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HomeMy WebLinkAboutIDD Provider Meeting Minutes 02-15-19Intellectual & Developmental Disabilities Provider Meeting Friday, February 15, 2019 IDD Provider Meeting 1 2/15/19 Meeting Minutes Welcome & Introductions Everyone introduced themselves and their agency affiliation. Fiscal Updates – Ashley McCartney » Friendly Reminders to our Base Funded Providers (Refer to procedure statement MHIDDEI-416)  February 15th: Quarterly Report of Expenditures (October – December)  Quarterly Report of Expenditures for October – December are due today. If you have not turned them in, please email them to Ashley.  March 15th: Appendix A and Budget Packets for FY19-20  May 15th: Quarterly Report of Expenditures (January – March) » FY19-20 contract season is approaching. Lori Young » DD Awareness Month March is Developmental Disabilities Awareness month. National Association of Councils on Disabilities theme is “Jazz It Up! Building on Our Potential.” The concentration is on the “building on our potential” part of the theme. The conference this year takes place in New Orleans which is where Jazz it Up! came from. The theme will concentrate on employment, education, community living, and inclusion. More information will come on this. The proclamation is scheduled for March 5th at the Commissioners building. All are welcome to attend. » QA&I Franklin/Fulton IDD program had their onsite this year. Results will be posted to MyODP for all to see. There was one area of improvement opportunity due to one ISP being one day overdue. A corrective action plan was written. The rule of ODP is 86% deficiency. ODP was happy that the county is stressing employment and to see trainings and resources in the area. » Provider Qualifications If Lori has reached out to you (providers), your provider qualifications are due this year. They must be submitted before March 30th. Q: if you do not have QA&I or provider qualifications due this year, do you still have to complete the Provider Qualification Documentation Record – A: you should keep it up to date but it will not be reviewed until you are due for provider qualification. Provider qualification documentation record is on MyODP and in announcement 19010. » Regional Collaborative: Next Workshop Training The Regional Collaborative has decided to partner workshops off of Community Fairs and other community events, such as the Transition Fair at Waynesboro High School. As part of life course planning tools, Regional Collaborative will partner IDD Provider Meeting IDD Provider Meeting 2 2/15/19 with PA Family Network for “Creating a Vision for Life after High School” event on March 23rd. If you know of anyone who would be interested, it is being held at the Waynesboro Library from 1:00 p.m. – 3:30 p.m. Free mentoring by the PA Family Network can be scheduled at this workshop if families are interested. Marion Rowe » HCQU – 2019 Training Location – as of this calendar year, all HCQU trainings are being held at the Human Services Building (HSB). Please make sure to remind your staff that the training location is at the HSB and not the Annex. Consumer Training – March is the last afternoon consumer trainings. After March, HCQU trainings will take place in the morning for anyone who is interested. Any other training that providers want to have for individuals registered for the program can contact the HCQU to coordinate. Fatal 4 – the ARC has training scheduled for their staff in June at the Franklin Learning Center in which the County IDD program will pair up with to host the family training on Fatal 4. Marion is waiting on approval from the ARC prior to send official notice. A flyer will be distributed to families once approved. There will be a morning session on June 12th from 9:00 a.m. – 11:00 a.m. and an evening session on June 13th from 3:00 p.m. – 5:00 p.m. Various providers discussed how they are educating and training their staff on risks of Fatal 4. Some provider agencies came up with a version called Fatal 5+1, have used material from HCQU, developed excel spreadsheets to list individuals in the group homes and what diagnosis they may have pertaining to the Fatal 4 (or 5+1), used ODP material, used the internet for more information, incorporated Fatal 4 into orientation training as well as annual training, developed protocol for anyone who has a Fatal 4 condition, have made caregivers aware of protocol, annual review of risk mitigations and ISPs, pre service, has had HCQU present on the importance of symptoms to look for, etc. Some counties are using ISPs to pull out diagnosis and possible medical conditions that put individuals at risk. The County has not completed this task yet to figure out how many individuals we support who could be at risk, who they are and what information is in their ISPs. However, it is encouraged that providers and Supports Coordinators (SC) do this at meetings to ensure information is accurate, consistent and staff are trained. Katie Freeman from the HCQU provided Fatal 4 packets of things she has found and what other agencies have used. The packet includes potential risks, causes, signs, what to do, health promotion activity plan, etc. If a provider has someone at risk, the packet is an example of something they can put together. There is information on feeding for individuals who are on an altered diet or have to be fed in a particular one. It’s a one sheet document that asks for a picture of the individual sitting in an appropriate position eating. It allows for others to see the correct position. It also lists things to take into consideration. IDD Provider Meeting IDD Provider Meeting 3 2/15/19 With any incident reports related to health concerns and risks, include any training provided to staff before and after the incident. Provide any follow up medical attention (such as individual going for swallowing study if they had a choking incident or individual had a neurology appointment due to increased seizures). There is different staff from ODP reviewing incidents depending on the day. ODP is paying close attention to incidents due to OIG reports. Those reviewing incidents are only going off what is in the incident not in the ISP. The information in the incident should be as if the person reviewing it does not know the individual. Risk mitigation is a big push right now. ODP is working on the incident management bulletin. It is okay for providers to follow up with ODP staff directly regarding incident feedback and disapprovals. ODP staff reviewing incidents will either reach out to the provider, cc’ the County or SC; or they will reach out to the County directly then county staff will forward the information to the provider. Katie Freeman noted that if providers put an incident about emergency room or hospitalization, or any mention of pressure wounds, you will receive a call from the HCQU to find out what is going on, to collect information and to see if training is needed. This came from ODO pertaining to their pressure pilot as they are tracking wound management. Training on pressure wounds is scheduled for the HSB in June. If providers know of anyone at risk or staff that would benefit, they can also come to your facility to provide training. HCQU nurses are well versed in wounds. Health Risk Screening – there are changes coming out with the 6100 regulations on health risk screening. ODP’s plan is to do best practice or use a tool. There has always been a tool called consumer data collection. However, it was heard they will be developing their own tool. If you type in health risk in Google, there is a company who does it. In the interim, some providers have been developing their own tools and assessments and some are using the consumer data collection from the HCQU. Providers can continue to use the consumer data collection tool or come up with their own tool. Providers are held accountable even if ODP does not come up with a tool to follow. Residential providers utilize CDCs in which the HCQU is tracking to ensure that individuals have them completed and are updated regularly. The 6100s are not finalized yet but have an implementation date of March 1st. ODP is still trying to figure out how to roll out the new regs. They expect to follow them even if they are in draft format. » Incident Management Reporting additional allegations during the course of investigations has come up recently. Providers may be working on a particular allegation and another allegation comes to light during interviews. Providers need to ensure that they notify the point person to enter another incident report. Since the investigator is currently doing interviews, they can utilize interview information for the subsequent allegation. However, it is difficult to go back after the investigator has completed the investigation. If you are getting a report and the target is family or someone unrelated to you (as a provider), you must contact the SC and let them know. The SC will enter IDD Provider Meeting IDD Provider Meeting 4 2/15/19 any allegations related to family member or someone in the community. If it’s another provider agency, the SC would know if it’s related to another agency. It is not up to the provider to enter these. If you are receiving a report from an individual, especially someone who may struggle with communication, ask clarifying questions such as what do you mean about that or show me what you mean by that. It is better to be clear about the potential allegation instead of entering a report that is miscommunication. There have been a lot of incidents submitted that have simply been miscommunications due to clarifying questions not being asked. Marion has forwarded resources for investigators out of Lehigh County to providers. Some providers have contracted with them to handle their investigations. The County has run out of investigators due to investigators being so busy. If you are looking for resources, please let Marion know and she will forward the information. » Transition Fair The County is hosting a Transition Fair for all Franklin County school districts at Wilson College on March 20th. The committee is anticipating 225 students. In the past, providers have come in and set up tables with information; however, it has been decided to focus on training at this session and due to space and trying to keep students in a centralized location, there isn’t room for providers to set up tables. If anyone is available to come help register the students, please let Marion know. Parents will not be with the students; only teachers. Jane Cline » Individual Transition within Providers and Between Providers Transition can be numerous things, such as one provider to another or within providers. If you have vacancy that comes open in 6400s and you completed the vacancy notice and sent it to Bill Bruaw, Waiver Capacity Manager at ODP, and you decide that the vacancy you want to fill is within your organization then a transition plan must be sent to Bill. You must meet with the individual you are moving in and assure they have visited the new site. Once this is complete and the plan is sent to Bill than that will determine where your vacancy is within your 6400 homes. The reason for the vacancy notice for 6400 is for when ODP asks if Franklin/Fulton is planning on filling the vacancy and if they are not planning on filling the vacancy it will be listed on the state wide 6400 vacancy list where the group home openings are statewide. All team members must be involved if you are transitioning an individual from current provider to another, whether voluntary or not. The whole team has to meet to discuss the transition, what it will look like, end dates for current provider and start dates for new provider, documentation needed from one provider to the next, etc. This is also for day program services. If you are not willing to support the individual anymore, discharge notices must be completed and must be sent to Bill Bruaw at ODP. This is noted in chapter 51. If it is a voluntary discharge (individual wants to leave) then no discharge notice is required. IDD Provider Meeting IDD Provider Meeting 5 2/15/19 Please review chapter 51. They noted what information must be sent to Bill. Providers must be specific in discharge notices or they will be told it does not meet criteria. Typical information provided is demographics and reason provider is no longer willing to provide services. There should still be a transition plan for agency transition. This is only for vacancy. Some providers do not do vacancy management (only 6400s). For those that are not 6400s, a transition plan still needs to be done with the team. » EVV Update The state is contracting with state wide vendor for Electronic Visit Verification (EVV). If you do not have a system already in place, there is the option to go to the state vendor system. More information will be sent out in the next couple months on how to sign up. If you are a provider in home and community supports, companion, unlicensed respite and homemaker, you have to have some kind of electronic verification system in place. If you have your own system, it has to be compatible with PROMISe. This will start this summer. EVV is a call in system to verify that you are at a home at a particular time. The purpose is to track the services being provided. Some providers have to have a landline; however, the vendor said they will allow cell phones. » Rate Exception Process An example of Life Experience Appraisal Protocol (LEAP) is in 6400s if you have a needs group individual that is a 4 and the provider feels the rate for that individual is not providing the necessary supports for them, then a needs exception allowance tool can be completed. The tool gets sent to Fiscal at ODP to review the tool. They then agree/disagree to give a different rate. There are six (6) counties (Alleghany, Dauphin, Bucks, Blair, Butler Lackawanna/Susquehanna) reviewing ISPs, incidents, SIS scores, SIS assessment tools, etc. They do not review their own ISPs. These counties have reviewed 225 individual ISPs this year. Through this, they determined there were 50 individuals they felt did not meet criteria for needs exception allowance. The reason for this was due to lack of information in the ISP not clarifying why the individual needed a higher rate. The request goes back to the registration county and ODP to make the final determination if a needs exception will be extended. The group has already reviewed 225 ISPs. They have approved 200 for FY19-20 and still have approximately 50 more. There are 0 in Franklin/Fulton that have needs exceptions. CSG Mobile Behavioral Intervention Services – Lori Nimmon Community Services Group (CSG) is a mobile behavioral intervention service. There is currently one individual active right now; soon to get a second individual started. During CSG’s time with the first individual so far, the clinician, Becky Rezena, has been able to have four (4) observation periods. The initial assessment with functional behavioral assessment has been started. There has been coordination of monthly IDD Provider Meeting IDD Provider Meeting 6 2/15/19 meetings that already exist. Becky has reported that the team has been really invested and excited which helps tremendously to get services started and keep things moving. Becky is working on building rapport with the individual. She is on track to complete the assessment by March 7th and has training planned with the team. It is a length process gathering information to get services started. Clinicians are very thorough and want to see all aspects of the individual’s life. The initial meeting is 2-3 hours and typically requires two (2) team members for the meeting. For the individual currently being served, the entire team showed up. The SC discussed how comprehensive the initial meeting was. The clinician will accompany the individual to psychiatric appointments as much as she is able to. If she cannot attend, there is a great deal of pre and post conversation to obtain information. The county contracted with CSG for FY 18-19 for two individuals to be served. Services only really started in December/January. County staff will observe to see how things go the rest of this FY and determine how many individuals are able to be served next FY. CSG is a county funded service. There was an initial list of individuals the AEs thought would benefit from the service as well as recommendations from SCs. If you have an individual in mind that could benefit from the service, please let Marion or Jane know. CSG is a good service for individuals that providers have been working with that have been challenging and other resources have not resulted in progress. CSG is another resource to the team. Most individuals have existing behavior supports in place but not quite enough. CSG services are only 6-9 months. It is important that individuals have a supportive team. If the team is not on board, it could take months to get them on board which results in only a few months being left to put strategies in place. Round Table / Provider Updates » Family Care Services Tony Fisher attended Learning Collaborative. It was mostly focus groups that broke out into tables of 6-8 individuals. Those tables were given topics to discuss and brainstorm how to make improvements. It was organizational structure turned into leadership discussion. Most providers were group home providers; FCS was the only LifeSharing provider.  They wanted to know how many CEOs are direct service providers – over 75% were. CEOs take initiative to be in their group homes frequently. They visit and meet with the clients and staff to see how things are going.  This all started at the end of last year when Nancy Thayer required mandatory training. Fatal 4 and meeting the needs of individuals with challenging behaviors came out of it.  Tony discussed doing dual diagnosis certification. All 20 parts must be completed or you cannot certify. All new agencies are required to do this. It’s on MyODP and is convenient to do at your desk.  The next two meetings (February 21st and March 21st) for Learning Collaborative are for direct service workers at the Farm Show building. The reason for two meetings is because they want 12 staff to attend from each agency. They want group home staff attending. After these meetings, CEOs will be called back to meet to discuss what was learned IDD Provider Meeting IDD Provider Meeting 7 2/15/19 from direct service workers. This will help identify what can be done from the top down to improve services. There is no update from the IDD Provider committee meeting. FCS has inspection next week (Tuesday through Friday). Last year, the focus appeared to be on personal hygiene products and being accessible as a poison. Items had to be described better in the assessment and ISPs if the ISPs say poisons are locked up. The process of opening new homes has changed. The new process appears to be much faster. FCS had a new site opened in less than 30 days (this including PROMISe enrolled). For LifeSharing, there is a new program capacity request you have to send in after getting licenses back. There are more steps to the process but overall quicker. FCS has individuals that cannot do 100% in the community. FCS is looking for providers that would be interested in serving these individuals. There have been zero providers interested in willing to expand and there is a limit on facility based programs. » Service Access & Management SAM has moved their office to Orchard Drive as of January. They have also hired a new IDD SC that will be starting next week. » HCQU The HCQU is fully staffed. A save the date flyer was provided. The event will take place on May 31st geared towards mental health clinicians, psychologist and psychiatrists. It is a day on how to adapt therapies for the IDD population. Dr. Gregory Cherpes will be there to discuss assessment techniques. There will be two breakout sessions in the afternoon: 1) medications, prescribing them and challenges; and 2) Robin VanEerden will present on how to adapt therapy modalities. The final flyer will be sent out soon. HCQU is working on CEUs. If you know of anyone who may be interested, please share the flyer. To register, they can contact Katie Freeman at the HCQU. If capacity is not met, the training will be opened up to SCs, direct support staff, providers, etc. » Person Directed Supports PDS is continuing the process of closing their licensed day program. There are approximately 20 individuals currently in the program. Meetings will take place in February. The goal is by March to have set days and times of when individuals will be doing things. By April, PDS will be looking at authorizations. » Kaleidoscope Family Solutions Kaleidoscope is actively looking for a Program Director. Laura is stepping done as of March 1st. She will assist in the transition and still have coordinators in the IDD Provider Meeting IDD Provider Meeting 8 2/15/19 area. In addition, Kaleidoscope is hosting activities at their office every other week for individuals. » Elder Day at Menno Haven Elder Day has two new individuals attending their program who are adjusting very well. Individuals must be over 60 for the program. There is still capacity. However, it is getting tight in the building. There is availability on Tuesdays, Wednesdays and Thursdays. Elder Day will have to review and make a determination if individuals are requesting Mondays and Fridays or need anything less than five days. Five days is priority. If individuals are only needing two days a week then Tuesdays – Thursdays will be looked at as Mondays and Fridays are really tight. » PA Mentor PA Mentor has been trying to open a new group home and it’s finally going to happen. There has been one person identified. Referrals will be accepted for male individuals. » Angels on Call Angels on Calls has a new MH/ID Coordinator. Trudy represents the Shippensburg Office. Angels on Call provides habilitation and companion services right now and are working on expanding services. » Tender Hearted Services Clients are loving being in the community. Tender Hearted Services will be taking on another client in the spring. Individuals are spending 90% of their time in the community; most volunteering. » Keystone Human Services Keystone is focusing on taking advantage of new rates and trying to upgrade vehicles. » AHEDD AHEDD is recruiting a full-time Employment Specialist. There have been some staff changes at AHEDD. Penny Baker was the Benefits Counselor and is no longer with AHEDD. Karen Price is also trained as a Benefits Counselor. » Occupational Services, Inc. OSI questioned when authorizations were due for FY 19-20. There has been no discussion on FY 19-20 in terms of prep. Typically, providers receive a packet but this has not occurred yet. – IDD staff confirmed that there are no cap exceptions next fiscal year. At this point, this is the only information known. Providers have been directed to follow the historical utilization format as done in previous years. This coming year, there will be two (2) years of CPS codes; use those two (2) years for history. IDD Provider Meeting IDD Provider Meeting 9 2/15/19 » The ARC Events coming up for the ARC –  Social is February 19th at 7:00 p.m. at St. Paul’s.  Paint Night is March 19th.  Walk/5K Run Fundraiser is April 6th at Shippensburg Township Park/Cumberland Valley Rails-to-Trails. Register online at timberhilltiming.com or contact the ARC office.  Talent Show is April 16th. » Merakey Merakey is continuing to work on meeting the 25% CPS with their day program. Tours are still available for day program with the knowledge that it is unknown how long the wait list will be. The wait list does not operate on a first come first serve; it is dependent upon the individual’s needs. The Behavioral Support Professional (BSP) that was going to start has decided to accept another position. Merakey will continue to contract with Cornerstone. Events & Info » Upcoming HCQU Trainings  3/8 ~ (10:00 a.m. – 12:00 p.m.) Observing, Reporting and Documentation; (1:00 p.m. – 2:00 p.m.) Consumer Training – Stress Management  Starting in April, HCQU trainings will be from 10:00 a.m. – 12:00 p.m.:  4/12 ~ Responding to Crisis  5/10 ~ Positive Behavior Supports  6/14 ~ Compromised Skin Integrity » Upcoming Events  Save the Date Flyer – share with psychiatrists/clinicians (see above for more information) Next Provider Meeting Friday, May 17, 2019 at 10:00 at the Human Services Building Remaining 2019 Schedule August 16th November 15th Minutes by Erin Nye