Georgia Quality Management System - Department of Behavioral ...

dbhdd.georgia.gov

Georgia Quality Management System - Department of Behavioral ...

GQMS Year 3 Annual ReportJuly 2010 – June 2011Section 2: Data Analysis and ResultsSamplesThe Georgia Quality Management System (GQMS) contract mandates that each provider renderingservices through the Medicaid waivers to individuals with developmental disabilities has one annualreview over the course of five years. Therefore, only 40 providers are reviewed each year through theQuality Enhancement Provider Review (QEPR) process (39 service providers and one supportcoordinator agency). Providers to receive the QEPR are randomly selected each year and 480 individualsfor the Person Center Reviews (PCR) are randomly selected from the caseloads of the 39 serviceproviders. The PCR sample is stratified by region and providers, meaning providers were first randomlyselected proportionately from each region, and then individuals were randomly selected from thoseproviders.For the QEPR process, a sample of individuals, excluding individuals who have had a PCR, is randomlyselected from the 39 service providers, with at least one and a maximum of 34 individuals per provider.The sample is stratified by service to ensure all services are represented. In addition to the sample ofindividuals for the QEPR, staff personnel records are reviewed for each service offered by the provider.A random sample of staff rendering supports and services, including sub-contractors, is selected from alist of all staff working with the provider. A minimum of two staff per service is selected, or 25 percent,whichever is greater. A maximum of 30 records is selected for review. For Support Coordination, up to30 records are randomly sampled from the support coordinators rendering services.Data PresentationIndividuals from both the PCR and QEPR samples participate in the Individual Interview Instrument(III) activity and Individual Support Plan Quality Assurance Checklist (ISP QA). Both processes alsoinclude a Provider Record Review (PRR), Staff/Provider Interview (SPI), and Onsite Observations ofday and/or residential programs.The PCR and QEPR also have some components that are specific to the review type. During the PCR, aSupport Coordinator Record Review (SCRR) is completed for the Support Coordinator working with theindividual. During the QEPR, each provider receives one Administrative Review, which includes tworeview instruments: Administrative Qualifications and Training (A Q&T) and Administrative Policy andProcedures (A P&P). The A Q&T includes a review of a sample of personnel records to determine ifstaff has the necessary qualifications, specific to services rendered, and if the training was received withinrequired timeframes. The A P&P includes a review of organizational records to determine if policies arein place and if procedures are delineated that are in compliance with state regulations.In this report, data from the III, ISP QA Checklist, PRR, SPI and Observations are presented usingaggregate information from individuals who participated in a PCR or QEPR process. “PCR Only”________________________________________________________________________________________________August 31, 2011 34

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