Supportive housing & homeless program goal setting & record keeping


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Documentation training for supportive housing and homeless programs.

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  • Good morning. On behalf of COHHIO, I wish to thank you for joining us this morning for our August Lunch and Learn Series, Case management for Supportive Housing - Program Goals and Outcomes. This monthly series, deals with the multifaceted work that each of you do in your communities to meet the needs of the homeless. Joining me this morning, will be Lianna Barbu from the Community Shelter Board.
    Before we begin this morning, I wish to go over a few webinar details. In a moment, I will be muting all of the phone lines. At that time, you will not be able to hear anyone speak besides the two of us. If you have questions, you will need to utilize the GoToWebinar Control Panel that is on the right side of your screen. You will need to click on the Questions line and then type in your question. Depending on the nature of the question, we will answer the question immediately, at the end of the session, or if we run out of time an answer will be sent to you through email. On that note, we will begin our presentation.
  • Why have objectives? Creating clear objectives during the service planning process serves the following purposes:
    Helps consumer and staff integrate all aspects of the plan
    Serves to connect implementation and evaluation to define impact
    Provides a clear focus for development and implementation
    Forms the basis for evaluating outcomes and successes
    To create attainable objectives:
    Consider the current level/status of the problem/area of identified need.
    Consider the conditions under which work of the objective will take place.
    To create objectives targeted to the identified need/desired impact:
    Ask consumer whether the desired impact requires knowledge, application, and/or problem solving.
    Match the action verb to the desired level (see lists of words above).
    Match objective with appropriate methodology.
    Ask consumer whether achieving the objectives can reasonably be expected to achieve the desired impact.
  • In 1956, Benjamin Bloom headed a group of educational psychologists who developed a classification of levels of intellectual behavior important to learning. The six levels are listed below along with verb examples that represent intellectual activity of each level. Bloom’s Taxonomy of Verbs can be utilized to develop goals and objectives that are concrete and measurable.
    Knowledge - Comprehend
    Apply - Analyze
    Synthesize - Evaluate
  • To begin with, you should remember that your documentation should “paint a picture” of the person you are working with and the interventions that you provided. As a reader that was not present for the situation, I should be able to understand what happened in your time together, what the goal of the interaction was, how you intervened, the person’s response to your interventions, progress or lack of progress that person has had in your program, and what the upcoming goals are.
    Remember that throughout the intake, assessment, service planning and intervention processes, that there should be a fluid line between them. What I mean by that is when you complete your intake and assessment of the household, that information and the household’s goals should develop your service planning, and then the service plan should drive the types and frequencies of the interventions that you provide as the consumer strives to meet his/her goals while in the program.
    You should review with the consumer what their goals are for each meeting/session you hold with him/her. Ask what they would like to accomplish and what they expect from you. Your documentation should reflect the person’s abilities and limitations and the reason why you were involved in the interaction. You should discuss how they are proceeding with program goals and what difficulties they are having. Finally you should complete an overview of the person/persons that you are working with. An example of those general observations can be found with one of the accompanying documents for today’s presentation - go to General Observation.
  • There are some primary pieces of information that all file should have in them. We’ll take the next few minutes to review what should be included in your housing program files -
  • Consent forms can vary from program to program, but different types of consent forms include:
    HMIS - data collection form
    Release and Exchange of Information
    Consent/agreement for services
  • Holland’s codes for vocational interests
    Realistic - outdoors; hands-on occupations
    Investigative - scientific
    Artistic - creative
    Social - counseling and teaching
    Enterprising - management and sales
    Conventional - clerical
  • This can be a self-assessment form where the household completes the forms for the various members. May also wish to secure information regarding family physician, specialists, hospital preference, etc.
  • Legal Aspects of Documentation
    Documentation is important!!
    キDirect planning and coordination of participant services
    キDescribe response to services and evaluate services provided
    キCommunication between team members
    キCompliance with regulatory bodies/standards of practice
    キProvide necessity for admission and services
    キDetermine and maximize reimbursement
    キProvide data for staffing decisions, education, research, peer review studies, and quality assurance and improvement
    キCreate a legal record for the participant and provide preventative legal maintenance
  • Be specific. Effective charting is factual. Use words that reference participant reaction, attitude, and symptoms. Mention specific progress or lack of progress.
    Don’t label a participant’s behavior without describing it. For example: harry Homeless was anxious as evidenced by pacing, hand writing, and fast paced speech.
    Never characterize the participant’s behavior with unflattering and unprofessional adjectives such as spaced out, flipped out, drunk as a skunk, etc.
    Don’t use the words appears or seems to without adding a statement such as as evidenced by or as indicated by
    Do use participant quotes, or paraphrase what he/she says – remember to utilize quotation marks if using quotes
  • Supportive housing & homeless program goal setting & record keeping

    1. 1. Welcome The Supportive Housing & Homeless Program – Goal Setting & Record Keeping webinar will begin shortly. This is a muted call, please submit your questions via the GoToMeeting question feature. Handouts will be made available after the webinar concludes.
    2. 2. Supportive Housing & Homeless Program – Goal Setting & Record Keeping Jonda Clemings, MSEd, LSW
    3. 3. Reasons for Documentation
    4. 4. Clinical • Planning & monitoring progress • Documentation of accomplishments • Quick access • Support staff work
    5. 5. Clinical • Identify patterns • Continuity of service • History of crisis situation/pattern
    6. 6. Compliance • Monitoring • Regulatory requirements
    7. 7. Legal • Behavior description • Data assessment & treatment plan • Data for evaluation • Funding source record • Justification for staff action
    8. 8. Legal Aspects of Documentation • Direct planning & coordination • Response to services • Team member communication • Regulatory compliance
    9. 9. Legal Aspects of Documentation • Necessity for services • Maximize reimbursement • Provide data for staff decisions • Legal record
    10. 10. Legal Parameters • Confidentiality & privileged • Accuracy • Objectivity
    11. 11. Legal Parameters
    12. 12. Goal Setting • Consumer centric • Help reach goals • Celebrate success • Problem goal vs. problem person • Inform choices
    13. 13. Goal Setting Skills
    14. 14. Goal Setting Skills
    15. 15. SMART Objectives • Specific • Measurable/observable • Attainable within time & conditions • Results-oriented • Targeted to the identified need & impact
    16. 16. Targeted Objectives
    17. 17. Goals & Objectives Identify various issues, functions, etc. that a person may need to set a goal/objective around to improve their housing stability. List as many of these as you can for each letter in the alphabet.
    18. 18. Bloom’s Taxonomy
    19. 19. Housing Services Plan
    20. 20. Intention • What is it that you want to achieve?
    21. 21. Specific • Who • What • Why • Where • When
    22. 22. Measurable • How much? • How often? • How many?
    23. 23. Attainable • Achievable?
    24. 24. Relevant • Is it important to what you want to achieve ultimately?
    25. 25. Time Based • When?
    26. 26. Sample Goal • Goal: Housing search • Objective: Submit application to MHA, apartment complex • Target date: by May 15, 2014
    27. 27. Amy is a new participant in your homeless shelter. When asked about her housing goals, she tells you that she doesn't have any housing goals. Amy states that she has received Medicaid in the past, but is not currently receiving it. She has no other income/benefits at this time. Amy is not interested in working nor is she interested in signing up for Medicaid, SNAPS, other housing, etc. •Goals: •Objectives:
    28. 28. Bill has been residing in your rapid re-housing program for six months now. He became homeless due to a layoff at the plant and has been having much difficulty finding other employment with comparable pay. Initially, Bill was sad about the loss of his housing, however he was very good at following up on possible job leads. During the past couple of months, Bill has become cool and distant. He appears disinterested and indifferent about finding a job. Goal: Objective :
    29. 29. What Should We Document? • Functional limitations & abilities • Barriers that led to homelessness • Program adherence • General observation
    30. 30. Record Maintenance • Locked • Organized • Sequential • Participant identification • No other consumer names • Individualized • Black/blue ink
    31. 31. Record Maintenance • Avoid backdating • No blank spaces • Streamline charting • Follow agency policy • Sign entry with name & title/ credentials
    32. 32. Record Maintenance • Specific • Don’t label, characterize, use cliches • Use quotes • Approved abbreviations • Legible, grammatically correct
    33. 33. Documentation Methods • SOAP – Subjective, Objective, Assessment, & Plan • DAP – Data, Assessment & Plan
    34. 34. Documenting Appearance
    35. 35. Documenting Mobility
    36. 36. Documenting Communication
    37. 37. Documenting Cognitive Functions
    38. 38. Building a Case File What Should Be Included
    39. 39. Face Sheet
    40. 40. Identifying Information & Picture ID • Drivers license • State ID • Birth certificate Ohio State ID
    41. 41. Social Security Cards
    42. 42. Homeless Status
    43. 43. Chronic Homeless Status • Unaccompanied individual or adult household member • Disabling condition • Living on streets or emergency shelter • 1 continuous year homeless or 4 episodes of homelessness in 3 years
    44. 44. Housing History • Why moved • Type of housing • Difficulties maintaining housing • Barriers • Housing needs
    45. 45. Disability Status • Long-term, indefinite duration • Impedes ability to live independently • Disability could be improved with suitable housing
    46. 46. Disability Status • Physical, mental or emotional impairment - including impairment solely due to alcohol or drug use • Written documentation must come from credentialed professional
    47. 47. Disability Documentation • 3rd Party Written Verification – Disability verification form by state licensed professional • Social Security Administration • Receipt of disability check • Oral third-party and self-certification is not appropriate
    48. 48. Consent Forms • Basic elements of consent • Informed choice • Overall experience • Voluntary participation
    49. 49. Educational & Vocational Assessment • Abilities • Interests • Personality
    50. 50. Employment History • Gaps in employment • Positions held • Frequency of job changes • Skills • Strengths
    51. 51. Criminal Background • Criminal history as it impacts housing & employment
    52. 52. Psychosocial Assessment • Mood & affect • Cognitive functioning • Memory • Communication • Appearance • Mobility
    53. 53. Health Assessment • Medications • Medication log • Allergies • Illnesses
    54. 54. Service Plan • Goals/objectives while in program • Drives service planning
    55. 55. Income Verification • Amount of income • Sources of income • Proof of income
    56. 56. Incident Reports • What happened • When it happened • Others involved • Follow-up
    57. 57. Discharge Summaries • Reason for discharge • Income sources • Income amounts • Destination • Progress made • Referrals made
    58. 58. Rent Reasonableness
    59. 59. Charting Legally Sensitive Situations • Objectivity • Nonjudgmental description • Accuracy • Completeness • Legibility • Justify actions taken
    60. 60. Dissatisfied Consumer • Utilize “quotes” • Don’t label - describe • History or crisis patterns • Attempts to satisfy • Choices provided made • Never characterize
    61. 61. Noncompliance • How person refused to comply • Failure to provide information • Attempts to remedy • Review of procedures
    62. 62. Confidentiality • HIPAA • Minimal access - need to know • Privileged communications
    63. 63. Peer Review • Impartial review • Share expertise • Diversity of opinion • Provide suggestions
    64. 64. Quality Monitoring • Look at process and outcomes • Drive improvement • Accountability • Refine service delivery • Track integrity and effectiveness
    65. 65. Coalition on Homelessness and Housing in Ohio Jonda Clemings 175 S. Third St. - Suite 250 Columbus, Ohio 43215 Phone 614-280-1984 Fax 614-463-1060