Author: Alan

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ISP Topic: Desired Outcomes

This 90-minute session will focus on how to create great outcomes in collaboration. This workshop is intended for Services Coordinators, Personal Agents, and providers who contribute to Desired Outcomes, including provider organization staff and foster providers.

During this training we will:

  • Discuss the purpose of Desired Outcomes and how great outcomes can support people toward the life they want
  • Explore roles when developing Desired Outcomes and supporting someone to achieve their outcomes
  • Practice developing and writing meaningful outcomes

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ISP Topic: Support Protocols

Note: this training was previously called Developing Person-Centered Support Documents

This 90-minute workshop will focus on how support documents are developed and the concept of ‘best supports’: the balance between important TO and important FOR. Best documentation practices will also be discussed. This workshop is intended for providers who develop support documents, including provider organization staff and foster providers.

During this training we will:

  • Identify contributors in developing support strategies, and how each person can contribute.
  • Discuss the balance between important TO and important FOR, and how this concept is central to person-centered support documents.
  • Explore best practices around writing person-centered documentation and practice identifying and correcting common errors.

NOTE: This workshop is intended for providers who develop support documents, including provider organization staff and foster providers.

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ISP Topic: Person-Centered Information

Note: this training was previously called Planning with People: This Is How We Do It!

Person Centered Information through the Oregon Individual Support Planning (ISP) process is an essential role for all supporters. This 90-minute workshop will:

  • Strengthen your role as an advocate during planning
  • Provide information about Person-Centered Planning
  • Offer hands-on practice using the Person-Centered Information (PCI) form
  • Explore additional tools for gathering person-centered information

During this training we will:

  • Explore the concept of Person Centered Information as a core component of planning with people
  • Discuss the values behind understanding and recording a person’s perspective
  • Provide tools and resources for better understanding a person’s perspective, a process often referred to as gathering Person Centered Information
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ISP Focus Area: Trauma-Informed Foster Support

Note: this training was previously called Fostering a Good Life: An Interactive Training for Foster Providers

This 90-minute session will focus on the important role of foster providers in planning with children, teens, and adults in foster care and supporting opportunities to build positive life experiences. There will be a focus on tools and resources that can help foster providers better understand, plan with, and support people toward experiences that build self-determination, social capital, economic sufficiency, and community inclusion. This workshop is intended for foster providers and their employees.

During this training we will:

  • Build planning skills, specifically focusing on present and future life outcomes that consider all life domains
  • Use the life domains framework and tool to explore the current realities in our lives while also thinking about what life experiences we want to have
  • Deepen understanding of how trauma can impact a person’s life experiences and discuss tools that can support someone to explore life goals and plan for the future

NOTE: This 90-minute session is for foster providers and their staff.

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ISP Focus Area: Documentation Best Practices

Note: this training was previously called Writing Meaningful Documentation that Tells the Whole Story

This 90-minute session will focus on effective progress notes; the purpose, how to capture relevant information using empowering language, and sample templates to promote learning. This workshop is intended for providers, including provider organization staff and foster providers.

During this training we will:

  • Build skills in person-centered documentation practices
  • Develop meaningful progress notes that connect to the person’s desired life

NOTE: This workshop is intended for providers, including provider organization staff and foster providers.

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Person Centered Thinking for Services Coordinators & Personal Agents

Person Centered Thinking is the foundation that underlies all person-centered approaches. It is essential for anyone who provides supports or services, develops plans, or participates in person-centered planning. This online training offers a series of workshops focused on person-centered discovery, listening, and management skills. Attendees are asked to participate in all sessions.

NOTE: Because this training is targeted to SCs and PAs, registration for this class is limited to employees of ODDS, CDDPs and Brokerages.

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Oregon ISP for Services Coordinators & Personal Agents

This two-day, facilitated online training is designed for CDDP Services Coordinators, Brokerage Personal Agents, CIIS Services Coordinators, ODDS Residential Specialists, and other ODDS staff. These discussion and activity-based sessions highlight case management skills and responsibilities for facilitating the Oregon ISP process. The focus of this training is planning that centers around the person, supports a person’s choices, and ultimately gets someone closer to the things they want in their life.

NOTE: Because this training is targeted to SCs and PAs, registration for this class is limited to employees of ODDS, CDDPs and Brokerages.

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Oregon ISP for Provider Organizations & Foster Providers

This online, facilitated half-day training is for Provider Organization staff and licensed I/DD Foster providers. It includes a broad overview of the Oregon ISP planning process and discusses how planning can happen in a way that centers around the person, supports a person’s choices, and ultimately gets someone closer to the things they want in their life. Provider responsibilities for contributing to the development and implementation of the Oregon ISP will also be discussed.

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Tips for Supporting Youth in Foster Care – Part 3 of 3

A cartoon graphic of a family hugging each other

Part 3 of 3: Supporting the Foster Provider

Being a Foster Provider requires a well-rounded skill set. Like Services Coordinators, Foster Providers support the whole team, not just the youth. This can include the family, the Services Coordinator, other supporters on the ISP team (including medical, mental health, and educational providers) and in some cases, Child Welfare.
 
The first article in this series was dedicated to helping youth navigate life in foster care. The second article in the series illustrated how important it is for families and youth to receive consistent and person-centered support when exploring the option of foster care. The last article in the series is focused on Services Coordinators can develop trusting relationships with Foster Providers and help them maintain a wide variety of skills.

Be Resourceful

Ensure the Foster Provider knows what their role is in the youth’s life, as well as the role of other on the team, including your role as the Services Coordinator. These conversations are best held in person (if possible) to connect about the importance of supporting a youth physically, emotionally, and spiritually. The donut sort is one possible tool for facilitating and recording this conversation. In addition, bring information about: 
 
  • Oregon Administrative Rules for Foster Care
  • Local community resources (Fun/free activities, medical/mental health resources, etc.) 
  • Monitoring schedules that your CDDP may have (Behavioral, medical, financial, ISP) 
  • Blank copies of ISP documents for review 
  • Your information and the best time to get a hold of you 
  • The Foster Care Certifier’s information 
The more knowledge a Foster Provider has, the more they will be prepared and ready to help the youth navigate through life during a potentially stressful time. The Foster Provider may have complex questions for you, especially if they are new to providing care and working with IDD Services. When I was a Services Coordinator, I often received many different questions and concerns, including insurance coverage for medical equipment, funding for Foster Care homes, and individualized questions about the youth they are supporting.
  
If you are feeling overwhelmed or not ready to answer difficult questions, think about bringing another Services Coordinator with you when you visit to help facilitate these conversations. This can also be a great opportunity to speak with your supervisor about training opportunities or continuing education for the Foster Provider or yourself.
 
Remember, you do not need to have the answer to every question. If you are not sure what the answer is, it is okay to say that you don’t know. If you say you will follow up with more information, make sure to do so. Be clear when communicating what the Foster Provider can expect from you, including how long it may take to hear back.

Training and Continuing Education

Foster Care training is an important part of the process of becoming a Foster Care Provider. Each Foster Provider has a unique set of skills and life experiences which can enable them to understand and support a youth in their home. It is important to build upon these skills and experiences regularly. 
 
Foster Providers should be equipped with the tools they need to address any complex situations that may arise. Training also providers the Foster Provider opportunities to help the youth grow and develop new skills.
 
Since Foster Providers may not be aware of local trainings or continuing education opportunities, provide them with resources regularly. Here are some resources within Oregon that may be helpful:
 
  • The Arc Oregon/OTAC Training
  • Oregon Department of Human Services (ODHS) Foster Provider Trainings 
    • Live online trainings for Foster Providers and Adoptive Parents. Training sessions range between 1-3 hours long and are hosted on Zoom. 
  • Foster Club Training 
    • FosterClub is a national network for young people in foster care. It provides young people in foster care an opportunity to connect and gain support from their peers. The non-profit organization also provides online training and resources for resource parents. 
  • Child Trauma Academy 
    • CTA works to improve the lives of high-risk children through direct service, research, and education. 
  • Trauma Informed Oregon 
    • Trauma Informed Oregon is a wealth of information about trauma informed supports, practices, and resources from across the state. It includes free online training modules introducing Trauma Informed Care.  
  • Foster Parent Lending Library 
    • The Oregon Post Adoption Resource Center (ORPARC) has a wonderful online Lending Library that is free to be used by Oregon Resource Parents, Relative Resource Parents, and Pre-Adoptive, Guardianship and Adoptive Parents.​ 
  • Foster Parent College 
    • Interactive multimedia training courses for foster providers and adoptive parents.

Build Positive Relationships

The relationship between the Services Coordinator and the Foster Provider is very important and can directly impact everyone in the youth’s life. However, building a strong professional relationship takes time and effort. We have the opportunity to regularly build and strengthen our connection with Foster Providers by:
  • Providing clear expectations and consistent follow through
  • Keeping your commitments
  • Asking questions and listening
  • Providing resources regularly
  • Offering assistance
  • Checking in frequently, using their preferred method of communication
  • Recognizing the work that they do and sharing appreciation for it

Conclusion:

Foster Providers have the ability to offer a loving and nurturing home where each child can feel safe and celebrated for their unique gifts. As Services Coordinators, we have the responsibility of actively supporting both prospective and current Foster Providers. By doing this, we can make a difference in a youth’s life and work towards increasing their quality of life.

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Tips for Supporting Youth in Foster Care – Part 2 of 3

A cartoon graphic of a family hugging each other

Part 2 of 3

Some families that are supported by IDD Services and their Community Developmental Disabilities Programs (CDDP) may choose foster care as an alternative to their child or loved one living in the family home. This difficult decision is very personal and can be a confusing and challenging time for families and youth.
 
The first article in this series was dedicated to helping the youth navigate life in foster care. The purpose of this article is to illustrate how important it is for families and youth to receive consistent and person-centered support when exploring the option of foster care.
 
Many families do not receive much information, training, or resources about foster care or how it can benefit the youth and/or the family. The family often relies on the Services Coordinator to provide information and choice counseling on this subject. Many youth receiving supports from IDD Services need additional help, most often with medical, behavioral, or other complex needs. At times, these needs can be overwhelming for a family, and they are not aware of the support they can receive. This can be extremely stressful and traumatic for families when they are not sure where to go for additional help. Foster care is an important resource that families can access.

Building Trust:

Trustworthiness and transparency is one of the key principles of Trauma Informed Care.
 
Ensure the family has a voice in the planning process and feels safe to speak up. Families that have accessed multiple systems for assistance may experience trauma around the planning process. The topic of foster care can activate specific traumatic feelings for some, such as fear, distrust, anxiety, and stress, or conflict with their cultural values and practices of caring for a loved one with a disability. It is important to build trust with the family while navigating through these difficult and uncertain times. 
 
  • Use Active Listening: Truly listen to the family and youth when they express their dreams, hopes, fears, and concerns for foster care and the future. Active listening keeps you engaged with your conversation partner in a positive way. It also involves paraphrasing and reflecting what is said and avoiding judgement and advice. 
 
  • Be Dependable: Be open, honest, and dependable. Families may look to you for advice or to help advocate for their rights or their child’s rights. Navigating multiple systems can be difficult for families. Be aware that systems of support (such as IDD Services, Medical Systems, and Mental Health Services) can inadvertently cause trauma. This ‘systems trauma’ can be elevated for families in these situations; ensure that you are following through with plans or commitments you make.
 
  • Have Empathy: Understand that the family you’re working with may experience life differently than you. Their experiences can often be complex and involve many factors you are not aware of. Offer a caring, understanding, and empowering environment for them. While offering a safe space for the family, remember to take care of yourself. Compassion fatigue and secondary trauma can affect emotional, mental, and physical health. Learn more about workforce wellness at Trauma Informed Oregon.

Working as a Team

Occasionally, outside support may be used in complex situations. For example, a youth who has many goals and a team with different perspectives may choose to access Wraparound Services. Wraparound is a unique program that guides youth and families in a goal-oriented approach. Different counties may have programs that look similar and support the team to be family-driven and person-centered.  
 
Everyone on the team benefits from clear and consistent communication. Depending on the youth’s needs, meetings may need to happen as often as once a week, or as little as once a month. During the planning process, the family may like additional check-ins from the SC to provide reassurance and promote trust.

Ongoing Support

Family planning and support will be ongoing after the youth moves into a foster home. In fact, this may be the most important time of the whole process. The youth and family may feel a variety of emotions during this time. This is the time to be creative about offering support to the family.
 
  • Encourage the provider to send fun photos of the youth engaging of activities that they enjoy. For example, if they are on the High School basketball team, snap photos of them playing and send to the family.
 
  • Send fun resources via email to the family and provider to encourage community engagement with the youth. There are lots of fun opportunities to be creative with this and tailor the experience to the family’s heritage and culture. For example, if the family celebrates Día de los Muertos, find a local celebration that can be enjoyed by the whole family. Occasionally, a foster provider and the youth may not share the same values, culture, or heritage. It is important to support the youth with their culture, even if it is different than the providers.
 
  • Promote communication between the family and youth by encouraging scheduled phone or video visits. This can be a great way for the SC to catch up with the youth also! The donut sort can be a creative way to plan and make sure everyone’s voice is heard. Working and not working can also be a helpful way to record different perspectives and creatively problem solve.

Conclusion:

The families and youth you are supporting will need a variety of different supports during this difficult time. Building trust, team collaboration, and ongoing support are just a few of the building blocks that make up the whole pyramid of support. Each family dynamic is unique, and we have the opportunity help families learn, grow, and develop skills together.

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Tips for Supporting Youth in Foster Care – Part 1 of 3

A cartoon graphic of a family hugging each other

Part 1 of 3

Many Services Coordinators (SC) work with youth who live in a foster care home, served by Oregon’s Department of Human Services, Office of Developmental Disabilities Services (ODDS). Often, there is a lack of training for Service Coordinators around best practices for supporting these children, families, and providers. This can affect the way youth living in DD certified foster homes are supported.
 
The purpose of this three-part series is to:
  • Recognize and honor relationships and networks of support in the youth’s life, which can often be complex.
  • Share effective approaches to support youth, families, and providers; and
  • Understand the significant role of the Services Coordinator in helping someone live their best life.
Foster homes are designed to be a structured, family-like environment that youth can live in short-term or long-term. There are specific monitoring requirements to help ensure health and safety risks are being addressed.
 
A parent or guardian may face a difficult decision and voluntarily choose to have their child or loved one move to a foster care setting. Other times, this decision is court-mandated by the Oregon Department of Human Services. Whether a move to a foster home is voluntary or court-mandated, it does pose a risk of trauma to the youth. This may impact the youth in many ways. When I worked as a Services Coordinator, I supported a child who went through multiple moves in two years, which negatively affected his mental health. He was not able to form stable bonds with foster providers and could not consistently engage in skill-building. Trauma-informed care is essential when supporting youth in foster care.
 
It can be difficult to balance the expectations of the family with the needs of the child. Services Coordinators often support three different entities throughout this process: the youth, the family, and the foster provider. It is important to focus on the youth and prioritize their needs to ensure they maintain their sense of safety, self, and well-being.

Support with Transitions

Moving into a new foster home can be a confusing and potentially painful time for youth. As a Services Coordinator, it is important to facilitate a conversation between the youth and the family about what foster care is and how they would like to be supported.
 
While the family is often making the decision for the youth, ultimately, we are supporting the youth and need to ensure their voice is heard and their needs are met. It is crucial to build trust and communication with the young person, to create a more trauma-informed move as well as support their positive trajectory to adulthood. Consider building a One Page Profile with the youth, focused on the move. This can help the youth be more involved and amplify their voice, perspective, and preferences.

Communication and Continued Connection with Family

During the planning process, speak with the youth, family, and foster provider about communication expectations. The youth should continue to be supported by their family, even while in a foster care setting. This can look very different for each family. Some families choose to call every day, and some have a specific time they call during the week. Some families choose to take the youth to every doctor’s appointment, while others may have the foster provider take on this responsibility. Sometimes families have monthly planned outings, while others may be more spontaneous. Whatever is decided, it should be in the best interest of the youth, to support them in their new home and make sure they feel loved and cared for.
 
The Services Coordinator may need to help facilitate communication and planning with the youth and others on their support team. It can be helpful to refer to the Trajectory to help everyone focus on the goal of helping the youth be happy and healthy. This tool can be especially helpful if disagreements or strong emotions begin to derail the conversation.
 
Be creative with planning continued family connections. Some youth like to video call their parents nightly, and this could become a routine that is important to them. Drawing pictures and sending mail can also be a fun way to keep in touch and allow the youth to embrace creativity.
 
When supporting a youth who has limited family connections, and/or an ODHS Guardian, the youth’s level of trauma will likely be higher. Services Coordinators may need to “think outside of the box” to prioritize physical and emotional safety around family connections. Some things to consider when working with a youth who has limited family connections:
 
  • Does the youth have any close friends or siblings they can connect with?
  • How often does the ODHS Guardian connect with the youth and what is their relationship like? Can you collaborate with the guardian to ensure that the youth has multiple trusted adults in their life? Can visits or communication with trusted adults be increased?
  • How often does the youth attend events where they can make friends? How are those going?
  • Do they have any safe distant relatives (Aunts, Uncles, Cousins, etc.) that can be contacted and brought into their life?
The definition of family can be broad and looks different for everyone. As Services Coordinators, we should recognize this and help the youth feel supported and whole in life. Consider using the Integrated Supports Star tool to help visually map out and explore important connections and possibilities with youth you are supporting
Using the Trajectory Tool to Support Youth in Foster Care
 
Download Henry’s Trajectory – this example trajectory demonstrates how the trajectory tool might be used to support a youth and their family and they prepare for a move into a foster care setting
 
Inclusive support is essential. While reviewing potential foster providers, chat about any important considerations the youth has (Cultural, Religious, Medical, LGBTQ+, etc.). Youth may have topics they don’t feel comfortable sharing with their existing family or potential new supporters, such as sexuality or gender expression. You might need to have more than one conversation to ensure safety and privacy. Ask the youth if they would like to invite another trusted adult they feel comfortable with into the discussion. A LifeCourse Trajectory can be very helpful in identifying what the youth and their family wants in this move, and what to avoid.
Give the youth and family information about the potential foster provider. This could include:
  • Where they live
  • If they have pets (pictures are a plus)Other youth in the foster home
  • Everyday life details: What they do for fun, what food they like, if they have any shared interests with the youth, etc.
Extend the opportunity to do a “meet and greet” with the potential provider to see if this home would be a good fit for the youth, and make sure to facilitate the meeting in such a way where the youth can ask questions and give their opinion without pressure. This would be a great time to review the youth’s One Page Profile with the foster provider.
Using a One Page Profile to Support Youth in Foster Care
 
Download Henry’s One Page Profile – this example One Page Profile demonstrates how this tool might be used to support a youth and their family and they get to know a new foster provider.
 
If possible, show pictures of the home including a bedroom, bathroom, and shared spaces. Families may want to complete an in-person tour before deciding. Virtual tours can also be a great option during COVID.
 
If a home is identified as a good fit, start the planning process with the family. This could include:
 
  • Making a visual schedule with the youth of timelines for their upcoming move.
  • Creating Social Stories or other visual tools to help explain to the youth what foster care is and why the transition is happening.
  • Providing opportunities to share hopes and fears as the move date approaches. It is likely the youth and their family may experience anxiety related to the move. Putting together or referring to a LifeCourse Trajectory can be helpful for youth and families to express hopes and fears.
  • Scheduling family or individual therapy sessions with a counselor they can relate to and feel comfortable with.
  • Discussing important relationships in the youth’s life and how they will be maintained throughout this move. If some relationships cannot be maintained, acknowledge the youth’s grieving process with empathy and help connect them with grief/mental health supports.
  • Finding out the youth’s comfort items to bring to the home (blankets, sheets, personal items, favorite foods, etc.)
  • Exploring school and bus schedules.
  • Preparing for Medical Provider transitions and ensuring the youth has an adequate supply of medication for the move.
Because this time can bring up a variety of emotions for the youth, try to limit the number of changes to reduce any additional potential stressors and trauma. For example, if the youth has many friends at their current school and they enjoy attending, advocate for them to stay in that current educational environment.

Conclusion:

There are many ways to support youth in a foster care setting. After working with youth in these settings for many years, I’ve realized that continued communication, advocacy, and consistency builds trust. When we build trust with a youth, family, and foster care provider, we have an increased ability to advocate for the youth and help them build their best life.
 
Foster care can be an important stepping stone in a youth’s life. It gives them a chance to learn skills and reach goals in a different environment while having the opportunity to increase the bond between family and youth or provider and youth. Many of these bonds can last for years and become an essential part of a youth’s life.
 
We will continue to explore this important topic in the coming months. If you have any questions, or would like to collaborate, please reach out to our team!

Meet the author

Emily Canela – OTAC Trainer

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Chosen Services: “List Needs Identified by the Needs Assessment”

Tips for Services Coordinators and Personal Agents

This month, we will take a close look at the Chosen Services section of the ISP, focusing specifically on one box within this section: “List needs identified by the needs assessment that this service will address”. This box can be found for each authorized service in the plan, regardless of funding stream (example: Chosen K plan services, Chosen waiver services, etc.). .

We’ve heard many questions over the years from Services Coordinators and Personal Agents about what information to include in this section, and we hope this article answers a few questions you may still have.

Minimum Expectation
 
It is an expectation that a person’s Oregon ISP will address all needs identified by their needs assessment. In other words, a person’s plan should include all of their support needs, whether those needs are being met by formal services, through other supports, or if a person is declining support at this time. There are many places in the ISP that different support needs are addressed. The section “List needs identified by the needs assessment that this service will address” for authorized services is one important place where support needs are addressed in the plan.
 
At a minimum, the “List needs identified by the needs assessment that this service will address” box should include a list of areas of support that the service will be assisting the person with, unless the need is addressed in another section of the ISP (such as the risk management plan).
 
For example, Alek’s in-home support provider assists him with cooking, laundry, transportation, and money management. Alek is at risk of financial exploitation, so his support need of money management is addressed the risk management section of his ISP. The chosen services section of Alek’s ISP that authorizes his in-home support provider might look something like this:

Writing “ADL/IADL” or “see ONA” is not enough information for this section. Areas of support should be clearly listed. The example above meets the minimum expectation; however, you may consider how much information and detail is helpful, as well as what language works best for the person and their family.

Consider how much detail is helpful

The example above does not provide any information about what best support looks like for Alek. Consider ‘laundry’. Does Alek just need some reminders or instructions on how to do the laundry? Does he need help carrying his clothes to the laundry machine? Does Alek need someone to do laundry for him, while he gives instructions on what clothes need to be washed?

If Alek has been with the same in-home support provider for a while, it may be that they already have a good idea of what support works best for Alek. They may already have worked with Alek to capture this information in his Person Centered Information form or have created instructions for new supporters about this best support. In this case, the example above may be enough information.

However, if the provider is new to Alek, additional information in this section would be extremely helpful. After all, ‘laundry’ only gives an idea of what area Alek wants support, but no clues on what that support should look like. Here’s another, more detailed example of this section:

Why not ‘Copy and Paste’?

Copying information from a person’s needs assessment and pasting it into the “list needs identified by the needs assessment that this service will address” is not considered a best practice. There are a few different reasons for this.

First, the plan belongs to the person. Language used in needs assessments is often technical and not person-centered. If this language is copied into the ISP, it may alienate someone reading their own plan. Instead, we want to consider what words or ways of writing information work best for the person and their family. What language would you want to see if this was your plan? The plan of someone close to you?

Second, the needs assessment is full of systems language and jargon which is not easily understood. A person has a right to understand and direct the contents of their plan. Plain language should be used whenever possible.

Consider the following examples:

Copied and Pasted

Plain language

Elimination, Toilet hygiene- supervision or touching assistance

After using the bathroom, Margret is supported to adjust and fasten her pants. 

Transferring and Positioning- Partial/moderate assistance

Amir needs to grab onto a steady arm that he can pull on when he stands up from a chair, couch, or his bed.

Transportation- substantial/maximal assistance, persons providing support accompany person on bus/van

Lidia gets around town with the support of staff in the accessible agency van. She also uses accessible busses if a supporter rides along.

While copying and pasting is typically not a best practice, you may consider whether ONA assessor notes provide helpful context and details about a person’s support needs. This information may be useful to include in the plan, while still using plain, person-centered language

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Desired Outcomes- Feeling Stuck?

Within the Oregon ISP process, Desired Outcomes are the things the person is interested in doing, learning, trying or accomplishing in the next year or beyond. A Desired Outcome is what a person wants their life to look like. It is the transformation that others can see once a person has taken specific steps or achieved goals.

Sometimes, writing Desired Outcomes is fun. The person and those around them may have a lot of ideas. The person may have a clear vision for what they want. There may also be a lot of excitement and creativity when coming up with Desired Outcomes.

Sometimes, we may feel stuck. Perhaps the person has had the same Desired Outcome year after year. Maybe it’s unclear what the person might want to do, try, or learn. The person may not be interested in anything suggested and struggle to come up with ideas themselves. We may not know where to start.

If you’re feeling stuck when developing Desired Outcomes, we have a few tips for you.

It starts with the person

The plan belongs to the person and so do their Desired Outcomes. Even when we do a lot of work to put the plan together, it’s still their plan- not ours. That’s why Desired Outcomes begin with the person:

  • What is the person telling us, with words or otherwise, about what they want to do? About what they want more or less of in their life? About their long-term hopes, dreams, and aspirations?
  • Are we listening to all the ways a person may be communicating their perspective? If we’re not sure of how someone communicates this perspective- who in their life can support us to better understand?
  • Is there a clear connection between the Desired Outcome and what is ‘important TO’ the person? Do the Desired Outcomes reflect the person’s vision of their own ‘good life’?

Each of us are the #1 expert in our own life. This means that we are the best source of information about ourselves. Desired Outcomes are all about the person- who they are, what is important to them, and what direction they want their life to go in

Who else does the person want to plan with?

Often, those closest to the person play an important role in planning- in helping the person communicate their perspective, in encouragement to dream big and imagining new possibilities, and sometimes offering support to make ideas happen. This can include family members, friends and other supporters.
 
Of course, it is a person’s choice who they want to plan with them and about what parts of their life. Being invited to plan with someone is an honor and important role.
Consider:
  • Have you ever been encouraged by a friend or family member to try something new? Did this lead to a new interest, passion, or skill?
  • Would all your friends or family agree with the things you want to do, try, and learn in the next year? Does this impact who you might want to invite to plan with you?
  • If fears or doubts are holding teams back- are we supporting the team to feel heard so we can move forward together? Are we able to identify and articulate the ‘why’ or ‘important to’ behind what a person is sharing with us?

'Important TO' is key

We each have things that are important to us. They come from our own perspective- those things that give us happiness, comfort, and fulfillment. If we are truly recording the person’s perspective in the Person-Centered Information Form, this can be a useful place to look for conversation-starting ideas.
 
Understanding a person’s ‘important to’s’ is not a one-time conversation. As supporters, we are constantly seeking to better understand who someone is and what’s important to them.
 
Each conversation, each interaction is an opportunity to better understand someone else.
 
Have you ever had the experience of purchasing a new vehicle and then suddenly noticing just how many of these cars are on the road? As humans, we tend to notice what we are focused on or paying attention to. When we keep Desired Outcomes on the forefront of our minds, we will naturally have more ideas and notice more opportunities.
 
Desired Outcomes don’t have to be only an annual conversation. Instead, as we learn new things and better understand the person and what is important to them throughout the year, we can dig deeper and have more meaningful conversations.
If you’re looking for more resources on Desired Outcomes, check out:
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Independence, Integration, Productivity – Values of the Oregon ISP Planning Process

Cartoon drawing of a girl in a pink shirt and grey pants standing on a rock. She is wearing an orange backpack and using binoculars to look at a lake with mountains in the background
Our team, while providing support around the Oregon ISP, often hears this question: What does it mean for an ISP to reflect Independence, Integration, and Productivity? These values are important in each of our lives and show up in many ways. But how do these values look when planning with someone within the Oregon ISP process?
 
There is no one answer. When we are invited to plan with someone around what a “good life” means to them, we must consider how the values of independence, integration and productivity can look different for each person. You’ll find these values listed in the ‘acknowledgments’ section of the Oregon Individual Support Plan (ISP).

ISP team – does this ISP reflect…
Independence: Having control and choice over one’s own life.
Integration: Living near and using the same community resources and participating in the same activities as, and together with, people without disabilities.
Productivity: Engaging in contributions to a household or community; or engaging in income-producing work that is measured through improvements in income level, employment status, or job advancement.

While we can all agree that these values are not only required but key to living a good life, how do we know if they are reflected in plans? The answer to that is much different than simply “checking the box”.

Values Embedded in the Planning Process

Independence, integration, and productivity are values embedded throughout the planning process. These values are intended to be part of a shift away from a plan that only reflects support needs and services. Instead, planning is about supporting someone to live the life that is meaningful to them. This is a very personal thing. After all, each of us have our own vision for a good life and what this means to us.
 
Consider your own life for a moment. What does “productivity” mean to you? What does it look like in your life, community, and culture? How is this different from others that are close to you? For example, “productivity” in a parent’s life will looks different that “productivity” in the lives of their children, their own parents, or even their partner. It can also look different depending on what is happening in that moment, that day, or that time of year. Productivity, as a life value, is something that is deeply personal, constantly evolving, and cannot be reduced to someone else’s checklist.
 
Ultimately, what’s guiding planning is the person: who they are, what is ‘important to’ them, and what their personal vision for a good life is. In the case of children, this also includes who the family is, what is ‘important to’ the family, and what the family’s vision for a good life is. When this happens, independence, integration, and productivity follow.
Cartoon drawing of a girl in a pink shirt and grey pants standing on a rock. She is wearing an orange backpack and using binoculars to look at a lake with mountains in the background

Common Misconception- Values, not Check-Boxes!

A common misconception about independence, integration, and productivity is that there is some part of a person’s ISP that must be specifically written to ‘show’ each of these values. This is not the case. The guiding force of the planning process is the person (or the family, in the case of children). If we support someone to pursue their ‘good life’, then these values will follow naturally. When this happens, we can confidently answer “yes” to the three questions about what the plan as a whole reflects.
 
There is no one section of the plan that must capture these values. These values will show up in many different places, if the person’s vision of a good life is truly leading the planning process. Consider these examples:
  • Gavin’s autonomy is reflected in their Desired Outcome to get a new tattoo. This reflects independence.
  • Malik, with support from his PSW (described in the Provider Service Agreement), creates pottery alongside other artists at his community college. This reflects integration.
  • Maria contributes her time as an usher at her church, as described in her Person-Centered Information. This reflects productivity.
When we write documents aiming to specifically demonstrate these values, it can shift the focus away from what is truly the person’s vision of their good life. In some cases, it may even lead to imposed or outside perspective of what “independence, integration, and productivity” should look like in someone’s life. Consider the examples below:
Desired outcome: Jackson increases his independence by learning to do his laundry by himself. VS Desired outcome: Jackson takes a road trip to a tabletop-game convention.
The first sample shows a desired outcome that may have been written to specifically demonstrate that Jackson’s ISP reflects independence. However, unless Jackson is interested in learning to do own laundry and this is part of his vision for a good life, we have missed the mark. Additionally, this outcome may reflect the values of others on the team, and what they believe ‘independence’ should look like in Jackson’s life. It may ignore Jackson’s perspective on what independence means to him.
 
The second example shows a desired outcome that has been written in response to Jackson’s ‘good life’ and something he is really hoping to do in the next year. Although this outcome was not written with independence in mind, there is a lot of things here that relate to independence- planning a trip, saving and budgeting money, taking that trip. In fact, Jackson might even be learning to do laundry so that he can pack fresh, clean clothes or wash his clothes while on vacation!

Yeah, but what about…?

If you are reading this article and wondering how it might apply to your work and the people you support, please reach out to our team! We understand this can be a complex topic and our team is happy to offer support.