“How can we help ensure providers offer person-centered services in Ohio? Based on our findings, CQL is the perfect vehicle to make it happen,” says Dr. Patrick Maynard, President and Chief Executive Officer of I Am Boundless (formerly FCRS) near Columbus, Ohio.
On October 14th, 2016, Boundless became the first agency in the state of Ohio to receive accreditation from CQL | The Council on Quality and Leadership, achieving Quality Assurances Accreditation. Boundless has now joined the hundreds of elite organizations across the globe who have made a commitment to person-centered practices in human services, by embracing a proven framework for excellence in quality enhancement.
“CQL will be impacting everything we do and will quickly become a foundation for our business operations. It’s going to influence how our board makes decisions, how human rights committees affect change, how people communicate, and how information is delivered to those served,” states Suzy Davis, Director of Advancement and Quality Initiatives for Boundless. She went on to say, “And the money that you put into it, will pay you back in spades. It’s worth every penny.”
Boundless supports more than 2,000 people to live up to their full potential in integrated, community-based settings. They provide a range of services for those with diverse support needs, including 24/7 services, supported living, in-home respite, emergency care, along with their unique ‘Parent and Person-Directed Program,’ which embraces an individualized and self-directed philosophy, where those receiving supports are selecting their desired services, direct support staff, scheduling and more.
To build upon their advancements in service delivery, Boundless sought out a renowned entity specializing in quality monitoring, measurement and enhancement. “There’s something incredibly important about having consistency in what practices we all do. When you get away from that consistency, it does affect people that we serve,” says Davis, adding, “Whether it’s our Chief Executive Officer or Direct Support Professionals, we’re now all working from a similar interpretation of quality care. CQL has been helping us consistently focus on our vision, and leading us to better service delivery.”
While there are other accrediting bodies in the human services field, Boundless welcomed the CQL model and it is in alignment with its mission and vision, focusing on organizational transformation, through enhancing supports and services that truly encompass person-centered practices. When evaluating other accrediting bodies, Susie Burke, Boundless Director of Community Living Services explains, “We found CQL really impacts the people we support, and our employees who work with them every day. CQL is more about how we support individuals to lead a more independent life.”
Preparing For The Accreditation
In 2014, staff members were introduced to CQL by Patrick Maynard, CEO of Boundless, who had previous connections to CQL while working in Illinois. “When I moved to Ohio and became the CEO, I was interested in fully implementing and integrating the concepts of person-centeredness and person-directed services. It made sense to introduce Boundless leadership to CQL,” says Maynard. This introduction began a robust evaluation process, where Boundless started to familiarize itself with CQL, by attending the 2014 CQL Conference in St. Louis, seeking out information online, talking with CQL staff, connecting with other agencies and taking part in a CQL Training in New York.
To begin their journey of organizational transformation, Boundless scheduled an Accreditation Preparation Workshop, where a CQL Quality Enhancement Specialist conducted an on-site training to help guide Boundless through the process for understanding and completing the Basic Assurances® and Shared Values Self-Assessments. Basic Assurances® are a set of factors that evaluate foundational elements of human services, such as health, safety and human security, whereas Shared Values look at an agency’s mission, vision, values and overall culture.
Boundless also held a Personal Outcome Measures® Workshop as part of the process to have a dozen staff members achieve Interviewer Certification. The Personal Outcome Measures® is a discovery process, where people supported and those who know them well are interviewed, to better understand what really matters in their lives. The information gathered during these interviews is used to assess the presence of outcomes, and the supports in place to help people achieve those outcomes, which can in turn be used to inform the person-centered plan. CQL’s exclusive tools of Basic Assurances®, Shared Values and Personal Outcome Measures® are key components of accreditation.
CQL’s Accreditation Process
Boundless had elected to dedicate extra time to accreditation preparation, in advance of their on-site visit. “We took a little more time than most people would to have our accreditation visit. We took nine months, only because we had so much to explore,” shares Davis. While the timeframe may have been altered to fit their unique needs, the overall accreditation process was the same.
Pre-Accreditation Planning Meetings
Conference calls to walk through the accreditation process
CQL visits and reviews sites where you provide services
Conversations with people supported and staff members
Personal Outcome Measures®
Evaluation of fundamental requirements for agencies
Separate discussions with staff and people supported
Meeting with diverse agency and external stakeholders
Stakeholder Event (For PCE & PCE-D)
Collection and analysis of outcomes and supports data
Data Collection & Analysis
Continual collaboration between CQL and organization
How The Partnership Pays Off
CQL takes a holistic approach to partnerships through accreditation, where an entire organization achieves the accreditation. This stands in contrast to other accrediting bodies, which offer accreditation at the programmatic level. CQL Accreditation involves an all-encompassing philosophy, since true organizational change is predicated on embracing ongoing transformation at all levels, across an agency. According to Davis, “This demanding and vigorous undertaking means that an agency will experience a significant impact on people supported, staff members and the organization as a whole.”
“A year ago I would have said we were real person-centered. But with the Personal Outcome Measures®, I was astounded to find out that I thought I knew the people served very well. Ironically, after the interviews, I was surprised to hear their responses!” exclaims Burke. Agencies find the new discoveries during a Personal Outcome Measures® interview, by exploring quality of life outcomes regarding relationships, rights, community, employment and more.
In conjunction, agencies then see how the information gathered during an interview can directly inform a truly person-centered plan. “It’s a great process from start to finish – engaging with people you’re supporting, finding out what it is they want, need and desire, and then developing plans around that,” says Maynard. “The plans are measured, so you can go back and look at your progress. If things aren’t going well, then you’ll know it, and you’ll be able to figure out why not. And if things are going well, you’re going to know that too.”
CQL incorporates diverse types of employees throughout the process, reinforcing the holistic focus for transformation, and building investment into the accreditation. During the on-site visit, a group of Direct Support Professionals are invited to participate in a focus group, sharing valuable feedback about services, staffing, employee relations, operations and more. They can also take part in the Person-Centered Excellence Stakeholder Meeting, where the agency develops action steps to turn innovative philosophies into best practices.
“I think this has been eye-opening for Boundless management and leadership staff. They’re feeling more empowered to know exactly what to do for the people we serve,” says Davis. Embedding CQL tools like Basic Assurances®, Shared Values and Personal Outcome Measures® into organizational practices, means that employees have a clear blueprint for carrying out their supports. These tools help turn traditional approaches for services, based on functional assessments or medical models, into one dedicated to outcomes-based supports. This new paradigm works to reinvigorate employees, offering an alternate outlook where their roles and responsibilities shift from direct care to direct support.
“CQL Accreditation is an organizational transformation process, and a culture shift. It’s about growing and learning. Every step you take in that growth, gives you a different perspective of more that you need to do,” states Maynard.
To create a framework for measuring their organizational transformation, Boundless can collect Basic Assurances® and Personal Outcome Measures® data in CQL’s PORTAL Data System, to evaluate the effectiveness of their supports, and determine if the resources being allocated are having the desired effect on the lives of those they support. Whether at the individual or aggregate level, this data can then be collected, analyzed and developed into detailed reports, which is critical in high-level planning.
“Boundless hasn’t traditionally looked at data and metrics to inform plans, processes and strategic visions. So we’re also going to be using the CQL PORTAL Data System, because you can’t make sweeping, big-picture changes, if you don’t pull all that information together and look at it,” says Davis.
The Future Of The Partnership
When describing the underlying elements of a partnership with CQL, organizations typically use the term ‘ongoing,’ in reference to organizational transformation. This phrasing is used deliberately as a recognition that no agency has attained or will attain the pinnacle of service provision, and no agency is exempt from improvement. “You need to constantly evolve and shift at the demands, needs and dreams of people you support, so I don’t see it as you reach an end. I see it as an ongoing process forever and ever, of continuously growing and evolving,” shares Maynard.
So, what’s next for Boundless? “We’re going to go for Person-Centered Excellence Accreditation and Person-Centered Excellence Accreditation | With Distinction. We know that this is a marathon and not a sprint. We’ll continue to be engaged with CQL for a very long time,” concludes Davis.
Ohio Quality Standards Crosswalk
CQL | The Council on Quality and Leadership has produced this crosswalk to demonstrate the practical application of CQL quality enhancement tools to Ohio’s compliance standards that were developed by the Ohio Department of Developmental Disabilities (DODD).Get The Guide