The DDD Scoop (10-27-17)

Helping Families. Supporting Communities. Empowering Individuals.

Welcome to the latest edition of the DDD Scoop.

National Breast Cancer Awareness Month

The National Breast Cancer Awareness Month is a collaboration of national public service organizations, professional medical associations, and government agencies working together to promote breast cancer awareness, share information on the disease, and provide greater access to services. Because of heightened awareness that has led to increased screening through mammograms, early detection from self-exams along with regular breast examinations by a doctor and improved treatment options, death rates have decreased over time. About 1 in 8 U.S. women will develop breast cancer compared to 1 in 1,000 men who will contract the disease.

Many great strides have been made in breast cancer awareness and treatment, but there is so much more to be accomplished.

National Domestic Violence Awareness Month

Domestic Violence Awareness Month evolved from the first Day of Unity observed in October, 1981 by the National Coalition Against Domestic Violence. The intent was to connect advocates for battered women across the nation who were working to end violence against women and their children. Both men and women can be subject to domestic violence, 12 million people in the United States are affected each year. We all need to take a stand and bring attention to this issue during the month of October and throughout the year. There is only one way to end domestic violence: together!

Late last week, the Division distributed some materials produced by Envision Illinois, These brochures dealt with safety planning for individuals with disabilities and individuals with hearing impairments who may be experiencing violence in their lives. If you are interested in learning more about Envision Illinois - or in receiving hard copies of these materials, please contact Teresa Tudor, Envision Illinois Project Director at 217-558-6192.

OIG Written Response Process Reminders and Changes

Bureau of Quality Management reviewers are now following up with agencies when submitted written responses need revisions. Items to remember that do lessen the amount of calls that reviewers need to make to submit the written response for approval follow:

  1. Be sure that the written response is signed by the Executive Director or his/her designee. If the designee is signing, sign the Executive Director name with the designee's initial after the signature. Be sure to notify OIG if the designee and/or Executive Director change.
  2. Be sure to fill out all columns on the written response form including the name and/or title of the person responsible and dates for the implementation and completion.
  3. If an employee has been terminated, the reason for termination is required and needs to be noted in the Service Provider Response column.
  4. If the allegation is substantiated and also has recommendations, the substantiated finding and each recommendation need to be addressed separately under the service provider response. If, however, the substantiated finding is addressed within the recommendation responses, NOTE UNDER THE SERVICE PROVIDER RESPONSE.
Findings/Recommendations Service Provider Response Person Responsible Dates for Implementation Dates For Completion
SUBSTANTIATED FINDING

RESPONSE REQUIRED

Note: if substantiated finding is addressed

within recommendation responses

RESPONSE REQUIRED RESPONSE REQUIRED RESPONSE REQUIRED
Recommendation RESPONSE REQUIRED RESPONSE REQUIRED RESPONSE REQUIRED RESPONSE REQUIRED
Recommendation RESPONSE REQUIRED RESPONSE REQUIRED RESPONSE REQUIRED RESPONSE REQUIRED
  1. The written response shall address the actions that it will take or has taken to protect individuals from abuse or neglect, prevent recurrence and eliminate problems (Title 59, Section 50.80). Many times agencies will respond with a policy or training that was done prior to the incident.

The response MUST BE actions that were taken after the incident occurred, i.e. retraining, changes in policy and training, staff counseling and/or termination.

  1. Agencies may also expect a phone call from a BQM reviewer at the time BQM receives the case report from OIG to assure that the agency received the case report and to remind the agency that the written response is due within 30 days.
  2. During the review process at the agency, BQM reviewers will be following up on all substantiated written responses at each agency. The reviewer will ask the agency to submit evidence that the Service Provider Response was completed to assure compliance with the performance measure (G2).
  3. Unfortunately, despite our best efforts, written responses are overdue and phone calls will be made to the agency to inform the agency of overdue written responses.

Further information regarding written responses can be found at:

http://www.ilga.gov/commission/jcar/admincode/059/059000500000800R.html

Additional training regarding preparing written responses is available at:

https://attendee.gotowebinar.com/recording/5356043668671451906

Guardian Call Process during BQM Review at Agency

Bureau of Quality Management Reviewers call guardians of all waiver sample recipients to ensure compliance with Performance Measures PM D1 (22D) and PM D11 (26D). Reviewers have had the best results with the telephone conversations when calling from the agency and/or when guardians are expecting a call from the reviewer. If the agency is prepared at the beginning of the review to assist the reviewer/reviewers with contacting the guardian to expect a call from the reviewer it is very helpful with assuring the best response rates for these Performance Measures.

Trainer's Corner-Quality Enhancement Unit

This edition's information is regarding Outcome #2 of the revised Personal Outcome Measures training, "People are free from Abuse and Neglect". It is our responsibility to ensure people are not subjected to abuse, neglect, mistreatment, and/or exploitation of any kind. No one threatens or intimidates people to make them comply with organizational policies or individual staff preferences. People live and work free from the fear of physical or mental harm.

Abuse and neglect are defined from the person's perspective. Organizations therefore identify people's personal definition of A&N. Support Staff need to be familiar with each person's perception of abuse and neglect so as to avoid any harm, no matter how inadvertent.

If safeguards against abuse fail, the organization needs to actively respond to each situation by implementing processes for investigating all allegations of A&N. Follow-up actions, either formal or informal need to focus on supporting the victim.

Values of this outcome:

  1. People are not subjected to actions, by others, that cause them physical or emotional harm.
  2. People are able to recognize and report all forms of abuse, neglect, mistreatment, and exploitation.

Principles for Organization:

  1. Expressly prohibit all forms of abuse, neglect, mistreatment, and exploitation.
  2. Address all allegations of abuse and neglect regardless of the source.
  3. Educate staff to recognize and report any suspected incidents of abuse and neglect.
  4. Provide support for the person who has been potentially victimized.

Person Centered Planning

The webpage entitled "Person Centered Planning Process for Medicaid Waiver Services" has been updated. All DDD Scoop articles related to Person Centered Planning have been compiled into one document. In order to access this document, click on the link below. Also, all Person Centered Planning webinars have been linked to this website page. When using the link, there is a short cut to these webinars. http://www.dhs.state.il.us/page.aspx?item=96986

Rule 116 Reviews

FY18 reviews by our Health Facilities Surveillance Nurses will once again include reviewing provider agency policies and procedures to ensure compliance with the Department's Administrative Rule 116 related to medication administration. Policies and procedures have not been reviewed for the past several years in anticipation of the changes/revisions to Rule 116. The review will be in the form of a desk audit and will be done by the Health Facilities Surveillance Nurses after the onsite review is completed. A thorough review of the policies and procedures will be done and technical assistance given as needed to help providers establish clear and workable policies and procedures related to medication administration. These policies and procedures should be a resource for staff and provide clear directions on your specific agency's practices regarding medication administration.

Following the successful completion of the desk audit, Anne Fitz, Statewide Nursing Coordinator, will send the agency a letter stating that policies and procedures have been accepted. During future 116 reviews of your agency, the reviewer would only need to review policies and procedures that have been revised since the date on the initial letter.

State Operated Developmental Center News

Choate Center: The Pumpkin People visited the Clyde L. Choate Mental Health and Developmental Center earlier this month. Twenty-one businesses/organizations committed to setting up displays which were available for viewing October 13-22, 2017. The trail of pumpkin people depicted various scenes from Dr. Seuss' favorite stories. Using approximately 110 pumpkins from St. Mary's Pumpkin Patch, 95 bales of straw donated by Stegle Plumbing and 55 mums from Choate Greenhouse, Pump People casts a spell throughout the campus. The smiles and laughter of children and adults alike shower the campus with joy as they explore the displays and make pumpkin people friends. A continuous line of cars parades through the grounds, bringing thousands of visitors to witness the creativity and ingenuity of the displays. Businesses and organizations participating in 2017 included: Anna Jonesboro National Bank, Reppert Publications, Cobden School, Choate Rehab and staff, Jim & Dot's Western Store, R.A.V.E., Inc., Walgreens, Union County CEO Program, Casey's General Store of Jonesboro, Horseshoe Lakers 4H, Jonesboro Rehab & Health Care, Tri-County School, SIU Credit Union, Sunrise Preschool, Southern Seven Head Start, Illinois Guardianship & Advocacy Commission, JR Centre, Pearson Farms, Kroger, AJ Clever Clovers 4H and Integrity Healthcare of Cobden.

Kiley Center: Several individuals tried out for the Kiley Kroakers, the center's basketball team, and team members have now been selected. Sixteen individuals in all were chosen for the team with 12 males and 4 females. A scorekeeper and assistant coach were also designated.

Mabley Center: One individual started a class at Mabley stores earlier this month. She is shadowing our Storekeeper two days a week for 30 minutes at a time to learn about manufacturing processes (receiving and storing materials, supplying materials to workers, and packaging). It is going well and both parties are enjoying it.

Murray Center: Recently, a group of guys from Murray Center enjoyed a train ride to Carbondale. They boarded the Amtrak at the Centralia Station and enjoyed the nice ride to Carbondale. The conductor was very nice and took the time to visit with the individuals. For most of them, this was their first time riding on a train. After arriving in Carbondale, everyone enjoyed a nice lunch at the Golden Corral. Thank you to the cottage staff and the Activities Department for all of your hard work in making this trip so enjoyable!

Shapiro Center: A total of 61 employees took advantage of the Flu Clinic held at the Center. In addition, during the month of October, all Shapiro Center employees are being in-serviced on Hygiene and Handwashing as well as Influenza.

The Right Time

Finally, in closing and as we come to the end of a busy month - which seems to have flown by - I'd like to reflect on a few things. First, as I have participated in conferences and expos over the last few weeks, I've appreciated the candid feedback I have received from system stakeholders about system change initiatives. Many have expressed frustration with the roll-out of the personal plan on July 1, 2017 - and I take full responsibility for failing to ensure a smoother transition. Many have questioned the timing of the roll-out - believing that we should have waited for a better time and more resources before initiating so many changes. While I believe this is fair and constructive feedback, I often find myself wondering if there is ever a good or right time to tackle difficult issues. Nevertheless, we will learn and grow from our mistakes, collaborate with stakeholders to enhance the person-centered planning process, and apply lessons learned from this experience to future initiatives.

Second, my heart and prayers go out to the families of the four U.S. soldiers killed in Niger and the families affected by the tragic event in Las Vegas. Americans are, once again, mourning the loss of lives as a result of the October massacre in Las Vegas, resulting in the death of 58 people and injuries to hundreds of innocent people. Regrettably, these incidents - which appear to be occurring more frequently and with more casualties - are typically followed by the perfunctory call for action to prevent such violent outbursts, which typically fall on deaf ears until the next tragic event. Out of an overabundance of caution that we not politicize the Las Vegas incident, we've decided that the timing is not right to talk about changes needed to prevent future violent incidents. But when is the right time?

Throughout our history, questions have been raised about the timing of critical events and actions, such as many of the events that occurred during the civil rights movement in the 1960's. Our country was polarized then - not unlike today - and many Americans were on edge and questions were raised about the timing of the changes necessary to ensure all people of all races had equal access to housing and jobs and were afforded opportunities to pursue the American dream of life, liberty and happiness.

And even today, almost thirty years after the passing of the ADA, which affirmed that people with intellectual and developmental disabilities are entitled to earn a living - we still have too many people that we serve who are unemployed or under-employed, even though they can and want to work and have so much to offer. So, when is the right time to address this disparity?

In the midst of the civil rights movement, when Martin Luther King, Jr. was asked about whether the timing was right for change, he responded, "it's always the right time to do the right thing".

Have a great weekend!