south carolina provider training review year 2005-06 first health services june 2005
DESCRIPTION
South Carolina Provider Training Review Year 2005-06 First Health Services June 2005. Provider Manual CD. 01 2005-06 Provider Manual Cover 02 2005-06 Provider Manual TOC 03 2005-06 Provider Manual Overview 04 2005-06 Provider Manual SOW - PowerPoint PPT PresentationTRANSCRIPT
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Discovery … Remediation … Improvement
South CarolinaProvider Training
Review Year 2005-06
First Health ServicesJune 2005
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Discovery … Remediation … Improvement
First Health Services of South Carolina
AGENDA
Topic Presenter
Welcome / Introduction Bob Jones
Provider Manual Bob Jones
Year-to-Date Scores Bob Jones
Indicator Reorganization Bob Jones
Overview of Revised Indicators Monica Owens
Surveys Bob Jones
Questions and Answers Team
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Discovery … Remediation … Improvement
Provider Manual CD
• 01 2005-06 Provider Manual Cover• 02 2005-06 Provider Manual TOC• 03 2005-06 Provider Manual
Overview• 04 2005-06 Provider Manual SOW• A1 2005-06 Provider Manual
Admin Indicators (Excel - multiple worksheets)
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Discovery … Remediation … Improvement
Provider Manual CD(continued)
• A2 2005-06 Provider Manual GA Indicators (Excel - multiple worksheets)
• A3 2005-06 Provider Manual EI Indicators (Excel - multiple worksheets)
• A4 2005-06 Provider Manual Prep List
• A5 2005-06 Provider Manual NCI Provider Surveys
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Discovery … Remediation … Improvement
• A6 2005-06 Provider Manual POC• A7 2005-06 Provider Manual
Interview Protocols• A8 2005-06 Provider Manual NCI
Family Surveys• A9 2005-06 Provider Manual
Acronyms
Provider Manual CD(continued)
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Discovery … Remediation … Improvement
Year-to-Date Aggregate ScoresAdministrative
Section CompliantNon-
CompliantPercent
CompliantPercent
Non
A1 976 86 91.9% 8.1%A2 278 0 100.0% 0.0%
Total 1254 86 93.6% 6.4%
General AgencySection Compliant
Non-Compliant
PercentCompliant
PercentNon
G1 11801 929 92.7% 7.3%G2 12776 884 93.5% 6.5%G3 6538 271 96.0% 4.0%
Total 31115 2084 93.7% 6.3%
Early InterventionSection Compliant
Non-Compliant
PercentCompliant
PercentNon
E1 369 8 97.9% 2.1%E2 1846 113 94.2% 5.8%E3 1071 90 92.2% 7.8%E4 546 48 91.9% 8.1%E5 424 53 88.9% 11.1%E6 208 4 98.1% 1.9%E7 4351 212 95.4% 4.6%
Total 8815 528 94.3% 5.7%
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Discovery … Remediation … Improvement
93.2%
94.8%
93.6%
85.0%
90.0%
95.0%
100.0%
2002-03 2003-04 2004-05
Administrative Aggregate ScoresReview Year Comparison
*Year-to-Date for 2004-05
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Discovery … Remediation … Improvement
General Agency Aggregate ScoresReview Year Comparison
*Year-to-Date for 2004-05
88.0%
91.3%
93.7%
85.0%
90.0%
95.0%
100.0%
2002-03 2003-04 2004-05
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Discovery … Remediation … Improvement
Early Intervention Aggregate ScoresReview Year Comparison
*Year-to-Date for 2004-05
88.4%
91.4%
94.3%
85.0%
90.0%
95.0%
100.0%
2002-03 2003-04 2004-05
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Discovery … Remediation … Improvement
Indicator Reorganizatio
n
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Discovery … Remediation … Improvement
Administrative Sections
• A1 Administrative Issues• A2 Fiscal Issues
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Discovery … Remediation … Improvement
General Agency Sections
• G1 The Plan
• G2 Service Coordination
• G3 Facility-Based Day Services
• G4 Individual Rehabilitation Supports
• G5 Supported Employment
• G6 Residential Services
• G7 Respite Services
• G8 Behavior Support Service
• G9 MR/RD Waiver
• G10 HASCI Waiver
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Discovery … Remediation … Improvement
Early Intervention Sections
• E1 Referral / Intake• E2 FSP• E3 Special Instruction• E4 Service Notes• E5 Other Documentation• E6 MR/RD Waiver• E7 HASCI Waiver• E8 BabyNet Only
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Discovery … Remediation … Improvement
Crosswalk: Administrative Indicators2005-06 2004-05 2005-06 2004-05A1-01 A1-01 A1-24 A1-22A1-02 A1-02 A1-25 A1-23A1-03 A1-03 A1-26 A1-23aA1-04 A1-04 A1-27 A1-24A1-05 A1-05 A1-28 A1-25A1-06 A1-06 A1-29 A1-26A1-07 A1-06a A1-30 A1-27A1-08 A1-07 A1-31 A1-28A1-09 A1-08 A1-32 A1-29A1-10 A1-09 A1-33 A1-30A1-11 A1-10 A1-34 A1-31A1-12 A1-11 A1-35 newA1-13 A1-12 A1-36 newA1-14 A1-13 *A1-37 newA1-15 A1-14 A2-01 A2-01A1-16 A1-15 A2-02 A2-02A1-17 A1-16 A2-03 A2-03A1-18 A1-17 A2-04 A2-04*A1-19 *A1-18 A2-05 A2-05A1-20 A1-18a A2-06 A2-09A1-21 A1-19 A2-07 A2-10A1-22 A1-20 A2-08 A2-11*A1-23 *A1-21 deleted A2-12
* Sanctionable
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Discovery … Remediation … Improvement
Crosswalk: General Agency Indicators2005-06 2004-05 2005-06 2004-05 2005-06 2004-05*G1-01 G1-01 G2-07 G2-02 G4-06 G2-33G1-02 new G2-08 G2-04 G5-01 G2-10aG1-04 G1-03 G2-09 G2-05 G5-02 G2-10bG1-04 G1-10 G2-10 G2-06 *G5-03 G2-10cG1-05 G1-04 G2-11 G2-08 G5-04 G2-10dG1-06 G1-05 G2-12 *G2-35 G5-05 G2-10eG1-07 G1-06 *G2-13 *G2-36 G5-06 G2-10fG1-08 G1-07 G2-14 G2-38 G5-07 G2-10g*G1-09 G1-03 G2-15 G2-39 G5-08 G2-10hG1-10 G1-11 G2-16 G2-40 G5-09 G2-10iG1-11 G1-12 G3-02 new G5-10 G2-10j*G1-12 G1-15 *G1-16 G3-03 new G5-11 new
*G1-17 *G1-18 G3-05 new *G6-01 *G3-01 G2-24dG1-19 G1-20 G3-07 new G6-02 G3-04 G2-24
G1-13 G1-21 G3-08 new G6-03 G3-06 G2-24a*G2-01 *G1-13 G3-10 G2-29 G6-04 G3-09 G2-24cG2-02 G1-14 G3-11 G2-24b G6-05 newG2-03 new G4-01 new G6-06 newG2-04 G2-02a G4-02 G2-29a G6-07 new*G2-05 *G2-01 G4-03 new G7-01 newG2-06 G2-07 *G4-04 G2-31 G8-01 G2-42
* Sanctionable G4-05 G2-32 G8-02 new
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Discovery … Remediation … Improvement
Crosswalk: General Agency Indicators(continued)
2005-06 2004-05 2005-06 2004-05 2005-06 2004-05G8-03 new G9-12 G3-14 G10-20 G3-22G8-04 G2-43 G9-13 G10-14 G3-15 G10-21 G3-32G8-05 new G9-14 G10-15 G3-16 G10-22 G3-33G8-06 G2-44 G9-15 G3-17 G10-23 G3-34G8-07 G2-45 G9-16 G10-16 G3-18 G10-24 G3-35G8-08 G2-46 G9-17 G10-17 G3-19 G10-25 newG8-09 G2-47 G9-18 G10-18 G3-20 G10-26 G3-36G8-10 G2-48 G9-19 G10-19 G3-21 G10-27 G3-37G8-11 G2-49 G9-20 G3-23 deleted G1-08G8-12 G2-50 G9-21 G3-24 deleted *G1-09G9-01 G2-37 G9-22 G3-25 deleted G1-12a
*G9-02 *G10-01 G3-01 G9-23 G3-26 deleted G1-15G9-03 G10-02 G3-03 G9-24 G3-27 deleted G2-03G9-04 G10-03 G3-04 G9-25 G3-28 deleted G2-09G9-05 G10-04 G3-05 G9-26 G3-29 deleted G2-10*G9-06 *G10-05 G3-06 G9-27 G3-30 deleted G2-21G9-07 G10-06 G3-07 G9-28 G3-31 deleted G2-22G9-08 G10-07 G3-08 G9-29 G10-28 G3-38 deleted G2-23G9-09 G10-08 G3-10 G9-30 G10-29 G3-39 deleted G2-39aG9-10 G10-10 G3-12 G10-09 G3-11 deleted G2-40a*G9-11 *G10-11 G3-13 G10-12 new deleted G2-41* Sanctionable G10-13 new deleted G3-02
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Discovery … Remediation … Improvement
Crosswalk: EI Indicators
2005-06 2004-05 2005-06 2004-05 2005-06 2004-05E1-01 E1-02 E2-18 E2-14 E6-03 E6-03E1-02 E1-03 E3-01 E3-01 E6-04 E6-04E1-03 E1-04 E3-02 E3-02 E6-05 E6-05E2-01 E2-00a E3-03 E3-03 *E6-06 *E6-06*E2-02 *E2-01 E3-04 E3-04 E6-07 E6-07E2-03 E2-01a E3-05 E3-05 E6-08 E6-08E2-04 E2-01b E3-06 E3-05a E6-09 E6-09*E2-05 *E2-02 *E3-07 *E3-06 E6-10 E6-10E2-06 E2-03 E3-08 E3-06a E6-11 E6-11E2-07 E2-04 E3-09 E3-07 E6-12 E6-12E2-08 E2-05 E4-01 E4-01 E6-13 E6-13E2-09 E2-06 E4-02 E4-01a E6-14 E6-14E2-10 E2-07 E4-03 E4-02 E6-15 E6-15E2-11 E2-08 E4-04 E4-02a E6-16 E6-16E2-12 E2-09 E5-01 E5-01 E6-17 E6-17E2-13 E2-09a E5-02 E5-02 E6-18 E6-18E2-14 E2-10 E5-03 *E5-03 E6-19 E6-19E2-15 E2-11 E5-04 E5-04 E6-20 E6-20E2-16 E2-11a E6-01 E6-00a E6-21 E6-21E2-17 E2-13 *E6-02 E6-01 E6-22 E6-22
* Sanctionable
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Discovery … Remediation … Improvement
Crosswalk: EI Indicators(continued)
2005-06 2004-05 2005-06 2004-05 2005-06 2004-05E6-23 E6-23 *E7-07 new HASCI E8-15 E7-16E6-24 E6-24 *E7-13 new HASCI E8-16 E7-17E6-24 E6-31 E7-23 new HASCI E8-17 E7-18E6-25 E6-25 E7-30 new HASCI E8-18 E7-19E6-26 E6-26 E8-01 E7-01 E8-19 E7-20E6-26 E6-32 E8-02 E7-02 E8-20 E7-21E6-27 E6-27 *E8-03 E7-03 E8-21 E7-22E6-27 E6-33 E8-04 E7-04 *E8-22 E7-23E6-28 E6-28 E8-05 E7-05 E8-23 E7-24E6-29 E6-29 E8-06 E7-06 E8-24 E7-25E6-29 E6-34 E8-07 E7-07 E8-25 E7-26E6-30 E6-35 E8-08 E7-08 E8-26 E7-27E6-31 E6-36 E8-09 E7-09 E8-27 E7-28E6-32 E6-37 E8-10 E7-11 E8-28 E7-29E6-33 E6-38 E8-11 E7-12 E8-29 E7-30
E7-01 - 30 new HASCI E8-12 E7-13 E8-30 E7-31*E7-02 new HASCI E8-13 E7-14 E8-31 E7-32E7-03 E6-02 E8-14 E7-15 deleted E7-10
* Sanctionable
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Discovery … Remediation … Improvement
Sanctionable Indicators
2005-06 Indicator 2004-05 2005-06 Indicator 2004-05A1-19 Abuse/neglect A1-18 G9-06 G10-05 LOC G3-06A1-23 Critical Incidents A1-21 G9-11 G10-11 E7-13 Choice of Providers G3-13A1-37 Admission / Discharge - G4-04 Individual Rehab Supports -G1-01 Plan G1-09 G5-03 IPSE -G1-09 Plan Amendment - G6-01 Residential Plan -G2-01 Monitorship G1-13 E2-02 Annual IFSP/FSP E2-01
- Monitorship G1-16 E2-05 BabyNet Exit Plan E2-02- Monitorship G1-17 E3-07 Outcomes Page E3-06
G1-12 Monitorship G1-18 - STS E5-03G2-05 Intake G2-01 E6-02 MR/RD Waiver Service Page -
- STS G2-35 E6-06 E7-07 LOC Waiver E6-06G2-13 Reportable Activities G2-36 E7-02 HASCI Waiver Service Page -
G9-02 G10-01 Summary Services G3-01 E8-03 BabyNet Annual IFSP E7-03G3-01 Day Service Plan - E8-22 BabyNet Outcomes Page E7-23
- BabyNet STS E7-30
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Discovery … Remediation … Improvement
Administrative
IndicatorChanges
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Discovery … Remediation … Improvement
• A1-12 (change) Human Rights Committee is composed of a minimum of 6 members. (previously composed of 5)
2005 - 2006 Administrative Indicator ChangesA1 Administrative Issues
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Discovery … Remediation … Improvement
• A1-35 (new) For consumers who receive Rehabilitation Supports (facility based or individual), a Lead Clinical Staff attends and chairs a staff meeting at least monthly during which administrative and consumer treatment issues are considered.
2005 - 2006 Administrative Indicator ChangesA1 Administrative Issues
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Discovery … Remediation … Improvement
• A1-36 (new) Board/Provider has an established procedure for using feedback from the consumer/family satisfaction surveys to improve and expand services.
2005 - 2006 Administrative Indicator ChangesA1 Administrative Issues
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Discovery … Remediation … Improvement
2005 - 2006 Administrative Indicator Changes
• A1-37 (new) Sanctionable** BOARD/PROVIDER CONDUCTS ALL RESIDENTIAL ADMISSIONS/DISCHARGES IN ACCORDANCE WITH 502-01-DD.
A1 Administrative Issues
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DeletedAdministrative
Indicators
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Discovery … Remediation … Improvement
Deleted Indicators
• A2-12 For Respite Service funded by individual and Family Support Services, the Board/Provider maintains bi-annual (i.e. June and December) written reports that contain the following information:-Unduplicated count broken into age groups of 0-21 years of age and over 21 years of age for consumers receiving Respite through Family Support Funds.-Cumulative total Respite hours provided.
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Discovery … Remediation … Improvement
General Agency
IndicatorChanges
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G1-01 (reworded) *SANCTIONABLE * THE PLAN IS DEVELOPED AND SIGNED BY THE SERVICE COORDINATOR EVERY 365 DAYS. (removed … by a facilitator or under the direction of a facilitator-or a Single Plan is developed by a DSN Board Plan Manager)
G1 The Plan
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G1-02 (new) The Record/Plan shows that facilitation was explained and choice was offered.
G1 The Plan
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G1-03 (reworded) Needs/goals reflected in the Plan must be justified by formal or informal assessment information in the record.
G1 The Plan
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G1-04 (reworded) Record must reflect that the consumer or his/her legal guardian was offered the opportunity to participate in planning.
G1 The Plan
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G1-05 (reworded) The Plan reflects the service needs/personal goals, priorities and concerns of the consumer or his/her guardian.
G1 The Plan
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G1-06 (reworded) The Plan identifies “Actions”/interventions that address the “Need”.
G1 The Plan
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G1-07 (reworded) The Plan identifies the name of the provider and the person responsible by name or title (i.e. CTH Coordinator, Service Coordinator, etc.) for implementing Actions/Interventions.
G1 The Plan
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G1-09 (new Sanctionable & reworded) *SANCTIONABLE* THE PLAN IS AMENDED/UPDATED AS NEEDED.
G1 The Plan
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G1-11 (reworded) “Needs”/personal goals are written to reflect the consumer’s needs rather than the service to be provided.
G1 The Plan
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G1-12 (reworded) *SANCTIONABLE* THE PLAN IS MONITORED AT LEAST QUARTERLY (QUARTERLY PLAN REVIEW).
G1 The Plan
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G2-01 (combination) *SANCTIONABLE* SERVICE COORDINATION ACTIVITY REFLECTS ONGOING NEEDS ASSESSMENT, PLANNING, AND MONITORING TO ADDRESS IDENTIFIED NEEDS AND PERSONAL GOALS.
G2 Service Coordination
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G2-02 (reworded) Face-to-face contacts occur as required.
G2 Service Coordination
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G2-03 (new) Contacts for Level II Service Coordination are provided at least every 365 days or as determined by the consumer.
G2 Service Coordination
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G2-09 (reworded) An index is maintained and followed for Service Coordination records.
G2 Service Coordination
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G2-12 (change) The STS is current. (no longer sanctionable)
G2 Service Coordination
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G3-01 (reworded) *SANCTIONABLE* THE CONSUMER HAS A CURRENT DAY PLAN THAT INCORPORATES 1. CARE: SUPPORTS TO MAINTAIN OR IMPROVE THE HEALTH AND PERSONAL RESPONSIBILITY OF THE CONSUMER; 2. SUPERVISION: SUPPORTS TO PROTECT THE CONSUMER FROM HARM AND/OR INJURY IN COMPLIANCE WITH DDSN POLICY 510-01-DD; 3. SKILLS TRAINING INTERVENTION: GOALS AND OBJECTIVES TO ASSIST THE CONSUMER IN ACQUIRING, RETAINING, OR IMPROVING SKILLS FOR OPTIMAL FUNCTIONING.
G3 Facility-Based Day Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G3-02 (new) The Day Plan must reflect the authorized service.
G3 Facility-Based Day Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G3-03 (new) Supports within the Plan correspond to the service definition.
G3 Facility-Based Day Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G3-04 (reworded) Each support, goal, and objective identified within the Plan corresponds to an assessed need.
G3 Facility-Based Day Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G3-05 (new) The record must clearly reflect the consumer’s approval of the Day Plan. If the consumer is under 18 or over 18 and deemed unable to consent, the approval come from the consumer’s legal representative.
G3 Facility-Based Day Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G3-06 (reworded) The consumer’s Day Plan is monitored by the Day Coordinator or Lead Clinical Coordinator (or designee) to insure plans are implemented as specified.
G3 Facility-Based Day Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G3-07 (new) For consumers who receive rehabilitation supports, a six-month review must be completed and address the following issues: – Are current goals and objectives appropriate and
effective in meeting the needs and goals of the consumer?
– Are there any other issues pertinent to the functioning of the consumer?
– Do the needs of the consumer support the continuation of rehabilitation support services?
G3 Facility-Based Day Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G3-08 (new) For consumers who receive Rehabilitation Supports, a Medical Necessity Statement has been obtained.
G3 Facility-Based Day Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G3-09 (reworded) The consumer’s Day Plan is monitored by the Day Coordinator or Lead Clinical Coordinator (or designee) to insure timely amendments are made to supports identified within the Plan when the consumer: – Meets a goal or objective;– Is not benefiting from a specific intervention,
service or support; – Requests a change– New support needs are identified
G3 Facility-Based Day Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G3-10 (reworded) If earning sub-minimum wage for work performed, the consumer is paid in accordance with Department of Labor Regulations.
G3 Facility-Based Day Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G3-11 (reworded) Documentation is available to show services were provided on the day that services were reported.
G3 Facility-Based Day Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G4-01 (new) The Individual Rehabilitation Support Record contains a Medical Necessity Statement.
G4 Individual Rehabilitation Supports
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G4-03 (new) Supports within the Plan correspond to the service definition.
G4 Individual Rehabilitation Supports
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G4-04 (reworded) *SANCTIONABLE* INDIVIDUAL REHABILITATION SUPPORTS RECORD CONTAINS A TREATMENT PLAN THAT IS REVIEWED EVERY 6 MONTHS AND REFORMULATED ANNUALLY BY THE LEAD CLINICAL STAFF (LCS) OR LIFE SKILLS SPECIALIST (LSS).
G4 Individual Rehabilitation Supports
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G4-05 (separated) Individual Rehabilitation Supports records contain Progress Summary Notes.
G4 Individual Rehabilitation Supports
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G4-06 (separated) Individual Rehabilitation Supports Progress Summary Notes contain documentation of delivery of service(s).
G4 Individual Rehabilitation Supports
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G5-03 (change) *SANCTIONABLE* INDIVIDUAL PLAN OF SUPPORTED EMPLOYMENT (IPSE) IS LOCATED IN THE SUPPORTED EMPLOYMENT RECORD.
G5 Supported Employment
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G5-11 (new) Documentation is available to show Supported Employment was provided on date service was reported.
G5 Supported Employment
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G6-01 (separated) *SANCTIONABLE* THE CONSUMER HAS A CURRENT RESIDENTIAL PLAN THAT INCLUDES INTERVENTIONS TO ADDRESS NEEDS IN THE FOLLOWING AREAS:
• 1. CARE: SUPPORTS TO MAINTAIN OR IMPROVE THE HEALTH AND PERSONAL RESPONSIBILITY OF THE CONSUMER;
• 2. SUPERVISION: SUPPORTS TO PROTECT THE CONSUMER FROM HARM AND/OR INJURY IN COMPLIANCE WITH DDSN POLICY 510-01-DD; AND
• 3. SKILLS TRAINING TO ASSIST THE CONSUMER WITH THE ACQUISITION, RETENTION OR IMPROVEMENT IN SKILLS RELATED TO ACTIVITIES-OF-DAILY-LIVING, SOCIAL AND ADAPTIVE BEHAVIOR THAT ARE NECESSARY TO ENABLE THE CONSUMER TO RESIDE IN A NON-INSTITUTIONAL SETTING.
G6 Residential Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G6-02 (reworded) Each intervention identified within Plan corresponds to an assessed need.
G6 Residential Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G6-03 (reworded) Once developed, the Plan is implemented.
G6 Residential Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G6-04 (reworded) The consumer’s Residential Plan is monitored at least monthly by the Residential Coordinator to insure services are effective.
G6 Residential Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G6-05 (new) Timely amendments are made to supports identified within the Plan when the consumer:
• Meets a goal or objective;• Is not benefiting from a specific service
or support; • Requests a change; or heath care
professional requests a change.• New interventions are needed
G6 Residential Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G6-06 (new) Documentation is available to show services were provided on every Day Services were reported.
G6 Residential Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G6-07 (new) Rights of the consumer are protected.
G6 Residential Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G7-01 (new) For respite funded through the DDSN Family Support Contract or Wavier, documentation is available to show respite was provided on the date reported.
G7 Respite Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G8-02 (new) A consumer's behavior(s) that pose a risk to the consumer, others, or the environment has a BSP consultation and plan (without consumer consent).
G8 Behavior Support Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G8-03 (new) A BSP is developed by an approved provider on the MR/RD Medicaid Waiver List for Psychological Services.
G8 Behavior Support Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G8-05 (new) A consumer who is receiving psychotropic medication and Residential or Day Program services, may not have a BSP under specific conditions.
G8 Behavior Support Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G8-09 (reworded) The Behavior Support Plan is reviewed at least quarterly and modified to revise behavioral objectives and/or procedures when needed, and discontinued after the person has met all objectives.
G8 Behavior Support Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G8-10 (reworded) All consumer records contain the Behavior Support Plan, if applicable in those settings.
G8 Behavior Support Services
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G9-01 (separated) For MR/RD Waiver funded services provided by the board (also called board-based services), documentation is available to show the service was provided on date service was reported.
G9 MR/RD Waiver
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G9-07 (reworded) The current Level of Care is supported by the assessments and documents indicated on the Level of Care determination. (Single Plan removed)
G9 MR/RD Waiver
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G9-08 (reworded) When the consumer refused a MR/RD Waiver service(s), the risks associated with refusing the service(s) were discussed. (Single Plan removed)
G9 MR/RD Waiver
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G9-12 (reworded) The Acknowledgement of Choice Confirmation (MR/RD Form 29) or Acknowledgment of Rights and Responsibilities (MR/RD Form 60) is completed annually.
G9 MR/RD Waiver
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G9-17 (reworded) MR/RD Waiver services are received at least every 30 days.
G9 MR/RD Waiver
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G10-12 (new) The Acknowledgement of Choice and Appeal Rights is completed prior to Waiver enrollment and annually thereafter.
G10 HASCI Waiver
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G10-13 (new) The Acknowledgement of Rights and Responsibilities is present.
G10 HASCI Waiver
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Discovery … Remediation … Improvement
2005 - 2006 General Agency Indicator Changes
• G10-25 (new) Service Notes reflect an on-site visit for Private Vehicle Modifications within two (2) weeks of completion.
G10 HASCI Waiver
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DeletedGeneral Agency
Indicators
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Discovery … Remediation … Improvement
Deleted Indicators
• G1-08 Service needs and personal goals identified subsequent to the Single Plan meeting are documented on the Single Plan and addressed annually.
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Discovery … Remediation … Improvement
Deleted Indicators
• G1-09 *SANCTIONABLE* A SINGLE PLAN IS REFORMULATED OR COMPLETED ANNUALLY.
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Discovery … Remediation … Improvement
Deleted Indicators
• G1-12a The Single Plan contains current and accurate information.
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Discovery … Remediation … Improvement
Deleted Indicators
• G1-15 Ineffective services, supports, or actions are terminated or modified and replaced by services, supports, or actions that are anticipated to be more effective.
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Discovery … Remediation … Improvement
Deleted Indicators
• G2-03 Documentation and record maintenance are consistent with DDSN service policy and procedures. (Leading question for questions 4-34).
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Discovery … Remediation … Improvement
Deleted Indicators
• G2-09 All records, except Supported Employment contain a current Single Plan signed and dated by the Plan Manager (N/A if still in intake process or if consumer is not in Level I Service Coordination).
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Discovery … Remediation … Improvement
Deleted Indicators
• G2-10 If documentation in the consumer’s records indicates that a critical incident has occurred, documentation of a report is available.
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Discovery … Remediation … Improvement
Deleted Indicators
• G2-21 Steps records contain the Steps referral, informed consent for participation, current medical information, a current Social-Sexual Assessment, and current Health Practitioner Input form.
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Discovery … Remediation … Improvement
Deleted Indicators
• G2-22 Steps records contain current Steps needs and documentation of Needs Assessment, Plan Development, and Individual/Family Consultation and/or Group Consultation.
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Discovery … Remediation … Improvement
Deleted Indicators
• G2-23 Steps records contain Individual Service Reports.
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Discovery … Remediation … Improvement
Deleted Indicators
• G2-39a For persons on Level II Service Coordination, annual contact is made with program providers to assure the consumer has no additional needs and continues to be appropriate for Level II Service Coordination.
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Discovery … Remediation … Improvement
Deleted Indicators
• G2-40a For consumers receiving Level II Service Coordination, a choice of alternative services and/or provider was offered at least annually.
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Discovery … Remediation … Improvement
Deleted Indicators
• G2-41 service Notes/progress notes are present for all DDSN program areas indicated in the Single Plan and accessed by the consumer including Service Coordination, Day Habilitation, Residential, Steps, Supported Employment, and Rehabilitation Supports.
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Discovery … Remediation … Improvement
Deleted Indicators
• G3-02 Waiver Enrollment date is documented.
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Discovery … Remediation … Improvement
Early Intervention
IndicatorChanges
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Discovery … Remediation … Improvement
2005 - 06 Early Intervention Indicator Changes
• E2-05 (change) *SANCTIONABLE* WHEN EXITING FROM THE BABYNET SYSTEM, THE INITIAL FSP WAS COMPLETED THE WEEK OF THE CHILD’S THIRD BIRTHDAY (NOT TO EXCEED THE CHILD’S THIRD BIRTHDAY).
E2 FSP
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Discovery … Remediation … Improvement
2005 - 06 Early Intervention Indicator Changes
• E2-09 (guidance change) When record is transferred from another SC/SI provider, a new IFSP/FSP is completed or the current Plan is updated within 14 days.
E2 FSP
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Discovery … Remediation … Improvement
2005 - 06 Early Intervention Indicator Changes
• E6-01 (reworded) The content of the IFSP/FSP clearly justifies the need for MR/RD Waiver services.
E6 MR/RD Waiver
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Discovery … Remediation … Improvement
• E6-08 (reworded) The current Level of Care is supported by the assessments/documents indicated on the Level of Care determination. (removed current IFSP/FSP)
2005 - 06 Early Intervention Indicator ChangesE6 MR/RD Waiver
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Discovery … Remediation … Improvement
• E6-13 (reworded) The Acknowledgement of Choice Confirmation (MR/RD Form 29) or Acknowledgment of Rights and Responsibilities (MR/RD Form 60) is completed annually.
2005 - 06 Early Intervention Indicator ChangesE6 MR/RD Waiver
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Discovery … Remediation … Improvement
• E6-17 (reworded) MR/RD Waiver services are received at least every 30 days. (removed ..by the consumer at least every 30 days and within the last calendar month for HASCI Waiver Services).
2005 - 06 Early Intervention Indicator ChangesE6 MR/RD Waiver
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Discovery … Remediation … Improvement
• E6-18 (reworded) Service needs outside the scope of Waiver services are identified in Plans and addressed.
2005 - 06 Early Intervention Indicator ChangesE6 MR/RD Waiver
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Discovery … Remediation … Improvement
• E6-20 (reworded) The established MR/RD Waiver documentation index is followed. (removed HASCI)
2005 - 06 Early Intervention Indicator ChangesE6 MR/RD Waiver
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Discovery … Remediation … Improvement
• HASCI Waiver Section Added
(E7-01 through E7-30)
2005 - 06 Early Intervention Indicator ChangesE7 HASCI Waiver
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Discovery … Remediation … Improvement
• E7-03 (change) Waiver Enrollment date is documented.
2005 - 06 Early Intervention Indicator ChangesE7 HASCI Waiver
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Discovery … Remediation … Improvement
• E8-22 (change) *SANCTIONABLE* SPECIAL INSTRUCTION ACTIVITIES CORRESPOND TO OUTCOMES ON THE IFSP OUTCOMES PAGES.
2005 - 06 Early Intervention Indicator ChangesE8 BabyNet Only
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Discovery … Remediation … Improvement
• E8-14 (guidance change) Outcomes are adjusted, terminated, or added based on ongoing assessment, lack of progress, or parent/professional request.
2005 - 06 Early Intervention Indicator ChangesE8 BabyNet Only
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Deleted Early InterventionIndicators
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Discovery … Remediation … Improvement
Deleted Indicators
• E7-10 Child Find Notification was sent to the Local Education Agency (LEA) no later than the child’s second birthday.
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Discovery … Remediation … Improvement
Surveys
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Information gathered from Families, Persons with
disabilities and advocates during the Contract Year
Surveys
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Discovery … Remediation … Improvement
Types of Surveys
• *Consumer• HASCI• Child• *Family Guardian• *Adult Family*National Core Indicators (NCI)
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Discovery … Remediation … Improvement
National Core Indicators (NCI)
• South Carolina is one of 21 states/regions participating
• States can compare data• Information can be retrieved
fromWWW.HSRI.ORG
National Core IndicatorsReports
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Discovery … Remediation … Improvement
Collection of Data
• Information for Consumer interviews are gathered at the time of the First Health Review– NCI Consumer Survey– HASCI– Child
• NCI Family Surveys (Adult Family and Family Guardian) collected from mail out survey during spring
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Discovery … Remediation … Improvement
How do we get the Sample?
• Consumer– 5% Stratified Sample
• Consumer asked to participate– Family or advocate may participate on behalf
of the person if unable or unavailable – Participation is strictly voluntary– Confidential but issues upon request maybe
shared with the Executive Director
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Discovery … Remediation … Improvement
Who do we Survey?
• Family Guardian • 1,500 surveys sent to families of
people who do not live at home with their natural families. – 2003-2004
• 57% of people who answered lived in group home environments
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Discovery … Remediation … Improvement
Who do we Survey?
• Adult Family• 1,500 surveys sent to families
with an adult family member with a developmental disability who live in the household
• The person receives at least one service in addition to Service Coordination
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Discovery … Remediation … Improvement
What does First Health do with the information?
• Provider (Consumer, HASCI, and Child)
• DDSN (Consumer, HASCI, Child, Adult Family and Family Guardian)
• HSRI (Consumer, Adult Family and Family Guardian)
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Discovery … Remediation … Improvement
National Core Indicator DataScoring Examples
• Consumer– Do you go shopping?
• South Carolina YES 92.6%• Average* YES 93.8%
• * Average of participating states
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Discovery … Remediation … Improvement
National Core Indicator DataScoring Examples (continued)
– Do you go out on errands and appointments?• South Carolina YES 97.3%• Average* YES 96.3%
– Do you go to religious services?• South Carolina YES 73.3%• Average* YES 55.8%
• * Average of participating states
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Discovery … Remediation … Improvement
Family Guardian
• South Carolina• Always/Usually
– 21.8%
• Sometimes– 48.1%
• Seldom/Never– 30.1%
• Average*• Always/Usually
– 21.0%
• Sometimes– 45.8%
• Seldom/Never– 33.2%
– * Average of participating states
Question: Are frequent changes in support staff a problem for your family member?
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Discovery … Remediation … Improvement
Adult Family
• South Carolina• Always/Usually
– 76.0%
• Sometimes– 16.3%
• Seldom/Never– 7.8%
• Average*• Always/Usually
– 76.9%
• Sometimes– 17.6%
• Seldom/Never– 5.5%
– * Average of participating states
Question: Can you contact the staff who assist you with planning whenever you want to?
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Discovery … Remediation … Improvement
Questions?