dda strategic plan - washington state department of social ... · 696 individuals are served at one...

1 | P a g e Developmental Disabilities Administration | DSHS

October 2017

DSHS MISSION To transform lives

DSHS VISION People are healthy People are safe People are supported Taxpayer resources are guarded

DSHS VALUES Honesty and Integrity Pursuit of Excellence Open Communication Diversity and Inclusion Commitment to Service

DDA MISSION Transforming lives by providing support and fostering partnerships that empower people to live the lives they want

DDA VISION Support individuals, Continually improving supports, Individualizing supports, Building support plans based on the needs and Engaging individuals, families

DDA VALUES Respect Person-Centered Planning Partnerships Community Participation


Table of Contents Introduction .................................................................................................................................................. 3 Goals ............................................................................................................................................................. 6 Strategic Objectives ...................................................................................................................................... 6

DDA Goal 1: Services for the Developmental Disabilities Administration clients are safe, community based, and high quality. ........................................................................................................................ 6

DDA Goal 2: Establish and maintain safe and healthy environments for staff and clients .................. 9

DDA Goal 3: Individuals with developmental disabilities are prepared for independence and self-sufficiency. .......................................................................................................................................... 12

DDA Goal 4: Ensure equity, diversity, and inclusion in recruitment, hiring, training, and retaining a diverse workforce in an effort to become an “Employer of Choice.” ................................................ 15

DDA Goal 5: Programs instill public trust and are tailored to meet the assessed needs of clients. ... 17

APPENDIX .................................................................................................................................................... 23


DDA Strategic Plan DEVELOPMENTAL DISABILITIES ADMINISTRATION

Introduction

Talk about support! DDA empowers those it serves to live the lives they want by respectfully engaging individuals and families in person-centered planning, ensuring self-respect and dignity. – Cheryl Strange, Secretary, DSHS

Our mission is to empower people to live the lives they want. Your efforts ensure the mission and are reflected in this plan. Thank you for all that you do every day for clients, families, and the community. – Evelyn Perez, Assistant Secretary, DDA


People with developmental disabilities and their families are valued citizens. Programs administered by the Developmental Disabilities Administration (DDA) are designed to assist individuals with developmental disabilities and their families to obtain services and supports based on individual assessments, needs and preferences. Link to Organizational Chart

https://www.dshs.wa.gov/dda

https://www.dshs.wa.gov/sites/default/files/SESA/office%20of%20the%20secretary/Org%20Charts/DDA_Org.pdf


DDA strives to develop and implement public policies that promote:

• Individual worth, self-respect, dignity, power and choice • Healthy, safe and fulfilling lives • Supports that meet the individual’s needs during the

person’s life span DDA offers the following supports and services:

• Case Management promotes collaboration during assessments, service determination and individual support planning. Case Resource Managers coordinate, authorize, monitor and evaluate the effectiveness of services available to address an individual’s identified health and welfare needs.

• Home and Community Based Service (HCBS) Waivers provide additional supports for Medicaid state-plan services. The DDA offers services under five HCBS waivers. Each of the waivers provide an array of services tailored to the specific populations they serve and are designed to meet the health and welfare needs of individuals living in their community rather than in institutional settings.

• Employment and Community Access Services offer persons

with intellectual and developmental disabilities the ability to more fully integrate and participate in society. These services provide access to employment and other community activities and increased independence from social-service systems.

• Community Residential Services provide a variety of residential options for individuals with intellectual and developmental disabilities who need support services to be able to live in and fully participate in the community. Supports range from a few hours a week to 24 hours a day. DDA provides residential supports to individuals in community settings such as their own homes, homes with supported living services both contracted and state-run, adult family homes, companion homes and state-operated living alternatives (SOLAs).

• Residential Habilitation Centers (RHCs) are state-operated,

residential settings that provide 24-hour support and habilitation training. An RHC may be certified as an Intermediate Care Facility for individuals with intellectual disabilities and/or licensed as a Nursing Facility. There are four RHCs in Washington State.

Our Work at a Glance

Each year • More than 3,600 DDA employees help

transform lives by providing individuals and families across our state with the resources and help they need to live the lives they want.

• DDA offers a continuum of supports and services through a safe, high-quality array of home, employment, community and facility-based residential services on a $1.50 billion annual budget.

• DDA serves more than 44,700 individuals with a paid services and no-paid services.

• More than 14,700 individuals receive employment, day supports, and child development services.

• DDA provides residential supports for more than 5,500 individuals in the community.

• DDA provides initial and ongoing training to all 3,600 DDA employees, for example over 200 new DDA CRMs went through CRM academy last year. In addition to providing training to DDA staff DDA also provides training to residential providers. Approximately 696 individuals are served at one of our four Residential Habilitation Centers.

• DDA administers five Home and Community Based Waivers of which over 19,400 DDA clients receive.

• DDA administers a quality management system that include quality assurance, monitoring, and training for staff and residential providers.

• DDA offers an array of administrative services, including communication, project management, National Core Indicators Survey, contracts and grants management, incident management, Residential Habilitation Centers special investigations, nursing care consulting, and contracted residential agency certification evaluation, and information and education related to the administration's quality assurance plan and activities.


• Community First Choice (CFC) is a Medicaid-covered program that provides in-home supports for assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs). ADL tasks include supports for eating, bathing, dressing, toileting and transferring. IADL tasks include supports for housekeeping, laundry, meal preparation, medication management, essential shopping and transportation. CFC provides services that increase independence or substitute for human assistance with ADLs and IADLs, (including skills acquisition and assistive technology) and offers back-up systems to ensure continuity of services and support, including personal emergency response systems and relief care.

Goals At DSHS, we transform lives. The strategic plan was created purposefully and is monitored frequently to ensure DSHS serves our clients and the State of Washington to the best of our ability. Whether we are fixing the plumbing at a state psychiatric hospital, assessing clients’ needs or ensuring kids have safe and stable living conditions, each of us has an effect on the lives of the 2.8 million clients that we serve. Every DSHS employee contributes to the strategic objectives in this strategic plan. In turn, each strategic objective aligns with the DSHS goals, which align with Results Washington goals. DDA is a partner in Governor Jay Inslee’s Results Washington. See Appendix. DDA has responsibility for two of the leading indicators under the goal topic Supported People: Stability and Self-sufficiency:

• Increase the percentage of DDA clients served in home and community-based settings from 97.4 percent as of July 2017 to 97.6 percent by June 2019.

• The percentage of working-age adults with developmental disabilities in employment

and day programs who are employed will increase from 66.2 percent in July 2017 to 67 percent by June 2019.

Strategic Objectives Below are the details of our plan to meet our strategic objectives. Each strategic objective includes a statement of its importance, a quantified success measure, a timeline and an action plan. DDA strategic objectives are monitored, updated and reported quarterly online here. Strategic Objectives, Importance, Success Measures and Action Plans

DDA Goal 1: Services for the Developmental Disabilities Administration clients are safe, community based, and high quality. Supports DSHS Goal: Protection - Each individual who is vulnerable will be protected. Strategic Objective 1.1: Ensure that services rendered to clients are community-based, safe and high-quality. Importance: An important indicator of quality of life is the opportunity to engage in stimulating activities. High levels of engagement indicate an environment that is providing opportunities for stimulation, learning and new experiences.

https://www.dshs.wa.gov/data/metrics/DDA.pdf#page=1


Success Measure 1.1.1: Increase the number of days per quarter that clients participate in community-based activities to 60 by June 2019.

Chart ADX.21: Average number of days per quarter in which individuals in supported living accessed community based activities

Action Plan: Residential providers are expected to complete an activities review summary for clients selected in a sample semi-annually.

• Results will be reported and the expectation to support community activities will be reinforced at residential provider meetings semi-annually.

• DDA will conduct case investigations and offer residential providers technical assistance for any clients who have two or fewer community outings in a sampled week.

• DDA will provide an online training resource and encourage residential provider staff to support community-based activities.

https://www.dshs.wa.gov/data/metrics/BHA.pdf#page=4



Success Measure 1.1.2: Ensure that 100 percent of supported living, group home, and group training home providers receiving a provisional certification from Residential Care Services (RCS) are offered technical assistance from DDA in an effort to correct findings and prevent decertification.

Chart ADX.28: Number of supported living and group home providers receiving provisional certifications, technical assistance, and decertification.

Action Plan:

• The DDA Residential Quality Assurance Unit will monthly monitor statements of deficiency (SODs) issued by RCS.

• Regional Quality Assurance Managers will visit all providers issued a SOD to ensure that plans of correction have been completed and implemented.

• The DDA Residential Quality Assurance Unit will analyze SODs and plan of correction outcomes to identify citation trends and inform technical assistance provided to residential vendors.

• DDA Residential Quality Assurance Unit will provide supported living and group home providers with training regarding needs identified from citation findings, trends, and plans of correction.




Success Measure 1.1.3: Complete standardized training for 180 supported living provider employees on writing functional assessments and positive behavior support plans by June 2019.

Chart ADX.27: Number of employees who completed standardized “Functional Assessment & Positive Behavior Support Planning” training.

Action Plan:

• Complete pilot project and analysis of outcomes for functional assessment and positive behavior support training by August 31, 2017.

• Finalize the curriculum for standardized functional assessment and positive behavior support online, blended training series by October 31, 2017.

• Promote training series (through DDA internet, at October 2017 Co-Occurring Disorders and Treatment Conference and at residential provider meetings).

• Offer on-going access to online training and at least one opportunity for in-person class and certification per quarter.

DDA Goal 2: Establish and maintain safe and healthy environments for staff and clients Supports DSHS Goal: Safety - Each individual and each community will be safe. Strategic Objective 2.1: DDA employees are trained to equip themselves with knowledge and skills to perform their duties in a manner that promotes safety in the workplace. Importance: Safety and continuity of operations are critical components to ensuring the health and safety of clients and staff.




Success Measure 2.1.1: Increase the percentage of DDA employees completing the online DSHS Active Threat safety training course to 95 percent by June 2019.

Chart ADX.29: Number and percent of DDA employees completing the online DSHS Active Threat safety training.

Action Plan: Provide regional and facility management with a monthly report that includes the number of employees who have completed training. Success Measure 2.1.2: Create continuity plans in all regions, state operated living alternatives (SOLA), and residential habilitation centers (RHC) in order to effectively respond to a disaster and subsequently continue operations by June 2019. Action Plan:

• Ensure that all four RHCs meet Centers for Medicare and Medicaid Services emergency management and disaster preparedness requirements by November 15, 2017.

• Update and revise emergency plans and continuity plan for DDA headquarters by June 2018. • Provide guidance and support for revision of region and SOLA emergency management

plans and continuity of operations plans by May 1, 2019. Strategic Objective 2.2: Ensure that service settings promote health, welfare and safety of clients. Importance: Strong case management and training ensure staff deliver the best service for clients. RHC maintenance is essential to ensuring health and safety for clients and staff that work and live there. Success Measure 2.2.1: Ensure all clients enrolled in the Enhanced Case Management Program (ECMP) receive a visit from a DDA case manager at least once every four months. The visit will evaluate the effectiveness of authorized services in meeting assessed support needs by June 2019.



Action Plan: • Ensure that 100 percent of clients enrolled in the ECMP receive a visit at least once every four

months. • Document scheduled visits, unannounced visits, and refusals to allow visit to be conducted in

the client’s record. • Provide monthly report to the DDA Executive Management Team that details caseload and

required visit activity.

Success Measure 2.2.2: Increase the percentage of RHC and SOLA staff who complete required Therapeutic Options certification training to 95 percent by June 2019.

Chart ADX.30: Cumulative percent of staff at RHCs and SOLAs completing required Therapeutic Options training.

0%

20%

40%

60%

80%

100%

2017 Jul 2017 Aug

81 %85%

88%

0%

25%

50%

75%

100%

Jul-Sep2017

Oct-Dec2017

Jan-Mar2018

Apr-Jun2018

Jul-Sep2018

Oct-Dec2018

Jan-Mar2019

Apr-Jun2019

June 2019 Target = 100 %



Action Plan: • Therapeutic Options training will be provided to RHC and SOLA direct support professionals. • Provide quarterly report to DDA executive management team on the number of direct support

professionals who have and have not yet completed Therapeutic Options training. • RHC and SOLA management teams will ensure that direct support professional staff complete

Therapeutic Options training. • Achieving this target will be included in the performance expectation plan for RHC and SOLA

managers. Success Measure 2.2.3: Ensure that RHCs are safe, secure, and well maintained and that campus spaces are used efficiently and appropriately as identified in the Ten-Year Capital Plan. All building systems and infrastructures that score less than “satisfactory” in the Facility Condition Assessment system will need to be addressed with capital projects by June 2019. Action Plan:

• Capital Facilities will conduct an annual assessment of each RHC to determine whether the facility’s infrastructure is adequate to meet the health and safety of each client.

• Capital Facilities will provide an annual report regarding the status of each facility’s infrastructure.

• Capital Facilities will prioritize capital projects requests related to resident health and safety for funding consideration.

DDA Goal 3: Individuals with developmental disabilities are prepared for independence and self-sufficiency. Supports DSHS Goal: Health – Each individual and each community will be healthy. Strategic Objective 3.1: Increase access to home- and community-based services. Importance: Individuals with disabilities should have access to services and resources that promote activities, routines, and relationships. This includes the ability to live in the community.


Success Measure 3.1.1 (RW): Increase the percentage of DDA clients with developmental disabilities served in home and community-based settings from 97.4 percent in July 2017 to 97.6 percent by June 2019.

Chart AD1.2: Percent of individuals with a developmental disability accessing home and community-based settings

*The above percent of individuals with a developmental disability accessing home and community-based services does not

include birth to age three clients accessing child development services.* Success Measure 3.1.2: Increase the number of clients moving from institutional settings to community based setting from 78 in July 2017 to 85 by June 2019.

Chart ADX.15: Number of clients moved into the community via Roads to Community Living grant

*Other = Children’s Long-Term Inpatient Program, state hospitals and community Intermediate Care Facility for Individuals with

intellectual disabilities.*




Action Plan:

• The Roads to Community Living Team will continue to connect with clients in institutional settings to determine their interest in moving into the community.

• Core and Basic Plus wavier requests are reviewed and monitored weekly basis determine eligibility and availability of requested services.

• Provide regional management teams with monthly reports regarding available service capacity in the community to provide clients with community-based service options.

Success Measure 3.1.3: Reduce the average emergent short-term stay duration at residential habilitation centers from 120 days in January 2017 to 100 days in June 2019.

Chart ADX.12: Average length of emergent stay (in days) at Residential Habilitation Centers (RHCs)

Action Plan:

• Review referrals for admission to RHCs monthly to ensure that all community-based service options are considered before admitting clients to the RHCs.

• Conduct quarterly reviews of all cases of clients who are in short-term stay status at the RHCs to identify contributing factors leading to the need for detainment and readmission to the state hospitals.

• Weekly review of community options and status updates for individuals in short-term stay status at the RHCs.

Strategic Objective 3.2: Increase the number of working-age adults with a developmental disability. Importance: Earning a wage is a powerful achievement for a person with a developmental disability. Increasing access to employment allows individuals to fully participate in their communities. DDA is committed to providing employment support to all working-age adult clients.



Success Measure 3.2.1: Increase the percentage of working-age adults with developmental disabilities receiving supported employment services who are employed from 66.2 percent in July 2017 to 67 percent by June 2019.

Action Plan:

• Increase training and educational opportunities for clients, families, school districts, providers, and counties regarding the value and benefits of employment.

• Provide regional management teams and county providers with quarterly data regarding supported employment activities and caseload.

• Use available funding to expand capacity on the Basic Plus waiver for individuals who are age 21, graduating from high school, Medicaid-eligible and interested in pursuing supported employment services.

DDA Goal 4: Ensure equity, diversity, and inclusion in recruitment, hiring, training, and retaining a diverse workforce in an effort to become an “Employer of Choice.” Supports DSHS Goal: Quality of Life – Each individual in need will be supported to attain the highest possible quality of life.

Strategic Objective 4.1: DDA will continue to support and promote equity, diversity, and inclusion in the workplace by recruiting, hiring, and retaining a diverse workforce through effective promotion, communication, and training. Importance: DDA is committed to promoting equity, diversity, and inclusion with the goal of creating a workplace environment of mutual respect and equal opportunity. Motivated and engaged staff will lead to better staff retention, organization health, identification of emerging leaders, and improved customer outcomes. Equity, diversity, and inclusion are core DDA values.

Chart AD2.1: Percent of working-age adults with developmental disabilities in day programs who are employed



Success Measure 4.1.1: Ensure 90 DDA supervisors complete Cultural Humility training by July 2019.

Chart ADX.31: Number of DDA supervisors completing cultural humility training

Action Plan: • Regional leadership teams will identify supervisors to attend the training. • Provide quarterly reports to management teams regarding progress toward achieving this success

measure. • DDA will include goal of completing cultural humility training in supervisor’s annual performance

plan.



Success Measure 4.1.2: Increase the percentage of DDA employees who complete a DSHS Equity, Diversity and Inclusion training to 95 percent by June 2019.

Chart ADX.32: Percent of employees who complete a DSHS Equity, Diversity, and Inclusion training

Action Plan: • Regional leadership teams will identify supervisors to attend the training. • Provide quarterly reports to management teams regarding progress achieving the success

measure. • Requirement to complete at least one DSHS Equity, Diversity, and inclusion training during the

biennium will be added to DDA employees performance plan. Success Measure 4.1.3: Increase the overall DDA employee survey response rates statewide from 64 percent in November 2015 to 75 percent by November 2019.

Action Plan: Increase employee engagement by developing statewide points of contact, working with points of contact to develop a communications plan to promote survey and developing work plans around survey results. Survey results will be shared with all appointing authorities.

DDA Goal 5: Programs instill public trust and are tailored to meet the assessed needs of clients. Supports DSHS Goal: Public Trust – Strong management practices will ensure quality and efficiency. Strategic Objective 5.1: Provide support and foster partnerships that empower people to live the lives they want. Importance: The percentage of assessments completed on time improves service delivery to clients.



Success Measure 5.1.1: Maintain a 95 percent on-time completion rate of initial assessments quarterly to ensure that support needs are evaluated timely.

Chart ADX.24: Percent of initial assessments completed on time for clients with developmental disabilities requesting

services.

Action Plan:

• Provide monthly assessment timeliness report to regional management. • Provide case resource managers training and ongoing support to better quip them with

knowledge and skills for assessment administration and person-centered support planning. • Monitor resource managers’ caseload size to ensure they are at or below caseload standard. • Engage human resources to conduct continuous targeted case resource manager recruitment.




Success Measure 5.1.2: Maintain a 99 percent on-time completion rate of annual reassessments quarterly to review the effectiveness of authorized services and determine if support needs have changed.

Chart ADX.1: Percent of annual on-time assessments for people receiving waiver, state-plan personal care and state-only funded services

Action Plan: • Provide monthly assessment-timeliness report to regional management. • Provide case resource manager training and ongoing support to better equip them with

knowledge and skills for assessment administration and person-centered support planning. • Monitor resource managers’ caseload size to ensure they are at or below caseload standard. • Engage human resources to conduct continuous targeted case resource manager recruitment.




Success Measures: 5.1.3 Increase enrollment in the Basic Plus waiver from 8,316 individuals in July 2017 to 8,916

individuals by June 2019.

Chart ADX.34: Enrollment on the Basic Plus waiver

5.1.4 Increase enrollment in the Core waiver from 4,626 individuals in July 2017 to 4,746 in June 2019.

Chart ADX.35: Enrollment on the Core Waiver




5.1.5 Maintain an average quarterly caseload of at least 6,400 clients on the Individual and Family Services Waiver.

Chart ADX.36: Enrollment on the Individual and Family Services (IFS) Waiver

Action Plan:

• Provide DDA Home and Community Based Services waiver committee with a real-time data report regarding enrollment and disenrollment activity of waiver caseloads. This will provide information on available capacity to support service requests.

• Use waiver enrollments requests to track outcomes of decisions made by the DDA waiver committee.

• Provide Central Office and regional management teams with monthly status reports regarding caseload activity of DDA’s home and community-based waivers.

Success Measure 5.1.6: Increase the percentage of DDA clients served in home- and community-based settings from 97.4 percent as of July 2017 to 97.6% percent by June 2019.

Action Plan:

• Who will review individual waiver enrollment requests weekly in order to quickly determine if the person qualifies for additional support.

• Expand capacity of the Basic Plus waiver, Core waiver and maintain the capacity of the Individual and Family Services waiver.

• Implement the Community First Choice State Plan, which expands service options to participants to meet their health and welfare needs.

Strategic Objective 5.2: Strengthen supports and services so individuals rely less on institutional measures. Importance: Emergent stays are taxing on institutional resources. Improved communications and support planning between individual clients, the regional office, community providers and institutions will reduce the length of emergent stays.



Success Measure 5.2.1: Provide DDA State Operated Living Alternative (SOLA) placements for 15 individuals who reside at Western and Eastern State Hospitals by June 2019.

Chart ADX.37: Number of clients moving from Western and Eastern State Hospitals to SOLA program

Action Plan: • DDA will work with staff at Western and Eastern State Hospitals to determine discharge

readiness of clients. • DDA will obtain homes in the community and recruit and hire staff to support clients in SOLA

program as funding becomes available and when clients are ready for discharge from the hospital.

• DDA will conduct quality assurance survey on clients who have moved to ensure that service and support needs are being met.

Success Measure 5.2.2: Increase the on-time completion of annual individual habilitation plans (IHPs) to 95% by June 2019, a random sample of individuals residing in Intermediate Care Facilities (ICF). Action Plan:

• RHCs will provide DDA with a monthly report regarding timeliness of completing IHPs. • Quarterly review a sample of IHP at each RHC to ensure they are updated within 365 days of the

IHP. • DDA will provide RHCs with a quarterly report showing the trend of timeliness in completing

IHPs.



APPENDIX


Each strategic objective in this plan supports one or more of the five broad goals for DSHS:

• Health: Each individual and community will be healthy. • Safety: Each individual and community will be safe. • Protection: Each individual who is vulnerable will be protected. • Quality of Life: Each individual in need will be supported to attain the highest possible quality of

life. • Public Trust: Strong management practices will ensure quality and efficiency.

DSHS’ goals of Health, Safety, Protection, and Quality of Life align with Results Washington Goal 4: Healthy and Safe Communities. The focus:

• Healthy People: Providing access to good medical care to improve people’s lives. • Safe People: Helping keep people safe in their homes, on their jobs and in their communities. • Supported People: Helping those most vulnerable become independent and self-sufficient.

The DSHS goal of Public Trust aligns with Results Washington Goal 5, Efficient, Effective and Accountable Government, fostering a Lean culture that drives accountability and results for the people of Washington. The focus:

• Customer Satisfaction and Employee Engagement: Employee satisfaction, positive work environment, including dignity, respect and a spirit of cooperation.

• Resource Stewardship: Money is used responsibly, Lean activites, efficient use of energy in facilities and vehicles.

• Transparency and Accountability: Knowing how money is spent, transparency of data, promotion of local, small businesses, and having strategic plans that align with Results Washington.

dda strategic plan - washington state department of social ... · 696 individuals are served at one...

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