Dear Friends and Colleagues:
Our agency and our field have made significant changes over the past year with a common goal of strengthening our system for the individuals we support.
I would like to thank each and every one of you for all you have done to make our system stronger. Sometimes this has involved identifying necessary changes within reforms already enacted; other times, it has involved developing a new initiative or program. Your feedback, suggestions, and constructive criticism have helped our efforts tremendously.
This week I’d like to provide you with an overview of some key changes, their implementation, and how they fit together. And while I hope you will review our six-month and one-year progress reports for more specific actions, this message will help connect the dots by focusing on four broad initiatives that are inextricably linked: quality improvement, the People First Waiver, the agency reorganization, and our overall culture.
Quality Improvement
In January, as part of OPWDD’s agency-wide reorganization, we changed the name of the Division of Quality Management to the Division of Quality Improvement (DQI). This involved much more than a new division title—in particular, it meant changing our focus from quality management to continual improvement. This represents a shift in our mindset, and sends a message that we will constantly evaluate our system to identify areas for improvement. Systems are not static, so our quality efforts must adapt, as well.
Thanks to many of you, we transformed how quality oversight is done. The people in the DQI division have done great work, but a common concern they expressed was that they were spending a disproportionate amount of time on poor performing providers, leaving less time to focus on how to improve quality providers and apply best practices system-wide.
We have now successfully created a framework for quality improvement across the state, in both state and voluntary operations. This framework empowers OPWDD to systemically collect, review, remediate, and develop ongoing strategies for improving provider performance. The work of quality improvement goes beyond DQI. Each division within this agency is similarly tasked with developing goals, metrics, and evaluating their progress toward these goals. This change is now part of the fabric of the agency, and places the obligation on us all to find ways to do better and adjust to changing needs.
People First Waiver
Service delivery needs are also changing. Need is continuing to grow, while resources have become more limited. If our goal were simply to make ends meet, the answer would be obvious—reduce access to services. But we can do better, while simultaneously making the system less institutional in nature and more person-centered.
Forty years ago, the people we served lived in institutional settings, and group homes were a new idea. Today, we have made enormous progress moving services to the community. Yet, while just about 1,000 people live in institutional settings (and we oversee 6,200 group homes), we have recognized the need to increase flexibility in service opportunities. The financial incentives have relied on an old system rather than focusing on what is possible and what may be needed and preferred by families and individuals.
Similar to OPWDD’s organizational structure, the service delivery system was designed more than three decades ago. Since then, our goals have changed and we need a system designed for current and future needs.
The People First Waiver is one mechanism to help redesign service delivery. Since development of the People First Waiver began, we have made an effort to include all stakeholders in its development, and to date, thousands have been engaged. For the last several months we have been in close negotiations with the federal government about the design of our system of services, and we will continue to involve stakeholders as this process proceeds. More information about the waiver is available online.
Agency Reorganization
Several months ago, we announced that OPWDD was undergoing a reorganization of its service delivery system and administrative support operations. That effort began in January with the transformation of DQI, the establishment of the new Division of Person-Centered Supports, and the consolidation of many support functions within the Division of Enterprise Solutions.
Our goals are to bring a consistent approach and culture to all OPWDD services, whether state- or voluntary-provided, so that anyone who receives support can expect the same quality and positive environment no matter what their needs are, where they live or receive services, or which provider supports them.
The reorganization, through changes to our regional office structure, ensures that our focus is primarily on service quality, not administrative and organizational functions. It also supports the structure we need within the People First Waiver to ensure maximum opportunity to deliver services in more integrated environments. The reorganization was completed earlier this month, and the new agency organizational chart and regional office maps are available online.
Culture
Culture is defined as “the set of shared attitudes, values, goals, and practices that characterize an institution or organization.” For us, that means identifying the best qualities within our agency, and putting the supports in place system-wide to meet our values and goals, and making sure all the pieces work together as a whole, instead of independently working against each other.
There are many factors that influence our culture—here are a few examples of initiatives in addition to the areas outlined above:
- · We are now beginning to implement a new training that replaces the SCIP-R training curriculum. It is called PROMOTE, which stands for Positive Relationships Offer More Opportunity to Everyone. This is a major shift in OPWDD training and builds on the foundation of proactive and positive approaches to support individuals and reduce the use of restraints.
- · Adoption of the National Alliance for Direct Support Professionals’ (NADSP) Code of Ethics. This code will help direct support professionals maintain the highest standards in providing quality services to the individuals we support. More information on the code is available at www.NADSP.org.
- · Core competencies for direct support professionals have been developed by the NYS Developmental Disabilities Talent Development Consortium. These standards cover seven major areas of knowledge and expertise that will strengthen our direct support services.
As you can imagine, this is an enormous undertaking. If the people we support, their immediate family members, employees, and advocates were in one geographic location, we would be a city nearly the size of Washington, DC. And like a city, we have different cultures, languages, ethnicities, religions, etc. Adding to that, we are spread across a large geographic area.
Thankfully, the roots of our culture already exist: we believe in dignity and equality for every person; we share a commitment to speaking out against wrongs; and we are working together to make the system better. Now it’s a matter of taking those qualities and ensuring we have the system in place to properly support these qualities in all of our work and operations.
Thank you again; your ongoing feedback remains critical to our collective success.
Sincerely,
Commissioner Burke
P.S. Communication is critical to our collective success, and OPWDD’s Facebook page is a great place for individuals, family members, employees, advocates, and other stakeholders to exchange thoughts and ideas. Please feel free to join the conversation.