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La presentación de hoy se publicará en el sitio web del DDS en: https://www.dds.ca.gov/initiative/stakeholder-events/

Today’s materials are posted on the DDS website at: https://www.dds.ca.gov/initiative/stakeholder-events/

Comments? Questions? Email: QualityIncentives@dds.ca.gov¿Comentarios? ¿Preguntas? Mande su correo electrónico a QualityIncentives@dds.ca.gov

Is it your opinion that the RCs won’t be involved in working with the consumers development of the Person Centered Plan? Since it should be the driver of their chosen services and supports..

On the HCBS compliance issue, does this mean that providers who are not HCBS compliant are ineligible for incentives?

With # 1 shouldn’t it be for every person in Residential , SLS, ILS etc... receive preventative? Is it narrow for a reason ?

Direct link to discussion document: https://www.dds.ca.gov/wp-content/uploads/2022/04/Handout_Quality_Incentive_Program_Workgroup_April_2022.pdf

the outcomes on the left are all related to residential facilities. what about non-residential / non licensed settings?

Is it also giving you time to set up the software for collection?

How many people are we talking about in these settings?

coordination of data would be helpful!

I think the challenge is the software, some providers already collect this date, others do not have a software system. Is there a plan for DDS to have the software ?

Thank you for the comparisons. In terms of access to services in rural and urban areas, is there any collaborative work being done with other entities in prevention/wellness? For example, a bill recently went up to look at funding/increasing accessibility of dental offices to better serve people who have I/DD? Some dental providers are challenged by rates paid vs specialized services and sites.

I think it might be good to get a few comments now. Employment is really different.

It's actually 1/10 of a percent of consumers.

Great question Pablo

When we look at the funnel strategy, do we have a cost model forecasted/associated with narrow to broad? In terms of measures, when we look at social determinants of health there are certain "levers" that have an exponential impact on other health measures. Is there a plan to try to measure this overall health care savings?

What Pablo raises is a critical issue. We discussed this for early intervention. We don't want programs to lose 10% if they don't meet the incentives. How do we help programs get better if we take away their funds. There needs to be a support program to help agencies meet these incentives.

I agree with Tania, social determinants of health are a good way to identify barriers that might exist..

For prevention and wellness, Patricia Deegan has done some innovative work which might be applicable in terms of quality of life from a personal, lived experience view.

I really appreciate Pablos’s comments/questions and his representation of the early intervention community. After decades of underfunding it would be catastrophic to take away 0-10% of funding out of the gates…there must be remediation and even a grace period to allow adequate funding (finally) to do the job we all expect it to do, which is improve quality.

Curious about the grouping. Why 10? Would we see placements just to meet the number to get the incentive? Not based on the best job match.

I am a bit confused. My understanding about the quality incentives is that they were being developed now for the 2024/5 years. Are we talking about incentives beginning before that? For many agencies, the 10% is a huge amount and having time to prepare for these incentive measures is very important.

Is the CIE/PIP incentive program similar to what is occurring now ?

all good Qs from Jacquie and Mark. and to Tania's points, providing incentives to providers when the person is employed for 30 days may incentivize providers to help people find jobs . . . that will last 30 days (rather than trying to find a really good match for the person through the job discovery process)

Agreed, very complex process which will need to start somewhere and evolve with time and the understanding of (intentional and unanticipated) impact. Thank you all for your work and ongoing input.

Excellent News Nancy! Thanks for clarifying.

Timeliness seems more like a regional center incentive than a provider incentive.

Thank you Mary Lou

how is this provider vacancy rate calculated?

To me, having vacancies does not necessarily mean a provider is not doing well - or vice versa. This should be more about a person's outcomes, not the provider's.

Translation for Rubi Saldana 02:20 PMWhy do we have such a low standard in the first place? Personally, I'm not thinking of my children working for anyone, on the contrary, I don't even agree with the incentives? Why Incentives? For putting my children to clean. Or in a humiliating job? Can we be proactive? That strategy has not worked for years.

https://www.supportedliving.com/resources/Documents/The%20DSP%20Staff%20Competitive%20Wage%20Matrix%20-%20A%20Market%20Rate%20Analysis%20of%20%20DSP%20Staff%20Compensation%20-%20Published%201-24-2019.pdf

yep

lol

NCI is a great way to start but is there a way to do a deeper dive into some CA data associated with these outcomes during NCI data collection-a subset of questions?

yes, and the sense of loss of privacy

Continuity and consistency are not an indicative of quality.

great question

I just do not feel this should be tied to our incentive... it is a nationwide problem. I think it is important to assess what the clients' staffing needs and satisfaction are, but to tie our funding to something out of our control

nationally some providers are also struggling with wages for DSP's and attracting new employees with sign on bonuses. The same providers-faced with a small bump in rates have not been able increase wages of experienced long-term DSP staff who suffer from wage stagnation.

The two helpful initiatives from last year bilingual pay and DSP training will hopefully be implemented

The staff stability survey should be mandatory. As an employer it is all information that is already reported to the state.

will people with ID/DD help train?

This requires a much bigger , focused conversation

lol

i do think we could create a survey

Great help would be to discuss with the Department of Education to get a lot of the workers loans be free after they work for 10 years. Not only for non-profits. DDS could certify the work done as “public work”. It happens for employees that are working with the school districts and is a way for them to retain employees. It will lead to carrier progress within DDS work environment.

The PAVE collaboration should also be in the Staff Development section. DSPU. Training is a large component of PAVE.

Person Centered Active Supports.

PAVE is great. I have complete confidence that the PAVE group is the best group so tackle those questions. Always ready to help.

Is the date of the referral or the date on the IFSP? Or is the day the POS is received by the provider? We need clarity on it. Also, will the providers know what their baseline know their “score” as it is happening in a place the providers can see it?

Nancy, Pete and Mary Lou and rest of the DDS: Thanks for developing the goals and a framework. It is a great start. It is a very complex process, but we have now some framework to use and perfect.

@Pablo--there is authorization, referral, acceptance, and receipt of service. We will need help with defining the appropriate timeframe for the measure, mindful of the "considerations" on the much earlier slide, including attribution.

@Pete: We will support providing more guidance on the Early Start. Have to go to another meeting!

PAVE: Person-centered, Advocacy, Vision and Education

Pablo and I are happy to help determine the dates for early start that we can use for when a referral is received and how to measure the 31 days. The Regional Center has the 45 day timeline for assessment and IFSP development. Then they refer to the program. If the program accepts the referral the 31 day clock should start.

@Sheri Rosen thank you for the offer- we will be happy to talk with you about the details.