Person-centered planning training for consumer-directed care for the elderly and disabled.

Based on the need for a training program for person-centered planning, SC Choice, a Real Choice/Independent Living Grant, included the development of training materials and a training program for the implementation of the transformation from agency case manager to care advisor. The development of this training included receiving the person-centered planning training currently used by the developmentally disabled agencies, as well as interviews and focus groups with interested staff and participants. A training program for the Elderly/Disabled Waiver population using adult learning techniques is described in detail. Included in this training are the philosophy, the activities, and the necessary steps to complete person-centered planning for the transition of a case manager to a care advisor in a consumer-directed program for the elderly. Keywords: person-centered planning; consumer direction; elderly; disabled; care advisor; empower "Im not a case, and I don't want to be managed" is the sentiment of a small but growing number of individuals receiving long-term care services (Moseley, 1999). Because of the "baby boomers" and their level of education and demands, these numbers are guaranteed to increase rapidly. One of the responses to this plea on the national level is the initiation of the consumer direction concept by the Centers for Medicare and Medicaid Services (CMS) for the improvement of services for the elderly and disabled population. This initiative addresses two challenges: shifting the mission of long-term care services to improving life experiences of the elderly and disabled; and moving case managers "beyond identifying and addressing the 'unmet needs' approach with service planning to one in which they focus on strategies necessary to enable clients to achieve explicit improvements in their life circumstances" (Caro, 2001, p. 308). The major component that drives consumer direction is personcentered planning. Since the late 1970s the principle of normalization has been used to improve the quality of services to people with developmental disabilities (O'Brien & O'Brien, 2000, p. 3). This principle began the concept of person-centered planning, a collection of techniques that agency staff is trained to use for planning purposes. More familiar approaches, including Essential Lifestyle Planning (Smull & Burke Harrison, 1992), Whole Life Planning (Butterworth, 1993), and Planning Alternative Tomorrows with Hope (PATH) (Pierpoint, O'Brien, & Forest, 1992), which were developed in the 1990s, emphasize knowing the person and his or her supports and allow for a vision of a "good life" in the community by the person with developmental disabilities (O'Brien & O'Brien, 2000, p. 24). In July 2001, the South Carolina Depattment of Health and Human Services (SCDHHS) Office of Senior and Long-Term Care Services received a Centers for Medicaid and Medicare Services (CMS) Real Choice Systems Change Grant for Community Living to implement consumer direction in a home- and community-based elderly/disabled Medicaid waiver program. Community Long-Term Care (CLTC) provides community services to Medicaid-eligible individuals who have been assessed by registered nurses to be at a nursing home level of care. Those eligible can choose to remain in their home with community supports rather than enter a nursing home. Trained social workers provide case management that includes support and management of selected services. Area administrators oversee the waiver programs in 11 regional offices across the state. A centralized state office staff (central office) oversees and coordinates their activities. Individuals eligible to receive services in CLTC, where the average length of services is less than 10 years, require short-term goals as opposed to lifetime goals, to meet personal care needs and maintain quality of life. In SC Choice, the CLTC consumer-directed program, a care advisor (case manager transitioned by training in person-centered planning), using person-centered planning principles with the participant or a representative chosen by the participant, facilitates the participant/representative to identify what personal care needs are necessary for the participant to remain at home. …