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Quality Assurance Webinar

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Learn more about our amazing Quality Assurance Department here at Support, Inc.! We discuss why having this department is reassuring for the people we serve, their families and providers. Not all agencies have a QA department and we know that good quality is good care. We strive to work with families within the rules and regulations to provide a person-centered approach to each unique situation we encounter. Today, we discuss the goals of the department and how our employees keep the people we serve safe out in the community.

 

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Quality Assurance News & Updates- Fire Preparedness

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To all Support, Inc. Network, Staff, Providers and Families,

Wildfire season has started in Colorado. This year with the hot and dry weather most of the state is under moderate to high risk for fires. Just this month three fires have erupted along the front range. It’s important everyone be fire aware and be prepared. For more information on how you can prepare for wildfires follow this link.

Each county has an emergency notification system. However, you are not automatically signed up for alerts and must opt in. Some counties have switched notification platforms, and you may no longer be signed up to receive alerts. We encourage everyone to sign up for or check that you are signed up for emergency alerts in your area.

County Emergency Alert Sign Up
Adams Use this link to sign up
Arapahoe Use this link to sign up
Boulder Use this link to sign up
Broomfield Use this link to sign up
Denver Use this link to sign up
Douglas Use this link to sign up
El Paso Use this link to sign up
Elbert Use this link to sign up
Jefferson Use this link to sign up
Larimer Use this link to sign up
Logan Use this link to sign up
Morgan Use this link to sign up
Phillips Use this link to sign up
Pueblo Use this link to sign up
Sedgwick Use this link to sign up
Summit Use this link to sign up
Teller Use this link to sign up
Washington Use this link to sign up
Weld Use this link to sign up
Yuma Use this link to sign up

The air quality around the state has been poor from fires locally and around the United States. Smoke originating from fires or poor air quality can negatively impact all individuals but is especially hazardous for those with compromised respiratory conditions such as: asthma, COPD, lung cancer, cystic fibrosis, and any other chronic or acute respiratory conditions. Everyone, especially people with respiratory issues, should take precautions. Keep all windows in the home closed, reduce or limit outdoor activities, run air purifiers if you have them. It is recommended that sensitive groups wear a mask if they must be outdoors.

If your respiratory symptoms are exacerbated, please reach out to your primary care physician.  Always make sure you have access to respiratory rescue medications such as rescue inhalers (example- Albuterol) if ordered by your physician. Always follow current evacuation orders. If you are experiencing respiratory distress, call 911. IQAir can be a helpful tool in monitoring air quality in your area :https://www.iqair.com/us/usa/colorado

Finally, if you have any questions or need support please don’t hesitate to reach out to info@supportinc.com. If you need assistance after-hours please call on-call at 720-841-3122.

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QA Department News & Updates

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Over the Counter (OTC) Medications:

We would like to give a reminder about over the counter (OTC) medications. This could include scheduled medications such as Zyrtec, Claritin, Vitamins, eyedrops or it could be as needed (PRN) medications such as Tylenol, Ibuprofen, Neosporin, etc. When purchasing these items for the person(s) you support please make sure you label the medication and the box with the person’s full first and last name. Because these items usually aren’t being filled by the pharmacy they will not come labeled with the person’s name. The labeling of these medications is a regulatory requirement.

For PRN medications, if the person(s) you support has a prescription medication ordered PRN, such as inhaler, rescue seizure medication, etc. you need to always have these medications available in the home. For over-the-counter PRN medications such as Tylenol, Robitussin, Milk of Magnesia, etc. we do not expect you to have these available in the home. These over-the-counter medications are likely to expire before you need to use them, and they are easy to get when they are needed from any local grocery store or retail pharmacy.

Please reach out to info@supportinc.com if you have any questions.

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QA Department News & Updates

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Changes to the individual service & support plan (ISSP):

If you’ve joined our provider town hall meetings you’ve heard about the many changes happening in the IDD system in Colorado. With all these changes, our regulations also needed to be updated. While there are many changes to our regulations, we want to take some time to talk about one major change to the individual services and support plan (ISSP) goals. Case Managers are no longer required to add ISSP goals to the service plan. Additionally, provider agencies are no longer required to develop and track formal ISSP goal programs. This has been a core function of the IDD system for many years and will take us some time to fully phase it out of our operating practices. We are still required to demonstrate that we are supporting people to achieve their goals. We will be doing the following over the next several months:

  1. We will work to discontinue current ISSP programs.
  2. We will stop checking ISSP requirements as part of our internal auditing beginning March 2024.
  3. By June 2024, we will solidify a plan to address how we demonstrate supports being provided to help people achieve their goals.
  4. We will remove the ISSP requirement across our internal tools over the next several months.
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Quality Assurance News and Updates

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As summer ends and cold weather settles in so comes cold and flu season. Colorado has also seen an increase in COVID-19 cases. Protect yourself, the person you serve and your family. As a reminder, please do not send people to work or day program if they are sick. If people arrive to day program/work showing signs of illness, you will be asked to pick the person up.

Healthy habits to help protect against illness:

  1. Avoid close contact with people who are sick.
  2. Stay home when you are sick. Please do not send people to work or day program if they are sick.
  3. Cover your mouth and nose with a tissue when coughing or sneezing.
  4. Wash your hands often to protect yourself from germs.
  5. Avoid touching your eyes, nose and mouth.
  6. Practice other good health habits such a cleaning and disinfecting.
  7. Getting a flu shot and COVID-19 vaccine. Contact your primary care physician, local pharmacy or use Colorado’s get vaccinated website to find vaccine providers near you.
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Tips and Tricks to Beat the Heat!

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After a long cool spring and early summer, Colorado temperatures are heating up fast and it’s important to protect yourself and the person you support from heat-related illness. When possible, stay inside during the hottest parts of the day. There are some things you can do to keep the interior of your home cool such as, block direct sunlight by using window shutters or awning and keeping thermal curtains/blinds closed, increase airflow in the home by using electric fans and opening windows during the early morning/ late evening, using air conditioning and monitoring the indoor temperature. Heat related illnesses are preventable, knowing the signs to look for a responding quickly can prevent a minor illness from becoming a medical emergency. Common heat related illnesses include: heat rash (a skin condition caused by blocked sweat ducts and trapped sweat beneath the skin), sunburn, heat exhaustion (a condition that happens when your body overheats) and the most serious of heat related illnesses heat stroke (occurs when the body can no longer control it’s temperature causing the body’s temperature to rise rapidly and become unable to cool down-requires immediate medical care). To learn more about these types of heat related illnesses, how to identify signs and symptoms and what to do click here.

Tips to prevent heat related illness:
1. Stay indoors, in a cool place during extreme heat.
2. Drink plenty of water. Dehydration is the primary cause of heat exhaustion. High temperatures increase the risk of dehydration.
3. Apply sunscreen every day. Reapply sunscreen every 2 hours throughout the day especially if you’ve been swimming or sweating.
4. Wear lightweight, light-colored and loose-fitting clothing.

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Quality Assurance News & Updates

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Coming July 2023: New Relias Training Plans.

At the end of 2022 we began an organization wide training project. This project included cleaning up our Relias (our E Training platform) system, reorganizing Relias hierarchies, developing a backend connection between Relias and ADP (our payroll and HR management system) and redesigning our training plans. We have reorganized our Relias hierarchies to assure each employee and contractor was attached to a supervisor. The Human Resources (HR) team is in the process of changing all employees and contractor’s usernames to align with ADP ID numbers. If you have not yet received your new Relias login name, please contact your supervisor. The HR team is also making the final backend connections to integrate ADP and Relias. The final piece of this will be rolling out the new training plans. We have developed new training plans based on job title in an effort to ensure new employees and contractors joining the organization receive training relevant to the work they do. We also streamlined annual training requirements for all positions. The new training plans will be rolled out in July 2023. Watch for emails from the Quality Assurance (QA) team with an official go-live date and a comparison of the changes based on your job title. If you have any questions please reach out to your supervisor, the HR team or the QA team.

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Upcoming Therap MAR Module Changes

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On May 14th, 2023, Therap will be planning to make all MARs older than one month read only. This will be a temporary adjustment while Therap works on the application behind the scenes. During this time, you’ll be able to view the old MARs, but no changes or edits can be made to a MAR created from March 2023 or older. April MARs can be edited, andthere will be no impact to the current and future MARs.

Tips and tricks to maintaining the person you support MAR:

1. Ensure you log medication administration on the MAR within the 1-hour window. This follows Support, Inc.’smedical administration policy and provides documentation that the person you support receives their medications as they are ordered.
2. After attending a medical appointment, please submit consultation forms and any order changes within 24-hours of the appointment. This ensures your MAR is always updated. During Therap’s update the nurse team has a narrow window to update MAR’s with order changes.
3. When you create the MAR for the new month, go line by line to verify the medications you have in the home match the MAR. Pay close attention to medication strength on the MAR vs what the pharmacy has provided you. For example, if the MAR says furosemide (Lasix) 20 mg tablet, take 1 tablet daily by mouth but the pharmacy has provided you with furosemide (Lasix) 10 MG tablets, take 2 tablets daily. If you identify any discrepancies, please contact your RPC immediately so the MAR can be corrected.
4. On the 1st day of each month, pull up your previous month’s MAR and double check you have signed off for all medications, treatments and logged all controlled drug counts. Sometimes we go back and realize Therap didn’t save our work so this is a great habit to adopt to double check the MAR is complete before the new month starts.

If you have any questions, concerns or need assistance please don’t hesitate to reach out to your Residential Program Coordinator.

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Quality Assurance- Federal Final Settings Rule Series

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In 2014, the federal Centers for Medicare & Medicaid Services (CMS) published a rule requiring home- and community-based services (HCBS) to be provided in settings that meet certain criteria. The criteria ensure that HCBS participants have access to the benefits of community living and live and receive services in integrated, non-institutional settings. Colorado has been working towards this transition for several years as CMS extended the transition period. The final transition period is March 2023 when all providers need to demonstrate full compliance with this rule.

Part One of our communication series will focus on person-centered practices.

Person-centered practices puts the person receiving HCBS services at the center, focusing on that person’s goals, values and the life they want to live. Through person-centered service planning, the team listens to what the person wants and tailors services and supports to meet that person’s goal. This is a change in how service planning often was in the past, when paid supports would voice what they felt the person should be doing. Through person-centered practices we give voice back to the person receiving services, recognize them as being the director of their lives and use services offered to them through paid support to meet their life goals.

Home and community-based services Comparison Chart
Traditional vs. Person Centered home and community based services

For more information from CMS about person-centered planning, follow this link to a slide deck presentation.

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Quality Assurance Updates

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Support, Inc. utilizes continuous quality improvement as an ongoing effort to evaluate our services, systems, and processes to identify problem areas and opportunities for improvement.  One of the ways we employ continuous quality improvement is through regular auditing completed by the Quality Assurance Department. These audits allow us to review service delivery and quality of care to the waiver participants we serve. Recently we redesigned our file review tool to bring all Support, Inc. services and departments into quality auditing practices. We are calling our new tool the mock audit. The mock audit is designed to mimic a CDPHE (Colorado Department of Public Health and Environment) licensing visit. CDPHE is required to survey every service agency in Colorado every 3 years.

Utilizing our own mock audit allows us to assess areas that need improvement while also identifying areas we are exceeding. The mock audit will also allow the Quality Assurance department time to prepare our internal teams and our providers for a CDPHE visit. As part of the mock audit the Quality Assurance Department, in conjunction with the Residential Program Coordinator will complete a site visit to the residential settings represented in the sample.

The site visit will cover a review of the key areas CDPHE assesses when they do their visits. This includes review of medications, review areas of health and safety of the participant, and ensuring the provider understands the support needs outlined in the service plan of the participant(s) they serve.

In addition, if the participant attends the Support, Inc. day program the Quality Assurance team will do a site visit. The day program site visit will review medications, areas of health and safety of the participant, compliance with regulation required inspections and ensuring the staff understand the support needs outlined in the service plan of the participant(s) they serve.  It is the mission of the Quality Assurance Department to engage all Support, Inc. employees and contractors in the planning and implementing of ongoing improvements while utilizing data to improve the quality of care for the individuals we serve. We look forward to starting mock audits in June; if you have any questions, please do to hesitate to reach out to Laura Viers at Laura.Viers@supportinc.com