July 27, 2012
Below, are various items I would like to share:
- Commissioner’s Roundtable: Last week, a meeting was held with various West TN providers to discuss ongoing issues and recent developments within DIDD. Deputy Commissioners Payne and Modell attended and presented on topics such as reengineering the HCBS Waivers, staffing ratios, Protection From Harm, realignment of Agency Teams, the provider periodic review process, and an overview of the new Policy Manual. Other members of DIDD senior management team were on hand to present on topics such as licensure updates, a report on federal lawsuits, nursing home initiatives, the statewide campaign to promote awareness of persons with intellectual and developmental disabilities, Project Titan, and DIDD financial reports.
- Nurse Delegation: At the roundtable last week, one issue which came up was the confusion between nurse delegation and an exemption. Therefore, I asked Dr. Cheetham to clarify the differences.
Delegation is entrusting another person with an assigned responsibility. When a registered nurse delegates a nursing activity, safety of the person is paramount. Final responsibility for the outcomes remains with the registered nurse who delegates, and she or he also is responsible for ensuring the person to whom a nursing task is delegated has appropriate education and skills to carry out the task in that specific situation.
Medication administration is a nursing activity. In 1999, DIDD (then DMRS) was given an exemption from the requirements of the Nurse Practice Act and the Rules of the Board of Nursing to allow unlicensed personnel who have successfully completed the approved medication program to administer medications. In contrast to nurse delegation, the responsibility rests solely with the person administering the medication.
- Provider/ISC Collaboration: A provider and ISC agency in the East region have been doing great work together. Directors from Emory Valley Center and Community Network Services have been meeting quarterly for the past year to share information, discuss concerns, and think about how to provide better services for the people they mutually support. Recently, Emory Valley and Community Network Services partnered in training on the Provider Periodic Review, looking at the review process and brainstorming how to capture learning, working, and not working in daily notes. Cooperation like this helps the people we support have better lives while getting the services they need.
- First Aid Kits: The revised Chapter 11 of the Provider Manual was intended to reduce the burden on providers regarding first aid kits, both the cost and the requirement for prescribers’ orders for medications in the kits. However, this was not the result. Having reconsidered the issue, the Department will leave it to providers to determine through their own agency policy the appropriate contents of their first aid kits. Please note that if an agency does not address this issue in their own policy, then current licensure rules specify compliance with recommendations of the local chapter of the American Red Cross. As DIDD assumes its recently enacted licensure responsibility, it is intended that preference for an agency policy will be reflected in DIDD rules. Therefore, providers are encouraged to adopt their own policy, as soon as practicable.
- Greeneville Astros Visit: Several persons who live at Greene Valley enjoyed a visit on July 19 from several members of the Greeneville Astros, a minor league affiliate of the Houston Astros located in Tusculum College’s Pioneer Park. Naturally, fans needed a memento of the occasion so the young men signed team photographs for everyone. They also posed for individual photographs. During this year’s Astros visit, a gentleman fan who is a comedian of sorts was asked about his favorite musical instrument. His reply of “radio” brought forth some hearty laughter from the team and other people as well. Astros fan Joyce Lowe was thrilled to have her photograph taken with the team and indicated she would happily put them all into her pockets and take them home with her! All in all, it was a delightful visit for people who live at Greene Valley and the Greeneville Astros. The annual tradition of the team visiting began with its very first season in 2004.
- Progress, Inc. Visit: On Monday, I met with the leadership team of Progress, Inc. to learn about what challenges they face in different program areas. They also reported on their successes and goals, including having begun efforts to become CARF accredited. Progress has a strong employment program and introduced me to Robert Page, who held his last position at Harris Hillman school for 15 years. It was a pleasure getting to hear of Robert’s triumphs and to meet the dedicated team at Progress. We also enjoyed the company of Representative Janis Sontany, who has been an advocate for Progress and has served on their Board. Thank you to Donna Goodaker and the rest of the group for sharing their insight.
- Michael Dunn Center: Recently, the Michael Dunn Center hosted its first Person-Centered Thinking class. The participants included direct support professionals, house managers, residential and day coordinators, nurses, quality assurance staff, case managers, an ISC, and staff from Emory Valley Center. By the end of the class, almost everyone had some great ideas about Level One changes they wanted to try with the people they support. I visited the class on the second day and thanked Michael Dunn for hosting the training and taking the challenge about PCT training seriously. I also spoke about the importance of Person-Centered Practices as part of the Department’s goal to obtain CQL accreditation and how Person-Centered Thinkers can make a difference in the lives of people we support.
- Focus Group Event: Members are planning their first dance for September 7, 2012. It will be held from 11-2 pm in the basement conference room of One Cannon Way on the campus of Clover Bottom. Admission is free. Attendees are asked to bring snacks and cold drinks to share with others. Music will be provided by the participants. This event is open to all who wish to attend. Please come and enjoy the music and socialization. For more information, please contact Tom O’Brien in the Office of Civil Rights at 615-517-6088.
- Human Resources Conference: On August 13th-17th, Human Resources employees across the state will be attending a Human Resources conference conducted by the Department of Human Resources and hosted by Belmont University. The focus on the conference is policy and procedural changes resulting from implementation of the TEAM Act. Additionally, on August 17th, Human Resources employees will be attending a workshop conducted by the State’s Benefits Administration to learn about changes occurring in the insurance program for 2013.
- Transition Now: After thorough discussion and consultation, I’ve appointed a taskforce to support and lend extended resources to the existing West Tennessee “At-Risk Team” in their continuous efforts to move Arlington Class Members out of nursing homes into the community to experience the benefits of community living. This task force is headed by DIDD Director of Advocacy Services, Vickey Coleman and consists of several senior management team members who will lend their expertise to ensure that this very important initiative will be accomplished as quickly as possible.
- Nominations for The Linda Maurer ISC Award: Tennessee Alliance of Support Coordinators (TASC) designed The Linda Maurer ISC Award to recognize Independent Support Coordinators (ISCs) in each region who are using person-centered thinking and practices to make a difference in Tennessee. This annual award was established to honor the legacy of the late Linda Maurer, former Executive Director of Neighborhood Network, Inc. Anyone can nominate an eligible ISC using the official form found at http://www.mytasc.org/The_Linda_Maurer_Award.html. The deadline for submissions is August 31, 2012. Please send any questions and completed nomination forms to firstname.lastname@example.org.