How Self-Determination Puts You in Charge of Behavioral Health Support

This time on the Summit Pointe Podcast, we explore how self-determination lets people direct Medicaid-funded services, hire trusted caregivers, and build real independence with guidance from our self-determination coordinator, Nicole. Freedom, authority, and responsibility turn support into a partnership where the person’s goals lead.

Episode Resources
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Summit Pointe Podcast 97 is a Livemic Communications production. 

Summit Pointe, the Behavioral Health Authority in Calhoun County, Michigan, is pioneering Community Mental Health Services by developing innovative ideas and community partnerships that lead to high-quality care and a healthy community.

Summit Pointe, the Behavioral Health Authority in Calhoun County, Michigan, is pioneering Community Mental Health Services by developing innovative ideas and community partnerships that lead to high-quality care and a healthy community.

Transcript

Welcome And Topic: Self-Determination

Richard Piet 0:07

I'm Richard Pyatt. Welcome back to the Summit Point Podcast. Summit Point is the behavioral health authority in Calhoun County, Michigan, Battle Creek, and all around. And we've talked on a number of subjects over the hundred or so episodes thus far. They're easily found. A couple of ways, first of all, the Summit Point website. We invite you to go there and have a look. Or you can certainly search Summit Point Podcast in your favorite podcast directory and subscribe. You'll be alerted when these new episodes come available. Today we're going to talk about something really interesting. Self-determination. What does that mean? Nicole is here from Summit Point, and I love Nicole's title, Self-Determination Coordinator. I love that. Welcome, Nicole.

SPEAKER_00 0:56

Thank you. Thank you for having me.

Richard Piet 0:58

So let's really understand. What are we talking about when we say self-determination? What does that mean?

SPEAKER_00 1:05

Sure. It's a question I'm receiving a lot lately. Uh so self-determination is really just giving the right of people back to figuring out how they want to use the services that they can be provided through public service through CMH. And so they come into a place like Summit Point and they it's determined that they can utilize some services. If they use self-determination, they have the authority then over those budget dollars that go through Medicaid. And that's a a different kind of a more full of topic, but uh they use those dollars and they essentially become the employer. They they pick who they hire to come in and support them in the goals that they're working towards through those Summit Point case managers and therapists.

Becoming An Employer Of Record

Richard Piet 1:50

Yeah, CMH community mental health, of course, is that uh designation. And uh organizations like Summit Point all around the state have this uh designation. And I presume when you say hire, you maybe put that in quotes a little bit. You you choose your provider, uh, and you have a role then in the services you receive.

SPEAKER_00 2:10

So they actually truly hire them.

Richard Piet 2:12

They do.

Core Principles: Freedom And Responsibility

Ways To Use And Family Hiring

SPEAKER_00 2:13

They do. They become an employer of record. And so they are managing, they complete timesheets. Well, their employers would complete timesheets, they approve them, and they go off to what we call a fiscal management service who works as their HR and does the payroll for them. And so um, there's a lot of responsibility with that. Some of, you know, there's a few core principles of self-determination. And, you know, those are freedom. They decide how to live a good life. So they're choosing those services that they want and those people that they want to support them. They have the authority, so they're controlling those dollars, but then they also have the responsibility of using them wisely and um ensuring that they're following things, even like labor laws and making sure that they're not running into like Medicaid fraud and their confirmation. So they're they're having a piece and a party in the system that is intended to help them, just in a little more of a direct way. There's a couple of ways to use self-determination. In one way, they could choose to, it's called like party with agency. And so they go through an agency and they pick the employer of or the employee of that agency. The way we have been using it more fully at some point is the customer, our person who comes in to get services, gets assessed, finds out what they're wanting to work towards and what services that they would be um approved for or authorized for. And then some of these services, they then can say, you know what, I want to self-direct them. I have um sometimes with our with I work with youth and adults. So maybe with a youth, it's a mentally impaired or an intellectually disabled or even physically disabled youth. And so mom says, We have an aunt, we have an older sibling, we have grandparents who are already doing this. They can choose to hire them and they are providing direct care and then getting paid through that budget, through those Medicaid dollars to provide that direct care. So they're still working with some at point, they still have a case manager, but those direct care supports are of their choosing. And they even have the responsibility of creating job descriptions and and their and what do we expect of our people? It's um, it's quite an undertaking. I was pretty surprised with the amount of well, it's just a heavy lift amount of work that these families are doing.

Richard Piet 4:41

That is really interesting. So when I first thought self-determination, this was a way to help folks as customers of Summit Point get through their own processes of their own care, but really it's a practical definition. That is to say, I am determining the care that my loved one, let's say, is going to receive. And I'm picking and choosing by way of summit point the providers who are going to give that care.

Coordinator Role And Adult Use Cases

SPEAKER_00 5:13

Yeah, yeah. They they pick their people. And um, we just I work as an intermediary for them. I am a liaison for them to help them. You know, uh we were talking about youth there for a minute, but then our youth grow up, right? So then we have conversations about our adults who are also still receiving services, maybe, um, or begin as adults receiving services. And so sometimes I'm talking, I just met a gentleman this week and he's starting this process. He's going to start to use the service. And so I'm talking to this young man about who do you think you want to hire? Who do you think is going to help you meet your goals? And then I'll sit down with him and go over how much do we want to pay him? How what does that look like? And so I'm, I'll walk alongside him and I tell my families or my customers, I'm as available as you want me to be. I can be here every step of the way. Some of them are a little bit more able to carry out some of those processes on their own. So they call me when they need me.

Richard Piet 6:14

This is really interesting because I think there is a perception that a preponderance of customers who are served by Summit Point come in the door, maybe at first step, maybe some other way, and uh they're guided through a process by which they receive the assistance they need. And it's like going to the doctor's office, I guess. You you avail yourself of what's there and and you move ahead. This is actually someone who's involved in determining uh the care they need and who they might identify as the person to assist them, and now you can see the uh coordinator's job, which is your job, to help them through that, because this is not something you could just, you know, like walk into the to uh the store and pick what you want. This is uh something that needs needs guidance and and advice.

Daily Living Skills And Community Inclusion

SPEAKER_00 7:08

Yeah. So I started in June. I've not been here that long. So social work is not new to me, but this is. And so I dove in, I wanted to learn everything I could learn about it. And I found this quote and it and it's so simple, but it's nothing about me without me. And it's an anonymous quote. And I'm like, yes, that's exactly what we're doing to the level that they can participate and be involved in their day-to-day life, their goals, what they want to do. They, being anyone, anyone receiving services, should be given that space to say, I want to learn how to make a birdhouse. I don't care what it is. Okay, great. So, how do we do that? Who's going to help you do that?

Richard Piet 7:49

Yeah. And I presume that's uh uh a simple example, but sometimes it let's talk about that. Who's helped by this and what might be an example of a typical thing with which they might want assistance?

SPEAKER_00 8:03

So for our youth, some of those typical things are a little more involved. And so I guess I'll talk about that for a minute because they still have their their grown-ups, their parents, their guardians, their caregivers, and they're helping with well care that's anywhere from learning how to use utensils, feeding utensils. Like, of course, parents are doing that. School might be doing that if they're in a school that can assist with that. But things like that take a lot of practice. And so we call them um CLS or community living skills. So they hire someone to help them be their community living skills support. And they're they will help them and teach them and practice that feeding themselves with utensils and making it less frustrating so that when they do go out, they, you know, they're doing this. And so it's empowering them to do what they can on their own for some independence, some um autonomy. And so feeding and, you know, bathing, going to the park. We talk about going to the zoo a lot, and we'll be talking about that more as the sun continues to visit us. Being in the community, being involved as much and as often as they can. They are part of our community. I say they, but any of our customers or individuals with disabilities, they are our community members and they should be out in the community and experiencing that. And then jumping to our older people, some of those tasks are again back to the gentleman I just because he's fresh in my mind, the young man. He's going to be, he wants to get fit and eat more healthy. And his person's gonna help him do that. So they're gonna do things like go to the grocery store and buy more appropriate food so they can not stop and eat out, which young people do anyways, but let's get away from that, right? I say young people, I am also guilty.

Richard Piet 9:45

I was about to say the same.

Health Goals, Gyms, And Trust

SPEAKER_00 9:47

Right. So planning meals, planning healthy meals, using your your money wisely, and then they're going to be going to the gym. And so we we take for granted, I think, as able-bodied, able-minded people of how easy it is to go to the gym or just to go over to the why. And it's not always that easy. And so if you've got a person that you know who can support you and is going to encourage and empower you to do those things, to have the autonomy to use your budget dollars to do that in a way that is comfortable. These are intimate things people are doing. We're talking about self-care. We're talking about learning how to engage in the community, to have a safe person who you know and trust to do that alongside of you. You know, you can't build a better program.

Richard Piet 10:31

Yeah, that must be tremendously rewarding for you, the coordinator. And I expect, uh, just focusing on something you said a moment ago, that uh there may be some days when your phone's ringing a lot. You just said, Well, I can be as involved in that or as uh a little involved in that as you want. So some days uh you might get a lot of calls.

SPEAKER_00 10:54

Oh yeah. Yeah. This this week uh and last week we're going through quite a project, and it's the project I'm working on is involving more than 50 of my customers. And so there is a lot of coordination and phone calls and emails and text. And some of them are like, cool, I got it. Thanks. And some of them are I'm going to physically go out there with the packets that we need to work on, and we're going to do them together.

Richard Piet 11:19

Uh, yeah. And there you are. So you're involved as little or as much as as is uh asked of you.

SPEAKER_00 11:26

Yeah.

Richard Piet 11:27

What a tremendous opportunity. So, how long are customers typically a part of this program? How long are they seeking this kind of involvement?

Workload, Support Levels, And Coordination

SPEAKER_00 11:38

So I guess the answer is I'm not sure yet. But what I am seeing and what I am learning is that some of them it might be a transitional situation where they're going for going maybe from something a little more restrictive to living with uh someone who's supporting them to hopefully being able to live on their own, you know, if their trajectory and their goals lead them to that. And some of our individuals will, you know, and so then maybe they'll goal out, they'll reach their goals and they won't need to do that. And some of them, I think, will be potentially lifelong participants in the program.

Richard Piet 12:11

Yeah, that's understandable. So, how do you uh come across the folks whom you end up helping? Uh, what's the typical path to get on your radar?

Duration: Transitional Vs Lifelong

SPEAKER_00 12:21

So the typical path right now is individuals come in, they become customers of Summit Point. And then their workers, they'll do their assessment and you know, see what they need. And then what we standardly see are those, like I talked about CLS, community living skills, and then respite, which is really just trying to give a break to their day-to-day caregiver. And then sometimes we have what's called overnight health and safety. So maybe they need somebody to be awake the whole night to ensure physical and medical safety. And we'll parents try as we might. We can't, you know, always do that. Uh, so those are standards. They talk to their case manager, their case manager, and really I'm actually doing trainings for as many people as I can within Summit Point so that this is available to anyone, anybody who receives services. And so I'm trying to educate the staff here so that they know hey, and I've created uh um an infographic like just a one-sheeter. If all customers can know about this, and if they choose to even learn more about it, contact me and we'll see if it might be a good fit and we'll take it from there.

Richard Piet 13:29

That's uh wildly interesting to me, the notion that uh someone can be involved in their uh care, whether that is a little of it temporarily or for a long-term situation. And it might not just be CLS, right? There might be some other reasons they would find this helpful.

SPEAKER_00 13:51

Yeah. It in the true core intent of self-determination, a person could have, in theory, the right to select their own therapist, their own counselor. And so it's trying to make those things that our customers need make sense for them.

Pathways, Services, And Staff Training

Richard Piet 14:07

Well, how about that? Ask about it if this has piqued your interest with Summit Point, self-determination. It really is something because I came to it thinking of this in an entirely different way. This is really a um somewhat literal meaning. You determine for yourself what some of your care will be, and there are folks at Summit Point, Nicole in particular, to help you make that choice and see it through. Incredible. Thank you, Nicole, for what you do and for explaining that.

SPEAKER_00 14:40

Oh, thank you very much.

Richard Piet 14:41

Don't forget you can subscribe to the Summit Point Podcast where you get your favorite podcasts, and there are more to come. Thanks for being with us. Working at Summit Point means you're not just part of a team, you're joining a mission. We make a meaningful difference every day in the lives of those we serve. If you're looking for a workplace where your voice is valued, your growth is supported, and your work has purpose, you found the right place. Check out the careers page on the Summit Point website. The link is in the show notes.