Person centered thinking and person centered planning seem to be the buzzwords in the disability world, again. We have been talking about these concepts for all of my 30+ years in the field. We all want to believe that we are providing person centered services and that we have been doing it all of our careers. However, the things we believed were person centered 20 years ago are now things we cannot believe that we did. We scratch our heads and say, “What was I thinking?” Being person centered means we must continue to think about our work and how what we do leads the people we support to the lives they want.

Effective January 2014, providers across the state of Minnesota are required to comply with a new rule, Chapter 245D “Home and Community-based Services Standards.” The intent of the rule is to assist us to be more person centered in our service delivery. It asks teams to look at not only what is important for a person (issues of health, safety and security) but also what is important to a person. Things that are important to a person are the things that help us all to feel satisfied, fulfilled, content and happy. Think about what’s important in your life … Who are the people you want to be with? What are the things you like to do? What are things you must have?

Really understanding what is important to a person requires us to plan in a different way. New assessment tools will ask different questions. They will focus on strengths and desires rather than on deficits and vulnerabilities. Our planning conversations will be different; we need to focus on the future and not as much on the past. The individuals we support need to be in control of their meetings and outcomes.

Everyone has hopes, dreams, and desires. Our job is to learn what they are and help each person move in the direction they choose. We must continue to work at being person centered. We don’t want to be scratching our heads another 20 years from now.

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Change is a normal part of everyday life; however, 2014 is shaping up to be a year of particularly big change in our field. This is being driven by two large revisions that have been a long time coming – a new rate setting system and the new 245D waiver regulations.

John Estrem (left) with Bruce Duffney, an individual we support

The rate setting system (called “Disability Waiver Rate System”) sets monetary rates for a waiver. This waiver rate is one way that a person with a disability pays for services and programming. In the past, these rates were essentially negotiated with the county. Starting January 1st, a statewide system was put in place to set all rates. Like any new large system, there will be a number of problems with it in these early days. Rates for individuals already receiving a waiver cannot change much in the next few years of this new system (this is called banding). It allows us time to work with the county and state to iron out the problems. The issue is more critical for someone getting their first waiver. We are working hard with ARRM to address any problems with the system.

The other big change deals with how we are licensed as a provider. It covers all regulations and procedures that go with a license. 245D is the title of the new law that structures our services (it was preceded by 245B). These new regulations change how we license our programs. There are a number of programming aspects that we must update or add in order to be in compliance with the law. You will see some changes in forms, procedures and training because of this.

John Estrem and Lisbeth Vest Armstrong at the “ARRM Day at the Capitol”

Again, our work with ARRM and other providers is critical to helping us navigate these changes. The goal is to understand as much as possible upfront and get proactive with the compromises and solutions we present. As we work through this year of big changes in our field, we know there may be a few bumps in the road. We ask for your patience and teamwork. Our commitment at Hammer, as always, is to provide the highest quality services possible. I thank you all for your continued commitment to help the individuals we serve live life to the fullest.

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