Posted on September 8, 2015

“South Dakota has had a long standing relationship with CQL,” says Dan Lusk, the Director for the Division of Developmental Disabilities in South Dakota, “but the partnership with CQL goes beyond accrediting the providers in our state.” While the connection between CQL and South Dakota started with a state contract covering accreditation, it has extended into training, data, consultation and certification services provided by CQL, to enhance individual quality of life and organizational quality of supports.

CQL State-Wide Accreditation & Outcomes

In 2004, CQL | The Council on Quality and Leadership entered into an agreement with the Division of Developmental Disabilities in South Dakota, to accredit all of the Community Support Providers throughout the state. CQL had already accredited a number of providers in South Dakota, before being selected as the exclusive accrediting body for organizations supporting people with intellectual and developmental disabilities.

“The purpose of that was for us to bring a very high-level of credibility and consistency to our provider accreditation and certification process, with a real focus on the Personal Outcome Measures® and Basic Assurances®” with Lusk also stating, “it has really fit nicely into the work that we’ve done in South Dakota, regarding person-centered practices.”

While Basic Assurances® focus on the health, safety and security, Personal Outcome Measures® drill down to discover what really matters to the people who are receiving supports. In a Personal Outcome Measures® interview, 21 indicators are used to understand the presence, importance and achievement of outcomes, involving employment, choice, social capital, relationships, rights, goals, dreams, desires and more.

In order to enhance best practices in the Personal Outcome Measures® process, and ensure reliability of data gathered during interviews, CQL is working with the Division of Developmental Disabilities to certify more than 40 Personal Outcome Measures® interviewers, including staff within the Division and employees from the Community Support Providers. “This will allow providers and the Division to assess the quality of supports being delivered and make systems improvements where necessary through a robust set of Personal Outcome Measures® data” says Lusk.

“One of the things that sets South Dakota apart from other State systems is the collaboration with providers during the accreditation process. Having the SD DDD Program Specialist participate in the onsite accreditation really demonstrates the commitment that South Dakota has to the process.” adds Becky Hansen, former CQL Chief Services Officer.

This increased capacity for organizations to make decisions based off of their data, will put them in a better position to apply for CQL’s Person-Centered Excellence Accreditation, With Distinction. “That higher level of accreditation really has that focus on, how are you going to use the information that you’ve learned and translate that into your own quality improvement processes,” adds Lusk. This will then enhance the ability of the state to focus on a more systemic-approach to continued quality improvement.

CQL Toolkit for States & CMS Reporting

CQL’s expertise in the collection and analysis of data, is also evident in South Dakota’s compliance in reporting to the Centers for Medicare & Medicaid Services (CMS) over the Home & Community-Based Services (HCBS) regulations. The HCBS regulations provide people receiving supports and services with greater rights, choices, options and access to community-based housing, employment, activities and relationships.

CQL’s Toolkit for States was used in the development of South Dakota’s transition plan, that is required by CMS. “The CQL Toolkit for States had a significant role as we were developing our transition plan. We selected some of the most important areas within the Personal Outcome Measures® and the Basic Assurances® that would really help solidify our plan in terms of monitoring quality of supports and compliance with the new regulations” states Lusk.

Their transition plan also utilizes data aggregated from CQL’s PORTAL Data System, the electronic System for Monitoring and Reporting Technology (SMART) and National Core Indicators (NCI), to display how South Dakota Community Support Providers meet or exceed compliance with the HCBS regulations. In cases where certain HCBS requirements need more attention, the Division can use the data to direct action plans, that will enhance supports in those particular areas.

Lusk highlighted a number of factors that contributed to the Division’s success in developing a robust transition plan:

• CQL’s Toolkit for States
• Additional CQL-Certified Personal Outcome Measures® Interviewers
• Data to support the transition plan
• Working closely with the South Dakota Medicaid agency
• Providers mobilized quickly
• Public forums were held throughout the process
• The size of the state and number of people supported

CQL Consultation & Co-Occurring Diagnoses

In addition to accreditation, certification, and data-related services, CQL also provides consultation to South Dakota in the support of people with intellectual and developmental disabilities, who also have a co-occurring behavioral health or mental health diagnoses. “We really see this as a key area in developing capacity at the provider level, as well as competency within the Division” states Lusk.

CQL provided guidance and expertise in the creation of a Behavior Support Specialists certification program, assisting in the identification of partners and curricula surrounding the program. “In addition to that, the CQL consultant has helped us and assisted us in laying the foundation for the development of the Technical Assistance Center” says Lusk. The Technical Assistance Center would provide people with co-occurring diagnoses evaluation, expertise and potentially direct supports as well.

CQL & South Dakota’s Lasting Partnership

CQL and South Dakota engage in ongoing conversations about best practices and how to strengthen our work together. Once per quarter, we have a webinar that all providers are invited to participate in. South Dakota DDD participates in the webinars also. It’s a great opportunity to engage in conversation, share information and learn from each other.” states Hansen.

CQL’s expertise in accreditation, certification, training, data and consultation is utilized throughout all the quality monitoring processes in the state of South Dakota’s Division of Developmental Disabilities, from the systems-level, to the provider-level, to the individual-level. “I think over the years the partnership has continued to evolve. We really wanted to set that standard at a very high level” says Lusk, adding that “the focus is on the person and placing their goals and their outcomes at the forefront of our service delivery system.”