ORIENTATION TOORIENTATION TOTHETHE

REVISED LICENSURE AND REVISED LICENSURE AND CERTIFICATION SYSTEMCERTIFICATION SYSTEM

Department of Developmental ServicesDepartment of Developmental ServicesOFFICE OF QUALITY MANAGEMENTOFFICE OF QUALITY MANAGEMENT

GAIL GROSSMAN, DOREET GOLDHABER, GAIL GROSSMAN, DOREET GOLDHABER, CONNIE LEHRCONNIE LEHR

JUNE, 2010JUNE, 2010

WHAT WILL BE COVEREDWHAT WILL BE COVERED

RATIONALE FOR CHANGESRATIONALE FOR CHANGES

OVERVIEW OF PROCESS USEDOVERVIEW OF PROCESS USED

EXPLANATION OF CHANGES (COMPARISON EXPLANATION OF CHANGES (COMPARISON OF CURRENT AND NEW)OF CURRENT AND NEW)

QUESTIONS AND ANSWERSQUESTIONS AND ANSWERS

NEXT STEPSNEXT STEPS

OVERVIEW AND RATIONALE FOR CHANGES TO THE OVERVIEW AND RATIONALE FOR CHANGES TO THE DDS LICENSURE AND CERTIFICATION SYSTEMDDS LICENSURE AND CERTIFICATION SYSTEM

SYSTEM 15 YEARS OLDSYSTEM 15 YEARS OLD

IMPORTANT TO EVALUATE PERIODICALLYIMPORTANT TO EVALUATE PERIODICALLY

NEED TO ALIGN WITH NEW WAIVER SERVICE NEED TO ALIGN WITH NEW WAIVER SERVICE DEFINITIONSDEFINITIONS

NEED TO ALIGN WITH NEW RFR’S FOR NEED TO ALIGN WITH NEW RFR’S FOR DAY/EMPLOYMENT SERVICESDAY/EMPLOYMENT SERVICES

CONCERNS RAISED BY PROVIDERS, DDS CONCERNS RAISED BY PROVIDERS, DDS OPERATIONS AND QE STAFF, FAMILIES AND OPERATIONS AND QE STAFF, FAMILIES AND INDIVIDUALSINDIVIDUALS

ISSUES RAISEDISSUES RAISED

TRANSPARENCYTRANSPARENCY WHAT WE RATEWHAT WE RATE HOW WE RATEHOW WE RATE SCORING SYSTEMSCORING SYSTEM

CONSISTENCY AND OBJECTIVITYCONSISTENCY AND OBJECTIVITY REDUCING SUBJECTIVITYREDUCING SUBJECTIVITY QUANTIFIABLE MEASURESQUANTIFIABLE MEASURES

ISSUES RAISED ISSUES RAISED (CONT:)(CONT:)

EFFICIENCY EFFICIENCY TIME – ON SITETIME – ON SITE USE OF AVAILABLE INFORMATIONUSE OF AVAILABLE INFORMATION MINIMIZING DUPLICATIONMINIMIZING DUPLICATION SAMPLING APPROACHSAMPLING APPROACH REPORT FORMATREPORT FORMAT

COLLABORATION BETWEEN PROVIDERS COLLABORATION BETWEEN PROVIDERS AND DDS STAFFAND DDS STAFF

PROCESS USEDPROCESS USED

DEVELOPED WORKGROUP OF ADDP PROVIDER DEVELOPED WORKGROUP OF ADDP PROVIDER REPRESENTATIVES, DDS OPERATIONS STAFF AND OQM REPRESENTATIVES, DDS OPERATIONS STAFF AND OQM STAFFSTAFF

SOLICITED INPUT FROM SELF-ADVOCATES, FAMILIES, CABS, SOLICITED INPUT FROM SELF-ADVOCATES, FAMILIES, CABS, SAC, QUALITY COUNCILS, DDS STAFF, QE STAFFSAC, QUALITY COUNCILS, DDS STAFF, QE STAFF

INCORPORATED INPUT INTO WORKGROUP REVIEWINCORPORATED INPUT INTO WORKGROUP REVIEW

MADE RECOMMENDATIONS TO COMMISSIONERMADE RECOMMENDATIONS TO COMMISSIONER

PILOTED IN FEBRUARY WITH FOUR PROVIDERSPILOTED IN FEBRUARY WITH FOUR PROVIDERS

MADE MODIFICATIONS BASED ON PILOT RESULTSMADE MODIFICATIONS BASED ON PILOT RESULTS JOINT TRAININGSJOINT TRAININGS

““GO LIVE” WITH SURVEYS SCHEDULED FOR JULYGO LIVE” WITH SURVEYS SCHEDULED FOR JULY

FEEDBACK FROM STAKEHOLDERS ON FEEDBACK FROM STAKEHOLDERS ON IMPORTANT INDICATORS OF QUALITYIMPORTANT INDICATORS OF QUALITY

CARING, COMPETENT, COMMITTED CARING, COMPETENT, COMMITTED STAFFSTAFF

SAFETYSAFETY

HEALTH AND WELLNESSHEALTH AND WELLNESS

MEANINGFUL ACTIVITIESMEANINGFUL ACTIVITIES

RELATIONSHIPSRELATIONSHIPS

COMMUNITY INCLUSIONCOMMUNITY INCLUSION

CHOICECHOICE

RESPECTRESPECT

NICE ENVIRONMENTNICE ENVIRONMENT

““INTANGIBLES”INTANGIBLES”

OVERVIEW OF CHANGESOVERVIEW OF CHANGES

SERVICES SUBJECT TO LICENSURESERVICES SUBJECT TO LICENSURE

REVIEW PROCESSESREVIEW PROCESSES

TOOLSTOOLS

SURVEY METHODOLOGYSURVEY METHODOLOGY

SURVEY FLOW AND TIMELINESSURVEY FLOW AND TIMELINES

OVERVIEW OF CHANGES (cont:)OVERVIEW OF CHANGES (cont:)

SAMPLING APPROACHSAMPLING APPROACH

RATING SYSTEMRATING SYSTEM

LEVELS OF LICENSURE AND LEVELS OF LICENSURE AND CERTIFICATIONCERTIFICATION

FEEDBACK AND REPORTFEEDBACK AND REPORT

FOLLOW-UP AND TARGETED REVIEWSFOLLOW-UP AND TARGETED REVIEWS

SERVICES SUBJECT TO LICENSURESERVICES SUBJECT TO LICENSURE

CURRENTCURRENT:: 24 HOUR RESIDENTIAL24 HOUR RESIDENTIAL LESS THAN 24 HOUR RESIDENTIALLESS THAN 24 HOUR RESIDENTIAL PLACEMENTPLACEMENT SITE BASED RESPITESITE BASED RESPITE EMPLOYMENTEMPLOYMENT COMMUNITY BASED DAYCOMMUNITY BASED DAY

NEWNEW:: SAME, WITH ADDITION OFSAME, WITH ADDITION OF INDIVIDUAL SUPPORT SERVICES (MORE THAN 7 HRS.)INDIVIDUAL SUPPORT SERVICES (MORE THAN 7 HRS.)

(INDIVIDUALIZED HOME SUPPORTS)(INDIVIDUALIZED HOME SUPPORTS) OUT OF HOME RESPITE (PLACEMENT SERVICE)OUT OF HOME RESPITE (PLACEMENT SERVICE)

REVIEW PROCESSESREVIEW PROCESSES

CURRENTCURRENT:: FULL LICENSURE/CERTIFICATION REVIEWS FOR SELECTED FULL LICENSURE/CERTIFICATION REVIEWS FOR SELECTED

SAMPLESAMPLE SAFEGUARD SYSTEMS REVIEWS FOR 50% OF 24 HOUR SAFEGUARD SYSTEMS REVIEWS FOR 50% OF 24 HOUR

LOCATIONS NOT IN SAMPLELOCATIONS NOT IN SAMPLE SEPARATE PROCESS FOR REVIEW OF SITE-BASED RESPITESEPARATE PROCESS FOR REVIEW OF SITE-BASED RESPITE SEPARATE CERTIFICATION REVIEW FOR INDIVIDUAL SUPPORT SEPARATE CERTIFICATION REVIEW FOR INDIVIDUAL SUPPORT

SERVICESSERVICES

NEWNEW:: ONE INTEGRATED PROCESS FOR ALL SERVICESONE INTEGRATED PROCESS FOR ALL SERVICES INDICATORS REVIEWED TAILORED TO REQUIREMENTS OF INDICATORS REVIEWED TAILORED TO REQUIREMENTS OF

SPECIFIC SERVICE TYPESSPECIFIC SERVICE TYPES

DESCRIPTION OF TOOLSDESCRIPTION OF TOOLS

CurrentCurrent:: BASED ON BROAD QUALITY OF LIFE BASED ON BROAD QUALITY OF LIFE

AREASAREAS

FURTHER DIVIDED INTO OUTCOMES AND FURTHER DIVIDED INTO OUTCOMES AND INDICATORSINDICATORS

EXAMPLES OF INTENT OF OUTCOME EXAMPLES OF INTENT OF OUTCOME NOTEDNOTED

DESCRIPTION OF TOOLSDESCRIPTION OF TOOLSNEWNEW::

LICENSURE INDICATORSLICENSURE INDICATORS:: ENVIRONMENTAL SAFETYENVIRONMENTAL SAFETY PERSONAL SAFETYPERSONAL SAFETY HEALTHHEALTH HUMAN RIGHTSHUMAN RIGHTS COMPETENT STAFFCOMPETENT STAFF SKILL DEVELOPMENT/ISP GOALSSKILL DEVELOPMENT/ISP GOALS

INCLUDES 8 CRITICAL INDICATORSINCLUDES 8 CRITICAL INDICATORS

CERTIFICATION INDICATORSCERTIFICATION INDICATORS::

BASED ON SERVICE EXPECTATIONS FOR EACH DISCRETE SERVICE BASED ON SERVICE EXPECTATIONS FOR EACH DISCRETE SERVICE TYPE (E.G., CAREER EXPLORATION ACTIVITIES; SUPPORT FOR TYPE (E.G., CAREER EXPLORATION ACTIVITIES; SUPPORT FOR PARTICIPATION IN CHOICES AT HOME)PARTICIPATION IN CHOICES AT HOME)

BOTH LICENSURE AND CERTIFICATION STANDARDS CONCRETE BOTH LICENSURE AND CERTIFICATION STANDARDS CONCRETE AND QUANTIFIABLEAND QUANTIFIABLE

DESCRIPTION OF TOOLS (cont:)DESCRIPTION OF TOOLS (cont:)

ALL STANDARDS CONTAIN:ALL STANDARDS CONTAIN: REGULATORY REFERENCEREGULATORY REFERENCE INTERPRETIVE GUIDELINESINTERPRETIVE GUIDELINES INFORMATION SOURCEINFORMATION SOURCE HOW STANDARD IS MEASUREDHOW STANDARD IS MEASURED CRITERIA FOR:CRITERIA FOR:

STANDARD METSTANDARD MET STANDARD NOT METSTANDARD NOT MET

SURVEY METHODOLOGYSURVEY METHODOLOGY

CURRENTCURRENT:: BASED ON FOLLOWING A SAMPLE OF BASED ON FOLLOWING A SAMPLE OF

INDIVIDUALS ACROSS ALL MEASURED INDIVIDUALS ACROSS ALL MEASURED INDICATORSINDICATORS

UTILIZES INTERVIEW, OBSERVATION UTILIZES INTERVIEW, OBSERVATION AND REVIEW OF DOCUMENTATIONAND REVIEW OF DOCUMENTATION

NEWNEW:: ““AUDIT” METHODOLOGYAUDIT” METHODOLOGY INFORMATION GATHERED FROM A VARIETY OF INFORMATION GATHERED FROM A VARIETY OF

DIFFERENT INDIVIDUALSDIFFERENT INDIVIDUALS DIFFERENT INDIVIDUALS SELECTED TO RATE DIFFERENT INDIVIDUALS SELECTED TO RATE

DIFFERENT INDICATORSDIFFERENT INDICATORS HEAVIER FOCUS ON ELECTRONIC DATA TO HEAVIER FOCUS ON ELECTRONIC DATA TO

INFORM CERTAIN INDICATORSINFORM CERTAIN INDICATORS INCREASED FOCUS ON PROVIDERS’ INTERNAL INCREASED FOCUS ON PROVIDERS’ INTERNAL

SYSTEMS WITH VALIDATION ON SITESYSTEMS WITH VALIDATION ON SITE CONTINUES TO UTILIZE INTERVIEW, CONTINUES TO UTILIZE INTERVIEW,

OBSERVATION AND REVIEW OF OBSERVATION AND REVIEW OF DOCUMENTATIONDOCUMENTATION

SURVEY FLOW AND TIMELINESSURVEY FLOW AND TIMELINES

CURRENTCURRENT:: PROVIDER SUBMITS APPLICATION 120-150 PROVIDER SUBMITS APPLICATION 120-150

DAYS PRIOR TO EXPIRATION OF LICENSEDAYS PRIOR TO EXPIRATION OF LICENSE

PROVIDER NOTIFIED 45 DAYS IN ADVANCE PROVIDER NOTIFIED 45 DAYS IN ADVANCE OF SURVEY DATES AND TEAM MEMBERSOF SURVEY DATES AND TEAM MEMBERS

PROVIDER NOTIFIED 21 DAYS IN ADVANCE PROVIDER NOTIFIED 21 DAYS IN ADVANCE OF SURVEY OF INDIVIDUALS AND OF SURVEY OF INDIVIDUALS AND LOCATIONS SELECTED IN SAMPLELOCATIONS SELECTED IN SAMPLE

SURVEY AVERAGES BETWEEN 7-10 DAYS SURVEY AVERAGES BETWEEN 7-10 DAYS ON-SITEON-SITE

SURVEY FLOW AND TIMELINES SURVEY FLOW AND TIMELINES (CONT:)(CONT:)

NEWNEW:: SAME WITH FOLLOWING CHANGES:SAME WITH FOLLOWING CHANGES:

PROVIDER NOTIFIED OF SITES TO BE VISITED AND PROVIDER NOTIFIED OF SITES TO BE VISITED AND INDIVIDUALS REVIEWED FOR SITE-LESS SERVICES ON INDIVIDUALS REVIEWED FOR SITE-LESS SERVICES ON THE FIRST DAY (AT ADMINISTRATIVE REVIEW)THE FIRST DAY (AT ADMINISTRATIVE REVIEW)

PROVIDER NOTIFIED OF INDIVIDUALS TO BE PROVIDER NOTIFIED OF INDIVIDUALS TO BE REVIEWED AT SITES WHEN SURVEYOR ARRIVES AT REVIEWED AT SITES WHEN SURVEYOR ARRIVES AT LOCATIONLOCATION

GOAL IS TO COMPLETE ON-SITE SURVEY WITHIN 5 GOAL IS TO COMPLETE ON-SITE SURVEY WITHIN 5 WORKING DAYSWORKING DAYS

ADMINISTRATIVE REVIEWADMINISTRATIVE REVIEW

CURRENTCURRENT:: PROCESS INCLUDES EXECUTIVE DIRECTOR PROCESS INCLUDES EXECUTIVE DIRECTOR

PRESENTATION/INTERVIEW AND DOCUMENTATIONPRESENTATION/INTERVIEW AND DOCUMENTATION BASED ON BROAD ORGANIZATIONAL AREAS AND OUTCOMESBASED ON BROAD ORGANIZATIONAL AREAS AND OUTCOMES OPPORTUNITY TO HEAR ABOUT NEW INTIATIVES AND BEST OPPORTUNITY TO HEAR ABOUT NEW INTIATIVES AND BEST

PRACTICESPRACTICES

NEWNEW:: INFORMATION EXCHANGE AND ADVANCE PREPARATION PRIOR INFORMATION EXCHANGE AND ADVANCE PREPARATION PRIOR

TO ADMINISTRATIVE REVIEWTO ADMINISTRATIVE REVIEW PROCESS INCLUDES INTERVIEW/DISCUSSION WITH EXECUTIVE PROCESS INCLUDES INTERVIEW/DISCUSSION WITH EXECUTIVE

DIRECTOR AND KEY PERSONNEL AND DOCUMENTATIONDIRECTOR AND KEY PERSONNEL AND DOCUMENTATION BASED ON SPECIFIC INDICATORS WHICH ARE VALIDATED ON-BASED ON SPECIFIC INDICATORS WHICH ARE VALIDATED ON-

SITESITE OPPORTUNITY TO HEAR ABOUT BEST PRACTICESOPPORTUNITY TO HEAR ABOUT BEST PRACTICES MORE EVIDENCE-BASED AND STRUCTURED MORE EVIDENCE-BASED AND STRUCTURED

SURVEY VISITS/ON-SITE AUDITSSURVEY VISITS/ON-SITE AUDITS

CURRENTCURRENT:: REVIEW OF QUALITY OF LIFE OUTCOMES FOR INDIVIDUALS IN REVIEW OF QUALITY OF LIFE OUTCOMES FOR INDIVIDUALS IN

SAMPLESAMPLE OBSERVATION AND INTERVIEW OF INDIVIDUALS SELECTEDOBSERVATION AND INTERVIEW OF INDIVIDUALS SELECTED REVIEW OF DOCUMENTATION AND ENVIRONMENT PRIOR TO REVIEW OF DOCUMENTATION AND ENVIRONMENT PRIOR TO

MEETING WITH INDIVIDUALMEETING WITH INDIVIDUAL

NEWNEW:: REVIEW OF INDICATORS THROUGH AUDITS AT EACH LOCATIONREVIEW OF INDICATORS THROUGH AUDITS AT EACH LOCATION INFORMATION COLLECTED FROM MULTIPLE INDIVIDUALSINFORMATION COLLECTED FROM MULTIPLE INDIVIDUALS INTERVIEWS MAY INVOLVE CONVERSATIONS WITH MORE THAN INTERVIEWS MAY INVOLVE CONVERSATIONS WITH MORE THAN

ONE INDIVIDUAL SUPPORTED AT LOCATIONONE INDIVIDUAL SUPPORTED AT LOCATION OBSERVATION MORE FOCUSED ON ALL INDIVIDUALS SERVED AT OBSERVATION MORE FOCUSED ON ALL INDIVIDUALS SERVED AT

THAT LOCATIONTHAT LOCATION REVIEW OF DOCUMENTATION AND ENVIRONMENT PRIOR TO REVIEW OF DOCUMENTATION AND ENVIRONMENT PRIOR TO

MEETING WITH INDIVIDUALMEETING WITH INDIVIDUAL

SAMPLING APPROACHSAMPLING APPROACH

CURRENTCURRENT INDIVIDUALS SERVED BY THE AGENCY SELECTED INDIVIDUALS SERVED BY THE AGENCY SELECTED

RANDOMLY AND RATED ACROSS RANDOMLY AND RATED ACROSS ALLALL INDICATORS INDICATORS

NUMBER OF INDIVIDUALS SAMPLED IS DETERMINED BY A NUMBER OF INDIVIDUALS SAMPLED IS DETERMINED BY A PERCENTAGE RANGE BASED ON TOTAL NUMBER OF PERCENTAGE RANGE BASED ON TOTAL NUMBER OF PEOPLE SERVEDPEOPLE SERVED

SAMPLE PROPORTIONAL TO NUMBERS IN EACH SERVICESAMPLE PROPORTIONAL TO NUMBERS IN EACH SERVICE

ADDITIONAL SAFEGUARD SYSTEMS REVIEWS FOR 50% ADDITIONAL SAFEGUARD SYSTEMS REVIEWS FOR 50% OF 24 HOUR HOMES NOT IN ORIGINAL SAMPLEOF 24 HOUR HOMES NOT IN ORIGINAL SAMPLE

SAMPLING APPROACH SAMPLING APPROACH (CONT:)(CONT:)

NEWNEW:: NUMBER OF AUDITS IS PROPORTIONAL TO NUMBERS IN NUMBER OF AUDITS IS PROPORTIONAL TO NUMBERS IN

EACH SERVICEEACH SERVICE SAMPLE ADJUSTED TO ADDRESS VARIANCE WITHIN SAMPLE ADJUSTED TO ADDRESS VARIANCE WITHIN

DIFFERENT SERVICE TYPESDIFFERENT SERVICE TYPES PROVIDERS WITH MANY SERVICE TYPES WILL HAVE PROVIDERS WITH MANY SERVICE TYPES WILL HAVE

SAMPLES DRAWN FROM EACHSAMPLES DRAWN FROM EACH 25% OF SERVICE LOCATIONS SELECTED RANDOMLY25% OF SERVICE LOCATIONS SELECTED RANDOMLY NUMBER OF INDIVIDUAL AUDITS WILL BE SPLIT ACROSS NUMBER OF INDIVIDUAL AUDITS WILL BE SPLIT ACROSS

SITESSITES INFORMATION WILL BE COLLECTED FROM MULTIPLE INFORMATION WILL BE COLLECTED FROM MULTIPLE

INDIVIDUALS TO INFORM EACH AUDITINDIVIDUALS TO INFORM EACH AUDIT MOST PROVIDERS WILL EXPERIENCE FEWER LOCATIONS MOST PROVIDERS WILL EXPERIENCE FEWER LOCATIONS

VISITEDVISITED

RATING SYSTEMRATING SYSTEM

CURRENTCURRENT:: QUALITY OF LIFE AREAS ARE DIVIDED INTO OUTCOMESQUALITY OF LIFE AREAS ARE DIVIDED INTO OUTCOMES OUTCOMES FURTHER DIVIDED INTO 2-4 INDICATORS PER OUTCOMES FURTHER DIVIDED INTO 2-4 INDICATORS PER

OUTCOMEOUTCOME FOR EACH INDIVIDUAL SAMPLED, EACH INDICATOR IS RATED YES FOR EACH INDIVIDUAL SAMPLED, EACH INDICATOR IS RATED YES

OR NO OR NO EACH OUTCOME ALSO RATED EXCEEDS, ACHIEVED, PARTIALLY EACH OUTCOME ALSO RATED EXCEEDS, ACHIEVED, PARTIALLY

ACHIEVED, NOT ACHIEVEDACHIEVED, NOT ACHIEVED PROVIDER’S RATING BASED ON THE CUMULATIVE OUTCOME PROVIDER’S RATING BASED ON THE CUMULATIVE OUTCOME

RATINGS OF INDIVIDUALS SAMPLEDRATINGS OF INDIVIDUALS SAMPLED

NEWNEW:: EACH INDICATOR IS RATED SEPARATELYEACH INDICATOR IS RATED SEPARATELY RATING IS EITHER STANDARD MET OR STANDARD NOT METRATING IS EITHER STANDARD MET OR STANDARD NOT MET THE PROVIDER’S RATING ON EACH INDICATOR IS COMPUTED BY THE PROVIDER’S RATING ON EACH INDICATOR IS COMPUTED BY

TALLYING THE NUMBER OF LOCATIONS/INDIVIDUALS WHERE TALLYING THE NUMBER OF LOCATIONS/INDIVIDUALS WHERE STANDARD WAS MET OVER THE NUMBER RATEDSTANDARD WAS MET OVER THE NUMBER RATED

LEVELS OF LICENSURE/CERTIFICATIONLEVELS OF LICENSURE/CERTIFICATION

CURRENT PROCESSCURRENT PROCESS:: ONE LEVEL OF LICENSURE FOR ENTIRE ONE LEVEL OF LICENSURE FOR ENTIRE

PROVIDER FOR ALL SERVICESPROVIDER FOR ALL SERVICES

CERTIFICATION LEVEL REPORTED BY NUMBER CERTIFICATION LEVEL REPORTED BY NUMBER OF QUALITY OF LIFE AREAS ACHIEVEDOF QUALITY OF LIFE AREAS ACHIEVED

CERTIFICATION APPLIES TO AGENCY AS A CERTIFICATION APPLIES TO AGENCY AS A WHOLE (COMBINES ALL RESIDENTIAL AND DAY WHOLE (COMBINES ALL RESIDENTIAL AND DAY SERVICES)SERVICES)

LEVELS OF LICENSURE/CERTIFICATION LEVELS OF LICENSURE/CERTIFICATION (cont:)(cont:)

NEWNEW:: SEPARATE LICENSURE GRANTED FOR EACH OF TWO SEPARATE LICENSURE GRANTED FOR EACH OF TWO

MAJOR SERVICE CATEGORIES:MAJOR SERVICE CATEGORIES: RESIDENTIAL/HOME SUPPORTS INCLUDINGRESIDENTIAL/HOME SUPPORTS INCLUDING::

24 AND LESS THAN 24 HOUR SUPPORTS24 AND LESS THAN 24 HOUR SUPPORTS PLACEMENT SERVICESPLACEMENT SERVICES INDIVIDUALIZED HOME SUPPORTSINDIVIDUALIZED HOME SUPPORTS SITE-BASED RESPITESITE-BASED RESPITE

EMPLOYMENT/DAY SUPPORTS INCLUDINGEMPLOYMENT/DAY SUPPORTS INCLUDING:: COMPETITIVE INTEGRATED EMPLOYMENTCOMPETITIVE INTEGRATED EMPLOYMENT INDIVIDUAL/GROUP SUPPORTED EMPLOYMENTINDIVIDUAL/GROUP SUPPORTED EMPLOYMENT CENTER-BASED WORKCENTER-BASED WORK COMMUNITY-BASED DAYCOMMUNITY-BASED DAY

LEVELS OF LICENSURE/CERTIFICATION cont:LEVELS OF LICENSURE/CERTIFICATION cont:

CERTIFICATION:CERTIFICATION:

SEPARATE REPORTING OF RESULTS SEPARATE REPORTING OF RESULTS FOR EACH DISCRETE SERVICE TYPEFOR EACH DISCRETE SERVICE TYPE

LICENSURE AND CERTIFICATION LICENSURE AND CERTIFICATION RESULTS RESULTS NOTNOT COMBINED COMBINED

LEVELS OF LICENSURE/CERTIFICATIONLEVELS OF LICENSURE/CERTIFICATION

CURRENTCURRENT:: LICENSURE LEVELSLICENSURE LEVELS::

TWO YEAR LICENSETWO YEAR LICENSE ONE YEAR CONDITIONALONE YEAR CONDITIONAL RECOMMENDATION FOR NON-LICENSURERECOMMENDATION FOR NON-LICENSURE

CERTIFICATION LEVELSCERTIFICATION LEVELS:: COMBINES BOTH LICENSURE AND COMBINES BOTH LICENSURE AND

CERTIFICATION QUALITY OF LIFE AREASCERTIFICATION QUALITY OF LIFE AREAS CAN RESULT IN CERTIFICATION WITH CAN RESULT IN CERTIFICATION WITH

DISTINCTION (ALL OUTCOMES MET) ORDISTINCTION (ALL OUTCOMES MET) OR NUMBER OF QUALITY OF LIFE AREAS NUMBER OF QUALITY OF LIFE AREAS

ACHIEVEDACHIEVED

LEVELS OF LICENSURE/CERTIFICATIONLEVELS OF LICENSURE/CERTIFICATION (CONT:) (CONT:)

NEW:NEW:

LEVELS OF LICENSURELEVELS OF LICENSURE:: TWO YEARTWO YEAR TWO YEAR WITH MID-CYCLE REVIEWTWO YEAR WITH MID-CYCLE REVIEW DEFERRED STATUSDEFERRED STATUS RECOMMENDATION FOR NON-LICENSURERECOMMENDATION FOR NON-LICENSURE

CERTIFICATION FINDINGSCERTIFICATION FINDINGS NUMBER OF STANDARDS MET FOR EACH NUMBER OF STANDARDS MET FOR EACH

DISCRETE SERVICE TYPEDISCRETE SERVICE TYPE

LEVELS OF LICENSURE/CERTIFICATION LEVELS OF LICENSURE/CERTIFICATION (CONT:)(CONT:)

TWO YEAR LICENSETWO YEAR LICENSE:: 80% OR MORE OF STANDARDS MET80% OR MORE OF STANDARDS MET ALL 8 CRITICAL INDICATORS METALL 8 CRITICAL INDICATORS MET

TWO YEAR WITH MID-CYCLE REVIEWTWO YEAR WITH MID-CYCLE REVIEW:: 60-79% OF STANDARDS MET60-79% OF STANDARDS MET ALL 8 CRITICAL INDICATORS METALL 8 CRITICAL INDICATORS MET

DEFERRED LICENSEDEFERRED LICENSE:: 60% OR MORE OF STANDARDS MET60% OR MORE OF STANDARDS MET ANY ONE OF THE 8 CRITICAL INDICATORS NOT METANY ONE OF THE 8 CRITICAL INDICATORS NOT MET

RECOMMENDATION FOR NON-LICENSURERECOMMENDATION FOR NON-LICENSURE:: 59% OR LESS OF THE INDICATORS MET59% OR LESS OF THE INDICATORS MET

FEEDBACK AND REPORTFEEDBACK AND REPORT

CURRENTCURRENT:: DRAFT REPORT SENT TWO DAYS IN ADVANCE OF DRAFT REPORT SENT TWO DAYS IN ADVANCE OF

SERVICE ENHANCEMENT MEETINGSERVICE ENHANCEMENT MEETING

SERVICE ENHANCEMENT MEETING HELDSERVICE ENHANCEMENT MEETING HELD

FINAL REPORT SENTFINAL REPORT SENT

REPORT FORMAT:REPORT FORMAT: VERY LENGTHYVERY LENGTHY EXECUTIVE SUMMARYEXECUTIVE SUMMARY DETAILED NARRATIVE FOR EACH QUALITY OF LIFE AREADETAILED NARRATIVE FOR EACH QUALITY OF LIFE AREA COMMENDATIONS, AREAS NEEDING COMMENDATIONS, AREAS NEEDING

IMPROVEMENT/SUGGESTIONSIMPROVEMENT/SUGGESTIONS SAFEGUARD SUMMARY REVIEWSSAFEGUARD SUMMARY REVIEWS

FEEDBACK AND REPORTFEEDBACK AND REPORT (CONT:) (CONT:)

NEWNEW:: SAME AS CURRENT PROCESSSAME AS CURRENT PROCESS REPORT FORMATREPORT FORMAT::

MUCH SHORTER; MINIMAL NARRATIVEMUCH SHORTER; MINIMAL NARRATIVE EXECUTIVE SUMMARY, INCLUDING BEST PRACTICESEXECUTIVE SUMMARY, INCLUDING BEST PRACTICES LIST OF AREAS NEEDING IMPROVEMENT AND LIST OF AREAS NEEDING IMPROVEMENT AND

COMMENDATIONS FOR PROVIDER AS A WHOLECOMMENDATIONS FOR PROVIDER AS A WHOLE DETAIL OF LOCATIONS, INDIVIDUALS WHERE STANDARD DETAIL OF LOCATIONS, INDIVIDUALS WHERE STANDARD

WAS NOT MET (FOR PROVIDER AND DDS ONLY)WAS NOT MET (FOR PROVIDER AND DDS ONLY) MASTER RATING SHEET WITH SCORES FOR EACH DISCRETE MASTER RATING SHEET WITH SCORES FOR EACH DISCRETE

SERVICE TYPE SERVICE TYPE ADDENDUM FOR ISSUES BEYOND PROVIDER’S CONTROL ADDENDUM FOR ISSUES BEYOND PROVIDER’S CONTROL

(FOR PROVIDER/DDS ONLY)(FOR PROVIDER/DDS ONLY) ADDENDUM FOR FAMILY COMMENTS (FOR PROVIDER/DDS ADDENDUM FOR FAMILY COMMENTS (FOR PROVIDER/DDS

ONLY)ONLY)

FOLLOW-UP AND TARGETED REVIEWSFOLLOW-UP AND TARGETED REVIEWS

CURRENTCURRENT:: FOLLOW-UP ON “ACTIONS REQUIRED”FOLLOW-UP ON “ACTIONS REQUIRED”

FOLLOW-UP ON QUALITY OF LIFE AREAS FOLLOW-UP ON QUALITY OF LIFE AREAS RECEIVING A PARTIALLY ACHIEVED OR RECEIVING A PARTIALLY ACHIEVED OR LOWERLOWER

FOLLOW-UP WITHIN 60 DAYS WHEN FOLLOW-UP WITHIN 60 DAYS WHEN THERE IS A RECOMMENDATION FOR THERE IS A RECOMMENDATION FOR NON-LICENSURENON-LICENSURE

FOLLOW-UP AND TARGETED REVIEWS FOLLOW-UP AND TARGETED REVIEWS (CONT:)(CONT:)

NEWNEW:: FOLLOW-UP ON “ACTIONS REQUIRED”FOLLOW-UP ON “ACTIONS REQUIRED”

FOLLOW-UP ON ALL INDICATORS WHERE THE FOLLOW-UP ON ALL INDICATORS WHERE THE STANDARD WAS NOT MET REGARDLESS OF STANDARD WAS NOT MET REGARDLESS OF LEVEL OF LICENSURELEVEL OF LICENSURE

FOLLOW-UP ON CRITICAL INDICATORS NOT FOLLOW-UP ON CRITICAL INDICATORS NOT MET WHEN PROVIDER IS IN DEFERRED STATUSMET WHEN PROVIDER IS IN DEFERRED STATUS

FOLLOW-UP ON RESULTS OF WORK PLANS FOLLOW-UP ON RESULTS OF WORK PLANS WHEN THERE IS A RECOMMENDATION FOR WHEN THERE IS A RECOMMENDATION FOR NON-LICENSURENON-LICENSURE

TARGETED REVIEWSTARGETED REVIEWS

PROVIDERS RECEIVING A FULL 2 YEAR PROVIDERS RECEIVING A FULL 2 YEAR LICENSE WILL RECEIVE A TARGETED LICENSE WILL RECEIVE A TARGETED REVIEW OF INDICATORS NOT MET IN REVIEW OF INDICATORS NOT MET IN PREVIOUS SURVEY AND WILL DO A SELF-PREVIOUS SURVEY AND WILL DO A SELF-ASSESSMENT OF REMAINING INDICATORSASSESSMENT OF REMAINING INDICATORS

PROCESS AND CONTENT UNDER PROCESS AND CONTENT UNDER DEVELOPMENTDEVELOPMENT

PRACTICES THAT REMAIN THE SAMEPRACTICES THAT REMAIN THE SAME

USE OF OBSERVATION, INTERVIEW AND USE OF OBSERVATION, INTERVIEW AND DOCUMENTATION AS SOURCES OF DOCUMENTATION AS SOURCES OF INFORMATIONINFORMATION

OPEN COMMUNICATION DURING SURVEYOPEN COMMUNICATION DURING SURVEY

RECONSIDERATION PROCESSRECONSIDERATION PROCESS

DEEMING OF CARF AND THE COUNCIL FOR DEEMING OF CARF AND THE COUNCIL FOR PROVIDERS WITH TWO YEAR LICENSEPROVIDERS WITH TWO YEAR LICENSE

ISSUANCE OF “ACTIONS REQUIRED”ISSUANCE OF “ACTIONS REQUIRED”

NEXT STEPSNEXT STEPS REVIEW MANUAL FOR MORE SPECIFIC REVIEW MANUAL FOR MORE SPECIFIC

INFORMATIONINFORMATION

REGIONAL QE STAFF ALREADY MEETING WITH REGIONAL QE STAFF ALREADY MEETING WITH PROVIDER WHOSE SURVEYS WILL OCCUR IN PROVIDER WHOSE SURVEYS WILL OCCUR IN JULY, AUGUSTJULY, AUGUST

ADDITIONAL ORIENTATIONS FOR OTHER ADDITIONAL ORIENTATIONS FOR OTHER PROVIDERS WILL OCCURPROVIDERS WILL OCCUR

FULL IMPLEMENTATION BEGINNING IN JULYFULL IMPLEMENTATION BEGINNING IN JULY

ALL PROVIDERS WILL HAVE FULL REVIEWS IN ALL PROVIDERS WILL HAVE FULL REVIEWS IN ORDER TO OBTAIN BASELINE INFORMATIONORDER TO OBTAIN BASELINE INFORMATION

ON-GOING PLANSON-GOING PLANS

FEEDBACK WILL BE SOLICITED FEEDBACK WILL BE SOLICITED AFTER EVERY SURVEYAFTER EVERY SURVEY

REVIEW OF PROCESS AFTER YEAR REVIEW OF PROCESS AFTER YEAR ONEONE

MODIFICATIONS, IF NEEDEDMODIFICATIONS, IF NEEDED

JOINT PROVIDER, QE TRAININGJOINT PROVIDER, QE TRAINING

QUESTIONS???????QUESTIONS???????

THANK YOU!THANK YOU!