P008: Division of Health Improvement/Health Certification Licensing and Oversight

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/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 health care plans, and insufficient 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 the 2017 calendar reporting period , the annual substantiated ANE rate was 7.2%. This result shows a decline of substantiated ANE by more than 3.0% from 2016.
On-going implementation of the statewide ANE training on recognizing and report ANE which uses a competency-based train-the-trainer model focusing on adult learning styles.
Increased reporting is one strategy to help prevent ANE. Using the Incident Management Bureau (IMB) database, the Division of Health Improvement (DHI) is now able to track patterns and trends that result in substantiated ANE. We can then address those causes with targeted training.

Partners

NMDOH Developmental Disabilities Supports Division (DDSD)
New Mexico Human Services Department (HSD)
Community-based providers
Community based waiver provider professional organizations, such as the 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.
Updating DHI's website to simplify reporting information and resources for the public.
New required ANE training utilizing the ANE Train-the-Trainer project.
Meeting with community based provider organizations to review trends, issues, and concerns.
Meeting statutory 45-day ANE Investigation timelines.
Rapid response to serious allegations of abuse (priority levels).
Adequate immediate safety and action plans.
Monthly regional meetings with DDSD to analyze data, review and address patterns, trends and other concerns, including case reviews, and trending of the top five potential causes of death (i.e., bowel obstruction, Gastroesophageal reflux disease (GERD), aspiration, dehydration, seizures).

Strategy

Implement the Recognizing and Reporting ANE Training for all community-based waiver providers.
Provide resources on the IMB-ANE website on recognizing and reporting ANE.
Partner with community-based waiver provider organizations to share annual incident data trends, discuss issues and concerns, and identify strategies to reduce abuse in New Mexico.
Meet monthly with 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 "Recognizing and Reporting ANE" for community-based providers training. Completed.
- Identify patterns, trends of abuse, and other areas of concern from IMB data and reporting issues to DDSD at regional monthly meetings. Completed.
- Through the use of overtime IMB investigators and the hiring of contractors, continue to process the backlog of cases.
Q2:
- Ongoing implementation of FY16 action items to complete investigations within 45 days.
- Identify patterns, trends of abuse, and other areas of concern from IMB data and reporting issues to DDSD at regional monthly meetings.
- Complete FY18 Annual Report.
- Complete and distribute the FY19 ANE reporting guide, both English and Spanish language versions.
- IMB is working on an employee retention and training program to ensure IMB has a competent workforce to conduct ANE investigations.
- IMB is evaluating its processes to streamline the investigation process and ensure timely notification of investigative results.
Q3:
- Ongoing implementation of the "Recognizing and Reporting ANE" annual refresher training for community based providers.
- Identify patterns, trends of abuse, and other areas of concern from IMB data and reporting issues to DDSD at regional monthly meetings.
- Distribute 2018 annual report.
- Continue quarterly training for IMB investigators.
Q4:
- IMB will seek public input on the FY18 IMB Annual Report to ensure the report captures the information that is most useful to the public and community-based service providers.
- The Q4 action plan will be updated in Q2 to reflect an analysis of current trends and needs.

FY18 Annual Progress Summary

During FY2018, the NMDOH Division of Health Improvement, Incident Management Bureau (IMB) continued to see improvement (decrease) in the abuse rate for individuals in community-based programs.
All community-based providers are now required to comply with providing the new course on recognizing and reporting abuse, neglect, and exploitation to their staff. The annual required refresher course is now available online for all staff to complete.
During the fourth quarter, IMB posted a headline banner on the NMDOH website to increase awareness on recognizing and reporting abuse, neglect, and exploitation.

FY19 Annual Progress Summary

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