Right, Jan Moxley, Options Counseling Program Specialist
A scenario is set in a Disability Rights NC training session:
Roberta, a 32-year-old woman with a spinal cord injury who lives in a nursing
home is a candidate for “Options Counseling,” a program to help older adults
and people with disabilities make decisions about current and long-term support
needs. Twelve counselors-in-training in the room must role play, conducting an
initial interview between Roberta and her counselor, using Options Counseling
If you think terms like “person-centered” and
“self-directed” are simply buzzwords, you should check this program out.
In 2012, the NC Department of Health and Human
Services Division of Aging and Adult Services introduced an Options Counseling
pilot program. Counselors with significant experience and education in the
human services field focus on empowering clients to make their own decisions.
Said Jan Moxley, options counseling program specialist,
“This service helps people think through the pros and cons of the various
options while taking into consideration their situation, values, resources and
And how is the program different from similar counseling
services for long-term care? Well, you may have heard stories of counseling
sessions that were rushed, not followed up on, or ended up with a plan that was
based more on the counselor’s preferences than that of the client. Big no-no’s
in this program.
“It’s all about the individual. What they think, want, need.
The counselor’s role is to listen, reflect back to the person what he or she
has heard, identify options and assist in weighing the pros and cons of each,”
said Moxley. “The individual sets the pace in conversation, whether or not to
develop an action plan, where to meet, when follow-up will occur.”
It works like this: the process is directed by the
individual or their legal representative, but may include others that they wish
to have present. The counselor conducts a personal interview to discover
strengths, values and preferences of the individual. The counselor helps
explore resources and service options and helps the individual weigh the pros
and cons of the different options. The counselor helps develop an action plan
and assists in applying for services when requested, and finally, follows up to
be sure that the decisions and supports are working well. The necessary time is
taken for all these steps to be fully played out.
North Carolina was one of twenty states to receive a federal
grant to develop the program. With approximately 600 people receiving
counseling in state fiscal year 2015-16, “this relatively young program has
room to grow in terms of the number of people served,” said Moxley. Across the state, 97 Options Counselors have
been certified, and another 12 are in training.
That training adds up to 42 to 50 hours. In addition to the one-day
disability rights and systems advocacy training provided by Disability Rights
NC, it includes two days of training in “person-centered thinking,” four
on-line training modules in Options Counseling concepts and standards,
interviewing, resources basics, and health literacy and cultural competency,
and an online SHIIP (Senior Health Insurance Information Program) training.
In the disability rights training, the trainees discuss as a
group the different issues that came up when they went through the Roberta role
play. Elaine Whitford of Disability Rights NC, who conducts the training, is
pleased that none of the trainees have hesitated to believe that Roberta can
move out of the nursing home if she wishes.
In fact, Roberta’s case is based on a real client, she said.
A young man who was in an accident and thought he’d never be able to live
outside a nursing home. “It took 18 months piecing together services, finding
an accessible location in the same town where his family lives, allowing him
the dignity of risk and to make his own mistakes,” she said. Now he lives in
his own apartment, hires and fires his caretakers, and with assistive
technology is feeding himself.
Individuals who are affiliated with an Aging and Disability
Resource Center (ADRC) or an Area Agency on Aging and meet the educational and
work experience criteria can apply to become certified as a counselor.
For more details on becoming a counselor, or for information
on how you or a loved one can receive Options Counseling, which is a free
service, contact Jan Moxley through the Division
of Aging and Adult Services website.