The newsletter of The Council on Quality and Leadership
Partners in Excellence; Leadership for the Journey

Quality Measures 2005SM: A Bridge to the Community Place

The Council on Quality and Leadership (CQL) is introducing Quality Measures 2005sm as a quality and leadership bridge to the community. This metaphor of a bridge signals our goal of using the Quality Measures 2005sm to connect people to their communities. We hope our bridge takes people to physical neighborhoods and social networks spread across distance.

In the 1990s CQL focused attention on each person. We defined quality by discovering the meaning that each person attached to the Personal Outcome Measuressm. CQL demonstrated national leadership in redefining quality in terms of people rather than compliance with organizational process and procedure.

Now, in 2005, we want to change the place we associate with quality. In the past, we grounded the definitions of quality in organizational places ­ the institution, group home, alternative living arrangement, workshop, home, or employer. CQL is again demonstrating national leadership in redefining quality in terms of community place rather than organizational place. These places no longer provide a meaningful context for the attainment of personal quality of life. We now want to measure quality of life in the context of community. This focus on community place means that the purpose for providing quality services and supports is to better connect people with their communities.

The construction of our Quality Measures 2005sm Bridge to Community Place has required solid foundations in the bedrock, flexibility in structure and respect for the differences and individuality of the people crossing the span, and convenience and ease of use.

The Foundations for the Quality Measures 2005sm Bridge are found in the values and Basic Assurancessm.

A New Role for Organizations

These Quality Measures 2005sm emphasize a new role for organizations. Organizations connect people with community, with other people and new opportunities. People, organizations and communities depend on each other. People and communities create, foster and define organizations that enable people to find meaning in, and interact with, the community. Organizations serve a mediating function. Whether formal or informal, large or small, organizations help people get along in the community.

A New (clearer) Role for CQL

The Quality Measures 2005sm are different than past CQL quality measures that were published in 1971, 1973, 1985, 1987, 1990, 1993, and 1997. Those past quality measures were directly related to accreditation. These new quality measures address the many different aspects of individual, organizational, and community quality design, definition and measurement.

Quality Measures 2005sm provide a comprehensive and integrated quality management system for organizations. Quality Measures 2005sm address the requirements for quality assurance, promote organizational quality improvement initiatives, and offer a valid and reliable method for measuring and assessing quality of life for people receiving services and supports.

The Quality Measures 2005sm address the data, information and evidence requirements for the new HCBS waiver application and Quality Framework. The Quality Measures 2005sm use the same Personal Outcome Measuressm metrics to address Basic Assurancessm, to measure accountability and responsiveness of the organization, and to measure quality of life and relate those measures to community indicators. Organizations, networks and systems no longer need one system for measuring Basic Assurancessm, a second system for person-centered planning, and a third system for assessing accountability in organizational and management quality performance.

New Strategic Quality Initiatives

The Quality Measures 2005sm provide CQL with the capability of working with organizations in many different strategic quality initiatives. The Quality Measures 2005sm will support a wide range of quality initiatives. CQL has developed Seven Quality Strategiessm that offer organizations alternatives for initiating an integrated quality management system.

These Seven Quality Strategiessm include:

In whatever way organizations choose to use Quality Measures 2005sm, CQL is committed to supporting them to use these measures to promote a world of dignity, opportunity and community inclusion for all people.

SPRING CONFERENCE IN SAVANNAH GEORGIA
The Road Ahead: Let's Travel Together

Continue on your path to excellence by attending The Council on Quality and Leadership's "Quality Connection Conference," May 10-11, 2005, Savannah, Georgia.

The 2005 Quality Connection conference will include such topics as:

  • The Council's Quality Measures 2005sm
  • Our Seven Quality Strategiessm
  • Our new "Partners for Excellence Program," a membership program for individuals with Council certification that provides you with an on-going opportunity to receive Council support, stay connected with others in our field, and continue your personal journey toward excellence in the profession.
  • This conference will be our best ever, and we expect it to sell out quickly. Register now!
  • Keynote speakers include: John O'Brien, Cathy Ficker Terrill and James Gardner.

    • Get more information and a registeration form online at: http://www.thecouncil.org/conferences/46/the-road-ahead-lets-travel-together

    CQL Pilots New Quality Measures

    CQL has successfully completed the pilots and field tests for the measurement tools and work processes of our new Quality Measures 2005sm. All new work processes, including Shared Values Alignmentsm, Basic Assurancessm Certification, Responsive Servicessm Award, and the individual certification process were piloted at organizations in the United States. The accreditation process was piloted at two sites and then field tested at two sites, including one in Canada. The field tests included the concurrent application of the current accreditation process and the new process and were used to set the accreditation criteria. Dates and locations of pilots and field test are listed below:

    During each pilot or field test, CQL staff and members of the organization involved discussed and evaluated the effectiveness of the tools and work processes that were used. Modifications to performance indicators, probes, information gathering strategies, and work processes were made based on these discussions as well as analyses conducted after the pilot or field test by CQL staff. We would like to thank all of the organizations that volunteered to participate in the pilots to develop our new measures.

    Real Choice Systems Change

    The Centers for Medicare and Medicaid Services (CMS) recently awarded a number of grants to help states make lasting improvements in their home and community-based services programs. The grants are part of the President's "New Freedom Initiative" which promotes the goal of community living for individuals with disabilities and long-term illnesses. They are designed to enable people with disabilities to reside in their homes and participate fully in community life.

    The Florida Agency for Persons with Disabilities (APD) was selected by CMS to receive one of nine state grants in the area of Quality Assurance and Quality Improvement in Home and Community Based Services (HCBS).

    The Council on Quality and Leadership (CQL) is pleased to serve as a partner with the Florida Agency for Persons with Disabilities (APD) and the Delmarva Foundation. We are playing a key role over three years to assist APD with the following goals:

    We congratulate Florida's APD on being selected for this important grant and look forward to continuing our partnership with the state and the Delmarva Foundation.

    To learn more about the CMS quality initiatives for Home and Community Based Services, visit www.cms.gov

    Crosswalk to Quality

    In 2002, the Centers for Medicare and Medicaid Services (CMS) introduced its Quality Framework for Home and Community Based Services (HCBS). The HCBS Quality Framework is intended to serve as a common frame of reference in support of productive dialogue among all parties who have a stake in the quality of services and supports for people with disabilities. The Framework focuses attention on the desired outcomes of HCBS quality management and improvement efforts. The framework defines quality through the delineation of desired outcomes for waiver participants across seven broad domains and 35 sub-domains. The seven broad domains are:

    To learn more, visit http://www.cms.hhs.gov/medicaid/waivers/82902ltr.pdf

    In response to many requests from our customers and partners, The Council on Quality and Leadership (CQL) designed a Crosswalk that identifies how CQL's Personal Outcome Measures system aligns with the CMS Quality Framework. We were able to demonstrate that CQL's measures address all of the domains in the Quality Framework.

    States and providers can work with CQL to support their quality management efforts.

    A free downloadable copy of the Crosswalk is available on our website http://www.thecouncil.org/pdfs/crosswalk404.pdf

    As part of the development of our new Quality Measures 2005sm, we are updating the Crosswalk. Each of the domains, desired outcomes and areas of focus in the HCBS Quality Framework is paired with one or more probes from Quality Measures 2005sm. The Crosswalk provides a template for organizations to assess their success in implementing the Quality Framework via use of the Quality Measures 2005sm. Once finalized, the new Crosswalk will be available for download on our web site.

    Organizations that are successful in implementing Quality Measures 2005sm will also be successful in implementing the HCBS Quality Framework. The properties of HCBS Quality Framework are being used by CMS in their new application and waiver renewal process.

    In Australia - Victoria Disability Services

    The Victoria Disability Services, the state agency in Melbourne, Australia, engaged in a partnership with CQL to conduct an Independent Quality Monitoring/Personal Outcome Measures Pilot Project. This partnership included accreditation reviews and other consultations to evaluate quality of services.

    During the months of July through September 2004, CQL in partnership with Victoria Disability Services conducted a project to assess the viability of CQL's Personal Outcome Measuressm as an effective external evaluation process. The project began with a cross walk between the Victoria Service Standards and CQL's Personal Outcome Measuressm. The pilot resulted in recommendations for Victoria's state policy considerations and for systemic changes.

    Six organizations serving people in the state of Victoria, Australia participated in the assessment process: Community Residential Services, Eastern Metropolitan Region; Disability Accommodations Services, Grampians Region; E. W. Tipping Foundation, Warragul; Melba Support Services, Inc., Melbourne; Wallara Australia Ltd., Dandenong; and Marillac House Ltd., East Brighton. Of these, Melba Support Services, Inc., Wallara Australia Ltd., and Marillac House Ltd. requested that a formal accreditation review be completed as part of this process and each received a two-year accreditation award.

    Ireland

    The Council on Quality and Leadership (CQL) and the Ireland Outcomes Network will sponsor a two-day conference in October, 2005. Day one of the conference will focus on CQL's Quality Measures 2005sm and day two will serve as a day of support and networking for all certified Trainers and Internal Quality Consultants.

    CQL welcomes the Irish Wheelchair Association as another valued customer in Ireland.

    CQL staff are continuing to assess the best ways to provide a network of support and coaching to all our colleagues in Ireland who are certified.

    ALLIANCE FOR FULL PARTICIPATION SUMMIT

    Many Voices, One Vision
    September 22-23, the Alliance for Full Participation will host a 2005 Summit: Many Voices, One Vision in Washington DC to bring together those committed to making the promises inherent in the Developmental Disabilities Act for Americans a reality. Over twelve hundred individuals are expected to attend to help craft a new strategic policy and social agenda in support of full participation, and to carry that agenda forward in their communities following the Summit to establish national strategic social and policy goals, and to create a proactive and responsive action plan for the future.

    In December 2003, ten leading organizations serving the developmental disabilities field officially joined together to form the Alliance for Full Participation, LLC (AFP). AFP's objective is full realization of the vision of people with developmental disabilities living meaningful, productive and personally satisfying lives in their community of choice. CQL is one of the founding members of AFP.

    For more information and to register, visit: http://www.allianceforfullparticipation.org/main/

    RESOURCES FROM THE COUNCIL ON QUALITY AND LEADERSHIP

    In addition to the Personal Outcome Measuressm, we have a number of resource materials to assist advocates, families, providers, and professionals. Visit our publications and resources to see what is available. These manuals are excellent tools for Learning, Training, and Improving.

    Recently published manuals include
    All About Rights(link to http://www.thecouncil.org/publications/gettingready.html#rights) The Place that Quality Built (link to http://www.thecouncil.org/publications/gettingready.html#qualityplace) A Proactive Guide to Incident Management (link to http://www.thecouncil.org/publications/gettingready.html#incidentmgmt)

    In addition, the web site also offers many free, downloadable reprints in our from the CQL archives in our Free Resources section, including:
    A Guide to Developing and Supporting a Board of Directors
    Importance Satisfaction Map™
    Practice Guidance for Delivering Outcomes in Service Coordination

    And from the Speaking Out Series
    Parents of Children with Disabilities Speak Out
    People with Brain Injury Speak Out
    People with Physical Disabilities Speak Out
    Self-Advocates Speak Out
    Teens with Disabilities Speak Out

    And over 30 brief articles on topics including Choice, Social Capital, Respect, Responsibility and many more. Be sure to visit: http://www.thecouncil.org/resources/?c=resource-articles

    National Data Base on Outcomes Grows to 5,500

    CQL has been committed to rigorous and reliable data collection since the introduction of the Personal Outcome Measuressm in 1991. We collect and analyze data through our interviews with people with disabilities. The National Personal Outcome Measuressm database now contains information on over 5,500 people.

    Findings from these data have been published in scientific journals and presented internationally. Organizations and policy makers are using the findings to benchmark their services and supports against national results. CQL also uses the database to study what is going well and where additional supports and evaluation methods are still needed.

    CQL Promotes Social Capital from Within

    At CQL, we are committed to enhancing the quality of lives for people with disabilities. We are experts at educating organizations on ways they can integrate the people they support into community life and increase their social capital. In 2004 we realized it was time for us to step back and evaluate our own social capital. How can we connect to others in the community? What personal experience can we offer? We recognize that each and every staff member has something to contribute and could be a valuable resource for social capital ideas. So beginning in 2004, CQL made the commitment to helping our employees increase their own social capital by offering paid days off to participate in volunteer activities. Some recent staff activities have included:

    CQL's main office in Towson, Maryland, has been sending a crew to Harford County, Maryland with hammers in hand to volunteer with Habitat for Humanity. Melanie Fender, Shelly McLaughlin, Mary Middendorf, Cheryl Purisch and Pam Scheuermann have been pounding nails, framing some walls and hanging drywall in a three bedroom house-to-be. As a group, we plan to volunteer with Habitat the third Wednesday of every month.

    In December, Kevin Edwards and his band, along with 70 other Texas musicians, participated in a 24 Hours of Blues to raise funds for Our Children's Center at Irving and the Family Outreach Center. Local businesses sponsored hours during the benefit, and together they raised over $4,000 for local Irving children's charities.