Quality Assurance and Quality Improvement in Home and Community Based Services

COLORADO

Grant Information

Name of Grantee

Colorado Department of Human Services, Division for Developmental Disabilities

Title of Grant

Quality Assurance and Quality Improvement in Home and Community Based Services for Colorado's Citizens with Developmental Disabilities

Type of Grant

Quality Assurance and Quality Improvement in Home and Community Based Services

Amount of Grant

$499,851

Year Original Funding Received

2003

Contact Information

Matthew Solano, Project Director
Director of Program Quality
Division for Developmental Disabilities
Colorado Department of Human Services
3824 West Princeton Circle
Denver, CO 80236
303-866-7439
matthew.solano@state.co.us

Subcontractor(s)

None.

Target Population(s)

Colorado waiver participants with developmental disabilities.

Goals

  • Improve efficiency and effectiveness of existing quality assurance/quality improvement (QA/QI) systems.
  • Promote the more active and effective involvement of consumers and families in QA/QI through Web-based information technology (IT) resources and direct assistance to strengthen self-advocacy and family advocacy.

Activities

  • Define and standardize a critical subset of quality assurance measures and apply these statewide.
  • Acquire and adapt a Web-based incident reporting system.
  • Purchase and implement an automated data capture system.
  • Establish a Web-based resource to provide information to and receive information from participants and families.
  • Provide training and assistance, including Web-based resources, for self-advocacy and family advocacy groups.
  • Award subgrants to enhance the effectiveness of local self-advocacy groups in improving the quality of waiver services.

Abstract

Colorado has a complex, decentralized developmental disabilities system that emphasizes small group living arrangements, promotion of individual and family choice of services/supports and providers, and a large number of providers. Colorado's incident management system is multitiered, with both county-based Community Centered Boards (CCBs) and service agencies having line responsibility for preventing, identifying, and following up on critical incidents. Colorado's baseline quality assurance standards and processes are fundamentally sound, but the challenge facing Colorado is to position QA/QI for HCBS to make smart use of IT to support quality management and improvement. The Division for Developmental Disabilities (DDD) does not currently have an efficient or effective system to capture information about critical incidents in real or near-real time, or to support trend and root cause analysis of such incidents. The lack of solid IT capabilities undermines the capacity to conduct performance appraisals, engage in effective quality improvement, and furnish important information to participants and families to aid them in selecting providers.

This project will provide the IT capabilities that DDD needs to efficiently and effectively identify trends and conduct root cause analysis regarding critical incidents. Further, this project will establish a statewide Project Advisory Committee to review critical incident data and will institute a review process to ensure that DDD and the CCBs demonstrate competence and diligence in responding to critical incident data. These efforts will enhance the efficiency and effectiveness of discovery, remediation, and systems improvement. The project will also provide a needed degree of standardization in information collection, without requiring administratively burdensome and costly changes to the systems that are already in place. DDD will seek only a subset of information, most of which is likely being collected already, and will provide an easily-accessible, automated data capture system to receive it.

The project also seeks to enhance the role and effectiveness of self-advocates as key guarantors of quality services. DDD has acknowledged the importance of self-advocacy in ensuring the quality of waiver services in Colorado and through this project will provide subgrants to local self-advocacy and family advocacy groups to support the development of new self-advocacy organizations or to expand the efforts of existing organizations (e.g., Speaking for Ourselves, Association for Persons in Supported Employment, etc.). This project will also reimburse travel expenses for self-advocates to attend and participate in DDD's Self-Advocate Advisory Council, which provides direct input to the DDD Director on statewide policy issues.

This project will position Colorado for sustained improvement in its QA/QI activities. The new systems and improvements to existing systems that the project will introduce are highly efficient and based on inexpensive, proven IT. Finally, the project will build the support of stakeholders for the information collection system through their involvement in the Project Advisory Committee and their continued involvement in an ongoing, statewide Quality Improvement Council.