Analysis of State’s Licensing/Certification Outcomes Processes Person-Centered Outcomes Respect and dignity Respectful interactions with staff Age

Analysis of State’s Analysis of State’s Licensing/Certification Outcomes Licensing/Certification Outcomes

ProcessesProcesses

Person-Centered Outcomes

Respect and dignity Respectful interactions with staff Age appropriate dress Respect for the individual’s culture and religion

Rights and responsibilities Privacy Having personal possessions Receiving payment for work Voting Having one’s own possessions Safeguards for the use of restrictive procedures

Personal safety and risk Abuse neglect Environment Individual’s fund

Person-CenteredPerson-Centered Outcomes Outcomes (continued)(continued)

Health and Medication Access to health care services Routine examinations, Management and administration Diet/nutrition Use of durable medical equipment Access to needed ancillary clinical supports such as Occupation therapy and physical therapy

Community inclusion and integration Working in integrated settings Using local resources and amenities

Independence and autonomy Prepare meals and do chores, perform work tasks and

live ad work in accessible settings

Choice and decision-making Everyday choices (e.g., meals, routines, activities) Higher level decision making (e.g., goals, jobs,

homes and housemates)


ProcessesProcesses

RELATIONSHIP OF PERSON-CENTERED OUTCOMES TO SERVICE PLANNING

Individual involvement in planning

Identifying people's preferences, choices (e.g., services, housemates, work) and personal goals

Assessing/evaluating people’s needs for support Developing strategies for implementing goals

Monitoring people’s progress


ProcessesProcesses

SURVEY METHODOLOGY

All person centered survey process have the following in common:

A “representative” sample of individuals served by the agency

Surveys are complete through Documentation Review Interviews with individuals, staff, family, case managers All Surveys include observation of

individuals in the location where they receive services

Most surveys also include a review of agency related documentation

Examples Staff orientation/training Investigation reports Incidents reports


ProcessesProcessesSAFEGUARDING OUTCOMES AND REQUIREMENTS

The most uniformly prescriptive set of requirements and outcomes:

Rights Informing individuals and family members about

individual rights and responsibilities

Abuse, neglect and exploitation Reporting allegations of abuse Investigate allegations, take action if the

investigations are substantiated Protect individuals from harm Take action if investigation substantiated

Restrictive procedures Psychotropic medications, behavior support

plans, and restraints Require

assessments plans monitoring external review prohibitions or limitations on some restriction

Staff training


ProcessesProcesses

Medications: Prescriptive requirements for management andadministration of medications

Health More prescriptive requirements for

medications than health. Require

Routine examinations Identification of health care needs Access to health care services Special diets nutritional meals

Environmental: Greatest requirements

Larger residential living situations And/or residences that provided 24-hour

staffing

Less prescriptive for more independent living situations People lived in their own apartments And/or received less than 24-hour supports

including

Accessibility required when needed

Analysis of State’sAnalysis of State’s Licensing/Certification Outcomes Licensing/Certification Outcomes

ProcessesProcessesSTAFFING AND STAFF TRAINING

Less emphasis on staff educational level and degrees

Staff ratios less prescriptive: tied into individual needs

Staff knowledge and competency seen as an essential safeguards!

Some training required before staff can work alone with individuals

Examples of orientation/training requirements: Emergency procedures (e.g., evacuation) Abuse/neglect reporting Knowledge support strategies for the individual Administration of medications (if the state has a delegated staff

giving medications) Human rights Incident reporting First aid and CPR Medication administration certification for states that

have the delegated model

Analysis of State’sAnalysis of State’s Licensing/Certification Outcomes Licensing/Certification Outcomes

ProcessesProcesses

Different Models of Licensing Certification

ONLY LICENSING (MINNESOTA)

COMBINED LICENSING AND CERTIFICATION PROCESS (MASSACHUSETTS)

SOME SERVICES LICENSED, OTHERS CERTIFIED (UTAH)

PROVIDER APPROVAL PROCESS (COLORADO)

STATE OF LOUISIANA STATE OF LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALSDEPARTMENT OF HEALTH AND HOSPITALS

OFFICE FOR CITIZENS WITH DEVELOPMENTAL OFFICE FOR CITIZENS WITH DEVELOPMENTAL DISABILITIES LICENSING AND CERTIFCATION DISABILITIES LICENSING AND CERTIFCATION

REFORM WORKGROUP TASKSREFORM WORKGROUP TASKS

OVERALL GOAL:

DEVELOP A FRAMEWORK FOR A REVISED SYSTEM FOR LICENSING AND CERTIFIYING SERVICES FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES

WORKGROUP TASKS: Review results of 5 state analysis Develop a set of operating principles Develop a core outcomes would apply to all services (refer to what 5

states determined to be important) Decide what services are subject to a regulatory review process Decide if there will be separate process for licensing and certification.

If yes,…

Decide what is the purpose of each process (e.g., enforcement, enhancement, contracting decisions, people and family members making choices about services)

Decide what services are subject to licensure and services subject to certification

Decide what is the “unit” of service to be certified and/or licensed (e.g., by provide, by location be service type)

LICENSING AND CERTIFICATION LICENSING AND CERTIFICATION REFORM WORKGROUP TASK, REFORM WORKGROUP TASK,

((Continued)Continued)

Decide what the relationship is between the two processes (refer to the different models among the 5 states)

Decide who is involved in each process

if no,… Decide what will be enforced and what will be

service enhancement.

Decide what is the “unit” of service to be certified and/or licensed (e.g., by provider, by location, be service type)

Decide who is involved in the process

Documents

Analysis of State’s Licensing/Certification Outcomes Processes Person-Centered Outcomes Respect and dignity Respectful interactions with staff Age