Mental Health Site Review
May
3-6, 1999
Wasilla,
Alaska
Site Review Team:
Grace
Samuelson, Palmer
Jaymie
Murphy, Wasilla
Patricia Mack, Medical Social Work
Department, Valley Hospital, Palmer
Fred Kopacz, Peer Reviewer, Southcentral
Counseling Center, Anchorage
Barbara
Price, Facilitator
Connie
Greco, DMHDD Quality Assurance Unit
Nancy
Mathis, DMHDD Quality Assurance Unit
Dan
Weigman, DMHDD Quality Assurance Unit
A review of the mental health (MH) services
provided by Life Quest in Wasilla, Alaska was conducted from May 3-6,
1999. Life Quest offers clinical,
emergency, rehabilitation, medical, residential and prevention/early
intervention/community education services.
Rehabilitation services are provided to SED youth and SMI adults. A consumer report responds to rehabilitation
services: "It lights me up and gets me through the day."
The age groups served include young children
(beginning at age three), adolescents, adults and seniors. The settings for these services are schools,
an assessment center, a club house, a food bank, two six-unit transitional
housing units, six single family homes, two fourplexes and one sixplex as well
as Life Quest's central offices.
Wasey House, funded with DFYS, provides a five bed
emergency shelter for youth in state custody (ages 10 - 17); Alternative
Placement Services, for sixth through eighth graders, provides anger management
and conflict resolution education; through a contract with Life Quest, Kids are
People offers prevention services to school aged children; peer helper programs
operate in six schools; a free standing clinic providing psychological
assessments and evaluations; a school based crisis counselor is available to
all public schools in the Mat-Su Valley.
Choicetime provides early childhood clinic based
activity therapy (ages 3-7); Buckeye is a children's clinic based activity
therapy program (children 7-11); House of Northern Lights is an adolescent
clinic based activity therapy program (middle and high school ages); Phoenix
House serves youth ages 7-17 with crisis/respite; home-based therapy for
children; all services related to serving AYI youth; Crosswinds Clubhouse
offers pre-vocational services and psychosocial development services for SMI
adults; Colony House provides crisis/respite for adults; New Directions is a
rehabilitation-focused transitional housing project for homeless SMI adults;
Bailey House provides rehabilitation-focused transitional housing project for
homeless dually diagnosed adults.
Mat-Su Mental Health Association was founded in
1977, changing its name to Mat-Su Community Mental Health Services in 1986 and
to Life Quest five years later.
Life Quest's service area is the Mat-Su Borough
which encompasses some 24,000 square miles including Wasilla, Palmer and nine
small communities in a largely rural section of the state. The population of the area is approximately
57,000 at present. A recent planning document indicates that the Mat-Su Borough
is the fastest growing area in the state where the population may double within
twenty years' time.
Most of the services are provided in the Wasilla
area. In addition there is a small case
management office in Big Lake, originating at the time of the Miller's Reach
fire, and an office in Talkeetna. In
conjunction with the Sunshine Clinic (a primary care clinic), services are once
again being provided in Talkeetna, where a clinician is available one day per
week and an Advanced Nurse Practitioner, two days each month. Itinerant case management is provided in the
seven remaining communities.
A new building is in the planning stages. It would provide an attractive environment
for both clinical and administrative functions.
In early April, 1999, a reorganization occurred
under the new Director. This organizational
plan divides the organization into administration (as a support for the
agency's "real services", explains the Director), medical services
and clinical services. Medical services
are provided by a medical director and four contract psychiatrists, the latter
providing one day of work each week (1.8 FTE's), three part time Advanced Nurse
Practitioners (1.8 FTE's) and one nurse.
The agency continues to advertise for a child psychiatrist.
In late April, 1999, a regional planning review was
completed. The planning process
included Life Quest, twenty related agencies and one mental health
consumer. The results were to identify
twenty issues and to set priorities (indicated with *) as follows:
*1. Focus on 24 hr/7 day MH crisis intervention and
response
2.
Psychiatric assessment in acute crises
3.
Continuity of care and discharge planning for the hospitalized
4. Crisis
respite for adults and teens
*5. Availability of case management and care
coordination
6. Access
to individual therapy
*7. MH services and supports in rural/remote areas
8. Provider
options for SMI and SED consumers
9. Access
to home based services
10. MH
services for those not eligible for Medicaid
11. Mobile
outreach to veterans
12. Access
to adjunctive treatment
13.
Teamwork between MH and substance abuse services
14.
Services for the dually diagnosed client
*15. Early intervention school counseling
*16. Comprehensive assessment and referral for
youth
*17. Blended funding for youth
*18. Affordable housing
19.
Affordable transportation
20. Daily
living supports in transitional and permanent supported housing
Life Quest has developed timelines for the
completion of these priorities for periods of time from three to thirty-six
months.
This is the first review conducted of Life Quest
using the Integrated Standards and Quality of Life Indicators.
To conduct this review, a team consisting of a
facilitator, three community representatives, a peer provider from a MH program
and three members of the DMHDD Quality Assurance Unit, met for four days in
Wasilla. The team conducted 28
interviews, of which 11 were randomly selected individuals and families who
receive services from Life Quest, 10 were related service professionals, 2 were
board members and 5 were Life Quest staff.
The team also reviewed program and agency materials.
Interviews were held in person at Life Quest's
offices or by telephone. The interviews
lasted from 20 to 60 minutes. After
gathering the information, the team members met to draft this report, which was
presented to the staff on the final day of the visit.
Monitoring and reporting the quality of life and
the quality of services for individuals and families makes an important
contribution to the State of Alaska's understanding of the effectiveness of
program services and supports.
The review team's findings are reported below. The report includes a review of the previous findings, a list of areas of excellence, an administrative review, areas of programmatic strength, specific services or procedures that are recommended for improvement and tables of consumer satisfaction with quality of life and services.
Program
Response to Previous Action Plan
As this is the first review of Life Quest using the
new program standards, there is no previous action plan for these integrated
standards. A plan of action for
required chart reviews will be addressed separately.
1.
Children's services: Life Quest has developed an
admirable array of services for children.
These services include Alternative Placement Services, Choicetime,
Buckeye, and Northern Lights. The
latter three specialize in consecutive age groups, assuring continuity. The designation of a single case manager for
all DFYS clients and one for the APS program were particularly cited as
innovative and effective. Children's
services exemplify superb program development at the agency level and very
strong agency collaboration. A consumer
stated "I like activity therapy.
It's cool." High praise
indeed!
2. In less
than one year, Life Quest has taken major strides toward turning
around
the agency's perspective in accordance with the integrated
standards, revealing an improved and consistent respect for consumers
and for
their families. These efforts are already
changing the perception
of many
related service providers, staff and consumers. As change is an
intricate and exceedingly creative task, as any consumer can attest,
this
achievement is exceptional and deserving of hearty applause.
Governance
The program is governed by a nine-member board,
which currently has two openings. The
seven board members are local professional people. Most Board members have a
family or personal involvement in MH services.
The Board is described in the Policy and Procedure Manual as having
fifty per cent consumer representation, defining consumer as a family member of
a consumer or a direct consumer. The
Board has fiduciary responsibility for the agency's programs. Up to five members of the board are members
of the Mat-Su Health Foundation, which raises funds to support the programs and
services of Life Quest. The two HUD
projects, Glacier Valley and Fireweed Homes, are separate corporations with
separate Boards.
Board members interviewed expressed delight with
the board training instituted by the new Director. They described the Board as consumer centered and expressed
concern that services be provided even for those who cannot pay for them. A Board member stated an interest in
establishing a local chapter of NAMI.
The Board is valued by the agency.
A staff member commented "We have a GREAT Board."
Recently, the Board has embarked on a review of the
agency's mission and the creation of a three to five year strategic plan. While this requires a great deal of thought
and hard work, it is invaluable in guiding the agency through the planning
process.
Funding
Life Quest's annual budget amounts to six and one
half million dollars of which approximately one half originates with Medicaid,
some twenty five per cent from a State Community Mental Health Grant, some ten
per cent from a group of small grants (from the Division of Alcoholism and Drug
Abuse, FEMA, the Mental Health Trust, the Rasmusson Foundation, HUD), and the
remaining fifteen per cent from the United Way, private insurance, Medicare and
self-pay. Self-pay consumers contribute
on a sliding scale basis described by one consumer as "very fair."
Audit
The annual audit, dated June 30, 1998 and 1997, was
provided. The management letter
recommended changes in purchasing controls.
The management letter also indicated that costs have been questioned in
the SAFAH program and HUD funding has been suspended pending an U.S. Inspector
General audit.
Personnel Policies
All employees receive an initial orientation which
includes a criminal history check, driving record check, current TB test
results, confidentiality form, child abuse/neglect form and a copy of their job
description among other documents.
Depending on job description, staff must provide copies of current CPR
certification, first aid certification, verification of restraint training,
professional licenses and certifications, a copy of college transcripts, and/or
character references.
Required orientation classes include ethics,
listening skills, proper boundaries, preparation of treatment plans and
progress notes, emergency procedures, crisis intervention and the like. A minimum of four hours job placement is
also required.
A review of ten personnel files was conducted. Two files documented the extensive employee
orientation. All files indicated the
receipt of confidentiality training and training on mandated reporting as well
as acknowledgement of having read the policy and procedure manual. None included job descriptions. Eight documented background and criminal
checks.
Five personnel files documented evaluations within
the last year. None documented regular
annual evaluations; in one case there was a five-year period during which no
evaluation was documented. All
evaluations included the employee's signature.
One indicated a response to the evaluation in the form of a letter and
the agency's response. Two files documented specific goals for the coming
year. None documented objectives. The
only timeline for achievement of these goals was the next annual review.
Training records were extensive and were available for all ten files. The confidentiality of the personnel files
was scrupulously observed.
The system of employee evaluation is currently
undergoing revision. The more recent
files already reflect improved standards and are clearly consumer focused.
The guidelines for family support case managers
have recently been revised and reflect a consumer oriented approach to services. Guidelines for other positions are currently
under review and are to be revised.
Director
No description of Life Quest's administration would
be complete without expressing the unanimous enthusiasm of staff, consumers,
related agencies, board members and community members for Life Quest's new
Director, Bill Hogan. Mr. Hogan has
held this position for only eight months but has clearly had a major and
positive impact on every facet of Life Quest's work.
Some typical comments were:
"Everything
has improved with the new Director."
"The
new Director shows sincere interest and commitment and supports integrated
services."
"The
new Director really knew how to meet the professional community. He came right over to our agency and
introduced himself. I was floored! This has never happened before. He did that with all the agencies."
The
Board is "delighted with the new CEO.
He's doing a great job. Anyone
else would have left the state!"
"Two
years ago if I could avoid sending someone to Life Quest, I would. All that has changed since Bill came."
Both staff and consumers commented on their ability
to meet with the candidates for the director's position and that the current
Director "was everyone's choice."
Unfortunately, this review occurs too soon after
the hiring of the new Director to adequately reflect these changes. In every administrative area reviewed, it
was clear that Mr. Hogan had been there first, identifying areas in need of
change and initiating that change. It
must be noted that the view of the agency and its services reflect an image
that, for the most part, predates the current Director.
Staff
Employee culture was severely impacted by a massive
layoff in April of 1998, an event referred to repeatedly as "The April
THING". This reduction in staff,
while not the first, impacted the trust of employees, reverberated in the
community and, in the view of some, negatively impacted consumers both in
eliminating valued services and possibly by discouraging participation in Life
Quest's services.
Whether through lay off or voluntary staff
turnover, several consumers noted rapid changes in personnel, especially in
children's services. They viewed this
with alarm as their children had attached themselves to these workers and the
family accepted them only to have them leave and be replaced. One parent reported refusing continued
services just to avoid learning to like, and then losing, yet another
worker. Other staff report considerable
stability in their departments, with many employees having five to ten years of
tenure at Life Quest.
The improvement of morale has been a concern for
the new Director. His review of staff
salaries and comparison with state averages resulted both in a cost of living
raise and salary adjustments to bring Life Quest staff in line with staff in
other Alaskan agencies. The benefits
package, limited to date, is also under review with an eye toward
improvement. The staff expresses trust
in the Director's concern for them.
Staff remarked that "there is a high commitment
to Life Quest among the staff."
Service Coordination
Life Quest coordinates services with the Mat-Su
school district, youth corrections, the Palmer Senior Center and DFYS with
marked success. The recent regional
planning project united Life Quest with some twenty local agencies in a
productive effort of great benefit to the community.
Community Opinion
The community opinion of Life Quest is
positive. Of particular note is Life
Quest's ability and enthusiasm for networking with other agencies to develop
community resources consistent with Life Quest's mission. In addition, both related agencies and
community members commented on Life Quest's ability to provide immediate, high
quality crisis services on a community level.
Examples given were Life Quest's response to the Miller's Reach fire and
to a rash of teen suicides.
A sample of comments received follows:
Life
Quest is "one of the best community oriented agencies."
Life
Quest "is very innovative and a leader in mental health services."
"They
support community efforts, using their reputation and financing."
"When
there's a crisis, Life Quest comes through."
"I've
NEVER heard anything bad about Life Quest."
Opinion of Related Service Providers
The opinion of Life Quest held by
related service providers as represented in our interviews was mixed. Excellent collaboration was noted with the
schools, the senior center, youth corrections and with DFYS. Several agencies remarked that this
coordination had occurred within the last year and represented a valuable and
necessary change. A sample of comments received follows:
Life
Quest is, "on the whole, real good."
Life
Quest "is relatively difficult to work with."
"In
the last two years a lot of bugs have been worked out."
Life
Quest's reputation with other agencies is "that they're big and bad. Better not mess with them."
"This
is Life Quest: bill, bill, bill, money, money, money and no call back."
"They
offer so many services, no one understands them all. They need better public
relations so people would know everything that they do."
"Referrals
and follow through have improved over the last six months."
Accessibility
Life Quest's facilities are accessible inasmuch as
all of those visited or viewed in photographs have a ground floor
entrance. Entrances at the Life Quest
main site are sufficiently wide for wheelchair access although the doors are
heavy and difficult to open. Only the
bathroom in the reception area is accessible.
A TTY system has been purchased in part but is not yet operational.
The center has undertaken an ADA review and
provided sensitivity training in regards to consumers with special needs. A team has been formed to study this issue
and it is their intent to see that the proposed new facility meets the ADA
requirements and/or that liaisons could be contracted to aid with other special
needs.
This portion of the narrative refers to the Quality
of Life Values and Outcome Indicators, as they relate to the specific services
offered by Life Quest. The items listed
below are those that the review team identified as strengths. If the team concluded that any of the
indicators warranted improvement, they are listed in the Areas Requiring
Response section of the report.
The team identified the following strengths under
Choice and Self-Determination for all people receiving services from Life
Quest:
+There is a vast array of services.
+ The case managers provide every possible choice
available in the agency.
Consumer comments:
"People
like me wouldn't have a place to go without Life Quest."
"They
(case managers) are the greatest people I ever met. They can do anything."
"When
it comes to meds, I tell HIM. And that's okay."
The team identified the following strengths under
Dignity, Respect and Rights for all people receiving services from Life Quest:
+ Many staff clearly communicate their respect for
and genuine interest in the consumers.
+ Consumers express their genuine respect and
affection for the clinical staff.
+ Confidentiality is maintained.
The following are examples of statements received
by the team:
"Life
Quest does a good job of letting kids know they're not the only ones with a
problem."
"The
system has treated me right."
"The
ladies at the window are absolutely wonderful.
They don't treat you like a freak.
They even know my name!"
"This
is a welcoming environment."
"Joel
is an angel. We'll miss him."
"The
case managers are great. They'll work
extra hours. They'll see to it that
you're taken care of."
"Steve
Hubbard is very, very, very concerned.
He's good. He REALLY
listens."
"The
front office staff, they're great!"
"Dr.
S. is the best person in the world for me to go to."
"Marlin
has a comfortableness…like with a coach."
"If
you want help, this is the place to go."
The team identified the following strengths under
Health, Safety and Security for all people receiving services from Life Quest:
+ Life Quest housing is described as of good
quality.
+ Life Quest housing maintenance is good and
response to maintenance needs is timely.
+ Life Quest housing is safe.
The following are examples of statements received
by the team:
"Life
Quest housing is very, very good."
"My
case manager, Jeanette, helped me with housing and a whole network of
services. She saved my life."
The team identified the following strengths under
Relationships for all people receiving services from Life Quest:
+ There is a relationship skills group.
+Home based services aid in preserving the family.
+Supported housing aids in preserving the family.
+ Staff model healthy interactions.
Community Participation
The team identified the following strengths under
Community Participation for all people receiving services from Life Quest:
+ Life Quest provides excellent transportation
services including transport to medical appointments, shopping and other needs.
+ Life Quest's recreational outings (e.g. fishing)
provide a sense of freedom and competence.
The following recommendations were identified by
the team as areas that need attention from the organization:
1.
Emergency services for non-clients is a need
identified by the Director and borne out by consumer concerns and the reports
of related agencies. A related service
provider quoted a Life Quest clinician as refusing emergency services any time
between 5 PM and 8 AM. The Director is currently meeting with hospital social
workers and emergency room doctors in an attempt to improve this deficit. The difficulty is increased by the fact that
there is no designated MH evaluation site.
Continue efforts to provide appropriate emergency services to clients
and non-clients alike.
2. The
high turnover in children's services staff has disconcerted consumers and their
families. Concerns were raised by
families and by other service providers that staff seemed to lack knowledge of
their case or, in some cases, to appear to lack training. Review the training needs of staff and
continue efforts to improve employee benefits and morale and decrease turnover.
3.
The Board's meetings are not adequately posted to
enhance the participation of the public.
The location of Board meetings may also discourage attendance by the
public. Board openings are not
advertised, as are those of other local non-profit agencies. Continue the
Board's exploration of means of opening their meetings to the public in
accordance with DMHDD expectations and with the Open Meetings Act. (Administrative Standard #8)
4.
The past pattern of expansion followed by layoffs
and termination of some services has had a negative impact on staff morale and
consumer trust. Continue to focus on
identifying and developing the agency's core competencies.
5.
The Policy and Procedure Manual reflects a value
conflict, juxtaposing financial viability and DMHDD standards. The Policy and Procedure Manual states than
an inability to pay will not limit access to services, but also states that if
fees are not paid in a timely matter, no further services will be provided except
for emergency services. Program
evaluation is equated to evaluation of the financial viability of a program,
but more recently produced agency policies reflect consumer-centered services. Consumers and staff suffer from this
dichotomy. Consumers note a lack of,
limitations on or termination of services to those who cannot pay. Staff and consumers note an emphasis on
billable hours as negatively affecting services. Continue to refine the
agency's mission and values in accordance with the integrated standards.
Consumer
comments included:
"I
had to drop out of group. I couldn't
afford it any more. When I pay off
my bill
I can go back. Until then, I don't have
anything."
6.
Consumers evidenced gaps in their education
regarding their medications. Physician
visits were consistently described as brief and perfunctory. Nursing services were described as
understaffed. Consumers expressed that
alternative medications and treatments were not considered when requested and
that their concern regarding unacceptable side effects of medication were not
responded to. Include medical staffing issues in the planning process.
7.
Consumers noted a lack of individual and family
therapy. A consumer commented "I
can't get individual services and I really need someone who'll listen to
me." Include these treatment
modalities in the agency planning process.
8.
Some consumers described incidents in which they or
their families felt diminished, blamed or disregarded. A consumer said "Life Quest is
providing services the family does NOT need and NOT providing the services
needed." Utilize effective client grievance procedures and incorporate
findings into staff training plans and agency planning.
9. Continue
to encourage direct consumer participation of the Board. (Administrative Standard #6)
10. Pursue compliance with the auditor's
management letter.
11. Perform annual employee evaluations. (Administrative Standard #29)
12. Document employee orientation, reference
checks, etc. (Administrative Standard
#19, 24)
13. Continue the revision of the employee
evaluation form to clearly provide space for and evidence of employee response
to the evaluation. (Administrative
Standard #28)
14. Provide goals, objectives and time lines in
each annual employee evaluation.
(Administrative Standard #31, 32)
15. Continue revision of guidelines and job
descriptions for each position.
(Administrative Standard #20, 21)
16. Continue efforts to meet ADA standards in all
facilities. (Administrative Standard
#11)
17. Seek training and/or technical assistance on
treatment planning.
18. Develop a policy on conflict of interest as
it affects the Board. (Administrative Standard #10)
19. Analyze
data from client evaluations of services and utilize it in the program
evaluation and planning processes. (Administrative Standards #12,13,14)
20. Revise agency publications to reflect
consumer centered service values. (Administrative Standard #16)
21. Establish policy on enhancing the community
participation of consumers. (Administrative Standard #26)
The State DMHDD staff conducted the mental health
file review portion of the integrated site review. A total of 31 files were reviewed, comprised of 25 Medicaid and 6
non-Medicaid charts.
The Quality Assurance team will present a separate
report on the file review. Designated
members of the team reviewed the files of those consumers who were randomly
selected. Inconsistencies were found
between the services documented in the treatment plans and the services
actually delivered to the consumer.
Treatment plans listed the services available rather than offering
individualized interventions aimed at individualized goals. The team suggests
that technical assistance can be made available to aid in improving these
practices and to clarify the expectations of the new integrated standards.
Each of the 11 consumers interviewed by the team
was asked whether or not they were satisfied with the quality of their lives as
they relate to each of the five Outcome areas and the quality of the supports
and services they receive from Life Quest.
The questions were taken from the Consumer Satisfaction section of the
five Outcome areas (Choice and Self Determination, Dignity, Respect and Rights,
Health, Safety and Security, Relationships and Community Participation) The
responses are presented according to type of service.
MH
|
Choice
N=11
|
Dig&Res. N=11
|
Hth,Saf,Sec N=11
|
Relatns. N=11
|
Com.Par. N=11
|
||||||||||
Outcome |
Yes |
No |
Part. |
Yes |
No |
Part. |
Yes |
No |
Part. |
Yes |
No |
Part. |
Yes |
No |
Part. |
|
Person/Parent/guardian |
7 |
4 |
|
10 |
1 |
|
9 |
2 |
|
10 |
1 |
|
9 |
2 |
|
Staff Performance |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Person/Parent/guardian |
6 |
5 |
|
8 |
3 |
|
8 |
3 |
|
7 |
4 |
|
7 |
4 |
|
It should be noted that the vast majority of
consumers, even some of those generally critical of the program, stated that
they would refer others to Life Quest.
The following are examples of statements the team
received from consumers and families regarding their satisfaction with their
quality of life and the quality of services.
"I
look forward to coming here."
"This
place has given me a new life."
Life Quest scheduled an open meeting giving members
of the community an opportunity to provide comment to the site review
team. The meeting was announced in the
local newspaper, The Frontiersman, consumers were informed by the case managers
and posters in the public areas of Life Quest's offices announced the
event. No member of the public attended
the meeting.
1.
The loss of the after hours program at the club
house was mourned by
Many consumers for whom it offered a safe
place to develop
relationships and to participate in group activities. Its closure
foreshortened newly established friendships and diminished the
consumers' opportunities. A
consumer commented: "I miss the after
hours
program. I'd cook. We'd do things together. I'd love to have
that
again. It was like a family."
2.
Several of those interviewed, consumers and related
service providers, recommended that the housing now overseen by Life Quest be
turned over to a private corporation.
The motivation of the consumers an assumption that they must continue
receiving services in order to live in this housing. The consumers questioned whether or not this denied their
improvement and increasing independence.
3.
Staff, consumers and related service providers all
expressed concern that certain programs would disappear based on their
financial viability. This uncertainty
colors consumers' use of services and agencies' willingness to
collaborate. Some consumers described
earlier elimination of programs as "abandonment."
4.
Both staff and consumers commented on the
"dark and dreary" buildings that currently house Life Quest. It was noted that the staff has gone out of
their way to decorate the offices in such a way that a "homey"
atmosphere is created. Those efforts
are very appreciated by consumers.
5. Comments
were received regarding the split in the Life Quest offices, with
administration in one building and clinical services in another. It was felt that
this split along with the multitude of cubicles was symbolic of or contributed
to poor communication patterns, so vital to an agency of the complexity of Life
Quest. One consumer noted that
administrative and clinical sections were two "cultures" as exhibited
in location, attitude and even dress.
Conscious team building could be considered.
6.
The Policy and Procedure Manual, in its Human
Resources Section, notes that Life Quest is a "competitive
environment". To the extent that
the description is correct, it may add to employee stress, low morale and high
turnover. The new Director's
cooperative style presents a contrast that is evidently appreciated by staff.
7.
Adult case managers were repeatedly singled out for
praise as collaborative, knowledgeable, trustworthy and thorough.
8.
Consumers commented that the prominence of names on
client files could result in a breach of confidentiality. One notes that the names of other consumers
were evident on a stack of files on a provider's desk. It was suggested that the file number alone
would provide greater protection.
9.
In the agency's refocusing of Life Quest's mission,
core competencies might be identified and used as a focus for services.
10. Life Quest is to be commended for the
regional planning project just completed.
This is an invaluable tool in the Board's development of long range
plans.
Life Quest is at a major turning point in its
development and all indications are that many of the concerns voiced in our
interviews this week have already been identified by the Director, that change
is underway and is clearly moving in the direction of services responsive to
consumer needs and concerns. The agency
is to be commended for braving this site review process just as it was
beginning to institute major self-examination and system change. The planning effort completed just days
before the site review is both a competent guide and an expression of sincere
interest in meeting the myriad needs of this large and diverse service area.
The team thanks the Life Quest staff, especially
Debi Shade, master scheduler, for their kind assistance during the site review
and their unfailing tolerance of our requests for materials, information and
guidance through the maze of offices!
You were very gracious to us and we hope that we were not disruptive to
your vital work this week.
You will receive a finalized report within 30 days
of this review, an overview of the agency's compliance with the standards and a
format for developing an action plan in response to items identified in the
review. Life Quest, in cooperation with
DMHDD, will be responsible for developing a plan addressing the issues noted in
the Areas Requiring Response.
We have every assurance that your good will and
regard for consumers will serve you well as you prepare for the new century.