Quality Council Data Presentation Florida Statewide Quality - - PowerPoint PPT Presentation

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Quality Council Data Presentation

Florida Statewide Quality Management System July 2017 – June 2018

• Person Centered Review
• Demographics
• Individual and SC Interview
• Record Reviews
• CDC+ Representative
• Health Summary
• Provider Discovery Review
• Observations
• P&P, Q&T, SSRR
• Background Screening
• Billing Discrepancies
• Alerts

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Person Centered Reviews

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Person Centered Review Activity July 2017 – June 2018 # of PCRs # of Declines

Region Waiver CDC+ Waiver CDC+ Northwest

140 24 44 11

Northeast

226 42 67 9

Central

290 58 90 7

Suncoast

325 45 85 18

Southeast

301 52 95 5

Southern

250 23 38 2

Total

1,532 244 419 52

Decline Rate: Waiver: 27.3%; CDC+: 21.3%; Review Next Year: 17.6%

Person Centered Review Decline Reasons July 2017 – June 2018

Decline Reason Waiver CDC+ Total Refused

261 18 279

Review Next Year

61 22 83

No Longer Receiving Services

54 5 59

Deceased

29 6 35

Moved Out of State

14 1 15

Total

419 52 471

PCRs by Region and Number of Declines

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48.8% 16.1% 33.4% 1.7% 91.4% 8.6%

0% 25% 50% 75% 100%

Family Home Independent/ Supported Living Group Home Other*

Waiver Participants (N = 1,532) CDC+ Participants (N=244)

PCR Demographics

Residential Setting Age Group Primary Disability

Note: Other home types include: Assisted Living Facility (n = 20) and Foster Home (n = 6) Other disability types include: Downs Syndrome (W = 57, CDC+ = 11), Spina Bifida (W = 19, CDC+ = 6), Prader Willis (W = 13), and Epilepsy (W = 3, CDC+ = 2)

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5.4% 6.6% 52.8% 30.4% 4.8% 12.3% 13.9% 60.7% 11.1% 2.0%

<18 18-21 22-44 45-64 65+

72.6% 10.8% 10.1% 6.5% 44.7% 23.8% 23.8% 7.8%

Intellectual Diability Cerebral Palsy Autism Other*

PCR Scores by Review Component July 2017– June 2018

Individual Interview

97.8% 99.1%

WSC/CDC+ Interview

99.3% 99.8%

WSC/CDC+ Record Review

95.6% 97.4%

CDC+ Waiver

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Individual Interview Scores

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98.1% 97.7% 96.7% 97.7% 98.2% 98.7% 97.8% 97.6% 98.9% 98.8% 99.7% 99.4% 99.4% 99.1% 50% 60% 70% 80% 90% 100% Northwest Northeast Central Suncoast Southeast Southern State Waiver Participants (N = 1532) CDC+ Participants (N = 244) Individual Interview Statistics Waiver Participants CDC+ Participants Low Score 46.2% 69.5% High Score 100.0% 100.0% Median 100.0% 100.0%

WSC and CDC+ Consultant Interview Scores

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99.0% 99.7% 98.8% 99.6% 99.3% 99.4% 99.3% 99.1% 99.8% 99.8% 99.9% 99.8% 99.7% 99.8% 50% 60% 70% 80% 90% 100% Northwest Northeast Central Suncoast Southeast Southern State WSC Interview (N = 1532) CDC+ Consultant Interview (N = 244) Coordinator Interview Statistics WSCs CDC+ Consultants Low Score 33.3% 90.4% High Score 100.0% 100.0% Median 100.0% 100.0%

Lowest Scoring Interview Indicators

Person is provided education/information about social roles in the community (W: 92.5%). Person has had more than just limited opportunities to develop new friendships/relationships (W: 93.7%, CDC+: 94.9%). Person knows how to change WSC/WSC Agency (W: 94.0%). Person's preferences concerning social roles in the community are addressed (W: 94.7%). Support Coordinator provides education/information to the person about social roles in the community (WSC: 95.2%).

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WSC/ CDC+ Consultant Record Review Results

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96.8% 94.0% 94.2% 95.6% 95.9% 97.7% 95.6% 98.2% 95.6% 96.9% 98.4% 97.9% 97.6% 97.4% 50% 60% 70% 80% 90% 100% Northwest Northeast Central Suncoast Southeast Southern State WSC RR (N = 1532) CDC+ Consultant RR (N = 244) Record Review Statistics WSCs CDC+ Consultants Low Score 43.5% 71.4% High Score 100.0% 100.0% Median 100.0% 100.0%

Lowest Scoring Record Review Indicators

Progress Notes demonstrate pre-Support Plan planning activities were conducted (WSC: 83.3%)

The current Annual Report is in the record (WSC: 89.3%, CDC+: 91.4%). Documentation shows efforts to ensure services are delivered in accordance with the service plan, including type, scope, amount, duration, and frequency specified in the Cost Plan (WSC: 90.1%)

Documents demonstrate efforts to assist the person to define abuse, neglect, and exploitation including how the person would report any incidents on an ongoing basis (WSC: 88.9%, CDC+: 90.1%). The Consultant documents efforts to assist the person/legal representative to know about rights on an ongoing basis (CDC+: 92.6%).

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CDC+ Representative

Record Review Results by Region Region # of Reviews Percent Met Northwest

27 89.1%

Northeast

51 94.1%

Central

60 95.1%

Suncoast

55 91.9%

Southeast

63 93.3%

Southern

26 92.7%

State

282 93.1%

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Lowest Scoring CDC+ Representative Indicators

The CDC+ Representative maintains the employment status of all who provide direct care on the Employee/Contractor Roster within the Clearinghouse (77.8%, n = 63) Background screening results for all providers who render direct care are available for review (80.7%, n = 274). Documentation is available to support the reconciliation of Monthly Statements (81.2%, n = 282). Accurate Signed and approved Timesheets for all Directly Hired Employees (DHE) are available for review (87.0%, n = 261) Signed and approved receipts/statement of “Goods and Services” for reimbursement items are available for review (87.8%, n = 74)

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Health Summary

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In the past 12 months…

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Question Waiver Participants (N = 1,532) CDC+ Participants (N = 244) # Yes % Yes # Yes % Yes

Has the Abuse Hotline been contacted by you or

• thers to report abuse, neglect, or exploitation?

35 2.3% 1 0.4% Have Reactive Strategies under 65G-8 been used due to behavioral concerns? 45 2.9% 3 1.2% Have you been admitted to the hospital (including baker acts)? 184 12.0% 25 10.2% Have you been to an Emergency Room? 274 17.9% 35 14.3% Have you been to an Urgent Care Center? 65 4.2% 13 5.3%

Prescription Drugs July 2017 – June 2018

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15.9% 45.4% 30.2% 8.6% 15.2% 59.0% 21.7% 4.1% 0% 25% 50% 75% 100% 1-3 4-6 7+

# of Prescription Drugs by Waiver Type

Waiver Participants (N = 1532 ) CDC+ Participants (N = 244 ) 24.2% 33.6% 62.1% 46.2% 38.8% 26.0% 23.8% 25.8%

Family Home Independent/ Supported Living Group Home Other* Total

% Taking 4+ Medications by Home Type

Waiver Participants (N = 594/ 38.8% ) CDC+ Particiapnts (N = 63/ 25.8% )

Note: Other home types include: Assisted Living Facility (n = 20) and Foster Home (n = 6)

Taking 4 or More Prescription Drugs July 2017 – June 2018

Number of PCRs Region Waiver CDC+ Northwest 140 24 Northeast 226 42 Central 290 58 Suncoast 325 45 Southeast 301 52 Southern 250 23 State 1,532 244

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25.8% 30.4% 26.9% 17.8% 20.7% 26.2% 45.8% 38.8% 49.2% 35.2% 39.1% 33.4% 43.4% 30.7% 0% 10% 20% 30% 40% 50% State Southern Southeast Suncoast Central Northeast Northwest

4+ Medications by Waiver Type and Region

Waiver Participants (N = 594/ 38.8% ) CDC+ Particiapnts (N = 63/ 25.8% )

Top 10 Medications for Group Homes (N = 512)

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Medication Name (Type) N %

Depakote (Anticonsultant) 139 27.1% Risperdal (Antipsychotic) 105 20.5% Seroquel (Antipsychotic) 96 18.8% Synthroid (Hormone) 93 18.2% Klonopin (Sedative) 74 14.5% Desyrel (Sedative & Antidepressant) 73 14.3% Cogentin (Anti-Tremor) 70 13.7% Keppra (Anticonvulsant) 56 10.9% Omeprazole (Antacid) 55 10.7% Zocor (Statin) 54 10.5%

Provider Discovery Reviews

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Provider Discovery Review Scores by Region

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Region Service Providers Waiver Support Coordinators # of PDRs Overall PDR Score # of PDRs Overall PDR Score Northwest 113 93.6% 44 98.1% Northeast 281 91.2% 76 96.5% Central 247 91.6% 118 95.1% Suncoast 359 91.9% 98 94.6% Southeast 246 92.0% 115 95.9% Southern 188 94.5% 66 97.0% State 1,434 92.3% 517 95.9%

PDR Observations by Location and Region July 2017 – June 2018

Region Licensed Residential Home Day Programs # OBS % Met # OBS % Met

Northwest 45 98.4% 10 97.5% Northeast 208 96.9% 31 99.1% Central 190 95.4% 22 98.5% Suncoast 293 97.7% 56 98.9% Southeast 176 97.8% 17 99.0% Southern 150 98.4% 19 98.7%

State 1,062 97.3% 155 98.8%

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Announced vs. Unannounced Observations by Region July 2017 – June 2018

Region Announced Unannounced # OBS % Met #/% OBS % Met

Northwest 42 99.0% 13 (23.6%) 95.8% Northeast 125 98.2% 114 (47.7%) 96.0% Central 140 97.4% 72 (34.0%) 92.5% Suncoast 278 98.0% 71 (20.3%) 97.3% Southeast 128 97.6% 65 (33.7%) 98.6% Southern 124 98.7% 45 (26.6%) 97.9%

State 837 98.0% 380 (31.2%) 96.2%

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Lowest Scoring Observation Indicators (LRHs) July 2017 – June 2018

Individuals have a key to their bedroom door (77.9%, n = 1,001) Individuals have a key to their home (84.0%, n = 826) Training in use of public transportation is available and facilitated (86.3%, n = 665) Individuals participate in the development of the ‘house rules’ (89.2%, n = 1,022)

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PDR Policies and Procedures July 2017 – June 2018

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Number of PDRs Region Service Providers WSC Northwest

113 44

Northeast

281 76

Central

247 118

Suncoast

359 98

Southeast

246 115

Southern

188 66

State 1,434 517

Northwest Northeast Central Suncoast Southeast Southern State Service Providers (N = 1434) 89.6% 89.2% 90.8% 91.3% 93.5% 94.7% 91.6% WSC (N = 517) 96.6% 93.9% 95.5% 90.5% 94.6% 95.8% 94.2% 50% 60% 70% 80% 90% 100%

Lowest Scoring P&P Indicators July 2017 – June 2018

Detailing how to ensure compliance with background screening and five-year rescreening (81.9%, n = 1,159) Detailing hours and days of operation and the notification process to be used if the provider is unable to provide services for a specific time and day scheduled. (83.2%, n = 1,158) Maintaining the employment status of all employees on the Employee/Contractor Roster within the Clearinghouse (84.0%, n = 570) . Which detail the methods for management and accounting of any personal funds for all individuals in the care of, or receiving services from, the provider (85.6%, n = 833)

The provider maintains written policies and procedures:

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PDR Qualifications and Training July 2017 – June 2018

Number of PDRs Region Service Providers WSC Northwest

113 44

Northeast

281 76

Central

247 118

Suncoast

359 98

Southeast

246 115

Southern

188 66

State 1,434 517

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Northwest Northeast Central Suncoast Southeast Southern State Service Providers (N = 1434) 90.6% 87.9% 85.8% 87.9% 86.9% 90.8% 88.0% WSC (N = 517) 96.3% 94.6% 90.5% 90.4% 91.0% 90.2% 91.7% 50% 60% 70% 80% 90% 100%

Lowest Scoring Q&T Indicators July 2017 – June 2018

The provider received training in Requirements for all Waiver Providers (SP: 60.6%, WSC: 74.0%) The provider has completed all aspects of required Level II Background Screening (SP: 84.5%, WSC: 93.4%) Provider received training in HIPAA (SP: 84.0%, WSC: 90.3%), HIV/AIDS/Infection control (SP: 84.5%, WSC: 88.0%), or first aid (SP: 85.9%, WSC: 87.8%) The Support Coordinator completes 24 hours of job related annual in-service training (80.0%)

For non-service specific training requirements

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Service Specific Record Reviews July 2017 – June 2018

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89.7% 91.7% 91.8% 93.6% 94.7% 91.6% 94.3% 89.1% 91.7% 94.5% 95.2% 50% 60% 70% 80% 90% 100%

Supported Living Coaching (464) Respite (424) ResHab Standard (982) ResHab Intensive (48) ResHab Behavior Focus (176) Personal Supports (1565) LSD 3 ADT(536) LSD 2 Supported Employment (211) LSD 1 Companion (798) Behavior Assistant (60) Behavior Analysis (229)

Lowest Scoring SSRR Standards July 2017 – June 2018

The Provider submits documents to the Waiver Support Coordinator as required (LSD2: 63.5%, Sup. Living: 65.1%, Respite: 65.5%, ResHab Standard: 69.1%, LSD1: 69.7%). The 3rd Quarterly/Annual Report covering services provided and billed during the period under review contains all required component (ResHab Intensive: 66.7%, ResHab Behavior Focus: 72.8%, LSD2: 74.0%) The current Implementation Plan covering services provided and billed during the period under review contains all required components (Supported Living Coach: 72.5%). Provider documents efforts to assist the person to define abuse, neglect, and exploitation including how the person would report any incidents on an ongoing basis (ResHab Standard: 73.4%).

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Background Screening and Billing Discrepancies July 2017 – June 2018

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Number of PDRs Region Service Providers WSC Northwest

113 44

Northeast

281 76

Central

247 118

Suncoast

359 98

Southeast

246 115

Southern

188 66

State 1,434 517

62.8% 65.5% 75.3% 49.0% 72.4% 79.3% 65.8% 86.4% 80.3% 69.5% 61.2% 84.3% 87.9% 76.6% 0% 25% 50% 75% 100% Northwest Northeast Central Suncoast Southeast Southern State

Providers with all Billing Standards Met

Service Provider WSC

87.6% 84.3% 82.6% 83.8% 85.8% 85.1% 84.5% 97.7% 96.1% 92.4% 92.9% 93.0% 90.9% 93.4% 0% 25% 50% 75% 100% Northwest Northeast Central Suncoast Southeast Southern State

Providers with all Background Standards Met

Alerts Identified by Region

(Service Providers and WSCs combined)

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Region Total #

• f PDRs

# of Providers with 1+ Alert Total #

• f Alerts

Rights Health & Safety ANE Back Ground Screening Clearing House Roster Med. Admin./ Training Med. Storage Drivers License/ Insurance

Northwest 157 20 28 3.6% 7.1% 0.0% 46.4% 28.6% 10.7% 0.0% 3.6% Northeast 357 68 81 0.0% 4.9% 0.0% 46.9% 25.9% 14.8% 2.5% 4.9% Central 365 76 87 1.1% 3.4% 0.0% 46.0% 34.5% 4.6% 5.7% 4.6% Suncoast 457 130 154 3.2% 10.4% 0.6% 25.3% 31.8% 15.6% 9.1% 3.9% Southeast 361 67 79 3.8% 11.4% 0.0% 40.5% 32.9% 7.6% 2.5% 1.3% Southern 254 41 45 0.0% 8.9% 0.0% 62.2% 22.2% 4.4% 2.2% 0.0% State 1,951 402 474 2.1% 8.0% 0.2% 40.1% 30.4% 10.8% 5.1% 3.4%

Questions Feedback Glasgowk@qlarant.com Palamoors@qlarant.com Kellys@qlarant.com

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