INFORMATION MANAGEMENT & MEASUREMENT ANNUAL REPORT

July 2015 - June 2016

Executive Summary

Progressive Residential Services of New Mexico (PRS-NM) has been providing Developmental Disabilities (DD) Waiver services in Las Cruces since the year 2000. During Fiscal Year 2015/2016, the organization served an average of 30 individuals in supported living at a total of nine (10) residential sites and 25 individuals in Customized Community Supports.

During this FY, Progressive Residential Services of New Mexico was still adjusting to the 2011 funding cuts from Developmental Disabilities Supports Division (DDSD) which had implemented plans to “transform and simplify the [DD Waiver] system into one that is fair, equitable and cost effective.” Those efforts included the implementation of a “standardized assessment . . . to quantify the support needs” of people receiving services, known as the Supports Intensity Scale (SIS). DDSD also revised the DD Waiver service packages and issued new provider reimbursement rates.

These changes translated to service and funding reductions, and were ultimately implemented in May 2013. The implications had obviously brought about future concerns for the health, safety and quality of life of people in service. There were also clear financial implications and staffing reductions which impacted PRS-NM and the entire provider system. PRS-NM was able to acquire additional funding through Intensive Behavioral Supports (IIBS) funding and Category H, funding for Customized Community Supports for individuals’ who needed additional staffing due to health and safety issues. Despite the changes, Progressive Residential Services, Inc. NM was able to remain committed to its values, mission and vision of the organization.

Our Mission

Our mission is to assist people with disabilities to discover their unique gifts and find ways to contribute those gifts to the community.

Our Vision

Our vision is that people with disabilities live full, meaningful lives as valued members of their communities.

Our Values

$1·     Community inclusion

$1·     Strong family partnerships

$1·     Health & wellness

$1·     Quality improvement

$1·     Respect

$1·     Dignity

$1·     Innovation

$1·     Individual choice

 

1

Strategic Planning Achievements

In FY 2015/2016 PRS-NM continued to prioritize the development and retention of qualified staff in FY15/16:

$1Ø  Specific attention was given to improved quality of staff by providing monthly and quarterly refreshers of ISP’s, Health care trainings, and changes in standards.  PRS-NM also requested trainings from DDSD on a quarterly basis to help with ISP outcomes and implementation.   

$1Ø  In an effort to increase staff morals, PRS-NM continues to hold staff appreciation events on a quarterly basis.  Events this year included a breakfast, popcorn and soda, Goody bags and Pumpkin pies were given out at Thanksgiving.  PRS-NM also recognizes outstanding staff by awarding “Employee of the Year”, “Admin of the Year” and “Day Hab Employee of the Month”.

$1Ø  PRS-NM implemented a new hire Orientation and training schedule.  Previously there were two full weeks of training before the staff was able to shadow or work in the program.  In FY15/16 changes were made which have the staff start with three days of training then shadowing for a few days before returning to training.  This has helped in our retention of staff and also their understanding of what the job entails.

Provide meaningful and diverse day services.

$1Ø  PRS-NM developed an events calendar during the FY2013/14 and has continued to do so in FY 2014/2015 and FY 2015/2016.  We continue to use the events calendar and provide monthly outings for the individuals who receive Customized Community Support Services.   Events included trips to museums and amusement parks in Albuquerque, Casinos in Ruidoso and Sunland Park, and a say at the Hot Springs.

$1Ø  With the renovation made at the Day Hab Center, we continue to implement life skills classes such as cooking classes and daily life trainings such as doing laundry.  There are also daily activities which continue at the center such as arts and crafts, ping pong, pool tournaments, corn hole tournaments, and karaoke.  They also celebrate non-traditional recognized holidays such as “National Wing Day” and “National Banana Split Day”  just to name a few.  They also have monthly scavenger hunts.

$1Ø  Two Stakeholder/Advisory meetings were held this FY, a Grand Opening at our new building and a Holiday Luncheon.  Attendance was good at both of these events.

$1Ø  PRS-NM held three fundraisers to help with special activities and events. Fundraisers included the 4th Annual Wine and Silent Auction Event, Enchilada plate sale, and an event at Texas Roadhouse which brought in money for FY15/16.

            

Service Outcomes

Satisfaction: PRS-NM overall average rate of all combined stakeholders was 94%.  These included percentages from the individual groups as listed below.

People in service: 94%

Guardians: 100%

Employees: 100%

Professionals (case managers, therapists, etc.): 100%

 “I like that the program involves person served in the decisions regarding their goals.” (Guardian)

“”I think that the current management is working better than that of the past.”  (Professional Stakeholder)

“I’d like to thank the administration for being prompt and thorough with the persons served and with paperwork.” (Guardian)

Access: There was an increase of seven persons served in Customized Community Supports and eight persons served in Supported Living during the FY15-16.

Effectiveness: At the onset of the fiscal year, PRS-NM began collecting outcome measurement information on the implementation of Individual Service Plans (ISP). Since there continued to be challenges with monitoring ISP implementation and documentation, it was ultimately decided to problem-solve these issues and established new documentation and monitoring procedures. 

Efficiency: PRS-NM did not meet its goal set to report incidents to DHI/IMB within the designated timeframe. The reason the goals was not met was due to outside agency reporting.  Though PRS reported all events on the GER, they were not all reported to DHI/IMB because the agency felt they did not meet the reportable criteria.  Most outside reporting resulted as unsubstantiated. 

Efficiency: The fundraising goal of $500 per quarter for meaningful day hab activities was exceeded. PRS-NM raised over $2,430 for FY 15-16.

Risk Management Overview

Providing Day Hab Services with larger groups of people and less staff: Due to changes in State guidelines, SIS (Supports Intensity Scale), services to individuals in day services underwent a significant change and PRS NM was required to provide services with a smaller staff ratio.PRS-NM fought the implementation of new assessment procedures and standards revisions that would decrease the amount of staff support for people with high behavioral challenges and medical needs. PRS-NM hosted forums and participated in events to educate legislative candidates, community members and government officials about the potential consequences. However, those changes were eventually enforced. As a result, the number of Day Hab staffing hours was reduced. Of particular concern was the agency’s ability to effectively support people who previously had one-on-one staff support in groups of four (4) or even six (6). Others who have significant needs related to health and/or aging could no longer receive Day Hab at home and were required to participate in community and facility-based Day Hab for six (6) hours a day.  Progressive Residential Services, Inc.-NM responded to this programmatic risk by providing more meaningful structured facility based activities and to help reduce any oversight of health related needs for persons, the agency increased health related trainings.  

                                                                            

Staff competency in health care, emergency medical response and therapy plans not where we want them to be:

Late reporting of incidents:  As addressed previously in this report,PRS-NM did not meet its goal set to report incidents to DHI/IMB within the designated timeframe. The reason the goals was not met was due to outside agency reporting.  Though PRS reported all events on the GER, they were not all reported to DHI/IMB because the agency felt they did not meet the reportable criteria.  Most outside reporting resulted as unsubstantiated. 

SIS scores affecting staff budgeting:  The implementation of the new standards and SIS scores had an effect of staffing.  Staffing budgets were cut due but with the acquisition of IIBS funding, PRS-NM was able to staff in a way that would keep all the individuals safe and healthy.

Direct service personnel salary has been at a cap amount for over seven years: PRS-NM administrative staff advocated for top out bonuses and it was developed and implemented.  Some employees have already been recognized and have received their bonuses.

Barriers to Service Delivery

Architectural: Emergency egress from the back door to the front of the home was an issue for four sites.  PRS NM was able to address one of the sites and there is now a pathway for the individuals in wheelchairs to use the back door of the home and wheeled to the front yard.  There are still issues at three of the homes which we are hoping to have completed during the next fiscal year. 

A temporary ramp was put at the exit of the back door at our day hab center.  Permanent ramps will be put in during the next fiscal year.

Attitudinal

Negative Community attitudes toward persons with disabilities:  PRS-NM distributed flyers and newsletters to community entities to help increase awareness of our agency, and services we provide for people with developmental disabilities.    

Community awareness of accommodations for persons with special needs:  PRS-NM found that there are many businesses that are not sensitive as to the accommodations needed for people with disabilities.  Unfortunately PRS-NM was not able to reach out to the community in this area as we had planned.  This goal will be carried over to the next fiscal year.

Poor Direct Care Staff Morale:  The Day Hab program does recognize “Employee of the Month”.  We continue to hold staff appreciation events on a quarterly basis.  A pizza party was given to “The house of the Year” and pies were given out to each employee at Thanksgiving.

Environmental

Summer Heat:  The summer heat limits the ability to participate in comfortable and safe outdoor activities.  PRS-NM did identify meaningful and structured activities for the Day Hab Center.  They continue to participate in life skills classes, art classes, movie day, Zumba, pool, karaoke and indoor basketball.  National holidays have been included in monthly calendar events and are celebrated in the day hab center.  Umbrellas were purchased that clip onto wheelchairs to help with sun burns when they are outdoors.

Financial

Wheelchair lifts and vans require constant repairs and maintenance:  PRS-NM has been awarded the NMDOT Transit and Rail grant for the last 3 consecutive years.  In FY 15-16 two additional vans were purchased and one van was donated to us by Dona Ana County Family and Youth, Inc.  PRS-NM also continues to follow lift and vehicle maintenance.  Staff are given refreshers on a quarterly basis on wheelchair lifts.

Employment

Staff Retention:  As previously addressed in this report, PRS-NM implemented a new hire Orientation and training schedule.  Previously there were two full weeks of training before the staff was able to shadow or work in the program.  In FY15/16 changes were made which have the staff start with three days of training then shadowing for a few days before returning to training.  This has helped in our retention of staff and also their understanding of what the job entails.

Communication

Need to have agency forms and brochures in alternate languages: A few documents such as the Consumer Handbook, some HR memos and Payroll memos have been made available in Spanish.  Though, this continues to be an issue.We would like to see some progress during the 2015/2016 fiscal year in this area.

Incident Management Guidelines not in Spanish:  We were unable to get the Incident Management guidelines translated to Spanish.

Transportation

$1Ø  The cost of vehicle and wheelchair lift maintenance continued to threaten transportation for the people served by PRS-NM. PRS-NM was awarded the NMDOT FY 2015 5310 Transit Grant.  PRS-NM received two mini-vans between February and April, 2015.  PRS was also awarded the NMDOT FY 2016 5310 Transit Grant and will receive two more minivans at the beginning of 2016.  With the closing of the Roswell program, the Las Cruces program was able to acquire a newer van which the program used.  All of the acquisitions have help keep our vehicle maintenance costs at a minimum.

$1Ø  PRS-NM fundraised to offset the cost of gas for day trips and has added more meaningful facility-based activities to its day hab program.

 

Media/Technology

Limited “Likes” to Facebook pages and agency Web Site:  The PRS-NM Web Site has been updated.  We received a few referrals from our Facebook page.

Community Integration

DDSD Waiver Rates based on 50% facility time: The goal was to provide more meaningful and structured activities.  Both of these barriers were addressed previously in this report. 

Cultural Competency/Diversity

PRS-NM accomplished the following goals in its Cultural Diversity Plan:

Goal: To promote awareness, understanding and appreciation of the disability culture by the general community.

•             PRS NM continued to distribute newsletters to all stakeholders and different community members and organizations to increase awareness of the agency and the services we provide.  The agency continued to maintain and a Facebook page.

•             PRS-NM participated in the Dona Ana County ADA Celebration.

Sentinel Events & Incidents

 

Substantiated

Unsubstantiated

Open

Abuse

0

1

1

Neglect

5

10

3

Exploitation

1

0

1

Suspicious Injury

0

0

0

Environmental

0

0

3

 

Occurrences

Comments

Emergency Services

73

Includes EMTs, Urgent Care and ER visits

Law Enforcement

15

Involved six individuals due to behavioral issues

Physical Restraint

11

Individuals involves had MANDT approved through HRC and BSC plan

 

Fall

53

Majority of individuals involved had unsteady gait and/or seizure disorder.  Also one individual had a rapid decline in function during this period.

Skin Breakdown

6

Includes rashes and redness; multiple reports for same/ongoing rashes.

Signs of Aspiration

2

 

Hospitalization

17

Hospitalizations for ongoing or recurring medical conditions.  Also one for scheduled medical procedure.  Several hospitalizations documented were for Psychiatric issues.  Lastly one individual had rapid decline in health.

Death

0

 

 

Grievances:

There were no formal grievances filed during the fiscal year.

Referrals and Inquiries:

               There were a total of 9 inquiries.  Five were inquiries about the DD Waiver.  Four were for Mi Via Services.   Five signed a secondary Freedom of Choice with PRS and were in services during the fiscal year.

Turnover Trend Report

Progressive Residential Services of New Mexico, Inc.

7/1/2015 - 6/30/2016

By: Michelle Carter Pierce

Title: General Counsel & Human Resources Director Date: August 17, 2016

$1I.                 Number of Employees

According to Human Resources reports, there were a total of 105 employees on payroll for the fiscal year beginning on July 1, 2015 and ending on June 30, 2016.

$1II.               Turnover Rate

During this time period, the program incurred a total loss of 46 employees. The total turnover rate was 44%.

The total number of employee losses was 12 less than the prior year, and the total turnover rate was decreased by 67% from the prior year.

$1III.              Loss Analysis

$1A.               Layoffs.

There were 0 layoffs this fiscal year. These layoffs were due to the closing of the Roswell program.

The total number of layoffs was decreased by 29 from the prior fiscal year.

$1B.               Terminations.

There were a total of 4 employees who were terminated. These terminations were primarily the result of policy violations, including violation of persons served rights, improper employee conduct, and irregular attendance.

The number of terminations was decreased by 8 from the prior fiscal year.

$1C.               Resignations with Notice.

There were 12 employees who resigned with proper notice. The reasons reported for the resignations included scheduling conflicts with school, second job, etc.

The total number of resignations with notice remained the same from the prior fiscal year.

$1D.               Resignations without Notice.

There were 42 employees who resigned without proper notice. The primary reasons for such resignations were attendance-related including multiple absences and consecutive no call/ no shows. Other reasons include voluntary resignations with immediate notice or less than 2 weeks’ notice.

The total number of resignations without notice was decreased by 10 from the prior fiscal year.

$1E.               Misc.

 

There was 1 person whose separation was due to their sudden passing during the fiscal year.

IV. Summary and Goals for Remediation

PRS NM’s goal continues to be to reduce the number of resignations, especially the number of resignations without notice.

The Director, Management and HR continue to collaborate on recruitment and retention efforts. Also, job descriptions are reviewed annually to capture the performance expectations of all positions and the expected skill level and experience required for success in any given role. 

As we continue to meet staff’s ideas and preferences, the Las Cruces office has expanded its day program by moving into a new building. This new environment has allowed the program to explore new initiatives, which has been well-received by the staff.

Technology

Confidentiality & Security

Current users of technology have a standard protocol of using the minimal amount of confidential information as possible.  Documents that contain confidential information or PHI are password protected for security purposes.  Staff persons have utilized flash drives that are encrypted with passwords to ensure security. 

FY Progress: Periodic checks are completed to ensure that computers are password protected with a log on screen and timed screensaver and that confidential information is secure on flash drives. Staff that use technology as part of their job are provided with information regarding checks and results of checks at staff meeting.    

Assistive Technology

PRS-NM currently addresses any assistive technology needs of both persons served and staff through a variety of mechanisms.  For persons served, the agency uses the Intake Questionnaire, Pre/Post PCP Planning document and meetings to identify any assistive technology needs.  For staff, the agency provides reasonable accommodations for any staff that requests or demonstrates a need for assistive technology. 

FY ProgressThe agency has made some strides in assuring that assistive technology devices are maintained and used as needed for persons served.  Assistive Technology is now added as part of their DD Waiver budget.

Disaster Preparedness and Back Up Policies

PRS-NM currently backs up all computer information to the server and individual flash drives. 

FY Progress:  PRS-NM is currently working with Administrative Management Office to identify a system that will protect information and provide for safe storage of agency documents as there is no back up to our server.

Hardware and Software

PRS-NM computers are purchased with updated software and hardware.  As needed, updates are provided for each program site.

FY Progress: No goal set for Hardware and Software.

Excessive paper documents for staff timesheets/record keeping.

 INFORMATION MANAGEMENT & MEASUREMENT ANNUAL REPORT

July 2015 - June 2016

Executive Summary

Progressive Residential Services of New Mexico (PRS-NM) has been providing Developmental Disabilities (DD) Waiver services in Las Cruces since the year 2000. During Fiscal Year 2015/2016, the organization served an average of 30 individuals in supported living at a total of nine (10) residential sites and 25 individuals in Customized Community Supports.

During this FY, Progressive Residential Services of New Mexico was still adjusting to the 2011 funding cuts from Developmental Disabilities Supports Division (DDSD) which had implemented plans to “transform and simplify the [DD Waiver] system into one that is fair, equitable and cost effective.” Those efforts included the implementation of a “standardized assessment . . . to quantify the support needs” of people receiving services, known as the Supports Intensity Scale (SIS). DDSD also revised the DD Waiver service packages and issued new provider reimbursement rates.

These changes translated to service and funding reductions, and were ultimately implemented in May 2013. The implications had obviously brought about future concerns for the health, safety and quality of life of people in service. There were also clear financial implications and staffing reductions which impacted PRS-NM and the entire provider system. PRS-NM was able to acquire additional funding through Intensive Behavioral Supports (IIBS) funding and Category H, funding for Customized Community Supports for individuals’ who needed additional staffing due to health and safety issues. Despite the changes, Progressive Residential Services, Inc. NM was able to remain committed to its values, mission and vision of the organization.

Our Mission

Our mission is to assist people with disabilities to discover their unique gifts and find ways to contribute those gifts to the community.

Our Vision

Our vision is that people with disabilities live full, meaningful lives as valued members of their communities.

Our Values

$1·     Community inclusion

$1·     Strong family partnerships

$1·     Health & wellness

$1·     Quality improvement

$1·     Respect

$1·     Dignity

$1·     Innovation

$1·     Individual choice

 

1

Strategic Planning Achievements

In FY 2015/2016 PRS-NM continued to prioritize the development and retention of qualified staff in FY15/16:

$1Ø  Specific attention was given to improved quality of staff by providing monthly and quarterly refreshers of ISP’s, Health care trainings, and changes in standards.  PRS-NM also requested trainings from DDSD on a quarterly basis to help with ISP outcomes and implementation.   

$1Ø  In an effort to increase staff morals, PRS-NM continues to hold staff appreciation events on a quarterly basis.  Events this year included a breakfast, popcorn and soda, Goody bags and Pumpkin pies were given out at Thanksgiving.  PRS-NM also recognizes outstanding staff by awarding “Employee of the Year”, “Admin of the Year” and “Day Hab Employee of the Month”.

$1Ø  PRS-NM implemented a new hire Orientation and training schedule.  Previously there were two full weeks of training before the staff was able to shadow or work in the program.  In FY15/16 changes were made which have the staff start with three days of training then shadowing for a few days before returning to training.  This has helped in our retention of staff and also their understanding of what the job entails.

Provide meaningful and diverse day services.

$1Ø  PRS-NM developed an events calendar during the FY2013/14 and has continued to do so in FY 2014/2015 and FY 2015/2016.  We continue to use the events calendar and provide monthly outings for the individuals who receive Customized Community Support Services.   Events included trips to museums and amusement parks in Albuquerque, Casinos in Ruidoso and Sunland Park, and a say at the Hot Springs.

$1Ø  With the renovation made at the Day Hab Center, we continue to implement life skills classes such as cooking classes and daily life trainings such as doing laundry.  There are also daily activities which continue at the center such as arts and crafts, ping pong, pool tournaments, corn hole tournaments, and karaoke.  They also celebrate non-traditional recognized holidays such as “National Wing Day” and “National Banana Split Day”  just to name a few.  They also have monthly scavenger hunts.

$1Ø  Two Stakeholder/Advisory meetings were held this FY, a Grand Opening at our new building and a Holiday Luncheon.  Attendance was good at both of these events.

$1Ø  PRS-NM held three fundraisers to help with special activities and events. Fundraisers included the 4th Annual Wine and Silent Auction Event, Enchilada plate sale, and an event at Texas Roadhouse which brought in money for FY15/16.

            

Service Outcomes

Satisfaction: PRS-NM overall average rate of all combined stakeholders was 94%.  These included percentages from the individual groups as listed below.

People in service: 94%

Guardians: 100%

Employees: 100%

Professionals (case managers, therapists, etc.): 100%

 “I like that the program involves person served in the decisions regarding their goals.” (Guardian)

“”I think that the current management is working better than that of the past.”  (Professional Stakeholder)

“I’d like to thank the administration for being prompt and thorough with the persons served and with paperwork.” (Guardian)

Access: There was an increase of seven persons served in Customized Community Supports and eight persons served in Supported Living during the FY15-16.

Effectiveness: At the onset of the fiscal year, PRS-NM began collecting outcome measurement information on the implementation of Individual Service Plans (ISP). Since there continued to be challenges with monitoring ISP implementation and documentation, it was ultimately decided to problem-solve these issues and established new documentation and monitoring procedures. 

Efficiency: PRS-NM did not meet its goal set to report incidents to DHI/IMB within the designated timeframe. The reason the goals was not met was due to outside agency reporting.  Though PRS reported all events on the GER, they were not all reported to DHI/IMB because the agency felt they did not meet the reportable criteria.  Most outside reporting resulted as unsubstantiated. 

Efficiency: The fundraising goal of $500 per quarter for meaningful day hab activities was exceeded. PRS-NM raised over $2,430 for FY 15-16.

Risk Management Overview

Providing Day Hab Services with larger groups of people and less staff: Due to changes in State guidelines, SIS (Supports Intensity Scale), services to individuals in day services underwent a significant change and PRS NM was required to provide services with a smaller staff ratio.PRS-NM fought the implementation of new assessment procedures and standards revisions that would decrease the amount of staff support for people with high behavioral challenges and medical needs. PRS-NM hosted forums and participated in events to educate legislative candidates, community members and government officials about the potential consequences. However, those changes were eventually enforced. As a result, the number of Day Hab staffing hours was reduced. Of particular concern was the agency’s ability to effectively support people who previously had one-on-one staff support in groups of four (4) or even six (6). Others who have significant needs related to health and/or aging could no longer receive Day Hab at home and were required to participate in community and facility-based Day Hab for six (6) hours a day.  Progressive Residential Services, Inc.-NM responded to this programmatic risk by providing more meaningful structured facility based activities and to help reduce any oversight of health related needs for persons, the agency increased health related trainings.  

                                                                            

Staff competency in health care, emergency medical response and therapy plans not where we want them to be:

Late reporting of incidents:  As addressed previously in this report,PRS-NM did not meet its goal set to report incidents to DHI/IMB within the designated timeframe. The reason the goals was not met was due to outside agency reporting.  Though PRS reported all events on the GER, they were not all reported to DHI/IMB because the agency felt they did not meet the reportable criteria.  Most outside reporting resulted as unsubstantiated. 

SIS scores affecting staff budgeting:  The implementation of the new standards and SIS scores had an effect of staffing.  Staffing budgets were cut due but with the acquisition of IIBS funding, PRS-NM was able to staff in a way that would keep all the individuals safe and healthy.

Direct service personnel salary has been at a cap amount for over seven years: PRS-NM administrative staff advocated for top out bonuses and it was developed and implemented.  Some employees have already been recognized and have received their bonuses.

Barriers to Service Delivery

Architectural: Emergency egress from the back door to the front of the home was an issue for four sites.  PRS NM was able to address one of the sites and there is now a pathway for the individuals in wheelchairs to use the back door of the home and wheeled to the front yard.  There are still issues at three of the homes which we are hoping to have completed during the next fiscal year. 

A temporary ramp was put at the exit of the back door at our day hab center.  Permanent ramps will be put in during the next fiscal year.

Attitudinal

Negative Community attitudes toward persons with disabilities:  PRS-NM distributed flyers and newsletters to community entities to help increase awareness of our agency, and services we provide for people with developmental disabilities.    

Community awareness of accommodations for persons with special needs:  PRS-NM found that there are many businesses that are not sensitive as to the accommodations needed for people with disabilities.  Unfortunately PRS-NM was not able to reach out to the community in this area as we had planned.  This goal will be carried over to the next fiscal year.

Poor Direct Care Staff Morale:  The Day Hab program does recognize “Employee of the Month”.  We continue to hold staff appreciation events on a quarterly basis.  A pizza party was given to “The house of the Year” and pies were given out to each employee at Thanksgiving.

Environmental

Summer Heat:  The summer heat limits the ability to participate in comfortable and safe outdoor activities.  PRS-NM did identify meaningful and structured activities for the Day Hab Center.  They continue to participate in life skills classes, art classes, movie day, Zumba, pool, karaoke and indoor basketball.  National holidays have been included in monthly calendar events and are celebrated in the day hab center.  Umbrellas were purchased that clip onto wheelchairs to help with sun burns when they are outdoors.

Financial

Wheelchair lifts and vans require constant repairs and maintenance:  PRS-NM has been awarded the NMDOT Transit and Rail grant for the last 3 consecutive years.  In FY 15-16 two additional vans were purchased and one van was donated to us by Dona Ana County Family and Youth, Inc.  PRS-NM also continues to follow lift and vehicle maintenance.  Staff are given refreshers on a quarterly basis on wheelchair lifts.

Employment

Staff Retention:  As previously addressed in this report, PRS-NM implemented a new hire Orientation and training schedule.  Previously there were two full weeks of training before the staff was able to shadow or work in the program.  In FY15/16 changes were made which have the staff start with three days of training then shadowing for a few days before returning to training.  This has helped in our retention of staff and also their understanding of what the job entails.

Communication

Need to have agency forms and brochures in alternate languages: A few documents such as the Consumer Handbook, some HR memos and Payroll memos have been made available in Spanish.  Though, this continues to be an issue.We would like to see some progress during the 2015/2016 fiscal year in this area.

Incident Management Guidelines not in Spanish:  We were unable to get the Incident Management guidelines translated to Spanish.

Transportation

$1Ø  The cost of vehicle and wheelchair lift maintenance continued to threaten transportation for the people served by PRS-NM. PRS-NM was awarded the NMDOT FY 2015 5310 Transit Grant.  PRS-NM received two mini-vans between February and April, 2015.  PRS was also awarded the NMDOT FY 2016 5310 Transit Grant and will receive two more minivans at the beginning of 2016.  With the closing of the Roswell program, the Las Cruces program was able to acquire a newer van which the program used.  All of the acquisitions have help keep our vehicle maintenance costs at a minimum.

$1Ø  PRS-NM fundraised to offset the cost of gas for day trips and has added more meaningful facility-based activities to its day hab program.

 

Media/Technology

Limited “Likes” to Facebook pages and agency Web Site:  The PRS-NM Web Site has been updated.  We received a few referrals from our Facebook page.

Community Integration

DDSD Waiver Rates based on 50% facility time: The goal was to provide more meaningful and structured activities.  Both of these barriers were addressed previously in this report. 

Cultural Competency/Diversity

PRS-NM accomplished the following goals in its Cultural Diversity Plan:

Goal: To promote awareness, understanding and appreciation of the disability culture by the general community.

•             PRS NM continued to distribute newsletters to all stakeholders and different community members and organizations to increase awareness of the agency and the services we provide.  The agency continued to maintain and a Facebook page.

•             PRS-NM participated in the Dona Ana County ADA Celebration.

Sentinel Events & Incidents

 

Substantiated

Unsubstantiated

Open

Abuse

0

1

1

Neglect

5

10

3

Exploitation

1

0

1

Suspicious Injury

0

0

0

Environmental

0

0

3

 

Occurrences

Comments

Emergency Services

73

Includes EMTs, Urgent Care and ER visits

Law Enforcement

15

Involved six individuals due to behavioral issues

Physical Restraint

11

Individuals involves had MANDT approved through HRC and BSC plan

 

Fall

53

Majority of individuals involved had unsteady gait and/or seizure disorder.  Also one individual had a rapid decline in function during this period.

Skin Breakdown

6

Includes rashes and redness; multiple reports for same/ongoing rashes.

Signs of Aspiration

2

 

Hospitalization

17

Hospitalizations for ongoing or recurring medical conditions.  Also one for scheduled medical procedure.  Several hospitalizations documented were for Psychiatric issues.  Lastly one individual had rapid decline in health.

Death

0

 

 

Grievances:

There were no formal grievances filed during the fiscal year.

Referrals and Inquiries:

               There were a total of 9 inquiries.  Five were inquiries about the DD Waiver.  Four were for Mi Via Services.   Five signed a secondary Freedom of Choice with PRS and were in services during the fiscal year.

Turnover Trend Report

Progressive Residential Services of New Mexico, Inc.

7/1/2015 - 6/30/2016

By: Michelle Carter Pierce

Title: General Counsel & Human Resources Director Date: August 17, 2016

$1I.                 Number of Employees

According to Human Resources reports, there were a total of 105 employees on payroll for the fiscal year beginning on July 1, 2015 and ending on June 30, 2016.

$1II.               Turnover Rate

During this time period, the program incurred a total loss of 46 employees. The total turnover rate was 44%.

The total number of employee losses was 12 less than the prior year, and the total turnover rate was decreased by 67% from the prior year.

$1III.              Loss Analysis

$1A.               Layoffs.

There were 0 layoffs this fiscal year. These layoffs were due to the closing of the Roswell program.

The total number of layoffs was decreased by 29 from the prior fiscal year.

$1B.               Terminations.

There were a total of 4 employees who were terminated. These terminations were primarily the result of policy violations, including violation of persons served rights, improper employee conduct, and irregular attendance.

The number of terminations was decreased by 8 from the prior fiscal year.

$1C.               Resignations with Notice.

There were 12 employees who resigned with proper notice. The reasons reported for the resignations included scheduling conflicts with school, second job, etc.

The total number of resignations with notice remained the same from the prior fiscal year.

$1D.               Resignations without Notice.

There were 42 employees who resigned without proper notice. The primary reasons for such resignations were attendance-related including multiple absences and consecutive no call/ no shows. Other reasons include voluntary resignations with immediate notice or less than 2 weeks’ notice.

The total number of resignations without notice was decreased by 10 from the prior fiscal year.

$1E.               Misc.

 

There was 1 person whose separation was due to their sudden passing during the fiscal year.

IV. Summary and Goals for Remediation

PRS NM’s goal continues to be to reduce the number of resignations, especially the number of resignations without notice.

The Director, Management and HR continue to collaborate on recruitment and retention efforts. Also, job descriptions are reviewed annually to capture the performance expectations of all positions and the expected skill level and experience required for success in any given role. 

As we continue to meet staff’s ideas and preferences, the Las Cruces office has expanded its day program by moving into a new building. This new environment has allowed the program to explore new initiatives, which has been well-received by the staff.

Technology

Confidentiality & Security

Current users of technology have a standard protocol of using the minimal amount of confidential information as possible.  Documents that contain confidential information or PHI are password protected for security purposes.  Staff persons have utilized flash drives that are encrypted with passwords to ensure security. 

FY Progress: Periodic checks are completed to ensure that computers are password protected with a log on screen and timed screensaver and that confidential information is secure on flash drives. Staff that use technology as part of their job are provided with information regarding checks and results of checks at staff meeting.    

Assistive Technology

PRS-NM currently addresses any assistive technology needs of both persons served and staff through a variety of mechanisms.  For persons served, the agency uses the Intake Questionnaire, Pre/Post PCP Planning document and meetings to identify any assistive technology needs.  For staff, the agency provides reasonable accommodations for any staff that requests or demonstrates a need for assistive technology. 

FY ProgressThe agency has made some strides in assuring that assistive technology devices are maintained and used as needed for persons served.  Assistive Technology is now added as part of their DD Waiver budget.

Disaster Preparedness and Back Up Policies

PRS-NM currently backs up all computer information to the server and individual flash drives. 

FY Progress:  PRS-NM is currently working with Administrative Management Office to identify a system that will protect information and provide for safe storage of agency documents as there is no back up to our server.

Hardware and Software

PRS-NM computers are purchased with updated software and hardware.  As needed, updates are provided for each program site.

FY Progress: No goal set for Hardware and Software.

Excessive paper documents for staff timesheets/record keeping.

 

PRS-NM wanted to explore costs associated with an electronic timekeeping system to cut back on excessive paper documents. 

 

FY Progress: Options were explored for a time keeper/electronic time clock and we found that it was too expensive.

 

INFORMATION MANAGEMENT & MEASUREMENT ANNUAL REPORT

July 2015 - June 2016

Executive Summary

Progressive Residential Services of New Mexico (PRS-NM) has been providing Developmental Disabilities (DD) Waiver services in Las Cruces since the year 2000. During Fiscal Year 2015/2016, the organization served an average of 30 individuals in supported living at a total of nine (10) residential sites and 25 individuals in Customized Community Supports.

During this FY, Progressive Residential Services of New Mexico was still adjusting to the 2011 funding cuts from Developmental Disabilities Supports Division (DDSD) which had implemented plans to “transform and simplify the [DD Waiver] system into one that is fair, equitable and cost effective.” Those efforts included the implementation of a “standardized assessment . . . to quantify the support needs” of people receiving services, known as the Supports Intensity Scale (SIS). DDSD also revised the DD Waiver service packages and issued new provider reimbursement rates.

These changes translated to service and funding reductions, and were ultimately implemented in May 2013. The implications had obviously brought about future concerns for the health, safety and quality of life of people in service. There were also clear financial implications and staffing reductions which impacted PRS-NM and the entire provider system. PRS-NM was able to acquire additional funding through Intensive Behavioral Supports (IIBS) funding and Category H, funding for Customized Community Supports for individuals’ who needed additional staffing due to health and safety issues. Despite the changes, Progressive Residential Services, Inc. NM was able to remain committed to its values, mission and vision of the organization.

Our Mission

Our mission is to assist people with disabilities to discover their unique gifts and find ways to contribute those gifts to the community.

Our Vision

Our vision is that people with disabilities live full, meaningful lives as valued members of their communities.

Our Values

$1·     Community inclusion

$1·     Strong family partnerships

$1·     Health & wellness

$1·     Quality improvement

$1·     Respect

$1·     Dignity

$1·     Innovation

$1·     Individual choice

 

1

Strategic Planning Achievements

In FY 2015/2016 PRS-NM continued to prioritize the development and retention of qualified staff in FY15/16:

$1Ø  Specific attention was given to improved quality of staff by providing monthly and quarterly refreshers of ISP’s, Health care trainings, and changes in standards.  PRS-NM also requested trainings from DDSD on a quarterly basis to help with ISP outcomes and implementation.   

$1Ø  In an effort to increase staff morals, PRS-NM continues to hold staff appreciation events on a quarterly basis.  Events this year included a breakfast, popcorn and soda, Goody bags and Pumpkin pies were given out at Thanksgiving.  PRS-NM also recognizes outstanding staff by awarding “Employee of the Year”, “Admin of the Year” and “Day Hab Employee of the Month”.

$1Ø  PRS-NM implemented a new hire Orientation and training schedule.  Previously there were two full weeks of training before the staff was able to shadow or work in the program.  In FY15/16 changes were made which have the staff start with three days of training then shadowing for a few days before returning to training.  This has helped in our retention of staff and also their understanding of what the job entails.

Provide meaningful and diverse day services.

$1Ø  PRS-NM developed an events calendar during the FY2013/14 and has continued to do so in FY 2014/2015 and FY 2015/2016.  We continue to use the events calendar and provide monthly outings for the individuals who receive Customized Community Support Services.   Events included trips to museums and amusement parks in Albuquerque, Casinos in Ruidoso and Sunland Park, and a say at the Hot Springs.

$1Ø  With the renovation made at the Day Hab Center, we continue to implement life skills classes such as cooking classes and daily life trainings such as doing laundry.  There are also daily activities which continue at the center such as arts and crafts, ping pong, pool tournaments, corn hole tournaments, and karaoke.  They also celebrate non-traditional recognized holidays such as “National Wing Day” and “National Banana Split Day”  just to name a few.  They also have monthly scavenger hunts.

$1Ø  Two Stakeholder/Advisory meetings were held this FY, a Grand Opening at our new building and a Holiday Luncheon.  Attendance was good at both of these events.

$1Ø  PRS-NM held three fundraisers to help with special activities and events. Fundraisers included the 4th Annual Wine and Silent Auction Event, Enchilada plate sale, and an event at Texas Roadhouse which brought in money for FY15/16.

            

Service Outcomes

Satisfaction: PRS-NM overall average rate of all combined stakeholders was 94%.  These included percentages from the individual groups as listed below.

People in service: 94%

Guardians: 100%

Employees: 100%

Professionals (case managers, therapists, etc.): 100%

 “I like that the program involves person served in the decisions regarding their goals.” (Guardian)

“”I think that the current management is working better than that of the past.”  (Professional Stakeholder)

“I’d like to thank the administration for being prompt and thorough with the persons served and with paperwork.” (Guardian)

Access: There was an increase of seven persons served in Customized Community Supports and eight persons served in Supported Living during the FY15-16.

Effectiveness: At the onset of the fiscal year, PRS-NM began collecting outcome measurement information on the implementation of Individual Service Plans (ISP). Since there continued to be challenges with monitoring ISP implementation and documentation, it was ultimately decided to problem-solve these issues and established new documentation and monitoring procedures. 

Efficiency: PRS-NM did not meet its goal set to report incidents to DHI/IMB within the designated timeframe. The reason the goals was not met was due to outside agency reporting.  Though PRS reported all events on the GER, they were not all reported to DHI/IMB because the agency felt they did not meet the reportable criteria.  Most outside reporting resulted as unsubstantiated. 

Efficiency: The fundraising goal of $500 per quarter for meaningful day hab activities was exceeded. PRS-NM raised over $2,430 for FY 15-16.

Risk Management Overview

Providing Day Hab Services with larger groups of people and less staff: Due to changes in State guidelines, SIS (Supports Intensity Scale), services to individuals in day services underwent a significant change and PRS NM was required to provide services with a smaller staff ratio.PRS-NM fought the implementation of new assessment procedures and standards revisions that would decrease the amount of staff support for people with high behavioral challenges and medical needs. PRS-NM hosted forums and participated in events to educate legislative candidates, community members and government officials about the potential consequences. However, those changes were eventually enforced. As a result, the number of Day Hab staffing hours was reduced. Of particular concern was the agency’s ability to effectively support people who previously had one-on-one staff support in groups of four (4) or even six (6). Others who have significant needs related to health and/or aging could no longer receive Day Hab at home and were required to participate in community and facility-based Day Hab for six (6) hours a day.  Progressive Residential Services, Inc.-NM responded to this programmatic risk by providing more meaningful structured facility based activities and to help reduce any oversight of health related needs for persons, the agency increased health related trainings.  

                                                                            

Staff competency in health care, emergency medical response and therapy plans not where we want them to be:

Late reporting of incidents:  As addressed previously in this report,PRS-NM did not meet its goal set to report incidents to DHI/IMB within the designated timeframe. The reason the goals was not met was due to outside agency reporting.  Though PRS reported all events on the GER, they were not all reported to DHI/IMB because the agency felt they did not meet the reportable criteria.  Most outside reporting resulted as unsubstantiated. 

SIS scores affecting staff budgeting:  The implementation of the new standards and SIS scores had an effect of staffing.  Staffing budgets were cut due but with the acquisition of IIBS funding, PRS-NM was able to staff in a way that would keep all the individuals safe and healthy.

Direct service personnel salary has been at a cap amount for over seven years: PRS-NM administrative staff advocated for top out bonuses and it was developed and implemented.  Some employees have already been recognized and have received their bonuses.

Barriers to Service Delivery

Architectural: Emergency egress from the back door to the front of the home was an issue for four sites.  PRS NM was able to address one of the sites and there is now a pathway for the individuals in wheelchairs to use the back door of the home and wheeled to the front yard.  There are still issues at three of the homes which we are hoping to have completed during the next fiscal year. 

A temporary ramp was put at the exit of the back door at our day hab center.  Permanent ramps will be put in during the next fiscal year.

Attitudinal

Negative Community attitudes toward persons with disabilities:  PRS-NM distributed flyers and newsletters to community entities to help increase awareness of our agency, and services we provide for people with developmental disabilities.    

Community awareness of accommodations for persons with special needs:  PRS-NM found that there are many businesses that are not sensitive as to the accommodations needed for people with disabilities.  Unfortunately PRS-NM was not able to reach out to the community in this area as we had planned.  This goal will be carried over to the next fiscal year.

Poor Direct Care Staff Morale:  The Day Hab program does recognize “Employee of the Month”.  We continue to hold staff appreciation events on a quarterly basis.  A pizza party was given to “The house of the Year” and pies were given out to each employee at Thanksgiving.

Environmental

Summer Heat:  The summer heat limits the ability to participate in comfortable and safe outdoor activities.  PRS-NM did identify meaningful and structured activities for the Day Hab Center.  They continue to participate in life skills classes, art classes, movie day, Zumba, pool, karaoke and indoor basketball.  National holidays have been included in monthly calendar events and are celebrated in the day hab center.  Umbrellas were purchased that clip onto wheelchairs to help with sun burns when they are outdoors.

Financial

Wheelchair lifts and vans require constant repairs and maintenance:  PRS-NM has been awarded the NMDOT Transit and Rail grant for the last 3 consecutive years.  In FY 15-16 two additional vans were purchased and one van was donated to us by Dona Ana County Family and Youth, Inc.  PRS-NM also continues to follow lift and vehicle maintenance.  Staff are given refreshers on a quarterly basis on wheelchair lifts.

Employment

Staff Retention:  As previously addressed in this report, PRS-NM implemented a new hire Orientation and training schedule.  Previously there were two full weeks of training before the staff was able to shadow or work in the program.  In FY15/16 changes were made which have the staff start with three days of training then shadowing for a few days before returning to training.  This has helped in our retention of staff and also their understanding of what the job entails.

Communication

Need to have agency forms and brochures in alternate languages: A few documents such as the Consumer Handbook, some HR memos and Payroll memos have been made available in Spanish.  Though, this continues to be an issue.We would like to see some progress during the 2015/2016 fiscal year in this area.

Incident Management Guidelines not in Spanish:  We were unable to get the Incident Management guidelines translated to Spanish.

Transportation

$1Ø  The cost of vehicle and wheelchair lift maintenance continued to threaten transportation for the people served by PRS-NM. PRS-NM was awarded the NMDOT FY 2015 5310 Transit Grant.  PRS-NM received two mini-vans between February and April, 2015.  PRS was also awarded the NMDOT FY 2016 5310 Transit Grant and will receive two more minivans at the beginning of 2016.  With the closing of the Roswell program, the Las Cruces program was able to acquire a newer van which the program used.  All of the acquisitions have help keep our vehicle maintenance costs at a minimum.

$1Ø  PRS-NM fundraised to offset the cost of gas for day trips and has added more meaningful facility-based activities to its day hab program.

 

Media/Technology

Limited “Likes” to Facebook pages and agency Web Site:  The PRS-NM Web Site has been updated.  We received a few referrals from our Facebook page.

Community Integration

DDSD Waiver Rates based on 50% facility time: The goal was to provide more meaningful and structured activities.  Both of these barriers were addressed previously in this report. 

Cultural Competency/Diversity

PRS-NM accomplished the following goals in its Cultural Diversity Plan:

Goal: To promote awareness, understanding and appreciation of the disability culture by the general community.

•             PRS NM continued to distribute newsletters to all stakeholders and different community members and organizations to increase awareness of the agency and the services we provide.  The agency continued to maintain and a Facebook page.

•             PRS-NM participated in the Dona Ana County ADA Celebration.

Sentinel Events & Incidents

 

Substantiated

Unsubstantiated

Open

Abuse

0

1

1

Neglect

5

10

3

Exploitation

1

0

1

Suspicious Injury

0

0

0

Environmental

0

0

3

 

Occurrences

Comments

Emergency Services

73

Includes EMTs, Urgent Care and ER visits

Law Enforcement

15

Involved six individuals due to behavioral issues

Physical Restraint

11

Individuals involves had MANDT approved through HRC and BSC plan

 

Fall

53

Majority of individuals involved had unsteady gait and/or seizure disorder.  Also one individual had a rapid decline in function during this period.

Skin Breakdown

6

Includes rashes and redness; multiple reports for same/ongoing rashes.

Signs of Aspiration

2

 

Hospitalization

17

Hospitalizations for ongoing or recurring medical conditions.  Also one for scheduled medical procedure.  Several hospitalizations documented were for Psychiatric issues.  Lastly one individual had rapid decline in health.

Death

0

 

 

Grievances:

There were no formal grievances filed during the fiscal year.

Referrals and Inquiries:

               There were a total of 9 inquiries.  Five were inquiries about the DD Waiver.  Four were for Mi Via Services.   Five signed a secondary Freedom of Choice with PRS and were in services during the fiscal year.

Turnover Trend Report

Progressive Residential Services of New Mexico, Inc.

7/1/2015 - 6/30/2016

By: Michelle Carter Pierce

Title: General Counsel & Human Resources Director Date: August 17, 2016

$1I.                 Number of Employees

According to Human Resources reports, there were a total of 105 employees on payroll for the fiscal year beginning on July 1, 2015 and ending on June 30, 2016.

$1II.               Turnover Rate

During this time period, the program incurred a total loss of 46 employees. The total turnover rate was 44%.

The total number of employee losses was 12 less than the prior year, and the total turnover rate was decreased by 67% from the prior year.

$1III.              Loss Analysis

$1A.               Layoffs.

There were 0 layoffs this fiscal year. These layoffs were due to the closing of the Roswell program.

The total number of layoffs was decreased by 29 from the prior fiscal year.

$1B.               Terminations.

There were a total of 4 employees who were terminated. These terminations were primarily the result of policy violations, including violation of persons served rights, improper employee conduct, and irregular attendance.

The number of terminations was decreased by 8 from the prior fiscal year.

$1C.               Resignations with Notice.

There were 12 employees who resigned with proper notice. The reasons reported for the resignations included scheduling conflicts with school, second job, etc.

The total number of resignations with notice remained the same from the prior fiscal year.

$1D.               Resignations without Notice.

There were 42 employees who resigned without proper notice. The primary reasons for such resignations were attendance-related including multiple absences and consecutive no call/ no shows. Other reasons include voluntary resignations with immediate notice or less than 2 weeks’ notice.

The total number of resignations without notice was decreased by 10 from the prior fiscal year.

$1E.               Misc.

 

There was 1 person whose separation was due to their sudden passing during the fiscal year.

IV. Summary and Goals for Remediation

PRS NM’s goal continues to be to reduce the number of resignations, especially the number of resignations without notice.

The Director, Management and HR continue to collaborate on recruitment and retention efforts. Also, job descriptions are reviewed annually to capture the performance expectations of all positions and the expected skill level and experience required for success in any given role. 

As we continue to meet staff’s ideas and preferences, the Las Cruces office has expanded its day program by moving into a new building. This new environment has allowed the program to explore new initiatives, which has been well-received by the staff.

Technology

Confidentiality & Security

Current users of technology have a standard protocol of using the minimal amount of confidential information as possible.  Documents that contain confidential information or PHI are password protected for security purposes.  Staff persons have utilized flash drives that are encrypted with passwords to ensure security. 

FY Progress: Periodic checks are completed to ensure that computers are password protected with a log on screen and timed screensaver and that confidential information is secure on flash drives. Staff that use technology as part of their job are provided with information regarding checks and results of checks at staff meeting.    

Assistive Technology

PRS-NM currently addresses any assistive technology needs of both persons served and staff through a variety of mechanisms.  For persons served, the agency uses the Intake Questionnaire, Pre/Post PCP Planning document and meetings to identify any assistive technology needs.  For staff, the agency provides reasonable accommodations for any staff that requests or demonstrates a need for assistive technology. 

FY ProgressThe agency has made some strides in assuring that assistive technology devices are maintained and used as needed for persons served.  Assistive Technology is now added as part of their DD Waiver budget.

Disaster Preparedness and Back Up Policies

PRS-NM currently backs up all computer information to the server and individual flash drives. 

FY Progress:  PRS-NM is currently working with Administrative Management Office to identify a system that will protect information and provide for safe storage of agency documents as there is no back up to our server.

Hardware and Software

PRS-NM computers are purchased with updated software and hardware.  As needed, updates are provided for each program site.

FY Progress: No goal set for Hardware and Software.

Excessive paper documents for staff timesheets/record keeping.

 

PRS-NM wanted to explore costs associated with an electronic timekeeping system to cut back on excessive paper documents. 

 

FY Progress: Options were explored for a time keeper/electronic time clock and we found that it was too expensive.

 

  

  

PRS-NM wanted to explore costs associated with an electronic timekeeping system to cut back on excessive paper documents. 

 

FY Progress: Options were explored for a time keeper/electronic time clock and we found that it was too expensive.

 

  

LAS CRUCES OFFICE 
1100 S. Main Street Ste A
Las Cruces, New Mexico 88005
Office:(575) 523-8431
Fax: (575) 525-2521

Follow PRS-NM on   facebook

Copyright © 2017 Progressive Residential Services of New Mexico, Inc

Thank you for supporting our efforts in making this the best program it can be.

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