Transcription
The National Center onAdvancing Person-CenteredPractices and SystemsBevin Croft, MPP, PhD, NCAPPS Co-DirectorSeptember 5, 2019
NCAPPS OVERVIEW2
The goal of NCAPPSis to promotesystems change thatmakes personcentered principlesnot just anaspiration but areality in the lives ofpeople across thelifespan.“3
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 choicePerson-centered planning A methodology that identifies and addresses the preferences and interests fora desired life and the supports (paid and unpaid) to achieve it Directed by the person, supported by others selected by the personPerson-centered practices Alignment of services and systems to ensure the person has access to the fullbenefits of community living Service delivery that facilitates the achievement of the person’s desiredoutcomes
NCAPPS Leadership TeamAdministration for Community Living(ACL): Shawn Terrell Serena Lowe Thom Campbell Dana Fink Joseph LugoCenters for Medicare & Medicaid Services(CMS) Amanda Hill Melissa HarrisHuman Services Research Institute (HSRI): Co-Directors - Alixe Bonardi and BevinCroft PAL-Group Coordinator – Nicole LeBlanc Project Coordinator – Miso Kwak TA Leads - Yoshi Kardell, Jami Petner-Arrey,Teresita Camacho-Gonsalves, AlenaVasquez5
National Organization Partners National Association of State Head InjuryAdministrators (NASHIA) National Association of States United forAging and Disabilities (NASUAD) National Association of State Directors ofDevelopmental Disabilities Services(NASDDDS) National Association of State MentalHealth Program Directors (NASMHPD) National Association of County BehavioralHealth and Developmental DisabilitiesDirectors (NACBHDD) National Association of Medicaid Directors(NAMD)6
Subject Matter Experts Georgetown National Center forCultural Competence Collective Insight Support Development Associates Pioneer Network University of Missouri Kansas CityInstitute for Human Development Live & Learn, Inc. Independent Living ResearchUtilization and the National Centerfor Aging and Disability Suzanne Crisp Eden Alternative Joe Caldwell, PhD Mark Friedman, PhD Mission Analytics Janis Tondora, PsyD Applied Self Direction and others7
Person-Centered Advisory and LeadershipGroup (PAL-Group) Majority are people with direct lived experience of navigatingHCBS systems Membership built with a strong focus on diversity ofperspectives, experiences, and backgrounds Promotes and actualizes participant engagement in all NCAPPScomponents and activities Meets twice a year, plus additional ad hoc meetings andcommunications As subject matter experts, members will contribute towebinars, resource development8
“To be person-centered means tofunction in a way that creates aculture where staff and providerspresume competence, have highexpectations and embrace thedignity of risk. Learning to “Let Go”is one thing we must strive for as asystem. By doing this it will supportpeople with disabilities to live theDREAM and experience life to thefullest.Nicole LeBlanc – PAL-Group Coordinator9
Our Websitencapps.acl.gov10
NCAPPS Webinars Delivered by national expertsand people with livedexperience Coordinated and hosted by HSRI Free and open to the public Topics derived from technicalassistance and prioritiesidentified by the PAL-Group All webinars recorded andarchived on our websitencapps.acl.govJuly 2019 WebinarPieces of the Same Puzzle: The Role of Culture inPerson-Centered Thinking, Planning, and PracticeAugust 2019 Webinar:Considering Brain Injury: Why Being Brain Injury–Informed Is a Critical Component of PersonCentered Thinking, Planning, and PracticeSeptember Webinar: Microboards 101: AnIntroduction to a Person-Centered Solution OfferingFull Accountability, Active Community Support, andLifelong Continuity of CareMonday, September 16th, 2:00pm to 3:30pm EasternTo register, visit:https://zoom.us/webinar/register/WN qXFYpdO4R3i NgA6umB6 g11
Learning CollaborativesGoal: Promote peer-to-peer learning toaccelerate improvement efforts Structured group work with support fromsubject matter experts 12-24 months duration, depending on topicand improvement framework Membership open to technical assistancerecipients and other system stakeholders withexpressed interest12
Learning Collaborative Topics Person-Centered Thinking, Planning, and Practice for People withBrain Injury [FALL 2019] Beyond Compliance: Enhancing Person-Centered Thinking, Planning,and Practice in Alignment with the HCBS Final Rule [SPRING 2020] Tribal Adaptations to Person-Centered Thinking, Planning, andPractice [FALL 2020] In the Driver’s Seat: Realizing the Promise of Self-Direction [TBD] Amplifying the Voice of Lived Experience in Human Service Systems[TBD]13
NCAPPS Technical Assistance OverviewGoal: Support systemschange efforts so theparticipant and family areat the center of thinking,planning, and practice Available to up to 15 States,Tribes, or Territories each year Up to 100 hours per year forthree years Delivered by national expertsbased on a detailed technicalassistance plan14
Technical Assistance ExpectationsWith 123Develop concretegoals and objectivesbased on one or moretechnical assistancedomains (practice,policy, payment,participantengagement)Create an evaluationplan for collecting,analyzing, andreporting whetherand how eachtechnical assistancegoal will be metEstablish strategiesfor meaningfulparticipant andfamily engagement inthe technicalassistance processand all systemschange efforts15
Selected States and Lead iiIdahoKentuckyMontanaNorth DakotaOhioOregonPennsylvaniaTexasUtahVirginiaLead AgencyAlabama Department of Mental Health (DMH)Colorado Department of Health Care Policy and Financing (HCPF)Connecticut Department of Rehabilitation Services (DORS) State Unit on AgingGeorgia Department of Human Services (DHS) Division of Aging Services (DAS)Hawaii Department of Human Services (DHS) Med-QUEST DivisionIdaho Department of Health and Welfare, Division of MedicaidKentucky Department for Aging and Independent Living (DAIL)Montana Department of Public Health and Human Services (DPHHS) Senior and Long Term CareNorth Dakota Department of Human Services (DHS)Ohio Department of Medicaid (ODM)Oregon Department of Human Services (DHS) Aging and People with Disabilities (APD)Pennsylvania Department of Aging (DOA) Aging and Disability Resource OfficeMedicaid and CHIP/ Policy and Program Development/ Texas Health and Human ServicesUtah Division of Services for People with Disabilities (DSPD)Virginia Department for Aging and Rehabilitative Services (DARS)16
UTAH’S TA GOALS AND CURRENT OBJECTIVES
Goal 1: By March 31, 2020, DSPD will identify and test twospecific strategies to support greater levels of self-advocate,service user, and family engagement.1. Map existing engagement strategies already inplace and their strengths and opportunities forimprovement (e.g., existing vs. intended targetgroups, focus, frequency, accommodations,feedback loop).Identify and secure engagementwith all relevant stakeholders, including serviceusers and families2. Using the Asset Map, identify two newengagement strategies to test.18
Goal 2: By September 30, 2019, DSPD will create a draftCommunications Strategy that outlines a plan for increasingstakeholder buy-in and awareness of person-centeredthinking, planning, and practice.1. Draft a Communications Strategy for increasingstakeholder buy-in and awareness of personcentered practice. The CommunicationsStrategy will detail regular and ongoingcommunications with service users and familiesand providers, identify multiple methods ofcommunication, and strategies for measuringthe effectiveness of the communicationsstrategy so that it can be refined over time.19
Goal 3: By September 30, 2020, ensure that person-centeredthinking and planning are translated into practice throughrevised Person-Centered Support Planning standards andprocedures.1. Develop an outline for a user manual of thePCSP process.2. Identify a suite of potential person-centeredplanning tools (including pre-planning tools) tobe used in the PCSP process.3. Create a draft protocol for integrating the useof those tools into the PCSP process andelectronic health record.20
Jenny Turner, LCSW Sibling of two sisters, one who is in her30s with a disability Licensed as a Clinical Social Worker Formerly a Support Coordinator andDirector of a Provider Agency Senior Research Associate, UMKCInstitute for Human Development
Universityof KansasWhatis aCity Institute for orates on a widevarietyPractice?of appliedresearch projects todevelop, implement,and evaluate new ideasand promising practicesthat support healthy,inclusive communities.
ExchangeBuild Access to Resources andTools Innovate and Enhance Training Research Technical Assistance DevelopCollaborate Network andConnect Share Learning Share Stories
Services and Supports are EvolvingEveryone existswithin the contextof family andcommunityTraditionalDisability ServicesIntegrated Servicesand Supports withincontext of person,family andcommunity
Joining Forces for a New Vision1950s Mom------------Parent-----Family Movement1970s Self-Advocacy and Independent LivingMovements (Nothing about me, without me!)2000s Siblings Movement1960s Medicaid and Medicare Established1980s Medicaid Waiver (Community Supports)2010s Affordable Care Act1970s Rehab Act: 504 Plans1975s Education for All Children1990s IDEA and ADA2000’s Community and Society
Current Reality of Services and SupportsDemand for ServicesExpectations,Values, CultureFederal Budget
What is aThe significantCommunitproblems we facey ofcan not be solvedPractice?at the samelevelof thinking wewere at when wecreated them.Albert Einstein
Type of Change that is NeededTransitional Change “Retooling” the system andits practices to fit the newmodel Mergers, consolidations,reorganizations, revisingsystematic paymentstructures, Creating new services,processes, systems andproducts to replace thetraditional oneTransformation Change Fundamental reorderingof thinking, beliefs,culture, relationships, andbehavior Turns assumptions insideout and disrupts familiarrituals and structures Rejects command andcontrol relationships infavor of co-creativepartnershipsCreating Blue Space, Hanns Meissner, 2013
Goal of theWhatisaNational CoPCommunitTo build capacity, through aofcommunity of ypractice,across and within StatesPractice?to create policies,practicesand systemsto better assist and supportfamilies that include amember with an intellectualand developmental disabilityacross the lifespan.
Evolution of CtLC Framework2010MissouriUCEDD andMo Family toFamily2011NationalAgenda onSupportingFamilies(Wingspread)Supporting FamiliesLifeCourse PrinciplesCharting the LifeCourseFramework and Tools2012NationalCommunity ofPracticeon SupportingFamilies
Application of Charting the LifeCourseGuiding FrameworkGuides thinking and problem-solvingPracticesSpecific Area(action, policy, procedure)to enhance or changeToolsEducational ResourcesPlanning & Problem-solvingWorksheets
Thinking That Guides the Framework
Core Belief:All people and theirfamilies have the right tolive, love, work, playand pursue their lifeaspirations in theircommunity.33
National “All People” withID/DD100%4.7 Millionpeople withdevelopmentaldisabilities75%25%National %Receiving StateDD Services** Based on national definition of developmental disability with a prevalence rate of 1.49%
Where do People with ID/DD Live?4.7 million estimated People with Developmental Disabilities*75%3,500,00012%672,00011%528,000Out of HomeServicesLiving atHomeNot Known toServicesLarson, S.A., Eschenbacher, H.J., Anderson, L.L., Taylor, B., Pengell, S., Hewitt , A., Sowers, M., &Bourne, M.L. (2017). In-Home and Residential Long-Term Supports and Services for Persons withIntellectual or Developmental Disabilities: Status and trends through 2015. Minneapolis: University ofMinnesota, Research and Training Center on Community Living, Institute on Community Integration.
All IndividualsExist in theContext ofFamily Family is definedWhatbyistheaindividualCommunit Individuals andytheiroffamily may needPractice?supports thatadjust asroles and needs of allmembers change Not dependent uponwhere the person lives
All People Exist Within the Contextof Family and CommunityAffection & Self-EsteemCaringAboutRepository of knowledgeLifetime commitmentProvider of day-to-day careCaringForMaterial/FinancialFacilitator of inclusion & membershipAdvocate for support*Adapted from Bigby & Fyffe (2012), Dally (1988), Turnbull et all (2011)
Good Life for ALLIndividuals will achieve self-determination,interdependence, productivity, integration,and inclusion in all facets of community lifeFamilies will be supported in ways thatmaximize their capacity, strengths, andunique abilities to best nurture, love, andsupport all individual members to achievetheir goals
What is aCommunity ofPractice?What I Want forQuality of LIFEVision of aGood LifeThe future is not somethingwe enter. The future issomething that we create.And creating that futurerequires us to make choicesand decisions that begin witha dream
What is aCommunity ofVisionPractice?of WhatVision of aGood LifeI Don’t Want
Trajectory Towards a Good LifeFriends, family,enough money,job I like, home,faith, vacations,health, choice,freedomVision of What I Don’t Want
Trajectory Towards a Good LifeChores andallowanceSummer jobs,Learning to say “no” babysittingMaking MistakesPlaying sports or an instrumentMy parents havepassed away,what do I do?Birthday parties with friendsScouts, 4H, faith groupsParentsTurn 65Medicare arlyChildhood/enter schoolTurning 18.Leavingschool at18 or 21LivingAdult Life
AnticipatoryGuidance & LifeExperiences
Integrated Life DomainsDaily Life and EmploymentHealthy Living(school/education, employment,volunteering, routines, life skills)(medical, behavioral, nutrition, wellness,affordable care)Community LivingSafety and Security(housing, living options, homeadaptations and modifications,community access, transportation)Social and Spirituality(friends, relationships, leisure activities,personal networks, faith community)(emergencies, well-being, legal rightsand issues, guardianship options andalternatives )Citizenship and Advocacy(valued roles, making choices, settinggoals, responsibility, leadership, peersupport)
IntegratedLife Domains
Three Types of SupportDiscovery&Navigation(Info andTraining)Connecting &Networking(Talking tosomeone thathas been there)Goods &Services(Day to Day,Medical,FinancialSupports)
Three Types of Support
IntegratedServices andSupportsMore than“NaturalSupportsandFormal, paiddevelopmentaldisability servicesand supports
Integrated Support Star
IntegratedSupports andServices
Integrated SupportCheat Sheets
BEFORE: Services and SupportsMom, DadBen’sServices &SupportsDDD Self-Directedwaiver PCA staff;Medicaid; SpecialNeeds Trust
AFTER: Services and SupportsAble to stay home alone forup to an hour; has &can use i-pad;i-pad whenhome alone;digital watchMom, Dad, Matt,Zac, Ali, Chad,Ericka, Roy,Ben’sCarol, Nick,Services &Spohn,SupportsFiremen at ESFD;coaches & staff at EShigh school; Omnibus;DDD Self-Directedwaiver PCA staff;Medicaid; SpecialNeeds Trust
Ben’s Life ActivitiesCan stay home alonefor up to one hourI-pad towatch WWEnetworkand musicvideos;facebookBen’s LifeActivitiesFire Station, Wal-Mart,movies, bowling, Sonic,Price Chopper, Church,High School, IHDMom, Dad, Matt,Zac & Ali; firemenfriends; Nick,Spohn, Mike,Ange, Chad, Ericka& twinsPaid staff thru SD waiverhelp with activities,ADL’s & accesscommunity; therapeuticriding
GoalAttainment
Balancing Human and System NeedsHuman Needs of Person and their FamilyTouchpoints between Person/Family and LTSSFront DoorInteractionIntake &AssessmentPerson CenteredPlan ProcessAccessingSupportsDeliveringServicesCheck-In &MonitoringSystem Requirements (Federal, State, Organizational)AnnualMeeting
Putting the Frameworkinto Action
Meet Mike About Mike 16-year-old young man who lives with parents and an older brother Attends XYZ high school and attends most general education classes (with the help of class withina class in several classes and one hour in the special education life skills classroom daily) Very social and loves being around his friends and classmates.Interests: Mike likes anything and everything sports, especially enjoys football, baseball and basketball. Football and basketball manager for his middle school and high school teams. Wishes he could play on the HS sports teams but he doesn’t have the skill level or enduranceneeded.Health: Mike gets tired if he is on his feet for too long, and does best when he can sit down frequently His mom says she doesn’t know if he has the endurance to work an 8-hour day. He has cerebral palsy and intellectual/developmental disabilityEmployment: When asked what kind of job he is interested in, he says he hopes he can someday work at Royalsstadium. His mom reports he gets excited watching the Royals grounds crew before and duringgames Mike’s parents would love to see him employed as an adult, but they have no ideas about what ispossible or what kind of a job would suit MikeMeet Mike
DiscoveringWho Adapted from The LearningCommunity for Person CenteredPractices and Helen SandersonAssociates to learn templates/ List positivestrengths, talentsand qualities. Ask family orothers who knowyou well for input People, places &things importantto you. Hobbies,possessions,rituals, routines,family culture. What do youvalue most?. Specific kinds of support that are helpful,and what is not. Support you need to create the bestenvironment and outcomes in your life. What is your preferred learningstyle? What keeps you motivated? How are you best encouraged?
1. DescribeMike’s vision foroverall “GoodLife”2. Then listwhat is notwanted
3. Current age4. Past lifeexperiences(positive ornegative impacton trajectory)5. Lifeexperiencesmoving forwardto try or avoid
DiscoveringHowresources, skills, abilitiescharacteristicsi-pad/smart phoneapps, remotemonitoring, cognitiveaccessibility,Adaptiveequipmentschool, businesses, church faithbased, parks & rec, publictransportationfamily, friends,neighbors, coworkers, churchmembers, communitymembersSHS services, Special Ed,Medicaid, Voc Rehab, FoodStamps, Section 8
DiscoveringWho Social andfriendly Helpful andenthusiastic Family andfriends Sports!Our Responses Make sure I am connected with friends andpeers I need to sit or be able to take frequentbreaks
DiscoveringHow SocialKnowledgeableabout sports Experience as team manager Need to find out more information ParentsBrotherTeachersCoachesClassmatesMike XYZ HighSchool Sportsteams/events Life SkillsclassClasswithinclass
Tips andTricks You don’t have to FILL THE PORTFOLIOOUT in front of person/family The Portfolio doesn’t have to becompleted in order - from front to backif it doesn’t make sense for a particularperson or circumstance (find what worksbest for your style and the person youare working with) Could use Portfolio to take notes as youhave a conversation Don’t have to “fill out” the entireportfolio – do what makes sense Sometimes you just use the frameworkto have conversations Could give it (in person or send ahead oftime) to the person/family and ask themto look it over and get back with you todiscuss
Using CtLC to Implement andMonitor Goals/Objectives
GoalAttainmentPlanning andTracking Success
Achieving our Goals Define expected success (3 stars) for a healthy living goal Describe what exceeding success (4 or 5 stars) and minimumsuccess (1 or 2 stars) looks like Explore strategies and supports for success Reflect on what’s working/barriers to success in meetinggoals
Goal AttainmentTool Step 1: Decide on aGoal Step 2: Define whatSuccess looks like Step 3: Define Strategies tothat will help you reach thegoal Step 4: Describe the IntegratedSupports who can help youpractice the strategies
Mike’s GoalAttainment SheetStep 1: Decide on a GoalGoals are part of ourVision for a Good LifeGOAL: Mike will gain work experience in a sports relatedfield
Mike’s Definitionof SuccessStep 2: Define Success Sometimes, success meansthat we have reached ourgoal what would that looklike? Sometimes, success meansthat we are actively workingon our goal what would thatlook like?Success means doing thingsthat will help me reach my goal.Mike will gain work experience in asports related fieldMike will have1 or more paidworkexperiencesMike willvolunteer in 3settingsMike willshadow atleast 1 setting
Mike’s Strategies How will you be successful? What can you do? When will you do it? Where will you do it? How often will you do it? Who can help you? What do you need to do?Success means doing thingsthat will help me reach my goal.
IdentifySupportsWhat supportscan be leveragedfor actionstrategies?Using Integrated Supports helps me todo things that make me successful. SocialKnowledgeableabout sports Experience as team manager Need to find out more information ParentsBrotherTeachersCoachesClassmatesMike XYZ HighSchool Sportsteams/events Life SkillsclassClasswithinclass
IdentifySupportsWhat supportscan be leveragedfor actionstrategies?Using Integrated Supports helps me todo things that make me successful.
TrackingSuccess
Comprehensive, Integrated &Coordinated Across All Life Domains andStagesPediatrician, Families and Friends,Faith basedIDEA Part C, Parents as Teachers,Health, HeadstartSchool, Special Education, Health,RecreationVocational Rehab, Health,Employment, College, MilitaryDisability Services, Health,Housing, College, CareersRetirement, Aging System, Health
Elevating the Voice of All TeamMembersSupporting Person’sSelf-Determination& Self-AdvocacySupportingFamiliesAcross theLifespanSupportingPerson-CenteredPractices
Tools for All Team MembersPlanning for Life Outcomesand/orService PlanningSelf-AdvocateTools & ResourcesFamily PerspectiveToolsFormal PlanningTools and Forms
Vision for aPersonCenteredSystemIn the RIGHTbox write yourvision for DSPD
Vision for aPersonCenteredSystemIn the RIGHT box writewhat you DON’T want forDSPD
ASSET MAPPING AND COMMUNICATIONS STRATEGY86
Communication Plan:Our Guiding Principles (1 of 2) We believe that “least restrictive” setting is the right place for all individuals to live,regardless if one has a disability or not. We believe that individuals and families, once educated, will see the opportunitiesafforded to them through the HCBS Setting Rule. We believe families deserve to be together and to make choices. We believe individuals should be given more opportunities to live, work, andsocialize within the communities they live as a result of our HCHS Setting changes.
Communication Plan:Our Guiding Principles (2 of 2) We understand that many people feel comfortable where they live and want to staythere; our policies and practices needs to respect all informed choices. We understand it is our responsibility to get all stakeholders to the table, informingthem of the HCBS Settings Rule and engaging them in systems change. We believe the HCBS Settings Rule will inform and enhance our existing system ofsupport, leading to enhanced quality of life of those we support.
Communication Plan:Our Short-Term Goals Educate service users, families, self-advocates, advocates, providers, and stateagency partners about the HCBS Settings Rule and the re-design process. Provide concrete strategies for service users, self-advocates, and families to bethe driving force in the redesign process. Support providers to understand the opportunities afforded to them under theHCBS Settings Rule. Provide concrete strategies to support providers to become compliant with theHCBS Settings Rule.
Communication Plan:Some Obstacles to Communication This topic does not impact me I don’t have anything to give to this process I don’t have internet This information is too complicated I need help accessing this information, but you don’t know how to help me
Communication Plan:Our MethodsHow should we communicate with stakeholdersabout the HCBS Settings Rule and Future SystemsChange Needs?
Stakeholder EngagementAsset Mapping Engagement often already happening, but knowledge of what is occurringand who is leading is not known system-wide Asset Mapping allows you to take a ‘snapshot’ of your system andengagement efforts Asset Mapping includes both written and visual displays of your existingstakeholder engagement assets Asset Mapping informs steps required to improve engagement methodswhile also building on the resources already in place
Asset Mapping ProcessDefineyour ScopeClarify yourTargetGroupsDefineyour TermsBrainstormExistingInitiativesSearch forInformationMAP!
Our Asset Mapping FocusWe want to Understand our existing strategies to engage service users,self advocates, family members, and advocates. Focus on individuals who are accessing or would like toaccess home and community-based services throughMedicaid Waivers, including individuals who are living inIntermediate Care Facilities (ICFs).
Our Asset Mapping FocusClarifying our Target GroupsService UsersFamily MembersSelf AdvocatesAdvocates
Sample of our Assets forEngaging Service Users& FamilyCenters forIndependentLivingUtah 2-1-1 What Disability Groupsare Not Well Representedin this Visual? Can you think of otherAssets to add?Disability LawCenterCenter forPeople withDisabilitiesUtah ParentCenterServiceUsers &FamilyMembersDisabilityResourceCenter(s) and Vendors sagesProgramIn Reach(ICFs)Project PEER
Sample of our Assets forEngaging Self AdvocatesEmployAbilityClinic, CPD What Disability Groupsare Not Well Representedin this Visual? Can you think of otherAssets to t andYouth Training,CPDBrain InjuryAssociation y CouncilProject PEERNINJA YouthProgramming
Sample of our Assets forEngaging isabilitiesAdvisoryCouncilBrain InjuryAssociation ofUtah What Disability Groupsare Not Well Representedin this Visual? Can you think of otherAssets to add?Disability RightsActionCommitteeAdvocatesDisability LawCenterCenters forIndependentLivingGovernor'sCommittee onEmployment forPeople withDisabilities
Vision forProvider’sRoleIn the RIGHTbox write whatyou want forproviders
Vision for aPersonCenteredSystemIn the RIGHT box writewhat you DON’T want forproviders
BREAKPlease put your post-its on the AssetMap Papers around the room.
Reflections andQuestions
Aha!Moments What is one thing youcan do in your own lifeor role? What is one thing yourorganization can do? What is one changeyou would like to seeat the system level?
Jennifer “Jenny” Turner, om
Thank you.Stay in touch at https://ncapps.acl.govNCAPPS is funded and led by the Administration for Community Livingand the Centers for Medicare & Medicaid Services and is administeredby HSRI.105
Coordinated and hosted by HSRI Free and open to the public Topics derived from technical assistance and priorities identified by the PAL-Group All webinars recorded and archived on our website ncapps.acl.gov July 2019 Webinar Pieces of the Same Puzzle: The Role of Culture in Person-Centered Thinking, Planning, and Practice August 2019 Webinar: Considering Brain Injury: Why Being .
