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Self-Determination & Individualized Funding

Self-Determination & Individualized Funding. Can We “Trust” Consumerism, OR Is “Regulation” Necessary?. Considerations for External Monitoring. Public Money is Being Spent Basic Health and Safety Responsibilities Legal Moral Vulnerable Population Recent Situations CA, DC, etc.

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Self-Determination & Individualized Funding

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  1. Self-Determination &Individualized Funding Can We “Trust” Consumerism, OR Is “Regulation” Necessary?

  2. Considerations for External Monitoring • Public Money is Being Spent • Basic Health and Safety Responsibilities • Legal • Moral • Vulnerable Population • Recent Situations CA, DC, etc. • Short Track Record for SD/IF

  3. Monitoring Possibilities • Federal Rules, Regulations and Inspections (ala HCFA) • Local/Regional Licensing • “Program” Process Certification • External Accreditation • Accepted Quality Indicators • Local Ombudsman/Advocate • Some Combination of the Above

  4. Sometimes We Feel A Bit Like This “I have met the enemy, and he is US!” Pogo, Walt Kelly

  5. National Accreditation • Not “Regulatory” - Not Rules • External, Impartial Observation • Standards = Quality Indicators • Focus on Results/Impacts in Life • Quality Improvement Structure • May Provide Information for Informed Choice/Decision Making/Service Access

  6. Implied Information • A Commitment to: • Consumer Partnership • Available Service Results Data • Qualified/Trained Staff • On-going Quality Improvement • External Observation • Efficient, Effective Resource Use

  7. Real Information • Access to 25,000 Services • Access to 100,000s of Direct Service Professionals • Consumer Information Products • Consumer and Family Guide to Quality Services • Using Individual Centered Planning for Self-Directed Services • How to Choose a Provider

  8. Possible Combination of Monitoring Activities • “Deemed” Status • Initial Service Licensing Compliance • Achieve National Accreditation • Absence of Formal Public Allegations • Consumer/Family/Funder Satisfaction • Annual Re-licensing - Waived or Reduced • Local “Hotline”, Emergency Response, Technical Assistance, Problem Solving, Complaint Resolution, etc.

  9. There are NO Guarantees! • Abuse Can Happen in ANY Setting • There are “Good” People and “Not-So-Good” People • There is always risk in everything • Information/Experience/Planning Minimize the Risks and Danger “Be Prepared!”

  10. What Do You Think? • How do we balance risk and responsibility? • How do we balance informed choice and concerns of well-being? • How do we stay out of the way and offer some protection to all the parties?

  11. Audience Comments/Answers • Can SD and accreditation co-exist? • What is an appropriate role for accreditation (Carf)? • A Natural tension between SD, Individual Choice, and accreditation is healthy - we may need new assumptions for a new service delivery system?

  12. Audience Comments/Answers • Some states use a multiple approach to QA - in concert with one another. • Regulations/standards are not necessarily in line with consumer preferences - they should be! • Paper on the wall - certificate - doesn’t assure safety!

  13. Audience Comments/Answers • Emphasize the local consumer component of any accreditation system. • Consolidate/simplify systems. • SD is about “relationships” any system needs a focus on people. • SD will sort out “bad” supports.

  14. Audience Comments/Answers • Current confusion between funding and regulation roles. • Some regulation, auditing or accountability is necessary - the question is how much and what kind.

  15. For More Information Contact: CARF Employment and Community Services Division, 4891 East Grant Road, Tucson, AZ 85712 Phone (520) 325-1044, FAX (520) 318-1129, Dale Dutton, x 133, or Paul Andrew, x112 Internet addresses: http://www.carf.org email: pandrew@carf.org, or ddutton@carf.org

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