Description
The
Clinical Services Branch coordinates the quality assurance, quality
improvement, and risk management responsibilities throughout the
division.
Health Risk Screening Tool (HRST)
The
Health Risk Screening Tool (see Related Links) is utilized with people
who receive residential supports through the SCL waiver. The HRST is
used to determine where an individual is likely to be vulnerable for
health risks. The greatest vulnerability to health risk could be
exhibited or experienced among those individuals whose services are
periodic or less intense than for someone who needs daily nursing care.
The
HRST assigns scores to rating items. The total points result in a
Health Care Level with an associated Degree of Health Risk. The Health
Care Levels are 1 through 6; Level 1 being the lowest risk for health
concerns and Level 6 being the highest risk for poor health. It is
important to understand that the HRST measures health risk, not
disability. HRST is used for:
- Identifying health risks to reduce and prevent complications.
- Increasing the monitoring of a person's health where applicable.
- Identifying additional training needs of provider staff.
- Identifying the need for increased monitoring of a person’s health
- Assisting the team in responding to identified health risks appropriately
Medicaid Waiver Management Application (MWMA)
The
MWMA is utilized to apply for and manage waiver activities across
waivers and roles, including providers, DDID staff, Medicaid staff, and
entities that Medicaid contracts with regarding the waivers.
DDID
staff have utilized it for reviewing applications, placing individuals
on the SCL and MP waiting lists, updating information regarding people
on the those waiting lists, allocating waiver funding, recording
information about SIS assessments, reviewing and following up on
critical incidents, and some of the provider monitoring duties. Access
the "Medicaid Waiver Management Application" Related Link for more
information.
National Core Indicators (NCI)
DDID
collaborates with the University of Kentucky Human Development
Institute (HDI) to improve lifelong opportunities and services for
individuals with disabilities, their families and the community. DDID
also works with HDI to measure the quality of services provided to
individuals with disabilities through participation in the NCI quality
survey.
The
national core indicators are standard measures used across states to
assess the outcomes of services provided to individuals and families.
Indicators address key areas of concern including employment, rights,
service planning, community inclusion, choice, and health and safety.
Staff
of HDI survey a sample of individuals with intellectual and
developmental disabilities (IDD) each year. Those surveyed receive a
variety of supports across settings and funding sources. The funding
sources may vary based upon goals, but can include the Supports for
Community Living (SCL) waiver, Michelle P. (MP) Waiver, intermediate
care facilities (ICFs), and community mental health centers (CMHCs).
A
stakeholder committee reviews the Kentucky core indicator results each
year, makes recommendations for improvement and suggests activities to
accomplish the recommendations. Websites with more information include: Kentucky NCI Quality Improvement Committee
Risk Management
Components of Risk Management include:
- Utilizing the health risk screening tool with those who receive residential supports in SCL.
- Utilizing the supports intensity scale for recognizing and mitigating risk for those in SCL.
- Utilizing information gathered through NCI surveys.
- Medication administration training and reporting.
- Complaint reporting/follow-up process for all individuals with IDD who receive funding through the state.
- Incident reporting/follow-up process for all individuals with IDD who receive funding through the state.
Supports Intensity Scale™ (SIS)
The
SIS includes complete person-centered assessments for Supports for
Community Living (SCL) Waiver participants in order to assist in
developing individualized person-centered service plans based on
identified needs.
The
SIS-Adult (SIS-A) version is a standardized assessment tool designed to
measure the pattern and intensity of supports required by a person aged
16 years or older with an intellectual or other developmental
disability to be successful in community settings.
Traditionally,
a person's level of developmental disability was measured by the skills
that the individual lacks. SIS-A shifts the focus from lacks to needs.
The
SIS evaluates practical supports that people with developmental
disabilities need to lead independent lives. The SIS is administered by
Division of Developmental and Intellectual Disabilities (DDID) staff
with a respondent group for each person who receives supports through
the SCL Waiver.
Waiver Quality Improvement Strategy and Performance Measures
In
order to be approved by the Centers for Medicare & Medicaid
Services (CMS), all waivers must include performance measures and a
quality improvement strategy. The performance measures are gathered and
trended, and strategies for improvement are developed and implemented as
needed.
Evidentiary
reports must be submitted to CMS. The evidence is gathered and reports
are drafted and submitted to the Department for Medicaid Services for
submittal to CMS. The report must include a statewide improvement plan
for any performance measure that falls below 86 percent.