Reinventing Quality 2021: Lessons Learned from 2020: Managing and Leveraging Disruptions. Baltimore, MD, August 8-10, 2021

2003 Reinventing Quality Conference
Conference Materials

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Conference Program (379 K)

Plenary Presentations

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Building for the Future- Terrill (312 KB)
Today's citizens embark on a new century, aware that many different unrelated trends outside the field of disabilities will impact people with disabilities and their families in the future. This presentation discussed social, economic, environmental, and technological changes now rapidly influencing global civilization. Although it is difficult to say with certainty how these millennial transitions may affect us, we recognize that such innovations will alter the ways we live, work, and learn.
Cathy Ficker Terrill; President & CEO, Ray Graham Associates
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Federal Quality Initiatives: Rethinking the Quality Conundrum- Gettings (105 KB)
A state service delivery system perspective.
Robert M. Gettings; Executive Director, NASDDDS

Workshop Presentations

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Pennsylvania's External Monitoring Project- Feinstein (201 KB)
Pennsylvania's External Monitoring Project- Olsen (14 KB)
This presentation discussed the efforts underway in Pennsylvania to develop a management information system that supports the state's quality improvement goals. Although all states have quality assurance systems, it is frequently the case that there is no effective means of converting the information collected into effective actions that result in measurable changes. The presenters discussed different mechanisms to collect data on quality and effective approaches to putting the information to use.
Celia Feinstein; Associate Director, Training and Technical Assistance, UCEDD, Institute on Disabilities, Temple University
Dana Olsen; Section Head for Quality Improvement, Pennsylvania Office of Mental Retardation
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Health Promotion and Monitoring- Grossman (36 KB)
This session provided an overview of the Massachusetts DMR initiative to enhance the quality of healthcare services for people in their service delivery system. The decision of DMR to develop a system that recognizes and supports the integral role of direct service staff in healthcare advocacy is key to this project. A review of the recently completed pilot, its objectives, and the barriers and challenges to implementation was discussed.
Gail Grossman MSSA; Asst Commissioner, Office of Quality Management, Massachusetts DMR
Sharon Oxx RN, CDDN; Director of Health Services, Office of Quality Management, Massachusetts DMR
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Improving AT Access for People with Developmental Disabilities: Building and Sustaining an AT Access Infrastructure.- Mollica (924 KB)
In today's economy we continue to struggle with limited time and money needed to meet all of the needs of individuals with disabilities. In rural communities this challenge is even greater due to lack of trained professionals, lack of transportation to needed services and great distances that staff must travel to provide these services. This session explored several of the factors inhibiting AT Access by people with cognitive disabilities, and highlighted the ways in which the State of Delaware is eliminating these inequities. This hands-on presentation focused on innovative approaches to meeting these assistive technology challenges in rural communities. Many of the ideas shared can also apply to urban communities as well.
Beth Mineo Mollica; Delaware Assistive Technology Initiative/ University of Delaware;
Therese Willkomm; Executive Director, ATECH Services
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College of Direct Support- O'Nell (399 KB)
The College of Direct Support is a multi-media training program for direct support professionals that offers exciting opportunities for increased education, training, and support. The College of Direct Support is an Internet-based, multimedia, interactive national training program for direct support staff. The presenters demonstrated the program; discussed the framework of the course, and the involvement of other professionals.
Charlie Lakin; Senior Research Associate, ICI/UMN
Amy Hewitt; Research Associate, RTC on Community Living, ICI/UMN
Bill Tapp; Project Director, College of Direct Support
Susan O'Nell; Project Coordinator, RTC on Community Living, ICI/UMN
Jim Hicks; RTC on Community Living, ICI/UMN
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One "Bit" at a Time: Information Technology as a Tool for Workplace Cultural Change and the Enhancement of Person Centered Outcomes- Bowman (236 KB)

One "Bit" at a Time: Information Technology as a Tool for Workplace Cultural Change and the Enhancement of Person Centered Outcomes- Fenton (539 KB)
This presentation discussed how leading edge information technology and Intermediate Service Organizations can impact quality assurance efforts. The speakers demonstrated and explained how the use of leading edge technology can overcome traditional staff resistance and build the capacities of a service broker organization in a complex geographic environment. This model has been successfully implemented at the Regional Center of Orange County with substantial results. Attendees had an opportunity to view a demonstration of the capabilities of the "Virtual Chart." The presentation also focused on the benefits of an ISO and how in Massachusetts the information system provides reports that are used by the agency and the persons and families enrolled in the ISO. Additionally, Ms. Anderson presented on the quality assurance process used by the ISO and the link to the National Core Indicators data for Massachusetts.
Bill Bowman; Executive Director, Regional Center of Orange County
Marc Fenton; Principal, Public Consulting Group - Boston
Cathy Anderson; Associate Manager, Public Consulting Group - Boston
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Working Together to Achieve the Good Life: Building an Independent Quality Management System- Hill (260 KB)
This session provided an overview of two innovative approaches to quality assurance. The independent quality management system implemented by the Delmarva Foundation, a quality improvement organization (QIO) in Florida for supports provided through the Medicaid Home and Community Based Services (HCBS) Waiver, provides an example of a cutting edge system. Results from the past two years from provider performance reviews and person-centered reviews were shared. This session will also describe Nebraska's multi-faceted approach to quality improvement funded by the state and implemented by a non-profit advocacy agency. This approach offers a profile of service providers that includes demographics, aggregate quality of life survey information, and changes over time. Additionally local community volunteer teams work with individuals in services and provider staff to improve quality of life.
Marcia Hill; Vice President for Florida Program, Delmarva Foundation
René Ferdinand; Executive Director, The Arc of Nebraska
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Developing Quality Standards for Case Management Systems- Klink (263 KB)
Developing Quality Standards for Case Management Systems- McFadden (555 KB)
This presentation described the results of an 18 -month stakeholder driven process that produced a set of quality standards for a case management system. The presentation addressed strategies for effective consumer, staff and provider involvement in the standards development process. Methodologies for development of standards that establish best practice competencies in the areas of self-directed supports, person-centered planning, advocacy and risk management were also addressed. The Quality Standards document was distributed as part of this presentation.
Jeff Coy; Community Alternative Specialist, Division of Developmental Services, Vermont DDMHS
Howard Klink; Consultant
Clare McFadden; Community Alternative Specialist, Division of Developmental Services, Vermont DDMHS
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A Balanced Plan to a Better Life- Tuller (696 KB)
There is a growing concern that person-centered planning leaves the people we support more vulnerable to exploitation, health risks and inadequately addressed behavioral challenges. Oregon's Individual Support Planning process is based in person-centered planning but uses a detailed Risk Tracking Record to ensure people are supported around their vulnerabilities. Specific steps are taken within the planning process to minimize risks and balance them in accordance with what the person has said is most important to them.
Jean Tuller; Executive Director, Oregon Technical Assistance Org
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Creating Quality through Partnerships with Self-Advocates- Stevens (691 KB)
This experienced-based model identifies partnership roles (e.g.: visioning, strategic planning, advisory boards, steering committees, training co-facilitation, research) and recruitment/support strategies. People with cognitive disabilities are valued content experts rather than as only recipients and subjects. The presentation included a conceptual model, self-advocate co-presenter's application examples, effective strategies for mutual coaching/support, and national efforts to expand this model. Participants were asked to contribute best practice ideas.
Judy Stevens; Director, Community Support Alliance at the CDD
Jon Peterson; Self-Advocate, Sergeant at Arms, People First of Albuquerque
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CMS National Contractor: Perspectives on State Technical Assistance- Bradley (693 KB)
An update on the CMS-sponsored technical assistance (TA) project designed to assist state MR/DD agencies in improving the quality of home and community-based services. The presentations covered the types of TA that have been provided through the project, emerging issues in quality management learned through the provision of TA, and works in progress through the contract.
June Rowe; Senior Project Director, HSRI
Val Bradley; President, HSRI
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What We've Learned About Personal Outcomes: There Is No Silver Bullet- Kauffman (97 KB)
The Council on Quality and Leadership, through the Personal Outcome Measures, has collected data for nearly 5,000 interviews. The data has helped us learn many things about services for people with disabilities. The data has also helped us learn that there is no one best answer for how services should be provided. There are, however, some ingredients that good services have regardless of size, funding, or location.
Cindy Kauffman; Vice President for Business Management, The Council on Quality and Leadership
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Microboards- Golden (74 KB)
Self-directed Support Corporations (SDSCs), a concept based on British Columbia's Microboards model but adapted for the United States. Self-directed Support Corporations (SDSCs)are legally developed not-for-profit corporations developed to provide a legal entity to manage the support system for a person with a disability through the establishment of a board of directors, and designed to contract directly with the Home and Community-Based Waiver Funding (Medicaid).
Jackie Golden; Executive Director, Inclusion Research Institute
Liz Obermayer; Quality Consultant; The Council on Quality & Leadership
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Risks and Root Causes-What Providers Need to Know and How They Can Learn It- Rose (1,737 KB)
This presentation looked at how recent court cases influence the DD field and impact provider agencies and address who determines the ability of an individual to accept the responsibility of choice. The presentation also included a brief overview of the process of root cause analysis, including a description of how it can best be used by DD managers to help prevent adverse events that pose significant risk to persons receiving supports from community or institutional providers.
John Rose; Irwin Siegel Agency, Inc.
Christopher Lyons; Irwin Siegel Agency, Inc.
Steven Staugaitis; Strategic Leadership Center, Connecticut DMR
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It's Basic. Quality Staff Lead To Quality Lives - One Person's Journey To A Good Life- Perry (603 KB)
The presentation discussed the relationship between the quality of support an individual receives and the quality of life he or she is able to access in the community. This session shared the results of a recent study in which self-advocates and family members of people with developmental disabilities who receive community supports were asked to describe how issues such as high direct support staff turnover, increased vacancies and poor training affect their lives. It also shared insights into how specific strategies used by one person to find, support and keep his staff have lead to a zero percent turnover rate, high staff satisfaction and amazing results in enhancing the individual's ability to get what he wants and needs out of life. It may be basic - but it works!
Amy Hewitt; Research Associate/Director Interdisciplinary Training, RTC on Community Living, ICI/UMN
Nathan Perry; Self-Advocate
John Sauer; RTC on Community Living, ICI/UMN
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The National Core Indicators: Performance at the State System Level- Bradley (207 KB)
The National Core Indicators: Performance at the State System Level- Babin (133 KB)
This panel covered the activities of the National Core Indicators (NCI)-a joint venture between the Human Services Research Institute (HSRI) and the National Association of State Directors of Developmental Disabilities Services (NASDDDS). NCI now includes 22 participating state agencies-all collecting the same data on individual and family outcomes as well as systems level performance. The panel reviewed national and state level NCI performance data and trends.
Val Bradley; President, HSRI
Sarah Taub; Project Director, HSRI;
Steve Staugaitis; Strategic Leadership Center, Connecticut DMR
Susan L. Babin; Administrator, Office of Quality Assurance, Rhode Island DMHRH/DDD
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Are You the Architect?- Ostrowski (40 KB)
Attendees were asked to come to this session prepared to experience a Learning Portrait. This session was informative and interactive. Self-advocates talked about their experiences as Commission Members, Team Members, and recipients of VOICE reviews. Five people involved in different aspects of the Region 10 Quality Assurance System talked about their experiences of being involved in the quality assurance process; present standings and future challenges as the concepts move statewide; and the uses of the information generated toward systems change at every level.
John Jordan; Minnesota Region 10 Quality Assurance Commission
Tom Cramer; Self-Advocate
Matt Shoen; Self-Advocate
Cindy Ostrowski; Project Director, MN Region 10 Quality Assurance Commission
Sue Miller; QA Manager, MN Region 10 Quality Assurance Commission
LeAnn Bieber; QA Assistant Manager, MN Region 10 Quality Assurance Commission
Kathy Sheppard-Jones; Univ of Kentucky
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Self Determination as a Quality Assurance Initiative- Rossiter (67 KB)
While Self-Determination is typically presented as a shift of power from governmental bureaucratic/provider agency control to empowering individuals with disabilities, it is also an opportunity to modify the usual approach to quality assurance from the point of view of the funder to the point of view of the recipient of support. This presentation highlighted Dane County's approach to quality assurance through self-determination efforts. Acumen presented significant data on the results of self-determination on staff turnover and consumer satisfaction.
Dan Rossiter; Community Services Manager, Dane County - Wisconsin
Marilyn Bown; Development Director, Acumen
Greg Murphy; North East Region Director; Acumen
Randy Auer; CEO, Acumen