I deliver or oversee person-centered services

A nurse helping an elderly man

On this page you will find person-centered resources for Home and Community-Based Service providers (residential and non-residential), Managed Care Organizations (case managers and insurers), service planners/care coordinators, direct service staff and service providers, agency management and State and local officials and staff.

Please note that this resource library is intended to support the development of person-centered thinking, planning and practice skills and concepts. The resources provided are not intended as legal guidance or direction, and may not be directly applicable to New York State, but rather are included for informational purposes and examples of best practices.

Resources are organized into the following categories (please click on the document title and/or the URL to access the resource):

  • General Resources for Service Providers

Person Centered Planning & Inclusion
Document Type: Podcast
Source: LOMAH Disability Podcast
Description: On this episode of the LOMAH podcast, guest Erin Sheldon discusses person centered planning and inclusive supports. Please click on the link titled ‘Episode Website' near the bottom of the page or on the left side of the page to listen to the podcast. You can also listen to the podcast on Apple Podcasts. Listeners do not have to subscribe to listen to the podcast.
URL: https://podcasts.apple.com/us/podcast/person-centered-planning-inclusion/id1238352496?i=1000419960374


Understanding Person-Centered Care
Document Type: Podcast
Source: Pursuing Quality Long-Term Care: National Consumer Voice for Quality Long-Term Care
Description: On this podcast Sonya Barsness discusses the philosophy that honors needs, preferences and goals of aging people by emphasizing choice, self-determination, relationships and purposeful living. Please click on the link titled ‘Episode Website' near the bottom of the page or on the left side of the page to listen to the podcast. You can also listen to the podcast on Apple Podcasts. Listeners do not have to subscribe to listen to the podcast.
URL: https://podcasts.apple.com/us/podcast/understanding-person-centered-care/id1522955998?i=1000499469082


Dr. Laura Brackin Returns to Discuss Person Centered Care Planning
Document Type: Podcast
Source: Home Care America Podcast
Description: In this episode of the Home Care America podcast, Dr. Laura Brackin discusses the importance of person-centered care planning with rich details from her decades of experience. You can click on the arrow beneath the box on the left side of the webpage to listen to this podcast. You can also listen to the podcast on Apple Podcasts. Listeners do not have to subscribe to listen to the podcast.
URL: https://podcasts.apple.com/us/podcast/dr-laura-brackin-returns-to-discuss-person-centered/id1605863897?i=1000552544478


An Introduction to Trauma-Informed Care
Document Type: Article
Source: Dr. Karyn Harvey
Description: An article that introduces trauma informed care and the positive impact that Direct Support Professionals (DSPs) can have on the quality of life of a person with a history of trauma.
URL: https://publications.ici.umn.edu/frontline-initiative/13-1/an-introduction-to-trauma-informed-care


Frontline Initiative
Document Type: Newsletter
Source: Institute on Community Integration
Description: This newsletter series covers the issues important to direct support professionals and supervisors who support people with disabilities living in a variety of community settings. Click on a topic of interest under the heading of products. The topic can then be downloaded for free to read by clicking in the yellow box where it says ‘Free'.
URL: https://ici.umn.edu/series/7


What does Person-Centered Planning mean?
Document Type: Article
Source: Institute on Community Integration: Frontline Initiative - Article by Betsy Gadbois
Description: An article by Betsy Gadbois that explores the essence of person-centered planning.
URL: https://publications.ici.umn.edu/frontline-initiative/14-1/what-does-person-centered-planning-mean


Choice, Direction, and Control: How do I support these in my duties as a DSP?
Document Type: Article
Source: Institute on Community Integration: Frontline Initiative - Article written by Desiree Loucks Baer
Description: An article exploring choice, direction and control from the perspective of the role of a direct support professional.
URL: https://publications.ici.umn.edu/frontline-initiative/14-2/choice-direction-and-control-how-do-i-support-these-in-my-duties-as-a-dsp


The Changing Roles & Expectations of Direct Support Professionals
Document Type: Article
Source: NADSP Update, Author Joseph M. Macbeth
Description: An article that explores the changing expectations and roles of direct support professionals.
URL: https://ici.umn.edu/products/frontline-initiative/151/DSP-Changing-Expectations/#DSP-Changing-Expectations


Person-Centered Cultural Humility: 10 Personal Commitments
Document Type: PDF Document
Source: Danyetta Najoli
Description: The 10 Commitments of Person-Centered Cultural Humility is a set of agreements that direct support professionals and front-line managers can use as they work to support people with disabilities.
URL: https://www.danyetta.com/_files/ugd/618f1e_bfaca23b3ded4d9fa9dbda0c634a09bd.pdf


Public Health Live! Person-Centered Healthcare in Planning and Practice
Document Type: Recorded Webcast
Source: University at Albany School of Public Health
Description: This one-hour webcast presents a conceptual understanding of person-centered planning and practice. The speakers, Tanya Richmond of Support Development Associates and Kate Barkley of Fort Hudson Care Management, share insights on the evolution of person-centered thinking, discuss person-centered planning and practice in the context of the HCBS Final Rule, and show how the core concepts of person-centered planning are being put into practice in a care management setting.
URL: https://www.albany.edu/cphce/phl_0320.shtml


Fact Sheet on Person-Centered Planning
Document Type: Fact Sheet (PDF)
Source: Public Consulting Group, Inc.
Description: A brief fact sheet including background information on the person-centered planning provisions included in the HCBS Final Rule.
URL: https://www.health.ny.gov/health_care/medicaid/redesign/person-centered_planning/providers/fact_sheet.htm


Person-Centered Planning, Practice and Thinking Poster (#14063)
Document Type: Poster (PDF)
Source: New York State Department of Health
Description: A one-page resource that provides easy to understand definitions of person-centered planning, thinking and practice.
URL: https://www.health.ny.gov/health_care/medicaid/redesign/person-centered_planning/providers/poster.htm


HCBS Rule Fact Sheet
Document Type: Fact Sheet (PDF)
Source: New York State Department of Health
Description: A fact sheet that gives an overview of the HCBS Final Rule and its relevance in New York State.
URL: https://www.health.ny.gov/health_care/medicaid/redesign/person-centered_planning/providers/hcbs_rule.htm


National Center on Advancing Person-Centered Practices and Systems (NCAPPS)
Document Type: Website
Source: Administration for Community Living (ACL) and the Center for Policy and Education (CPE)
Description: The NCAPPS website hosts many current informational resources to help States implement person-centered thinking, planning, and practice in a way that is in line with federal policy. The goal of NCAPPS is to promote systems change that makes person-centered principles not just a hope but a reality in the lives of people who use services and supports across the lifespan.
URL: https://ncapps.acl.gov/


When People Matter More than Systems
Document Type: Presentation (PDF)
Source: Michael J. Kendrick, PhD
Description: The keynote speaker presentation from "The Promise for Opportunity" Conference held in Albany, NY, on March 27-28, 2000.
URL: https://creativeoptionsregina.ca/wp-content/uploads/2015/08/When-People-Matter-More-Than-Systems.pdf


Shared Decision-Making
Document Type: Article (Web)
Source: William Godolphin, Healthcare Quarterly 12(sp), August 2009, Longwoods.com
Description : An article that discusses shared decision making.
URL: https://www.longwoods.com/content/20947/healthcare-quarterly/shared-decision-making


Adult Day Services in Home and Community-based Settings
Document Type: Recorded Webinar
Source: New York State Office for the Aging
Description: A webinar presentation describing the historical institutionalization of individuals with disabilities and disabling conditions, leading up to the Home and Community-Based Services (HCBS) Final Rule and the culture change required to implement the Rule. The presentation also addresses Adult Day Services and the Day Habilitation Model in the context of person-centered planning and implementation across the Aging network in New York State.
URL: https://meetny.webex.com/recordingservice/sites/meetny/recording/0ea7e95bf6e71039bdea0050568ced19/playback

Listen, Learn, Act: Selected Writings by Michael W. Smull on Essential Lifestyle Planning, Self-Determination, and Organizational Change
Document Type: Article (Web)
Source Support Development Associates, Michael W. Smull
Description: This resource provides a compilation of articles by a single author on topics related to person-centered planning for Individuals with Disabilities.
URL: https://allenshea.com/wp-content/uploads/2019/04/listenlearnact.pdf


Person-Centered Planning: PATH, MAPS, and Circles of Support
Document Type: Article (Web)
Source: Inclusion Press
Description: This resource outlines the person-centered planning tools PATH, MAPS and CIRCLES which were developed to assist individuals, families, and their support networks to plan positive futures.
URL: https://inclusion.com/path-maps-and-person-centered-planning/


Person-Centered Planning: Overview and Workshop
Document Type: Website and Video
Source: Administration for Community Living
Description: An overview of person-centered planning, including a video of an ACL-hosted person-centered planning workshop from August 2017 which provides an example of a long-term services and supports system embracing person-centered thinking, planning, and practices.
URL: https://acl.gov/programs/consumer-control/person-centered-planning


Person-Centered Planning: Analysis of Research and Effectiveness
Document Type: Research Article (PDF)
Source: American Association on Intellectual and Developmental Disabilities, Claudia Claes, Geert Van Hove, Stijn Vandevelde, Jos van Loon, and Robert L. Schalock, Intellectual and Developmental Disabilities , Vol. 48, No. 6: 432-453
Description: A research article on the effectiveness of person-centered planning.
URL: https://www.health.ny.gov/health_care/medicaid/redesign/person-centered_planning/providers/docs/analysis.pdf


Becoming a Person-Centered System – A Brief Overview
Document Type: Article (PDF)
Source: Michael W. Smull, Mary Lou Bourne, & Helen Sanderson, April 2009.
Description: Click on the ´Attachments´ link at the bottom of the webpage to find the full text of the article that describes creating a person-centered system based on the concept that use of a set of values-based skills at all levels of the system will drive change throughout the system.
URL: http://allenshea.com/wp-content/uploads/2017/02/BecomingaPersonCenteredSystem-ABriefOverview.pdf


Self-Directed Services
Document Type: Website
Source: Centers for Medicare and Medicaid Services
Description: This page provides an overview of self-directed Medicaid services, including service options, self-direction guidelines, support guidelines, and financial management services (FMS).
URL: https://www.medicaid.gov/medicaid/ltss/self-directed/index.html


Moving Past the Limits in Person-Centered Planning
Document Type: Article (PDF)
Source: John O´Brien, Inclusion Press, December 2017
Description: An article written by Learning Institute Faculty member John O´Brien on moving past limits in person-centered planning, identifying constraints on inclusive roles and relationships, and ideas for strengthening person-centered planning.
URL: https://inclusion.com/site/wp-content/uploads/2017/12/Past-the-Limits-of-Person-Centered-Planning.pdf


The Contribution of Person-centered Planning to Care Management
Document Type: Article (PDF)
Source: John O´Brien, Inclusion Press, February 16, 1999
Description: An article written by Learning Institute Faculty member John O´Brien on the contribution of person-centered planning to care management, including potential benefits, costs and uncertainties, and distinct contributions and processes.
URL: https://inclusion.com/site/wp-content/uploads/2017/12/Person-Centered-Planning-and-Case-Management.pdf


Situational Tool for Exploring Possibilities
Document Type: Assessment Tool (PDF)
Source: Rutgers University, The Boggs Center on Developmental Disabilities
Description: The Situational Tool for Exploring Possibilities (STEP) is part of a person centered, individual-focused planning process to support job seekers in an effective job search. The purpose of a situational assessment is to discover a job seeker´s skills, preferences and support needs when that person requires additional work experiences to help determine his/her career goal.
URL: https://rwjms.rutgers.edu/boggscenter/publications/documents/STEP-F.pdf


Balancing Choice and Risk
Document Type: Presentation (PDF)
Source: Centers for Medicare and Medicaid Services
Description: A presentation that discusses the dignity of risk and the importance of choice and self-determination and provides insights from an individual and systems perspective on balancing choice and risk.
URL: https://www.medicaid.gov/sites/default/files/2019-12/balancing-risk-choice_0.pdf


Supports for Community Participation
Document Type: Presentation (PDF)
Source: Centers for Medicare and Medicaid Services
Description: A presentation that discusses supports for community participation, including emerging practices, sample definitions, policies and procedures, and an overview of system structures to support community participation.
URL: https://www.medicaid.gov/sites/default/files/2019-12/supports-for-community-participation-final.pdf


Risk Assessment and Mitigation Strategies
Document Type: Presentation (PDF)
Source: Centers for Medicare and Medicaid Services
Description: A presentation on risk assessment and mitigation strategies, including information on federal regulations and key elements of a comprehensive risk assessment and mitigation process.
URL: https://www.medicaid.gov/sites/default/files/2019-12/risk-assessment-mitigation.pdf


Person-Centered Planning: A Guide to Help Direct Support Professionals Understand their Role in the Person-Centered Planning Process
Document Type: Guide (PDF)
Source: Community Mental Health for Central Michigan
Description: A guide to help Direct Support Professionals understand their role in the person-centered planning process, including a PCP training checklist, history of person-centered planning, guiding principles, and forms.
URL: https://www.cmhcm.org/userfiles/filemanager/1124/


Minnesota Guide to Assistive Technology: Getting Started
Document Type: Website
Source: State of Minnesota
Description: Information to help with the consideration, selection, and use of assistive technology to help people with disabilities, and those who serve and care for them, better understand and access assistive technology.
URL: https://mn.gov/admin/at/getting-started/

Person-Centered Care Planning in the States
Document Type: Website
Source: Justice in Aging
Description: An article that outlines person-centered planning rights under the Medicaid Home and Community Based Services Final Rule.
URL: https://www.justiceinaging.org/resources-for-advocates/mltss-in-managed-care-toolkit/person-centered-care-planning/


Person-Centered Care: The Business Case
Document Type: Report (PDF)
Source: The SCAN Foundation, June 2016
Description: A report that discusses the business case for a person-centered approach to health care and community-based service delivery for older adults with chronic illnesses and functional limitations.
URL: https://www.thescanfoundation.org/sites/default/files/business_case_for_pcc_full_report_june_2016.pdf


The Fundamentals of Person-Centered Care for Individuals with Dementia
Document Type: Article (Web)
Source: The Gerontologist 2018, Vol. 58, No. S1, S10-S19
Description: This review article outlines the history, components, and impact of person-centered care practice for people living with dementia.
URL: https://academic.oup.com/gerontologist/article/58/suppl_1/S10/4816735


Person-Centered Care: A Definition and Essential Elements
Document Type: Article (Web)
Source: Journal of the American Geriatrics Society, January 2016-Vol. 64, No. 1
Description: In this article, the American Geriatrics Society (AGS) in collaboration with a research and clinical team from the Keck School of Medicine of the University of Southern California provide an evidence base to support a definition of person‐centered care and its essential elements.
URL: https://onlinelibrary.wiley.com/doi/10.1111/jgs.13866


Key Elements of a No Wrong Door System of Access to Long-Term Services and Supports for All Populations and Payers
Document Type: Report (PDF)
Source: Administration for Community Living, Centers for Medicare and Medicaid Services and the Veterans Health Administration
Description: This report provides a look at the key elements of a No Wrong Door system, a coordinated system of access to make it easier for consumers to learn about and access LTSS.
URL: https://acl.gov/sites/default/files/programs/2016-10/nwd-national-elements.pdf


Person-Centered Care Starts With a Conversation
Document Type: Article (Web)
Source: Peter Notarstefano for LeadingAge Magazine, March-April 2018, Vol. 08, Number 02
Description: This article describes how a LeadingAge member uses purposeful conversations and a measurement tool to understand the preferences of residents and clients in all levels of care.
URL: https://www.leadingage.org/magazine/march-april-2018/Person-Centered-Care-Starts-with-a-Conversation-V8N2


Person-Centeredness in the Care of Older Adults: A Systematic Review of Questionnaire-based Scales and their Measurement Properties
Document Type: Research Article(Web)
Source: Wilberforce et al. BMC Geriatrics (2016) 16:63
Description: A research article on person-centeredness for older adults, including a systematic review of measures of person-centeredness.
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4782329/pdf/12877_2016_Article_229.pdf


Achieving Person-Centered Care: The Five Pillars of System Transformation
Document Type: Policy Brief (PDF)
Source: The SCAN Foundation, Policy Brief No. 7, September 2012
Description: This policy brief establishes a basis for the critical system transformation activities necessary to produce a high-quality, person-centered system of care for older adults and people with disabilities.
URL: https://www.thescanfoundation.org/media/2019/07/tsf_policy_brief_7_five_pillars-sep-2012.pdf


Principles for Person-Directed Services and Supports during Serious Illness
Document Type: White Paper (PDF)
Source: Administration for Community Living
Description: A paper that outlines the Administration for Community Living´s person-directed principles, describing how their stakeholders believe health care and the long-term services and supports systems would work best for them when they are seriously ill.
URL: https://acl.gov/sites/default/files/Aging%20and%20Disability%20in%20America/Serious%20Illness%20Principles%208-30-17%20508%20compliant.pdf


What Does It Mean to Be Age-Friendly?
Document Type: Quick Reference Guide
Source: The Institute for Healthcare Improvement
Description: A one-page guide on the 4Ms framework of Age-Friendly Health Systems: What Matters, Medication, Mentation and Mobility. The guide includes actions for adopting the 4Ms in both hospital and other settings.
URL: http://www.ihi.org/Engage/Initiatives/Age-Friendly-Health-Systems/Documents/AgeFriendly_4MsBySetting_FullGraphic.pdf


Assistive Technology for Older Persons
Document Type: Handbook (PDF)
Source: Idaho Assistive Technology Center
Description: This handbook is designed as a guide for older citizens who, as they age, wish to preserve their independence, autonomy, productivity, and dignity. It is intended to provide information about assistive technology, home modifications, and the many service options available to older people.
URL: http://idahoat.org/Portals/60/Documents/Services/Resources/AT_OlderPersonsHandbook.pdf


Assistive Technology Industry Association (ATiA) Research Articles and Tools
Document Type: Website
Source: Assistive Technology Industry Association
Description: A list of research articles and tools on assistive technology.
URL: https://www.atia.org/at-resources/research-articles-tools/


The Power of Technology for People with Disabilities
Document Type: Website
Source: Microsoft Corporation
Description: A collection of articles that highlight the impact technology can have in helping people with disabilities.
URL: https://news.microsoft.com/features/the-power-of-technology-for-people-with-disabilities/


The Institute for Matching Person and Technology Inc.
Document Type: Website
Source: The Institute for Matching Person and Technology Inc.
Description: The main homepage of the Institute for Matching Person and Technology. The Institute for Matching Person & Technology was created to match users of technologies with the most appropriate devices for their use.
URL: https://sites.google.com/view/matchingpersontechnology/home

Person-Centered Planning: Practice and Resources
Document Type: Website
Source: New York State Office of Mental Health (OMH); Developed by Diane Grieder, Janis Tondora, and Valerie Way in Collaboration with OMH PROS Staff
Description: A comprehensive tool for implementing person centered recovery planning in Personalized Recovery Oriented Services (PROS). The tool is organized into five chapters which each discuss an aspect of integrating person centered recovery philosophy into PROS Services and practices.
URL: https://www.omh.ny.gov/omhweb/pros/person_centered_workbook/index.html


Wellness Recovery Action Plan (WRAP)
Document Type: Website
Source: Advocates for Human Potential, Inc., Human Potential Press
Description: A website where you will find information about Wellness Recovery Action Planning (WRAP), WRAP resources, and a powerful search function to help you find articles and other information.
URL: https://mentalhealthrecovery.com/wrap-is/


Person-centered Care Planning and Service Engagement: A Study Protocol for a Randomized Controlled Trial
Document Type: Research Article (Web)
Source: National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health Stanhope et al. Trials (2015) 16:180
Description: A research article on a study conducted to assess the effectiveness of person-centered care planning for service engagement in the mental health system.
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4409728/


Person-centered Planning in Mental Health: A Transatlantic Collaboration to Tackle Implementation Barriers
Document Type: Research Article (Web)
Source: National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health Miller, Stanhope, Restrepo-Toro, Tondora. Psychiatric Rehabilitation Journal. 2017; 20(3): 251–267.
Description: This article reviews international efforts to promote person-centered care planning (PCCP) in the context of a randomized clinical trial in the United States and in the ‘Meaningful and Measurable´ initiative, a collaborative action research project involving diverse provider organizations in Scotland.
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6800658/


Improving Cultural Competence: KAP Keys for Clinicians
Document Type: Manual (PDF)
Source: Substance Abuse and Mental Health Services Administration (SAMHSA)
Description: A manual for professional care providers and administrators that describes the influence of culture on the delivery of substance use and mental health services.
URL: https://store.samhsa.gov/sites/default/files/d7/priv/sma16-4933.pdf


Helping Individuals Consider Employment: Tips for Mental Health Practitioners
Document Type: Worksheet (PDF)
Source: The IPS Employment Center at the Rockville Institute, July 1, 2016
Description: This document includes tips and a worksheet for mental health practitioners to help guide discussions about employment. The document also includes discussion and planning strategies.
URL: https://ipsworks.org/wp-content/uploads/2017/10/Helping-Individuals-Consider-Employment.pdf


SAMHSA´s Working Definition of Recovery: 10 Guiding Principles of Recovery
Document Type: Pamphlet (PDF)
Source: Substance Abuse and Mental Health Services Administration (SAMHSA)
Description: A resource guide pamphlet on SAMHSA´s Working Definition of Recovery and descriptions of the 10 Guiding Principles of Recovery.
URL: https://store.samhsa.gov/sites/default/files/d7/priv/pep12-recdef.pdf


SAMHSA´s Wellness Initiative: Eight Dimensions of Wellness
Document Type: One-Pager (PDF)
Source: Swarbrick, M. (2006). A wellness approach. Psychiatric Rehabilitation Journal, 29(4), 3311-3314.
Description: A one-page document with an overview of the eight dimensions of wellness and a link to the initiative website.
URL: http://www.ncdsv.org/images/SAMHSA_EightDimensionsOfWellness_revised2012.pdf


The Four Walls
Document Type: Article
Source: Mark Ragins, Recovery Stories
Description: An article written on the four walls to person-centeredness.
URL: https://www.recoverystories.info/the-four-walls-by-mark-ragins/


SMART Goals and Mental Health
Document Type: Fact Sheet
Source: Mental Health & Developmental Disabilities National Training Center
Description: A resource with information regarding goal setting and self-determination for individuals who experience both developmental disabilities and mental health concerns.
URL: https://www.mhddcenter.org/wp-content/uploads/2021/01/SMART-Goals-Mental-Health.pdf


The Many Flavors of Medicaid Waivers
Document Type: Podcast
Source: Navigating Life as we Know It
Description: This podcast episode discusses Medicaid Waivers, with a focus on person-centered-planning (PCP) and the proper use of two assessment tools associated with person centered planning process: the Supports Intensity Scale (SIS) and the Psycho-Social Assessment (PSA). Please note that these are Michigan waivers and not all characteristics of these programs are the same in New York. They are included as examples of how waiver services can involve person-centered planning and can help people. Please click on the link titled ‘Play' near the top of the page to listen to the podcast. Listeners do not have to subscribe to listen to the podcast.
URL: https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5idXp6c3Byb3V0LmNvbS8xMjc4MjI0LnJzcw/episode/QnV6enNwcm91dC05NDgwMTM5

Medical Monday Ep 39: Person Centered Thinking
Document Type: Podcast
Source: Friends For Life Podcast
Description: On this episode of Medical Monday, Craig Escude M.D. explains person centered thinking for individuals with developmental disabilities. You can listen to this podcast episode by clicking on the large arrow on the left side of the page. You can also listen to the podcast on Spotify or Apple Podcasts. Listeners do not have to subscribe to listen to the podcast.
URL: https://friendsforlifepodcast.libsyn.com/medical-monday-ep-39-person-centered-thinking


Office for People with Developmental Disabilities (OPWDD) Person-Centered Planning
Document Type: Website
Source: Office for People with Developmental Disabilities (OPWDD)
Description: A resource page that provides an overview of person-centered planning, an introduction to person-centered outcomes, and a video featuring one individual´s person-centered planning story.
URL: https://opwdd.ny.gov/providers/person-centered-planning


Person-Centered Planning (PCP)
Document Type: Website
Source: Foundation for People with Learning Disabilities
Description: A website and article that includes a description of person-centered planning and some key questions to think about in person-centered planning.
URL: https://www.mentalhealth.org.uk/learning-disabilities/a-to-z/p/person-centred-planning-pcp


Best Practice, Expected Practice, and the Challenge of Scale
Document Type: Article (PDF)
Source: NASDDDS, Michael W. Smull, Mary Lou Bourne & Helen Sanderson (2010)
Description: This article provides insight in taking best practices on person-centered planning to scale across systems to create positive pressure for change.
URL: https://allenshea.com/wp-content/uploads/2017/03/BestPracticeExpectedPractice.pdf


Reconnecting Hearts and Minds: A Paradigm day of conversation about ensuring good support with and for people with learning disabilities
Document Type: Conference Notes (PDF)
Source: John O´Brien
Description: This document is a compilation of John O´Brien´s notes based on large group discussions from the conference, ‘Reconnecting Hearts and Minds: A Paradigm day of conversation about ensuring good support with and for people with learning disabilities.´
URL: https://paradigm-uk.org/wp-content/uploads/2019/11/Hearts-and-Mind-John-OBrien-.pdf


The State of Tech: Getting and Communicating Information
Document Type: Article (Web)
Source: Ohio Developmental Disabilities Council
Description: An article that discusses the impact of technology advances and the digital divide for people with disabilities.
URL: https://ddc.ohio.gov/the-state-of-tech-2


Ohio Technology First
Document Type: Website
Source: Ohio Department of Developmental Disabilities
Description: The Ohio Technology First website provides extensive resources on assistive technology for people with disabilities.
URL: https://dodd.ohio.gov/wps/portal/gov/dodd/about-us/resources/tech-first/tech-first


Technology First
Document Type: Website
Source: Missouri Department of Mental Health
Description: The Missouri Technology First website includes multiple resources for assistive technology, including success stories and multiple resource links for providers, products, and more.
URL: https://dmh.mo.gov/dev-disabilities/technology-first


DIDD´s Enabling Technology Program
Document Type: Website
Source: Tennessee Department of Intellectual and Developmental Disabilities (DIDD)
Description: A library of video features on individuals that use the Tennessee Enabling Technology Program.
URL: https://www.tn.gov/didd/for-consumers/enabling-technology.html


White Paper: Use of Remote Support in Ohio and Emerging Technologies on the Horizon
Document Type: White Paper (PDF)
Source: Ohio Department of Developmental Disabilities (DODD), Jordan B. Wagner, Marc J. Tass©, Daniel K. Davies, & Steven E. Stock. Nisonger Center, The Ohio State University, May 1, 2018.
Description: A white paper on the use of remote support and emerging technologies for individuals with disabilities in Ohio.
URL: https://nisonger.osu.edu/wp-content/uploads/2017/02/White-Paper-Use-of-Remote-Support-in-Ohio-and-Emerging-Technologies-on-the-Horizon.pdf


Technology First: The Missouri Division of Developmental Disabilities´ Assistive Technology Initiative
Document Type: Presentation (PDF)
Source: Missouri Division of Developmental Disabilities and Missouri Inclusive Housing Development Corporation
Description: A presentation on Missouri´s assistive technology initiative, including an overview of assistive technology, considerations for the use of assistive technology, and individual stories.
URL: https://dmh.mo.gov/sites/dmh/files/media/pdf/2019/08/technology-first-webinar-presentation-02052019.pdf


State Roles in Promoting Community Life Engagement: Themes from the State Employment Leadership Network´s Working Group
Document Type: Journal Publication (PDF)
Source: ENGAGE, Issue No. 8, 2018, State Employment Leadership Network
Description: A journal article that discusses states´ role in supporting person-centered community engagement, with a focus on integrated employment.
URL: https://scholarworks.umb.edu/cgi/viewcontent.cgi?article=1035&context=thinkwork


Guidance for Conversations: Identifying and Designing Pathways towards Rewarding Employment
Document Type: Guidance Document (PDF)
Source: State Employment Leadership Network
Description: A guide for having conversations about identifying and designing pathways toward rewarding employment. The guide describes a series of pathways that the authors feel reflect most people´s current circumstances and understanding. Each pathway is defined and questions for exploration and discovery are provided. Worksheets are available at the end of the document.
URL: https://ohioemploymentfirst.org/up_doc/SELNguidancejan2019.pdf

Why Being Brain Injury Informed Is a Critical Component of Person-Centered Thinking, Planning, and Practice
Document Type: Recorded Webinar
Source: The National Center on Advancing Person-Centered Practices and Systems (NCAPPS), Administration for Community Living
Description: This webinar features presenters from the National Association of State Head Injury Administrators (NASHIA) and two individuals with lived experience of brain injury. The webinar´s key points of focus include how brain injury considerations and person-centered practices differ from plans supporting other disability popolations; and accommodations and strategies for addressing brain injury-related cognitive, behavioral and social issues with regard to person-centered plan development. (On the page, navigate to August 2019 under "Past NCAPPS Webinars")
URL: https://ncapps.acl.gov/webinars.html


3-Part Webinar Series: Person-Centered Planning: From Dreams to Reality
Document Type: Recorded Webinars
Source: National Association of State Head Injury Administrators
Description: This 3-part webinar series has been developed to address person-centered planning as a critical component of the delivery of brain injury services. The webinars include: Webinar 1: An Introduction to Person-Centered Thinking; Webinar 2: From Person-Centered Thinking to Creating the Plan; and, Webinar 3: Applying Person-Centered Planning and Thinking Principles in the Delivery of Supports & Services for Persons Living with a Traumatic Brain Injury.
URL: https://www.nashia.org/trainings/3-part-webinar-series-person-centered-planning-from-dreams-to-reality

The Many Flavors of Medicaid Waivers 301 - Children's Waivers & Independent Facilitation
Document Type: Podcast
Source: Navigating Life as we Know It
Description: This episode is about two Medicaid Waivers in Michigan (The Michigan Waiver for Children and the Michigan Waiver for Children with Serious Emotional Disorders (SED)), and how they provide valuable supports to children in the state. Please note that these are Michigan waivers and not all characteristics of these programs are the same in New York. They are included as examples of how waiver services can involve person-centered planning and can help people. Please click on the link titled ‘Play' near the top of the page to listen to the podcast. Listeners do not have to subscribe to listen to the podcast.
URL: https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5idXp6c3Byb3V0LmNvbS8xMjc4MjI0LnJzcw/episode/QnV6enNwcm91dC05NTY5Njgy?sa=X&ved=0CAUQkfYCahcKEwiwqpDoiLz2AhUAAAAAHQAAAAAQLQ


A Family-Centered Approach to Early Intervention
Document Type: Journal Article (PDF)
Source: WestEd´s R&D Alert,® Fall 2011, Vol. 12, No. 3.
Description: A Journal Article that describes a family-centered approach to early intervention.
URL: https://www.wested.org/wp-content/uploads/2016/11/1372729797article_familycenteredapproach_2011-3.pdf


Family-Centered Practices in Early Childhood Intervention: Values, Paradigms, Principles and Practices
Document Type: Presentation (PDF)
Source: Carl J. Dunst, Ph.D. Orelena Hawks Puckett Institute
Description: A presentation that describes the role of values in early childhood intervention and how family-centered beliefs can be used as the foundation for parent, family, and child capacity-building intervention practices.
URL: http://www.puckett.org/presentations/Family-Centered%20Practices%20in%20Early%20Childhood%20Intervention.pdf


What is Family Centered Practice?
Document Type: Website
Source: The National Resource Center for Family Centered Practice, The University of Iowa, School of Social Work
Description: The website for the National Resource Center for Family Centered Practice, which provides a description of family centered practice and its components.
URL: https://clas.uiowa.edu/nrcfcp/what-family-centered-practice

Federal Register, Vol. 79, No. 11, Rules and Regulations, Thursday, January 16, 2014, 441.725 Person-centered service plan (page 3036)
Document Type: Regulatory Document (PDF)
Source: Centers for Medicare and Medicaid Services
Description: The regulatory language on page 3036 outlines requirements for states for developing and approving person-centered service plans, in a process driven by the individual.
URL: https://www.govinfo.gov/content/pkg/FR-2014-01-16/pdf/2014-00487.pdf


Final Rule Medicaid HCBS
Document Type: Presentation (PDF)
Source: Centers for Medicare and Medicaid Services
Description: Pages 29-40 of this document outline the requirements for person-centered service plans under the Home and Community-Based Services Final Rule.
URL: https://www.medicaid.gov/sites/default/files/2019-12/final-rule-slides-01292014.pdf


Person-Centered Service Planning Provisions and Modifications to HCBS Settings Criteria
Document Type: Question and Answer Document (PDF) (Web)
Source: Centers for Medicare and Medicaid Services
Description: A question and answer document for providers regarding the person-centered planning provisions of the HCBS Final Rule.
URL: https://www.health.ny.gov/health_care/medicaid/redesign/person-centered_planning/providers/docs/provisions.pdf


Key Message and Tips for Providers: Person-Centered Service Plans
Document Type: One-Pager (PDF)
Source: Centers for Medicare and Medicaid Services, August 2015
Description: A message and tips for providers regarding guidelines for person-centered service plans.
URL: https://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/Medicaid-Integrity-Education/Downloads/key-messages-Person-Centered-Service-Plans-[September-2015].pdf


Fact Sheet: Home and Community Based Services
Document Type: Fact Sheet (Web)
Source: Centers for Medicare and Medicaid Services
Description: This fact sheet provides an overview and describes key provisions of the Home and Community Based Services Final Rule, including person-centered planning.
URL: https://www.cms.gov/newsroom/fact-sheets/home-and-community-based-services


Guidance to HHS Agencies for Implementing Principles of Section 2402(a) of the Affordable Care Act: Standards for Person-Centered Planning and Self-Direction in Home and Community-Based Services Programs
Document Type: Guidance Document (PDF)
Source: Centers for Medicare and Medicaid Services
Description: This guidance document outlines the standards for person-centered planning and self-direction that should be reflected in all HHS programs that fund or provide HCBS.
URL: https://acl.gov/sites/default/files/programs/2017-03/2402-a-Guidance.pdf


Steps to Creating a Statewide Person-Centered Service Planning System
Document Type: Presentation (PDF)
Source: Centers for Medicare and Medicaid Services
Description: This training presentation provides guidance to states for creating a person-centered service planning system, including an approach to systems change and specific state examples.
URL: https://www.medicaid.gov/sites/default/files/2019-12/steps-creating-a-person-centered-planning-system.pdf


System-Wide Person-Centered Planning
Document Type: Presentation (PDF)
Source: Centers for Medicare and Medicaid Services
Description: This training presentation provides guidance to states on system-wide person-centered planning, focusing on the differences between traditional service systems and person-centered systems, including case examples.
URL: https://www.medicaid.gov/sites/default/files/2019-12/system-wide-person-centered-planning.pdf


Thinking Differently About Person-Centered Planning
Document Type: Presentation (PDF) (Web)
Source: Money Follows the Person Technical Assistance Project, Centers for Medicare and Medicaid Services and New Editions Consulting, Inc.
Description: This training presentation covers a brief look at the history of person-centered planning and practice, an overview of the Home and Community-Based Services Final Rule, and an introduction to person-centered planning.
URL: https://www.health.ny.gov/health_care/medicaid/redesign/person-centered_planning/providers/docs/think_different.pdf

Person-Centered Service Plan Template
Document Type: Plan Template (PDF)
Source: New York State Department of Health
Description: Plan of Care Template created in accordance with Person-Centered Service Planning Guidelines and provided for guidance.
URL: https://www.health.ny.gov/health_care/medicaid/redesign/hcbs/docs/pcp_template.pdf


Nursing Home Transition and Diversion (NHTD) Initial Service Plan
Document Type: Plan Template (PDF)
Source: New York State Department of Health
Description: Initial service plan for the Home and Community Based Services Medicaid Waiver Nursing Home Transition and Diversion (NHTD) program
URL: https://www.health.ny.gov/health_care/medicaid/redesign/person-centered_planning/providers/docs/nhtd.pdf


Assisted Living Resident Service Plan
Document Type: Plan Template (PDF)
Source: New York State Department of Health
Description: Resident Service Plan for the Division of Assisted Living
URL: https://www.health.ny.gov/health_care/medicaid/redesign/person-centered_planning/providers/docs/alrs.pdf


Adult Behavioral Health HCBS Plan of Care
Document Type: Plan Template (PDF)
Source: New York State Department of Health/Office of Mental Health
Description: Adult Behavioral Health Home and Community Based Services Plan of Care
URL: https://www.health.ny.gov/health_care/medicaid/program/medicaid_health_homes/docs/hcbs_poc_template.pdf


The Life Plan
Document Type: Website
Source: New York State Office for People with Developmental Disabilities
Description: The Life Plan development is driven by the person, with input and participation of all members of the care-planning team.
URL: https://opwdd.ny.gov/providers/what-life-plan

Person-Centered Service Planning Guidelines For Medicaid Managed Care Organizations, Local Departments of Social Services, and Health Homes
Document Type: Guidance Document
Source: New York State Department of Health
Description: These guidelines are intended to provide information regarding the requirements for the Person-Centered Service Planning process for enrollees in Medicaid Managed Care, and individuals receiving services through fee for service from Local Departments of Social Services.
URL: https://www.health.ny.gov/health_care/medicaid/redesign/hcbs/pcp_guidance.htm


Adult Behavioral Health Home And Community Based Services (BH HCBS) Plan of Care
Document Type: Guidance Document (PDF)
Source:  New York State Department of Health
Description: Guidance on the complete process to access Adult Behavioral Health Home and Community-Based Services, including the person-centered Plan of Care requirements.
URL: https://www.health.ny.gov/health_care/medicaid/program/medicaid_health_homes/workflow_guidance.htm


Person-Centered Planning and Community Inclusion
Document Type: Website
Source: Office for People with Developmental Disabilities
Description: Resources to support the planning process and the delivery of exceptional care in the most integrated community settings, including the Strengths and Risk Inventory Tool.
URL: https://opwdd.ny.gov/providers/person-centered-planning-and-community-inclusion


Person-Centered Planning: Addition of New 14 NYCRR Part 636, Amendments to 14 NYCRR Parts 633, 635, 671, & 686 FINAL REGULATIONS
Document Type: Regulatory Document (PDF)
Source: Office for People with Developmental Disabilities
Description: Person-centered planning regulations found at 14 NYCRR § 636, subpart 636-1 Person-Centered Planning, effective November 1, 2015.
URL: https://opwdd.ny.gov/system/files/documents/2020/01/person-centered-planning-text.pdf


Person-Centered Planning Practice and Resources - A Handbook for Rehabilitation and Recovery
Document Type: Website
Source: New York State Office of Mental Health
Description: This handbook for Rehabilitation and Recovery has been developed as a comprehensive tool for implementing person centered recovery planning in Personalized Recovery Oriented Services (PROS).
URL: https://www.omh.ny.gov/omhweb/pros/person_centered_workbook/


Federal Adult Behavioral Health Home and Community-Based (HCBS) Services Plan of Care (POC) Documentation Requirements
Document Type: Website
Source: New York State Department of Health
Description: A checklist for the Federal Adult Behavioral Health HCBS Plan of Care (POC) Documentation Requirements.
URL: https://www.health.ny.gov/health_care/medicaid/program/medicaid_health_homes/bh_hcbs_checklists.htm


Person-Centered Addiction Treatment Services
Document Type: Training Video
Source: New York State Office of Addiction Services and Supports
Description: A video on person-centered addiction treatment services, including an overview of updates to Office of Addiction Services and Supports regulations plus newly released guidance documents regarding Medication-Assisted Treatment (MAT).
URL: https://www.oasas.ny.gov/person-centered-addiction-treatment-services


Recovery-Oriented Systems of Care: The Foundation for Recovery in New York State
Document Type: Website
Source: New York State Office of Addiction Services and Supports
Description: An online resource on recovery-oriented systems of care, including information on system development, person-centered care, and recovery activities and resources.
URL: https://www.oasas.ny.gov/providers/recovery-oriented-systems-care


Core Skills Refresher, Options Counseling (OC), and Person-Centered Counseling (PCC)
Document Type: Presentation (PowerPoint) and Video Presentation Recording
Source: New York State Office for the Aging
Description: NY Connects Information & Assistance (I&A): Part 1 of this session is a core skills refresher for existing staff who were previously trained on I&A and formal training for new staff who are delivering I&A. Part 2 of this session is a skills-based interactive training on options counseling and an introduction to person-centered counseling.
URL: https://aging.ny.gov/ny-connects-information-and-assistance-ia