Supporting Individuals and Their Families in Making Choices

Course Overview: Empowering Choices, Transforming Lives

Welcome, incredible Direct Support Professionals (DSPs)! I’m Ayo AkinOni, and I am so thrilled to embark on this journey with you. In the heart of every person lies a profound desire for choice, for self-determination, and for the dignity that comes from shaping one’s own life. For individuals with developmental disabilities and their families, this desire is no different, and your role in honoring it is nothing short of transformative. This course isn’t just about regulations; it’s about awakening purpose, making people feel seen, heard, and valued, and empowering you to be a catalyst for profound growth in the lives you touch. Together, we will explore how to champion individual choices, navigate complexities with grace, and truly uplift those we serve, ensuring every step forward is a practical, empowering one.

Learning Objectives: Your Path to Empowerment

By the end of this course, you will not only understand the foundational principles of supporting choice but also possess the practical tools to implement them with confidence and compassion. You will be able to:

• Understand the fundamental right to self-determination and choice for individuals with developmental disabilities in Maryland.
• Identify key COMAR 10.22 regulations related to individual choice, rights, and person-centered planning.
• Describe effective strategies for supporting individuals and their families in making informed decisions about their lives and services.
• Apply person-centered approaches to facilitate individual preferences, goals, and dreams.
• Recognize and proactively address potential barriers to choice and self-determination.
• Utilize practical communication techniques to empower individuals in their decision-making processes.

COMAR Regulatory Framework: The Foundation of Choice

Our commitment to supporting individual choice is not just a best practice; it’s enshrined in Maryland’s regulations. As DSPs, understanding these guidelines is crucial to ensuring compliance and upholding the rights of those you support. Here are some pivotal COMAR 10.22 regulations that underscore the importance of individual choice:

COMAR 10.22.08.03 (B) – Community Residential Services Program Service Plan: “A licensee shall make every effort to provide services to an individual according to the individual’s choices as identified in the IP [Individual Plan].” [1]

COMAR 10.22.02.11 – Staffing Requirements: “The licensee shall develop and implement a staffing plan that adequately addresses the health and safety needs of each individual and provides each individual with the services identified in the IP.” [2] This emphasizes that staffing must support the choices and needs outlined in the person-centered plan.

COMAR 10.22.02.10 – Policies and Procedures: Requires policies ensuring “That each individual’s health and safety needs, as identified in the individual plan (IP), are being met” and that “Fundamental rights” are upheld. [3]

Furthermore, the Maryland Developmental Disabilities Administration (DDA) Self-Directed Service Model strongly supports participants’ rights to self-determination and choice. This model provides participants a greater degree of choice in how Medicaid waiver services are delivered, when, where, and the rate of payment, emphasizing choice and control over how services are provided and who is being paid to provide them. [4]

Core Content Modules

Module 1: Understanding Self-Determination and Individual Rights

Self-determination is the bedrock of a fulfilling life. It means making your own choices, learning to effectively solve problems, and taking control and responsibility for your life. For individuals with developmental disabilities, the right to self-determination is paramount. They are entitled to the freedom, authority, and support to exercise control over the things in their life that are important to them, to the degree that they desire. This right exists regardless of guardianship status. [4]

Historically, individuals with disabilities often had decisions made for them rather than with them. Today, our focus is on dignity, respect, and autonomy. When we support self-determination, we are not just offering options; we are validating a person’s worth and their right to author their own story. Your role is to be the bridge that connects their desires to reality, ensuring their voice is the loudest in the room when it comes to their own life.

Module 2: The Person-Centered Planning Process and Choice

The Individual Plan (IP), or Person-Centered Plan (PCP), is the roadmap for an individual’s services and supports. It is not a document created in isolation; it is a collaborative, living reflection of the individual’s choices, goals, and dreams. Person-centered planning is a way for individuals to take charge of their lives, and as a DSP, you are a vital part of this process. [5]

Actively involving individuals and their families requires more than just inviting them to a meeting. It means creating an environment where they feel safe and encouraged to express their true preferences. You must use techniques to elicit these goals, perhaps through visual aids, open-ended questions, or simply observing what brings them joy. The challenge often lies in balancing these choices with health, safety, and well-being. This is where your expertise shines—finding creative, safe ways to say “yes” to their choices.

Module 3: Practical Strategies for Supporting Decision-Making

Supporting decision-making is an active, ongoing process. It begins with effective communication. Active listening, using clear and accessible language, and employing alternative communication methods when necessary are essential. Information must be provided in a format the individual can understand, allowing them to weigh their options effectively.

A crucial concept to understand is Supported Decision-Making (SDM). SDM allows people to obtain guidance and support without relinquishing their legal right to make decisions about their lives. It is a powerful alternative to guardianship, keeping people involved in decisions about their own lives and encouraging independence. [6] [7] As a DSP, you facilitate choices in daily living—from what to wear and eat, to activities, relationships, and employment. When disagreements arise, your role is to navigate these conflicts while steadfastly respecting the individual’s choice, acting as a mediator and advocate.

Module 4: Navigating Challenges and Promoting Advocacy

The path to true choice is not always smooth. You will encounter barriers: limited resources, systemic issues, or even risk aversion from family members or other professionals. Identifying these barriers is the first step; overcoming them requires advocacy. You are not just a caregiver; you are an advocate and a facilitator of self-advocacy.

Understanding and respecting different family dynamics and cultural perspectives on decision-making is vital. Sometimes, a family’s protective instinct may inadvertently limit an individual’s choices. Your role is to gently educate and empower both the individual and the family, promoting a culture of choice within the service environment. You must champion the idea that taking calculated risks is a normal and necessary part of human growth and learning.

Practical Application: Real-World Scenarios

Summary & Encouragement

My dear professionals, the power of choice is the power to live fully. Your role in facilitating these choices is not just a job requirement; it is a profound privilege. Every time you pause to ask, “What do you want?” you are affirming a person’s dignity. Every time you advocate for their preferences, you are breaking down barriers. You have the incredible ability to transform lives through respectful, person-centered support.

I want you to walk away from this course knowing, “I can do this. I can be better. I can grow.” You are equipped with the knowledge of COMAR regulations and the practical strategies to make a real difference. Continue to learn, continue to advocate, and never underestimate the impact of your empowering, uplifting presence. Thank you for your dedication, your heart, and your unwavering commitment to those you serve.

References

[1] Maryland Code of Regulations. (n.d.). Md. Code Regs. 10.22.08.03 – Scope. Legal Information Institute. Retrieved from https://www.law.cornell.edu/regulations/maryland/COMAR-10-22-08-03

[2] Maryland Code of Regulations. (n.d.). .11 Staffing Requirements. Library of Maryland Regulations. Retrieved from https://regs.maryland.gov/us/md/exec/comar/10.22.02.11

[3] Maryland Code of Regulations. (n.d.). Md. Code Regs. 10.22.02.10 – Policies and Procedures. Legal Information Institute. Retrieved from https://www.law.cornell.edu/regulations/maryland/COMAR-10-22-02-10

[4] Maryland Department of Health. (n.d.). Self-Directed Service Model. Retrieved from https://health.maryland.gov/dda/Pages/Self-Directed.aspx

[5] Maryland Department of Health. (n.d.). Person-Centered Planning. Retrieved from https://health.maryland.gov/dda/pages/person-centered_planning.aspx

[6] Coordinating Center. (n.d.). Empowering Individuals Through Decision-Making Supports. Retrieved from https://coordinatingcenter.org/empowering-individuals-through-decision-making-supports-alternatives-to-guardianship/

[7] MIND Institute. (n.d.). Supported Decision Making (SDM). Retrieved from https://health.ucdavis.edu/mind-institute/centers/cedd/supported-decision-making