INTEGRATED QUALITY ASSURANCE REVIEW
Hope
Community Resources, Inc.
March
20-24, 2000
Anchorage, Alaska
SITE REVIEW TEAM
Kathy Fitzgerald, Community Member
Bill
Miner, Community Member
Neil
Hickok, Community Member
Ann
Hutchings, Community Member
Maxwell
Mercer, Peer Reviewer
Lynn
Caswell, Peer Reviewer
Sherry
Modrow, Facilitator
Robyn
Henry, Facilitator
Connie
Greco, DMHDD QA Staff Member
INTRODUCTION
A review of Developmental Disabilities (DD) and
Mental Health (MH) services provided by Hope Community Resources, Inc. (Hope)
was conducted from March 20th to March 24th, 2000, using the Integrated Quality
Assurance Review process.
This report summarizes the impressions of the community team after interviewing consumers, staff members, community members and staff of other agencies. It also includes a limited administrative review. It does not represent or reflect a comprehensive review of this agency. The community team has collaborated on this report and the findings represent their consensus. DMHDD Quality Assurance staff conducted the Clinical Record Review and provided that section of this report.
Description
of Program Services
Hope is a private nonprofit organization that provides support to over 750 individuals across the state through its central office in Anchorage and regional hubs in the Mat-Su Valley, Dillingham, Kodiak, Seward and Juneau. This site visit includes a review of the services provided in Anchorage and the Mat-Su Valley as well as the overall administrative functions of the central office.
Approximately 630 people are served in the area being reviewed. The support areas and activities provided to individuals receiving services from Hope include:
- Supported Living- individuals' choice of community living
- Supported Employment and Inclusion Activities- assistance with independent and community employment and volunteer opportunities
- Foster Care- supports children and adults in family settings
- Shared Care- supports to children and families in their own home with time spent in another family’s home
- In-home Assistance- provides the needed support to a family to keep their family at home
- Home Ownership- assistance with home ownership
- Inclusion- assists the community in developing opportunities to include individuals who experience developmental disabilities in all aspects of community life
- Community Health and Wellness- supports individuals in choosing their own health care professionals
- Family Support- assists families with accessing community supports, acquiring specialized equipment and home modifications that prevent crisis and/or lead to out-of-home placement.
- Rural and Urban Subsistence Activities- assist people to engage in activities that are traditional to their family or culture.
A 19-member board of
directors meets monthly and governs the organization. The agency employs
approximately 450 full and part time people statewide and 400 people in the
South Central / Mat-Su Valley regions.
Description
of the process
To conduct this review, an interview team
consisting of two facilitators, four community representatives and two peer
reviewers conducted 89 interviews over five days in Anchorage, Alaska. Client
interviews, which included adults and the parents/guardians of children or
adults who receive services, were determined from a list of randomly selected
clients. Of those people successfully contacted from the list, 30 individuals
and 12 guardians/family members actually spoke with team members. In addition,
7 foster parents were interviewed.
Fifteen interviews were conducted with related service professionals, 3
interviews were with board members and 22 were with Hope staff. Interviews
lasted from 15 minutes to two hours and were held in person in the community,
at Hope’s offices or by telephone.
The interview team members also reviewed 10
randomly selected personnel files, the agency’s policies and procedures
manuals, the agency’s annual report and other administrative documents. After
gathering the information, all the team members met to review the data and
draft the report that was presented to the agency staff on the final day of the
visit.
During this same period of time a member of the
DMHDD Quality Assurance Unit performed a review of randomly selected client
records.
Open
Forum
A public
forum was held in Anchorage at Catholic Social Services at 7:00 P.M. on March
20th. Hope advertised the event by publishing a public notice in the Anchorage
Daily News. There was no attendance at
the forum.
FINDINGS
Progress
Since Previous Review (October, 1997)
(Note: items with an asterisk carry forward to
recommendations in this year's report.)
1.
Make an absolute commitment to recruit consumers
for the Board of Directors.
At least two individuals
who experience a developmental disability have been invited to join the board
since the previous review. None has accepted a board seat and no adults who
experience a developmental disability currently sit on the Hope board. Several
board members are secondary consumers.
Staff currently are developing a
mentorship plan for self-advocates that will assist in building an
understanding of management, policy and philosophical issues. The intent is that this process will lead to
board membership. Hope staff expect to support full inclusion of people who
wish to become Board members. The commitment has been demonstrated and the
agency will continue working on direct membership of people who experience
developmental disabilities on their board.
2.
Make greater effort to improve communication
between Board, consumers and staff.
The agency has developed
several initiatives. Examples include monthly program presentation to the board
by staff; board members visiting residences and programs; annual picnic
including board members, staff, individuals who receive support and their
families; and a variety of staff recognition mechanisms.
3.
Consumer grievance procedure should be written in
plain language.
* Although the consumer
grievance policy has been revised during this year, the language in this
document remains dense and rather complex. It should be reviewed again.
4.
Continually work to assure that everyone has the
special equipment and interpretive services they need.
People indicated they had
specialized equipment or interpretive services if they needed them.
5.
Assure consistent consumer participation in the
hiring process.
Families and individuals
affected by the hire of a direct service staff person are invited to
participate in the hiring process.
6.
Assure that training specific to job requirements
is provided.
* Comprehensive training
is provided to each employee and staff training records and calendars indicate
specific job training is available. Some staff indicate specialized training
needs exist related to the care of people with complex needs.
7.
Community integration has been inhibited through
lack of adequate staffing ratios.
The agency's focus on
inclusion has resulted in significant community-based activity. Staff shortages
continue to make this challenging and Hope has dedicated considerable energy to
creative approaches to this issue.
8.
Assure that performance appraisals are current.
Review of staff records
indicates appraisals are current for classifications of employees who receive
formal appraisals. Management staff utilize an informal review process that
does not include personnel file documentation.
9.
Explore ways to increase the variety of friends and
acquaintances.
Hope's inclusion and
supported employment programs seek to provide people with the variety of public
contacts that everyone expects. There appear to be varying outcomes. Although people generally feel they have
more opportunities to be around people, their contact and proximity frequently
do not lead to more friendships. The review team also feels it is important to
recognize the positive value people with disabilities place on having
friendships with and access to other people with disabilities when that is
their choice.
10. Assure
that people are given sufficient opportunity to express preferences for other
employment opportunities.
Hope's staff have made
significant strides in making employment options available.
11. Improve
the process for assisting consumers in their decision-making process to show
consumers are making informed choices.
Staff appear to make a
concerted effort to help people make choices with appropriate information.
12. Improve
staff efforts to identify the skills and support needed to locate and secure
employment.
This is being addressed
within the Supported Employment program.
13. Improve
efforts to assist individuals in securing employment in regular community work
settings.
Hope's Supported
Employment and dayhab initiative now provide regular community
employment/activities for 101 individuals.
14. Continue
to problem-solve with consumers to clarify and resolve barriers (i.e. vouchers,
finding providers, turnaround time for reimbursement, etc.)
Problem solving is part
of an on-going effort at Hope.
15. Assure
that planning occurs when it is convenient to consumers and families and
actively ask consumers what worked and how it could be improved.
Hope staff arrange
meetings at the convenience of individuals and families.
16. Assure
that all staff are aware that plans of care may be amended on an ongoing basis.
Consumers should also be assured that any changes they wish to make to their
plan will be welcomed by staff.
A review of consumer
files indicates staff are aware of and facilitate changes to plans of care.
17. Plans
should include: more descriptive strategies, ongoing documentation of status,
closure of accomplishments, documentation that non-paid staff is considered and
that staff has the necessary support to implement the consumer's goals.
Some plans are more specific than others, but most indicate attention is being paid to writing plans in a detailed, respectful manner that notes changes and updates goals.
Model Practice
Innovation -- Hope demonstrates
consistent commitment to flexibility and innovation that results in ongoing
leadership in DD service delivery. Hope consistently moves new concepts into
practice in a way that is appropriate and pervasive in the agency. Among those
programs at Hope that illustrate this strength of the agency and are
recommended by the team for consideration as model practices by the State of
Alaska are the following:
¨
College internships offer students an opportunity to learn inclusion
on-the-job and offer Hope access to relief staff. This summer, Hope will be
adding a quality assurance role to the work performed by graduate student
interns that promises to further empower networks to measure their
effectiveness and improve services.
¨
Urban subsistence connects individuals to cultural activities such as
hunting, camping and fishing in a meaningful and direct program.
¨
The Health and Wellness Center helps families, individuals and staff
heal when they experience hurtful and painful situations.
¨
Home Alliance brings close relationships and intensive services to a
new level of collaboration for people served by this program.
Areas of Excellence
An
area of excellence is considered by the site review team to be exemplary
characteristics and practices of the organization.
Agency Culture and
Philosophy--
All staff understand the philosophy of Hope and they successfully integrate the
agency's mission and values into the delivery of services. Hope makes
exceptional efforts to educate all staff to the agency's standards for service
delivery. With few exceptions, staff
respond by treating their vocations as being more than just a job.
The agency clearly documents their focus
on the philosophical foundation of the agency through almost all its literature
and publications. The agency emphasizes
a client-centered, individualized service approach that clearly values the
people served.
The agency's willingness to anticipate
change and to apply creativity to all areas of service mean that Hope is
continually evolving: "We are our own best critic." They do this while
keeping their core values at the forefront of everything they do.
Hope places great importance on
sensitivity to family issues.
Medical quality assurance -- The health and well
being of people receiving services at Hope receive comprehensive and consistent
review. The full-time Medical Director provides a quality assurance role in
reviewing clients' medical histories and medications.
Choice/Self-determination
The team identified the following strengths under Choice and Self-Determination:
+ Home
Alliances appear to foster choice, particularly for individuals who are
nonverbal. The collaborative nature of this concept allows caregivers to become
aware of physical and emotional cues given the depth and intensity of their
relationships.
+ Almost
all people interviewed indicated that they felt listened to in the development
of their care plan.
+ Three
individuals, with the support of Hope, now successfully own their own home.
+ Goals
and plans developed with the agency generally focus on a person’s future vision
and dreams.
+ The
language in many of the ISP’s focuses on the perspective of the individual
being served.
+ Several
people interviewed noted the agency’s willingness to incorporate new ideas and
act on suggestions.
The team identified the following weaknesses under
Choice and Self-Determination:
- Several
people reported that they do not always have choices about housemates, about
particular living situations or about whether they are moved to a different
home.
- One
guardian expressed concerns about “people
being moved (at the) convenience of the agency
or political placements”.
- Several
people reported that they did not know they had an ISP.
- Several
people interviewed from all groups cited staff turnover and shortage of direct
care staff as a disruption to direct care services.
- One
person reported feeling that the agency's increased use of staff as
“generalists” occurs at the cost of losing valuable staff expertise in
specialty areas. The restructuring plan at Hope is, in part, a response to the
agency's recognition of this theme.
Dignity,
Respect and Rights:
The team identified the following strengths under Dignity, Respect and Rights:
+ Almost all individuals interviewed reported being respected at Hope.
+ Staff / client interactions appeared comfortable and respectful.
+ Observations indicate outstanding response by staff to the cues of non-verbal individuals.
+ Most
people said they were informed about and know their rights.
+
Language in service plans is individualized and respectful.
The team identified the following weaknesses under
Dignity, Respect and Rights:
- One
foster care provider indicated not being respected by the agency: “The less I see of the agency the better.”
- A
parent indicated “I’m not respected when
I don’t agree with the team.”
- Another parent indicated that staff being overworked and unhappy creates disrespectful situations.
- One
guardian reported significant difficulty obtaining Medicaid cost sheets and
explanatory information related to funding supports.
Health,
Safety, Security
The team identified the following strengths under Health, Safety and Security:
+ Most people indicated their health needs are being met.
+ Most people feel safe and secure where they live.
+ One person indicated that Hope staff consistently maintain their focus on supporting personal choice and independence while also taking into consideration individual concerns about safety and security.
+ Medical quality assurance and nursing are strengths of this agency's services.
The team identified the following weaknesses under
Health, Safety and Security:
- One
guardian expressed concern about safety and security outside of the inpatient
setting, although there has been no report of any incidents. This person also
reported that there were fewer occupational therapy services available than
before they received Hope supports. A
loss of motor skills occurred subsequent to placement in this agency. (System
issue: They liked the ICFMR.)
- One
guardian said there was a concern about getting an adequate diagnosis of the
consumer.
- A
guardian related that they repeatedly requested medical information about their
ward and the information was not received.
- One
child reported that their foster parent constantly smoked in the car and that
they had a hard time breathing.
- A
foster parent said she should have been informed about communicable diseases an
individual carried before the person came to live in her home.
Relationships
The team identified the following strengths under Relationships:
+ Direct care staff work with exemplary dedication to enhance the lives of people in their care.
+ Hope places great importance on sensitivity to family issues. Staff are insightful about families and respectful of the family's roles and rights. The team appreciated that Hope recognizes the differing concerns of families.
+ Most people indicated that they were satisfied with the role Hope plays in helping them connect with their biological family. One person indicated that Hope paid for the ticket to visit a biological family member.
The team identified the following weaknesses under
Relationships:
- Many
people interviewed said they wished they had more non-paid friends. Site review team members observed that many
people had good support from Hope staff but their natural supports and personal
relationships did not extend beyond Hope.
The agency also identified this as an area of concern for them.
- One
staff member reported that if it weren’t for their recent, independent efforts
to connect several long-time clients with their family members, it would not
have occurred.
Community Participation
The team identified the following strengths under Community Participation:
+ The team was impressed with the agency’s strong Inclusion program with a focus on involving people in outside activities and community participation.
+ Waiver services and ISP’s focus on community participation.
+ One person talked about a consumer having a friendship with a former staff member who makes regular time to take the person out.
+ Several people commented on how pleased they were with the employment program.
+ Several employers expressed how much they valued the work of employment program workers and commented on the extent that the employees are integrated into the work setting.
The team identified the following weaknesses under
Community Participation:
- Two
people reported that they would like to spend more time with people without
disabilities.
- Several
people reported that while they have many opportunities to be in the community,
they are generally in the company of paid staff.
- Several
people said they would like a paid job or more meaningful and valued daytime
activities.
- Several
family members and guardians expressed concern about the selection and
appropriateness of work activities, preferring opportunities for job
advancement and better pay.
Staff
Interviews
Many people on staff feel supported and valued.
Some mentioned that it is very important for Hope to recognize the critical
role of the person who is the team leader. Some staff indicated that they felt
there was a large gap between management and line staff. The site review team
heard some staff express a difference between the way people at the management
level think about line staff and the way line staff believe they are being
treated. As line staff, they did not
feel their concerns were heard to the point that any action was taken. One person expressed this by saying, “They forget to take care of the people who take care of the people." Staff shortages and staff turnover create an
atmosphere of burnout among direct care staff.
Staff perception of a lack of support from
supervisors is a concern to the site review team. Several people indicated that
it was very difficult to get relief and sometimes they were not able to get to
ISP meetings or leave when they were sick. Some expressed a sense of isolation
as direct care staff in homes. Several reports indicated a need for line staff
training, especially for high-need clients.
The team is impressed with Hope’s creative efforts
to address the chronic issue of staff shortages including the initiation of the
summer internship program which utilizes the services of college interns for
providing coverage for line staff.
The team was impressed with the immaculate
appearance of some of the residences. The concern was raised about whether
staff have the added duties of having to be primary housekeepers.
Collateral
Agency Interviews
The team interviewed 15 collateral agencies and
employers, as follows:
·
Anchorage School District's Whaley School
·
Office of Public Advocacy
·
DMHDD Nursing
·
South Central Foundation
·
Alaska Regional Hospital Pediatric Unit
·
Probation Office/MYC
·
ARC of Anchorage
·
Butterfly Daycare
·
Governor's Council on Disabilities and Special
Education
·
Frontier Medical
·
Glacier Brewhouse
·
Medical Supply vendor
·
Hogg Brothers
·
Mat-Su Services
·
ASSETS
Overall feedback about the program was very
positive. “I wish all agencies were like
Hope,” said one. Several people indicated that Hope was one of the best
agencies to work with. Regarding the services Hope provides, one agency
representative said, “(I) can’t say
enough about what a good job they are
doing for the child.” Another person reported that the agency does “excellent follow-up”.
Hope staff are well respected by many of those we
interviewed. One person indicated that Hope staff are a good team of
professional and dedicated people. Another described Hope as being “value driven”. A couple of the community employers we
talked to indicated that they are very satisfied with their worker from the
employment program.
Areas of concern identified by related service
agencies included a belief that Hope may be too “top heavy” at the expense
of support to line staff. Peoples’ reports of follow through from Hope staff
were inconsistent. One person reported that there are delays in obtaining
information about medically involved children, but noted that there is a good
review process in place for these children.
One respondent commented that it would be helpful
for Hope to have advisory councils and/or board seats for each of their distant
programs. This person indicated that it would have been helpful if Hope had
involved the community in its plans for a presence in the Matanuska-Susitna
Valley before opening the office. (Hope
staff described their efforts in this regard and stated they have either a
board seat or an advisory group for each rural area served.)
A tally sheet of specific questions asked of each
agency is attached to the report.
Administrative/Personnel
Narrative
Those standards not fully met include:
1.
The agency’s governing body includes significant
membership by consumers (DD, MH), and embraces their meaningful participation.
(Standard #6) The agency’s nineteen-member board has four members who are
family members of a person receiving services.
2.
The agency evaluation system provides performance
appraisal and feedback to the employee and an opportunity for employee feedback
to the agency. (Standard #28) There is no formal written process for evaluating
management staff although informal, ongoing feedback forms an integral part of
the management culture.
3.
A staff development plan is written annually for
each professional and paraprofessional staff person. (Standard #29) As above.
4.
The performance appraisal system adheres to
reasonably established timelines
(Standard #31). The evaluation system for non-management staff meets these
standards and is current. See above regarding management staff.
CLINICAL
RECORDS REVIEW (conducted by DMHDD QA staff)
INTRODUCTION
The
clinical chart review was conducted for the purpose of determining what
information the agency needs to be able to generate documentation that reflects
good clinical practice. Another reason
for the review was to conduct a mini-event for the Division of Medical
Assistance (DMA) to determine that the services delivered are reflective of the
services billed to Medicaid. The charts
reviewed were determined by a random sample taken from data supplied by DMA for
Medicaid cases. The number of charts to
be reviewed was determined by a Range Table based on the total number of cases
supplied by DMA. The Quality Assurance file review consisted of a review of
four areas, Assessments, Treatment Plans, Progress Notes, and Treatment Plan
Reviews. The team reviewed five (5)
Medicaid charts.
STRENGTHS
The current ASSESSMENT
form contains all of the necessary requirements for a good assessment with the
exception of an area that specifies Eligibility Statement. Implementation of this section would assure
that the Comprehensive Assessment meets all Medicaid and Integrated Standards
requirements and would eliminate the need for a separate SED screening
document. Some of the strongest
assessment material is found in the treatment plan. If possible you may wish to include this in the comprehensive
assessment as it is good support for the diagnosis and provides a much more
comprehensive assessment. The TREATMENT PLANS in the children's
charts are extremely well developed and contain clear goals and measurable,
achievable objectives. The Discharge
Summary in those treatment plans is clear and very well stated. There was 100% compliance with the
Integrated Standards in the Children's treatment plans. Almost all PROGRESS NOTES were present in the
charts. Out of 141 notes reviewed, only
one note was not found. Most of the children's progress notes fully met the
Integrated Standards. The TREATMENT PLAN
REVIEWS in the children's charts are extremely well developed and contain
all components required to meet the Integrated Standards. There was 100% compliance with the Standards
in the Children's treatment plan reviews
AREAS FOR IMPROVEMENT
The Integrated Standards require that a Comprehensive
ASSESSMENT be conducted annually.
Please be sure to complete each area of your assessment in full rather than
refer to older assessments. Please be
careful to use the client’s words in the area for client's desired services rather
than the clinician’s words. When generating a problem list and documenting
services recommended, please be specific. In charts where Intensive
Rehabilitation Services are being recommended clearly document the service
being recommended. When treating
dual-diagnosed consumers, please carefully document which system you will be
using. If you plan to treat in the
mental health system, there must be a mental health diagnosis. There cannot be a diagnosis only related to
a medical condition or only related to substance abuse. There was not current TREATMENT PLAN in the adult file that
was reviewed. It might be beneficial to adopt the treatment plan currently in
use for children. One area to be
alerted to in PROGESS NOTES is that
notes contain all of the goals that could be addressed, therefore the service
delivered should be careful to document which ones are addressed for the
service being delivered at the time.
There were some notes that were process oriented and the agency might benefit
from a technical assistance on writing notes that contain only clinically
relevant information. Being clear about the goal(s) being addressed could be
beneficial in eliminating some of the process oriented wording in the notes. In
the adult chart, the notes were subject to pay back as there was not treatment
plan to establish that the services were medically necessary. A further issue
was with the notes for Intensive Rehabilitation Services (IRS). There appears
to be come confusion as to what is required in an IRS note. While the note may be generated weekly, the
interventions and the consumer's response to those interventions must be
recorded daily. In TREATMENT PLAN REVIEWS, the adult file
that was reviewed did not contain a treatment plan review and could benefit
from using a review plan similar to the one in the children's charts.
SUMMARY:
The Children’s Mental Health Charts are
exceptionally well documented and the agency should be commended for
maintaining the mental health charts and the developmental disabilities charts
with such clarity as to what is required in each. There are technical
assistance areas noted surrounding documentation and the Division of Mental
Health and Developmental Disabilities is available for technical assistance
upon request.
Program Management
It is apparent to the team that Hope’s management
staff work very hard to constantly improve the services they provide. The
agency’s current plan to restructure its organizational make-up is just one
example of the continual forward thinking that has been part of Hope's
long-standing reputation.
Hope voluntarily closed its Intermediate Care
Facilities and has successfully completed the transition to community-based
living for all people served by the agency. The team was impressed with Hope's
leadership role in making this change.
The Home Alliance concept fits well within Hope's
mission and particularly helps to serve people who previously lived in
institutional environments.
Mission and vision are an integral part of Hope and
permeate the agency's service delivery. Staff at all levels see the big
picture. They are top quality, dedicated and committed to those they serve.
There is no question as to the focus--the individual comes first. There is no
such thing as "I can't." Everyone places high value on "normal"
life to the extent possible.
People at Hope recognize their weaknesses and
understand the limitations inherent in developing natural supports. They are
concerned and actively working to find solutions to this.
Hope has developed a plan with a health and
wellness focus, which is expected to open in a separate facility in the summer
of 2000. Because people who experience developmental disabilities have
complicated, and sometimes severe, conditions, everybody in this field lives
and works in daily contact with pain and death. This program will help people
in the community, staff and the individuals they serve to deal with loss and
grief.
Overall, Hope appears to be continually improving
services. People like the change from institutions to living in homes. The
agency's internship program demonstrates their commitment to seeking creative
solutions to complex problems.
During the transition to Medicaid funding, Hope
experienced financial difficulties that took attention away from some areas of
improvement. The team also became
acutely aware that there is a major barrier for providers in navigating the
Medicaid system. Providers ask for clear direction about where to go for
answers, improvement in timeliness, relief of up-front expense, with a written
procedure for Medicaid services and billings. Conflicting information,
procedures and instructions from DMA, DMHDD and First Health provide no clear,
concerted direction. The team recognizes Hope’s efforts to lead in this area.
Areas Requiring Response
1.
Although the consumer grievance policy has been
revised this year, the language in this document remains dense and rather
complex. It should be revised. (Prior review)
2.
Specialized training needs persist, particularly
related to the care of people with complex needs. (Prior review)
3.
Hope has moved in the direction of a mentoring
program that is intended, among other things, to result in membership on the
Board of people who experience developmental disabilities. The agency should
continue developing this or alternate plans that will carry the principle of
inclusion to the Board level. (Standard
#6)
4.
There is no formal written process for evaluating
management staff although informal ongoing feedback forms an integral part of
the management culture. We recommend some formalization of this process, such
as a letter or other documentation that summarizes feedback and sets goals at
least on an annual basis. This should include feedback to the employee and an
opportunity for employee feedback to the agency (Standard #28) and
5.
… a staff development plan written annually
(Standard #29) and
6.
…a system that adheres to reasonably established
timelines. (Standard #31).
7.
Staff shortages and staff turnover create an
atmosphere of burnout among direct care staff. Perceptions from staff of lack
of support from management or supervisors need to be addressed: by improving
the timeliness of response from team leaders, the ability to obtain time off,
and reduction in staff isolation.
Even though it can be very difficult to find enough people to perform
direct care roles as line
staff
and relief, Hope must ensure that the people they hire in those roles can work
with
individuals in the homes and are willing to accept the responsibilities
of the job. The team
recognizes that restructuring may address
these issues.
Other Recommendations
1. In planning for any further expansion of Mental Health services, the team recommends that the organization pay close attention to building mental health capacity both clinically and programmatically on all levels of service delivery. This will ensure that service interventions are provided using an approach that is consistent with the person’s mental health needs. Hope may benefit from developing internal mental health training that clarifies their model and approach to providing mental health services, especially regarding services to children.
2. People in team leader positions have a pivotal role in either enhancing or blocking the way in which line staff carry out the values of Hope. The agency should actively seek to provide people in these positions with the resources and authority to allow the networks to function at peak capacity. Hope's plans for reorganization, as described to the site review team, would appear to provide the agency with the increase in capacity that is required to accomplish this recommendation.
Closing
The team finds Hope Community Resources to be a
dynamic, strong, innovative agency that puts the needs and wishes of
individuals being served first. The team wishes to thank the staff of Hope
Community Resources for their cooperation and assistance in the completion of
this review. A process such as this can be very disruptive to the office
environment and your hospitality has been appreciated by all of the team
members.
The final draft of this report will be prepared
within 7 days and sent to DMHDD. DMHDD
will then contact Hope within 30 days to develop collaboratively a plan for
change.
Attached: Administrative and Personnel Checklist;
Questions for Related Agencies (tallied), Report Card (tallied)