Transcript CORE INDICATORS FAMILY SURVEYS AND CONSUMER …

Using CORE NDICATORS
in Federal HCBS Reviews
Jon Fortune, Ed.D
David Heath, MPA
Wyoming Developmental Disabilities Division
& the Wyoming INstitute for Disabilities
(WIND-UCE)
HCBS Quality Framework Protocol
Red - Indicates that information gathered by Core Indicators
provides data that can be reviewed by CMS
Domain
Sub-Domain
I. Participant Access
A. Information/referral
B. Enrollment
II. Participant-centered
Service planning and
Delivery
A. Participant-centered service planning
B. Service Delivery
III. Provider Capabilities
A. Provider Networks & Availability
B. Provider Qualifications
C. Ongoing Monitoring
HCBS Protocol (cont.)
Domain
Sub-Domain
IV. Participant safeguards
A. Abuse, neglect, exploitation
B. Major & unusual Incidents
C. Housing & environment
D. Behavior interventions
E. Medication management
F. Personal safety & security
G. Natural disasters
V. Participant rights &
Responsibilities
A. Grievances
B. Due process
C. Fundamental Rights
HCBS Protocol (cont.)
Domain
Sub-Domain
VI. Participant outcomes & A. Participant satisfaction
Satisfaction
B. Participant outcomes
VII.System performance
A. System performance appraisal
B. Continuous quality improvement
C. Cultural competency
D. Participant & stakeholder
involvement
E. Financial integrity
Several other features in addition
to 150 core indicators helped:
• Use CARF…The Rehabilitation Accreditation
Commission’s national standards for 3
waivers
• Individual waiver budget
technology (DOORS)
with good system
architecture
* Extensive rules/training
• RN, CDDN consultation
• Published service provider site survey
reports http://ddd.state.wy.us
‘02 & ‘03 Results – Wyoming
(Consumer Survey)
Wyoming’s performance was strong along
four principal scales – community
inclusion, support-related choices,
personal choices, and service
coordination
Satisfaction with Work/Day
Program (Consumer Survey)
2001
2002
89.1% (n=264) -YES - 94.2% (n=260)
5.7% (n=17) -In between- 4.3% (n=12)
5.0% (n=15)
-NO-
1.4% (n=4)
Satisfaction with Residential
(Consumer Survey)
2001
2002
89.4% (n=288) -YES- 89.7% (n=272)
3.4% (n=11) -In Between- 5.6% (n=17)
7.1% (n=23)
-NO-
4.6% (n=14)
Case Management - 2002
(Individually-Selected Service Coordination)
(Consumer Survey)
94.7% know their case manager
93% say their case manager helps them
get things that they need if they ask
89.6% say that their case manager asks
them what they want
Case Management
(Family Surveys)
80.9% (combined total)
Satisfied With Services Provided by Case Manager
71.3% Adult/Family
89.1% Child/Family
78.2% Family/Guardian
(Thanks Washington State and Lisa Weber!!!)
General Information
91.6% (n=372) get the services that they need
(66% of those answering were consumers)
3.1% of agency boards are consumers
19.8% of boards are family members
Community Inclusion is high (often @ 90%)
Choice and decision making was high
(most had input)
Range of annual per person expenditure
by living arrangement (2002)
Minimum
Maximum
Average
Living Arrangement
$1,800
$187,270
$31,657
1
With parents or relatives
$32,700
$73,447
$58,745
2
Foster Home
$1,800
$109,187
$21,009
3
Independent in own home or rental unit
$1,800
$135,760
$36,361
4
Independent with regular home-based services
or monitoring
$21,528
$185,432
$59,897
6
Semi-independent unit with supervisory staff in
bldg.
$9,864
$299,134
$82,648
7
Group residence with staff providing care,
supervision and training
$26,500
$173,130
$75,570
8
Personal care facility with staff providing care,
but no training or nursing services
Mortality, Serious Injury and
Abuse/Neglect (2002)
CMS reviewers liked:
NCI definitions of abuse/neglect (and that
information was broken down in respect to restraints, injuries, and
“substantiation”)
NCI breakdown of mortality (by age and total
number in each population bracket)
NCI breakdown and definition of crimes
(forcible rape, aggravated assault, larceny theft)
673 Workers Needed Today
Turnover rate: 50%
HELP WANTED
Direct service staff members $5.66
Need $10.23
(Core Indicator: staff pay and turnover)
Funded July 1, 2002
Wyoming Legislature
Contact Information
http://www.hsri.org/cip/core.html
National Core Indicators Web Site
Jon Fortune, Ed.D
[email protected]
307-777-7115
David Heath, MPA
[email protected]
307-766-2609
DDD Wyoming Web Site
http://ddd.state.wy.us
http://wind.uwyo.edu/wycip/
Wyoming Core Indicators Web Site