Community First Choice Implementation Council

Summary of Meeting Minutes Date 2012 July 27 Agenda Topic Self Direction: consumer training and employer authority

2012 October 15

Accessing and understanding CFC

2012 November 15 CFC Program Overview

2012 December 10 Provider qualifications for personal care agencies

2013 January 10

Progress Report and Task List

2013 January 24

Provider qualifications for independent personal care attendants

2013 February 12

Service Definition: Personal Care and Quality in personal Care Services

plementation Council
Discussion Voluntary consumer training includes how to select and dismiss attendants, identifying and reporting abuse, and employer responsibilities. Other topics could include cultural competency, behavioral management, and financial management. Other options may include peer mentoring/counseling, the registry, developing backup systems. Self direction and working with the unions: organized labor wants to work with consumers. Non-union personal care attendants may participate in CFC. Regulations and the State Plan Amendment will be worked on jointly by the Council and the Department over the next several months. CFC services will be accessible thorough the Maryland Access Point sites. Other social and health services will be coordinated through partner agencies with DHMH. The interRAI assessment is used to make medical eligibility determinations. The determinations will be sent to DelMarva for review. The interRAI includes quality indicators. The participant may use a variety of entities to support their self direction experience: the use of the supports planner, the voluntary consumer training, health service entities. CFC program flow: an individual undergoes an eligibility screening, assessment of functional assessment, develops a plan of service and individual budget, and receives service. Support staff include supports planners and the interRAI nurse. The plan of service and budget are developed using the results of the functional assessment. Service and budget are linked to needs identified in the assessment. Service definitions and provider requirements for LAH, MAPC, OAW, and CFC will be streamlined and standardized; the Council will take part in revisions. Quality for consumers means: flexibility in provider selection, adequate provider pool, consumer safety, consumer satisfaction, person-centered approach. Quality for providers means: recognition for quality care, professionalism, open communication and respect.

Agencies should be responsive to consumer needs 24/7, not 8am-5pm. Supervision of attendants should occur at times that are convenient for the consumer. RSA, HHA, or NRSA certifications may serve as the provider qualifications necessary for personal care provider agencies to participate in CFC. CFC will be implemented in January 2014 Review of Council policy considerations January 2012-present. Includes development status of program eligibility, service definitions, person-centered plan, service models, support system, service budget, provider qualifications, and quality assurance. Key dates: SPA and regulations must be complete by July 1st. Allow waivers for age limitation, English literacy, CPR/First Aid, and criminal background checks.

 The federal CFC regulations describe the services that are allowed, permitted, and prohibited under CFC. These help to define the service limits for personal care and are available at 42 CFR 441.520-525. Personal care services include assistance with ADLs and IADLs, assistance with skills and services related to ADLs and IADLs, delegated nursing functions, assisting the participant with services outside of the home, and household tasks that are incidental to care. Personal care services do not include services that are provided to anyone other than the participant, services, heavy cleaning, skilled medical services, and services unrelated to care for the participant. There are three types of quality: structural, process, and output. Examples of output quality for personal care services include: health and well-being of the participant, satisfaction with services, participant independence. The preferred method of collecting quality information from participants is via survey. Face-to-face surveys/interviews may provide the best and most accurate information for quality tracking purposes.