Congratulations! You have completed Effective Case Work Documentation! Please note that your supervisor may have follow-up questions or need more information. Please respond to any requests promptly.
Once you click “mark complete,” a certificate of completion will be available to you. You may print or download your certificate to verify the completion of this course. This certificate will also be available at the beginning of this course anytime you log on.
Reminder from Aida
This course is part of a series of trainings required for all new employees. All new hires are required to satisfactorily complete trainings before being assigned cases.
All courses must be completed in order and in a timely manner.
This includes:
New Employee Orientation Part 1 (completed!)
New Employee Orientation Part 2 (completed!)
Guardianship Program Overview (completed!)
Effective Case Work Documentation (completed!)
KYGFIS
Note: The above courses are required for Guardianship, Fiduciary, and Benefits staff. Additional courses will be assigned upon completion of these required core courses.
Click the “Mark Complete” button below to access your certificate of completion.
Per regulation 922 KAR 5:170 and standard operating procedure (SOP) GField-18, Face to Face visits are a requirement for each individual under guardianship.
Face-to-Face visit is defined as an in-person, on-site meeting with an individual in their residence, workplace, day program, and/or other community location.
FaceTime/video visits do not meet the SOP requirements for face-to-face visits, but can be utilized in addition to the required visits.
In this lesson, we’ll review why face-to-face visits are important, how to prepare for them, and how to effectively document them.
Now that you’ve had a chance to engage with Ronnie to talk about what events are, Aida joins you to discuss a series of scenarios.
“Hello again. It’s Aida. With each scenario below, you will read a description of the scenario; write a sample case note, and compare your case note with my sample response.”
Within each scenario, you will:
Read a description of the scenario.
Write a sample case note.
Compare your case note with a sample response Aida provides.
Apply what you have learned about creating an effective event note.
You have completed Person-Centered Planning! Please note, that your supervisor may have follow-up questions or need more information. Please respond to any requests in a timely manner.
Once you mark this final lesson complete you will have access to your certificate to verify the completion of Person-Centered Planning. This certificate will also then be available at the beginning of the course anytime you log on.
Reminder from Aida
This course is part of a series of trainings required for all new employees All new hires are required to satisfactorily complete trainings before being assigned cases.
All courses must be completed in order and in a timely manner.
This includes:
.ugb-f2e2b11 li{margin-bottom:0px !important}.ugb-f2e2b11 li::before{background-image:url(‘data:image/svg+xml;base64,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’)}.ugb-f2e2b11 li ul{margin-bottom:0px !important}.ugb-f2e2b11.ugb-icon-list ul{columns:1}
New Employee Orientation Part 1 (completed!)
New Employee Orientation Part 2 (completed!)
Guardianship Program Overview (completed!)
Person-Centered Planning (completed!)
Effective Case Work Documentation
KYGFIS
Note: The above courses are required for Guardianship, Fiduciary, and Benefits staff. Additional courses will be assigned upon completion of these required core courses.
Click the “Mark Complete” button below to access your certificate of completion.
“Hi, I’m Ronnie. I’ve been working in the guardianship program for 3 years. I’m here to assist you in learning more about effective casework documentation. “
Course Goals
This training course is designed to provide a general overview of effective casework documentation.
Learning Goal #1 Identify required elements of documentation.
Learning Goal #2 Evaluate a note for poor documentation.
This course is part of a series of trainings required for all new employees. All new hires are required to satisfactorily complete trainings before being assigned cases.
All courses must be completed in order and in a timely manner.
Documents actions of GSSW taken on behalf of an individual in KYGFIS.
Documents and reports on actions taken to meet the individual’s needs and desires.
Documents events in the individual’s life.
Is a legal document.
Example of Events to be Documented:
All meetings and follow-up activities related to those meetings.
Ongoing documentation on problematic or unresolved issues and follow-up.
A plan to address identified needs but lack a resource to get the need met.
Any life-altering events, including but not limited to changes in family or marital status, elopement, housing situation or arrangements, employment status, etc.
All actions taken by the GSSW or others members of the team related to the individual’s services. Including but not limited to individual visits, phone calls, meetings with other service providers, etc.
Medical/dental appointments, updates, and changes.
Current individual Status: Physical appearance (appropriate clothes, good hygiene), mental status, health, safety, and wellbeing.
Ronnie tells you, “Effective documentation is an important part of Guardianship. Let’s talk about why it is so important.”
Effective documentation:
Establishes accountability and evidence of services provided.
Provides an accurate, timely, objective account of an individual’s situation, services, plan of care progress or the lack of, interventions, challenges, health, and other relevant information.
Is valuable at the time of intervention and for years in the future.
What is the purpose of effective documentation?
Helps to assure continuity of care.
Helps the service team remember events.
Serves to tell a story and helps identify patterns of behavior.
Provides a record of information used by the GSSW and other service providers in team meetings and court hearings.
Poor documentation:
Lacks clarity, specificity, and completeness.
Is subjective and contains the writer’s opinion and feelings versus facts.
Prevents a clear presentation of the individual under guardianship’s story.
Has the potential to create risks and lead to unintended negative consequences which could compromise an individual under guardianship’s health, safety, & welfare.
KYGFIS:
The Kentucky Guardianship Fiduciary Information System (KYGFIS or GFIS), is a database system where all relevant individuals under guardianship information and documentation (referred to as events) are entered or attached and stored.
Next, we will discuss what information should be documented in KYGFIS and how.
Person-centered planning takes into consideration the whole person. The person in need of services is seen and understood by those who deliver the service. This results in an internal consistency in the ways that person is served.
Service Plan versus Contract
Person-centered is different from more traditional approaches to service delivery. In more traditional methods the service team makes the decision FOR the person and not WITH them.
In Guardianship, we do not use the term “contract” when referring to person-center planning with individuals under guardianship.
A person-centered plan:
Is a non-authoritative approach and does not involve professional superiority over an individual receiving services.
Allows an individual to take a lead role in discussions and decisions made regarding their care, services, personal goals, etc.
Requires compassionate facilitation and critical listening skills without judgment of an individual’s personal experience, circumstances, thoughts, and feelings.
Supports and guides an individual in a way that empowers their voice, motivates self-confidence, and a stronger sense of identity.
Is individualized and flexible and takes into account that everyone has a unique level of ability and that people are more than their diagnosis.
Frames care and services thru the eyes and voice of the recipient of services.
It is important to remember that your role as a guardian is to set high, but achievable, expectations based on what is both positive and possible and not based on the limited life experiences the person may have had. Many people who come under State Guardianship have experienced significant trauma and thus may have low self-esteem, a lack of willingness to trust others, and a dearth of real-life experiences which would lead to a positive identity for the person.
Ensure the individual under guardianship has a voice and empower active participation, to the best of the person’s ability in the planning process and decision making.
Involve the individual under guardianship by asking and gathering information about the person’s likes, dislikes, wants, needs, hopes, dreams, and desires.
Understand that everyone is different so the person-centered planning process is not a “one size fits all” approach.
Remain unbiased and non-judgmental.
Ensure the process is carried out in a way that promotes self-confidence, a stronger sense of self-identity, healing, and positive growth.
You have completed Guardianship Program Overview! Please note, that your supervisor may have some follow-up questions or need more information. Please respond to any requests in a timely manner.
Once you click “mark complete” a certificate of completion will be available to you. You may print or download your certificate to verify completion ofGuardianship Program Overview. This certificate will also be available at the beginning of the course anytime you log on.
Reminder from Aida
This course is part of a series of trainings required for all new employee. All new hires are required to satisfactorily complete trainings before being assigned cases.
All courses must be completed in order and in a timely manner.
This includes:
New Employee Orientation Part 1 (completed!)
New Employee Orientation Part 2 (completed!)
Guardianship Program Overview (completed!)
Effective Case Work Documentation
KYGFIS
Note: The above courses are required for Guardianship, Fiduciary, and Benefits staff. Additional courses will be assigned upon completion of these required core courses.
Click the “Mark Complete” button below to access your certificate of completion.
This course is part of a series of trainings required for all new employees. All new hires are required to satisfactorily complete trainings before being assigned cases.
All courses must be completed in order and in a timely manner.
According to the Administration for Community Living (ACL), person-centered planning is a process for selecting and organizing the services and supports that an older adult or person with a disability may need to live in the community. Most importantly, it is a process that is directed by the person who receives the support.
Person-centered planning identifies the person’s strengths, goals, medical needs, needs for home-and community-based services, and desired outcomes.
The approach also identifies the person’s preferences in areas such as:
recreation,
transportation,
friendships,
therapies and treatments,
housing,
vocational training and employment,
family relationships, and
social activities.
Unique factors such as culture and language are also addressed.
Perhaps the most powerful idea of person-centered planning is that the way a person who needs services is seen and understood by those who deliver that service generates a powerful internal consistency in the ways the person is served.
-A. Frank Johns
Person-Centered Planning in Guardianship; Part III Person-Centered Philosophy2012 A. Frank Johns, JD 1971 Florida State University, LL.M. in Elder Law
Take a moment to reflect, on how the definition of person-centered planning applies to your work as a guardian. Think about your own life – would you want to be told where to live, if you could work and where, or if you would be sent to a care facility during the day?
A court-appointed person or entity with the duty and authority to make personal, medical, and financial decisions on behalf and in the best interest of the individual in guardianship.
Responsible to make ethical and person-centered decisions with and on behalf of the individual. The Guardian should involve the individual to the fullest extent possible in making decisions that affect their lives. The Guardian will also work as part of a person-centered team that involves the courts and a variety of service providers.
Primary duties include (but are not limited to)…..
Adheres to all state guardianship statutes, regulations, and policies
Completes all necessary documents and reports
Makes routine and emergency visits with individuals under guardianship
Attend meeting(s) to plan for services and supports with the Person-Centered Team
Approves living arrangements
Approves healthcare decisions
Applies for and establishes the individuals benefits i.e., Medicare, Medicaid, Medicaid Waivers, SSA, VA, food stamps, etc. (approval not guaranteed)
Files state and federal taxes
Sets up budgets, pays reoccurring bills
Manages and invests funds and assets as applicable
Establish burial arrangements as needed
Secure and liquidate assets
Attends court hearings
Fiduciary and Benefits Branches
There is a three-pronged approach to ensure guardianship roles and responsibilities are met for our individuals under guardianship.
The Division of Guardianship Services works with and is supported by the Benefits Management Branch and the Fiduciary Management Branch. These two branches operate under the DCBS Division of Administration and Financial Management.
The Benefits and Fiduciary Management Branches are responsible for applying for and maintaining benefits (e.g., Medicaid, SSI, Veterans, etc.), filing taxes, managing/investing funds and paying bills and expenses on behalf of our individuals.
While we have reviewed several limitations to guardianship and what a guardian cannot provide, there are many things that a state guardian can provide. These services include:
Regular visits with the individual under guardianship.
Routine medical/end-of-life decisions.
Approval of residential placement.
Arranging transportation when funds are available.
Establishing burial arrangements.
Attending court hearings and meetings on behalf of the individual under guardianship.
Contract with providers for an individual’s services.
Keeping in contact with an individual’s family.
Applying for benefits (Medicare, Medicaid, SSA, VA, food stamps, Medicaid Waivers, etc.).
Setting up budgets and paying reoccurring bills.
Manage and invest an individual’s funds.
File state and federal taxes.
Secure or liquidates assets.
Much, much more based on the individual needs of the person.
“One of the individuals I work with was suddenly discharged from their placement. The person was very upset and had nowhere to go. I was able to help him contact his uncle, who provided him with funds to stay in a hotel until we were able to help secure him a new placement.”
Ronnie
CHFS Guardian
Guardianship Statutes and Regulations
Aida
As mentioned in New Employee Orientation Part 1, there are Kentucky Regulatory Statutes (KRS) that govern the state guardianship program. It is important to become familiar with these regulations, where to locate them, and what they mean. In later trainings, we will spend more time looking at these laws in more detail. When you have time, go ahead and start looking through and familiarizing yourself with the KRS and KAR.
Guardianship employs nurse consultants who assist guardians with healthcare, medical treatment, and end-of-life procedures for individuals under guardianship.
Services are carried out as authorized by the district court and in accordance with regulations and healthcare standards.
Nurse consultants will work closely with physicians, nurses, and social workers, at medical or residential facilities across the state, as needed.
They are also instrumental in reviewing and working with CHFS Office of Legal Services, in obtaining approval for certain medical procedures and treatments.
