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P008: Division of Health Improvement/Health Certification Licensing and Oversight (FY17-FY19 Strategic Plan)

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P008: Abuse Rate for Developmental Disability Waiver and Mi Via Waiver clients

Current Value

7.2%

2017

Definition

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Story Behind the Curve

  • Abuse, neglect, and exploitation (ANE) of individuals with intellectual and developmental disabilities (I/DD) has a direct impact on their quality of life and results in increased emergency room visits, additional medications, and related medical treatment. Neglect is the most common allegation. Lack of adequate supervision, failure to follow healthcare plans, and staff training are the most common reasons for substantiated neglect.
  • Many adults with I/DD are unable to recognize danger, understand their rights, and protect themselves. Neglect is the leading cause of premature death for this population.
  • In FY17, the annual substantiated ANE rate was 7.2 %. This result shows a decline of substantiated ANE by 3.0% from FY16.
  • At the end of FY16, the Incident Management Bureau (IMB) launched an ambitious project to roll out a new ANE Train-the-Trainer project, where provider-agency staff were given a curriculum for teaching ANE recognition and reporting. Throughout FY17, trainings were held state-wide to give agencies the tools necessary to provide in-person ANE training to their staff. 
  • Increased reporting is one strategy to help prevent ANE. Using the new Division of Health Improvement (DHI) Incident Management Bureau (IMB) database, we are now able to track patterns and trends that result in substantiated ANE. We can then address those causes with targeted training.

Partners

  • New Mexico Department of Health (NMDOH) Developmental Disabilities Supports Division (DDSD)
  • NM Human Services Department (HSD)
  • Community-based providers
  • Community-based waiver provider professional organizations, such as, Association of Developmental Disabilities Community Providers (ADDCP)
  • NMDOH Learning Center
  • Local law enforcement agencies
  • Disability Rights New Mexico

What Works

  • Having clear, simple, and accessible processes for reporting suspected abuse, neglect and exploitation.
  • Monthly regional meetings with DDSD to analyze data. Also, review and address patterns, trends and other concerns, including case reviews and trending of the top five potential causes of death.
  • Reviewing data from the IMB database “causation” tab, to trend the most frequently cited causes of substantiated neglect in order to develop strategies to reduce incidents of neglect. 
  • New required ANE training utilizing the ANE Train-the-Trainer project.
  • Meeting statutory 45-day ANE Investigation timelines. 
  • Adequate Immediate Safety and Action Plans (IASP).

Strategy

  • Partnering with providers to share incident data trends and identify strategies to reduce ANE.
  • Monthly meetings between DHI and DDSD to review substantiated cases of ANE, review consumers at high risk of health and safety issues, and review the status of providers who have been referred to DDSD for technical assistance.

Action Plan

  • Q1:
    • Ongoing implementation of FY16 action items to complete investigations within 45 days. Completed. 
    • Ongoing implementation of the new Recognizing and Reporting ANE for community-based providers training. Completed.
    • Share  patterns, trends of abuse, and other areas of concern from IMB data and reporting issues with DDSD at regional monthly meetings. Completed.
  • Q2:
    • Partner with the NMDOH Learning Center to develop an online annual re-certification training on recognizing and reporting ANE.  Phase 1 completed. 
    • Continue development of on-line annual re-certification training on recognizing and reporting ANE.  Phase 2 completed.
    • Develop and implement rotating web banner on reporting abuse for the NMDOH website homepage. Delayed: Posted during April and May 2017.
    • Transfer the online annual re-certification training project to DDSD. Completed.
  • Q3:
    • Continue the development of online annual re-certification training on recognizing and reporting ANE.  Phase 2 completed.
  • Q4:
    • Develop and implement a rotating web banner on reporting abuse for the NMDOH website homepage. Delayed: Posted during April and May 2017.
    • Transfer the online annual re-certification training project to DDSD. Completed.

FY17 Annual Progress Summary

  • IMB continues to see improvement and a decrease in the abuse rate for individuals in community-based waiver programs. 
  • For the FY16-17 reporting cycle (April 2016-March 2017), the substantiated rate was on target at 7.2%.  
  • IMB now requires all waiver staff to complete the new course on recognizing and reporting abuse, neglect, and exploitation.  IMB also posted a headline banner on the NMDOH website homepage during April and May 2017 to increase awareness on recognizing and reporting ANE. 
  • IMB analyzes data, shares reports, and addresses any concerns with the Developmental Disabilities Steering Committee on Quality Improvement (DDSQI) for remediation or other actions.  

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