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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 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. During the first half of FY18 the ANE rate has continued to decline, to 5.2%. Note, there is a two-quarter lag in reporting.
  • At the end of FY16, the Incident Management Bureau (IMB) launched an ambitious plan to roll out a new ANE Train-the-Trainer project, where provider agency staff were given a curriculum for teaching "Recognizing and Reporting ANE." Throughout FY17, trainings were held statewide to give agencies the tools necessary to provide ANE training to their staff.
  • 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

  • Implementing the Recognizing and Reporting ANE Training for all community-based waiver providers.
  • Providing resources on the IMB-ANE website on recognizing and reporting ANE.
  • Partnering 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.
  • 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.
    • Identify patterns, trends of abuse, and other areas of concern from IMB data and reporting issues to DDSD at regional monthly meetings. Completed.
    • Complete transfer of statewide ANE training to the DDSD Training Unit. Completed.
    • Partner with the DDSD and NMDOH Learning Center to develop an on-line annual recertification training on recognizing and reporting ANE. Completed in Q3.
    • Begin drafting FY17 Annual Report. Completed in Q2.
    • Publish FY18 ANE Reporting Guide. Ccompleted in Q2.
  • Q2:
    • Ongoing implementation of FY16 action items to complete investigations within 45 days. Completed.
    • Identify patterns, trends of abuse, and other areas of concern from IMB data and reporting issues to DDSD at regional monthly meetings. Completed.
    • FY17 Annual Report is complete and being reviewed.
    • FY18 ANE Reporting Guide is complete. The Spanish language version is being updated and both will be distributed soon.
  • Q3: 
    • Ongoing implementation of the new 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.
    • Distribute 2017 annual report. Completed.
    • Distribute 2018 ANE reporting guide, both English and Spanish language versions. Completed.
    • Hire contractor to process backlog of cases. Completed.
    • Implement quarterly training for IMB investigators. Completed. 
  • Q4:
    • Develop and implement a splash banner on reporting abuse for the NMDOH website homepage. Completed

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.

 

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