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Buffalo River Services Participates in Focus Forum

August 25 , 2011

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Buffalo River Services, Inc. is a private non-profit corporation licensed and contracted by the State of Tennessee to provide services to adults with disabilities.

We are pleased to share this conversation with Philip C. Garner, Executive Director.

What was the decision-making process to choose to work with CQL?
We have had people trained in the past ten years as interviewers for the Personal Outcome Measures assessment process.  We have integrated this into our internal quality assurance plan.  For many years we have attempted to weave the concepts and philosophy of person centered planning and thinking into our work.  Starting in 2008 we began a project in collaboration with the Tennessee Division of Mental Retardation; now known as the Department of Intellectual and Developmental Disabilities (DIDD).  This was a technical assistance grant that was planned and facilitated by Michael Smull, The Learning Community for Person Centered Practices and Helen Sanderson Associates.
Buffalo River Services, Inc. worked with this project for three years learning more about person centered thinking and planning. This allowed us to incorporate some of the ideas and tools into our everyday work.  After that project ended it only seemed natural to engage CQL in renewing our assessment team and then to engage in the Focus Forum. We understood that the Focus Forum would bring the loose ends together. We expected that it would provide an excellent method to do needs assessment for not only some of our service recipients but for the organization as a whole. CQL’s Jill Westring led us through several activities and tasks that were industry and agency specific similar to S.W.O.T. (Strengths, Weaknesses, Opportunities and Threats) and the ‘environmental scans’ as known by other industries. Together with the information which was gleaned from the Personal Outcome Measures® interviews which we completed, we had a good picture of where we were and where we wanted to be. Thus, we had the origination of a strategic plan for quality improvement and enhancement.

Tell us about how your organization prepared for your Focus Forum?
We did interviews with about 20% of our service recipients and their families in the weeks prior to the Focus Forum. This perhaps is not always necessary but we wanted to have more interviewers trained and this gave us tons of information that we might not have garnered otherwise.  We invited family members, members of the community that were stakeholders, consumers/self-advocates, representatives from the state and representatives from advocacy organizations. 

In hind sight we did not spend as much time in planning to have better representation from as many stakeholders as we probably should have. We were able to include several of our service recipients and some representatives from the DIDD  and from The ARC  of Tennessee.  Of course we had been gathering suggestions and ideas from others for several months prior because of the Person Centered Planning project. All these things were prepared in report format and shared with the group at the Focus Forum.  We provided an off -site location so as not to be interrupted. It was complete with all the nice things such as refreshments and a conducive atmosphere.  We ensured that we had plenty of markers, note pads, wall charts and other things needed by the participants.  Self-advocates were partnered with “secretaries” who were paid DSPs and they all were engaged in the process.  The agency wanted to have the majority of representation in the Focus Forum to be from service recipients and Direct Support Professionals. We also had representation from Independent Support Coordinators.    The records of the past several POM interviews and the results were pulled and organized into one document to allow a historical perspective of the agency’s efforts to assess and rectify barriers to full spectrum person-centered services. The consolidated report was used in the FF to assist in building outcomes and goals.

Tell us about your Aha moments.
The best “aha’ moment came a bit after the Focus Forum when a long time employee and advocate. Pati Dodson, Program Assistant for Buffalo River Services, Inc., envisioned our mantra that was adopted by the agency. It states, “our ‘duty’ is not to tell, teach or lead but to listen, support and accompany”.  This unvaryingly summed up the whole event.  This was a very inspiring moment.

We also became highly sensitive to the idea that we must try to do the best we can to care for the Direct Support Professional because that person will do a better job for the consumer if they feel supported. Thus we expanded on an idea that we had a couple of months prior to utilize an on-going committee we called the Motivation Committee. This group devised a system to allow all staff to be extra rewarded for great work, actions that go above and beyond the call of duty.  We call it “Buffalo Bucks”.  This allows staff members to be given Buffalo Bucks, an agency generated piece of paper, to later be traded in for tangible items. Once per month the “Trading Post is open and people can trade the Buffalo Bucks for tee shirts, pens, bags, restaurant gift cards and other  items.  It is a lot of fun creating an atmosphere of celebration and cheerfulness. This provides a way of saying that we notice which doesn’t over extending budgetary limitations. We all know that funding is an obstacle to plan around. 

We continue to plan for the improvement of the DSP position as it is the most important position in the organization and comprises 82% of the employees. 

What are your next steps and how can CQL help you implement the changes you identified and prioritized during the Focus Forum?
We are in a state of constant revamping the strategic plan to accommodate new information or a new outcome that is needed.  As stated earlier, we intend to continue to use the POM assessment as part of our CQI initiatives but also it is helping us to stay within acceptable parameters when the day comes for us to seek accreditation.   We are working from the idea that we need certification for DSPs.   We assisted in helping to pilot one certification test for direct care workers and we plan to continue the search for a compatible certification process. We are working with the Direct Care Association of Tennessee as we explore potential avenues of DSP certification. We believe (as was evident through our work with the Focus Forum), that the Direct Support Profession should be considered as a career path. The DSP is a career not just a job or job title.  We are hoping that more states will soon recognize accreditation as an option to seek in replacement of state audits.  This is where we could use some assistance with CQL.

What do you think will be the short-term and long-term impact of increased focus on person-centered excellence?
Buffalo River Services intends to stay targeted on person centered thinking and planning.  We expect that we will continue to have an impact on this movement as it continues across our home state and the country.  To have a person centered philosophy is vital to supports becoming the property of the service recipient and their families.   The impact should be to see greater levels of satisfaction with people getting the supports and better efficiency by the system in the allocation of those supports.  In our own organization the challenge is to “keep the faith” in person centered thinking and planning, “to listen, support and accompany”. 

Anything else you would like to say about CQL or the Focus Forum?
So in summary, we have a detailed plan (with many outcomes that we have not discussed here) to help us as we validate and continue planning the needs of our current people receiving supports, the needs and wants of the potential consumers and a host of other issues such as training, hiring and development of best practice.  The Focus Forum started this progression. We want to thank CQL’s Jill Westring for her excellent facilitation and encouragement. Also thanks to Carrie Guiden of The ARC of Tennessee for helping to plan the final version of our plan, Also Michael Barbour, Case Manager , Tennessee DIDD,  provided excellent insight and assistance during our Focus Forum.

We highly recommend that the FF is an excellent method to streamline a plan of action toward continuous quality improvement with a person centered foundation.

For more information on Buffalo River Services, click here. 




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