Real Life Choices
( Reprinted from NJ Division of Developmental Disabilities website )

Real Life Choices is a self -directed approach that represents a system change. It provides services and supports based on an individual budget. The individual and family can purchase services and supports to achieve the outcomes they have identified in their Plan of Care.

Real Life Choices is based on assisting individuals and families to create outcomes through a Person-Centered Thinking model, Essential Lifestyle Planning (ELP). This is a strength based tool that helps individuals and their families to go beyond the identification of available services and allows them to focus on what is important to them and how to build those choices into their plan. The system is changing from focusing on goals identified by professionals to outcomes developed by the consumer and their families. Since outcomes are identified by the individuals and their families, their satisfaction is a major indicator of achievement of those outcomes.

A description of the major elements of the Real Life Choices follows:

Assessment Tool
In order to plan for individualized service needs, it is necessary to gather common information and determine the needs of individuals utilizing a common understanding of the level of individual needs. DDD contracted with the Developmental Disabilities Planning Institute, New Jersey Institute of Technology to develop a Resource Tool after extensive study of other states’ surveys and proven testing for reliability and validity. This Assessment Tool statistically assesses individual competencies and determines relative need for service. The Assessment Tool is designed to assess the strengths or competencies of individuals with developmental disabilities in the areas of cognition, communication, self-care, and mobility and determine the specific levels of need. There are four levels under Real Life Choices:

Individualized Budgets
Once a level of need is determined, this information is used to develop an individualized budget. There is a strong correlation between individualized competencies and the amount of support time needed. Family members of individuals with developmental disabilities with the lowest competencies spend the most support time and have the highest need for services. The assessment and individual budget builds equity into the system by determining who needs more support and ensuring those with like needs receive like resources.

Plan of Care Development Through Essential Lifestyle Planning (ELP)
The Division has incorporated ELP, a nationally recognized life planning tool as the Plan of Care planning model for Real Life Choices. While it is true that like needs are directly linked to like supports and services, the types of services need to be very individualized. ELP starts with identifying how a person wants to live (Important to) and balances that with any health and safety issues (Important for). ELP is a guided process for learning how someone wants to live and for developing a plan to make it happen. The essential lifestyle plans, developed through a process of asking and listening, provide a snapshot of how someone wants to live today, serving as a blueprint for how to support them tomorrow.

Unlike any tool used in the past, the Plan of Care that is developed through this ELP process, talks about the individuals strengths, not weaknesses. It allows individuals with disabilities and their families to discuss great things about the person. What are their strengths mentally, physically and spiritually? What people like about the person. What is important to the person? What are the characteristics of people who support the person best? What others need to know or do to support them. In this model, the individual is the focus, not the service or the program.

Support Coordination & Team Process
Individualized Support Coordination is a critical element in fostering self direction under Real Life Choices. Support Coordination is an empowerment and facilitative process that assists family through the process and allows them to remain in control of their plan. This function is provided by individual Support Coordinators who work face-to-face with the individuals and their families throughout the process. Individual and Family Mentors also assist with the development and implementation of the plan by developing a relationship with the family, through the sharing of their own real life experiences.

While the role of the Support Coordinators and the Mentors are the primary contact with the families, they are part of a team that is ultimately responsible for assisting families in the development and implementation of the Plan of Care.

Fiscal Intermediary
Since the state cannot give funds directly to individuals to pay for their services, DDD utilizes a fiscal intermediary to pay for the services and supports identified by Real Life Choices participants and their families. The major functions of the fiscal intermediary are to disburse the public funds allocated to individuals via payments to service providers and act as employer of record for staff hired directly by the individuals. Easter Seals of New Jersey is the agency that is providing fiscal intermediary services on behalf of individuals who are self-directing their services through Real Life Choices.


Qualifying Individual and Agencies
Historically, services could only be accessed by providers under contract with the DDD. This limited any choice for the individual with a developmental disability and their family. As part of the System’s Change to expand the ability for self-directed services and choice, DDD created the Process for Qualifying Individuals & Agencies for Real Life Choices. This process has not only increased the number of agencies and individuals available to serve people with developmental disabilities, but the types of services have grown as well. DDD is beginning to qualify more generic types of agencies to provide services to individuals. For example, a few local YMCA’s and YWCA’s have been recently qualified, along with several fitness centers and evening adult schools.

Target Population

• Adults on the priority waiting list who are DDD and ICF/MR eligible and fulfill all requirements to become eligible for the CCW waiver. 
  
• Individuals with developmental disabilities that are transitioning from special education to adult life who are ICF/MR eligible and fulfill all requirements to become eligible for the CCW waiver. 
  
• Individuals referred by the DDD who are currently in services and choose to self-direct who are ICF/MR eligible and fulfill all requirements to become eligible for the CCW waiver. (option currently under development).
  
• Current priority is given to individuals with developmental disabilities who are on the priority waiting list and second priority is given to individuals transitioning from special education.