Real Choice Systems Change

NEBRASKA

Grant Information

Name of Grantee

Nebraska Department of Health and Human Services Finance and Support

Title of Grant

Real Choice for Nebraskans

Type of Grant

Real Choice Systems Change

Amount of Grant

$2,000,000

Year Original Funding Received

2001

Completed

Contact Information

Mary Jo Iwan, Deputy Administrator
402-471-9345
maryjo.iwan@hhss.state.ne.us

Joni Thomas
System Change Grants Coordinator
Office of Aging and Disability
301 Centennial Mall S, 5th Floor
PO Box 95044
Lincoln, NE 68509-504
402-471-1764
joni.thomas@hhss.state.ne.us

Subcontractor(s)

University of Nebraska
Public Policy Center
Nancy Shank, M.B.A.
402-472-5687

University of Nebraska Medical Center
Munroe Meyer Institute
Barbara Jackson, Ph.D.
402-559-5765

Target Population(s)

Children and adults of all ages with physical disabilities, developmental disabilities, or behavioral health problems.

Goals

  • Implement a consumer-directed model of services coordination and services delivery.
  • Improve consumer access to, and information about, supports and services.
  • Develop a system that allows consumers from various disability systems to access and receive needed services.
  • Implement a quality management system that ensures the health and well-being of consumers through continuous consumer-directed monitoring and improvement.
  • Make available to consumers and agencies a comprehensive, statewide resource database of health and human services.

Activities

  • Gain consensus of consumer task force on choice definition, risk, and guiding principles for systems development.
  • Market Real Choice philosophy to internal and external target audiences, and articulate what it means in practice.
  • Analyze current services coordination across systems to determine steps needed to implement consumer-directed approach and transdisciplinary model.
  • Set uniform standards, practices, and methods pertaining to collection, management, use, and promotion of data for resource directories across local and state agencies and organizations.

Abstract

Nebraska's current service delivery system comprises programs that provide services and supports through consumer-directed, as well as state-directed, philosophies, and variations in between. Many of these programs operate in isolation from one another, even though consumers often need services across programs. Consumers and policymakers have become aware of, and are advocating for, systemwide adoption of a consumer-directed philosophy.

Nebraska is struggling with the challenge of moving from an inspection and certification-based philosophy to one that gives consumers more responsibility in monitoring and quality assurance. In the realm of consumer-directed services, the state's process of identifying, approving, and monitoring providers must be revisited to ensure that consumers have real choices, are provided with full disclosure, and are provided necessary safeguards. For consumers to have real choices, consumers need to have easy, consistent, and timely access to information on available programs, resources, and services.

Nebraska proposes to implement a consumer-directed philosophy across populations—children and adults of all ages with physical disabilities, developmental disabilities, or behavioral health problems—with consumer choice and risk defined and incorporated into services, delivery, regulations, quality assurance, and practices. Consumers, agency, and program staff, will collaborate to design and implement effective and enduring improvements in a culturally competent community long-term service and support system. They will also collaborate to identify quality measures and to design and implement a sustainable quality management system to monitor the efficiency of services in achieving the client outcomes desired and the delivery of services in a manner that meets consumers' expectations and preferences.

Consumers, services coordinators, providers, and other stakeholders participating in long-term support systems will have needed information about services and supports at the right time to effectively make informed choices regarding services that are appropriate, effective, and user responsive through improved access to long-term support systems.

Through consumer role enhancement, skill building, training, and support, consumers will have the necessary skills, knowledge, and supports to successfully live in the most integrated community settings chosen; exercise meaningful choices; and obtain quality services.

Services coordinators across programs will embrace a consumer-directed philosophy and have the necessary knowledge and skills to effectively support consumers, exercising meaningful choices in obtaining quality services through services coordination role redefinition, skill building, training, and support.

Note: This Compendium form was not reviewed by the Grantee prior to publication.