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Quality of Services: Integration Metrics
Pilot Project
The Quality Outcomes Workgroup began meeting in October 2013 as a sub-committee of the Superintendent’s Future Systems Transformation Workgroup. At that time the workgroup was comprised of just five county board representatives. It was quickly realized that broad representation would be helpful with such an amorphous topic and a larger group began meeting in June, 2014. The group’s primary task has been to identify and agree upon measures of quality indicators and outcomes across developmental disability systems in Ohio. To address the question “ What does a quality life look like?”
Background
Workgroup Participants: The workgroup is comprised of a diverse group of people representing county
boards, DODD, advocates, and provider organizations. Those participating are:
Alice Pavey, Hamilton County Board of DD
Ann Mahler, Lake County Board of DD Beth Chambers, DODD Billy Jo David, Summit County Board of
DD Brandy Koffel Christine Merriman, Independent
Provider Dana Charlton, OSDA Diana Malrose, Advocate – Hamilton
County Jaime Graham Jeff Davis, OPRA Jo Spargo, The Mentor Network
Joe Russell, OACB Kara Brown, Union County Board of DD Laura Zureich, Champaign/Shelby County
Boards of DD Lew Hurst, Seneca County Board of DD Linda Lehman, OACB Board Member / Allen
County Liz Owens, Privatization Support Group and
Alpha Inudstries Marci Straughter, Advocate – Franklin County Mary Thompson, PSG, Hopewell Industries,
and LICCO Steve Oster, Knox/Coshocton County Boards
of DD Teresa Kobelt, DODD Phil Miller, PSG and Portage Industries, Inc.
Steps toward operationalizing a pilot:
Privatization Support Group (PSG) – Quality services definition and Quality tool
BHN Alliance – Partnerships for Quality Services Initiative
Clearwater COG – Working with Jim Conroy on the Protocol for Outcomes and Quality Tracking
Provider Excellence Network – Focused on code of conduct and values for providers
Step Up To Quality – education system
After several meetings which centered on
philosophical discussions related to quality, the group began to narrow the focus. Quality initiatives already in place or in development throughout the
state were reviewed:
Work completed by Ohio’s Aging System related to quality
DODD’s Service Provider Interview Guide Provider certification standards as a means to
guide/develop/control quality Opportunities for Ohioans with Disabilities (OOD)
Provider Scorecard The Imagine Guidebook – Person Centered
Practices: An Approach
Steps toward operationalizing a pilot continued:
Credit must be extended to Hopewell Industries for its decision to track quality outcome data beginning in 2013 for the purpose of illustrating with the move to privatization that the quality of services were actually improving. Hopewell’s process, which was then carried through to the Privatization Support Group (PSG) utilizes the National Core Indicators (NCI) Individual Outcomes Domain to track quality outcomes. The work of Hopewell and the PSG is the basis for this pilot initiative.
Work – People have support to find and maintain community integrated employment.
Community Inclusion – People have support to participate in everyday community activities.
Choice and Decision-Making – People make choices about their lives and are actively engaged in planning their services and supports.
Self-Determination – People have authority and are supported to direct and manage their own services.
Relationships – People have friends and relationships.
Satisfaction – People are satisfied with the services and supports they receive.
The NCI Individual Outcomes are:
Enhance the quality of life.
Access and participation in the greater community.
Freedom and support to manage work and non-work time.
Personalized opportunities with established outcomes.
The four key indicators for quality service are:
The indicators of quality service can be measured by utilizing the metrics below. The first two metrics would be used by providers of adult day services or by providers with work centers (sheltered workshops). The third metric would be used for home based services and supports. Under the list of the three metrics are examples.
Everyone’s life SHOULD consist of 2 to 5 or 3 to 5 experiences in a 24 hour day. The ratings recorded should reflect what is in the person centered plan. The provider’s responsibility is to encourage movement of the individual toward choosing more integrated experiences, thus showing progress.
Answering the question, “What does a quality life look like?” is different for everyone.
Its NOT About Scoring “5”
The provider can score a 5 for individuals who are competitively employed in the community. The score continues to go down with workshop or work center activities continuing to be a last choice available but still a valuable option for many people.
Work Indicator Section:
The provider can score a 5 when individuals are in the community and participating in things such as volunteering, classes in the community, etc. As with the Work Indicator section, workshop or work center activities continue to be an option.
Non-work Indicator section:
The provider can score a 5 when individuals are in the community and participating in activities that interest them where they have participation and presence. The score continues to decrease as the level of integration decreases for the person.
Home Indicator Section:
Metrics are weighted to promote level or scope of integration (5 highest):
Work Indicators Non-Work Indicators Home based Services5 Competitive Employment (use
new state database)5 Community presence and
participation5 Community presence and
participation
4 Supported Employment Community (use new state database)
4 Community participation 4 Community participation
3 Supported Employment Enclave
3 Community trip 3 Community trip
2 Works center with reverse integration (target 30% typical peers)
2 Work center w/reverse integration (target 30% typical)
2 Home setting 4 or less people etc.
1 Work center 1 Work center 1 Home setting 5 or more people etc. Weigh
tLevel of Integration:
Definition: Examples:
5 Community presence and participation
Having an individual identity with contribution
Kiwanis Member, Rotary Member, County Leadership Program, Volunteer w/typical community volunteers, Theater member, Community cooking class,
4 Community participation
Participating in a community event
1st Friday, Jazz & Rib Festival, Theater Performance, Relay for Life, Community Fitness class,
3 Community trip Visiting, investigating and exploring the community
Shopping, Going out to eat, Zoo, Picnic, Riverboat ride,
Service providers achieving a combination of 3, 4, and 5 weighted indicators, by individual, are progressing in transforming the developmental disabilities service delivery system.
Tenants of the Quality Outcomes Pilot:
The definition of quality is tied to the National Core Indicators.
Core Indicators are already agreed upon standards.
These standards can continue to be used across Ohio and in comparison to other states.
National Core Indicators:
The metrics are weighted toward integration with capabilities for data specific progress reporting:
Individual specific Provider specific County specific
Regional State-wide
Advisor workshop module
Care Tracker
Documentation can be merged into Excel.
Google Form method of data collection for those without a system
Ability to replicate:
Providers who have committed to the initial implementation of the Pilot:
Hopewell Industries, Mary Thompson-Hufford – CEO
637 Chestnut Street Coshocton, Ohio 43812 (740)-622-3563 Email: [email protected]
The Alpha Group of Delaware, Inc, Liz Owens – CEO
1000 Alpha Drive Delaware, Ohio 43015 (740)-368-5810 ext. 113 Email: [email protected]
Portage County Board of DD, Jennifer Derthick 2606 Brady Lake Rd,
Ravenna, OH 44266 (330) 297-62092 Email: [email protected]
Portage Industries, Phil Miller – CEO 7008 State Route 88 Ravenna, Ohio 44266 (330)-296-2839, Ext. 3122 Email: [email protected]
Koinonia, Jennifer Hudak – Director of Koinonia Enterprises
6161 Oak Tree Blvd., Suite 400 Independence, Ohio 44131 (216)-588-8777, Ext. 159 Email: [email protected]
Data Collection
Tying collected data to the National Core Indicators
Identifying data collection points
Training staff and agencies on how to collect the data
Keeping the data and compiling it into meaningful reports
Ensuring that data is consistent across providers
Melissa Skaggs of Provider Resources Group has agreed to provide data collection and other services for the first six months of implementation at no
charge. Their role will focus on:
Creating a common format to report the information
Tying information back to ISP outcomes as much as possible
Writing training materials
Development of a Q&A website for participant use
Data Collection Continued:
Ways in which data is utilized to affect people’s
lives:Trend lines are used to monitor quality and make program adjustments.
When a staff member’s trend line is neutral or negative, problem solving is initiated and coaching is provided as appropriate.
Positive trend lines are discussed to capitalize on success.
Staff performance reviews are tied to data.
Conversations regarding how people are supported have changed.
Ways in which data is utilized to affect people’s lives continued:
Staff have the opportunity to understand the increased value of integrated supports.
Staff discuss individual outcomes in conjunction with work indicators, non-work indicators, and
home indicators.
Data can be individually analyzed or shared by programs, creating opportunities for growth.
Integration
Tier 5 – Positive Linear
Coaching & Performance Monitoring
Staff Reviews
Journey From Group Home to Apartment
No longer has a guardian Works in the community Active in advocacy
Directs her supports Transportation to work & events Assistance w/shopping, some meal
prep and housework
Lindsey’s Data
Charity’s Log Late 2012
Sit further away from her. Didn’t scratch anyone today. Keep her away from her victims. Don’t let her use her hands.
Charity’s Log
Loves to shop @ Dollar Tree Enjoys listening to a variety of music Likes animal YouTube videos (especially baby
animals) Likes to make presents for others Helpful in the kitchen
Charity’s Data
Questions
