Quality Assurance and Quality Improvement in Home and Community-Based Services (QA/QI)

ALASKA

Target Population

Participants in all the State's home and community-based services (HCBS) waiver programs.

Geographic Focus

Pilot in eight regions of the State and Anchorage, then statewide for the assessment tool and database implementation.

Primary Focus

Integrate and consolidate data into an existing division-wide data management system, using the design and systems improvement functions of the Centers for Medicare & Medicaid Services (CMS) HCBS Quality Framework, and pilot a person-centered quality of life assessment tool and methodology to improve system performance, participant outcomes and satisfaction, participant safeguards, and person-centered service planning and delivery.

Goals, Objectives, and Activities

Goal: Develop a quality of life assessment tool and methodology to provide more accurate information on the effectiveness of the State's HCBS waiver programs.

Objectives/Activities

• Identify existing assessment instruments and methodologies that measure quality of life and conform with the CMS HCBS Quality Framework to serve as a guide for developing a quality of life assessment tool.
• Implement a quality of life assessment tool, test the assessment tool with a sample of consumers, make revisions, and finalize the tool.
• Modify existing State consumer satisfaction surveys to make them person-centered and focused on quality of life issues.
• Develop and disseminate information in multiple formats (e.g., pamphlet, online, large print, audio) to waiver services recipients and providers about the quality management system and how to access quality assurance information, give feedback, file complaints, and make incident reports.

Goal: Assist in the implementation of a new quality management database system that will more effectively track complaints and incident reports across all State agencies and departments.

Objectives/Activities

• Prepare the quality assurance system to receive data, train personnel to import existing data into the new system, and develop protocols for maintenance of the system.
• Train State agency and provider staff to use the new quality database system.
• Develop reports to be used for distributing quality assurance findings to consumers, families, and providers.

Goal: Evaluate the project's effectiveness toward meeting the State's goals and objectives and implement necessary modifications to replicate activities statewide.

Objectives/Activities

• Assess progress toward meeting goals and objectives of the project over time.
• Prepare and post quarterly progress reports on the State's Web site http://www.hss.state.ak.us/dsds.
• Conduct a summative evaluation, prepare project evaluation reports, and post to the State's Web site.

Key Activities and Products

• Conduct a pilot test of the quality of life assessment tool and methodologies with 200 consumers to improve consumer satisfaction and quality of services.
• Develop materials and other informational resources to promote the quality assurance/
  quality improvement system.
• Integrate existing data systems to provide easier access to and distribution of quality assurance information.
• Produce data-driven quality assurance/quality improvement reports to inform the federal agency, consumers, families, providers, and the general public.

Consumer Partners and their Involvement in Implementation Activities

Partner organizations in the proposed project have predominant or entire memberships comprising persons with disabilities and family members. These organizations will be involved in development of the assessment tool. Additionally, consumers will be involved in grant activities through participation in the pilot of the person-centered quality of life assessment tool.

Public and Private Partners and their Involvement in Implementation Activities

• Alaska Mental Health Trust Authority, which provided funding to purchase the software and licensing for the SAMS2000 database system, will assist in the integration of quality of life data with other data (e.g., eligibility and case management data) in an already existing data management system.
• The Alaska Commission on Aging, the Alaska Mental Health Trust Authority, the Governor's Council on Disabilities and Special Education, and the State Independent Living Council will examine instruments and methodologies for assessing quality of life and make recommendations on the development of the assessment tool to the Quality Improvement Steering Committee.

Advisory Body, Committee, or Task Force

A Quality Improvement Steering Committee, comprising State agency management and program staff, will oversee the development and implementation of all quality assurance activities in Alaska's long-term care programs. The committee will meet quarterly to monitor the grant's progress.

Formative/Process Evaluation Activities

The Center for Human Development (CHD) at the University of Alaska Anchorage will assess the State's progress toward meeting project goals and objectives. The CHD will document whether tasks are completed; document problems that arise and recommended solutions; and document changes that are recommended and implemented. Additionally, the CHD will determine if the project reached targeted populations and if anticipated outcomes are achieved. Results will be reported quarterly.

Summative/Outcome Evaluation Activities

The CHD at the University of Alaska Anchorage will also conduct an independent evaluation of the project to determine if the assessment strategies are cost-effective and provide worthwhile results; determine if the database system is being utilized effectively by State agencies and service providers; and determine if data-driven information is accessible to consumers, providers, and other stakeholders.

Strategies to Ensure Sustainability

• The processes and structures built under this project are intended to provide a permanent foundation that will endure after the grant period, and from which effective quality assurance and continuous quality improvement can function and evolve. At the end of the grant, the quality of life assessment process will be a permanent part of the system.
• The grant will help create an integrated database that staff will be trained use. This will result in a uniform system of quality management for participants in the State's waiver programs.