Posted on August 27, 2019 by Mary Kay Rizzolo, CQL President and CEO

This year, CQL | The Council on Quality and Leadership celebrates the 50th Anniversary of its inception. The story of CQL began in the late 1960s through a National Planning Committee consisting of industry leaders like the American Association on Mental Deficiency – AAMD (now the American Association on Intellectual and Developmental Disabilities (AAIDD)), the National Association for Retarded Citizens (now The Arc), the Council for Exceptional Children (CEC), and United Cerebral Palsy (UCP).

The Start of CQL

In 1969, The Joint Commission brought together this National Planning Committee to create an accreditation council that could develop quality standards for state institutions. This resulted in the establishment of The Accreditation Council for Facilities for the Mentally Retarded (ACF/MR), now known as CQL | The Council on Quality and Leadership. To improve conditions for people with disabilities in institutions, CQL developed the very first and subsequent sets of standards and performance indicators for adults and children receiving services.

Community-Based Services In The 70s and 80s

During the 1970s and 1980s, CQL took on a leadership role in the transition to community-based services. We developed national consensus standards for organizations providing services to people with intellectual disabilities in the community. The standards reflected the principles and values of professionals, families, provider organizations, and government agencies, later being adapted for use as Federal Standards by the Health Care Financing Administration (now the Centers for Medicare and Medicaid Services (CMS)). CQL’s standards were also incorporated into the historic Wyatt v. Stickney landmark court decision. In addition, federal courts later merged CQL’s standards into legal settlements in Texas, North Dakota, California, Arkansas, West Virginia, and other states.

A Focus On Outcomes In The 90s

CQL was at the forefront of a new era in quality measurement in the 1990s, involving personal outcomes. This entailed a shift for how the human services field defines quality, looking at responsiveness instead of solely compliance-based approaches. In 1991, CQL began work on the now internationally-recognized Personal Outcome Measures®. This tool for person-centered discovery, originally called the Outcome Based Performance Measures, was developed from numerous focus groups hosted by CQL Board Directors and staff members, and attended by people with intellectual and developmental disabilities, as well as those with psychiatric disabilities.

In 1993, the Outcome Based Performance Measures were first introduced, and then later modified into the Personal Outcome Measures® in 1997. These efforts initiated by CQL, ultimately influenced person-centered approaches in numerous states, at the federal level through CMS, as well as across the greater human services field.

Getting Social During The Turn Of The Century

In a recognition that personal outcomes are not realized in isolation, throughout the 2000s CQL worked to advance the social and community context for the attainment of personal quality of life. One component of this involved the development of the Community Life® measures, which explore the bridging role of organizations in facilitating relationships between people and their communities.

CQL also placed emphasis on the concept of Social Capital, which involves the ties, trust, and reciprocity that results from the identification, development, and maintenance of relationships with friends, family, neighbors, colleagues, and other social circles. In addition to the introduction of Community Life®, CQL incorporated this and four other tools including Shared Values, Basic Assurances®, Responsive Services®, and Personal Outcome Measures® into the publication ‘Quality Measures 2005’ – a far-reaching initiative to support the promotion of integrated quality management systems.

Putting People First In 2010 And Beyond

After being created in 2009, the What Really Matters initiative came to life in the 2010s. This placed person-centered services and supports in the spotlight, through the identification and development of a key set of 34 success indicators that characterize person-centered supports and promote personal quality of life outcomes.

In 2015, CQL Accreditation experienced some enhancements by providing organizations with three different accreditation options to meet their specific needs and desires. While the ‘menu’ of accreditation options expanded, agencies continued to experience the same collaborative partnership that comes with CQL Accreditation, focused on ongoing organizational transformation instead of a ‘checkbox’ model of policy review. This approach was embodied by a greater emphasis on Basic Assurances® in CQL Accreditation, to ensure that organizational policies are actually playing out in systems and practice.

In 2017, CQL also released an upgraded platform for data collection and analysis, through the PORTAL Data System, which provides human service organizations and state agencies with reporting, tracking, analysis and logging of personal outcomes and supports for people receiving services. PORTAL encompasses CQL’s Personal Outcome Measures® and Basic Assurances®, to collect and evaluate quality of life areas including health, safety, social roles, rights, relationships, community integration, employment and so much more. Through the PORTAL Data System and CQL’s research expertise, we have published numerous articles and studies to share information about quality of life outcomes and the impact of organizational supports.

Here are some examples of recent articles:

• HCBS For Older Adults
• Deinstitutionalization or Transinstitutionalization?
• Intimate Relationships – Organizational Supports Can Make The Difference!
• Ableism and Community Living
• The Impact of Self-Management of Health
• The DSP Crisis: Reimbursement Rates, Retention, and Research

It isn’t only individual human service providers that benefit from partnership with CQL. This collaborative relationship expanded to state systems in Tennessee, South Dakota, New York, Maryland, and more. One example of partnership opportunities at the state level involves the Tennessee Department of Intellectual and Developmental Disabilities (DIDD), which achieved their second term of CQL Network Accreditation in 2019.

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

As we look back on 50 years of leadership in human services, we look forward to a bright future in continuing our work on improving the quality of services that organizations provide – and more importantly – the quality of life for people receiving those services.