University of Massachusetts Boston (ICI)

Document Sample
University of Massachusetts Boston (ICI) Powered By Docstoc
					                               Department of Mental Retardation
                 Office of Quality Management, Office of Quality Enhancement
                                   Licensure and Certification


                                                                            Report Date: 8/1/2007

Agency: Institute for Community Inclusion/University of Massachusetts, Boston

Review Dates: 6/5/2007 to 6/18/2007

Licensure: 6/28/2007 to 6/28/2009

Licensure Level: Two-Year License

Follow-Up Required: No

Certification Performed By: DMR for Employment Supports

Certification Completed On: 6/28/2007

Certification Outcome: Certification with Distinction

Survey Team: Kathy Harris (Team Leader)

Citizen Volunteer(s): None

Number of Individual Reviews Completed: [5]
                                                                                   [N/A] Residential Reviews
                                                                                   [5] Work/Community Reviews
                                                                                   [N/A] Respite Reviews (Not Rated)
                                                                                   [N/A] Safeguard System Reviews
                                                                                       (Not Rated)

                                       EXECUTIVE SUMMARY

The Institute for Community Inclusion (ICI)/University of Massachusetts, Boston is a University Center for
Excellence that emphasizes people with disabilities have freedom, equality, and opportunity to participate fully
in public life. Approximately thirty-five individuals in the DMR Greater Boston Area receive employment
supports through this Institute. A Licensure and Certification review was conducted; and, once again, true to the
previous five DMR Quality Enhancement Surveys, the Institute has earned a Two-Year License and
Certification with Distinction. The Institute received a rating of “Achieved” in all outcomes defined within the
five Quality of Life Areas as well as a rating of “Achieved” in all Organizational Outcomes.

The Institute puts into practice ideals which promote all people to be respected and appreciated as valuable
employees regardless of their disabilities or health care needs. People were successfully supported to work at
jobs in the community that pay a competitive wage and offer benefits such as vacations and holidays. People
were guided and educated so they would not settle for less rewarding jobs. Instead, they were given the tools to
have careers that use their capacities to the fullest extent. The Institute supported people to obtain employment
with preferred community-based companies. ICI employment specialists focused their supports to individuals
                                                        1
in ways that capitalize upon people’s capabilities with the minimum amount of natural supports necessary (i.e.,
co-workers) in order for them to meet all job responsibilities. The specialists stressed that the role of co-
workers was one of friendship, camaraderie and support for individuals to meet or exceed the work expectations
of the employer.

Throughout this survey, it was evident through the quality and detail of information, documentation and
observed interactions between the specialists and individuals that the Institute continues to provide exemplary
assessment and case management to people with disabilities who seek integrated employment in preferred
settings. The individual’s confidential file contained human rights training materials inclusive of information
regarding DPPC reporting that was written in a manner designed to be respectful as well as easily understood.
Also contained within the record was emergency contact and medical information, regular assessments of
people’s abilities and interests and detailed contact notes as well as notations regarding all communication with
the individual’s clinical team, DMR service coordinator/MRC case manager, guardians/families and employers.

Each of the people surveyed expressed total satisfaction with their work and the supports received through their
employment specialist. All but one of the individuals surveyed chose to be interviewed in coffee shops near
their place of employment; therefore, there was no direct observation by this reporter of individuals’ work
environments. Individuals proudly described their work as contributing to the overall greater good of the
company/business. Individuals felt valued by their employers and confident that they were not given special
consideration due to their challenges. They were proud to be working in integrated communities with fellow
employees who are not disabled. People were held responsible for pulling their own weight by having an active
role in seeking and maintaining employment. The one person not employed at the time of the survey was an
integral partner, with the specialist, in completing assignments that complimented efforts to obtain employment
for this person in a preferred setting.

As noted in Institute policies, practices and procedures, safeguard systems were routinely analyzed and modified
for increased effectiveness. Numerous internal and external reviews occurred to continually identify ways to
avoid reoccurrences of problems that had arisen and proactively improve overall service delivery. The
Institute’s Human Rights Committee was shared with two other agencies without compromising the committee
members’ responsibilities and effectiveness in ensuring safeguards for individuals supported by the Institute.
The committee met on a quarterly basis, and meeting minutes reflected representation from all three agencies
including human rights officers, individuals and a parent. At the corporate site, there were well-established
safety protocols that were followed which ensured overall safety including the use of additional specialized
equipment to assist those with physical challenges. Individuals participating in the survey received ongoing
training in responding to unsafe conditions at their employment sites (should they occur) by following site
specific protocols as defined by the company or business.

An exceptional strength of ICI’s supports is the competence of its specialists who respected the wants, needs
and choices of the persons on their case loads. Each specialist appeared to have a very comfortable personal as
well as professional relationship with each person supported. Institute specialists have been trained in first aid
and CPR as well as the identification of potential unsafe conditions in the individuals’ work environments.
When necessary, specialists advise people of measures to be taken to ensure their safety and well-being.
Specialists and administrators alike have ample opportunities and are expected to enrich their professional skills
by attending and presenting at continuing educational forums through the University of Mass, local and national
seminars and conferences.

In summary, staff at all levels of the Institute for Community Inclusion have continued to provide personally
designed supports that lead to persons working in preferred jobs at competitive wages with employers and
employees in a wide spectrum of community businesses.

                                                        2
                                      Provider Scoring Summary

Licensure Review
                                                 Work/
  Quality of Life         Residential          Community                 Respite           Overall Provider
      Area                 Supports             Supports                Supports               Rating

Rights & Dignity                            Achieved                                          Achieved
Personal Well-
Being                                       Achieved                                          Achieved
Organizational Outcomes: The organization has systems in place to safeguard people.           Achieved



Certification Review
                                                 Work/
  Quality of Life         Residential          Community                 Respite           Overall Provider
      Area                 Supports             Supports                Supports               Rating

Individual Control                               Achieved                                     Achieved
Community and
Social Connections                               Achieved                                     Achieved
Personal Growth &
Accomplishments                               Achieved                                        Achieved
Organizational Outcomes: Staff have the skills and knowledge to support the quality
                          of life of people.                                                  Achieved
Organizational Outcome: The organization supports growth and change to continually
                         improve its quality of supports                                      Achieved



Organizational Combined Rating:
(Based on both the licensure organizational outcome and the two certification quality of      Achieved
life outcomes)




                                                      3
              Department of Mental Retardation
Office of Quality Management, Office of Quality Enhancement
                  Licensure and Certification




                          Section I


                   Licensure Review
           Outcome of Individual Quality Reviews

                        Rights and Dignity
                       Personal Well-Being




                Outcomes for the Organization

        The agency has systems in place to safeguard people.




                                 4
                                            QUALITY OF LIFE AREA
                                            RIGHTS AND DIGNITY
                                               Rating: Achieved
Principles: Support and affirmation of individual rights are safeguards for all people as citizens of the United
States. These rights are framed in the Constitution, Bill of Rights, and Federal and State statutes. They include
such freedoms as the rights to privacy, free speech and due process. The actualization of individual rights is
especially important to people with disabilities because they have not always been afforded these most basic of
guarantees and may need support to exercise their rights. In order to have their rights affirmed, individuals first
must be respected, valued and treated with positive regard.

                                    QUALITY OF LIFE SCORING SUMMARY

                                                                   Work &                            % of Indicators
                  Outcomes                         Residential                        Respite
                                                                  Community
                and Indicators                      Reviews                           Reviews        (Excluding Respite)
                                                                   Reviews
             People are valued:
                 Achieved                          Yes     No     Yes      No       Yes       No      Yes         No
A. Interactions are respectful of people.                          5        0                         100%         --

B. People are supported to identify themselves                     5        0                         100%         --
   as adults.
C. People are supported to take pride in                           5        0                         100%         --
   themselves and their surroundings.
D. People live and work in settings that are                       5        0                         100%         --
   typical of other members of the community.
      People’s rights are affirmed:
                Achieved                           Yes     No     Yes      No       Yes       No      Yes         No
A. People and/or those supporting them                             5        0                         100%         --
   understand individual rights.
B. People’s rights are exercised in their                          5        0                         100%         --
   everyday lives.
C. People receive the same treatment as other                      5        0                         100%         --
   employees.
D. People receive comparable wages and                             5        0                         100%         --
   benefits as other employees.
      People’s rights are protected.
                Achieved                           Yes     No     Yes      No       Yes       No      Yes         No
A. All interventions are the least intrusive and                   5        0                         100%         --
   are based upon people’s unique needs.
B. All interventions are included in a written                    N/A      N/A                        N/A        N/A
   plan.
C. People, or their guardians, knowingly and                      N/A      N/A                        N/A        N/A
   voluntarily give consent and have the
   opportunity to refuse or withdraw
   approval.
D. Safeguards ensure a thorough review and                        N/A      N/A                        N/A        N/A
   approval process when needed.
E. All interventions are safely, accurately and                   N/A      N/A                        N/A        N/A
   consistently implemented.




                                                           5
                                           QUALITY OF LIFE AREA
                                           PERSONAL WELL-BEING
                                               Rating: Achieved
Principles: Being safe, secure and healthy provides a foundation that enables people to have a truly fulfilling
life and do the things that are important to them. As with rights, certain universal things contribute to the well-
being of everyone in society, regardless of who they are and their personal circumstance. These universals
include having routine physical examinations, wearing seat belt, or installing smoke detectors. Beyond the
universal safeguards, personal well-being is supported by a recognition of people’s skills and needs as balanced
against their lifestyle choices. Services are designed to assist people to be secure, achieve and/or maintain good
health, to make decisions that keep them out of harm’s way, and to ensure a prompt response when people’s
safety, security or health are compromised.

                                    QUALITY OF LIFE SCORING SUMMARY

                                                                   Work &                            % of Indicators
                 Outcomes                          Residential                        Respite
                                                                  Community
               and Indicators                       Reviews                           Reviews        (Excluding Respite)
                                                                   Reviews
   People are safe at home and work:
                Achieved                           Yes     No     Yes      No       Yes       No      Yes         No
A. People’s home and work place are safe,                          5        0                         100%         --
   secure, and in good repair.
B. People and their supporters know what to                        5        0                         100%         --
   do in an emergency.
C. People can safely evacuate from their home                      5        0                         100%         --
   or work place in an emergency.
D. There are adequate supports for people to                       5        0                         100%         --
   be safe in their home and work.
E. People use materials and equipment safely.                      5        0                         100%         --
       People are free from harm:
                Achieved                           Yes     No     Yes      No       Yes       No      Yes         No
A. Supports are in place if people make                           N/A      N/A                        N/A        N/A
   decisions that put them at risk.
B. Immediate actions are taken to ensure                          N/A      N/A                        N/A        N/A
   people’s safety.
C. Actions are taken to correct the situation                     N/A      N/A                        N/A        N/A
   when people have been mistreated.
D. Steps are taken to prevent the situation                       N/A      N/A                        N/A        N/A
   from occurring again.
E. People know how or have support to report                       5        0                         100%         --
   a situation where they feel they are being or
   have been mistreated or harmed.




                                                           6
                               PERSONAL WELL BEING: - Continued

                                                               Work &                 % of Indicators
                Outcomes                        Residential                Respite
                                                              Community
              and Indicators                     Reviews                   Reviews    (Excluding Respite)
                                                               Reviews
      People maintain good health:
               Achieved                         Yes     No    Yes   No    Yes    No    Yes         No
A. People are supported to have a health                       5     0                 100%         --
   lifestyle.
B. People are supported to be active                          N/A   N/A                N/A        N/A
   participants in their health care.
C. People have needed routine and specialized                 N/A   N/A                N/A        N/A
   health care services.
D. Supporters are knowledgeable about                          5     0                 100%         --
   people’s health care needs.
E. People’s medications are given properly                    N/A   N/A                N/A        N/A
   and as prescribed by the practitioner.
    People’s funds are safeguarded:
                                                Yes     No    Yes   No    Yes    No    Yes         No
A. People receive the support and/or                          N/A   N/A                N/A        N/A
   education they need in managing their
   financial resources.
B. People’s funds are managed properly and                    N/A   N/A                N/A        N/A
   with their consent.




                                                        7
                           OUTCOMES FOR THE ORGANIZATION

Principles: Positive outcomes for individuals are the result of many factors, not the least of which is a strong,
coherent organizational structure. For positive outcomes for individuals to be sustained over time, across all
settings and by all staff, agencies need to create an infrastructure and culture that supports quality and
safeguards individuals.

                                               SCORING SUMMARY

                                    Outcome and Indicators                                                 Agency
                                                                                                           Totals
           The organization has systems in place to safeguard individuals:                                      % of
                                                                                                    Finding   Indicators
                                                                                                               Present
A. The organization has strategies that proactively ensure that essential safeguards are in place    Yes
   across settings and over time.
B. The organization has systems in place to affirm and protect the rights and dignity of             Yes        100%
   individuals.
C. The agency implements procedures that minimize unnecessary risk to individuals.                   Yes




                                                             8
                  Department of Mental Retardation
    Office of Quality Management, Office of Quality Enhancement
                      Licensure and Certification




                             Section II


                     Certification Review

              Outcome of Individual Quality Reviews

                           Individual Control
                   Community and Social Connections
                  Personal Growth and Accomplishment



                    Outcome for the Organization
Staff have the skills and knowledge to support the quality of life of people.
     The organization improves services as a result of these analyses.




                                      9
                                          QUALITY OF LIFE AREA
                                          INDIVIDUAL CONTROL
                                             Rating: Achieved

Principles: Being able to direct the course of one’s life is something for which all people strive. Self-
determination is expressed in all aspects of people’s lives, both in little, everyday things such as deciding when
to get up as well as in major life decisions that may have a deep, long lasting effect such as deciding on a certain
career or moving to a new community. The type and amount of support people need to take charge of their lives
varies greatly. For some, even making everyday choices is a new experience and they need much guidance in
learning how to make both everyday and major choices. For others, periodic check-ins and discussions are
needed to keep them on course and to make sure they have an understanding of their options and of the
consequences of their decisions. What is important is that people have all the information they need to make
decisions, that they are empowered and supported to take action, and that they understand how their decisions
affect their lives.

                                   QUALITY OF LIFE SCORING SUMMARY
                                                                   Work &                             % of Indicators
                 Outcomes                       Residential                            Respite
                                                                  Community
               and Indicators                    Reviews                               Reviews        (Excluding Respite)
                                                                   Reviews
         People are understood:
                Achieved                        Yes      No       Yes       No       Yes      No       Yes         No
A. Supporters understand what people are                           5         0                         100%         --
   expressing.
B. Supporters use people’s primary means of                        5         0                         100%         --
   communication.
C. Supporters assist people to communicate                         5         0                         100%         --
   with and be understood by others.
          People make choices in
           their everyday lives:                Yes      No       Yes       No       Yes      No       Yes         No
                 Achieved
A. People make choices about their routines                        5         0                         100%         --
   and schedules.
B. People make choices about the work and                          5         0                         100%         --
   household tasks for which they are
   responsible.
C. People spend their leisure time in                             N/A     N/A                          N/A        N/A
   personally satisfying ways.
    People are the primary decision-
         makers in their lives:                 Yes      No       Yes       No       Yes      No       Yes         No
                Achieved
A. People develop their personal goals.                            5         0                         100%         --

B. People influence who provides their                             5         0                         100%         --
   supports.
C. People control important decisions about                       N/A      N/A                         N/A        N/A
   their home and home life.
D. People choose where they work or, if they                       5         0                         100%         --
   choose not to work, people have options
   that are meaningful to them.



                                                        10
                                 QUALITY OF LIFE AREA
                            COMMUNITY AND SOCIAL CONNECTIONS
                                     Rating: Achieved
Principles: Membership in community life supports people’s sense of belonging and provides opportunities for
citizenship, friendship and valued roles in society. Everyone has unique, identifiable ways that he or she is
connected to the community and to other people who are important to them. Being a part of community life
means that people are using all the resources and amenities that others use. Being connected also means that
people have other people in their lives who are important to them, who are there for them when needed and with
whom they can share their thoughts and concerns. It also includes having a place in society, a place that other
people recognize and value. It may mean helping out neighbors and friends when needed or having talents and
gifts that are recognized and shared with other people.

                                 QUALITY OF LIFE SCORING SUMMARY

                                                                 Work &                          % of Indicators
                Outcomes                        Residential                        Respite
                                                                Community
              and Indicators                     Reviews                           Reviews       (Excluding Respite)
                                                                 Reviews
        People are integrated into
           their community:                     Yes     No     Yes      No       Yes      No       Yes        No
                 Achieved
A. People live and work in communities with                     5        0                        100%         --
   the resources they want and need.
B. People use the same community resources                      5        0                        100%         --
   as others on a frequent and ongoing basis.
       People are connected with
           their community:                     Yes     No     Yes      No       Yes      No       Yes        No
A. People are supported to explore their                       N/A      N/A                        N/A       N/A
   personal interests and options for
   community involvement.
B. People are involved in activities that                      N/A      N/A                        N/A       N/A
   connect them to other people in the
   community.
       People have relationships:
                 Achieved                       Yes     No     Yes      No       Yes      No       Yes        No
A. People are supported to maintain and                         5        0                        100%         --
   enhance relationships with family, friends
   and co-workers.
B. People are supported to develop new                         N/A      N/A                        N/A       N/A
   friendships.
C. People are supported to explore, define,                    N/A      N/A                        N/A       N/A
   and express their need for intimacy.




                                                       11
                                 QUALITY OF LIFE AREA
                         PERSONAL GROWTH AND ACCOMPLISHMENT
                                     Rating: Achieved
Principles: While developing one’s own goals is a critical first step in making decisions about one’s life,
achieving personal goals and developing the skills to be as independent as possible give individuals a sense of
purpose, direction and self-fulfillment in their lives. The strategies and support used in assisting people to reach
their goals takes on many forms and should be tailored to people’s unique skills, needs, preferences and style of
learning. It includes helping people to learn from both planned as well as unanticipated events in their lives.
While there is much to be proud of in acquiring the skills to do things independently, it does not mean that
people are independent in everything they do. There is the joy that people feel in accomplishing things together
and the feeling of self-worth that comes with completing something as independently as possible.

                                   QUALITY OF LIFE SCORING SUMMARY

                                                                    Work &                            % of Indicators
                 Outcomes                         Residential                          Respite
                                                                   Community
               and Indicators                      Reviews                             Reviews        (Excluding Respite)
                                                                    Reviews
     People accomplish their goals:
               Achieved                           Yes     No      Yes       No       Yes      No       Yes         No
A. People’s goals are the basis of actions and                     5         0                         100%         --
   supports.
B. There is a match between what people are                        5         0                         100%         --
   doing now and what they want to do in the
   future.
C. People have access to needed resources in                       5         0                         100%         --
   order to accomplish their goals.
D. There are supports to get a job that people                     5         0                         100%         --
   like.
E. There are supports to succeed at the job.                       5         0                         100%         --
F. People are supported to advance in their                        5         0                         100%         --
   job.
         People have autonomy:
                Achieved                          Yes     No      Yes       No       Yes      No       Yes         No
A. People complete day-to-day activities, tasks                    5         0                         100%         --
   and chores as independently as possible.
B. People have access within their home and                        5         0                         100%         --
   workplace.
        People grow through their
            life experiences:                     Yes     No      Yes       No       Yes      No       Yes         No
                 Achieved
A. Supporters are sensitive and attuned to                         5         0                         100%         --
   both small and large events in people’s
   lives.
B. People are encouraged to understand                             5         0                         100%         --
   experiences in their lives.
C. People are supported to grow from events                        5         0                         100%         --
   in their lives that affect them.




                                                         12
                                Department of Mental Retardation
                  Office of Quality Management, Office of Quality Enhancement
                                    Licensure and Certification



                            OUTCOME FOR THE ORGANIZATION

Principles: Positive outcomes for individuals are the result of many factors, not the least of which is a strong,
coherent organizational structure. For positive outcomes for individuals to be sustained over time, across all
settings and by all staff, agencies need to create an infrastructure and culture that supports quality and
safeguards individuals.

                                                SCORING SUMMARY
                      Staff have the skills and knowledge to support                                     % of
                             the quality of life of individuals:                            Finding    Indicators
                                                                                                        Present
A. The agency recruits and maintains a competent work force.                                  Yes
                                                                                                         100%
B. The agency has ways to support staff knowledge, effectiveness and creativity.              Yes


             The organization supports growth and change to continually                                  % of
                        improve its supports to individuals:                                Finding    Indicators
                                                                                                        Present
A. The organization has processes to evaluate the quality of its supports.                    Yes
                                                                                                         100%
B. The organization improves services as a result of these analyses.                          Yes




                                                             13
14
15