“Printed Materials” about “Goal/Vision Setting” for “Youth”
“Websites” about “PCP Documentation”
“Templates” for a “Direct Support Practitioner”
Official 2014 Rule of the Department of Health and Human Services requiring person-centered planning in Home and Community-Based Services and Long-term Services and Supports.
In this brief, Martha Barbone, a member of the NCAPPS Person-Centered Advisory and Leadership Group, describes the role peer support can play in addressing common concerns regarding person-centered planning.
This training provides coaching and tools to address this issue and support the development of person-centered plan documentation in alignment with the NC PCP Guidance document.
2023 Official CCBHC Certification Criteria
The Mapping Relationships tool is designed to promote discussion, self-awareness, shared knowledge and facilitate planning when thinking about the people that are important to a person.
This tool is to help individuals of all ages start to think about a more specific vision for life in the future and narrow down what life domain(s) to focus on at this point in time.
Use the Integrated Supports Star templates to explore current needs, identify gaps, or plan how to access supports for the future.
The Integrated Supports Star Tip Sheet can be used by anyone (individuals, families, or professionals) for mapping current services and supports, problem-solving for a specific need or planning next steps.
Access person-centered tools that are flexible and can be used for problem-solving, decisions making, or future-focused planning.
The Life Trajectory Template is a strengths-based concept designed to help think about life, both short and long term. It can also be used to promote discussion, self-awareness, shared knowledgeand facilitate planning with a person and their support team.
The Life Trajectory Tip Sheet tool is a visual aid to guide and help a person explore and plan things in their life. It can be used by anyone at any stage or age of life, for short-term or long-term goals or even problem-solving day-to-day life.
The Combined Reframing Language Guide was created by a consortium of organizations dedicated to person-centered and equity-focused supports for marginalized people/groups. It was designed to inspire new thinking and change the way we talk about historically marginalized groups to utilize more respectful, person-centered, and culturally responsive terms. A wide variety of language principles and corresponding examples are shared around mental illness, African American populations, those who are aging, and LGBTQ+ individuals.
A Communication Chart is an essential tool to use when people don’t communicate with words or who communicate with behavior.
The Interview Guide Tool will help build a customized interview guide based on the CFIR constructs that are the focus of an evaluation.
Tip sheet for directly soliciting input from the person/family to inform person-centered planning.
This toolkit is designed to provide a blueprint that aids in the development of a comprehensive system of care that supports individual recovery, community inclusion, and opportunities for a full and meaningful life.
Documentation tip sheet on writing meaningful short-term SMART objectives
This interactive webinar explores practical, person-centered approaches to crisis prevention and intervention. Participants will learn tools and strategies that honor individual choice, foster collaboration, and promote safety in challenging situations. The session will provide guidance on developing supportive plans that reduce risk, strengthen relationships, and empower people to navigate crises with dignity and respect.
This resource document created by the National Center on Advancing Person-Centered Practices and Systems (NCAPPS) provides guidance on how to incorporate cultural awareness and sensitivity into person-centered planning practices.
The decision-making agreement looks at specific situations that are important to a person, and sets out the decision-making process relating to each one.
This study presents the validity and reliability of the Person-Centered Care Planning Assessment Measure (PCCP-AM), an objective measure of the extent to which service planning is person-centered.
Assessment instrument based on Consolidated Framework for Implementation Research (CFIR) to predict an organization's success in implementing a particular practice or behavior
This guide details five strategies and proven practices to directly involve people who receive services in system planning and improvement.
90-minute webinar on family engagement in PCP co-sponsored by the Substance Abuse Mental Health Services Administration and the National Federation of Families.
Plain language version of the NCAPPS resource, "Five Competency Domains for Staff Who Facilitate Person-Centered Planning"
Get expert coaching, practical tools, along with resources and strategies on how lived experience can shape both systems and service delivery to bring the “nothing about us, without us” principle to life.
Brief toolkit to support mental health service users in better understanding person-centered planning and preparing to partner in the creation of their recovery plan.
Documentation tips sheet on writing meaningful long-term goal statements.
This person-centered thinking tool helps you to have conversations about what a good day is like, from when a person wakes up to when they go to bed. You can then look at the same detailed information for a bad day. This helps us to learn what is important to the person – both what must be present in their day and what must not happen.
Person-centered thinking tools are a set of easy-to-use templates that are used to give structure to conversations. Access the Helen Sanderson Associates (HSA) website for practical training, facilitation, coaching and resources to affect lasting change using person-centered approaches and self-management practices.
Book chapter describing the history and core principles and practices of the youth Wraparound model - including how it parallels person-centered planning as it has emerged in other disability populations.
Learn how a thoughtfully designed EHR can facilitate person-centered practice by increasing the focus on key person-centered concepts, facilitating dialogue between providers and persons served, and generating the co-creation of meaningful PCPs to help shape the person’s journey forward.
Goal setting Tips Sheet for mental health service users
White paper document developed as a part of a SAMHSA-sponsored consensus-building process to further define the principles and practices of PCP.
Journal article sharing lessons learned in a Person-Centered Recovery Planning Learning Collaborative (PCRP) facilitated by the New England Mental Health Technology Transfer Center.
This resource offers overarching person-centered language guidelines that should be considered in both written documents and verbal interactions.
Documentation tip sheet on writing professional interventions and actions by the person and chosen natural supporters.
Set of facilitation tools to lead groups of any size to accomplish an array of objectives. Easy to use and step-by-step instructions available for public use online.
Series of short videos on cultural considerations and modifications to enhance the responsiveness of person-centered planning.
Review the NCCMT website for background information, methods, and tools to assess organizational readiness and barriers to implementing a new practice, including an Organizational Readiness to Change Assessment (ORCA) developed for the Veteran's Administraton, and mapped to the the Consolidated Framework for Implementation Research (CFIR).
Set of person centered planning implementation benchmarks specific to NIRN implementation drivers (e.g., staff selection, training, coaching, decision support using data, and technical leadership)
Refer to the website of the National Wraparound Initiative for a wide range of resources regarding the implementation of youth-based wrap-around practices, including the practie of collaborative, team-based planning. This practice closely resembles person centered planning models that have been developed for primary application in other contexts such as in PCP with individuals/families with developmental disabilities.
Review this 13-item auditing tool designed to monitor the quality of person centered recovery plans, developed and implemented by Newport Mental Health, a comprehensive community based mental health center and Certified Community Behavioral Health Clinics (CCBHC).
A Walk-Through Guide by NIATx, including steps and sample recording templates. Observations can be used to modify and streamline process and procedures, cross-walk the range of intake forms/assessments identified to eliminate internal redundancies, and ensure collection of needed information for recovery plans throughout the service recipient experience.
A Walk-through Guide by NIATx, including steps and sample recording templates. Observations can be used to modify and streamline process and procedures, cross-walk the range of intake forms/assessments identified to eliminate internal redundancies, and ensure collection of needed information for recovery plans throughout the service recipient experience.
North Carolina-specific resource created by Vaya Health and the Council on Developmental Disabilities to better help people with disabiliites to live in a home of their choice in the community with certain supports.
Register/login to the NCCDD Natural Support Network Development Resource Portal for print and multimedia tools developed to help teams create personal support networks. The tools include Full Circle Planning Guide for Community Connectors; Full Circle Information for Families and Friends; Full Circle Planning for a Good Life.
Official individual crisis plan PCP template required by DMHDDSUS. Note that the Crisis Plan must look exactly like the plan format offered in the Excel spreadsheet. Providers are not allowed to add to this template or remove any content.
Suggested North Carolina DHHS PCP Template
Official PCP practice guidelines from the NC Division of Mental Health Developmental Disabilities and Substance Use Services (DMHDDSUS)
"Frequently Asked Questions" document addressing the North Carolina Mental Health, Developmental Disabilities, and Substance Use Services (DMHDDSUS) Person-Centered Planning Guidance document and associated expectations.
Learn more about using person-centered principles to support autonomy and decision-making with people who have guardians.
Learn ways to balance personal autonomy and guardian concerns while ensuring the individual’s voice is central to the Person-Centered Plan (PCP).
Access this 10-item checklist designed as a monitoring tool for the person-centered recovery planning process. The tool includes versions for both staff and for the person receiving services.
Educational handout for family members and other natural supporters re: roles and responsibilities in person-centered recovery planning.
Pre-planning worksheets with a series of person-centered interview questions across a variety of life domains. Designed to shape the conversation and directly solicit input from the person to inform the development of the written recovery plan.
Review this set of PCRP coaching competencies developed from evaluating site-based PCRP Coaches following a multi-year PCRP implementation program.
Feedback form for people developing skills as a "PCRP Coach" to be used following a specific coaching session.
Review this orientation session to the PCRP Consultation Corner Series for key PCRP definitions and essential elements; tactics designed to increase familiarity with existing and emerging state and federal requirements regarding PCRP; and guidance on ways to articulate differences between traditional methods of treatment planning and best-practice PCRP.
Review this series overview for key PCRP definitions and essential elements; tactics designed to increase familiarity with existing and emerging state and federal requirements regarding PCRP; and guidance on ways to articulate differences between traditional methods of treatment planning and best-practice PCRP.
Review Session Five of the Person-Centered Recovery (PCRP) Consultation Corner, "Person-Centered Advance Crisis Planning to Maximize Choice & Control." This webinar addresses both the principles of person-centered advance crisis planning as well as tools and resources to support its implementation, e.g., collaborative safety planning, Wellness Recovery Action Planning, and Psychiatric Advance Directives.
Review Session Four of the Person-Centered Recovery (PCRP) Consultation Corner, "Designing Planning Templates & Electronic Health Records to Support PCRP." This session offers practical guidance to mental health systems so they can move toward the development of electronic health records that facilitate, rather than hinder, the uptake of Person-Centered Recovery Planning.
Review Session Three of the Person-Centered Recoery (PCRP) Consultation Corner, "Peer Specialist Roles in PCRP." This session explores tensions that can arise when peer professionals work to maintain their never-directive, non-clinical stance while immersed in an environment that is heavily defined by clinical professionals, processes and services.
Review Session Two, “Co-Creation of the PCRP Document-Partnering, Goal Discovery & Emphasis on Real Life Results.” This session will help you to co-create recovery plan documents in alignment with person-centerd principles as well as fiscal and regulatory requirements.
Review Session Six, "How to Reinforce PCRP in Practice: PCRP Staff Training, Supervision and Quality Monitoring." A dynamic panel of experts with decades of experience in leading PCRP organizational change efforts share a variety of leadership, staff development, and quality monitoring strategies to support initial implementation and ongoing sustainability.
A toolkit of curated person-centered thinking tools gathered by subject matter experts associated with the National Center on Advancing Person-Centered Practices and Systems (NCAPPS).
A national overview of person-centered principles and definitions as reflected in a wide variety of health and disability service systems, including mental health systems.
The Plan-Do-Study-Act (PDSA) method is a simple way to test a change what is implemented. These step-by-step instructions, worksheets, and examples are widely used in implementation for many new practices/behaviors.
A feedback form for practitioners on PCRP performance/skills in relation to one person served/one plan. Feedback addresses strengths and areas for improvement related to the plan document, but focuses primarily on the professional (or multidisciplinary team's) overall engagement with the individual served, including process, philosophy, and the intended products or client-level outcomes pursued.
Person-centered thinking tool to capture information about what rituals and routines help to create a positive experience and good day for a person. Rituals can be selected from a list or others can be added that are important to a person.
Review this fact sheet developed by the North Carolina Council on Developmental Disabilities (NCCDD) to encourage dialogue around the importance of ensuring everyone has the right to self-determination, voice, and choice in the pursuit of life experiences.
The Substance Abuse and Mental Health Services Administration (SAMHSA) developed this series to provide guidance to states related to critical issues that may be addressed by the Community Mental Health Services Block Grant (MHBG).
A feedback form to support the ongoing development of new trainers responsible for teaching other organizational staff.
Paper written by the National Leadership Consortium on Developmental Disabilities describing continued barriers to community inclusion for people with disabilities.
Sample strengths-based interview to solicit strengths-assets directly from a person/family to inform the person-centered plan.
Access the Support Development Associates website for resources and tools designed to promote the abilities and talents of every individual.
Website of the Learning Community for Person Centered Practices (TLC PCP) is an international community of volunteers that organized themselves to promote the use of person-centered practices globally. We strive to be diverse, inclusive, and accessible so that people with lived experiences of disability, family members, advocates, professionals, and all others can participate. TLC PCP is widely recognized as the originator of many of the person-centered thinking tools that have been developed in partnership with organizations such as Supprt Development Associates and Helen Sandersen Associates.
Journal article providing practical recommendations for the design of EHRs to support the uptake of PCRP in clinical practice settings.
Learn practical strategies to create strengths-based Person-Centered Plans that honor the individual while meeting compliance and documentation requirements in this 90-minute interactive webinar.
Part of the Recovery Roadmap Tips series, this is a 21-item quality review tool to help people in recovery/families to reflect on the extent to which their planning documentation reflects certain person-centered practices and content.
Part of the Recovery Roadmap Tip series, this is a 21-item quality review tool to help staff to reflect on the extent to which their planning DOCUMENTATION reflects certain person-centered practices and content.
Part of the Recovery Roadmap Tip series, this is a 25-item quality review tool to help staff to reflect on the extent to which their planning PROCESS (meetings/conversations, etc.) reflects certain person-centered practices and content.
Part of the Recovery Roadmap Tip series, this is a 25-item quality review tool to help people in recovery/families to reflect on the extent to which their planning process (meetings/conversations, etc.) reflects certain person-centered practices and content.
The National Center on Advancing Person-Centered Practices and Systems (NCAPPS) Toolkit guides state and organizational leaders on ways to proactively plan for maximum stakeholder engagement in person-centered planning systems change.
Access the UNC CARES website for education, community engagement strategies, and policy analysis across the state designed to empower older adults, adults with disabilities and their families, to experience choice and dignity in their lives.
SAMHSA Recovery to Practice highlight describing common barriers to goal setting and offering possible strategies for overcoming barriers.
This person-centered thinking tool works helps to identify, from multiple perspectives, what is working and not working about a person's current situation.
Documentation tip sheet on writing person-centered integrated summaries.
Staff "booster" training exercise to practice writing quality short-term goals/objectives in the person-centered plan.