Georgia Quality Management System - Department of Behavioral ...

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GQMS Year 3 Annual ReportJuly 2010 – June 2011Throughout the three years of the contract, results from the staff/provider interviews and observationshave remained relatively high. It is not clear why there has been so little variation in these areas whenfacilities are likely to present a wide variety of quality in their services.Recommendation 16: Delmarva and the Division should consider revising the tools or processesused to collect information from observations and onsite interviews with staff. Procedures could bemodified to include unannounced observations of day and residential programs. If results aresimilar to previous findings, this would lend support to the current processes and tools.Administrative policies and procedures indicated only 65.1 percent present for the Expectationmeasuring if the individual’s personal funds are managed by the person and are protected. Data indicatesome key issues in this area include:• Not having procedures regarding personal funds incorporated in the Quality Improvement Plan.• For an individual who has a combination of earned and unearned income or solely earnedincome, the room and board rate is not always the equivalent of 90% of the current year’s SSIfederal benefit rate, with all remaining funds, earned or unearned, belong available to the personserved.• Persons who receive SSDI do not always pay the equivalent of 90% of the current year’s SSIfederal benefit rate amount towards room and board.• Providers of residential services, upon admission and annually thereafter, often do not completeAttachment C - Standard Room and Board Contract. Copies of each contract must bemaintained in the record of the person served.Recommendation 17: Providers who are handling funds for individuals need more training in thisarea. It is recommended the Division provide training and/or a FAQs sheet regarding the new policyrecently distributed.________________________________________________________________________________________________August 31, 2011 88
GQMS Year 3 Annual ReportJuly 2010 – June 2011Regional resultsAttachment 1: : Overview of Delmarva ProcessesThe Georgia Quality Management System consists of two main processes, the Person Centered Review(PCR) and the Quality Enhancement Provider Review (QEPR). The PCR is designed to assess theoverall quality of the supports and services a particular person receives though interviews with theindividual and his or her provider(s), record reviews, and observations. The process explores the extentto which the system enhances the person’s ability to achieve self-described goals and outcomes, as well asindividuals’ satisfaction with the service delivery system. Each PCR includes a face to face interview witha randomly selected individual using the National Core Indicator (NCI) individual survey tool andadditional interview questions using Delmarva’s Individual Interview Instrument (III). 16In addition to the interview, records of the most recent twelve (12) months of services received by theperson are reviewed and used to help determine the person’s achievement of goals that matter most.Onsite observations are conducted for individuals who receive day supports or residential services toobserve the person in these environments, the individual’s reaction to supports, and how well supportsinteract with the person. Interviews with the individual’s support coordinator and provider/staff furtherassist the consultant in gathering information to help determine how the person is being supported andthe person’s knowledge of the supports and services being provided. A review of the person’s centralrecord is also part of this process and includes a review of how well the person’s Individual Support Plan(ISP) reflects the person, including goals, talents, strengths and needs. A total of 480 PCRs will becompleted each year of the contract.The QEPR is used to evaluate the effectiveness of the provider’s supports and services, organizationalsystems, records, and compliance with Division of DD standards for policy and procedures, as well asstaff training and qualifications. The intent of the GQMS contract is for Delmarva to complete a QEPRwith all providers at least one time over the course of five years. During the each contract year, 39providers and one support coordinator agency will participate in a QEPR. For each provider, arepresentative sample of individuals is chosen to participate in an interview using the III, which beginsthe QEPR process and helps determine what individuals receiving services perceive as strengths and/orareas needing improvement within the provider’s service delivery system.Other resources used during the QEPR to gather information regarding the provider’s supports andservices are individual record reviews, onsite observations for individuals receiving day supports and/or16 Individual participation in any interview as part of the QA process is voluntary. Individuals may refuse toparticipate for any reason and may also have anyone present at the interview they choose to have present.________________________________________________________________________________________________August 31, 2011 89
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