Quality of Services:
Integration Metrics
Pilot Project
Background
 The Quality Outcomes Workgroup began meeting in October 2013
as a sub-committee of the Superintendent’s Future Systems
Transformation Workgroup. At that time the workgroup was
comprised of just five county board representatives. It was quickly
realized that broad representation would be helpful with such an
amorphous topic and a larger group began meeting in June, 2014.
The group’s primary task has been to identify and agree upon
measures of quality indicators and outcomes across developmental
disability systems in Ohio. To address the question “ What does a
quality life look like?”
Workgroup Participants:
The workgroup is comprised of a diverse group of people representing county boards, DODD,
advocates, and provider organizations. Those participating are:
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Alice Pavey, Hamilton County Board of DD
Ann Mahler, Lake County Board of DD
Beth Chambers, DODD
Billy Jo David, Summit County Board of DD
Brandy Koffel
Christine Merriman, Independent Provider
Dana Charlton, OSDA
Diana Malrose, Advocate – Hamilton County
Jaime Graham
Jeff Davis, OPRA
Jo Spargo, The Mentor Network
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Joe Russell, OACB
Kara Brown, Union County Board of DD
Laura Zureich, Champaign/Shelby County Boards of DD
Lew Hurst, Seneca County Board of DD
Linda Lehman, OACB Board Member / Allen County
Liz Owens, Privatization Support Group and Alpha
Inudstries
Marci Straughter, Advocate – Franklin County
Mary Thompson, PSG, Hopewell Industries, and LICCO
Steve Oster, Knox/Coshocton County Boards of DD
Teresa Kobelt, DODD
Phil Miller, PSG and Portage Industries, Inc.
Steps toward
operationalizing a pilot:
After several meetings which centered on philosophical
discussions related to quality, the group began to narrow the
focus. Quality initiatives already in place or in development
throughout the state were reviewed:
 Privatization Support Group (PSG) – Quality services definition
and Quality tool
 BHN Alliance – Partnerships for Quality Services Initiative
 Clearwater COG – Working with Jim Conroy on the Protocol for
Outcomes and Quality Tracking
 Provider Excellence Network – Focused on code of conduct
and values for providers
 Step Up To Quality – education system
Steps toward operationalizing a pilot
continued:
 Work completed by Ohio’s Aging System related to quality
 DODD’s Service Provider Interview Guide
 Provider certification standards as a means to
guide/develop/control quality
 Opportunities for Ohioans with Disabilities (OOD) Provider
Scorecard
 The Imagine Guidebook – Person Centered Practices: An
Approach
Credit must be extended to Hopewell Industries for its decision
to track quality outcome data beginning in 2013 for the purpose
of illustrating with the move to privatization that the quality of
services were actually improving. Hopewell’s process, which
was then carried through to the Privatization Support Group
(PSG) utilizes the National Core Indicators (NCI) Individual
Outcomes Domain to track quality outcomes. The work of
Hopewell and the PSG is the basis for this pilot initiative.
The NCI Individual Outcomes are:
 Work – People have support to find and maintain community integrated
employment.
 Community Inclusion – People have support to participate in everyday
community activities.
 Choice and Decision-Making – People make choices about their lives and are
actively engaged in planning their services and supports.
 Self-Determination – People have authority and are supported to direct and
manage their own services.
 Relationships – People have friends and relationships.
 Satisfaction – People are satisfied with the services and supports they receive.
The four key indicators for quality
service are:
 Enhance the quality of life.
 Access and participation in the greater community.
 Freedom and support to manage work and non-work time.
 Personalized opportunities with established outcomes.
The indicators of quality service can be measured by
utilizing the metrics below. The first two metrics would
be used by providers of adult day services or by
providers with work centers (sheltered workshops).
The third metric would be used for home based
services and supports. Under the list of the three
metrics are examples.
Its NOT About Scoring “5”
Everyone’s life SHOULD consist of 2 to 5 or 3 to 5 experiences
in a 24 hour day. The ratings recorded should reflect what is in
the person centered plan. The provider’s responsibility is to
encourage movement of the individual toward choosing more
integrated experiences, thus showing progress.
Answering the question, “What does a quality life look
like?” is different for everyone.
Work Indicator Section:
The provider can score a 5 for individuals who are
competitively employed in the community. The score
continues to go down with workshop or work center
activities continuing to be a last choice available but still
a valuable option for many people.
Non-work Indicator section:
The provider can score a 5 when individuals are in the
community and participating in things such as
volunteering, classes in the community, etc. As with the
Work Indicator section, workshop or work center
activities continue to be an option.
Home Indicator Section:
The provider can score a 5 when individuals are in the
community and participating in activities that interest
them where they have participation and presence. The
score continues to decrease as the level of integration
decreases for the person.
Metrics are weighted to promote level
or scope of integration (5 highest):
5
4
3
2
1
Work Indicators
Competitive Employment (use new
state database)
5
Non-Work Indicators
Community presence and
participation
5
Home based Services
Community presence and participation
Supported Employment Community
(use new state database)
Supported Employment Enclave
Works center with reverse
integration (target 30% typical peers)
4
Community participation
4
Community participation
3
2
Community trip
Work center w/reverse
integration (target 30% typical)
3
2
Community trip
Home setting 4 or less people etc.
Work center
1
Work center
1
Home setting 5 or more people etc.
Weight
Level of Integration:
Definition:
Examples:
5
Community presence
and participation
Having an individual identity with
contribution
4
Community
participation
Community trip
Participating in a community event
Kiwanis Member, Rotary Member, County Leadership
Program, Volunteer w/typical community volunteers,
Theater member, Community cooking class,
1st Friday, Jazz & Rib Festival, Theater Performance, Relay
for Life, Community Fitness class,
Shopping, Going out to eat, Zoo, Picnic, Riverboat ride,
3
Visiting, investigating and exploring the
community
Service providers achieving a combination of 3, 4, and 5 weighted indicators, by
individual, are progressing in transforming the developmental disabilities service
delivery system.
Tenants of the Quality
Outcomes Pilot:
National Core Indicators:
 The definition of quality is tied to the National Core Indicators.
 Core Indicators are already agreed upon standards.
 These standards can continue to be used across Ohio and in
comparison to other states.
The metrics are weighted toward
integration with capabilities for data
specific progress reporting:
 Individual specific
Provider specific
County specific
 Regional
 State-wide
Ability to replicate:
 Advisor workshop module
 Care Tracker
 Documentation can be merged into Excel.
 Google Form method of data collection for those without a system
Providers who have committed to the
initial implementation of the Pilot:
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Hopewell Industries, Mary Thompson-Hufford – CEO
637 Chestnut Street
Coshocton, Ohio 43812
(740)-622-3563
Email: mthompson@hopewellindustries.org
Portage Industries, Phil Miller – CEO
7008 State Route 88
Ravenna, Ohio 44266
(330)-296-2839, Ext. 3122
Email: pmiller@portageind.org
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Koinonia, Jennifer Hudak – Director of Koinonia Enterprises
6161 Oak Tree Blvd., Suite 400
Independence, Ohio 44131
(216)-588-8777, Ext. 159
Email: jennifer.hudak@koinoniahomes.org
The Alpha Group of Delaware, Inc, Liz Owens – CEO
1000 Alpha Drive
Delaware, Ohio 43015
(740)-368-5810 ext. 113
Email: lizowens@alphagroup.net
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Portage County Board of DD, Jennifer Derthick
2606 Brady Lake Rd,
Ravenna, OH 44266
(330) 297-62092
Email: jenniferd@portagedd.org
Data Collection
Melissa Skaggs of Provider Resources Group has agreed to
provide data collection and other services for the first six months
of implementation at no charge. Their role will focus on:
 Tying collected data to the National Core Indicators
 Identifying data collection points
 Training staff and agencies on how to collect the data
 Keeping the data and compiling it into meaningful reports
 Ensuring that data is consistent across providers
Data Collection Continued:
 Creating a common format to report the information
 Tying information back to ISP outcomes as much as possible
 Writing training materials
 Development of a Q&A website for participant use
Ways in which data is utilized to
affect people’s lives:
Trend lines are used to monitor quality and make program adjustments. When a
staff member’s trend line is neutral or negative, problem solving is initiated and
coaching is provided as appropriate.
Positive trend lines are discussed to capitalize on success.
Staff performance reviews are tied to data.
Conversations regarding how people are supported have changed.
Ways in which data is utilized to
affect people’s lives continued:
Staff have the opportunity to understand the increased
value of integrated supports.
Staff discuss individual outcomes in conjunction with work
indicators, non-work indicators, and home indicators.
Data can be individually analyzed or shared by programs,
creating opportunities for growth.
Integration
Tier 5 – Positive Linear
Coaching & Performance
Monitoring
Staff Reviews
Journey
 From Group Home to Apartment
 No longer has a guardian
 Works in the community
 Active in advocacy
 Directs her supports
 Transportation to work & events
 Assistance w/shopping, some meal prep
and housework
Lindsey’s Data
Charity’s Log Late 2012
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Sit further away from her.
Didn’t scratch anyone today.
Keep her away from her victims.
Don’t let her use her hands.
Charity’s Log
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Loves to shop @ Dollar Tree
Enjoys listening to a variety of music
Likes animal YouTube videos (especially baby animals)
Likes to make presents for others
Helpful in the kitchen
Charity’s Data
Questions