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May 17, 2013

Open Line

This edition of Open Line includes important information I want to share with you:

Waiver Roll-Out Meetings: In preparation for the availability of three new Waiver services, Semi-Independent Living, In-Home Day Services, and Intensive Behavioral Residential Services, the department has scheduled roll-out meetings in each region. These sessions will provide an overview of the services, approved rate information, and an opportunity for interactive dialog. Discussion will also be held relative to the national impact of the Oregon litigation against segregated Day Services. Finally, information on the new training platform with Relias/Essential Learning will be discussed. Dates and times are listed below:




June 5, 2013
10:00 a.m. to 12:00 p.m.
275 Stewart’s Ferry Pike
One Cannon Way Basement
Nashville, TN 37214

June 6, 2013
10:00 a.m. to 12:00 p.m.
2247 Western Avenue
Knoxville, TN 37921

June 7, 2013
10:00 a.m. to 12:00 p.m.
1119 Old Humboldt Rd.
Jackson, TN 38305

*The July 12 East Provider Meeting has been canceled in lieu of this meeting.

clipCommunity Visits: This past week, my wife Pat and Susan Moss visited with staff and persons supported at Progressive Directions Inc. in Clarksville. Jay Albertia, Executive Director took them on a tour of Kids Depot which provides before and after school care for elementary children. Their Early Intervention program serves children from birth to three years with a range of special needs. The next stop was the Adult Day Center where their annual May Day Celebration was in full swing with games, food, music and a dunking booth, providing everyone with an opportunity to take some time off from their daily jobs and enjoy the sunny day. Then it was back to the PDI Administrative office for lunch and sharing both by Pat and the staff. Thank you to Jay, your staff and all the persons you support. It was a great visit.

An Ounce of Prevention: This week, we want to emphasize the importance of the upcoming Waiver Roll Out meetings, scheduled for June 5, 6, and 7 (see above article). For providers, these meetings will be your best opportunity to learn about new waiver services, any revisions to existing services, and associated requirements. Your attendance and participation is an excellent opportunity to prevent future monitoring and audit deficiencies.

Accreditation Update: Four DIDD staff are in the process of becoming Certified Quality Analysts with CQL. As part of this certification process, each staff has chosen a project related to DIDD and the services provided. These projects are:

  • What data is used by DIDD and what data needs to be collected and used to measure success for the “What Matters Most” indicators used for CQL for accreditation?
  • How can families become more educated about Person Centered Thinking?
  • Will the new tool developed for ISCs improve ISPs, specifically outcomes and actions?
  • What are the provider characteristics which help promote supporting individuals and informed choice?

Department staff are currently in the process of collecting data for these projects. The projects should be complete within six months and will be finished with a presentation of the summary of findings and recommendations for DIDD based on these projects. We are certain there will be a lot learned from their work as they pursue certification to assist DIDD in the accreditation process.

As mentioned before in Open Line, the DIDD accreditation staff are working hard the remainder of this calendar year to train as many provider staff as possible regarding the Personal Outcome Measures (POM) and Basic Assurances. Positive feedback has been received after every workshop. The work done in the POM workshop can be tedious and sometimes difficult, but participants leave with a better understanding of the CQL expectations and have more tools in their tool box when doing their jobs. I can’t express enough how much DIDD appreciates the overwhelmingly positive responses and support from the provider community regarding our accreditation efforts. This is your opportunity to learn about potential system changes that will happen as a result of accreditation before they are made.

Beginning in 2014, the “official” sample of people receiving services and providers will be selected by CQL for review.

There will be approximately 420 Personal Outcome Measures Interviews conducted in early 2014. In addition, there will be approximately 35 Basic Assurances Self-Assessment Validations completed during the first six months of 2014. The likelihood of your organization being involved in some way is very HIGH.

One of the Personal Outcome Measures is People Are Respected. In thinking about respect, there are many aspects to consider. This outcome goes far deeper than looking at the day to day interactions with people. This outcome includes examining expectations we have for the people who use our services. Do we limit people because we have lower expectations of them than we do for ourselves or our friends? Do we expect people to behave in ways we feel are appropriate for an adult, but develop plans to support that behavior using childlike interventions such as stickers or smiley face charts? These are the bigger issues of respect that we need to pay attention to and support for the people who use our services. The department and our provider network now have the opportunity to determine how to best support if this outcome is present for people. We look forward to continued learning and enhancing our system so that persons supported have the best quality of lives.

Being person centered goes beyond attending the two-day Person Centered Thinking training. Person centered means using a variety of skills and tools when working with people so that we can understand what is important to people and what supports need to be in place to improve their quality of life. This involves listening to people who use our services and people who know them best to learn how they define quality of life for them. We may not define quality of life in the same way, but then we are all different. No longer can we tolerate day services programs where adults are spending time trying to put together puzzles with missing pieces, thumbing through old magazines, or moving blocks and beads around for no particular purpose. Day hours should be spent learning about people's definitions of each of the 21 Personal Outcome Measures by educating, experiencing and exploring options so that people can make informed choices such as for which jobs they would like to apply. In addition, we cannot settle for service interventions that are childish or unintentionally demeaning in nature. The people we support are counting on us the make the difference in their lives.

To learn more about the workshops and/or CQL accreditation process please contact Laura.Doutre@tn.gov.

NASDDDS Grant: The department, along with the Tennessee Council on Developmental Disabilities (TNCDD), has been awarded a grant from the National Association of State Directors of Developmental Disability Services (NASDDDS) to become involved in a five state community of practice to learn more about best practices regarding supporting families. This Community of Practice hopes to identify and share its insights every step of the way and share with the broader disability community in order to get further feedback and to also provide valuable recommendations and innovations.

The work will begin at the end of May with an orientation call for all five states and will continue for the next four years. The department and the TNCDD have a rich history of being successful partners in such endeavors and we look forward to learning how to support better lives for all Tennesseans with intellectual disabilities. The other four states selected to participate in this Community of Practice are Washington, Washington, D.C., Connecticut, and Oklahoma.

Wanda Willis, Executive Director of the TNCDD stated, “The Council is very excited and grateful that Tennessee has been selected for the family support community of practice. We have a tremendous partner in the Department of Intellectual and Developmental Disabilities. We look forward to our work over the next four years to learn as much as we can about the most effective ways to support families.”

We will keep the DIDD community updated in this exciting endeavor as we learn more details.

Employment Success Story:  As we work towards accomplishing our employment initiatives, it is important to celebrate the achievements of persons who have been successful in attaining gainful employment in the community. Susie Bourque, Director of Policy and Planning for the Tennessee Department of Labor and Workforce Development, recently shared the story of Nancy with us, as told to her by a Disability Resource Coordinator.

 Nancy came into the Disability Employment Initiative (DEI) program in November 2012 through a presentation made on the DEI and Ticket to Work program at the Friendship House of Helen Ross McNabb, a local mental health provider. Nancy did not receive SSI or SSDI and got a small amount of financial support from her family. She expressed an interest in working and asked for help.
 After an initial meeting at the Career Center, Nancy came into the Resource Room of the Career Center every Monday to apply for jobs and find out about any hiring programs. She was then enrolled into the Workforce Investment Act (WIA) and DEI programs.
 Soon after, Nancy experienced a series of personal upsets resulting in her residing at an area rescue mission and losing custody of her son. At the end of December 2012, Nancy was informed about Walgreen’s Retail Employees with Disabilities Initiative (REDI) program. DEI subcontracted with the Cerebral Palsy Center to provide job coach training required by the REDI program. An Integrated Resource Team was developed to support Nancy in becoming successfully employed. This team consists of her case manager at Helen Ross McNabb, a Vocational Rehabilitation counselor, job coach, DRC and WIA staff, and a former employment counselor.
 On March 4, 2013, Nancy entered the four-week training program and quickly stood out to management. They were so impressed with her hard work and ability to catch on quickly that they began discussing employment before her second week of training had been completed. Nancy was officially hired and began her first evening of work on April 11. Her goals are to work hard, save money, get a two-bedroom apartment and reunite with her son.

I encourage those who also have inspiring employment stories to notify Amy Gonzalez, State Director of Employment and Day Services, at Amy.Gonzalez@tn.gov. We would like to highlight some of these in future editions.

Community Conversations: Throughout this summer and fall, members of the Tennessee Works employment partnership (www.tennesseeworks.org) and local communities across the state will be partnering to host "community conversations" on improving employment opportunities for people with intellectual and developmental disabilities. A community conversation is a creative, fun, and powerful way of identifying how diverse members of a community might work together in compelling ways to solve an important challenge. The focus of each of "community conversation" will be on how we might support meaningful employment for people with intellectual and developmental disabilities living in our communities. By drawing out the best ideas of parents, educators, service providers, community leaders, employers, and ordinary citizens, communities can discover they already have the capacity to make real change in this area.

Although specific dates have not yet been set, we anticipate holding these community events across east, middle, and west Tennessee in the Greenville, Chattanooga, Johnson City, Lawrenceburg, Shelbyville, Murfreesboro, Jackson, and Memphis areas. If you live or work in these areas, please contact Sarah Harvey 615-322-4999 (office), 615-615-497-8516 (cell), or sarah.harvey@vanderbilt.edu to join the planning team or find out more about how to attend or spread the word about the event. If you would like to host one of these events in your community, you can also contact Sarah.

The Tennessee Works project was funded to build capacity and commitment across our state toward connecting young people with intellectual and developmental disabilities to meaningful jobs in their communities.

Fiscal Accountability Reviews: During Fiscal Accountability Reviews (FAR), one of the areas of focus is a review of provider documentation to determine if this documentation supports the provider’s billing for services. Generally, the reviewer selects a three-month period to conduct this part of the review. As the provider is required to have daily communication notes to document the provision of services, these notes are what the reviewer uses to verify billing. On occasions when the provider cannot produce the daily notes for the FAR review, the reviewer may accept staff timesheets as an alternative means for verifying provider billing. The acceptance of timesheets for this purpose is done at the reviewer’s discretion for exceptional occurrences rather than as standard practice. In other words, reviewers should not be expected to accept timesheets for the majority of the time period being reviewed. Timesheets, while verifying that a staff person did work for the agency for a specified time period, do not always provide the information necessary to show with whom the staff worked or the activities that occurred during the staff’s work time.

It is a DIDD requirement that providers have the required daily communication notes available for examination during FAR reviews.

DIDD Training Update: Thirty-two agencies went live this week and over fifty others are in the final stages of loading their staff into the Elevate system. Two webinars were conducted this week on next steps in the launch process. Next week, the same webinar “Your Bulk Load is Complete! What’s Next?” will be offered again. The dates and times are:

Monday, May 20: 1:00 p.m. Central (2:00 p.m. Eastern)
Tuesday, May 21: 10:00 a.m. Central (11:00 a.m. Eastern)

For agencies still working on their bulk download staff lists, click here for a recorded webinar on the topic. For your convenience, there is list of frequently asked questions about the bulk download worksheets, with answers on the right side of the screen when you log into the Tennessee Essential Learning site at http://tndidd.training.essentiallearning.com or your agency sub-portal. Please remember the last day to run reports or work in CDS will be Friday, June 21 unless you negotiate your own contract for their content and services.

East Planning and Policy Council (EPPC): The EPPC has an unexpected vacant seat. We are looking for an individual who is an advocate for children with intellectual and developmental disabilities.
The interest form is available here. Please submit it to Jennifer Pfeiffer at Jennifer.Pfeiffer@tn.gov if you are interested by June 14, 2013. The Council meets in Knoxville quarterly, with the next meeting set for July 11, 2013. Information about the Council is on our website under the link “DIDD Planning and Policy Councils” on the main page if you would like to learn more. I appreciate all those who are willing to volunteer their time.

Statewide Planning & Policy Council (SPPC) Annual Report Update: Per the TCA, the Statewide Planning and Policy Council (SPPC), in conjunction with the Commissioner, reports annually to the Governor. The SPPC submitted their 2012 annual report to the Governor in December 2012 and also offered specific recommendations to DIDD. The department’s leadership has responded to those recommendations and you can find those responses here.

Middle Tennessee Residential Vacancies: Every two months, the Middle TN Regional Office (MTRO) Compliance Unit sends a Residential Vacancies grid to providers who have previously expressed an interest in submitting information about vacancies they have in their residential programs. Providers are asked to submit information about roommate vacancies they may have. All information received at MTRO is placed on the vacancies grid and sent to ISCs, the MTRO Intake Unit, Transitions, and interested providers. If your agency would like to participate or needs additional information, please contact Crissonya Phillips, MTRO Compliance Director at 615-231-5092 or Crissonya.Phillips@tn.gov.

clipGreene Valley: Greene Valley is a Partner in Education with Chuckey Elementary School and for many years has sponsored an end of the year reward trip for a most improved student from each class. The bright side for some who live at Greene Valley is that they met the students and participated in some co-shopping with them. Everyone gathered this year at the local Kmart to spend their gift cards and enjoy each other’s company.

Larry, Billy, Michelle, Tracy, and Melissa also received a gift card so they too could make some impromptu purchases of their own. Groups were formed and the Kmart store was buzzing with excitement as everyone raced towards shoes, clothing, and toys. This was clearly a win-win trip for the Chuckey Elementary students and those living at Greene Valley.