Team 5: Monitoring and Quality Meeting Minutes (4-17-14)

Members Present

  • Shawna Egan (Communicator), Little City
  • Patty Walters (Chair Person), DSC
  • Patty O'Brien, Suburban Access
  • Matt Toohey, Access Services of No IL
  • Trevelyn Florence-Thomas, DHS/BTS
  • Joshelle Gilden-Williams, Service, Inc.
  • Mary Lou Bourne (Facilitator), SDA/NASDDDS
  • Steve Zider, CAU
  • Mary Jane Friedrich, Western Illinois Service Coordinatio

Members Absent

  • Deb Stanley, Suburban Access
  • Michael Hurt, DHS
  • Trina Steling, Trinity Services
  • Meeting Notes:

Highlighted Items

  1. Look at Person Centered Plan
  2. Review payment structure to cover actual costs of monitoring

Introductions

Role of ISC Discussion

  • 1-Assure/Report on the health and welfare of individual served
  • 2-Assure/Report that services are being delivered according to the Person Centered Plan

ISC Monitoring/Visits

  • The group identified the difference between "compliance" and "quality" and that current practice is that ISC's are required to complete "monitoring" forms from DHS that uses language suggesting compliance
  • ISC's feel that this sets up an adversarial relationship with providers from the onset of communication and required visits.
  • The group decided a better word than "monitoring" needs to replace the description of this activity
  • ISC's are directed to visit providers 1x per quarter - however, this is not defined well and nearly 6 months can occur if a visit is on Jan 1 (Q1) and June 30 (Q2)

PUNS/Eligibility

  • The group agreed with portions of the new DD System Guidepost "TO BE in 2014" such as determining eligibility prior to placing on PUNS
  • Suggest that the Department adopt the SIS = Support Intensity Scale as part of determination
  • The group recognized that while determining eligibility first, this would incur significant costs to the ISC agency which is not reimbursed
  • Suggest the Dept. accept school psychologist report for determination

Discussion on Other Teams' Activities and Progress 

  • This team wants to review and have input on the Person Centered Plan template
  • This team wants to review and have input on Profile and Provider Selection
  • Team encouraged to reach out to other teams as colleagues for information sharing

What Currently Takes Place as Quality

  • Compliance - binary/attribute data, either meets requirement or doesn't
  • Data tables and spreadsheets - ex. People asking for services that do not exist
  • Events - complaints and interviews can trigger a review (reactive)
  • Quarterly ISC visits

Definition of Quality Discussion 

  • Quality is what occurs "beyond" minimal expectations
  • Should incorporate national quality benchmarks
  • Metrics should demonstrate low-medium-high quality
  • Should identify "desired outcomes"
  • Viewed video "200 Years 200 Countries" as an example of understanding data
  • Should always be opportunities for improvement (OFI's)
  • We reveal our values through the language we use

Quality Measurements Discussion

  • Binary data is one dimensional and does not provide useful information for performance improvement
  • Variable data provides multi-levels of information that allows for multi-levels of performance improvement
  • Data table provide information needed for visual Charts
  • Different Charts communicate various types of meaningful information
  • Must have a body of knowledge to have quality performance improvement
  • Must be willing to compare to other ISC's and Providers to establish benchmarks and revealactual quality measurements

Examples of Quality Measurement Classifications 

  • Number of non-paid staff at a planning development meeting
  • Quality by Perception - measured through survey
  • Quality by Fact - actual data
  • Review of consumer complaints - length of time to resolve issue, how issue was resolved and review of trends in complaints
  • % of staff who speak a second language
  • Rate of staff turnover
  • Cost per person served
  • Track referrals - where them come from and where referred to

Technology

  • Lack of technology identified agreed by group
  • Recommendation to explore opportunity with FEIS, a Chicago-based software company that builds systems for healthcare and long-term care field, DD agencies

Homework

  • Review ISSA notes form
  • Compare ISSA notes form/Service Coordination with South Carolina DD and Quality and Georgia.DD.quality or DELMARVA

Next Meeting 

Tuesday, April 29th
10am - 2pm
Suburban Access - Homewood