SD #15:  Keeping it all together:  Collecting and Managing Data for Progress Notes

In this blog post, I will share how I keep track of “all the stuff” to make the progress note process run smoothly.

When your child was on an IEP, you would receive progress notes throughout the school year.  When your person transitions to an ISP in adult programming, you will continue to receive progress notes from that program.  If you are running a Participant Directed Program, as the case manager, it is your responsibility to coordinate and complete the progress notes to be presented during the annual ISP meeting with your DDS Support Broker.

What are progress notes?

As the form states, progress notes are a formalized form that DDS uses to gather information on what your person completed during the previous ISP period.  Per DDS, progress notes should be submitted to the DDS Support Broker at the semi-annual mark (180 days after the ISP meeting) and 15 days before the scheduled annual ISP meeting.  Depending on your programming, your DDS Support Broker may also ask you to complete quarterly progress notes.  

Who completes the progress notes?

I have the staff who work with L on each particular goal complete a progress note, and I also complete one as his case manager. This way, DDS is receiving information not only from myself but also from the staff working directly on the goal with L.  

I also have L complete the progress note questions within his person-centered planning. Within that plan, we not only talk about future goals and objectives but also look at and reflect on what he has accomplished so that his voice is represented during the progress note process.

What does the progress note look like?

Below, I have attached a blank copy of the most recent ISP Progress Note we are currently using.  Let’s highlight some of the key takeaways on this form:

1. Goal from Last ISP and Objective Sections:  This is where you will list the specific goal that you are writing about in the progress note.  You need to complete a progress note for each individual goal (just like the teachers/service providers needed to do when completing the progress notes for the IEP).  I will give each service provider their sheet with the goals and objectives already listed for them.
2. Objective Status:  This is where the person completing the form will indicate the status of the goal.  It is not uncommon that during the semi-annual review, the goal will either be “not met” or “partially met”.  Having the staff reflect and check this off is a good way to know what may need to be tweaked or revised within the program to reach the goal.  
3. Describe what progress has been made towards reaching the goal:  this is where the staff will detail what (if any) progress has been made towards reaching the goal.  They can also indicate if they believe that if all goes as planned, the person will achieve this goal upon completion of the ISP period.
4. Are there any recommended changes to aid in supporting reaching the goal?  This is where the team members can indicate if they will need to make any course corrections to the goal, i.e.,  if they need to change strategies.  Do they need additional programming support or resources to help them reach the goal?  Does the goal need to be broken down into smaller components?  

**If you are looking to make any changes, you would also complete the ISP Modification form to be attached as an addendum to the current ISP.  The following (taken from the DDS ISP Training PowerPoint) lists those situations that would warrant the team completing an ISP Modification form:

• •Per DDS Regulation 115 CMR 6.25, a Modification to an ISP may include one or any combination of the following elements all under the same Reason for Modification.
  1. Any change in the Goals for an individual
  2. Any change in the types of supports or services that will be used to help the individual to attain his or her outcomes or changes in the duration and frequency of such supports
  3. A change in the strategies that will be used to meet unmet support needs
  4. A change in the priority for services or supports assigned to the individual’s needs where such a change will affect the services or supports that are provided and available to the individual
  5. Initiation of a behavior modification plan or modification of any part of a behavior modification plan involving the use of an aversive or intrusive technique
  6. A change in the location of an individual’s home, from a home operated by the Department or a provider certified by the Department to another such home
  7. NOTE: Changes in an individual’s life that would substantially change the ISP content should be considered for a full ISP meeting.

How do we collect data to make this process easier?

When your child was in school, the team members working with your child on their IEP goals needed to take data and save documentation to support if your child was meeting the goals as written.  Now, your adult child’s team members are charged with collecting information and data to show that the goals and objectives are, or are not, being met.  This task can be daunting if you have never had to write progress notes before, so where can you begin?

First, I recommend gathering information on a minimum of a monthly basis. Why? It will make writing the semi-annual and annual progress notes easier if you have a monthly entry to go back and reference.

Next, you need to set up a system that works for you and the team on how to collect the data.  I emphasize “what works for you and the team” because what works for me may not work for others.  Some minimum information to help you track this information is:

1. Create a paper or digital file with the individual goals and objectives listed on each page.
2. Do a monthly reflection:  ask your adult child how the month is going related to the goal.  What wins did they have that month?  What struggles are they having?  Do they need additional resources or support?  Do they need to add a step to the process to reach the goal?  Do they need to take a step back?  You can write these questions down and use them monthly as reflection pieces.  Attached at the bottom of this post is the template that we use for our monthly reflection.
3. If you need to take data points, consider setting up a Google Form that is shared with all staff who can complete the form after every shift or whenever you have determined the information needs to be gathered.  All of the information on the form will be date-stamped and fed into a single Google Sheet. You can also create charts or graphs in Google Sheets directly from the data given.
4. Use a third-party progress note program:  within the Unique Learning System Transition program, they have job readiness self-reflection and staff reflection sheets, and we have used these as a way to collect information on L’s vocational jobs. These sheets get attached to the Progress Note as additional documentation.

No matter which method you choose, having a system in place to consistently collect information, reflections, and data will make the process so much easier when you need to complete your annual and semiannual notes. This will also give you information that your person can use when creating their person-centered plan so that they can better reflect on how the year has progressed and what the next steps may be for the upcoming ISP.

Call to Action

*Progress Notes are an integral part of the ISP process, allowing the person and the team members to see semi-annually and annually how the goals and objectives are, or are not, being met.

*As a team, determine a system for capturing data and information on a consistent, minimum monthly basis so that you are recording the information in real time when memories are fresh.  A paper sheet, a Google or Word Doc, a Google Form, or a third-party program are just a couple of ways the team can consistently collect data and information throughout the year.

*Ask for help:  you should not be completing these forms alone.  All members of the team that are involved in the execution of the goals, including the adult in the participant-directed program, should have their voices heard about how the goals and objectives are being delivered and the progress that is being made.  You should also contact your DDS Support Broker, especially if a goal is not moving according to plan and you need additional support and resources to work on these goals and objectives.

In a future blog post, I will discuss the systems we have in place for the program’s day-to-day running, which is also helpful when completing the semi annual and annual progress notes.  

Until next time,

Cheryl

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