DDES INFO MEMO 2006-14
STATE OF WISCONSIN
Department of Health and Family Services
Division of Disability and Elder Services
DDES Info Memo Series 2006 - 14
Date: July 24, 2006
Index Title: Assuring Wisconsin Functional Screen Quality and Requesting
Feedback
To: Listserv
For: Aging and Disability Resource Center Directors
Alcohol and Other Drug Program Directors
Area Administrators / Human Services Area Coordinators
County Departments of Community Programs Directors
County Departments of Developmental Disabilities Services Directors
County Departments of Human Services Directors
County Departments of Social Services Directors
County Child Welfare Program Directors
County Developmental Disability Coordinators
County Family Support Coordinators
County Mental Health Coordinators
County Substance Abuse Coordinators
County Long-Term Support Coordinators
Family Care Care Management Organization Directors
Wisconsin Partnership Program Directors
From: Sinikka Santala, Administrator DDES
Subject: Assuring Wisconsin Functional Screen Quality and Requesting
Feedback
Background
The Division of Disability and Elder Services (DDES) has the long-term
goal of ensuring quality and statewide consistency in determining an
individual's eligibility for Wisconsin's long-term care programs. The
Department of Health and Family Services (DHFS) has developed several
web-based functional eligibility screening tools for various target
groups.
DHFS has utilized Screen Lead Workgroups as the process for
involving local agencies in ensuring screen quality. However, due to the
expansion to multiple screening tools and target groups, as well as the
expansion of the number of screeners, the DHFS needs a more comprehensive
and coordinated process for assuring screen quality.
DHFS will be developing and implementing a new Functional Screen
(FS) Quality Assurance Framework beginning in 2007. The purpose of this
information memo is to provide general background information on the
aspects of this framework that are most relevant to local agencies in
order to solicit your comments and feedback on this plan.
The Centers for Medicare and Medicaid Services (CMS) Quality Framework:
Design, Operations, Discovery, Remediation and Improvement, was used as
the basis for a comprehensive plan to assure quality for all Functional
Screen types in the State of Wisconsin. These screen types include the
Adult Long-Term Care Functional Screen (LTC FS), Children's Long-Term
Support Functional Screen (CLTS FS) and the Mental Health and Alcohol and
Other Drug Abuse Functional Screen (MH/AODA FS).
A robust system of quality policies, procedures, and processes are
needed to ensure FS quality. This system also needs multiple levels of
responsibility and improvement strategies from local screening entities
and county departments, to the state-level, to ensure adequate FS quality
and oversight. A group of DHFS staff, representing each screen type,
joined forces to develop a coordinated statewide screen quality plan, and
DDES is proposing this framework for your consideration and comment.
The new FS Quality Assurance Framework has many elements of the
existing system such as:
- State-level quality oversight;
- The use of the Functional Screen listservs to notify users about
changes to the screen, clinical instructions or other screen
information;
- New screener training; and
- Local screener input related to improvements.
The FS Quality Assurance Framework also includes new elements
reflective of the FS evolution over the past several years. These changes
include:
- Screen Consultation Groups: Screen Consultation Groups will
be established for each type of screen: LTC FS, CLTS FS and MH/AODA
FS. Each group will have geographic and diverse types of users
represented. For example, the LTC FS Consultation Group will include
screeners from Aging and Disability Resource Centers, Family Care,
Home and Community-Based Services Waivers, and Wisconsin Partnership
Program agencies. These groups will be established through a volunteer
process. FS User Manual: Another planned improvement is to develop a
web-based FS User Manual that will consolidate information for issues
common to all screen types, with references to unique materials or
resources as needed for the various screens. As the DHFS develops this
manual, we will undertake a survey process to solicit input into the
manual. We will also survey screeners and agencies related to the need
for improvements in the screen, instructions, training, and electronic
mailings, as well as clinical and technical help supports.
- Local Quality Assurance Procedures: Local quality assurance
procedures make an important contribution to the Functional Screen
Quality Assurance Framework. Annually, counties and local entities
will need to submit a Local Functional Screen Quality Plan. The DHFS
will establish the format and content of this plan with the intent of
facilitating local development of required elements, as well as the
assurance that the plan requirements are consistent across each screen
type. Counties and local entities that administer more than one screen
type will be able to submit a combined plan.
- State-Level Changes: Functional Screen duties at the DHFS
will be centralized. Two staff members will be charged with primary
responsibility for quality, data management and coordination of the
Functional Screen. One role for these staff will be to assure
consistent approaches whenever possible among the multiple screen
types. These staff will also assure that data are evaluated to
determine needed improvements or trends in functional screens with the
purpose of maintaining the highest possible quality and accuracy of
all eligibility decisions. The two staff members will work with
existing staff as needed to carry out these functions.
- DHFS, in partnership with the Consultation Groups, plans to
design an ongoing process to assure that each certified screener
demonstrates the needed skills and knowledge to achieve an accurate
screen result. This will include an evaluation of the LTC FS
Inter-Rater Reliability Testing (IRRT) process. Other options and
procedures, such as annual testing, or required refresher training and
testing to demonstrate this outcome will also be evaluated. The
on-line learning modules and testing of new screeners will also be
assessed through this process. Finally, the need for web-based
training for specific and related skills such as interviewing skills,
privacy requirements, and risk assessment will be evaluated.
DHFS is inviting written input and feedback related to the
proposals outlined in this memo. This will assure success as we move
forward with a comprehensive quality assurance framework for the
Functional Screen. This is a preliminary opportunity for comment. As each
element of the FS Quality Assurance Framework is developed and
implemented, further input from the Consultation Groups, and broader input
will be solicited as needed.
A feedback form is attached to this document. This form is also
available electronically on the DHFS web site if you prefer to complete
and submit this form electronically. Comments are due to Hollister Chase,
contact information as noted below, by August 31, 2006.
Thank you for your continued commitment to the people of Wisconsin and
your partnership in determining people's eligibility for various, critical
support and service programs. A comprehensive framework for FS quality
will assure that people can continue to expect the same high quality and
consistency of support.
REGIONAL
OFFICE CONTACT:
Human Service Area Coordinator
Central Office Contacts:
Hollister Chase
DDES, Bureau of Long-Term Support
1 West Wilson Street, Room 518
PO Box 7851
Madison, WI 53707-7851
Tel: 608/261-8877
Fax: 608 266-5629
E-mail: chasehl@dhfs.state.wi.us
MEMO WEB SITE: http://dhfs.wisconsin.gov/dsl_info/
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Last Revised: August 02, 2006 |
