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New Staff OrientationRevised 6/1/20

PCA MISSION STATEMENTPCA’S mission is to improve the quality of life for Philadelphians who are older or who have disabilities, assisting them in achieving maximum levels of health, independence, and productivity.Revised 6/1/20

PCA’S MISSION IN ACTION1. ADMINISTRATION & FISCAL MANAGEMENT2. ADVOCACY3. PLANNING4. PROGRAM DEVELOPMENT5. SERVICE COORDINATIONRevised 6/1/20

HOW PCA CAME TO BEOAA Mandated ServicesOlder American ActRegulatory Mandate Revised 6/1/20

Government StructureFederal - Administration on Community LivingState - PA Department of AgingOffice of Long- Term LivingLocal -Area Agency on Aging (AAA)Revised 3/20/23

Regulatory MandatesOlder Americans Act (OAA)Older Pennsylvanians ActRevised 6/1/20

OAA Mandated Services Employment Information and Referral Legal Long Term Care Senior Community Centers TransportationRevised 6/1/20

Older Americans Act #1 Assure that preference will be given to providing service to older persons with the greatest economic need and greatest social need, with particular attention to low-income minority individuals. Revised 6/1/20

Older Americans Act #2• Greatest economic needs means the need resulting from an income level at or below the poverty line.• Greatest social need refers to non-economic circumstances including: (1) Physical and mental disabilities or language barriersRevised 6/1/20

Older Americans Act #3(2) Cultural, social, or geographical isolation including isolation caused by racial or ethnic status that: -restricts the ability of an individual to perform normal daily tasks. -threatens the capacity of the individual to live independently.Revised 6/1/20

Services Provided by AAAs Attendant Care Health Insurance Counseling Health Promotion Assessment Management of Services (Care Management/Service Coordination) Adult Day Service Community Living Options Older Adult Protective ServicesRevised 11/2022

Older Pennsylvanians Act AAAs are to give priority to older persons with greatest needs and least resources.  Priority factors are: functional ability, isolation, advanced age (75+), low income, minority status, inadequate housing, lack of access to recreational and social activities. Revised 6/1/20

Long Term Care (LTC) Services Long Term Care Access Long Term Care Options Waiver Consumer Service Coordination ( PCA Care Connections) Caregiver Support Program Community Living Options Older Adult Protective ServicesRevised 6/1/20

LTC Subcontracted Services Adult Day Service Home-Delivered Meals Home Support & Home Health Ombudsman Services Personal Care Respite ServicesRevised 3/21/23

PCA STAFF OPPORTUNITESCommittees & Teams Emergency Fund Team Employee Recognition Team Ethics Committee Internal Communications TeamRevised 6/1/20

PCA Committees & Teams (cont’d.) Personnel Committee Recreation Committee Safety & Security Committee Working on Wellness (WOW)Revised 6/1/20

Events At PCACasual Dress Fridays (Free Summer only)Coffee & ConversationEmployee Appreciation DayDepartmental Holiday PartiesSummer Food Giveaways (June-Aug)Revised 6/1/20

The Training Team Lois Hayman-El, Training SpecialistLois.hayman@pcacares.org267-663-4184 Javella Caines-PhillipJavella.caines-phillip@pcacares.org445-264-8820 Tom Shea, Manager of Training & Staff Development Thomas.shea@pcacares.org215-715-7020 (cell)Revised 08/2023

Who is Trained?• LTCO – Long Term Care Options• LTCA – Long Term Care Access • CSP – Caregiver Support Program• CLO – Community Living Options• OAPS – Older Adult Protective Services• PCA Care Connections• Other PCA StaffRevised 11/2022

How We Train Interactive presentations Encouraging participation Raising questions Emphasizing the importance of integrating content and experience Field observations to see classroom learning in actionRevised 6/1/20

Who are the Trainers Vincent Gallagher, PCA Network AdministratorConnie Jones, Geriatric Nurse Practitioner /ConsultantNancy A. Morrow, PhD Assist. Director Field Education Bryn Mawr Graduate School of Social Work and Social Research/ Consultant Dan Eaton/ Hannah Mogaka –Basic and Advanced IT TrainingMary Ann Sheehan, Geriatric Nurse Practitioner/ ConsultantPCA’s Training TeamRevised 6/1/23

ELEMENTS OF LTC TRAININGUnderstanding Your RoleConducting a Person-Centered/Strengths-Based Motivational InterviewCultural Competence in Person-Centered ServicParticipant Health Issues and ConcernsFED (Functional Eligibility Determination), NAT(Needs Assessment Tool), NAT-E, Inter RAI, RON, &PS Invest Care Planning and Documentation Departmental Operations and Field ObservationsRevised 6/1/20

What makes training successful?o Training is an essential part of your work.o Be on time.o Approach field time in the same manner as classroom instruction.o Give trainers attention and respect.o Satisfactory performance on competency-based tests.Revised 6/1/20

Time Commitment During Initial Training Period Department Time: 8:30 am - 9:00 am Training Time: 9:00 am - 4:00 pm Department Time: 4:00 pm - 4:30 pm If session ends earlier than scheduled, return to your department.Revised 6/1/20

IMPORTANT NOTE If a trainer has not arrived within 10 minutes of the start time, please contact: Lois Hayman-El: ext. 5066Cell: 267-663-4184Javella Caines-Phillip ext. 5958 Cell: 445-264-8820Or Tom Shea: text. 5065 Cell #: 215-715-7020It is important that you speak with a person. Please do not leave a message. Revised 8/1/2023

Welcome to PCARevised 6/1/20

Understanding Your RolePCA’s Referral Process: Intake/ Assessment/ Service DeliveryNancy A. MorrowTrainer/Consultant in AgingAdjunct FacultyUniversity of Pennsylvania School of Social Policy and Practice1Revised 9/2013

IntakeAssessmentCare PlanningFollow Up/MonitoringReassessmentTerminationComponent Parts of Care Management/Service Coordination2Revised 9/2013

Functions of Intake (Engagement) Screening Develop an understanding of the context of the contact Information giving or preparation Triage (LTCA, OAPS, senior center, etc.) First contact with the agency!3Revised 9/2013

IntakeAssessmentCare PlanningFollow Up/MonitoringReassessmentTerminationComponent Parts of Care Management/Service Coordination4Revised 9/2013

IntakeAssessmentCare PlanningFollow Up/MonitoringReassessmentTerminationComponent Parts of Care Management/Service Coordination5Revised 9/2013

AssessmentThe collection of in-depth information about a person’s situation, skills, abilities, preferences, and functioning which allows identification of the person’s strengths, interests, goals, problems, and care needs in all the major functional areas.6Revised 9/2013

Principles of Assessment The assessment is the foundation on which all other care/service coordination is based. Core to assessment is the face-to-face interview - use active and passive techniques. Assessment takes a functional perspective - focus is on consumer’s current level of functioning. The assessment is comprehensive - not limited to the presenting problem or one domain but covers all major functional areas. Use a standardized assessment form (electronic). Must maintain confidentiality of client information! Only shared information with those who have a “need to know” in order to serve the consumer.7Revised 9/2013

IntakeAssessmentCare PlanningFollow Up/MonitoringReassessmentTerminationComponent Parts of Care Management/Service Coordination8Revised 9/2013

Service Coordinators & Investigators Conduct person-centered assessments/investigations of a participant’s strengths, needs, preferences, supports and desired outcomes. Develop service plans with participants to design a plan of care that enables them to meet their goals.Revised 9/20139

Service Delivery Follow Up: The contact among service providers (formal and informal), consumer, and service coordinator to confirm that service delivery has begun or is scheduled to begin as planned (done within 2 weeks of service implementation)Monitoring: The continuing contacts the service coordinator has with consumers & providers to ensure that services are being provided in accordance with the care plan and to determine if the services continue to meet the consumer’s needs.10Revised 9/2013

Assessors, Investigators, and Service Coordinators To assure the quality of service for consumers/participants the LTC workers make referrals. They provide information to help participants choose qualified providers.  Investigators and Service Coordinators make arrangements to assure providers follow the service plan. Remediation supports participants in resolving problems when something goes wrong as well as anticipate the potential problems.Revised 9/201311

Strengths-Based Approach: Principles to Guide Intervention The focus is on individual strengths and capacities rather than illness and deficits The worker - consumer relationship is primary and essential The preferred mode of intervention is assertive outreach to informal services Interventions are based on mutual collaboration and empowerment with the consumer taking an active role in the planning process12Revised 9/2013

Critical Factors Risk Factors Protective Factors Generative Factors13Revised 9/2013

Strengths-Based ApproachTraditional Problem SolvingEngagement IntakeStrengths assessment Assessment of needs/problem identificationPlanning & implementation(framing solutions)Goal setting & planning(care plan development)Collective & continuous collaborationEvaluation / monitoringAdvocacyGraduated disengagement Reassessment/Termination14Revised 9/2013

Assessors and service coordinators assist consumers by: Engaging with consumer and build a trusting relationship Determining consumer’s strengths/assets & needs Problem solving with consumer and family Linking to services Providing support Coordinating with other professionals Working with families Providing crisis intervention and on-going assistance15Revised 9/2013

Assessment Instruments: FED – Functional Eligibility Determination Inter- RAI – Service Coordinator Tool PS Invest- OAPS Investigative Too16Revised 6/2020

Service Coordinator Supervisors Audit Service Coordinator Performance and Outcomes Finalize and Follow-Up on Reported Incidents Monitor Compliance with Requirements and CaseloadRevised 9/201317

Important Practice Principles in LTC: Promote maximum functioning Provide care in least restrictive environment  Use the least intrusive intervention Respect the consumer's dignity  Respect cultural differences18Revised 9/2013

Important Practice Principles in LTC Set individualized, appropriate goals Work with a systems perspective Focus on improving quality of life Consumer Choice Strengths-Based Approach19Revised 9/2013

CMS HCBS Waiver Assurances Level of Care ISP Qualified Providers Health and Welfare Your Rights As A Participant Financial Accountability Administrative AuthorityRevised 9/201320

SAFETY IN THE OFFICE ANDIN THE FIELD

Your workspace and personal items You have been provided a key for your desk, laptop and your desk drawers. Know and follow current PCA guidelines for social interactions inside and outside the office (masks, social distancing, etc.). If issued to you, you are responsible for your PCA cell phone and iPad.  Please inform your Supervisor right away of any issues with these items.

General Agency Tips AED (Automated Electronic Defibrillator)  There is an AED located on each floor. CPR with AED classes are offered monthly (except January & February). Fire ExtinguishersLocated in all departments  Incident ReportsEforms >HR Forms >HR PCA Incident ReportOne should be completed any time an incident occurs – in or out of the office

General Agency Tips (cont.) What to do in case of a lost ID card Report to the Human Resources Dept.(5th floor) Locked doors and the entrance of unknown persons If you do not recognize an individual looking to enter a department, please ask to see their ID. If they cannot show you a PCA ID or they admit they do not work here, direct them to the receptionist on the 5th floor.

Emergency Building Evacuation If the fire alarm sounds, GET OUT… always assume it is NOT a drill, and exit the building. Locate yourself with your department (see next slide). Do not return to the building until (the Safety Committee Rep) or your Supervisor give you the “go ahead.” Need for assistance in case of an emergency? Tell your Supervisor.

WALLACE BUILDING EMERGENCY MEETING LOCATIONSMELON STREET8 ● 13 ● 14  7  15thST.8516PARKINGLOT7311126TRIAGE1BROADST.1015 2 4PCA ENTRANCE640 LOFTSCOMMANDCENTER(Sr. AdminStaff)SAFETY&SECURITYCOMMITTEE9EmergencyEvacuation Meeting Locations1. ADMINISTRATION2. INFORMATION TECHNOLOGY (IT)3. CAREGIVER SUPPORT PROGRAM (CSP)4. FISCAL5. HOUSING6. HUMAN RESOURCES/TRAINING7. LONG TERM CARE ACCESS (LTCA)8. LONG TERM CARE OPTIONS (LTCO) AND PCA CARE CONNECTIONS (PCACC)9. COMMUNITY LIVING OPTIONS (CLO)10. PLANNING/COMMUNICATIONS11. BUSINESS ADMINISTRATION12. COMMUNITYT ENGAGEMENT13. OLDER ADULT PROTECTIVE SVS. (OAPS)14. HELPLINE15. COMMUNITY RELATIONS16. LONG TERM CARE ADMIN

Avoiding Infestations in Departments Careful preparation for field visits can minimize the possibility of bringing pests back to the office. If you make a confirmation call prior to your visit, ask the participant about pets or infestations. Even if the participant tells you there are no bugs, prepare as if there could be: Avoid sitting on couches, beds or stuffed chairs Wear light-colored clothes, shoes and socks so insects are more easily seen. Only take necessary items into the home – keep handbags or briefcases on your lap – not on the floor. Pay attention to the inside and outside of shoes, socks, pant legs and around hands and arms.

Avoiding Infestations in Departments - 2 Keep the following items in your car:Spray bottle with 70% alcohol solutionDisposable plastic bagsA change of clothes and shoes As soon as possible, remove infested clothes on a hard floor and put them in the disposable plastic bag. Wash clothes in hot soapy water and dry in the dryer at the highest setting for at least 15 minutes. If you have been exposed, contact your supervisor immediately. They will refer you to the nearest worker’s comp site for examination and treatment. You will also need to complete a PCA incident report.

Visit Preparation Prepare the client and structure the visit schedule and parameters (OAPS is the exception). Call ahead to confirm, and inform participant/family/facility staff of the itinerary, always arriving and leaving on time Observe your home department’s begin and end of day safety call in procedures. Observe your home department’s change in normal schedule procedures. Family pets should be restrained, and it is advisable to make this request beforehand.

Visit management Visits should be conducted during the hours that are the safest for that neighborhood, generally daylight hours (between 9am – 5pm). Choose appropriate attire.  “Home visit” clothing and shoes allow for mobility and do not attract undue attention.  Use reliable transportation.  Emergency items should be available in the car: water, blanket, emergency flashers, can of tire sealant, flashlight, jumper cables, shovel and scraper for snow.

Visit management - 2 Know the travel route and avoid being rushed.  Avoid the look of “being lost.” Choose a parking space that allows the best access. Carry keys in a pocket or hand at all times. Allow sufficient time for travel. Circling the area ONCE to observe before leaving the car is often advisable. Use technology and equipment that enhance safety.  Proper use of your cell phone can enhance safety.

Visit management - 3 Observe carefully before entering a home.  Step back from the door of the client’s home after knocking, and observe carefully before entering. Linger on the doorstep a moment to assess. If something seems amiss, do not enter. Remain alert and observe carefully.  Upon entering the home, remain alert and use sharp observational skills, making an immediate visual assessment of the environment. Listen for others approaching, for shouting, and observe body language. Know where the exits are.

Visit management - 4 Conduct yourself in a confident, courteous, and assertive manner.  Your conduct should never be aggressive. In line with the Code of Ethics, it is important to respect the dignity and worth of the client and conduct oneself in a manner that displays that respect. Show respect for clients and their “turf.”  No matter the intent of the visit, the worker is always in someone else’s home - on someone else’s turf. Using basic “guest techniques” - be respectful, and courteous, clearly explain the purpose of the visit, and maintain boundaries and limits.

Visit management - 5 Presence of exposed weapons (guns, knives, etc).  Ask Participant politely to stow the weapon in a separate spot. If they won’t do this, you need to excuse yourself and leave – consult your Supervisor. Drug transactions or associated violence.  If there are groups of people on the corner or anything in the home that appears to be associated with illegal or unsafe activity – excuse yourself and leave – consult your Supervisor. Dangerous or volatile behavior.  If there is behavior that is unsafe or disrupts the purpose of the visit – excuse yourself and leave – consult your Supervisor.

Visit management - 6 Unsafe building or structure. Consult with Supervisor – get to a safe spot. Presence of aggressive or uncontrolled animal(s) Ask Consumer politely if the animal(s) can be kept in another area during assessment – if they cannot keep your area safe, you need to excuse yourself and leave – consult Supervisor.Assessments or Home Visits can always be rescheduled – so make the safest choice for your personal safety.