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Does participating in the licensing of providers increase a county's liability?

DHS still has the final liability for Region 10 QA opted in counties for they continue to be the final license issuer. However, all counties, regardless if they are using VOICE or the traditional DHS licensing systems, have the responsibility to ensure that providers are meeting quality standards in their county. By opting into Region 10 Quality Assurance and using VOICE, counties play a more active role in the assessment and licensing of their providers. In the past 10 years of using the alternative licensing system through VOICE, there have been providers and Quality Circle members seeking appeals on VOICE Review Action Plans and Licensing Recommendations. In all cases, these issues were resolved through the Quality Assurance Review Council and not at the DHS or county court levels.

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What is QA?

The Quality Assurance Process for persons with developmental disabilities is:

  • A way to assess the quality of life (are people having good experiences and are people happy).
  • A way to assess and monitor the quality of support (are support providers giving people the kind of support they need based on what is important to each individual).
  • An alternative licensing system that makes licensing recommendations to the State of Minnesota.

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What does QA do?

The QA Process:

  • Promotes and encourages quality improvement in the support services to persons with developmental disabilities
  • Encourages and challenges the whole system of supports to look at individual choices and needs and provide supports based on each individual's choices and needs
  • Uses VOICE (Value Of Individual Choices and Experiences) a person driven process developed by the Stakeholders to assess the person's overall experiences and to assess provider contributions. Trained review team members (Stakeholders from Region 10 Minnesota: persons receiving support, family members, advocates, providers, and case managers) interview persons receiving support services and talk to family, friends, support providers and case managers. Findings are given to reflect the person's overall experiences in his or her life and to reflect how the support providers are doing at supporting the person based on his or her choices and needs.

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Why is QA important to me?

  • If you are a person receiving support services, you might be selected to have a VOICE Review. Having a VOICE Review is a way by which you and the people that support you (your quality circle) can review what is important to you and if the support provided to you is what you want and need in your life. You are given an opportunity to get your VOICE heard. Through interviews, the review team is able to identify what is going good for you and what you might want changed based on what is important to you
  • Based on findings from your VOICE review, Action Plans may need to be developed. You and your quality circle will work together to identify the action you and/or your family want to better support you reflecting your choices and needs.
  • You can request a review to be done. If you are a person receiving support services through a participating county, (Fillmore, Houston, Mower, Olmsted, and Winona) you can call the QA Manager and request a review to be done
  • If you are a family member, advocate, conservator, support provider or a case manager, a VOICE review is a good way to assess if the quality circle is supporting the person as the person wishes. It is a way to get your VOICE heard as to what is working well and what needs to be improved in order to better support the person

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Who is the QA Commission responsible to?

The Region 10 Quality Assurance Commission is responsible to the Minnesota State Legislature and the Region 10 Stakeholders -including- persons receiving support services, family members, conservators, advocates, support providers, county and state representatives.

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How can QA do licensing?

Through the Minnesota Legislature, the QA Commission has been authorized to develop and implement an alternative licensing system. Using VOICE, the Region 10 QA Standards, and the protective standards, the participating counties have an agreement with the state to carry out licensing functions. The counties that are participating have hired a Quality Assurance Manager to coordinate the reviews and to staff a county review council. The county Quality Assurance Review Council (QARC) is made up of Stakeholders from Region 10 - Minnesota. The QARC makes licensing recommendations to the county and the county makes a recommendation to the State of Minnesota.

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How is the Region 10 QA system different from the traditional system?

1.     In a traditional licensing format, people and families receiving support are not always participants in the process; the focus is on a minimum standards and external requirements. Through Region 10 Quality Assurance, licensing of support providers is based on findings from individual VOICE reviews. Individuals and families receiving support are given a VOICE and are key players in the process; indeed, they drive the process. The Quality Assurance Process enhances the quality of life for people and encourages continuous improvement in the support system.

2.     Traditional systems do not include quality evaluation of county case management services as well as unlicensed supports such as schools. This alternative approach evaluates all elements of the support system and brings recommendations to all quality circle members regardless if they are licensed, unlicensed or a county, state and federal agency.

Through this comprehensive approach, the Region 10 Quality Assurance System combines three types of quality review processes, which are traditionally separated:

  • quality assurance to evaluate whether individuals are receiving appropriate supports and services;
  • quality improvement to assist specific providers, groups of providers, and the system as a whole to help individuals achieve better life outcomes; and
  • licensing of programs that use public funds to support individuals with developmental disabilities.

Combining these efforts reduces redundancy in regulations and shifts the system into a process of continuous feedback and improvement. The process encourages providers to develop new and more effective means of support while assuring that basic safety and welfare are protected. It also provides a comprehensive and current overview on how well the system is working.

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How does the QA keep the level of volunteerism going?

Volunteers are vital to the Region 10 QA Commission and VOICE Reviews. Volunteers serve on the Commission, Quality Assurance Review Council, and various Commission Committees and as Quality Assurance Team members that conduct VOICE Reviews. Several factors aid QA in finding and retaining volunteers. Since QA was developed by the Region 10 Stakeholders, there is a strong commitment by the Stakeholders and they encourage many people to start volunteering. Once people begin to be involved in QA, we find that they grow to believe in the process that has been developed, see actual improvments in other people’s lives and so continue to make a commitment to give of their time. Support providers and counties give in-kind contributions of staff's time because they see this process makes a difference in a person's life, it encourages communication and coordination and it is good professional learning experiences for the staff that get involved. Persons receiving support, family members, advocates and other community members feel this process gives people a louder VOICE and is making a difference. Stipends are given to people who are not paid thorough an agency for their time to complete a VOICE review.

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What is the Stakeholder group?

The Region 10 Stakeholders are a group of people who volunteer their time. They meet on a quarterly basis and work to improve the support system for persons with developmental disabilities. Stakeholders are people who receive support services, family members, conservators, advocate, interested citizens, support providers, county representatives and state representatives.

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Are the stakeholders elected or how does a person get involved?

There is NO election process. Anyone who wants to attend the Stakeholder meetings is welcome to attend. Through their efforts the Region 10 Quality Assurance Commission and our VOICE Review Process were developed. They continue to discuss issues surrounding people with disabilities. October 2006 they began specific work on issues surrounding funding of supports and services. If you would like more information on the Stakeholder Meetings, you can contact Arc SE Minnesota at (1-888) 732-8520.

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How are people selected for a review?

There are currently 5 out of 11 counties in Region 10 Minnesota that are participating in Region 10 Quality Assurance Alternative Licensing. The QA Manager randomly selects names of people receiving support services. If you are a person receiving case management services from one of these counties and/or receive services through a licensed support provider, your name could be selected for a review.

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How many people are selected for a review?

The Minnesota State Legislation mandates that a minimum of 2 people or 5% of persons being supported through a licensed program be interviewed during that licensed program review period. A typical licensed review period is 2 years.

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What is a "paper review"?

A "paper review" is a review of a licensed provider’s policy and implementation of the protective standards and the Region 10 Quality Assurance Standards.

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How often do the "paper reviews" take place?

A paper review is completed when a new program is licensed, 12 months after an initial license is issued and then at least once every 24 months after that.

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How many counties are involved?

As of July 1, 2001 there are five out of eleven counties in Region 10 Minnesota participating in the Region 10 Quality Assurance process, which includes the alternative licensing system – Fillmore, Houston, Mower, Olmstead, and Winona.

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How does a county get to participate?

Each year, counties in Region 10 are invited to participate. The county board makes the final decision for participation in the Region 10 QA process. If a county chooses to participate, the County Director notifies the QA Commission. The county is given grant money from the QA Commission to support its participation. The county is responsible for hiring a county QA Manager and coordinating a county Quality Assurance Review Council (QARC). A group of counties (which currently the 5 participating have decided to do) can choose to pool their grant money and QARC and also hire shared staff to carry out the licensing responsibilities for their counties. Persons receiving support services, family members, support providers and county staff can encourage county participation.Back to top

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