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HomeMy WebLinkAboutIDD Provider Meeting Minutes 11-15-19Intellectual & Developmental Disabilities Provider Meeting Friday, November 15, 2019 MEETING MINUTES Welcome & Introductions Everyone introduced themselves and their agency affiliation. Marion Rowe  Risk Assessment Pilot Update A two phase process has been in the works. A meeting took place to work on the first phase. Then at the last meeting, those present went over their thoughts of the first phase. Phase one is the overview of the QA&I process that providers have gone through, licensing, and any areas that might be of concern that we might want to dive into to see if a provider is at risk. Phase one is approximately an hour long process for the three (3) IDD Program Specialists along with input from the Supports Coordination Organization. Forms are completed to see if things need to be looked at further. Phase two is a deeper dive into the concerns identified in phase one. The process is similar to the County’s assessments with ODP and licensing exits in that information is gone through then reviewed with those involved at the end. The purpose is to note things identified as risks to providers then develop a plan of correction from there. The workgroup plans to finalize the tool for the first phase. The tools will be completed by the Administrative Entities (AEs). It is required for all providers who provide authorized services in the County whether Lori is the lead AE or not. The workgroup is planning to meet with ODP as they must be on board with this pilot. The workgroup wanted to develop the tool first prior to meeting with ODP so that everyone was doing the same thing. The purpose of all this is to allow us to collaborate with other counties that share the same providers and to make sure everyone is on the same page and using the same tool. It may show that one county is having concerns with a provider but maybe another is not. A county can note what they are seeing from a provider and see if others are seeing the same. This has to be done by the end of the calendar year for implementation for next fiscal year.  HRST Update Most residential providers have completed some of the requirements for HRST. Statewide they have only screened 15%; Franklin County has completed 38%; 71% of level sevens are complete. Make sure to use Google Chrome for the tool. It has taken some time to get most providers access. However, bulk of access has been granted. As of now, it is pretty much happening the same day when providers are asking for access. Adding/removing individuals into the database has been an issue. It is done on a monthly update through HCSIS. Any time there is a change to an individual’s file IDD Provider Meeting in HCSIS it can take up to six (6) weeks for that new information to be downloaded. Some individuals have been removed from the system by mistake. If you start to clinical review or regular screening and no longer see an individual listed, please let Katie Freeman know. There is no timeline on new admissions. The response received was “agency best practice to come up with one.” Family Care Services is going to try to do them with ISPs – 90 days. A guideline may eventually come out on when to do new admissions but at this time, each agency should develop their own policy. HRST, where does it go in the ISP? – SCO training is not until December. How will the annotated ISP be used? – Service Access & Management is using it for all new intakes. The hard copy annotated ISP form was sent out with the staffing ratio changes. It is not in HCSIS. It is not changing the format or adding new categories in HCSIS. It’s simply the information that is inserted into each category. Service considerations/training considerations – there is a lot of information. If a level 2, there are about 30 considerations; a level 3 and 4 have more. Providers are already doing risk mitigations and putting them in the ISPs now these considerations need to be added. However, some do not apply. The HRS website does provide information pertaining to what to do with the considerations and when. Providers are to prioritize them in team meetings and determine which ones are relevant. Family Care Services has noted that they are doing clinical review on all individuals for the first time as best practice. There is supposed to be random sampling of a certain percentage every quarter. If you continue to do that everyone will eventually need a clinical review. There will be training developed on the QI process of the sampling to make sure tools are being done the way they should be. Expanding scoring descriptors – this is where clinical reviewers would say they need more information. If doing a rating on an individual, you should have the expanding score document with you as it will be helpful. If HRS is doing the clinical reviews, be prepared for a lot of back and forth conversation. The clinical reviewer will agree or disagree with the rating. They will provide explanation of why and what information they need. The rater will then need to go in and fix the information. It will go back and forth until the rater and clinical reviewer both agree. As a rater, you can prevent the added back and forth conversation by adding as much detail as possible and using the expanding scoring guideline. Side note (pertaining to above discussion on HCSIS): there has been discussion about HCSIS moving to a different system. The state is gathering information to see how they can incorporate all information into one system. Right now, counties/providers go through multiple systems to pull up information. The idea of moving to a different system is in the beginning phases. The state is asking those IDD Provider Meeting involved what they dream of a new system to look like. With the new system, the idea would be to be able to click on an individual and see everything related to that particular individual instead of having to use multiple systems.  Incident Management Workgroup Marion has been sitting on the Incident Management Workgroup. Those attending went into the workgroup in hope they could impact on proposed changes in the bulletin. However, it was made clear that there will be no changes to the bulletin. There will still be a soft roll out with I2I abuse investigation with the exception of sexual abuse and injury requiring more than first aid investigation. The goal is that over the next year there will be a lot of trainings on the expectations. The workgroup has one more meeting in December and while they cannot impact change to the bulletin, they can impact what trainings may take place. Roll out of trainings is expected for the beginning of the calendar year. In terms of investigation, there is no work around in terms of this piece. An investigation is an investigation. They are allowing providers the next year to take a look at the individuals they support that might be struggling with each other to see what they can put in place as far as risk mitigation. If providers have individuals not getting along, they are encouraged to take a deeper dive into what is going on. Providers will be required to do investigations once the soft rollout is complete. Until then, it gives providers time to see what they can implement and work on so there is not a huge increase in investigations. The Risk Management Committee looks at quarterly incident numbers. Each quarter may average about 24 incidents of I2I abuse. Please look at your incident data closely to determine trends and begin working with teams on risk mitigation. Attendees of the workgroup discussed what they liked about the bulletin. One of the things mentioned is the more definitive information received in terms of incident categories. The new bulletin is not as long as the old bulletin but it gives more explanation than the original one. The bulletin is still in draft. There is no exact date of when it will be approved. However, providers will have 120 days after its approved to be in compliance. Comment has been made that it will be approved at the end of the year/beginning of the calendar year. The bulletin is currently with the lawyers. Choking protocol document was provided during the IDD Provider Meeting and will be sent out to providers with the minutes. The document provides what the Office of Developmental Programs (ODP) is looking at in terms of incidents related to an individual choking. Make sure this information is included in your incident management reports. ODP has changed their regional review. There are certain ODP program reps that are reviewing certain categories. Audrey Wicks will review hospitalizations and deaths. Theresa Burgard will review neglect, abuse & misuse of funds. A list will be sent out with the minutes. If providers have particular questions, they can reach out to that specific program rep. IDD Provider Meeting Question was posed on whether the trainings on My ODP are required. – It is encouraged but not mandated. Marion encourages providers to go to the My ODP website and take a look at the trainings they are offering. Four (4) of the orientation topics are on My ODP. Providers can complete the training and receive a certificate. ODP is making it clear that they do not have answers to any specific questions related to 6100 regs at this time. They are working on a regulatory compliance guide similar to the one that came out previously. They expect that to be out at the end of the year/beginning of calendar year. The guide will give a better explanation of expectations of the regulations as a lot of the information currently listed is very vague.  MH Information Session A training flyer was sent out regarding the Mental Health Information Session on December 5th from 10:00 a.m. to 12:00 p.m. The training will take place at the Administrative Annex (218 North Second Street). If you are not registered, please send Marion an email to let her know who will be coming from your agency. Mental Health Program Specialists will be there to review the involuntary commitment process and de-escalation for those who are dually diagnosed. The HCQU will review common mental health diagnosis and symptoms associated with those diagnoses. Crisis staff will also be present. It is a great opportunity to receive information, have conversation on the entire process and discuss barriers that IDD providers have been experiencing. Construction has officially started at the Annex resulting in limited parking. There is meter parking along Second Street. You cannot access the Annex from Grant Street at this time; you must come down Second Street. Parking is available at the Commissioner’s Office across the street. Parking for the Annex does go around the building or you can park down King Street by the Library.  OVR Order of Selection There has been various conversations on OVR’s order of selection. Marion wanted to make sure providers understand OVR has a wait list. No one is getting served at this time if it is a new referral. If you have an individual who is interested in employment services, they need to choose an employment provider and a referral needs to be made to employment. For those not in waiver, there is only one option – AHEDD. The County has a contract with AHEDD for supported employment services. There is a certain amount of dollars allocated. Understand that OVR’s closure might take some time. The last meeting noted they may reopen the list by the end of the year. It will open for those who have been on the wait list but in terms of new referrals, it may be awhile. Make sure individuals are not waiting on supported employment services. Discuss this with the SC. Choose a provider and move forward with a referral. An OVR determination letter is not needed to move forward with the employment service. IDD Provider Meeting Lori Young  QA&I Update/Provider Qualifications QA&I is in the process of Year 3, Cycle 1. If you have QA&I this year, you have provider qualifications in February. QA&I and provider qualifications used to be completed at the same time but ODP has split them up. They must be done at two (2) separate times in a fiscal year. ODP is waiting to send the tool out for the next cycle as it will be changing for Cycle 2 due to 6100 regs and new priorities.  Provider Profiles for Residential on My ODP Provider profiles for residential providers are on My ODP. The easiest way to access them is to type “provider profiles” into the search bar. Some providers will only have one page where bigger agencies will have one for statewide and one for their county. If a provider did not have five (5) or more IM4Q interviews, there will be not be a second page on their profile. It will only be what they submitted. ODP is starting to branch out to other services for provider profiles but right now it is only residential providers. They are used for individuals who are seeking services. You can log onto the site as a guest and review the profiles.  Comprehensive Reports Published on My ODP On the same screen as the provider profiles, comprehensive reports for QA&I Year 1, Cycle 1 have been uploaded. Year 2 is not loaded yet and Year 3 has not been completed yet. Lori does send a copy of the comprehensive reports to providers prior to sending them to ODP.  IM4Q Update IM4Q cycle is in full swing. If you get a call, the individual is the only one who can deny completing the interview. According to Temple University, the guardian cannot deny on behalf of the individual. According to the Mental Health Association and a judge that was consulted, the guardian can deny. If an individual denies an interview for the current fiscal year, their name will automatically go onto the list for next fiscal year. Some individuals do not want to answer questions as they feel they are too intrusive. Individuals are able to deny answering particular questions. If they say they do not want to answer a question, the surveyor will move onto the next. The SCs have 190 pre-surveys they must fill out. They are due by next Friday (11/22). The pre-surveys will be provided to Jane Cline when they are 100% done. There has to be 68 surveys completed (individuals saying yes to complete the survey). In our county, we serve about 600 individuals. Pulling names of individuals not surveyed before is a long process. For those wondering why their name keeps coming up for a survey, it is because they have not taking it yet. Their name will continue to come up until they complete a survey. IDD Provider Meeting A question was asked if there are two (2) individuals from the same family, can they complete the survey together but record each individual’s response. – Lori will follow up on this. Jane Cline  Residential Staffing Ratio Training Sessions Jane was unable to attend the meeting. In her absence, Tony Fisher from Family Care Services spoke on the topic of residential staffing ratio training sessions. Training sessions are on My ODP. Many of the webinars are actually orientation training. Trainings take place on person-centered thinking, risk, rights, knowing the balance between choice and risk, assessing risk, and annotated ISPs. The biggest thing noted, which does not apply to LifeSharing, is staffing ratios will disappear in January. In group homes, you have to provide the ratio to support the individuals; does not matter if it is one (1) or five (5). A train the trainer training will be coming at some point. Reports  Friendly reminders of due dates for Base funded providers (See procedure statement MHIDDEI-416) % November 15th – Quarterly Report of Expenditures (July – September) % December 31st – Audited Financial Reports (for fiscal year ending June 30th) % January 10th – Audited Engagement/Extension Letter (for calendar year ending December 31st) % January 31st – Progress Report on Outcomes in Appendix A If you have any fiscal questions, please contact Ashley McCartney. Any questions regarding whether you are required to submit a report, please reach out to Marion Rowe or Jane Cline. Round Table/Provider Updates  AHEDD OVR Order of Selection is impacting AHEDD. OVR was a huge funding source for services. Due to the closure, it puts more pressure on the County whom will not be able to sustain that level of funding. AHEDD has the Transition to Adult Life Success (TALS) program to work with school students. AHEDD has received a lot more referrals and is going through funding extremely fast. AHEDD is trying to look into other options. Private pay is an option if families are able to do so. However, a majority of the time, it is not an option. Employment services is a mandated service. OVR funding for initial job supports and assessments (the parts that take the longest time) assisted in reducing the IDD Provider Meeting cost for County funded support. As a result of the closure, the County has to cover all the support needed which impacts the overall IDD budget. If individuals applications were in before July 1st and OVR made their determination, OVR still has to support them during the closure. It is those who came in after the closure that OVR will not be assisting. IDD staff reviewed the list of applications sent to OVR in the last three (3) to four (4) months prior to the closure. There were about four (4) individuals that’s were not in services. Providers are encouraged to still submit OVR applications to OVR (simultaneously with a referral to selected supported employment provider) so OVR has an idea of how many individuals are waiting for services.  Family Care Services Medication course will be coming out for LifeSharing and un-licensed LifeSharing. It was initially to come out in November but it has not yet. There are eleven (11) parts; four (4) questions per lesson. The course will eventually be on My ODP. Approved Program Capacity (APC) is now required for LifeSharing. Most of Family Care Services homes have an APC of zero. Within the last year, they started to assign APC based on license capacity. Now, APC has to match your service not license capacity. If you have a capacity of two (2) but there is only one (1) individual, you have to change the APC to one (1). You have to continue to do two (2) person rate. This is a big change of how LifeSharing has always done it. There is an Approved Program Capacity training. It mentions reserved capacity can now be asked for after 30 days for medical leave and therapeutic leave. The recording is online. There are new things required in room and board that weren’t before; such as internet, nutritional drinks, going out to eat, etc. Is the County providing a Human Rights Team or is the provider required? – County is not doing a Human Rights Team for providers. Discussion took place at the time of the initial bulletin and it was determined that the County will not take on that role. Providers must have one within their own agency as they must have one for restricted procedures. The County will review restricted procedures and rights violation as the Human Rights Committee during quarterly Risk Management Meetings. The group needs to know all individuals in your program that has a restricted procedure in place. The risk group is not giving approval on whether the restricted procedure should take place but reviewing the support plan, making sure all elements are included in the plan, making recommendations on the information in the plan, and making sure its comprehensive and detailed. The group is not making a determination; just providing quality review and ensuring rights are protected. FCS is working as quickly as they can to meet the high demand. Lately, as soon as a home is opened, the slot is filled. There are four (4) admissions planned for December 1st. IDD Provider Meeting  Keystone Human Services Keystone is starting a new electronic health record. It was done in the residential program and seems to be going well. Staff are doing well with documentation and the system is user friendly. All case notes will be in a record. Right now, Keystone has two (2) to three (3) different systems and they are working on getting it all in one (1) system.  Occupational Services, Inc. Grace’s Closest (a clothing bank in Greencastle) is seeking donations. If you have gently used clothing you would like to donate, please drop them off at the OSI office on Redwood Street or contact the office and they would be willing to pick items up.  Angels on Call Angels on Call continues to hire new staff and provide training for Companion and Home and Community Habilitation. Angels on Call is working on scanning their files. All goal sheets, client files, employee files, etc. are being scanned. Mary questioned for those still using traditional progress notes on paper, can they scan, download and show the documents or what is preferred. – SAM SC Supervisor stated that any form is acceptable. If it is electronic, it can be reviewed electronic or it can be printed and sent.  The ARC of Franklin and Fulton Counties The ARC has been chosen from the Giant on Norland Avenue to do the Bags-4- My-Cause program. For every time someone purchases a reusable bag, they can direct $1 donation to a local nonprofit of their choice. Upcoming Socials at St. Paul’s – November 19th: Bingo December 17th: Holiday party  Service Access & Management, Inc. Monitoring tools will be updated in January. Shana Golden has not completed training yet to see what all is changing. Providers are welcome to meet with SAM to discuss any questions they may have regarding the monitoring tool or to see the questions on the tool. Some SCs do not ask the questions word for word as they are able to have conversation throughout the process and answer various questions. Jim Schu from SAM wants to make sure everyone is comfortable in the process. So if anyone does have questions on why SAM is doing what they are doing or why they are looking at what they are looking at, a conversation can take place. If SCs are requesting information/documentation, please make sure they receive the information in a timely manner. SAM has an internal policy to have the monitoring entered within three (3) days from the time someone was seen. The monitoring tool is currently 50 questions for home visits. SCs are making observation and interpreting what they are reviewing. A lot of questions can be answered through recent meetings and conversation. SCs are encouraged to IDD Provider Meeting explain to providers what they are doing. SCs should be seeing someone at a minimum of every six (6) months at their home. This timeline is on a rolling calendar. Consolidated visits used to take place monthly (one would be at their home, community, day program, etc.). ODP has changed it to every other month now. However, some SCs have kept the same monthly schedule. HCQU Updates The HCQU has started offering live online training option. Starting in January, the HCQU will offer one (1) topic live online on two (2) different days, two (2) different times. It will be the first Tuesday of the month from 10:00 a.m. to 12:00 p.m. then the second Tuesday of the month from 1:00 p.m. to 3:00 p.m. The hope is to expand the live online training down the road. The live online trainings will be listed on the syllabus. The live online training has been put in place of face-to-face training in two (2) counties due to attendance. The HCQU has offered to go to provider agencies to provide training. Only one provider has shown interest in having syllabus training at their agency. If interested, please let Marion or Katie Freeman know so they can create a schedule (dates, times, topics). Monthly HCQU trainings at the Human Service Building are not client specific but can be if the training comes to your agency/staff. Syllabus trainings across the board are dwindling. Training schedules have been changed in four (4) of nine (9) counties; three (3) of them are no longer doing face-to-face training. In Franklin County, it’s pretty consistent with the same four (4) to five (5) attending. Upcoming Trainings  December 5th: MH Information Session (10:00 a.m. – 12:00 p.m.)  December 13th: HCQU ~ Effective Communication (10:00 a.m. – 12:00 p.m.)  January 7th – 9th: EveryDay Lives Conference (in Hershey) Next Provider Meeting Friday, February 21, 2020 at 10:00 a.m. at the Human Services Building. 2020 Provider Meeting Schedule February 21st May 15th August 21st November 20th (Please add these dates to your calendar!) Minutes by Erin Nye