Quality Service Review PIP

1. Quality Service ReviewPIP

4. What to Expect • What the QSR Process was like • What we learned • What we did with the information • QIA’s

5. Quality Service Review • Chippewa/Luce/Mackinac QSR in July 2017 • Six total cases • Interviewed parents, children, service providers, courts, attorneys, and family members

6. QSR • Child and Family Status Indicators • Safety-Exposure to Threats • Safety-Behavioral Risk • Stability • Permanency • Living Arrangement • Physical Health • Emotional Functioning • Learning and Development • Voice and Choice • Family Functioning and Resourcefulness • Caregiver Functioning • Family Connections

7. QSR • Practice Performance Indicators • Responsiveness to cultural identity and need • Engagement • Teaming • Assessment and Understanding • Long-Term View • Planning Interventions • Medication Management • Tracking and Adjusting

9. Now what? • Developed a short presentation that broke down results • Identified our strengths • Identified all areas where improvement needed • Created a meeting for all staff in the tri-county to attend • Went over the results with all staff together as a group • Courtney and Harmony were present at the meeting to offer support

11. Next Steps • How do you get staff involved? • Gave our workers voice and choice • This is about quality • This is what staff were asking for!

12. QSR

13. Chippewa/Luce/Mackinac PIP • #1 Teaming: Support improved teaming through building honest and genuine relationships with parents/families and community partners • The Pre-FTM will be held and the 1160 will be provided • Caregivers (Foster Parents/Relatives) will be invited to the FTM for discussion and case planning for the care of the children.

14. Chippewa/Luce/Mackinac PIP • #2 Family Functioning and Resourcefulness: Improve family functioning, resourcefulness and safety • Parents/families will be provided with a copy of community resources • Include age appropriate children in case planning and/or FTMs • Parents will identify at least one support (family, friends, service provider-other than DHHS worker)

15. Chippewa/Luce/Mackinac PIP • #3 Voice and choice: Increase parent and family involvement as an active member of case planning and decision making • Ask parent/family what they need or what barriers they identify prior to completing the service plan/agreement • FTMs will be completed prior to completing a service agreement/case plan • F2F contacts will be maintained with parent/family • CW will provide options/preferences to parent/family in choosing a service provider

16. What did we find?

17. Findings 14+ invited to FTMs • Youth were not being invited to the case planning FTMs as they typically had a coinciding FTM and were only invited to the coinciding FTM (Semi-Annuals) • Policy changed to 11+ and not all staff/sups were aware • How do we ensure our staff/sups are up-to-date on policy? • Need to document why youth were not invited

18. Findings Decrease in Pre-Meeting • On surface it appeared to be missed, Why? • Parents were dodging or hard to contact • Recently discovered we are not having Pre-Meetings or having others invited to FTMs when parents are in jail. • Phone calls? How do we get mom and dad on the phone at the same time? • Maybe schedule the FTM around court hearings since they are out of the jail and family may be present • Other thoughts or ideas?

19. Findings • Need more education on what we are actually reading for/measuring • Worker A is amazing at documenting (teaming, engaging, voice and choice) in the Pre-Meeting. Everything on 1160 is covered but it was not documented worker handed the 1160 to the family. • Worker B gives the 1160, documents it, but does not document the discussion. • We documented to the plan not the quality we are providing. • Not the intent of the plan put in place

20. Findings • Tracked the community resource list for all cases during first two reads • Low numbers due to ongoing and foster care not providing the information to the family • Not a fault of ongoing or foster care! • Services are already started/getting started so the family is typically aware of what is out there. • The information should be provided up front to assist with voice and choice. • Added community resources to the back of the DHS-1450 • Opened the door for a conversation of services when providing DHS-1450 • Can be reference by ongoing and foster care or they can provide again

21. Findings • Stopped monitoring face to face statistics • Was not being accurately counted • Supervisors already tracked stats/MMR • QAA’s began to track

23. Our Growth-Teaming • Pre-FTM will be held: 78%-93% • Caregivers invited to FTM: 93%-93%

24. Our Growth-Family Functioning/Resourcefulness • Provided with community resources: 36% to 100% • Age appropriate children to FTM: 78%-82% • Identify one support other than DHHS: 78%-100%

25. Our Growth-Voice and Choice • Ask for needs and barriers: 60%-100% • FTM completed prior to service agreement: 97%-93% • Options for provider: 70%-92%

26. Evolution • OAG Audit • CQI Process • MiTEAM QAA • QIA’s • SCP

27. GOALS of CQI • Reduce problems • Increase/improve quality • Collect, evaluate, and report • Benchmark using best practices • Identify and implement improvements • Monitor the system of care • More of the “why?”

29. CQI-shift in thinking • Clients • Viewed as people we provide services to by court and legal mandate: to a “customer” with specific needs • Quality • Viewed as some-one else’s job: to being the responsibility of every employee • Individual effort • Viewed as balance between individual and team effort, understand being part of the process chain • Decisions • Based on “gut feeling, or history/experience”: to being based on objective data • Problems • Viewed as who didn’t follow the rule/policy/did it wrong to: identifying problems in the system and root causes • If it aint broke don’t fix it • Evolves to if it aint broke you’re not looking hard enough!

30. QIA • Audit Findings • Relative Placements • MiTEAM Sustainability • Permanency

31. QIA-Audit Findings • Team met and agreed to work on LEN’s • Send notice to newly assigned worker and MiTEAM QAA • What about redacting 154 • Training for Staff • Redaction Unit • MiTEAM QAA track the assignments and read for compliance • Was LE the RS? • What is the intent of the LEN?

32. QIA-Relative Placements • Train the Trainer • Trainings • Case Reads • Local Planning

33. QIA-MiTEAM Sustainability • New as of last week • Sent out the survey on Monday • Explained the WHY behind the survey

34. QIA-Permanency • We are one of the ten counties identified (Chippewa) • Focus Group • 22 participants attended • 5 questions boiled down to two themes • Communication • Teaming • Now what?

35. It’s a Process! • This may seem overwhelming and it is-to an extent • Understanding this is a process and it takes time • Look at our QSR-Two years in the making and we are still making discoveries. • Share the responsibilities! • We have 5 different plans right now • I kept the LEN data • Relative training is complete and WE are implementing the new protocol-Training Support • Sustaining MiTEAM: keep looking at ways to engage and team so we can assess and mentor • Permanency: It’s amazing what people can come up with together! • QSR-staff do the work, staff do the reads, I report the data.

36. “The early bird gets the worm, but the second mouse gets the cheese.”