Strategy for the Application of the DAILY Living
Support Assessment ON BEHALF OF Cognitive disability strategy
Issue:
Currently there are more than six different vendors who complete DLSA on behalf of the Cognitive Disability Strategy. These include; school board staff, health district staff including mental health and Wascana Rehab, a CDS consultant, two CBOs, CFS, and CLSD.
There have been numerous issues identified regarding timeliness of the assessments, the consistency of administration, the quality of the assessments and the integrity of the tool. A formal response to address these issues has been requested by different stakeholders.
Also, it is considered best practice by some researchers and jurisdictions that the completion of assessments related to funding should be done by an “at arm’s length from the funder” third party.
It is estimated that there will be between 150 to 200 assessment requests for CDS per year across the province. This will include new assessments related to intakes, and any re-assessments that may be requested.
Solution:
The Ministry of Social Services has entered into a formal contract to have Saskatchewan Abilities Council administer the DLSA on behalf of clients accessing CDS. This plan will take effect May 15, 2012.
Included in this document is a flow chart and procedure that details how DLSA will be accessed when required by CDS. CLSD and CFS will continue to complete the DLSA for those individuals who meet their mandate.
CDS CO - 7 - April, 2012
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CDS CO - 7 - April, 2012
CDS CO - 7 - April, 2012
PROCESS FOR COMPLETION OF DLSA ON BEHALF OF CDS
DLSA Assessments
All individuals requesting Cognitive Disability Strategy Flexible Benefit funding will be assessed using the Daily Living Support Assessment.
All individuals requesting CDS Flexible Benefit funding will be assessed by the Saskatchewan Abilities Council (SAC) with the exception of those individuals who meet the mandates of Child and Family Services and Community Living Service Delivery. These individuals will be required to access assessments through those two service providers.
DLSA Re- Assessments
Assessments will be re-administered upon request of the individual, their family, the support provider, Ministry staff or advocate when there has been a significant change in the persons support needs. This change must exist for a period longer than six months and is likely to persist for an extended period of time.
Re-assessment requests will be directed to the CDS Intake Committee who will review the request.
Responsibilities:
Cognitive Disability Regional Intake Committees will be responsible for identifying assessment need within the regions. This need will be identified in consultation with individuals and their families, team leads, CBOs, and they will:
§ Coordinate and facilitate assessment requests (Chairperson of CDS Intake Committee or designate) including providing previous assessment (if available) and liaise with the Saskatchewan Abilities Council to ensure their completion
§ Identify reassessments when there have been significant changes in the individual's support requirements
Saskatchewan Abilities Council will be contracted to complete assessments for individuals receiving CDS supports. These assessments will occur primarily with the families of the individuals or direct support providers as identified. They will be responsible for the scoring of all completed assessments and the development of an electronic data base to house all results obtained. They will also be responsible for providing status reports on work completed and submit data obtained to the Ministry on a regular basis (monthly). Saskatchewan Abilities Council will:
§ Organize, facilitate and complete ongoing assessments as requested by the regional CDS Intake Committees. Assessments will occur in various communities located throughout the province
§ Score each completed DLSA utilizing the ministry’s assessment scoring tool
§ Maintain an electronic data base which will include, the provincial region, the individual’s name and DLSA score including sub-score, demographic, default, .5 discretionary, and assessors name
§ Provide second level review and sign off on all DLSA completed that are scored as 4.0 and higher.
§ Annually on a random basis review of a minimum of twelve (12) DLSA completed that are scored below 4.0.
§ Provide ongoing consultation with the ministry on the assessment process, the assessment tool and provide recommendations.
Program and Service Design will oversee the assessment process and maintain global management of the project and contract. Program and Service Design will:
§ Maintain and provide overall direction in the delivery of the project
§ Provide ongoing consultation, education and training in the utilization of the assessment tool
§ Perform random audits to evaluate the assessment process and administration for reliability and validity, as a measure of quality control
§ Review all DLSA assessment appeals that cannot be resolved by the Saskatchewan abilities Council
Assessment Timelines:
The Abilities Council will normally complete assessments within six weeks of the date the request is received. This timeframe includes completing the assessment, subsequent scoring, tracking, and communicating the score to the Intake Committee Chairperson or designate. Assessments requests for the most part will be dealt with on a first come first served basis, however variances may exist. These variances can be as a result of CBO staff availability, travel logistics, and urgency of request.
Urgent assessment requests will be completed within three weeks of the date the request is received. This timeline includes completing the assessment, subsequent scoring, tracking, and communicating the score to the Intake Committee Chairperson. Variables that would impact timely delivery of assessments include: respondent availability, (urgent) assessment request volume, and travel logistics.
The regional CDS Intake Committees are responsible for communicating assessment requests to the Abilities Council. The intake committee should consider assessment timelines when making assessment requests to ensure that assessments are timely in support of planning and budgeting needs. Consideration should also be given to peak assessment request periods as this increased volume may impact on delivery of completed assessments.
Procedure for Completion of Assessments
1.) The CDS Intake Committee will make determination if the completion of a DLSA is required.
2.) The CDS Intake Committee Chairperson or designate notifies SAC by email that a DLSA is required on a specific individual. The request is sent to
Janine Baumann, Program Manager
Telephone 306-664-7207
3.) When making the request the CDS Intake Committee Chairperson or designate clearly indicates the return e-mail address and mailing address for the returned results of the assessment.
4.) SAC coordinates the completion of the DLSA with their assessor or in the case of a conflict of interest the contracted assessor.
5.) The DLSA score will be provided electronically and a paper copy of the assessment is returned to the CDS Intake Committee Chairperson or designate by registered mail.
6.) The Intake Committee communicates the DLSA score to the individual.
Second Level Sign Off
In order to maintain a high standard of administration and integrity of the tool a second level sign off will be provided. All DLSA completed that score 4.0 and higher will be reviewed by the SAC Program Manager.
Audit
On an annual basis Saskatchewan Abilities Council will complete a random audit of twelve (12) assessments that are scored below a 4.0. Audits will be initiated internally by the supplier in addition to Ministry driven audits. Audits may require the provision of documentation and video footage demonstrating reliability.
Audits will evaluate the assessment process and administration for reliability and validity, as a measure of quality control. Quality control methods will include a normative audit, statistical analysis of assessment data, and factor analysis.
Appeals
Where any involved party disagrees with the outcome of an assessment, the following progressive steps will be employed until resolution is achieved:
§ The Saskatchewan Abilities Council assessor will attempt to resolve the concern with the concerned party or designate.
§ The assessor will discuss the matter with the Saskatchewan Abilities Council designate and again attempt to resolve with the concerned party or designate.
§ The Saskatchewan Abilities Council designate will discuss the matter with the concerned party or designate and if necessary will arrange to have the assessment re-administered by an independent assessor.
§ If necessary the CDS Intake Committee will refer the matter to IADS Program and Service Design for review.
The review at any step of this process is a review of the validity and reliability of the completed Day Living Support Assessment. The rate structure of the Flexible Benefit per se is not a consideration in the review.
Accountability Structure
Conflict of Interest
The potential for conflict of interest both perceived and otherwise, may exist as the Saskatchewan Abilities Council administers assessments provincially.
The reporting structure includes provisions to mitigate this risk through sub-contracting in instances where potential risk exists. Sub-contractors will conduct all assessments for individuals attending Saskatchewan Abilities Council programs.
The Saskatchewan Abilities Council has created a project structure outside of their existing organizational structure to mitigate any risk for potential conflict of interest.
CDS CO - 7 - April, 2012