Quality Assurance and Quality Improvement in Home and Community-Based Services

COLORADO

Target Population

Colorado waiver participants with developmental disabilities.

Geographic Focus

Statewide.

Primary Focus

• The project will address the design, discovery, remediation, and systems improvement functions of the Centers for Medicare & Medicaid Services (CMS) Home and Community-Based Services (HCBS) Quality Framework (hereafter, the Quality Framework) by defining and standardizing a critical subset of quality assurance measures, acquiring and adapting information technology to improve critical incident reporting and general communication, and promoting more active involvement of consumers and families in quality assurance and quality improvement (QA/QI).



• These activities will enhance and improve the Quality Framework focus areas of participant access, participant safeguards, and system performance.

Goals, Objectives, and Activities

Goal: Improve the efficiency and effectiveness of existing QA/QI Systems.

Objectives/Activities

• Define a set of provider organization-specific performance measures to serve as the basis for quality improvement.



• Standardize critical elements of the participant/family survey of Colorado's Department of Human Services Division for Developmental Disabilities Community Centered Boards (DDD/CCB) for statewide application.



• Standardize elements of critical incident reports for statewide application.



• Acquire and adapt one of a number of existing web-based incident reporting systems for the timely reporting and follow-up of standardized incident information by DDD.



• Purchase and implement an automated data capture system that will scan participant/family survey forms and regulatory survey forms into a computer readable form in order to yield more timely and efficient results.

Goal: Promote more active and effective involvement of consumers and families in QA/QI through web-based information technology (IT) and direct assistance to strengthen self-advocacy and family advocacy.

Objectives/Activities

• Establish a web-based resource for participants and families to provide information on system navigation, provider assistance and performance, and other resources that support participants and inform choice.



• Build a web-based "suggestion box" and rapid response system to encourage direct, unfiltered feedback from consumers, families, community workers and others in the Colorado DDD community, and promote their positive engagement in QA/QI.



• Provide downloadable/web-accessible education and training materials designed to promote quality in order to facilitate access and encourage wider use.



• Help self-advocate and family advocacy groups around the State establish Advocacy Growth Projects, through technical assistance, cash, and in-kind support.



• Help self-advocate and family advocacy groups around the State to establish QA/QI Projects, through technical assistance, cash, and in-kind support.

Key Activities and Products

• 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 consumers and families.



• Provide training and assistance, including web-based resources, for self-advocate and family advocacy groups.

Consumer Partners and their Involvement in Implementation Activities

Consumers and their families will be involved in the Project Advisory Committee and will participate in the development of web resource products intended for their use.

Public and Private Partners and their Involvement in Implementation Activities

Public Partners

Colorado Health Care Policy and Finance (HCPF) and Colorado Association of Community Centered Boards, will be represented on the Project Advisory Committee and will work on developing cost effective, web-based linkages between the statewide systems developed as part of this project and their existing systems.

Private Partners

Colorado Speaking for Ourselves, The Arc of Colorado, The Legal Center for People with Disabilities and Older People, Colorado Association for Persons in Supported Employment, the Service Provider Organization of the Colorado Association of Community Centered Boards, and the Colorado Association of Private Resource Agencies will be represented on the Project Advisory Committee.

Advisory Body, Committee, or Task Force

The Project Advisory Committee will include representatives of provider organizations, the State Association of Community Centered Boards, the State Association of Private Resource Agencies, consumer organizations such as the Association for Persons in Supported Employment, the Colorado Developmental Disabilities Council, Arc Colorado, Speaking for Ourselves, and the Office of Information Technology Services. This committee will provide ongoing input from all key stakeholders and is intended to evolve into a statewide Quality Improvement Council with significant representation by consumer and family groups.

Formative/Process Evaluation Activities

• Each subcommittee and committee meeting will begin with a review of progress and problems to date, to identify any issues (barriers) that must be addressed, when, and by whom, before proceeding.



• Funds are budgeted for a mid-course evaluation of the project by a qualified and disinterested third party.

Summative/Outcome Evaluation Activities

• After implementation of the systems, DDD will conduct a survey with end-users to solicit their opinions concerning usability and relevance. Survey results will be used to make further adjustments.



• Funds are budgeted for a final evaluation of the project by a qualified and disinterested third party.

Strategies to Ensure Sustainability

• The project will take advantage of proven, economical, and sustainable IT systems by borrowing and building on technology already developed and in operation elsewhere and will consider only systems/solutions with a near zero net long-term operating cost effect. Colorado is committed to ensure the maintenance of such a system.



• The Project Advisory Committee is expected to evolve into a statewide Quality Improvement Council.