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Advisory Council April 2019 Meeting Presentation: Person-Centered Thinking

Monday, April 29, 2019

Printer Friendly Version in PDF Format (12 PDF pages)


Person-Centered Thinking, Planning, and Practice

Shawn Terrell, ACL


  • Person (and Family)-Centered Thinking, Planning, Practice
  • NCAPPS Overview and Components
  • National Quality Forum: Person-Centered Planning

Person Centered Thinking, Planning, and Practice is the foundation of HCBS

What is person-centered thinking, planning, and practice?

  • Person-centered thinking
    • A foundational principle requiring consistency in language, values, and actions
    • The person and their loved ones are experts in their own lives
    • Equal emphasis on quality of life, well-being, and informed choice
  • Person-centered planning
    • A methodology that identifies and addresses the preferences and interests for a desired life and the supports (paid and unpaid) to achieve it
    • Directed by the person, supported by others selected by the person
  • Person-centered practices
    • Alignment of services and systems to ensure the person has access to the full benefits of community living
    • Service delivery that facilitates the achievement of the person's desired outcomes

Interactions: Person-Centered Planning, Assessments, Service Authorizations, Forms/Tools

  • Distinct functions that are often conflated in practice
    • Person centered planning: driven by the person and reflects his/her perspective and preferences
    • Assessments: judgments made by professionals (e.g. diagnosis, functioning, service needs)
    • Service Authorizations: the final determination of what services are provided for what purpose
    • Form/Tools: Implemented effectively by those with the skills and knowledge to use them.

Current State of Practice

  • Several states have committed, ongoing emphasis on person-centered planning in part or all of their HCBS programs.
  • Most states have very small commitments
  • Large state demand for technical assistance
  • No consensus on practice standards or systems design requirements
  • Little end user awareness of what to expect
  • Little research on best practices, KSAs, systems design.

Status Quo Prevails

  • People are often left with someone else's plan:
    • Doing things they don't want to do
    • With people they don't want to be with
    • In places they don't want to be

ACL Vision for Person-Centered Systems

  • People know what to expect
  • Competent planning facilitation
  • Systems deliver services and supports in a manner consistent with person-centered values
  • Quality measures are developed and implemented for process fidelity, experience, and outcomes based on each person's preferences and goals.
  • Principles of continuous learning are applied throughout the system.
  • Formalized and ongoing partnerships with people with disabilities and older adults in designing and implementing person-centered thinking, planning, and practices in systems.

Addressing the Challenges

  • National Center on Advancing Person-Centered Systems and Practices
  • National Quality Forum: Person-Centered Planning Project


The National Center on Advancing Person-Centered Practices and Systems

NCAPPS Goals and Priorities

  • NCAPPS Goal: Promote systems change that makes person-centered principles not just an aspiration but a reality in the lives of people across the lifespan
  • Key Priorities:
    • Participant and family engagement
    • Cultural and linguistic competence
    • Cross-system collaboration

...transforming how we think, plan, and practice

NCAPPS is for...

  • States, Tribes, and Territories
    • Systems for people with disabilities and older adults with long-term service and support needs, including
      • Brain injury
      • Intellectual and developmental disabilities
      • Aging and disability
      • Behavioral health

Person-Centered Advisory and Leadership Group (PAL-Group)

  • Majority are people with direct lived experience of navigating HCBS systems
  • Building membership now with strong focus on diversity of perspectives, experiences, and backgrounds
  • Promotes and actualizes participant engagement in all NCAPPS components and activities
  • Meets twice per year with additional ad hoc meetings and communications
  • As subject matter experts, members will contribute to webinars, resource development

National Organization Partners

  • National Association of State Head Injury Administrators (NASHIA)
  • National Association of States United for Aging and Disabilities (NASUAD)
  • National Association of State Directors of Developmental Disabilities Services (NASDDDS)
  • National Association of State Mental Health Program Directors (NASMHPD)
  • National Association of County Behavioral Health and Developmental Disabilities Directors (NACBHDD)
  • National Association of Medicaid Directors (NAMD)

NCAPPS Website

Screen shot of NCAPPS Home Page
Our Website:

NCAPPS Resources

  • Resources on
    • Education and Awareness
    • Technical Assistance and Training
    • Policy and Research
    • Quality and Service Delivery
  • Resources such as
    • published articles and reports
    • practical tools and frameworks
    • recorded webinars and slides
    • validated scales and measures
    • person-centered planning resources
    • links to partner orgs and related initiatives
    • federal guidance on person-centered thinking, planning, and practice

NCAPPS Webinars

  • Delivered by national experts
  • Coordinated and hosted by HSRI
  • Free and open to the public
  • Topics derived from technical assistance, Learning Collaboratives, and priorities identified by the PAL-Group

Listserv and Communications

  • Central mailing list to share NCAPPS news and resources
  • Subscribe by sending an email to
  • Working on developing a social media presence

Technical Assistance

  • Goal: Support systems change efforts so the participant and family are at the center of thinking, planning, and practice
  • 15 States, Tribes, or Territories each year
  • Up to 100 hours per year for three years
  • Delivered by national experts based on a detailed technical assistance plan

Learning Collaboratives

  • Goal: Promote peer-to-peer learning
  • Structured group work
  • Topic-specific, for example
    • Expanding expectations of person-centered practices through participant and family engagement
    • Cultural and linguistic considerations
    • Aligning financing to support delivery of person-centered supports
  • Membership open to technical assistance recipients and other system stakeholders with expressed interest


National Quality Forum: Person-Centered Planning and Practice project


Background: 2014-2016 NQF HCBS Quality Project

  • HHS awarded a Task Order to NQF to convene a multi-stakeholder Committee
    • Identify HCBS measurement gaps
    • Prioritize measurement opportunities
  • The final report identified 11 domains for measure development, including person-centered planning and practice.

NQF Person-Centered Planning Project

  • Refine the current definition(s) for PCP;
  • Develop a set of core competencies for performing PCP facilitation;
  • Make recommendations to HHS on systems characteristics that support person-centered thinking, planning, and practice;
  • Develop a conceptual framework for PCP measurement; and
  • Conduct an environmental scan including the historical development of person-centered planning in LTSS systems to include a research agenda for future PCP research
  • 25 person multistakeholder committee
  • 8 web meetings starting May 2019 through June 2020