System-Wide Clean Up Results in Doubling of Terminations Sought
Fast-Track Reforms Are Making a Difference in Agency’s Obligation to
Protect Individuals; Next Steps Include an Agenda of Improvements to Services and Care
(Albany, NY) Commissioner Courtney Burke of the state Office for People With Developmental Disabilities (OPWDD) today released a six-month progress report outlining her administration’s efforts to reform New York’s vast system of care for its more than 126,000 individuals with developmental disabilities and improve efforts to keep people safe while in care.
Since Commissioner Burke’s confirmation by the State Senate in April, OPWDD has implemented several major reforms, overhauling virtually every aspect of the agency’s operations, including hiring, discipline, and service opportunities for people receiving the agency’s support.
“As Governor Cuomo, individuals in our care, their family members, and advocates have known, OPWDD’s basic obligation to protect health and safety needed broad, deep, and meaningful reform. Some of our initiatives, including creation of a new culture of staff responsibility, will take time. But we have made great strides in the first six months that are making this system safer today,” Commissioner Burke said.
She noted several areas of key progress:
· Nearly doubling the number of OPWDD employees whose termination the agency is seeking for abuse and neglect to 130;
· Increasing the percentage of physical abuse allegations that have been reported to law enforcement http://www.opwdd.ny.gov/news/abuse_reporting_reform.jsp> from 16 to 93 percent, and the percentage of sexual abuse allegations reported to police from 75 to 98 percent;
· Holding nonprofit providers http://www.opwdd.ny.gov/commissioner/quality/management.jsp> (that provide nearly 80 percent of OPWDD’s services) accountable for safety, fiscal, and governance deficiencies in their operations;
· Partnering http://www.opwdd.ny.gov/news/fire_safety.jsp> with the Office of Fire Control and Prevention to ensure external controls and oversight of fire safety at group homes. Additionally, for the first time, standardizing fire safety practices at all state and nonprofit homes, including smoking policies, unannounced observations of evacuations and fire drills, and minimum requirements on fire safety training and drill reporting.
· Strengthening hiring practices to require, for the first time, that every new employee pass a rigorous system of checks that includes mandatory drug and psychological fitness testing; and
· Ensuring for the first time that every new employee has at least a high school diploma or its equivalent, a valid driver’s license, and is cross-checked with the state’s child abuse and sex offender registries.
Commissioner Burke’s report also outlined her agenda of continued actions the OPWDD administration will take in the next six months—and over the long term—to improve services and opportunities for the growing number of individuals utilizing state and nonprofit programs through systems redesigns.
A few of these critical next steps include:
· Compiling and publishing online report cards for each of the more than 700 nonprofit providers across the state, providing grades on fiscal management, governance, and care compliance issues;
· Implementation of the 1115 People First Waiver http://www.opwdd.ny.gov/2011_waiver/index.jsp> , which will move the system away from a one-size-fits-all model and empower individuals and families to have greater choice over the types of services they receive;
· Continue a new and aggressive fire safety initiative by convening a panel of state and national fire safety experts to review safety at all state and nonprofit homes, and make recommendations on prioritizing upgrades to sites; and
· A workforce-driven culture change initiative based on the concept of collective mindfulness, which ensures all employees understand and share OPWDD’s values, recognize their responsibilities and obligations, and have the information and resources they need to do their jobs effectively.
The report is available online at www.opwdd.ny.gov http://www.opwdd.ny.gov/> .
Commissioner Burke said, “Because of inconsistent and inadequate oversight, and the lack of accountability throughout the system, the health and safety of the individuals in our care was not always a priority in the past. Our first six months have focused largely on shoring up every aspect of OPWDD’s role as an oversight agency. That included how we hire, train, support, and hold the workforce accountable, as well as improving operations internally and throughout our vast network of nonprofit providers. We will continue to enact health and safety measures, and also work closely with our partners across the system to improve the care we provide and to create new opportunities for people with developmental disabilities.”
Joseph Rich, founder and former CEO of the Disabled Persons Action Organization said, “I enthusiastically applaud the efforts of Commissioner Courtney Burke in improving the lives of people with developmental disabilities. I also thank Governor Cuomo for focusing his attention on supporting our state’s most vulnerable people, and improving systems of care throughout all state operations. OPWDD has been implementing monumental health and safety improvements, while at the same time changing the emphasis from a one-size-fits-all program design to one that is tailored more specifically to meet the needs and desires of each person. At a time of limited resources, it is critically important to utilize funds in the most efficient and yet meaningful way possible, and under the direction of Commissioner Burke this is being accomplished.”
“I wholeheartedly agree with the commissioner’s approach to ensuring that safeguards are in place for my daughter and others in the OPWDD service system,” said Louis Best of Oneida, whose daughter, Karen, lives in a state-operated residence. “As parents, we rely on the integrity of the system and the people involved to weed out any abuse, to proactively take steps to ensure that staff are properly trained, and to address issues immediately as they arise. We have faith in the system and know that the staff who are working with our daughter have her best interests at heart.”
KEY AREAS OF PROGRESS
Health and Safety Reforms
Recognizing systemic weaknesses in the oversight of services, Commissioner Burke established a specialized unit in April 2011 to manage incidents on a statewide basis and involve law enforcement more directly in the prosecution of crimes. OPWDD now seeks the termination of any employee found guilty of egregious abuse or neglect, and will not settle for a lesser penalty in arbitration proceedings.
By the Numbers
· 70 percent – the reduction in the time it takes to report an incident (all incidents, not just abuse) since OPWDD implemented mandatory reporting to central operations of incidents at all state and nonprofit provider sites. Prior to April, the average incident was not reported centrally for more than 10 days—it is now down to less than 72 hours. OPWDD is working to reduce that number to less than 24 hours by the end of November
· 5 times – the increase in reporting of allegations of physical abuse to legal authorities. Since requiring that all allegations of physical and sexual abuse be reported to police, reports of physical abuse have increased from 16 to 93 percent; sexual abuse reports have risen from 75 to 98 percent.
· 51 – the number of investigators who have been trained and certified to carry out the agency’s new investigations process http://www.opwdd.ny.gov/news/reforms_investigation_process.jsp> , which includes centralized oversight and consistent discipline for all employees found guilty.
· 88 percent – the increase in the number of employees found guilty of abuse or criminal activity that the agency has placed on unpaid suspension while seeking their termination.
Workforce Reforms
Soon after her appointment, Commissioner Burke held a series of listening tours around the state, and a consistent concern from individuals, family members, and others is that the direct support professionals who assist individuals with developmental disabilities often lacked the resources, information, and consistent expectation to do their job effectively. To raise the bar and ensure that people served by OPWDD have access to trained, competent, and caring staff, Commissioner Burke increased the qualifications required of state staff and is implementing a comprehensive plan that provides OPWDD’s direct support professionals with the resources they need to be successful.
New hires must have at least a high school diploma or its equivalent and undergo pre-employment psychological and fitness testing, mandatory drug testing, state and federal criminal background checks, and be vigorously vetted against the Statewide Central Registry of Child Abuse and Maltreatment and the Medicaid Excluded Provider Registry.
By the Numbers
· 23,000 – the number of employees (all) required to attend a mandatory training to reinforce principles of individual respect, dignity, and professional ethics around supporting individuals with developmental disabilities. This training has also been made available to the 700+ nonprofit providers regulated by OPWDD.
· 17,000 – the number of direct support professionals throughout the system who will benefit from the agency’s first-ever set of core competencies and supports http://www.opwdd.ny.gov/news/talent_dvpmt_consortium.jsp> for all direct support staff. These include:
o Crisis prevention, intervention, and resolution skills.
o Recognizing and reporting abuse immediately.
o Cultural awareness and sensitivity.
o Ethics.
Consistent Accountability for All Nonprofit Providers
Providers were notified in June 2011 that New York State Law allows OPWDD to take adverse actions against nonprofit provider agencies that have failed to comply with the law and OPWDD regulations. These actions could include the imposition of a fine up to $15,000 per violation to revocation of their operating certificate. Oversight reforms included a revamping of the OPWDD’s Early Alert program, which audits nonprofits’ fiscal, governance, and compliance matters, identifies weaknesses, and requires the provider to make corrective actions.
By the Numbers:
· 700 – more than 700 nonprofit provider agencies offering a vast array of services and programming are under OPWDD’s regulation.
· 4 – the number of nonprofit providers that have been levied a fine for operational failures. Fines began in September, the first time Mental Health Law was leveraged to hold nonprofits accountable.
· 13 – the number of nonprofit providers currently placed on Early Alert status.
· 2 – the number of nonprofit providers removed from Early Alert soon after placement by improving previously deficient operations.
· 8 – the number of nonprofit providers that have recognized as OPWDD COMPASS agencies—organizations that go above and beyond expectations in their service.
Partnership with State Police on Abuse Reporting
In August, Governor Cuomo, Commissioner Burke, and the New York State Police announced a new protocol for reporting abuse to police whenever a possible crime is committed. In the past, incidences of physical abuse that constituted crimes were not consistently reported to police agencies and were often viewed as an internal matter. The agreement between the State Police and OPWDD, for the first time, provides clarity and consistency in reporting potential crimes against individuals with developmental disabilities to law enforcement. It clearly identifies the types of incidents that warrant a criminal investigation. The agreement also ensures the training of State Police Academy recruits.
Table of Penalties for Consistent Discipline
As a result of the collective bargaining agreement struck between Governor Cuomo and the Civil Service Employees Association (CSEA), New York State will for the first time work to establish a set framework of arbitration-defined penalties for serious types of abuse and neglect, and also for lesser infractions that may include mitigating circumstances that can provide for progressive discipline. Once implemented, the table of penalties will ensure that in instances of egregious abuse, OPWDD will be able to appropriately discipline employees. The ability to do so will also encourage good employees to report abuse.