Introduction Facilitation and planning with people with developmental disabilities is important and valuable work. This paper is a snapshot of what has been happening with respect to facilitation and planning in the province of Ontario. The information in this paper is based on interviews conducted in August and September 2019 with people and agencies who offer some model of independent and/or quasi- independent facilitation/planning and also with people who had been involved in these types of planning models. It includes a summary of information from interview respondents about process, time commitment, time frame, scope, cost, what the plan document looks like, and methods/tools used. A companion paper, “Suggestions for Implementing Independent & Quasi-Independent Facilitation/Planning in Ontario” contains suggestions for those interested in implementing a more independent approach to facilitation and planning.
Respondents generally spoke positively about the experience, the facilitator/planner (FP), and the impact on the person’s overall life. Whether or not the FP is fully independent or quasi-independent, if done well, the process and outcome have the potential to be more person-directed versus service- directed.
For the purposes of this paper, independent facilitation/planning refers to services offered by someone who is not an employee of the Transfer Payment Agency (TPA) involved in providing direct support to the person. Conversely, quasi-independent facilitation/planning refers to planning done by TPA employees who are not directly involved in providing supports to the person.
At the end, there is a list of the terms and acronyms used in this paper. Also, three documents were used as a reference point to anchor the observed findings:
Person-Directed Planning and Facilitation Guide. (November 2013) Ministry of Community and Social Services https://www.mcss.gov.on.ca/documents/en/mcss/publications/developmental/Person_DirectedPlanning.pdf
Creating a Good Life in Community: A Guide on Person-Directed Planning. (2006) Individualized Funding Coalition https://individualizedfunding.files.wordpress.com/2014/07/a-guide-on-person- directed-planning-english.pdf
A Facilitator’s Guide to Person Directed Planning https://familyservicetoronto.org/wp- content/uploads/2016/03/A_Facilitators_Guide_to_Person_Directed_Planning_6.pdf
Respondent Information For this project, 21 people participated in a semi-structured open-ended phone or face-to-face interview. Respondents included people doing planning and/or facilitation independently (4), people doing planning and/or facilitation as part of a planning organization (3), representatives from developmental service TPAs who offer planning on a fee-for-service basis and/or have a quasi-independent model of planning (9), employees who support people who have had a plan developed by an independent or quasi-independent FP (4), and one person for whom a plan was developed.
Respondents do not represent a random sample. Potential respondents were identified based on known contacts and then by asking respondents for additional contact suggestions. Respondents were primarily based in southwestern Ontario. Not all potential respondents that were contacted were able to be interviewed within the required timeframe.
Planning versus Facilitation This project involved connecting with a wide range of respondents with various experiences, backgrounds and current roles. It can be helpful when discussing the ideas that form the basis of this paper to be explicit about how people use the terms planning and facilitation. Many respondents articulated that planning and facilitation are different. In the broad terms and for the purposes of this paper, facilitation refers to the process during which someone comes alongside a person and works with them and their support network to identify new opportunities and explore what the person wants in their life. The facilitation process may or may not be guided by a written document and may or may not result in a written document. Conversely, planning refers to the process of working with a person and their support network to develop and create a written document that is the person’s and provides a holistic picture of the person, including current goals. The development of the plan generally includes connecting with the person and people who know them well through one or more meetings.
Planning, with the intensity and time commitment that happens with a FP, does not need to happen on an annual basis. This perspective was noted by both independent FPs and quasi-independent FPs. A comprehensive life plan may only be needed every few years, in response to changing circumstances, in response to a lack of change in the person’s life, or as prompted by the person and their natural support circle as they want to initiate change in their life. Life plans may not be reviewed within 365 days from last review, but generally are reviewed annually.
Some respondents provide facilitation supports, some planning supports, and some a combination of both. All respondents were clear that neither planners nor facilitators are direct support professionals and do not provide direct support on an on-going basis. In some cases, respondents provide support to a person to explore opportunities, but this is always on a short-term basis.
Learnings from Respondents Respondents were asked about process, time commitment, time frame, scope, cost, the plan document format, and methods/tools used. Many respondents spoke about how the processes, models, and tools they use had morphed and changed over time. Sometimes change happened due to FPs leaving roles, sometimes change happened as FPs were exposed to a wider range of situations and experiences, sometimes change happened because others became more comfortable with facilitating and implementing person-direct plans so the FPs adjusted their role. For example, when the FP modeled seeing the community as a first resource and connecting with natural supports to support quality of life and goal implementation; over time, others connected to the person also changed their approaches. Additional examples of how working with independent or quasi-independent FPs has led to change include that openness to involving more non-paid people in the meeting and that the coaching provided to support teams resulted in improvements in the quality of written goals.
Process Respondents use a wide variety of processes to get to know people, develop a plan with a person, and document and implement the actions identified. Processes varied as much across the subgroups interviewed, as within any subgroup. Some of the variety in process is directly linked to a person- directed philosophy, in that one size does not fit all people, and so FPs adapt their process to the person and situation.
While processes varied, many respondents had a similar general process when the person is new to them. This general process aligns with the processes outlined in the three reference documents. Initially there is a lot of direct interaction or observation with the person and people who know them well. This can range from one month to six months and from one visit to eight or more visits. Some respondents indicated they review existing documentation in some situations. Some respondents indicated they collect information through forms/tools completed by the person or people who know them well. A couple of respondents commented on using videoconferencing to connect with people.
Following the initial phase of getting to know the person, the next phase generally involved at least one meeting with the person and people who know them well to review information about the person and develop goals. Some FPs book and coordinate the meetings, in other situations, a paid support person coordinates the meetings that include the person, their natural supports, paid support and the FP. These meetings are facilitated by the FP and can involve a variety of methods and tools. One respondent shared that in the past she used meetings to develop goals, but at this point, has found it more effective to bring draft goals to the meeting for the group to review and discuss.
Following the planning meeting(s), if there is going to be a written plan document, the document is finalized. In quasi-independent planning models, some FPs are responsible for the final written document. In other situations, the direct support team is responsible for the final written document (particularly when reviewing and updating previous documentation). FPs may take the lead on writing some or all goals and breaking the goals down into actions, who is responsible, timelines, etc., but again this varied by agency and within agencies by situation.
When the person is known to the FP, the process generally focused on a meeting or event during which the current plan is reviewed, revisions discussed and documented, goal progress assessed, and new goals are developed. Respondents indicated the meeting to review an existing plan can take between one and a half to three hours. Many respondents commented on who controls the planning and the process. When the planning is provided by an independent FP, is it often easier to be clear with the person and their family that they are in control of the process and the outcomes; regardless of whether or not the person or an agency is paying for the service. In quasi-independent models, it can be more challenging to ensure the person controls and directs both the process and the outcome.
Monitoring and Implementation The role of respondents in monitoring and follow-up varied. Many were not directly involved in this aspect, and this was true for both independent FPs and quasi-independent FPs. A few independent FPs said they do check-ins and follow-up. Similarly, some quasi-independent FPs were involved in monitoring, some directly (i.e., contact the person or support team at specific points throughout the year) and others indirectly (i.e., through the agency database). At least one respondent from an agency with quasi-independent FPs mentioned that the FP involvement in monitoring had changed over time. In this situation, FPs worked to help change the culture of support to focus more on community and relationships. Initially FPs needed to be very active in monitoring goal implementation to support this change; as the agency culture changed, FPs became less involved in goal implementation.
Ideally, the plan would be monitored and implemented by the person and their natural support network. Some respondents worked to create circles of support to monitor implementation; in these cases, the FP often provided support to the circle as needed. Agencies with quasi-independent planning generally saw monitoring and implementation (either by the FP or a direct support professional) as an agency responsibility. This sense of agency responsibility is likely related to QAM ISP requirements.
Some respondents noted that independent facilitation/planning can result in poor plan implementation and follow through, especially when the FP does not have a role in on-going monitoring. However, as noted by one respondent, the specific processes used for planning and monitoring are not as important as ensuring that the process used leads to engagement from all stakeholders, which is essential to ensuring the plan is implemented.
Time Commitment In only a couple of situations, could the respondent provide detailed and specific information about the amount of time that is spent on any stage or specific activity in the facilitation/planning process. This was true across all subgroups. For agencies with quasi-independent FPs, estimates on time involvement varied from two hours per year for some people to thirty hours per year for other people. In all the agencies interviewed, the employees doing quasi-independent planning were responsible for planning with a specific number of people or a “case load”. The “case load” size varied from around forty people to over 150 people.
Within TPAs, time commitment and the specific number of people FPs plan with was dependent on the role responsibilities, the technology used by the agency, the skills of other employees within the agency, if the person is known to the FP, etc.. None of the respondents identified a formula or method for how they determine case load and responsibilities. Some FPs had dedicated planning positions, some FPs did planning as a portion of their role, and some FPs did planning in addition to another position.
Independent FPs also generally could not provide detailed and specific information about time commitments. While one independent FP offers a very specific service package, in most cases, respondents indicated that the time commitment per person was very fluid and reflected person- specific and situation-specific factors. Some FPs said they spend a month or two getting to know a new person over four to six visits. Others indicated it can take three to six months to get to know a new person and connect with their support network. Respondents noted that it can take six to nine months to develop a comprehensive plan and in some cases up to another year to implement it.
Overall, there is an awareness that not every person needs or wants the same amount of support from the FP. That said, respondents spoke about comments they have gotten from others regarding the amount of time a FP spends getting to know the person. There was no common theme in this area; in some cases, it is felt that too much time is spent and in others cases it is felt that too little time is spent, and the comments were not correlated with the actual time spent getting to know the person. None of the three reference documents include specific information about the total number of hours of direct or indirect planning support or the period of time over which planning may take place. It may be important to note that several respondents emphasized the importance of not underestimating the amount of time, in terms of minutes/hours or in terms of date delays, associated with the logistics of connecting with people and also with coordinating and accommodating the schedules of multiple people.
The Document Not all independent FPs provided the person with a written document as part of their service. The independent FPs interviewed who do provide written documentation or a plan, generally do not provide documentation that meets QAM ISP requirements. A couple of respondents produce a consistent final document, and in one case, the plan document does meet QAM ISP requirements. Respondents said the inclusion of a graphic element varies by the person. Respondents indicated that very rarely is there no documentation. However, documentation may take the form of notes; meeting minutes; emails summarizing ideas or agreed to actions; and simple tools that include information about the person, discussions with the FP, and future activities or ideas to be explored. Some TPAs have separate planning and ISP documentation processes and/or utilize their databases to connect different pieces of documentation to meet QAM ISP requirements.
Many respondents mentioned that having flexibility in the appearance of the final document or lack of documentation, reflects person-directed and person-specific planning processes, in that the FP (whether independent or quasi-independent) uses tools and documentation that reflect the person, their situation, and their preferences.
Methods/Tools
The majority of respondents used a variety of methods and tools and indicated that the methods, tools, and document (or lack of document) should reflect the person and the situation. A few respondents said they have done MAPS or PATHs with people, but this model was used infrequently. Specific tools and models mentioned included:
Personal Profiles
MAPs and PATH - https://inclusion.com/path-maps-and-person-centered-planning/
HSA (Helen Sanderson Associates) Person-Centred Thinking tools http://helensandersonassociates.co.uk/person-centred-practice/person-centred-thinking-tools/
New Story Values and Principles - http://www.johnlord.net/facilitating-an-everyday-life/
Personal Outcomes Measures https://c-q-l.org/the-cql-difference/personal-outcome-measures
Steps to Independence https://connectability.ca/2014/06/24/steps-to-independence-2/
Community Maps & Asset Based Community Development
Connections resource https://www.yssn.ca/Publications
Framework for Accomplishment – John O’Brien
Costs Not all respondents could provide information about costs. Among the respondents who had this type of information, cost models and amounts varied greatly. Observations related to cost included:
Many FPs work within the $2500 passport allocation model, some do not. However, there was no consistency in how they applied that model. For example, some charge $2500 and track the time spent based on an hourly rate, until the money is used up; some charge $2500 for a year of support and bill the person 1/12th per month; some have a package/service with clear deliverables that costs $2500.
Of the respondents who have rates, the rates ranged from $40/hour to $200/hour.
Costs included both direct and indirect activities. Respondents do not have different rates for direct and indirect activities.
Some respondents charge for mileage, others do not. There was no observable trend.
Some respondents charge for travel time, others do not. There was no observable trend.
Some respondents consider travel time part of their hours, others do not. Some charge for travel time only when the travel is a significant distance. There was no observable trend.
Skills/Training Often before being asked, respondents identified the skills of a good FP. While the skills identified by respondents align with skills noted in the three reference documents, respondents identified many more skills than any of the reference documents. Identified skills included:
Listening skills
Communication skills
Building working relationships with others
Problem solving and decision making
Strategic thinking
Creative/Innovative
Resourceful
Curious
Able to read the audience
Positive and encouraging
Able to manage a group and facilitate a group
Not being afraid to ask tough or controversial questions
Respectful and tactful
Not needing to be liked
Hospitality
Not being too attached to one process, tool, etc.
Ability to think quickly and pull from a range of skills, tools, etc.
Keeping people on track – time management and organization skills
Able to support people (this includes employees, family members, etc.) to move in directions that make them uncomfortable
Able to work independently
Okay not being in full control of the process or the outcome
Writing skills
Awareness of community resources, both formal and informal
Knowledge of and experience in the sector which assists with respect and credibility
In addition to skills, a couple of respondents mentioned the values of the FP that are important. All three of the reference documents identify values and principles for person-directed planning. Values mentioned by respondents included:
Community First philosophy
Focus on Relationships “good FPs are always thinking about who outside the system to invite into someone’s life”
Person-Directed and Person-Centred philosophies
Rights, choice, language, power Respondents were also asked about training they had participated in and/or would recommend. Most respondents had not participated in facilitator or planner specific training. Only a couple of respondents identified role specific learning opportunities (those mentioned are included in the list below). As a result, a wide range of training opportunities were identified, some of which may not be currently as available in Ontario as they were at one time. The trainings mentioned by respondents reflect those identified in the Person-Directed Planning and Facilitation Guide (MCSS, 2013). Trainings and workshops mentioned by respondents included:
MAPS and PATH - https://inclusion.com/path-maps-and-person-centered-planning/
HSA Canada annual gathering
Personal Support Network Facilitation On-Line Course Plan Institute https://planinstitute.ca/learning-centre/personal-support-network-facilitation/
Essential Lifestyle Planning https://tlcpcp.com/work/essential-lifestyle-planning/
Social Role Valorization http://www.srv-sotg.ca/ https://socialrolevalorization.com/training/training-events-calendar/
New Story Workshop – Facilitating an Everyday Life offered by the Facilitation Leadership Group http://www.facilitationleadership.com/what-we-do/
Team management/dynamics
Conflict resolution
Basics of rights, choice,
Goal setting and SMART goals
CQL Personal Outcomes Self-Assessment workshop https://c-q-l.org/training-and-certification
Workshops and presentations by Dave Hingsburger or John Lord
Networking and Coaching/Mentoring The role of a FP generally involves working independently of others; (most respondents indicated they do not have a second person work alongside them when meeting people, facilitating meetings, etc.. Frequently, respondents spoke about the importance of being part of a community of practice to support on-going skill development, knowledge of tools and practices, and professional development. Networking can include accessing guest speakers to speak to the group of FPs or to a wider audience, watching and discussing videos or webinars, and learning about specific community resources.
In addition, respondents spoke of the importance of coaching and mentoring and not just for people new to the FP role. Coaching and mentoring should include shadowing opportunities where different styles and approaches can be observed, and feedback can be provided. Coaching and mentoring should also include opportunities to brainstorm about how to approach specific situations and debriefing and reflection after working through a unique circumstance. One respondent commented that too often FPshave been thrown into the role and they do not have opportunities to get feedback and support from another FP. The respondent observed that people with the potential to be great FPs have sometimes failed due to the lack of mentoring and support. FPs should always be looking for ways to gain new skills, connect with other FPs to learn what’s working or not working, observe and give feedback, and be observed and receive feedback. While respondents spoke of the importance of networking and coaching, they identified that the time to engage in these activities is often overlooked when considering workloads and/or fee-for-service compensation rates.
The importance of being part of a community of practice and of mentoring and coaching is particularly emphasized in the Person-Directed Planning and Facilitation Guide (MCSS, 2013) reference. This reference includes very specific recommendations regarding hours spent co-facilitating and in a mentoring/coaching relationship.
Conclusion
As evident in the summary above, there is much variety in many aspects of how planning and facilitation is currently provided to people with developmental disabilities in Ontario. While some of this variety can be attributed to a person-directed philosophy, other variety reflects the preferences, experiences, and resources of the individual FPs or agencies. In this case, variety should not necessarily be thought of as negative, as the variety can result in more choices and options for people. Furthermore, as already noted variety and change is often the result of growth and learning, which leads to most positive experiences for those using the services.
Terms Used in this Paper To ensure all readers have the same understanding, this section outlines some terms and acronyms used in this paper. The terminology below is specific to this document only and may not necessarily reflect other definitions used within the developmental services sector or across sectors.
Independent Facilitators: People who do planning and/or facilitation either as a sole proprietor or for an independent facilitation organization that is not directly funded by the MCCSS to provide these services.
OIFN: Ontario Independent Facilitators Network provides support to independent facilitation and planning by strengthening self advocacy and autonomous family voices, offering mentoring, and education for independent facilitators in their local practice. https://www.oifn.ca/
Person-directed: In this paper, the term person-directed is used to capture both person-centred and person-directed philosophises, unless the interviewee was specifically referring to the use of HSA Person-Centred Thinking practices and tools.
Facilitators/planners (FPs): People who do planning either independently, as part of a planning/facilitation organization, or as an employee of a developmental service transfer payment agency.
QAM ISP: The Quality Assurance Measures (QAM) regulation outlines that each person must have an Individual Support Plan (ISP) which meets a specific list of requirements.
Quasi-independent planning: The term quasi-independent planning is used to refer to planning done by employees of a transfer payment agency who are not directly involved in providing supports to the person.
Reference documents: The three guide-type documents that were reviewed and used as a reference point and are listed at the beginning of this paper.
Respondents: People who provided information via phone or face-to-face interviews that contributed to this paper.