Live captioning by Ai-Media
JENNY SICHEL:
Hello everyone, as you start to come in we are going to give it about 30
seconds to wait for the attendee field to populate and wait for everyone to
come in and then we will get started.
We will give it another couple seconds here, it looks like people are still
joining in.
OK, so hello everyone. My name is Jenny Sichel with the national Council on
independent living and I helped coordinate logistics for these events. I am
also the operations record NCIL, I want to welcome all to our webinar 'CIL's
Use of Self and Peer Mentoring as a Management Tool'.
My pronouns are she, her. To give you a visual discretion I'm a white female
with brown hair pulled back, I have on a navy blue shirt. Yes, that is my
awesome description (Laughs).
Today's presentation is brought to you by the IL-NET Training and Technical Assistance
Center for CILs and CILs. (indiscernible) operated by ILRU and collaborations
with the (indiscernible) University of Montana with support provided by the
ministries for community living at the US Department of health and human
services.
So before we get fully into this webinar today, I want to go through a couple
of housekeeping tips and accessibility items.
We do have CART captioning and ASL interpreters that are available today.
You can access the captioning through the show subtitle tab in your menu bar.
If you do not see that, you can link -- look under more options and it should
be on the right hand side under more or the three ...
Our ASL interpreter should be appearing in the video screen next to me. Make
sure you are in gallery mode in order to see them.
And as we will be screen sharing, this is also very important that you ensure
that you are in side-by-side mode. I'm going to be forcing this presentation in
gallery so it should look OK but if you are not already, when I start screen
sharing, which I will start now so everybody can do it if they need to.
OK, there we go. So now that I am screen sharing, make sure you are in
side-by-side mode. And if you are not doing this already you can go up to the
top of your screen where it says "Jenny Sichel is sharing her
screen"and in the drop down there make sure you are in side-by-side mode.
If you are using two monitors you can check optimize for dual monitors and what
this will allow you to do is adjust the video and PowerPoint size, PowerPoint
to the size that you prefer.
If you have any troubles or questions, please just let us know in the chat.
In addition to our panel today, we will have plenty of time for audience questions
and you will be able to answer, or ask questions, by going through the Q &
A feature, in the Zoom panel.
There we go! Soon Q & A tab by emailing jenny@ncil.org, or if you are
calling over the phone you can press*9 on your keypad to raise her hand and we
will click on you.
We will have a few question answer breaks, also nearing the end of the webinar
we will have a Q&A portion.
I did want to mention that we have an evaluation that will be posted in the
chat box also towards the end of the webinar and then it will pop up on your
screen. We would be grateful if you could complete the evaluation at the end of
this.
And I just want to make sure, and people just put into the chat box, if you are
able to see the closed captions? Just put yes or no, I just want to be sure
about that.
OK, beautiful, thank you guys for your feedback there.
And so if you are unable to see the captions, to let you know again, you can go
to the "more"and you will see a "show subtitle setting",
make sure that you hit "show subtitle" in order to bring the
subtitles up. Once we kind of get started I will also throw a link into the
chat box that will provide you with more information, will bring you to the AI
Media site and then you can zoom in, adjust the captions and what they look
like.
That is a different site, but I will put it into the chat as soon as we get
started with this.
So it is about that time to begin today's presentations. I first off want to
introduce our presenters, we have Annetta Johnson, who is the executive
director of North West Virginia Center for Indepedent Living.
We have Kyle Kleist was the executive director at the Center for Independent
living for Western Wisconsin and we have Paula Michael Wade who is the director
of technical assistance at the IL-NET Training and Technical Assistance Center
for independent living at ILRU.
I want to thank you and everybody on this call for taking time for today's
event. Make sure you follow the evaluation at the end. So with that, we are
going to get started.
Just kidding, apology want to go over this a little bit?
PAULA McELWEE:
Sure, I can do that. Hi everybody, I am Paula. I am a silver haired, ruddy
complected, Scottish heritage and other British Isles, person. And I am wearing
a striped shirt but I guess you cannot see that very well.
What we are going to talk about today, I think is really important and it is
about how you assess your own program performance because you know that other
people are going to assess it in different ways and we will talk a little about
that as we weave through this topic but he will probably have a state review if
you receive part B money or state funds for your Independent Living program.
You will also, that sometimes has a separate review for the financial piece.
You have your own internal audit, that you hire independent auditors to do,
probably. You are not always for Carl -- word two, depending on your size but
probably you do that.
And the question is are you looking for yourself at the regulations, what they
require and what you do to meet them?
We believe that the importance of assessing your own performance is directly
connected to the Independent Living philosophy and we want to emphasize that
with you.
How you assess your level of regulatory compliance and quality performance
yourselves using some kind of organizational self-assessment tool. We are going
to talk about a couple of them. That is going to be one of the things you will
learn.
And also how to utilize those tools now before you have a review, or the next
review (Laughs) In order for you to have the information you need about what
you need to do to improve your performance.
So all of those are going to be things that we will discuss as we go along.
Next slide please, Jenny.
We are going to talk about self-monitoring and we have just a few thoughts
about the.
As I said, most of you have external monitoring, monitoring is not that new.
Federal monitoring has been less frequent but part C centers know they may get
a federal review at any time so the folks at ACL probably are or almost always
are inking about where they go for the next federal monitoring.
So it could be anyone. So you might ask the question "then why should we
adware workload by monitoring ourselves?".
While our question is "is it really added work or doesn't focus the work
you do so that you are always prepared for someone to come along and take a
look at your services?".
Next slide, please, Jenny, thank you.
So because we are consumer controlled, we need to remember that the best way to
apply regulations and policies for our community is for our community to do it
itself.
But we have to understand them. We have to know what to the regulation say,
what are the policies around what we are required to do? And then be proactive
in understanding those regs. so we do not just look at a piece of paper that
says these are the regulations you have to follow, or just look at a sample
review instrument and say "oh, yes, I think we need all those".
But to actually drilling a little bit, understand what the requirements are,
make sure that we are applying those regulations to allow us to present our
consumer perspective about them, to anybody who reviews us.
So that we can say to them "this is how we do this and this is why".
One of the things that is unequally understood across the country is that there
is a lot of autonomy for the centers on how they apply regulations. There is
not just one way to do things.
And so when you look at a monitoring instrument, it is not as rigid as you
might think. There are lots of ways for many of those regulations to be
applied.
For example, how you all do peer support.
How do you provide peer services, how do you monitor them? Are your staff
considered peers, is the work they do then considered peer support? Do you only
do it in group settings? Do you do it one-on-one? Do you use volunteers?
All of these are real options for meeting that one core service but that one
core service is not defined. So you get to pick how you apply the regulations
to provide that one core service. What do you do? And it may be very different
from your neighbor down the street or in the next state.
And that is true of a number of things within the regulations. There is
flexibility. We are consumer controlled and our centers should be choosing to
do the thing that you feel is most important for you to do for your center.
I hope that made sense. So what you are looking at is a way to be proactive,
understand the regs but then also decide what we want to do to perform well in
that specific area.
Next slide please.
So when we look at this whole issue of monitoring, we want to talk a couple of
centers that are doing it.
So I am going to ask Annetta first and then Kyle second to tell us how your
center conducts reviews to assess your compliance to regulations?
So Annetta, tell us how you do that.
ANNETTA JOHNSON:
(audio issues) management team will look at everything that we have available
with policies and procedures and use the COMP Tool to guide us into what we
need to be looking for then take it step-by-step so that we can go through.
We include the Board of Directors in doing the research and making sure that we
are meeting everything that we need to have.
We have found some things that we need to continue to work on and bring up to
be in total compliance. We are but there were always little things that you can
change.
It provided a lot of structure in the orca Xi -- organizational framework that
a lot of our individuals, the information they were not aware of before so we
have used it to definitely help us get on the right track.
PAULA McELWEE:
Let's talk more about what the COMP tool is. I will put a link to that. Tell us
more net on where you found this and what it is.
ANNETTA JOHNSON:
My program director found it online and had been using it to review things for
a few years before I came along. It is put out by -- federal regulations. To
help you make sure you have all of the requirements- it points out you have to
have your 501(c) certificate, your bylaws, your IRS form 990. And then
organizational documents, fiscal documents you need to have and program
documents. So that you have this list of items, if you are reviewed, that can
help you – if you have the stuff available and you know exactly where it is.
Then you are able to provide it a lot easier to the reviewers.
And make the whole process simpler.
PAULA McELWEE:
The COMP process stands for Compliance and Outcome Monitoring Protocol. That's
what COMP stands for. It was a process put together by ACL. Will they ever
change their process? I don't know if you are ever planning to but if they do,
our suggestion is you go with that flow.
As Annette's organization has been doing, we suggest that it might be useful
for you to use this tool. It has the actual checklist that the people
monitoring use. It has documents that it lists for you as Annetta was saying so
that you know some of the documents you need for review. And it puts it
together in a format that the reviewers should be looking at when they come to
see you in person.
If your federal -- reviewers come out, this is their document. Your state
reviewers may not have this document. We suggest they use it, several states
asked me specifically, if we have to do monitoring. (indiscernible) or using
the RSA document which is pre-2014. (Audio breaking up) very useful and I think
it's more effective to be looking at this document because this is current. Are
some of the questions the same? Sure because some of the regulations are the
same for topic covers the regulations, goes through the process, and make sure
that you take a look at that.
So you are looking at the same things that the reviewer will look at. My
suggestion is when you look at the checklist, that you do not just check yes or
no. But that you write, how you do it or what it is you do. Or the policy
number that applies. Make that checklist a place where you keep notes about
your own performance.
I think that is very useful. Carol, you ask about the controlled self
assessment and off the top of my head, I don't know what that is. If you would
write another note and tell me more, that would be useful.
I did just put the link to this assessment in the chat. It
is@acl.gov/programs/(indiscernible) dot comp. So you will find it there. It's
the last comment in the chat. That is one of the ways you can certainly look at
your own self-assessment because we find it might be useful to use the same
tool that the reviewer's useful stop like I said, not all your states use it.
Some of the centers are getting together, and taking a look at the whole state
and asking the question, should we/could we do all of this at the state level?
And make sure that we are all doing it and ask our state, our DSC, to use the
same instrument so we are on the same page. A couple questions showing up in
the chat to the panelists, not to the whole group but let me throw them out.
Really quickly. (Reads chat) the O in COMP stands for Compliance and Outcome
Monitoring Protocol. The instrument Carol was referencing as an instrument her
state is using for not one I am familiar with unless someone else's. So if it
is the instrument the DRS uses, your department, of rehabilitation services is
using, it's up to you whether you want to advocate for a switch to this
instrument. I think it is useful.
I think it is really helpful for you to take a look at that. There are some
thoughts on that. Kyle, we want to know about how you do compliance in
Wisconsin because it's a very different model. So let us talk a little about
what you do there.
KYLE KLEIST:
Thank you Paula. Kyle Kleist, pronouns are (he/him). White male with glasses,
graying hair and goatee. Paula, you brought up some really great points about
using the compliance tool. I like to think prior, to assessment. Here in
Wisconsin, we have what is called the quality indicators and independent living
services as a review tool developed by the centers. As a way of making sure
that all centers are not only complying but shall we say, having breast practice
-- best practice when it comes to services across the spectrum. COILS tool --
quills tool provides great format for the documents you will need and go
through. As part of the review.
I found it helpful as a process, as I am collecting the documents and going
through everything and even the checklist, it makes me dig deeper into seeing
how I'm actually doing. When it comes to those services. But it really provides
a great format to get everything together as far as all the documents.
You brought up a great point about digging deeper as well because one of the
things about the Quills review, it not only looks at the checklist but digs
deeper into how are you providing the services, making sure they really meet
the IL philosophy. Consumer controlled and things like that.
Also I found, it will make you aware of any shortcomings you might have prior
to having the review. You will probably be aware as Executive Director, even
going into the review, some things you may not be doing so well.
But really getting prepared for it is a way to discover, these are some of the
things that you may find out as a process of the review. I will stop there for
now.
PAULA McELWEE:
Don't stop quite yet. (Laughs) You know, this was a very different process.
What you just heard about was that the state centers had come up with their own
process. It doesn't match everything else that is being done but they do
something really interesting. That is, it is a peer review process not a self
review process.
You may use the instrument for yourself review first but it is a peer-reviewed
process. What is it like Kyle to submit yourself to your peers for that kind of
a review?
KYLE KLEIST:
Paula, one of the things I find really to be one of the best things about the
quiz review is that it is done by your peers. So it is not, you are not looking
at it this is your compliance officers coming in but these are your peers and
people you work with, network with on a regular basis that are coming in.
I have been part of a review on several ends. I have been part of a review when
I was on the board, I've been part of federal RSA review toward the end. When I
first was assistant director. I have been a facilitator of doing a review for
another center. And also, then recently having reviewed on – personally from
the process, knowing it was my peers that were coming in, that were doing it, I
felt it was almost a safer environment for me.
And the feedback I would receive. And it would be, from a compliance officer so
to speak.
PAULA McELWEE:
I like to hear that because it seems to me, that has multiple advantages.
Within a state, if you're willing to work together to do your internal
self-review process, and use peers to help with that monitoring process, I
think you will become a state that is more open with one another. About what
are the areas of weakness where some areas that you can work together to build
out your program and make it more effective and interesting. I think it just
has a lot of advantages to have a peer process of that sort.
I like – I like the idea of having your peers be side-by-side with you post
not everyone is comfortable with that. There are all kinds of reasons why, you
learned how competitive your state is, how much trust there is between centers,
but I think, a goal for doing this kind of thing, has advantages to building
those relationships between one another for Annetta, if I can ask you, how is
this review different from your audit, independent audit?
ANNETTA JOHNSON:
The only independent audit we get is with our financial auditors. That come in
once a year. They make sure that we are in compliance with financial type
stuff. But, as far as whether we have this other stuff, there is no one
monitoring that at this point.
We don't get a state audit per se. That looks at this type of stuff on a
regular basis.
PAULA McELWEE:
But that is kind of what I mean. Your financial audit is a group of auditors
who ask you for a bunch of papers, right? (Laughs) Whether they do that in your
office or in their office and how much of that is electronic. All that
continues to shift to more and more of an electronic process I think COVID
drove it faster maybe.
(Laughter)
PAULA McELWEE:
But that is kind of a very narrow look isn't it? Or what you do? Where your COMP
system hits almost every area. It hits management, it is finance, personnel...
ANNETTA JOHNSON:
It's a lot more detailed to me. Prior to this I have always been on the
financial side of it. I worked with the auditors on the financial part every
year. That was my main job, was the financial cycle stops so this is a lot more
– I'm learning a lot, this is, as you know, shorter-term for me so far. All
of the things I'm seeing, we are required to have whether we have them or not,
it's a lot of information. And it is very much more far-reaching than just the
financial audit.
PAULA McELWEE:
It really is helping you do a deeper dive as we mentioned coming in. A deeper
dive than you usually get to see of your own program.
ANNETTA JOHNSON:
Yes.
PAULA McELWEE:
Who has time to go around and double check some of the stuff we ought to double
check unless we make time for Ben this is the process that helps us make time
for
ANNETTA JOHNSON:
Yes, it definitely does help. I'm learning a lot from it. Like I said, there's
a lot more information involved than I would've ever dreamed. But it gives a
lot of guidelines, and different suggestions, and are just very helpful.
PAULA McELWEE:
Yes. Kyle, if you wouldn't mind it would be great if you answer the question,
you are answering in the chat. From Darrell Christiansen. If you would answer
that here.
KYLE KLEIST:
Sure, he was asking about the quails review, does go into making sure that you
are providing the core services I'd required (indiscernible) goes over – it
covers what your federal requirements are. It's best practices and independent
labeling. One of the great things in Wisconsin is a lot of that, not just I/O
services -- IL services, that we offer, making sure we do some of the best
practice way, but the fee-for-service work we do as well. Kind of as a network
of centers.
PAULA McELWEE:
That is also another thing that really is an advantage of having a peer review
as part of your internal review, or your review process to is to share best
practices because sometimes somebody else has got that best practice nailed and
really share that well, which is advantageous.
If and when you all look at the COMP system, go ahead Kyle-
KYLE KLEIST:
Paula, I was just going to add to the other part that I added to, is other
services that you offer, making sure that they stay within that IL philosophy
of consumer control. We operate a couple other programs that we want to make
sure that those programs really stay within the IL philosophy to.
I think that is important. In the review looks at those as well.
PAULA McELWEE:
Yes it doesn't really look set does the philosophy present, is the IL
philosophy present throughout your program?
If you look at the form, you will find their instructions and then you will
find there is a checklist. And I mentioned before, do not just check off yes or
no on the checklist but make comments.
There is a comment section on that form and so what that comment section does
is give you an opportunity to actually say how you do it.
So it asks "did you provide independent skill training during the last
year?", The period of time that they are reviewing. And you can just say
"yes" or you could think to yourself "what is the best way I
have to show them how great our independent living skills training is?".
Best practices, right?
So you've got that concept and you want to make sure that whatever you do, you
are doing the best within the philosophy. And so the questions themselves, and
Darrell, this caused your question on how do you measure the IL philosophy for
review, you have to continually, I mean they have measurements in here about
consumer control, but you have to continually think "let me think about it
how do I do this and do it well?".
In the questions and answers throughout the checklist, if you actually take the
time to answer them thoroughly, will lead you in the right direction.
I want to mention something that can happen during such a review.
It is never good news exactly but it is preferable to the alternative.
As one of the things that can happen during either a review on your part, is
that you may find that there is something going on that should not be.
How serious that is can vary a lot from one place to the next. So when one case
it might be a serious embezzlement. In the next case it might just be that
someone does not understand your record-keeping system and is not keeping good
records of services. And everything in between.
But when you do your own thorough review, you will find things that need to be
improved and you want to do them now regardless of whether you are going to
have a federal review in the next few years are not. Because you want to do the
best services you can do, right?
So as you do a review you may yourselves find something that needs correction.
And do not be afraid of that. And in fact embrace it because isn't it better
that you find it than if it is the state, you know, the state DR or the DSC or
federal reviewers?
You need to know yourselves whether things are being handled according to your
policies and procedures. And one of the things they will do is say "do you
have a policy?", And then they will ask you if you follow it.
You cannot just check the yes box and say you have a policy, you have to also
think in terms of how -- are you following all of the elements of the policy.
Sometimes you may be wondering if the policy is thorough or not?
So I was talking to somebody earlier about conflict of interest and we were
discussing the conflict of interest policy and we were thinking out loud about
a situation, personal situation where there was a conflict. And whether or not
the policy adequately covered that situation.
You should be doing that kind of review every time you use a policy.
Is this policy the very best it can be to address the situation? Whatever the
situation is.
And that is what you are seeking as you go through this checklist. That is what
you are really wanting to look for as you go through.
There are lots of sections in the checklist. I do not know how many pages it is
total but only eight pages total, but if you write your notes in the comments
and then turn over the paper and write them on the back, (Laughs), Or use an
electronic version and keep letting the comments expand, I think you may find
that you really will know more about your organization than you did before you
started.
Because they may be asking questions you just have not thought of before.
The questions are all directly related to compliance so they are important but
they are also useful. They help you with your organizational structure.
Let us look at that next slide, Jenny.
So, here is the question that I have kind of been circling around. "How
does this process help your center to perform better?". Annetta, would you
like to lead off on that?
ANNETTA JOHNSON:
Um, the process is helping us get a better understanding of what we need to be
doing, where we need to be at and doing research for how others are doing the
processes is also helping us to modify hours to where we need to be.
We have had to show a little progressiveness (Laughs) As far as coming up to
the current time for the things that we do at the center.
PAULA McELWEE:
I hate to interrupt you but your sound is not very good. Could you come closer
to the microphone, we are having trouble hearing you.
PAULA McELWEE:
OK, I think in the process that we are coming up a little better with the
times. But going into the details of the things we are supposed to have, how we
do them, and then additionally how other people are doing them, are helping us
to improve the process of how we are dealing with our consumers.
PAULA McELWEE:
And I do not know if either of you have done this but one of the things that I
have seen that I really like is after you have finished your review, whether
you do an annual review or every two or three years, that you feed the review
information back individually to some of the staff that it impacts, both
complements and things that need corrected so that you can continue that
process.
Kyle, how does the process help your center perform better?
KYLE KLEIST:
Paula, same thing as what Annetta was getting at. One, like she was saying,
modified or making sure we are creating processes, making sure you have those
in place. Really finding out what you can be doing better. Where are your
shortcomings?
So I mean one of the things that came out of our review was we need to be doing
a better job when it came to peer support. I mean, I knew we were not doing a
very good job but the review process really kind of made that stand out.
In one of the things, I know you and I were talking about prior to this, was,
use it for strategic planning. So we had done the review prior to our
three-year strategic plan.
So what came out of the review was so helpful, so we could include those things
in our three-year strategic plan to make sure that as a center we were going to
address them.
I mean really developing goals and strategies around them.
So things like peer support. Things that came out like outreach to underserved
populations. So that went into our strategic plan.
Training, more additional training for staff around like diversity, equity,
inclusion. That wound up in our strategic plan.
So that was one of the things I really found most helpful, was coming out of
the review and going into our strategic planning, it really helped to guide us
as a center and as her board found it very helpful as well.
So, whether you're going to be going through any kind of compliance review or
not, if you're coming up in years three year strategic plan, you know just
going over the COMP Tool is a way to look at whether there are things you need
to be addressing over the next three years.
PAULA McELWEE:
I really like the idea of the COMP Tool leading directly into planning. I think
that anytime you assess yourself, you should find ways individually or as an
organization as a whole, that you can continue to progress to meet the needs
that you have uncovered through your review process.
An attack, there is a question for you in the chat. I think you must've use the
word progressiveness and said you have fed -- have had very little
progressiveness and they are wondering what you meant by that?
ANNETTA JOHNSON:
Well in West Virginia, until the last year or two, there has been executive
directors that were the same executive directors since the 90s or 80s, whenever
the individual center started, that continued to do this -- things the same way
as they did and they started.
Times are a little different now (Laughs), The availability of different types
of communication and electronics that are out there, it is definitely changing
the way that we can do things and so in the time, the six or seven months since
I have been the ED, we have been able to bring us a little more up-to-date, and
progress in ways that we can perform our services with our consumers and get
our messages out there.
Does that answer the question?
PAULA McELWEE:
I think it does, thank you very much.
You know as we look at this whole big picture of what centers, what the
landscape looks like for centers, I do not know if we should call it post
COVID, I have not decided but post most of the COVID response, we did learn
some things through that process.
And I think one of the things that we learned is both the strengths and
weaknesses of electronic information. And I just want to suggest that as you
look at a performance review process that you do two things.
That you look first at the policy or the written documentation, and then you say
to your staff "OK, now show me how you do this". Because you are
never going to really have a complete picture, right? Of the things that are or
are not happening if you do not have that direct response from your staff.
Let us look at that next slide, Jenny.
Here is a fun one. So you're going to have a review process. So you are asking
questions and looking around and maybe you have some peer-reviewed was as a
part of your process. OK, do you find that that review process then becomes a
place for your staff to vet personal gripes and how do you handle that? I'm
going to direct this one to Kyle first.
KYLE KLEIST:
Ah! Thank you Paula, yes. So, as I previously said, I have been part of a
review team, so cofacilitator. And then as recently -- and that has recently
gone through a review.
So let me just say, not going into any details or anything but this you might
see as an opportunity that staff may have grievances or issues that have
nothing to do with how you are performing as a center. But they may use this as
a venue to air some of those grievances.
How I handle that, I just look at it as what it is. I will deal with that after
the review process or have this -- their supervisor deal with it, whatever the
case may be but just getting back and refined -- reminding the reviewers as
well that this is all about, we are operating as a center and you know, but you
know on the same note the reviewers may come across a serious issue that you
might not be aware of so if something like that came out, I mean, one of the
great things is you know, that with the QUILS review that your peers, that you
are working with in dealing with, so if a serious issue did come out, rather
than anybody on your compliance officers shall we say.
But I have seen from both sides both opportunities that your staff might use
this just as a way of airing some of their grievances.
PAULA McELWEE:
Sometimes they feel... Have a person here who has to listen to me because they
are in the process of doing this review. Annetta have you had an experience of
that sort it all?
ANNETTA JOHNSON:
(Audio breaking up) no matter what you're doing they want to get their personal
gripes in there. I usually try to divert the conversation by, this isn't the
time and place, so we should set up a time to talk.
But, as far as the review, I have not had that come up yet.
PAULA McELWEE:
One of the things I suggest when it's in the middle of a review, is to look at
the policy on what you are supposed to do about this. So we look at the policy
and procedure, and it says, whatever it says. That it must be in writing to the
supervisor or goes rectally to the executive director there's a grievance
committee or board. There are a lot of different setups within your centers so
you want to follow your own policy. Looking to see what that policy says first.
So that you know exactly what is going on.
Following that policy, help -- helping the staff to follow that policy is
important. In this process, sometimes you realize a staff person doesn't know
where to find the policies. They were not told, they did not get a copy of the
personnel handbook, they came on board during a transition and did not get the
update. Whatever the weird situation is, sometimes a person does not know.
Or says they do not know, in which case you still want to go back to the
policies and say, "here's the policy, let us follow the policy to resolve
this gripe. Let's follow it through."
So you can see how that process works at the same time. Maybe not completely,
because the policy sometimes gives you 30 to 60 days or whatever, to resolve
it. And of course your COMP reviews will be 2 to 3 days, so maybe not entirely.
Next slide.
I think we may have covered this Kyle, because I jump ahead sometimes. Anything
else to say on your peer review process and how you accept peers feedback?
KYLE KLEIST:
You know Paula, goes to one of the great things about the peer review is, it is
confidential. So when you get that file report back, from the review team,
which member, those are your peers, it generally consists of three people that
would be within administration.
Within an IL center, but also includes experienced IL staff as well. That is
yours to do with as you will. Since the review was paid for, through the State
Independent living Council, one of the requirements is that you just highlight
a couple of the areas that you plan to work on, but generally the tools –
what came out of it, is yours to do with.
You could say that you don't agree with any of it and throat away, or you can
take it to heart and say that you really need to look at some of the stuff and
dig into it. And find out, how you could do better.
But like I said, one of the things I found is that when I know it is coming
from my peers, I find it easier to accept. Because these are people I know, for
the most part, have been at IL and are providing direct services as well.
I tend to take the more optimistic side. When it comes to accepting the review
and the feedback from it.
PAULA McELWEE:
I like that! Honestly, I think it is so healthy when a state can do that. When
they can do a peer review because they have a good enough relationship between
the network members in that state. That they can actually review and follow-up
and follow-through and support each other. In improving services statewide. Let
us look at the next slide.
Whoops! (Laughs) This slide is to remind you about that evaluation but we will
go to questions and answers now. In a slide or two. So the COMP review
developed by the feds addresses the core services. And there are more than just
core services available. It does address some of those programs as far as the
philosophies that are captured in the questions.
Let us talk more about exactly how it boils down and helps you with those
services that were not poor. Kyle let's start with you because you mention this
earlier.
KYLE KLEIST:
Thank you Paula. One thing that I point to is, we have a personal assistant
services or a PAS program. I know a number of independent women's centers
across the country are getting into the personal-care business because we are
wanting to be there to provide those home and community-based services. So give
people a lot of institutions. But as those programs go larger are they staying
with the IL philosophy yet are they consumer directed or are they becoming more
of a service provision than part of your IL center. Is your agency and IL
center at the heart? Regardless of whatever programs you operate. We operate a
volunteer driver program that covers half the state of Wisconsin.
When we do that, are we staying true to independent living when it comes to the
services we are providing? When it comes to the riders? And what their goals,
their wishes are?
Even with the drivers, when we do our training, for our drivers, is it talking
about independent living? So, really, that's what we want to stay true to. As
other programs grow, other IL centers get into that fee-for-service game, we
want to make sure it is driven by that IL philosophy of consumer control.
That is my personal belief as well. But I believe it should speak true for all
of the other programs that we operate, from IL centers outside of those five
core services.
PAULA McELWEE:
Annetta, did you have anything to add to that?
ANNETTA JOHNSON:
(Audio breaking up) I know that we are starting a veterans program. Mainly,
because it was brought to us by ACL. But it does definitely fill the IL
philosophy. How the COMP tool is going to help or hurt with that I'm not sure
yet because we haven't gotten into it that far. I know because of the COMP
review, I am looking at things a little closely with this new program.
To make sure it keeps in line with where it needs to be.
PAULA McELWEE:
That's a really good point, as you look at any new programs that you are putting
into place, they are -- there gonna be things about goalsetting and
record-keeping and other things that apply to whatever services you provide. In
fact, did you all know that centers are required to prevent the core services
+2? Have you ever heard of that? Core services +2? I had almost forgotten about
it because it's been so long since I've heard about it and then I read through
the COMP tool and in section 9, in case you want to check me out and see if I
know what I'm talking about, in section 9 it says during the reporting year,
did the CIL provide accommodation of any two or more of the other IL services
defined in section 718 B? And there's a list of other services that can be
Independent Living at one time it was clear to us that we must provide two more
besides the core services.
While that has not been talked about a lot lately, that is still in the COMP
tool. So it is evidently that ACL will be looking for. It was worth it to come,
just to hear that, right? (Laughs) Let us go ahead and look at the next slide.
Questions! I hope that you do have some questions about how to do this,
anything that we have not made clear as we have gone along here.
Here's one from Tiffany (Reads chat) don't feel like some of the funds coming
through to centers via ACL and federal entities are not challenging us? On the
philosophy?
Kyle, Annetta, why don't you answer these questions as they come up? Alright,
do you feel that the funds are not – or the funders are not challenging us on
the philosophy?
KYLE KLEIST:
I think I would agree with that Paula. There may be times that the funders are
not challenging us. That is where we have to challenge ourselves. Or, even make
sure that our board is challenging us.
You know? Or your staff could for that matter. Staff that are involved, make
sure that it is being driven by the independent living philosophy because there
is so much that goes on that somebody – so many centers are involved in
providing those home and community-based services. We want to make sure they
are really driven by that philosophy.
PAULA McELWEE:
This compliance tool has some philosophy elements that I'm not sure centers
think about very much. So if you look at section 5, of the COMP tool, it is
talking about, from the purposes of the rehab act, it's talking about the equal
access section. From the purposes.
It's a specifically active the (indiscernible) access for individuals with
significant disabilities within their communities and to all service programs
and so forth ... and there is, three or four questions with equal access
specifically. It asks about, are you reaching out to our range of significant
disabilities? It's asking that cross disability question.
Philosophy has to do with a lot more sometimes than just consumer control.
Which is essential. Absolutely. They are not saying it isn't. But wow! What a
big deal it is to think about equal access. Where on earth do we have equal
access really? Right? And to ask what are we doing to address equal access and
to take four questions, ask for questions, and this compliance tool of only
eight pages is a pretty big challenge to our philosophy.
Tiffany, I think you are right, sometimes it doesn't come through. Sometimes
the focus seems to be just on the consumer information file. Or the core
services and not really on the philosophy pieces. As centers, we need to make
sure we focus on those philosophy pieces. They are important things we must
also do.
I know there are some centers out there that are getting paid based on time,
provided for each core service. In one of the challenges that I gave back,
although you know, this particular state said that they give lots of money so
they don't need to worry about it. But my challenge back is, as soon as you try
to pay for so many hours of core services, you are missing this whole point.
It's a very important thing to look at equal access. And we can't miss that.
So, we need to keep a look at that.
KYLE KLEIST:
Paula, I want to say that one of the great things about the QUILS review, that
I found helpful, they interviewed both my transportation director, my finance
director, my PAS program director and those staff as well. It was the entire
agency at all of the staff and all of the programs that we operate that were
part of that whole review process.
PAULA McELWEE:
Yes, so Angela is asking about financial policies, they are extensive, helpful
in making it through but how do we get the board to review them? I think the
responses you interview the board about them. And that is part of this COMP
process.
As you can ask the board what do they know but the financial policies and
procedures? They are in charge of that. They have the responsibility at the end
of the day for the finances of the organization so I think taking the bylaws
back to them and asking them questions as part of the interview process, doing
the same with both the financial policies and their policies and procedures,
sometimes they have policies and procedures, and then the bylaws themselves, I
think would be a really effective way to do that.
What you guys think?
KYLE KLEIST:
I agree 100%.
PAULA McELWEE:
OK. Other questions y'all? You have lots of time.
KYLE KLEIST:
Paula, you know one last thought that came up that you and I had discussed that
nobody I am surprised is brought up today is virtual versus in person. We are
still in the time of COVID and conducting a review.
Being there in person you have so much access to staff, if you needed to follow
up on policies and getting questions answered, it was really easy to do.
When it was consent -- conducted at my center the year before, during COVID, it
was done virtually and even those people that conducted the review pointed that
there were a number of shortcomings, since it was conducted virtually.
And I will agree with that hands down. We were not able to really get the full
feel of the center, so to speak, really talk with the staff, be there in
person, get real good and quick follow-up if you had questions and things like
that.
So, I would highly encourage people, if you can avoid doing it virtually, do
so. In person is so much better and you will really get much better information
doing things that way.
PAULA McELWEE:
And when you're doing a self-review, when you're doing each of these questions
the most effective way to do it is to go to the person responsible and to say
to them "show me how you do this". And they can show you where they
take notes or show you, their phone log or whatever it is that demonstrates
what it is they do.
And you cannot really do that effectively, you can say "tell me
about" but it is not the same as seeing or hearing directly from them as
they are actually showing you a process. Any other questions or comments?
Darrell asks "to this point: what are ACLs plans moving forward in
conducting reviews? Have they said how many? Virtual or in-person? What do you
know?"
What they have said is the PPR process, the program performance report that you
submit in December each year, that that process itself is part one of the review
and that they will look at that and they will give you feedback, and they will
ask questions and they will make sure that you have, you know, met the
compliance required for your center based on your PPR. So that is part one.
And they intend to do that for all centers and they only have, I think they
said they only have one center that did not provide the PPR. So that is an
interesting one to look at.
As you consider that, as the first process, then the question is "what
would other processes be?" And they do do some phone follow-up. If they
get a complaint, I understand that they do sometimes follow up with that
center.
I do understand that they are also preparing to do their first in person views
sometime in the coming, the rest of this calendar year or next year. I do not
know exactly when. They were contacting us about a piece of the process but
they did not tell us how many are aware or anything like that but I can tell
that there was activity around it.
So I think they are moving towards doing those in person reviews at some point
in the future and I think we will look forward to seeing that.
Good question though and we would all love to know when and where and how many
reviews.
ANNETTA JOHNSON:
Paula, I think so but he had their hand up.
PAULA McELWEE:
I saw that and I do not know what to do with that but Jenny is working on it.
Because I hand up does not show in this format of webinar so-
SPEAKER:
I can just chime in, if you have your hand raised, for accessibility, that is
great. If you are able to type your answer to -- into the Q&A section, that
would be better so we can reserve hand raising for individuals who are phoning
in. So if you can just let us know either way in the Q&A section, I can
either unmute you or we can answer your question after you type it in.
PAULA McELWEE:
And do you know (indiscernible) question?
JENNY SICHEL:
I do not known (Unknown Name)'s question.
PAULA McELWEE:
(Unknown Name), we do not have any way to my mic you.
JENNY SICHEL:
Go ahead, Kobe. You just have to take your cell phone off of mute.
SPEAKER:
Thank you, great. This is Kobe Livinstone and I am they Vice Chair in
Albuquerque for the state was Independent living Council. I am legally blind
and I cannot type and listen, I really wanted to just talk and I could not do
that in the webinar thing so this is great.
So when you talk about a state, when you talk about a strategic plan are you
talking about the state plan that comes every three years?
PAULA McELWEE:
No, we are talking about the centers plan so each center, this is not the SPIL
but the SILC does, but each center must also have some kind of a work plan. It
is actually for the center specifically.
SPEAKER:
So when each of the panelists talked about the state review, is that the SILC
reviews?
PAULA McELWEE:
No, the SILC does not review the CILs, it is the designated state entity/that
is the state of New Mexico's department.
SPEAKER:
Right. OK.
KYLE KLEIST:
Paula, I just wanted to answer Jacoby's point, one of the things is that we do
provide feedback on the QUILS to our state of independent living Council since
the funding for that review does flow through them. As well as the DSC as well.
SPEAKER:
Thank you, and how many states on average have the state as the DSC?
PAULA McELWEE:
Every state has a DSC,
(Multiple speakers)
PAULA McELWEE:
But I only know of three states where it is not the Department of
rehabilitation.
SPEAKER:
OK.
SPEAKER:
That is because her history and where we came from so to break free from that
is not always something that makes sense.
SPEAKER:
It is not an easy thing and it is something, we are talking about in New
Mexico.
PAULA McELWEE:
Kobe, we need to get you on the SILC calls.
SPEAKER:
I would love that.
PAULA McELWEE:
I think I sent you that information but if I will work on it and if I do not
get it to you I will call you.
SPEAKER:
I'm glad to have this. In our state (indiscernible) (Unknown Name) living
counsel will be going through a, what is going on in New Mexico? Why can't we
keep an executive coordinator director?
PAULA McELWEE:
Why don't you and I talk about that further. Because I want to be on that call.
I need to answer couple of other questions
(Multiple speakers)
SPEAKER:
My point is it is so important not to do the (indiscernible) game, use my time
to air my griefs. I just thought that was a great point and really needs to be
emphasized and handled with care. Thank you Paula and the rest of you.
PAULA McELWEE:
We will talk to you a little bit later, yes. Lois, you ask what the options are
for the Plus2 services? It is a long list and it includes things that do not
make any sense to me like psychological therapy, as in other at the end. So it
includes just about everything you can imagine.
You can look at that reference that we had on the slide or I can send you a
reference with the list.
Would you take a second, Kyle and explain how your QUILS process came about?
KYLE KLEIST:
Oh boy, I am not as well versed on the history but it came about as a result of
really wanting to look at best practice within Independent Living.
I believe it was the first review was done back in the 90s.
PAULA McELWEE:
OK, I am old enough
(Laughter)I can give some of this.
So the centers just decided to be proactive about it. They looked around and
saw that nobody was really reviewing about the things we think are important,
let us put it together and review each other.
And it was done mostly by the state association of centers. That is who took
the lead. It was Maureen Ryan who was the director there at the time, and took
the lead on that.
And it really was, it filled a very important gap I think in review processes
and was very useful in that way.
The question about whether you would do it quite the same way though now, I
think there is already discussion right about the QUILS process being so
different from the COMP process and that you would not necessarily set one
aside from the other because they are complementary. Is that accurate?
KYLE KLEIST:
Yes, that is accurate. Absolutely, we would still, I mean even if we use the
COMP, we still feel that the QUILS review is a really helpful tool as well.
PAULA McELWEE:
And as far as part B versus part C, the COMP system really does address the same,
part B centers and part C centers are really not that different what they are
required to provide, and they still have to meet the federal regulations. So
the actual process of reviewing them with the COMP system is going to be the
same and it is going to be virtually no differences between the two when you
look at the review process.
So the things that are reviewed by both part B and part C, part C is usually
who is reviewed directly by ACL, part B centers are reviewed by the DSC. These
are the requirements they should meet, but your DSC may have another instrument
that they are using, so be aware of that and find out what they are using. Talk
them into using this (Laughs). Alright, other questions that we can answer?
SPEAKER:
I want to direct you to one in the chat section from Curtis.
PAULA McELWEE:
I hear these reviews are awesome but other than making sure we are compliant
and staff are documenting correctly I don't see the connection of how this lets
you know how you can better improve services to consumers. (Reads chat)
There are elements we haven't talked in detail about, that have to do
specifically with the consumer satisfaction with your process. You are looking
at consumer satisfaction, you are looking at the quality of goal setting. Whether
or not goals are being met by consumers, you are looking at several of those
kinds of things.
We haven't emphasized that but we should have more. There are some very direct
connections. But the other part of it is, as a center, isn't it cool to look at
your whole set up at once? Really examine every piece over a week at the most.
A few days. Look at it, make notes, and at the end, celebrated.
Bring everyone who wants to come in, and. If you are doing in person stuff, if
you are not doing that, have an online party and celebrate here are the things
we felt we were doing well. Here are the things we discovered that we want to
improve. Let us all get on board, congratulations to everyone for such a good
job. Thank you for participating in this... it's a way to encourage people for
the things they are doing well and a way to solicit input from the consumers,
your consumer surveys can fit right into the process.
And you can continually look at how to improve. Hopefully that is something
that works for everybody. Further questions or comments? Last thoughts from
Annetta? Did you have a comment?
ANNETTA JOHNSON:
I was going to say, using the COMP tool, there's a compliance review document
upload section. It just gives you a checklist. One of the things that I never
thought of, that is on the accessibility checklist part, is making sure there
is Brailler raised markers on the microwave. We have a staff kitchen, we don't
have one necessarily for consumers but that was something I hadn't thought of.
There are little things in here that are helpful even if you don't go full bore
on to make everything they are suggesting the way you do things. There was
definitely a lot in here, that brought things to my attention. Or were helpful
to me that I would definitely suggest people look into it.
PAULA McELWEE:
I did a review with the center with a person I respect very much. As the
executive director. I walked in and there were candles burning. -- Of course we
want to keep our environments free of anything that will trigger negative
reactions, allergies and so forth with people who have sensitivity around that.
So, I stopped to talk to each person at their desk about that. It is not a
great idea, I went back to talk to the executive director about it and he was
sitting there with the associate director and they looked at each other,
(Laughs), And they said, "we have had a sewer smell in the back of the
building and we thought it would make a worse impression. On the reviewers,
then the candles. So we have all these candles burning." And I said,
"you have to do what you think is right. And you have a policy, don't you?
About scented items in your workplace? Let's take a look at that."
We have time for a couple more questions if you all have some.
KYLE KLEIST:
Paula, I want to include one out last thought as well. One of the great things
we do here in Wisconsin with the QUILS review, is we highlight the things you
are doing great as well.
It's not just compliance, are you documenting? When you are really doing great
stuff, the review highlights that and says, "you know you guys really rock
when it comes to doing ..." it's not just looking at what your
shortcomings are. It's looking at your strengths as well.
PAULA McELWEE:
Good point. You really want to celebrate those. What about frequency of
reviews? Are you doing them manually or doing less frequently than that?
ANNETTA JOHNSON:
I plan to do them annually, this is my first year. (Laughs) We are working on
it. But I think it will probably be directly once a year but it is an ongoing
process throughout the year when you get new programs. When anything you have
that comes up that's an issue in your center, that's something you can go back
to.
PAULA McELWEE:
Go back and review.
ANNETTA JOHNSON:
See with the recommendations are. For me, being new, that's where I met with
it.
KYLE KLEIST:
It does not hurt to review it annually. I would say dig deep into it. At least
every three years when you go to do your center strategic planning.
PAULA McELWEE:
I think digging deep is important. So if that means every other year or every
three years for you as you do your planning, I think that is certainly
acceptable. You just need to make sure that it is meaningful review. Because if
you don't do a meaningful review, your process is cursory. If you dig deep into
each of these things and really ask yourself, "how do I prove this and
show this? Is this something we can demonstrate that we are doing?" I
think it really does make a big difference.
Jenny, I think we may be done.
JENNY SICHEL:
OK. Great. We will go to the last slide. And make sure that people do fill out
our survey. I will put it one more time into the chat. And then, I will come on
video here.
If everyone could fill out the evaluation, thank you again for joining in. Have
a great afternoon! Thanks all!
Live captioning by Ai-Media
![logo](https://us.ai-live.com/Areas/MAL/Content/Images/LOGO_ailive.png)
|
NCIL-Assessing Your CIL’s
Success: Using the ACL M (USNCIL2308B - Ai-Live Premium)
|
|
|
|
Page
of
|
Downloaded
on: 24 Aug 2022 8:08 AM
|
![logo](https://us.ai-live.com/Areas/MAL/Content/Images/LOGO_ailive.png)
|
NCIL-Assessing Your CIL’s
Success: Using the ACL M (USNCIL2308B - Ai-Live Premium)
|
|
|
Page
of
|
Downloaded
on: 24 Aug 2022 8:08 AM
|
|