ISP Monitoring 2014 - Lesson 2 Printable Version PD€¦ · ISP Monitoring 2014 - Lesson 2 1. This webcast includes spoken narration. ... print a copy, do so now and press the play

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Course Number: 005-15-02

1ISP Monitoring 2014 - Lesson 2

This webcast includes spoken narration.

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Certificates of Achievement will be available to Administrative Entity staff, Providers, Supports Coordinators, and SC Supervisors after completing all course requirements. Please view and then save or print your certificate in order to receive credit for this course.

For SCs and SC Supervisors, course requirements include successful completion of a pre‐test and post‐test.



Hello, my name is Sonya Hipple, Supports Coordination Organization Lead (SCO) for the Office of Developmental Programs. Welcome to Lesson 2 of ISP Monitoring 2014.



This lesson will introduce new annotations for the Monitoring Tool which is the paper copy that SCs take to monitoring visits to make notes for entry later into HCSIS.

Leah Napoli from the Office of Developmental Programs Consulting System will be your narrator.



Thank you, Sonya.

We’re going to jump right in and talk about the Annotated ISP Monitoring Tool. This is the paper copy of the Monitoring Tool that SCs use to take notes during monitoring visits that they can refer to later when entering the monitoring information into HCSIS. In addition to providing space for notes, the Annotated Tool has a wealth of information that can provide clarity and guidance for the SC to complete thorough monitoring. I suggest you have a copy of the Tool printed for reference as I talk about it. It’s located in the same place you found the webcast. If you need to pause the webcast and print a copy, do so now and press the play button when you’re ready to resume.

The annotations provide guidance to SCs on:

• What is the intent of the question?

• What are some ways to ask questions to determine thorough answers to the questions?

• What documents can provide insight into understanding the question and

• Questions to prompt conversation with the individual and caregivers

We won’t go through each question individually. Instead, we’ll talk about each section of the Monitoring Tool to give you an idea of what’s included in the section.



The annotations were updated in order to provide a common understanding among all SCOs of the intent of each question. SCOs also requested guidance in understanding the questions and knowing where to look for answers.

The annotations were developed by ODP and several SCOs working collaboratively over several months in 2012 and 2013. Clarifications were added based on the information received from SCOs during the ISP Monitoring SCO Conference Calls in February 2014.



As I’m describing the Annotated ISP Monitoring Tool, keep in mind that its structure reflects the current structure of the screens as they are now in the Home and Community Services Information System (HCSIS). You may be aware that ODP recently reached out to SCOs for their feedback on what changes they would like to see in the HCSIS Monitoring Tool. This information was forwarded to the Bureau of Information Systems (BIS) for consideration. However, at this time, ODP is not able to proceed with implementing any of the suggested changes.



Let’s remember the overall intent of monitoring:

• Determine what’s happening now in the individual’s life – right now

• Identify trends over time

• Determine if the ISP is being implemented as intended

• Identify areas of risk that need to be addressed and

• Discover opportunity for improvement. Is the individual satisfied with the ISP and how the plan is being implemented?



As we’re now reviewing the annotations, keep in mind that ODP expects that each question in ISP Monitoring should go beyond a simple “yes” or “no” answer and include more detail. We’ll talk more about this when we discuss issues and comments further in Lesson 3.



This is the structure of the sections of ISP Monitoring. Each of these six areas contains several questions. I’ll talk about each section separately, the intent of the questions in it, and give a few examples of the guidance the new annotations provide.



The Health/Safety/Well‐Being section is intended to comprehensively review the individual’s health care, environment, and emotional well‐being. It includes questions about medical appointments, provision of adequate and timely care, documentation of correct administration of medications, use of interventions and equipment specific to the individual’s needs, safety of the environment, and emotional well‐being for the individual.

The annotations help the SC make connections with the ISP by referring to the Health Promotions section of the ISP to determine if strategies are effective in promoting optimal health. There are prompt questions that help the SC talk with caregivers about changes in health that might warrant further attention or trends that need to be watched.



Questions about medical appointments include ways for the SC to discuss with caregivers any barriers to regular medical care and how to overcome them. This section goes beyond looking at the quality of medical care to include the individual’s emotional well‐being; the annotations provide ways for the SC to observe if the individual is interacting with others in a way that shows freedom from intimidation and a sense of control and self‐direction.



The next section of the Monitoring Tool is about medications and medical information. Recording medications during monitoring has not changed: the SC needs to record detailed information on the monitoring form. The annotations in the Medical Information section include common barriers to regular medical care, such as difficulty finding practitioners or financial barriers. These are intended as reminders that, if there is an issue with the individual receiving needed medical care, the SC needs to help the individual and caregivers understand the barriers and make a plan to overcome the challenges.



The medical section includes specific questions about medications: whether they are having the desired effect, if providers and caregivers know potential side‐effects and what to do if they occur, including reminders about whether blood levels are being obtained when they are needed for certain medications.

This section includes both physical as well as behavioral health care.



When completing this section of the Monitoring Tool, remember ODP’s expectation, included in the Introduction to ISP Monitoring course: if the individual takes medications in any setting, the SC should complete the medications information in every setting. In other words, even if the individual only takes medications at home, medication information should still be completed when monitoring at a day program, because everyone who supports the individual should be aware of the medications he or she takes, potential side effects, and how to respond if they occur.

As I mentioned, ODP does not have plans at this time to make changes to HCSIS, so medication information needs to be kept current on both the ISP and in monitoring if monitoring reveals changes in medications, the SC needs to note the changes in both the monitoring entry in HCSIS as well as through a general update to the ISP.



This section looks at whether services are delivered according to what was outlined in the ISP, if changes are needed, and if the individual understands his or her rights in regard to services and supports. Questions in this section underscore the connection between the ISP and monitoring. The annotations provide guidance to SCs to think about processes that are closely related to the ISP and delivery of services and supports, such as the ISP Review Checklist. As part of completing monitoring questions about the status of the ISP, the SC is also checking on progress toward achieving outcome statements – including whether outcome actions developed by the team are supporting progress or if actions need to be re‐examined by the team.



The questions in this section focus attention on whether the level of staff support is adequate to meet needs and support progress. But review of the ISP during monitoring also means that the SC is taking a broader view of services and supports outside the intellectual disability system, include unpaid supports, and if services and supports are coordinated and aligned with the individual’s needs and outcomes.

Also, the questions in this section involve more than checking off whether or not services are received in the planned frequency and duration. There is also a question about the individual’s knowledge of appeal rights when changes to the ISP are proposed. In addition, the SC is asked to observe and comment on the interaction of the individual and staff providing support since respectful and supportive relationships can positively impact the quality and effectiveness of service.



Reviewing incident reports is an opportunity to reinforce the importance of being prepared for a monitoring visit in advance. The annotations provide several ways for SCs to check incidents to ensure they are up‐to‐date on what has occurred in the individual’s life since the last visit and be prepared to check on the status of corrective action when they are at the site of the monitoring. The annotations also remind the SC to be aware of new incidents that have recently occurred as well as events in the individual’s life that may represent an unreported incident that must be documented and followed up.

Also included in this section is an annotation that reminds SCs to be sure they are giving the individual important information about the Right to Report Abuse at the monitoring visit preceding the Annual Update ISP, so the individual is given time to think about the information and ask questions prior to the meeting.

And again, the annotations provide a reminder to the SC to ensure that new information is included in ISP updates soon after the monitoring visit (for example, incidents that result in changes to health status, such as hospitalization).



Financial information, in the context of ISP Monitoring, includes two related areas. Are the individual’s assets and benefits well‐managed by caregivers? And does the individual have control over personal funds and spending, to the best of his or her ability?

The annotations provide SCs with guidance to think about access to bank accounts and earnings statements and the relationship of personal assets to public benefits, such as Social Security. The SC is asked to think about how the use of finances and assets are documented and the level of control the individual has over purchases and other financial decisions.

The financial information learned during monitoring should match exactly the information in the corresponding section of the ISP. In thinking about this section it is also a good time to remember that the expectation for documentation of finances is much different in funded programs than in private homes. The Monitoring Tool Annotations provide more insight into the differences. However, regardless of the setting, the SC is still expected to evaluate whether the individual’s assets and finances are available to the individual and well‐managed.



How often are you asked about your satisfaction with services you receive in your life? Do you pay attention to satisfaction surveys you receive in the mail or online or do you more often discard them?

Now imagine that someone you have come to know and trust asks you questions about whether a service is meeting your specific needs. They understand what your needs are and what you want from the service because they helped you make the plan. Imagine that the person you know and trust took time to sit down with you, face to face, to ask if you were satisfied ‐ and you really felt listened to – even when you were dissatisfied or wanted to make changes. Would you be likely or hesitant to tell that person what you liked and didn’t like about a service?

This section of the ISP Monitoring can be a powerful way to keep the individual in the center and in control of the services he or she receives. All of us can find ways to express satisfaction in words and by what we do. The annotations in the Consumer Satisfaction section of the ISP Monitoring are written to give the SC specific ways to support the individual’s choices and control of how services are provided, as well as remind the SC and the individual of processes like fair hearing and complaint procedures that can be used to request changes.



This webcast has been developed and produced by the Office of Developmental Programs Consulting System on behalf of the Pennsylvania Department of Public Welfare, Office of Developmental Programs.

Thank you for participating in this lesson.



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ISP Monitoring 2014 - Lesson 2 Printable Version PD€¦ · ISP Monitoring 2014 - Lesson 2 1. This webcast includes spoken narration. ... print a copy, do so now and press the play