2005 SE Provider Meeting Report

2005 SE Provider Meeting Report
9/2/2019 4:36:15 PM 2005 Community Practice Review Southeast Region DRAFT Findings Presented: September 20, SE Review held August 22-26, 2005

Class Members: 43 Number in Sample: 15 (35%) DSLM 8 in sample
Five Independent Case Management Agencies Represented in the Sample DSLM in sample PRMC in sample J&J Home Care 2 in sample Laurel Ridge in sample Sun Country in sample

Number Reviewed by Day and Residential Provider
Day Residential ResCare ENMRSH Leaders Tobosa Alliance CARC Casa Alegre Door of Opportunity High Desert Peak

9/2/2019 4:36:15 PM Class Members with Immediate or Special Needs Individuals Needing Immediate Attention: 2 People 13% of sample Individuals for whom health, safety, environment and/or abuse or neglect issues were identified during the review. Individuals Needing Special Attention: 7 People 47% of sample Issues were identified that may, if not addressed, effect the person’s health safety and welfare. In 2004, four people required Immediate Attention (27%) and two people required Special Attention (13%). (15 people in the 2004 sample)

9/2/2019 4:36:15 PM Identified Indicators of Good Practice People play valued roles in their community Nine people are regulars at their local libraries. Three people are active swimmers. Five people regularly attend church – and one volunteers in the nursery. Three people go bowling frequently. Three people attend the annual Piñata Fest – one of whom is on the volunteer board. Four people are involved with national awareness groups: Special Olympics, People First!, Boys & Girls Club, & Good Samaritans.

9/2/2019 4:36:15 PM Identified Indicators of Good Practice People are a part of and integrated into their communities Ten people (67%) were seen as adequately integrated into the community. Five people are increasing the number of times they are in the community and are improving how they interact with others. People have friends Seven people have friends that they meet and interact with in the community – one person regularly exchanges with two friends! People are employed Three people are engaged in supported employed and work at least 10 hours per week.

9/2/2019 4:36:15 PM Identified Indicators of Good Practice People benefit from long term, caring and respectful staff Five people have residential staff that have been with them for at least five years. One for 10 years! Twelve people have case managers who “know” them and can describe their preferences, wants and needs. Nine people have shown progress in their activities and/or interactions with their day providers. Thirteen people are treated with dignity and respect.

9/2/2019 4:36:15 PM Identified Indicators of Good Practice People have proactive advocates Case Manager/Guardian Eleven Guardians found the Case Manager helpful. Six people were identified as having actively involved guardians. (Seen at least 3 times a month) Nine people were determined to know their guardians. Twelve people have case managers who are available to them.

9/2/2019 4:36:15 PM Identified Indicators of Good Practice People have shown evidence of progress Four people are increasing their communication abilities. Seven people are more physically able: walking more, engaging in more activities and tasks in their homes and in the community. Six people are becoming more independent in their homes: cooking, cleaning, dressing and other daily tasks. 102 assistive technology and adaptive equipment devices are needed by the members of the sample – 84 of which are available and used at all needed times (82%).

2005 SE Provider Meeting Report What We Learned: Other Findings
9/2/2019 4:36:15 PM What We Learned: Other Findings A. Expectations for Growth and Quality of Life Noteworthy Practice: 87% were provided the assistance and support needed to participate meaningfully in the planning process 80% (up from 40% in 2004) were offered a range of opportunities for participation in each life area. 90% (up from 67% in 2004) had the opportunity to make informed choices about where and with whom to live, and 73% about where and with whom to work/spend his/her day. 100% know their guardian and believe their guardian is helpful. 100% (up from 33%) of retired persons have adequate opportunities to engage in activities of interest during the day. 13 of 15 persons (87%) were found to be treated with dignity and respect (47% in 2004).

9/2/2019 4:36:15 PM Other Findings A. Expectations for Growth and Quality of Life Practice Challenges: 53% had achieved clear progress in the past year. 13% (an increase from none last year) have achieved no progress. While there has been some improvement since last year, in less than half (47%) of the sample was the IDT found to have an appropriate expectation of growth for the person. Of support persons, case managers were least likely to have an appropriate expectation of growth, while approximately 2/3 of day and residential staff had an appropriate expectation. 60% (67% last year) of persons were found to have the opportunity to make informed choices. While the individuals know and believe their guardians to be helpful, only 67% have guardians who could be described as actively or moderately involved in the person’s life and service planning.

A. Expectations for Growth and Quality of Life
Other Findings A. Expectations for Growth and Quality of Life Question Response % Yes 84. Based on all of the evidence, in the opinion of the reviewer, has the person achieved progress in the past year? 8 Yes 5 Partial 2 No 53% 85. Overall, does the IDT have an appropriate expectation of growth for this person? 7 Yes 7 Partial 1 No 47 % 31. Does the case manager have an appropriate expectation of growth for this person? 6 Partial 42. Does the [day services] direct service staff have an appropriate expectation of growth for this person? (1 person in sample has no day services) 10 Yes 4 Partial 71% 52. Does the residential direct service staff have an appropriate expectation of growth for this person? 9 Yes 60% 86. Was the person provided the assistance and support needed to participate meaningfully in the planning process? 13 Yes 87% 87. Is the person is offered a range of opportunities for participation in each of the life areas? (1 CND) 12 Yes 1 Partial 86%

A. Expectations for Growth and Quality of Life (continued)
Other Findings A. Expectations for Growth and Quality of Life (continued) Question Response % Yes 88. Does the person have the opportunity to make informed choices? (5 CND) 6 Yes 3 Partial 1 No 60% 89. About where and with whom to live? (5 CND) 9 Yes 90% 90. About where and with whom to work/spend his/her day? (4 CND) 8 Yes 2 Partial 73% 95. Does this person know his/ her guardian? (2 N/A, 4 CND) 100% 96. Does this person believe the guardian is helpful? (2 N/A, 10 CND) 3 Yes 97. What is the level of participation of the legal guardian in this person’s life and service planning? (13 % or 2 people, N/A) 3 Limited 4 Moderate 6 Active 23% Limited 31% Moderate 46% Active 100. If the person is retired, does he/she have adequate opportunities to engage in activities of interest during the day? (8 N/A, 1 CND) 103. Is the person treated with dignity and respect? 13 Yes 87%

9/2/2019 4:36:15 PM Other Findings B. Satisfaction Noteworthy Practice For persons for whom it could be determined, 100% were identified as getting along with their case manager (9 CND) and finding them helpful (11 CND). 100% had adequate food and drink available. 100% get along with their residential provider staff. 87% (up from 73%) were determined to have adequate transportation to meet their needs.

9/2/2019 4:36:15 PM Other Findings B. Satisfaction Question Response % Yes 105. Does the person get along with the case manager? (9 CND) 6 Yes 100% 106. Does the person find the case manager helpful? (11 CND) 4 Yes 108. Does the person have adequate food and drink available? (1 CND) 14 yes 109. Does the person have adequate transportation to meet his/her needs? 13 Yes 2 Partial 87% 111. Does the person get along with their day program employment staff? (1 N/A, 1 CND) 11 Yes 85% 112. Does the person get along with the residential provider staff? (1 CND) 14 Yes

9/2/2019 4:36:15 PM Other Findings C. Assessments Noteworthy Practice Improvements were realized in scoring for each of these questions, with the 2004 results ranging from 20% to 27% compliance and the 2005 scoring ranging from 40% to 67%. Practice Challenges In 47% of instances, the team did not or did not fully consider what assessments the person needs and would be relevant to the team’s planning efforts. In 60% of instances the team did not arrange for and obtain all of the needed, relevant assessments. In one instance assessments were not considered by the team or used in planning.

Other Findings C. Assessments
Question Response % Yes 57. Did the team consider what assessments the person needs and would be relevant to the team’s planning efforts? 8 Yes 6 Partial 1 No 53% 58. Did the team arrange for and obtain the needed, relevant assessments? 6 Yes 8 Partial 40% 59. Are the assessments adequate for planning? 10 Yes 4 Partial 67% 60. Were the recommendations from assessments used in planning? 9 Yes 5 Partial 60%

9/2/2019 4:36:15 PM Other Findings D. Adequacy of Planning and Adequacy of Services Noteworthy Practice The ISP was developed by an appropriately constituted Team in 64% of instances, up from 33% in 2004. The functional supports assessment gave adequate guidance to achieving the person’s long-term vision in 71% of those reviewed. (33% in 2004) A major increase is noted (13% to 64%) on question 67; the goals in the ISP include criteria by which the team can determine when the goals have been achieved. The strategies in the ISP were found to be sufficient to ensure consistent implementation of the services planned in 71% of instances, up from 33% in 2004. Crisis pans that meet the person’s needs were included in 92% of ISPs, up from 23% in 2004. Specific arrangements for primary health care are identified in 86% of ISPs, up from 40%. 86% of ISPs identify how the person will obtain prescribed medication, up from 20%.

9/2/2019 4:36:15 PM Other Findings D. Adequacy of Planning and Adequacy of Services Practice Challenges Half of all ISPs contain an adequate long term vision. While a significant increase was realized, only half of all ISPs contain goals that address the person’s major needs. Similarly, while a significant increase was realized, in 50% of the instances recommendations and/or objectives/strategies of ancillary providers were integrated into the goals, objectives and strategies of the ISP. In 36% of instances the ISP was found to be adequate to meet the person’s needs. Regarding those instances (10) in which the ISP was found to not be fully adequate, only one person was found to have services adequate to meet the person’s needs.

9/2/2019 4:36:15 PM Other Findings D. Adequacy of Planning and Adequacy of Services Question Response % Yes 62. Was the ISP developed by an appropriately constituted IDT? (1 N/A) 9 Yes 5 Partial 64% 64. Overall, is the long-term vision adequate? (1 N/A) 7 Yes 7 Partial 50% 65. Overall, does the functional supports assessment give adequate guidance to achieving the person’s long-term vision? (1 N/A) 10 Yes 4 Partial 71% 67. Overall, do the goals in the ISP include criteria by which the team can determine when the goals(s) have been achieved? (1 N/A) 1 No 69. Overall, do the goals in the ISP address the person’s major needs? (1 N/A) 7 No 71. Overall, are the strategies sufficient to ensure consistent implementation of the services planned? (1 N/A) 2 Partial 2 No 72. Overall, are the recommendations and/or objectives /strategies of ancillary providers integrated in to the goals, objectives and strategies of the ISP? (3 N/A) 6 Yes

9/2/2019 4:36:15 PM Other Findings D. Adequacy of Planning and Adequacy of Services Question Response % Yes 73. Does the ISP contain a specific crisis plan that meets the person’s needs? (2 N/A) 12 Yes 1 Partial 92% 74. Does the ISP contain specific arrangements for primary health (medical) care? (1 N/A) 2 Partial 86% 76. Does the ISP reflect how the person will obtain prescribed medications? (1 N/A) 78. Overall, is the ISP adequate to meet the person’s needs? (1 N/A) 5 Yes 9 Partial 36 % 79. If #78 [above] is rated “2”, is the ISP being implemented? (10 N/A) 4 Yes 80% 80. If there is no ISP, or if #78 is rated “0” or “1”, are current services adequate to meet the person’s needs? (5 N/A) 1 Yes 8 Partial 1 No 10%

9/2/2019 4:36:15 PM Other Findings E. Individual Service Planning Noteworthy Practice With regard to every protocol question there was at least some increased compliance. More than twice as many people (40% to 87%) were found to have adequate access to and use of generic services and natural supports. Also twice as many people (1/3 of sample to 2/3 of sample) were found to be adequately integrated into the community. Practice Challenges More than half of persons were found to not fully receive services and supports as recommended in the ISP. One third of persons remain not adequately integrated into the community.

Individual Service Planning
Other Findings Individual Service Planning Question 2000 2001 2002 2004 2005 Does the person have an ISP that addresses living, learning/working and social/leisure… 79% 84% 75% 53% 73% Does the ISP contain a functional supports assessment based on a long-term view? 90% 89% 82% 60% Does the person receive services and supports recommended in the ISP? 67% 69% 70% 40% 47% Does the person have adequate access to and use of generic services and natural supports? 57% 78% 87% Is the person adequately integrated into the community? 63% 71% 66% 33%

E. Individual Service Planning
Other Findings E. Individual Service Planning Question Response % Yes 146. Overall, is the ISP adequate to meet the person’s needs? 5 Yes 9 Partial 1 No 33% 147. Is the total program of the level of intensity adequate to meet this person’s needs?

9/2/2019 4:36:15 PM Other Findings F. Team Process Noteworthy Practice 100% of ISPs were found to have been reviewed by the IDT within the last 6 months. 87% (up from 40%) have records or facts to indicate that the team convened meetings as needed due to changed circumstances and/or needs. Similarly in 80% of the sample there was adequate communication among team members between meetings to ensure the person’s program can be/is being implemented. It appears that in the past year the occurrence of physical, behavioral and functional regression is down (27% and 33% in 2004 to 7% and 14% in 2005). 86% of the day staff knew the person well. 87% of the residential staff knew the person well, 80% had adequate input into the person’s ISP. (Q# 44 & 45)

9/2/2019 4:36:15 PM Other Findings F. Team Process Practice Challenges Individual members of the IDT were found to be following up on their responsibilities in 27% of the sample (same as 2004). Of the day staff who knew the person well, 64% had adequate input into the person’s ISP. 9 People had an appropriately constituted IDT. For 4 people, their “missing team members” participated in the development of the ISP, but 5 people did not have input from all IDT members. “Missing Members” were noted as: the class member, nutritionist, nurse, therapy providers and guardians

9/2/2019 4:36:15 PM Other Findings F. Team Process Question Response % Yes 113. Is there evidence that the ISP was reviewed by the IDT within the last six months? (2 N/A) 13 Yes 100% 114. Are the individual members of the IDT following up on their responsibilities? 4 Yes 11 Partial 27% 116. Do records or facts exist to indicate that the team convened meetings as needed due to changed circumstances and/or needs? 2 No 87% 117. Is there adequate communication among team members between meetings to ensure the person’s program can be/is being implemented? 12 Yes 3 Partial 80% 119. Is there evidence or documentation of physical regression in the last year? (1 CND) 2 Yes 12 No 14% 120. Is there evidence or documentation of behavioral or functional regression in the last year? 1 Yes 14 No 7%

9/2/2019 4:36:15 PM Other Findings G. Health Related Needs Practice Challenges Team members interviewed were able to describe the person’s health related needs in 27% of instances (same as 2004). In 20% of instances (down from 27% in 2004) did the reviewer find the person’s health supports/needs to be adequately addressed. Question Response % Yes 54. Overall, were the team members interviewed able to describe the person’s health-related needs? 4 Yes 10 Partial 1 No 27% 56. In the opinion of the reviewer, are the person’ health supports/needs being adequately addressed? 3 Yes 11 Partial 20%

H. Supported Employment
Other Findings H. Supported Employment Practice Challenges For those person’s identified as needing a supported employment assessment, 88% (down from 100%) actually received such an assessment. In 3 of 8 instances the supported employment assessment conform to the DOH regulations. One person (of 8) had a career development plan that meets the person’s needs. Of the six persons who would be expected to be involved in supported employment 50% (down from 60% last year) were found to be so engaged.

H. Supported Employment – Disengagement Table
Other Findings H. Supported Employment – Disengagement Table Question 2000 2001 2002 2004 2005 Need an employment assessment? 62% 100% 79% 73% 50% Need supported employment? 46% 85% 71% 67% 43% Receive supported employment assessment? 91% Assessment conforms to DOH Regulations? 88% 92% 64% 9% Has a Career Development Plan? 36% 0% 17% Receives employment services? 83% 55% 30% 40%

9/2/2019 4:36:15 PM Other Findings I. Day Services Note: 1 class member does not receive Day services Noteworthy Practice 79% of Day direct services staff received training on implementing the person’s ISP (up from 47% in 2004). 93% of Day direct services staff were able to describe his/her responsibilities in providing daily care/supports to the person (up from 73%). The day/employment environment was found to be generally clean, free of safety hazards and conducive to the work/activity intended for 91% of the sample (up from 45%). Practice Challenges More than one quarter of the Day direct services staff cannot describe the person’s health related needs. More than one quarter of the Day direct services staff do not have an appropriate expectation of growth for the individual.

9/2/2019 4:36:15 PM Other Findings I. Day Services Note: 1 class member does not receive Day services Question Response % Yes 37. Did the direct service staff receive training on implementing the person’s ISP? 11 Yes 3 Partial 79% 38. Was the direct service staff able to describe this person’s health-related needs? 10 Yes 4 Partial 71% 39. Was the direct service staff able to describe his/her responsibilities in providing daily care/supports to the person? 13 Yes 1 Partial 93% 42. Does the direct service staff have an appropriate expectation of growth for this person? 43. Is the day/employment environment generally clean, fee of safety hazards and conducive to the work/activity intended? (3 N/A) 91%

J. Behavioral Support Services
Other Findings J. Behavioral Support Services Noteworthy Practice 2/3 of those sampled were identified as needing behavior services. In 60% of those needing such services a behavioral assessment had been completed (up from 30%). Of those with behavioral support plans, 78% of the staff reported having been trained on the plan (up from 50%). Practice Challenges 40% of people needing a behavior assessment had not received one. Only 20% of the person’s receiving behavioral services were found to be receiving those services consistent with his/her needs (down from 40% in 2004). Regarding the ten individuals identified as needing behavior services, half were found to have behavior support services integrated into the ISP.

J. Behavioral Support Services
Other Findings J. Behavioral Support Services Question 2000 2001 2002 2004 2005 Does the person need behavioral services? 62% 77% 71% 67% 60% Have adequate behavioral assessments been completed? 88% 70% 40% 30% Does the person have behavior support plan developed out of the behavior assessments that meet the person’s needs? 50% Have the staff been trained on the behavior support plan? 90% Does the person receive behavioral services consistent with his/her needs? 20% Are behavioral support services integrated into the ISP? 13% 80%

9/2/2019 4:36:15 PM Other Findings K. Adaptive Equipment/Augmentative Communication Practice Challenges Half of the person’s needing adaptive equipment received all of it (down from 67% in 2004). Half of the person’s needing assistive technology had received all of it (up from 29% in 2004). 46% of person’s needing communications assessments had completed such assessments (up from 36% in 2004). Adaptive Equipment/Augmentative Communication Question 2000 2001 2002 2004 2005 Has the person received all adaptive equipment? 59% 73% 83% 67% 50% Has the person received all assistive technology needed? 54% 60% 81% 29% Has the person received all communication assessments and services needed? 49% 51% 61% 36% 46%

9/2/2019 4:36:15 PM Other Findings L. Case Management Noteworthy Practice 80% of case managers were identified as “knowing” the person (53% in 2004). 87% of case managers had received training on the topics needed to meet the needs of the sample class member (53% in 2004). 80% of case management records contained documentation that the case manager is monitoring and tracking the delivery of services as outlined in the ISP (up from 27% in 2004). Practice Challenges Slightly over half of CM (53%) were able to describe the individual’s health related needs (up from 40% in 2004). The same number (53%) had an appropriate expectation of growth for the person (up from 20% in 2004). Less than half of case managers were found to provide case management services at the level needed by the person (47%, up from 13% in 2004).

9/2/2019 4:36:15 PM Other Findings L. Case Management Question Response % Yes 26. Does the case manager “know” the person? 12 Yes 2 Partial 1 No 80% 28. Did the case manager receive training on the topics needed to assist him/her in meeting the needs of this person? 13 Yes 1 Partial 87% 30. Was the case manager able to describe the person’s health related needs? 8 Yes 6 Partial 53% 31. Does the case manager have an appropriate expectation of growth for this person? 32. Does the cm record contain documentation that the case manager is monitoring and tracking the delivery of services as outlined in the ISP? 33. Does the cm provide cm services at the level needed by this person? 7 Yes 7 Partial 47%

9/2/2019 4:36:15 PM Other Findings M. Home/Residential Noteworthy Practice All homes were found to be safe. 93% of the homes were found to offer a minimal level of quality of life (up from 73% in 2004). Practice Challenges 60% of residential direct services staff were found to have an appropriate expectation of growth for the individual. Same as in 2004. 53% (down from 60% in 2004) of residential direct services staff were able to describe the person’s health related needs.

9/2/2019 4:36:15 PM Other Findings M. Home/Residential Question Response % Yes 47. Is the residence safe for individuals? (void of hazards?) 15 Yes 100% 48. Was the residential direct service staff able to describe this person’s health-related needs? 8 Yes 6 Partial 1 No 53% 52. Does the direct service staff have an appropriate expectation of growth for this person? 9 Yes 5 Partial 60% 53. Does the person’s residential environment offer a minimal level of quality of life? 14 Yes 93%

Thank you! Lyn Rucker Community Monitor rpaltd@aol.com
Office: Cell:

2005 SE Provider Meeting Report

Similar presentations

Presentation on theme: "2005 SE Provider Meeting Report"— Presentation transcript:

Similar presentations

About project

Feedback

Log in

Auth with social network:

2005 SE Provider Meeting Report

Similar presentations

Presentation on theme: "2005 SE Provider Meeting Report"— Presentation transcript:

Similar presentations

About project

Feedback