As Promised! Follow-up Items from the Regional Calls

June 09, 2021

There were definitely some common themes:

• Competencies -There is still a struggle with trying to comply with the competencies, both initially and long term.  Our conversation, and we can have this conversation again on the call this Friday was two fold:
  • First, for those skills which must be judged “competent” before the individual can work alone, the provider needs to assess their existing system of onboarding and training.  It is highly likely that a “competent” provider organization has in place all of the training, supervision, shadowing, OJT requirements to insure that staff are able to perform the assigned tasks before they are asked to do so without direct supervision.  Think of the “competency” form as just an added method of documentation for you existing practices/protocols/procedures.
  • Second, all staff who provide direct services are required to be proficient.  Proficiency is, therefore, the bare minimum of performance.  Is someone falls below the bare minimum, it will (or should) warrant some type of corrective action/disciplinary action/counseling memo.  The expectation is set that they need to be back to baseline within 7 days.  If there is a repeat within three months (which cannot be rectified as a part of disciplinary action within 7 days) then you would have the documentation to terminate the employee’s services.  We make an assumption that a performance failure sufficient to have a provider stop billing for services is substantial and perhaps warrants firm and decisive action.  We also make the assumption that absent disciplinary proceedings it will be very difficult to explain in the unemployment hearing that the individual was separated because they were “competent, but not proficient” at their job.  Proficiency has become the bare minimum!
    
    
• Supervisory Training – We (along with the able help of many of our members) have submitted comments;  to date there has been no formal response, but we’re hopeful.  In the meantime, the three modules are posted on the DD/DOJ Member’s page for your information.  This will give you the opportunity to advise new supervisors that much of the information is not relevant to thier position and/or in conflict with agency policy.
  
  
• HCBS visits – There are a number of issues and concerns which we will discuss during the next meeting when an update is given – the lack of coordination among the multiple site reviews. 
  • The documentation required includes material that would be provider specific but would not vary by site.  Instead of asking for documents to be uploaded for each round, once should be sufficient! 
  • It is unclear if records for all individuals served, all served in January 2020, or selected individuals in settings serving more than one, are being requested.  If for all individuals, the volume of material is truly overwhelming!
  • Every provider who made this part of the discussion at the meeting commented that during the day selected for the Desk Audit (when a staff person needed to be available for the entire day to answer questions), no call were received or questions asked.  It was, however, obvious from the report that some material uploaded was not clearly understood.
  • It was also asked if “virtual” was being done at the convenience of the reviewers rather than in accordance with safety protocols.
    
    
• There were multiple comments/discussions about the continuing pressure on providers from the layer upon layer of oversight and regulatory activity, frequently redundant reviews of the same service/event or incident which appear to have no coordination!