Integrated Quality Management Functions

When the Department of Mental Health, Office of Constituent Services, 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.

The 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.

The Health Risk Screening (HRS) Process is the Division’s QE monitoring process for the identification and remediation of health risks for individuals who are 1915 ( C ) Waiver participants with the Division of DD.  A Health Risk Screening Tool (HRST) is completed on all persons with a 1915 ( C ) Waiver who are new to Waiver services, annually to align with the Individual Support Plan (ISP), as well as when there are significant health changes that impact any of the rating items in the HRST screening tool.  Based on the results of the screening tool, Health Risk Support Plans are developed in the system to support the Healthy Living section of the ISP.  Regional Office RNs complete Clinical Reviews and Expanded Clinical Reviews for residential Waiver participants whose screens meet a certain criteria to review integrity of the HRST screen as well as evaluate the supports and services that are in place for individuals.

Licensure and Certification 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.

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.

Provider Relation staff from the Regional Office 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.

In accordance with the Home and Community Based federal regulation, the Quality of Services Review prescribes a standardized procedure to ensure the individual has full access to benefits of community living and the opportunity to receive services in the most appropriate integrated setting, assess the person-centered planning process and provide feedback to the interdisciplinary team about utilizing key points of self-determination.

Support Coordinators monitor for effective and efficient provision of services and supports that enable the individual to achieve his/her basic needs and personal goals. Support 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 a local regional office.

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