start-Up Broker/Support Broker Role

Getting a better future is not done alone. Life decisions especially changes,requires consensus of many people committed to changeA facilitator keeps the circle of support on task and moving forward through good and challenging times– A Start up Broker assists to develop the CSS planA– Support Broker keeps the plan alive and working over

the long term

OMRDD’S Long-Term COMMITMENT

Continuation of the Consolidated Supports and Services HCBS Waiver Program

Provision of Training Requirements for Start-Up/Support Brokerage Services– Broker Training Institutes (2-day)– Conduct of 4 required Training Programs– Continuing Professional Education

• 12 hours annually

Go Build CIRCLES

And

HELP OTHERS TO BUILD THEIRS.

THANK YOU!!!