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Accreditation in Arkansas: Independent Case Management, Inc.

By Michael Clausen

There are a lot of reasons why a human services organization might choose to pursue accreditation, and over the years I’ve seen a wide range of factors that influence that decision. As CQL encounters with so many of our partners, it was clear to me from the onset that Independent Case Management, Inc. (ICM) was in it for all of the right reasons.

As my colleague Elizabeth Sites and I quickly discovered, ICM approached this accreditation as an opportunity to implement best practices throughout the organization. Prior to the accreditation, ICM had begun a broad review of policies, procedures, and systems and used the accreditation review as a chance to receive objective feedback regarding these revisions.

The organization has a goal to enhance their systems for data collection and quality management, so throughout the week we supported the organization to connect pertinent metrics to key systems, and provided resources to continue the development of a holistic quality monitoring system. ICM engaged stakeholders throughout the state of Arkansas, which enabled diverse perspectives and robust discussions throughout the week.

“We looked at other accrediting bodies and found that they all focus heavily on processes, while CQL focuses more on outcomes.”

Josh Wilson, Independent Case Management, Inc.

About Independent Case Management, Inc.

Independent Case Management, Inc. (ICM) is a 501(c)(3) not-for-profit organization that provides home and community-based supports to individuals with intellectual and developmental disabilities (IDD) throughout the state of Arkansas.

Created in 1988, ICM began as a pilot project in partnership with the state to implement a 1915c Medicaid home and community-based supports waiver for people with IDD. ICM serves over 280 people with IDD, employees over 600 people, and generates approximately $14M in annual revenue.

The majority of funding stems from Medicaid services that ICM provides to people with IDD within their homes and communities. Other services include applied behavior analysis therapies to children with autism, clinic-based habilitative services, and specialized foster care. To support pre-employment skill readiness, ICM owns and operates three retail stores in Little Rock and a fried pie manufacturing and delivery business in Prescott. The main administrative office is located in Little Rock, Arkansas.

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ICM Achieves CQL Quality Assurances Accreditation

Following planning meetings, self-assessments, focus groups, Personal Outcome Measures® interviews, Basic Assurances® factor reviews, virtual site visits, and ongoing collaboration, Independent Case Management, Inc. formally achieved CQL Quality Assurances Accreditation on January 15th, 2021.

Independent Case Management views their accreditation as a significant moment within an ongoing journey. As detailed below, the organization has set some ambitious goals moving forward that include improving internal efficiencies, expanding its use of data, confronting workforce issues, and supporting outcomes involving independence and choice. While these goals are ambitious, Independent Case Management has demonstrated a strong commitment to moving forward and achieving their objectives.

I know that they’ll continue to improve their organizational systems and practices – and ultimately people’s lives – in the weeks, months, and years ahead. I also know that CQL will be working right alongside them throughout this journey. We’ll not only be providing guidance and support, but especially learning from all of the great work they’re doing so we can pass that knowledge along to other human service organizations.

ICM And Their Experience With CQL

For a first-hand perspective on ICM and their partnership with CQL, we asked Josh Wilson, CEO Designate of Independent Case Management, Inc. a series of questions about their organization, recent accreditation, and more. This is what Josh had to share about their continuing commitment to improving quality at their organization and supporting people to achieve their outcomes.

What are some changes your organization has experienced over the last several years?

Our organization has made many positive changes during the last several years to better serve the people we support. In 2015, we opened a community center in Little Rock, Arkansas called BRAVO (Bridging Recreational and Vocational Opportunities) for people with disabilities to engage in recreational activities while cultivating daily living and prevocational skills.

To aid in prevocational skill development we connected three retail stores, Bamboo (home-décor), Biscuits (homemade dog treats), and Brushes (art gallery), to the community center. After opening BRAVO, we also purchased a fried pie manufacturing and delivery business to provide integrated job training and employment opportunities in an economically depressed area of the state.

Around the same time period, we purchased and renovated a large building for our administrative offices and remodeled our former office building to serve as four independent apartments for people we support. Unlike some group home models, our apartments are self-contained and private, thus allowing tenants to enjoy individualized living. Most recently, we launched a state-wide specialized foster care program to help address the need for children with disabilities to receive supports within home-based environments instead of facilities.

Why did you decide to pursue CQL Accreditation?

We discussed seeking accreditation for several years and always found ourselves drawn to CQL. Oftentimes, competition and accountability are necessary for organizations to raise quality above minimum standards. While we certainly believe our supports exceed regulatory requirements, we want to be held to a higher standard that is informed by data-driven and person-centered best practices from around the world.

“We want to be held accountable by standards that reflect our beliefs about dignity, human agency, and great service.”

Josh Wilson, Independent Case Management, Inc.

We looked at other accrediting bodies and found that they all focus heavily on processes, while CQL focuses more on outcomes. While CQL emphasizes establishing processes that lead to outcomes, we found that they place a greater emphasis on how processes and practices actually impact people supported. We want to be held accountable by standards that reflect our beliefs about dignity, human agency, and great service.

How did you prepare for your CQL Accreditation?

Our preparation for CQL Accreditation began in earnest shortly after the COVID-19 pandemic began in early spring of 2020. We knew early on that our philosophy and practices aligned with the Basic Assurances®, but our procedures required some work. So, we rewrote our procedures to conform to all Basic Assurances® factors, indicators, and probes.

We developed a spreadsheet and listed each probe in one column and procedure manuals in the others. We then matched each probe to a procedure if one existed or created new procedures when necessary. This activity consisted of a small group of administrators and directors meeting daily for several months. Staff training on the new processes began shortly after completing the procedural revisions and is still ongoing.

What are your goals as an organization?

Our primary goal is to be the premier provider of home and community-based services for people requiring long-term supports in Arkansas. To accomplish this goal, we have focused our efforts in three primary areas: efficiency and growth, people, and quality.

For the first area, we intend to focus on taking advantage of revenue-growth opportunities to expand our support options, streamlining and standardizing processes while allowing the customization of our supports to meet individual needs, and developing systems to gather and report meaningful data for performance and quality monitoring.

Second, we hope to become the “Google” employer in our industry whereby our culture and employment practices attract and retain high performing employees. Markers of success include ample availability of applicants desiring to join our organization, low vacancies and turnover, and high retention levels.

Third, and where the other two items culminate, is the quality of supports we provide. The people supported should define quality while we provide the supports to help them exercise their human agency and gain more independence. This means that we should help people in gaining access to greater choice-making opportunities so that their options are meaningful. We should then provide the necessary supports so that people can realize the decisions they make.

Have questions about CQL Accreditation?

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Since 1969, CQL | The Council on Quality and Leadership has been a leader in working with human service organizations and systems to continuously define, measure, and improve quality of life and quality of services for youth, adults, and older adults with intellectual and developmental disabilities, and psychiatric disabilities. CQL offers accreditation, training, certification, research, and consultation services to agencies that share our vision of dignity, opportunity, and community for all people.