Transcript Document

Office of Developmental Programs
Today’s Vision…Tomorrow’s Reality
Futures Planning Implementation Proposal
December 17, 2013
© Copyright 2011. Alvarez & Marsal Holdings, LLC. All Rights Reserved.
Perspectives
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Today’s Vision
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ODP Mission and Vision
Futures Planning is founded on the Mission and Vision of the
Office of Developmental Programs (ODP):
Mission
The mission of the Office of Developmental Programs is to
support Pennsylvanians with developmental disabilities to
achieve greater independence, choice and opportunity in their
lives.
Vision
Our vision is to continuously improve an effective system of
accessible services and supports that are flexible, innovative
and person-centered.
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Futures Planning Purpose
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Enrich chances for meaningful lives for Pennsylvanians
with developmental disabilities
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Ensure the service system achieves quality outcomes for
individuals and families
•
Reduce service system complexity to simplify access to
services
•
Develop a service delivery system that is more fair and
carefully manages taxpayer resources
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Planning Structure
• ODP and Stakeholders
worked together through
consensus
• Drafted
recommendations on
service system redesign
based on existing mission
and vision statements
• Incorporated feedback
from community & staff
into final
recommendations
• All stakeholders had multiple
and varied opportunities to
offer suggestions and give
feedback
• Everyone was encouraged to
get involved and spread the
word
•ODP Leadership Staff
•Participated in Extended
Team
•Used feedback from
community & staff in
draft recommendations
Extended
Team/Action
Plan Teams
ODP Core
Team
Broader
Engagement:
Community &
Staff
ODP Team
• Source of exchange
between staff and Core &
Extended Teams
• Provided input
• Provided Subject Matter
Expertise as needed to
Core and Extended Teams
• ODP Team members acted
as Action Plan Team Co-Leads
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Statewide Stakeholder Representation
•Individuals and Families
•Providers
•County/Administrative Entity Staff
•Advocacy Organizations
•University Partners
•State Agency Partners
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Futures Planning Time Line
Jan
2013
Jun
2013
Action Plan
Teams Formed
Futures
Planning Began
Aug
2013
Mar
2013
Second Public
Comment
•First Extended
Team Meeting
•Long Range
Goals
Developed
•First Public
Comment
Oct
2013
May
2013
•Final Public
Comment
•Self-Advocate
and Family
Open Forums
Objectives
Developed
Nov
2013
Action Plans
Finalized
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Stakeholder Outreach
• Expectation of Extended Team to be a link or liaison with
their respective community groups
• Website for all Futures Planning materials
http://www.odpconsulting.net/odp-futures-planning/#.UbDOpPk-ZzD
• Public comment periods advertised through the website
• Statewide listening tours throughout the year by the Deputy
Secretary
• Two open forums at the PA Disability Employment and
Empowerment Summit (PADES)
• Five regional self-advocate and family forums hosted by
ODP
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Tomorrow’s Reality
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Tomorrow’s Reality - Long Range Goals
Each person is supported to:
1. Live and lead a productive, self-determined and safe life.
2. Make informed choices.
3. Enjoy real opportunities for a variety of relationships in which they are accepted, valued, and included.
4. Access services and supports throughout life that are creative and flexible.
5. Have their family and/or circles of support respected and assisted as needed with the understanding that
the needs of the individual come first.
6. Receive well-coordinated quality supports and services from natural, public and private sectors.
7. Receive high quality services and supports in inclusive community settings.
8. Choose to self-direct paid services and supports within a defined budget based on assessed need.
9. Access the full range of technology to promote independence, inclusion, productivity and selfdetermination.
10. Experience seamless transitions throughout the life span.
11. Have the services and supports for their desired work, vocation and/or education.
12. Access unique, innovative, non-traditional services and supports.
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ODP Futures Planning Objectives
1. Each person’s budget is based upon assessed needs, and the individual will know
and be able to control the services within their budget.
2. Review and revise qualifications so that people will be supported by professionals
who are appropriately qualified and trained to their individuals’ needs, including a
focus on people with complex physical or behavioral health needs.
3. Define a process to support creation of and funding for newer, better, reduced-cost
ways to provide services.
4. Integrate flexible models of service that can support peoples’ changing needs in their
home communities, including supporting people through a physical or behavioral
health crisis.
5. Determine the best and simplest system to manage services to improve outcomes.
6. Develop steps to define quality measures. The results of the measures then can be
used to develop an action plan to improve quality of life for those supported by the
ODP system. ODP will work with individuals, families, providers and others to develop
meaningful measures that go beyond the minimum standards.
7. Develop design options for a pilot program for managed care of developmental
disability services.
8. Pennsylvania will be an Employment First state. Employment is the first priority for
people with disabilities.
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Action Plan Development
• The eight work groups of the Extended Team developed
action plans for each objective to move ODP toward the
overall Long Range Goals. These plans included:
• Action items that will achieve the overall objective
• Action steps required to achieve the action item
• For ease of understanding, each action plan was
summarized for the final public comment period and public
forums
• All comments from public input and open forums were
considered in the development of the Action Plans
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Action Plan Prioritization
The Core Team brought together the eight separate Action
Plans and prioritized activities in a first phase implementation
proposal for 2014. Consideration was given to:
• DPW Strategic Plan
• ODP Mission and Vision
• Themes across action plans
• Action items that needed to occur before other action items
• Action items that are realistic and doable
• Staff and financial resources
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Implementation Proposal
• Based on the prioritization process, selected activities from
all eight objective action plans are proposed
• Expected outcomes and resource needs are considered
• Necessary first steps for the long term success of the
Futures Plan fall into the following areas:
• Using a Person-Centered Assessment
• Identifying Service Needs and Gaps
• Improving Provider Qualifications
• Ensuring and Enhancing Quality
• Designing Broad System Change
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Implementation Proposal Structure
Implementation proposals are structured as follows:
•Objective Number Reference
•Selected Action Items
•Expected Outcomes
•Time Line
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Using a Person-Centered
Assessment
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Implementation Proposal – Person Centered Assessment
Person-Centered Needs Assessment and Budget Process (Objective #1)
 SELECTED ACTION ITEMS
• Evaluation of current assessment process through interviews with
individuals, families and other stakeholders
• Evaluation of available tools
• Finalize tool(s) to be used
• Create exception and appeals processes
• Explore establishing all service rates based on the cost to serve
people with similar needs
• Explore relationship between assessment scores and budget ranges
• Develop operational process, including waiver, regulation, fiscal and
other changes
• Create measures and begin monitoring to establish baselines
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Implementation Proposal – Person Centered Assessment
Person-Centered Needs Assessment and Budget Process
 EXPECTED OUTCOMES
• Provides more evidence-based understanding of services and
supports that are focused on individual needs
• Provides individuals the opportunity to control their services and
budget
• Offers consistency of practice
• Anticipated savings due to simpler process, allowing for the
expansion of the number of people served
• Provides chance to more accurately connect needs to the budget
• Long range impact will be determined after development of the
assessment and link to budget
 TIME LINE
• Selected action items will be done over 12 months
• 2-3 years to complete the full needs assessment and budgeting
process
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Identifying Service
Needs and Gaps
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Implementation Proposal - Service Needs and Gaps
Innovative Services and Supports (Objective #3)
 SELECTED ACTION ITEMS
• Develop and implement the standards and process for the introduction
of new/different ways that address services and supports
• Identify resources that aren’t currently used or that are not used
enough
 EXPECTED OUTCOMES
• Encourages creativity and innovation in program development and
service delivery
• Allows ODP to know what else can be provided in a more efficient way
than what is currently being offered
• Anticipated savings at an individual level
• Overall, provides data that shows gaps and how changes can be made
• May identify resources that aren’t currently used
 TIME LINE
• 12 months
• Ongoing assessment and evaluation of new process and standards
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Implementation Proposal – Service Needs and Gaps
Supports for Changing Needs in Times of Crisis
and Transition (Objective #4)
 SELECTED ACTION ITEMS
• Conduct gap analysis with a cross-system team to determine what
currently exists, what is working, and activities that can be easily
replicated
• Continue implementation of Dual Diagnosis Initiative focusing on
regional stabilization teams
 EXPECTED OUTCOMES
• Reduction in costs for people by providing support before a crisis
occurs and before issues happen during a key transition period
• Use of supports that improve quality of life and avoid more intensive
or higher cost services
 TIME LINE
• 6-9 months; some things already in process
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Implementation Proposal – Service Needs and Gaps
Employment First (Objective #8)
 SELECTED ACTION ITEMS
• Implementation of this Action Plan along with the Governor’s
employment initiative and work among agencies including the State
Employment Leadership Network (SELN)
 EXPECTED OUTCOMES
• Improved quality of life for individuals through gainful employment as
a respected member of their community
• Long term savings in improved outcomes by people working and
being less dependent on public supports
 TIME LINE
• 12+ months
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Improving Provider
Qualifications
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Implementation Proposal – Provider Qualifications
Provider Qualifications (Objective #2)
 SELECTED ACTION ITEMS
• Conduct a review of service definitions (current and proposed) and
provider qualifications to identify necessary changes
• Align and improve training with current and proposed provider
qualifications; identify training gaps; complete development of preenrollment training; create a record of current ODP training offerings
• Explore workforce development activities through higher education
and vocational education
• Create a training curriculum about intellectual disability and autism
for Certified Nursing Assistants
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Implementation Proposal – Provider Qualifications
Provider Qualifications (Objective #2)
 EXPECTED OUTCOMES
• Enhanced quality of life for people
• Increased provider capacity
• Improved staff expertise in supporting people with intellectual
disabilities and autism
• Workforce having proper training results in less time to learn the job
and improved length of time on the job
• Proper training creates better management for individual behavioral
challenges and physical health reducing the need for increased
staffing
 TIME LINE
• 12-18 months
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Ensuring and Enhancing
Quality
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Implementation Proposal – Ensuring and Enhancing Quality
Quality (Objective #6)
 SELECTED ACTION ITEMS
• Identify quality of life and outcome measures
• Collect data on existing quality measures and data sources and gaps
• Publish first list of selected quality measures
• Create provider profiles and determine whether providers or ODP will
collect and display the profile information
• Build structure for quality improvement projects
 EXPECTED OUTCOMES
• Remove data and reports that are currently being collected and
developed but not used
• Anticipated savings because of quality monitoring and improved
outcomes
• Long term reduction in services that don’t achieve individual outcomes
• Improved individual outcomes due to better options over time
 TIME LINE
• 18-24 months
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Designing Broad
System Change
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Implementation Proposal – Broad System Change
Create the Best and Simplest System of Services
and Supports (Objective #5)
 SELECTED ACTION ITEMS
• Review current and new support and system options
• Improve the Individual Support Plan (ISP)
• Reevaluate required duties of Administrative Entities and the
Operating Agreement
• Reevaluate required duties of Supports Coordination Agencies and
the Provider Agreement and related policies
• Train Supports Coordinators about ISP monitoring (already
happening)
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Implementation Proposal – Broad System Change
Create the Best and Simplest System of Services and Supports
 EXPECTED OUTCOMES
• Improves focus on outcomes for people in the ISP process
• Improves Supports Coordination focus on identifying risk factors and
addressing them early
• Maximize and strengthen chances for community inclusion and use
of natural supports
• Improvements to ISP monitoring for intended outcomes
 TIME LINE
• 9-12 months
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Implementation Proposal – Broad System Change
Integrated, Coordinated Support (Objective #7)
 SELECTED ACTION ITEMS
• Design an integrated, coordinated model of support that addresses
the needs of individuals with developmental disabilities and can lead
to a pilot after Year 1
 EXPECTED OUTCOMES
• Improved individual outcomes and quality of life if supports are
coordinated
• Anticipated savings will be measured through the pilot model
 TIME LINE
• 12 months
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Activities to
Support Implementation
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Activities to Support Implementation
Stakeholder Input/Data Collection
• Assess the current ODP service system through data collection and
stakeholder interviews, surveys, focus groups, etc.
Resources
• Evaluate internal resources that can be realigned and redeployed
• Evaluate new resources required, some of which may be flexible, short-term
or specific to a single task
Communication
• Implement a communication strategy that continually informs and engages
stakeholders, both internally and externally
Policy Revisions
• Assess current policies for relevance, clarity and the need for new and
changed policies (including changes to Medicaid Waivers)
Information Technology
• Assess current information technology needs
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Proposed Implementation Structure
• Implementation of all proposals will require a great deal of effort
and coordination
• A proposed structure will guide implementation:
Deputy Secretary
Executive Leadership
Team
Project Manager
Steering Committee
Implementation
Teams
Extended Team
Stakeholders
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Steering Committee
• Charged with oversight and coordination of integrated Action
Plan implementation
• Staffed by members of the ODP Executive Leadership Team
• Reports to the ODP Executive Leadership Team and DPW
Leadership
• Led by the ODP Project Manager
• Guided by a project work plan
• Gives regular reports to ODP and DPW Leadership and the
Extended Team that include:
• Project status
• Major milestones
• Anticipated challenges
• Updates on communication with stakeholders
• Suggested changes to project work plan
• Acts as a liaison between the ODP Executive Leadership Team
and Implementation Team leads
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Initial Implementation Time Line
Jan
2014
•Start ODP Steering
Committee
•Form Implementation
Teams
•Continue evaluation
of internal resources
that can be realigned
•Develop and start
using communication
strategy
Feb
2014
•Begin stakeholder
input activities
•Collect data from
other states
•Implementation
teams begin work
Mar
2014
• Extended Team
update meeting
• Finish stakeholder
input activities for
initial assessments
• Evaluate other work
supporting all
objectives– policy,
regulation, waiver
amendments, IT
changes, training/
education; strategy
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Next Steps - 2015
• These proposals are meant to create the foundation for full
realization of the ODP Futures Plan
• The Extended Team worked in partnership with ODP to
determine additional short term objectives and parking lot
issues
• Planning for 2015 will revisit these suggestions
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Tomorrow – A Story
Perspectives
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Today’s Vision…Tomorrow’s Reality
Thank you to everyone who took part in and
gave input to
The Office of Developmental Program’s
Today’s Vision…Tomorrow’s Reality
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