Integrated Quality Management Functions
When the Department of Mental Health, Office of Consumer Safety, receives a complaint regarding Division of DD supports and services, the Regional Office and appropriate agency staff are notified. Designated Regional Office personnel will follow up on all reported complaints to assure resolution. Concerns related to health, environment/safety, rights, services, or money is entered into a database for tracking. When action taken results in recommendations, it is incorporated into the Quality Improvement Plan for the facility or in the individual's personal plan as appropriate.
Office and Division of DD Central Office staff complete fiscal reviews of provider agencies to ensure that funds appropriated for services are used in accordance with service requirements.
Health Identification Planning System (HIPS)
HIPS is the Division's QE monitoring process for the discovery and remediation of health and safety concerns for individuals in Division of DD community residential services. A Health Inventory tool is completed on all persons entering community placement and annually, as well as when there are significant health changes. Regional Office RNs complete Nursing Reviews on individuals with a defined score on their health inventory. Nursing Reviews evaluate the provider's health supports and services, evaluates the individual’s response to treatment, and supports identifying unmet healthcare needs.
- 3.090 Health Identification and Planning System Process
- Nursing Review
- Focused Review
- Health Inventory
- Operational Definitions
- Action Plan
- HI Scoring Instructions
- HIPS Flow Chart
- HIPS Action Plan
Licensure and Certification Unit (L&C)
Provides quality oversight to Department of Mental Health agencies, both public and private, in the State of Missouri. This oversight is carried out in order to license or certify these facilities or programs that offer services to consumers. Monitoring ensures providers maintain compliance with applicable state standards and remain consistent with the Department of Mental Health’s vision, principles of practice, and values.
Following the death of individuals receiving services, Regional Office RNs conduct an evaluation of the circumstances surrounding the death. The evaluation ascertains if all necessary measures were taken to provide for the health, safety, and welfare of the individual and determine if there were any identifiable risk factors that could affect others receiving that service.
- 3.070 - Consumer Death Notification and Mortality Review Process
- DD Consumer Mortality Review Form
- Mortality Review Flowchart
Individual Plan Reviews
Ensure the individual planning process leads to person centered quality outcomes for individuals, evaluates the effectiveness of support services in meeting the individual's needs, and identifies service strengths as well as areas in need of enhancement.
- 4.060 - Person Centered Planning Guidelines and Quality Enhancement Review
- Plan Review Form - Hab Center
- Plan Review Form – Community
- Level of Care Form
Provider Relations Review
Provider Relation staff from the Regional Office will partner with providers in order to enhance service development, self assessment and best practice by offering technical assistance and reviewing provider information systems such as employee files, policies and procedures, facility systems and safety, staffing patterns, contract language and modifications. Provider Relations will work with contracted providers to ensure service delivery is consistent with best practices, State Rules, Medicaid waiver guidelines and DMH Contract and policy. Provider relations will conduct and annual review of all Division of DD contracted providers. An annual meeting is held to assist provider with performance review and goal development for the upcoming year.
Quality Enhancement Review
Quality Enhancement (QE) works in partnership with contracted providers that are nationally accredited and with those who are licensed or certified by the Division of DD to assist in achieving/maintaining the identified credential. Regional QE staff conducts a review of systems related to health, safety, and rights. The review is based upon the related Missouri Quality Outcomes, National Core Indicators, Certification principles, and outcome of accreditation activities.
Service Coordinators monitor for effective and efficient provision of services and supports that enable the individual to achieve his/her basic needs and personal goals. Service Coordinators conduct monitoring through face-to-face visits with the individual. The following areas are monitored: Health, Environment/Safety, Consumer Rights, Services/Staff, and Money.
For additional information regarding these or other quality assurance processes, please contact the State Quality Assurance Team Member in your area.