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RC Performance Measures Workgroup Meeting - Shared screen with speaker view
Amy Wall
24:20
Si alguien necesita interpretación en español, haga clic en el globo blanco en la parte inferior de la pantalla con la etiqueta "Interpretation." Luego haga clic en “Spanish” y seleccione "Mute original audio.”
Amy Wall
28:35
Today’s materials are posted on the DDS website at: https://www.dds.ca.gov/initiative/stakeholder-events/
Marty Omoto
29:21
Nancy - Thanks for the overview so far. Can you update also how all of this connects with the rate study implementation and quality incentives program? Also how the data side of things link to the CA Health and Human Services (CalHHS) Health Data Framework efforts - thanks.
Amy Wall
29:49
La presentación de hoy se publicará en el sitio web del DDS en: https://www.dds.ca.gov/initiative/stakeholder-events/
Nancy Bargmann
30:31
Great reminder Marty - I will make sure I touch on those points today...
Marty Omoto
33:33
Those guiding principles of the CA Health and Human Services agency are important to unify the departments in their efforts toward long term services and supports, etc and to help us all to break down the silos and help all of us look at the "whole person" (or "whole child") linked to person centered services, supports and needs - and outcomes tied to that. The person centered outcomes is going to be a challenge (as Pam Scarano has said in the past) but its something we all need to work to make happen. Doing this right will help also further the issues of equity, and make sure differences with individuals, families, groups and communities are not only recognized but addressed (ie for instant, families with infants or toddlers who are deaf)
Amy Wall
36:22
Comments? Questions? Email RCMeasures@dds.ca.gov
Amy Wall
36:50
¿Comentarios? ¿Preguntas? Mande su correo electrónico a RCMeasures@dds.ca.gov
Joyce McNair
38:08
For me, the eight priority areas fall into three categories:
Marty Omoto
38:20
We need to all work to make sure that its more than just listening - but that the goals and other needs are done in a person centered process and included in all documents that direct and/or fund or authorize services including the IPP
Marty Omoto
41:55
Regarding accountability - , someone during our previous workgroup meetings asked the question if certain measures or standards are not met - what happens. Likewise, what incentives are given when measures or standards are met or exceeded? Also we need to be careful - all of us - in how we define a goal and how we measure success. Not reaching a goal or not succeeding in a goal may in fact be a good outcome. Pam Scarano and I and others have talked about this
Joyce McNair
42:08
The three categories are: satisfaction of clients and families who receive services, consumer employment, and fulfilling government mandates, i.e., fulfilling HCBS standards.
Marty Omoto
43:34
Those numbers - the data just mentioned by Mary Lou can be a part of the measures, but those are utilization and spending numbers that only tell a small part of the picture - but going back to individual person centered outcomes - how is that measured?
Jacquie Foss
43:38
Marty, you are saying everything I am thinking.. Brilliant as always
Marty Omoto
44:08
also we need to think about how implementing these measures impact the people who provide services.
Jacquie Foss
44:50
That was a mistake
Jacquie Foss
45:57
Ignore that old file, I was trying to cut and paste Martys words
Marty Omoto
46:25
I have a question and want to be put in the question que - I don't see any hand for me to raise
Marty Omoto
46:45
Just found it under "reactions"
Mark Melanson
47:58
It may be helpful for workgroup members to get an update/status report on the Provider Self Assessments and the Departments Virtual Site Assessments for HCBS compliance.
Kavita Sreedhar
49:48
Exactly Kathy !!!! Bingo ! The inconsistency is a key factor contributing to the disparity of service access
Roy Schutzengel (Elwyn) (he/him)
51:40
My definition of Quality: "Achieving the desired outcome(s) regardless of the provider or the location of service." This addresses the inconsistency in services across RC.
Kathy Sanders Platnick
53:11
One other point I should have mentioned is that a key challenge is lack of quality programs and we need to give some consideration to the roll of RCs in recruiting new providers.
Amy Wall
54:40
Workgroup Members: Please keep your comments as close to 1 min as possible if speaking to make sure we can get through all 8 areas. Longer thoughts/comments can be put in the chat to help make sure we get through the agenda. Thank you!
Sherry Johnson
56:55
All RC consumers with no or low POS, should automatically receive specialized case management that should include solid interagency collaboration( foster care, Department of Mental Health, etc.)RC's should be proactive in identifying issues consumers are dealing with, such as food insecurities, experiencing homelessness etc.Regionals Centers should develop strong relationships with community-based organizations that are on the frontline addressing the community's concerns.
Kathy Sanders Platnick
57:31
Great input Sherry. I especially like the special case management idea.
Josefina Nieves
58:41
I agree Sherry, Low/ no POS should have a different system to reach them.
Joshua Souder
01:01:24
Hi Joshua Souder here from Inland
Joshua Weitzman
01:01:31
How would you differentiate low POS for those who are receiving everything they need compared to those not getting needed services?
Roy Schutzengel (Elwyn) (he/him)
01:02:12
Consider a metric that looks at the clinical benefit (such as physical therapy hours achieved for those in need of PT) and not just the financial benefit.
Linda Plourde
01:02:27
Great point Joshua
Pamela Scarano
01:02:41
Desire for employment first yes I agree with Karen then you need to consider experience and skill set. Basic/Middle/Advanced:
Pamela Scarano
01:04:01
Basic: Volunteer/Assessment of skills/Job Exploration Middle: Development of job choice/skills set development Advanced: PIP/CIE placement
Kathy Sanders Platnick
01:04:04
I think one of the challenges in consumer employment is making people aware of the options available to them. Many people aren’t even aware of the CIE options and thus may not have expressed an interest in a job. It is also interesting to look at who can actually get employed—especially for someone with an intellectual disability.
Kathy Sanders Platnick
01:04:27
Great point Beth re Dept of Rehab.
Marty Omoto
01:04:51
Support what Beth is saying - important that everyone is responsive not just monitoring or handling a case.
Marcia Eichelberger
01:05:08
Yes Beth. I agree. Thanks for sharing.
Sherry Johnson
01:06:54
Regional Centers, training Service Coordinators on the DOR system. Unfortunately, some Service Coordinators will refer the consumer to contact DOR, but will not provide any further assistance. Additionally, some RC staff may not have knowledge of the DOR system and how the system could serve the consumer. Stronger interagency relationship with DOR.
Roxy Ortiz
01:07:05
Great point Kavita- employer training is critical
Eric Zigman
01:07:24
One of the key areas, related to performance in Employment (and Community Engagement as well) is how well the individual is being supported to broaden life experiences so that their aspirations and future goals can be defined and expressed.
Kavita Sreedhar, PRAGNYA.org
01:07:35
Thank you Roxy.
Marty Omoto
01:08:44
BUT to follow-up on the concern Beth raised - if someone is not being responsive - then what happens? How does the measurements or standards reflect that? But more important, how can the individual or family elevate the problem they are facing (in terms of someone not being responsive) so they can get the response or help needed. In other words - how do we make things happen so people are helped (and how do the measurements and standards also reflect)
Kavita Sreedhar, PRAGNYA.org
01:08:54
Exactly Eric.
Pamela Scarano
01:08:54
Is it employer training or is it really about working with employers to show how their business can be benefited by hiring individuals with different abilities that can diversify their workforce.
Jacquie Foss
01:09:18
I agree Gabriel, If a person does not know their choices, are we giving them the breadth of those options.. We say the person does not want to work but without the life experience then the person may not know they have that choice..
Amy Wall
01:09:55
Depending on what version of Zoom you have an how yours is set up - the "Raise Hand" feature will either be under the smiley face "Reactions" icon at the bottom of your Zoom screen, or you can open the "Participants Box"
Ardena Bartlett
01:10:02
I would ask the question what does employment mean? It could look different for many different people maybe the question could be what is your purpose or pursuing a purpose rather than a job so to speak. I think the conversation will be differnt
Jacquie Foss
01:10:07
Integration vs inclusion is the bigger question
Michael Pereira
01:10:09
From an employment stand point, a major issue is the dearth of local businesses to see the benefit of hiring a person with a disability or IDD. While metrics are important to establish for the individuals, and Karen M's point about the person centered approach to determining the denominator based on the desire to be employment is well taken, one of the roles that the Regional Center (in conjunction with DOR) could be very helpful in would be the exposure and engagement of the local business communities about the viability of accessing this untapped resource pool of candidates. Simple metrics and targets could be based on contact and relationship building target Chambers of Commerce, BBB, etc. Addressing an employment rate of 14% for our community will have to be tackled on all sides
Marty Omoto
01:11:19
Pam's question is a good and important one - I think its both. Efforts need to work with people in businesses in addition to employment training.
Michael Pereira
01:11:19
With respect to this topic, the integration of consumers in the community, I hope that there can be a differentiation of the concept of being "IN" the community, versus being "OF" the community
Beth Burt
01:11:37
To repeat Marty, integration needs to be person-centered. How many hours, types of activities, what kind of support, exercise, mental wellness, recreation. Needs to meaningful to that person
Kathy Sanders Platnick
01:12:25
Jacquie—great point about being “of the community.”
Ken Carabello
01:13:08
General thought - the resources needed to properly collect, analyze, design solutions for improvement and repeating the whole process should be considered and identified. To properly accomplish the benefits from performance measures there needs to be sufficient resources to properly carry it out.
Marty Omoto
01:16:33
Good point Jacquie - similar in some respects to the old discussions back in the 1960's and early 1970's about community integration (racially) in public schools and the solution then to solve that - busing that took children out of their communities. In most cases that solution didn't work . There needs to be a good understanding and balance or else we can end up implementing solutions that are harmful or counter-productive or simply do not work. Inclusion is one thing. Integration is another thing. Sometimes it can be the same thing. Sometimes not.
Roy Schutzengel (Elwyn) (he/him)
01:16:34
The metric could be something as simple as "number of community-based partnerships sponsored by the RC"
Pamela Scarano
01:16:52
I believe this gets done if vendors utilize their laison to help advertise what their organization offers
Eric Zigman
01:17:02
I think engagement in community is extremely important. If our overall goal over the first 50 years was to close large state institutions and support individuals living in what used to be called "the least restrictive" environment, what does that mean for an overarching goal moving forward (now that the DCs are closed). In my experience supporting people, it's in the "full community membership" (having REAL equal access to do what one wants and be seen as a valid member of a local community) that we see the embodiment of the core spirit of the Lanterman Act. I don't know how to "measure" that but what is called "social capital" or "quality of life" might be a place to look
Pamela Scarano
01:17:13
Like employment options and skills set training
Kavita Sreedhar, PRAGNYA.org
01:17:59
Eric - again, 100% agree with you ! :)
Josefina Nieves
01:18:39
I agree with the lady, I think RC should do the outreach to big / important agencies not only CBO. Explaining the benefit of having a client that match what they do.
Joyce McNair
01:18:57
I agree with Harry! Person-centered planning is the heart of all of these priorities.
Kim Mills
01:19:34
That is a great point Harry. It should start with the person centered plan ( a person's chosen way of life).
Marty Omoto
01:20:16
totally agree with Harry. It is foundational and helps lead to addressing the other issues and metrics. Also measurements need to reflect or measure unmet needs - that ultimately would come from a person centered plan where a service or need is not met
Roy Schutzengel (Elwyn) (he/him)
01:20:46
Recommend looking at the IHI (Institute for Healthcare Improvement) Toolkit for "What Matters to You" for older adults: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/viewer.html?pdfurl=http%3A%2F%2Fwww.ihi.org%2FEngage%2FInitiatives%2FAge-Friendly-Health-Systems%2FDocuments%2FIHI_Age_Friendly_What_Matters_to_Older_Adults_Toolkit.pdf&clen=2277407
Marcia Eichelberger
01:20:51
I agree Harry. Great points.
Michael Pereira
01:21:15
Per usual, Harry speaks truth... and if the Performance Incentives are developed well from a Person Centerd perspective, THEN the outcomes measures connected will be more easily encountered. Capacity, skill building, and embrace of what can be a philosophical shift in some respects has to be foundational.
Sherry Johnson
01:21:16
Yes Harry! Shift the system to revolve around the individual. Well said
Jacquie Foss
01:21:24
We need to get to Person Centered Agencies where the agency shifts to meet the needs of the consumer. Our current system is always about the consumer having to shift. If we ever get to the system revolving around the chosen way of life of the consumer, we might get closer to true person-centered thinking.
Roy Schutzengel (Elwyn) (he/him)
01:22:42
Page 22 of the What Matters toolkit lists specifically how you can measure the success of a program in delivering person-centered care.
Linda Plourde
01:23:08
I agree Jacquie. The consumer has had to shift in some cases, and not always in their best interest.
Joyce McNair
01:24:10
Can we receive with each handout before our workgroup meetings the guiding principles of CHHS as a reminder of what we are directed to do.
Pamela Scarano
01:24:21
Great job Harry and Marty spot on!
Roxy Ortiz
01:25:47
I agree Jacquie, we need to truly move to become person-centered agencies (systems change). It about "better lives, not better paper"
Jacquie Foss
01:26:57
Are you looking at the needs and chooses of the consumer or are we looking at a checklist ? Good points Marty, if a person has food insecurity then nothing else matters ..
Eva Casas-Sarmiento
01:28:07
A priority area I'd like to see added is one for Transparency and Accountability - data needs to be presented in easy to understand way; increase uniformity amongst RC practices and POS guidelines/publish those/make them plain language; also, increase use of DDS clarifying letters and issue plan of corrections when measures not met. Also - to achieve equity, it's necessary to look at the whole person and take a multi-disciplinary approach. Too often, we hear from consumers and families say RCs decline approval for needed services because the service is not related to the developmental disability - but for underserved communities if you do not acknowledge barriers not related to the developmental disability, you will not make progress on reducing disparities.
Kavita Sreedhar, PRAGNYA.org
01:29:34
One aspect of Person Centered Planning that we may not have discussed is that “nothing about the person without the person” - as a person centered planner myself, one emerging issue has been coming through is the family or caregivers wanting to have the plan done a lot of the time without the presence of the individual, attributing it to their inability to communicate - is there a way we can include a mechanism that the RC can track how much of the plan included the input, the presence of the individual themselves ? Everyone communicates and it is crucial to ensure the person is present for a person centered plan at least for a large portion of the time
Karen Mulvany
01:29:38
Outcomes-based Measures should always be person centered. Consumers/families that provide the input for outcomes based measures should also be empowered to access that input online as recorded in a government funded survey or assessment, and request corrections.
Kathy Sanders Platnick
01:32:20
Compliance with CBS rules is important for funding purposes and consistency, but I think this category is otherwise subsumed by the other categories.
Kathy Sanders Platnick
01:33:42
For satisfaction purposes, I’d like to see a survey go to each client at least month before their annual IPP meeting to ask for input on their satisfaction with their services. That could then provide the basis for a person centered discussion of what’s best for that consumer.
Eva Casas-Sarmiento
01:35:45
Many families of color refer to the fair hearing process as the "unfair hearing" process - overwhelming, complex, skewed in favor of RCs which have in-house experts to testify, $ to hire outside counsel, etc.
Joyce McNair
01:35:49
I agree with Ardenna whole heartedly! My daughter was denied services twice before finally allowed to enter the regional center.
Jacquie Foss
01:35:55
That means a more robust data system.. Big issue is we don’t know what we don’t know
Sherry Johnson
01:36:05
Awesome suggestion Ardena!
Jacquie Foss
01:39:11
I was just having this conversation around Deafness; it is not just about sign language but more critical is understanding the Deaf Culture. Why you should capitalize the D in Deaf is recognition of the culture..
Amy Wall
01:44:34
All WORKGROUP MEMBERS, please stay signed in to Zoom for the break to facilitate assignments to Breakout Rooms
Linda Plourde
01:44:37
So refreshing Kavita, to hear that “everyone” can communicate. It is essential that the person’s whole life/current circumstances is considered when making decisions for their future. Non verbal should not mean non communicative.
Marty Omoto
01:45:48
Hey Amy should hv Marylou mention what you said in chat about workgroup members staying on during the break
Judy Mark
01:47:33
There hasn’t been discussion of the implicit ableism that has been reported by many self-advocates. I feel like there aren’t enough voices of self-advocates in this workgroup.
Jacquie Foss
01:48:26
Agree Judy
Amy Wall
01:48:42
Sorry, my mute got stuck! yes, 2:00
Kavita Sreedhar, PRAGNYA.org
01:49:36
Thank you Linda. We have an internal theory about PRAGNYA - that you cannot “not communicate” - even when we say nothing we are communicating something and even with any form of behavioral manifestation, it is a form of communication. It is important to have the individual whom we are looking to serve have a say in their plans
Eva Casas-Sarmiento
01:51:39
Thank you all; see you in a bit
Amy Wall
04:30:48
Anyone who is NOT a Workgroup Member will be staying in the main room and having a discussion there.
Kavita Sreedhar
04:33:37
still not added to a breakout -
Kavita Sreedhar
04:33:46
pls let me know
Kavita Sreedhar
04:34:06
havent received a request
Kavita Sreedhar
04:36:39
I am not sure if I was added to my room since I didn’t receive the request to join :)
Jami Davis she/her Marin Ventures
04:47:48
LIke Jacquie said, more than half the people we support do not have active family participation
Nina Spiegelman
04:51:46
Agree w Jacquie on importance of access- is there equity in hearing about potential services available
Jacquie Foss
04:52:07
A, E and G
Sarah Verity
04:52:10
person centered planningequity in service access
Judy Mark
04:56:48
Of course, if we choose E, then it must include C and D and B.
Kavita Sreedhar
04:57:28
i got disconnected - and dropped out of my breakout room
Pamela Scarano
05:10:02
Valid points Judy
Jami Davis she/her Marin Ventures
05:11:04
Judy makes good points about IPP. This is why I believe innovation is important. RCs and agencies need support to turn this huge ship
Pamela Scarano
05:11:44
I echo your thoughts Jami
Steven Sanchez
05:14:46
That’s wrong to have Ipp without someone
Judy Mark
05:14:53
How about asking: Was the person actually at their own IPP?
Amy Wall
05:15:29
Public Poll Top 4:1) D- Person-Centered Planning (tied w/2)2) F- Consumer & Family Exp. & Satisfaction (tied w/1)3) A- Equity in Svc. Access & Purchase of Svc.4) C- Integration of consumers in the communityWorkgroup Member Top 4:1) A- Equity in Svc. Access & Purchase of Svc.2) D- Person-Centered Planning (tied w/2)3) F- Consumer & Family Exp. & Satisfaction4) G- Innovation in Svc. Availability & Delivery
Amy Wall
05:22:10
Time Check - 5 minutes until we all come back together in this main room.
Joyce McNair
05:29:08
What happened? Group A got kicked out of our discussion.
Amy Wall
05:29:42
Everyone is back in the main room now, the breakout sessions were only going until 3:10
Amy Wall
05:31:28
Reposting just in case it doesn't show for people who were in the breakout rooms:Public Poll Top 4:1) D- Person-Centered Planning (tied w/2)2) F- Consumer & Family Exp. & Satisfaction (tied w/1)3) A- Equity in Svc. Access & Purchase of Svc.4) C- Integration of consumers in the communityWorkgroup Member Top 4:1) A- Equity in Svc. Access & Purchase of Svc.2) D- Person-Centered Planning (tied w/2)3) F- Consumer & Family Exp. & Satisfaction4) G- Innovation in Svc. Availability & Delivery
Gabriel Rogin
05:37:15
Great job Roy!
Mark Melanson CCLN
05:40:47
Thank you, Diana!
Michi Gates
05:41:29
That was great Diana!
Eva Casas-Sarmiento
05:41:46
Thank you Diana!
Ardena Bartlett
05:43:10
Kaiser On The Spot survey
Ardena Bartlett
05:43:30
Thanks Beth!!1
Josefina Nieves
05:43:39
Thank you Beth!! great reporting!!!
Beth Burt
05:44:03
Great teamwork. Go team C!
Josefina Nieves
05:44:15
IUJJJJ!!!
Anthony Hill
05:44:22
Great job Team C. Catherine & Jo!
Ronke Sodipo
05:46:57
Thanks Kathy--
Roy Schutzengel (Elwyn) (he/him)
05:50:57
Appreciate opportunity to participate and to the engagement of everyone on the call.
Josefina Nieves
05:50:59
What a great day!! Thank you DDS and Group C as well.
Amy Wall
05:50:59
IF you have more info you want to share from the discussions today, please email RCMeasures@dds.va.gov
Harry Bruell
05:51:10
Thank you all - much appreciated the passion, knowledge and commitment of this group!
Kathy Sanders Platnick
05:51:11
Thank for the great input everyone. Great discussions both verbally and in the chat today!
Mark Melanson CCLN
05:51:23
Thanks all!
Diana Pastora Carson
05:51:27
Thanks, everyone! Have a great evening!
Ronke Sodipo
05:51:30
Thanks Team D-- nice meeting you all
Steven Sanchez
05:51:43
Thanks again