8/12/2016 LEARNING OBJECTIVES. Gain a better understanding of how Quality Assurance will prepare you to stay in compliance with all HUD requirements.

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1 Building communities through service coordination In partnership with Madelyne J. Pfeiffer, MSW Dedicated to providing: Service Coordination Quality Assurance Services Grants Administration Training Building communities through service coordination In partnership with LEARNING OBJECTIVES Gain a better understanding of how Quality Assurance will prepare you to stay in compliance with all HUD requirements. Prepare attendees for the periodic Quality Assurance Review and/or HUD desk audit Review Learn how to organize and create an all in one binder that will contain everything needed to be in compliance with the SC Program 1

2 QUALITY ASSURANCE Quality Assurance is critical for the Service Coordinator Program Quality Assurance prepares a Service Coordinator for a HUD Desk Audit. A Quality Assurance Review mimics what a HUD desk audit actually entails. QUALITY ASSURANCE WHAT IS QUALITY ASSURANCE? Quality Assurance is an integral part of the Service Coordinator Program and provides step by step, explicit preparation for a HUD desk audit. The primary function is to ensure compliance with HUD requirements for the RSC position, with oversight of the position s mandatory reports and documentation. Quality Assurance is a quantitative assessment of social services delivery, effectively measuring reporting in relation to regulatory compliance. The Quality Assurance Supervision (QA) focuses on assuring that the service coordination function is effectively implemented by measuring: 1. Productivity 2. Quality Indicators 3. Compliance to the Grant 4. Customer Satisfaction 5. HUD Policy Priorities Management/Ownership must assure that the service coordinator function is effectively implemented. Therefore, quality assurance is an allowable administrative expense. A project may propose a cost of 8 10 percent of the service coordinator salary to provide limited monitoring oversight of the service coordinator by a qualified third party. The project must provide a written justification along with the budget. QUALITY ASSURANCE Quality Assurance oversight is provided in the following ways: Ensuring that the documents listed below are accurately executed and present in each resident file. The required documents are: 1. Intake Form 2. Assessment Form 3. Service Management Plan (also called a Case Management Plan) 4. Confidentiality Form 5. Release of Information Program evaluation review, six months after the program s start date and every 12 months thereafter, per HUD requirements. Monthly monitoring services, statistics, and HUD requirements on AASC online. Review and timely submission of all HUD required reports, such as both Semi Annuals (October 1 st March 31 st and April 1 st September 30 th ), the Training Log, the Financial Status Report and the Grant Extensions with budgets. Review of resource directory Annual submission of program evaluation reports to the local HUD Field Office staff on or before October 30 th. 2

3 QUALITY ASSURANCE QUALITY ASSURANCE Quality Assurance insures Up to Date HUD information on changes in compliance. Quality Assurance providers receives ADVANCE NOTICE of changes and are AWARE of HUD expectations. Questions 1. What are the top 5 HUD Service Categories? 2. What are 8 other Service Types listed on the Semi Annual? QUALITY ASSURANCE Answers 1. Section 6:HUD Priorities/Service Categories: Assessments Advocacy Benefits (actual intervention or assistance with benefits as listed on AASC) Case Management (any assistance/resident that is more than one task) Monitoring Services 2. The eight other Service Types listed on the Semi Annual: Fair Housing and Civil Rights Assistance General Information and Referral Isolation Intervention Legal Assistance Outreach Resident/Tenant Councils (in regards to Resident/Tenant Councils, SCs should offer support via outreach We are here to help. ) Tax Preparation Services Translation/Interpretation 3

4 Building communities through service coordination In partnership with QUALITY ASSURANCE ADDDITIONAL BENEFITS TO HAVING A QUALITY ASSURANCE PROVIDER: 1) QA Provider can implement a Memorandum of Understanding between SCs and Property Management in order to insure a clear understanding of roles and responsibilities and how to work effectively together. Housing Facility Date Introduction For the elderly, "aging in place has become a term used to describe the increasing age of residents in federally assisted, public housing and other affordable housing communities. Longtime residents have aged in their residences with the risk of becoming more frail. For families, self sufficiency has become a term used to describe the family s non reliance on subsidies and/or other public supports to maintain a job, housing or other basic needs of daily life. For low income families trying to rise out of poverty, there may be barriers that hinder these efforts. Historically, resident managers, who were hired to address the business and maintenance aspects of their housing community, found themselves dealing more and more with complex social and personal resident problems. While resident managers have often been involved extensively in coordinating services for residents, they often lack the time and available resources needed to perform this service, or may not have the educational background sometimes required for complex resident issues. It is the mission and policy of this housing organization to assist its residents in maintaining or achieving a self reliant lifestyle. Further, the U.S. Department of Housing and Urban Development (HUD) has responded to this need providing for service coordinators in selected HUD programs. Additionally, state/local housing finance entities may provide tax incentives to affordable housing developers that include aservice coordinator program as part of their housing development. Service coordinators are persons with the background and training to assist in the identification of resident needs and the accessing of community services and support systems to address these needs. QUALITY ASSURANCE Purpose of the Memorandum of Understanding (MOU) The property manager and service coordinator are both professionals whose special positions enhance the lives of residents and add to the welfare of the housing community as a whole. The property manager is responsible for the healthy operation and maintenance of the entire housing community as well as the safety and security of the residents. The service coordinator expedites service management within the housing community. Each should consider the other as part of the facility team, with the understanding that each has separate identifiable roles. Each has specific responsibilities which are outlined in the following "Memorandum of Understanding" (MOU). This agreement outlines most of the responsibilities of each participant as it pertains to the service coordinator position at this facility. However, the management company and/or owner of the property may use this document in accordance with company policies as long as they do not counteract HUD s administrative policies. As with other contracts or agreements affecting the community, the property manager has broad oversight of implementing them and this includes the service coordinator program "Memorandum of Understanding". The property manager may not be responsible for the direct supervision of the service coordinator, still they are responsible to see that the content of this agreement is being responsibly managed and enforced. The management team (including all appropriate staff) will participate in an orientation of the service coordinator program before implementing this "Memorandum of Understanding". 4

5 QUALITY ASSURANCE The Service Coordinator will: Provide hours of service to the housing facility Participate in orientation of the service coordinator program When possible and appropriate, will participate in training Follow and abide by housing authority/organization/facility rules Become familiar with housing industry regulations surrounding tenancy, Fair Housing, and 504 regulations (reasonable accommodation) Inform management of any resident incident or issue which adversely impacts management or the safety and security of other residents or the building Maintain an office in the facility Communicate with manager(s) about changes in residents' condition that does not compromise resident privacy Ensure confidentiality of resident files including the acquisition of a 'release of information' form from residents Meet at least weekly with the manager to review work activities and # of residents being served Complete and distribute appropriate reports in a timely fashion and document appropriate information in resident files Inform management of resident problems that interfere with the safety or security of the building Report any suspected cases of abuse, neglect or exploitation of a resident to appropriate agency Advise residents and families of community resources, services and service options but not compel residents to accept their services or the services of outside providers Link residents, as requested, to appropriate community services Monitor the effectiveness of services and inform management of any concerns. Report problems of service providers to the appropriate agency Advise management of the potential changes in a resident's condition which may interfere with their residency (decisions involving Long Term Care) or lease violations Inform all residents of the availability and purpose of the service coordinator position Provide information for reporting to HUD as appropriate QUALITY ASSURANCE Management will: Whenever possible, participate in the evaluation process of the service coordinator Meet or communicate regularly (at least once weekly) and on an as needed basis with the service coordinator regarding service management and their awareness of changes in a resident s condition Ensure that the service coordinator does not provide direct services to residents and sees to it that the service coordinator is not involved in the planning or preparation of social or recreational activities of the overall housing community Allow the service coordinator access to manager s resident files on an as needed basis with a release of information from the resident unless specifically prohibited by Federal law or regulation (e.g., EIVS information) Inform the service coordinator of changes in a resident's condition that may impact the resident's ability to meet lease obligations Introduce the service coordinator to residents, families, and known service providers Ensure that the service coordinator will not act on behalf of or in place of the manager Advise the service coordinator that they are not to act as a Notary Public nor as a witness to a Health Care Proxy, or Power of Attorney Advise the Service Coordinator that they are not to accept valuable gifts from residents or service providers Provide (as appropriate) necessary training of the service coordinator Participate in setting goals and objectives in relation to facility needs affecting the residents Supervises the M.O.U. with communication to the Quality Assurance Administrator as to its' effectiveness and/or suggestions for modification The Quality Assurance Administrator will: QUALITY ASSURANCE Implement the M.O.U. after consultation with the housing management, the property manager and the service coordinator Initiate the reporting and policy procedures of the position and see to the adherence of such procedures including HUD requirements by all participants Assist in the development of the service coordinator program at each housing community Be available for conferencing in unresolved issues facing the service coordinator and management Select resident files to review to ensure that the service coordination and follow up monitoring provided is appropriate and in accordance with federal regulations and recommended standards of practice Provide guidance on problem solving methods and service coordination practices Recommend and monitor educational opportunities regarding service coordination Provide necessary training and orientation of service coordinator and manager, as appropriate, and ensure the service coordinator follows training guidelines, where required =================================================================== Prior to signing the 'Memorandum of Understanding,' it is recommended that all parties review the job description of the Service Coordinator as a further clarification of this document. All parties will meet at least to discuss results achieved and directions for future efforts. This Memorandum of Understanding is made as of, by and between the following parties: Housing Management Service Coordinator 5

6 QUALITY ASSURANCE 2) Provide training with Property Management and Service Coordinator on how to work cohesively as a Team. Below is a 2 hour Training I do with all new SCs and PMs Training is based on: POLICY RECOMMENDATIONS FOR A SUCCESSFUL PROGRAM American Association of Service Coordinators, Janice Monks, LSW, RHP, President Service Coordinator and Property Managers: How to work as a cohesive team QUALITY ASSURANCE A Service Coordinator program without Quality Assurance can suffer on account of: Lack of risk management No direct relationship with HUD representatives and up to date HUD information Lack of oversight in meeting all HUD requirements and possibly failing on site HUD desk audit, including presentation of files, semi annual submissions, resident satisfaction surveys, accounting reports and back up receipts Exploitation and potential mismanagement of federal funds Lower chances of having funding renewed. Should funds become limited and budget cuts made, those without Quality Assurance in place will lack the meticulous reporting and adherence to HUD requirements that would facilitate funding with HUD Lack of training and education between property management and service coordination which can lead to conflict and communication issues. 6

7 WHAT IS A HUD DESK AUDIT? A periodic HUD desk audit is when 1 or 2 HUD Representatives will come and do a site visit and a desk review at a SC s property to evaluate the SC, the resident satisfaction and accounting (reports and back up receipts). The audit is to determine whether the SC and Administration are in compliance with the requirements of the HUD Service Coordinator Program as stated in the HUD Handbook, Chapter 8. WHAT DOES HUD TYPICALLY EXAMINE DURING AN AUDIT? HUD staff will give the SC and Property Manager/Administration approximately 2 weeks to prepare for the audit. When HUD Reps visit they will use an evaluation form to determine if the SC and Administration are providing either Satisfactory or Unsatisfactory services. If the building does not pass, the SC and Administration will have an opportunity to rectify the gaps in service and reporting. HUD will specifically review resident files SC must have a Release of Info signed by residents allowing HUD to review files. The AASC Online Confidentiality Form includes in it s content HUD and QA Provider have access to resident files so you do not have to have residents sign a Release of Info. Releases will be reviewed in further detail later in the training HUD will come to the building and speak with the SC, Property Management Staff and Residents. WHAT MONITORING FORM DOES HUD USE WHEN THEY VISIT? HUD does not have an official monitoring form. HUD Field staff use a sample provided by HUD Headquarters called the SC Review Form or design their own. All Service Coordinator programs, regardless of their funding source, must follow the same standards and requirements. If you have quality assurance, the HUD SC Review Form could be similar to what your annual Quality Assurance Reviews is based on. 7

8 Service Coordinator Review Form U.S. Department of Housing and Urban Development Project Name and Grant or Project No: Project Address: Loan Status: Insured Section 8 Contract Administration Subsidized - Yes No (If yes, indicate all that apply) Section 8 Rent Supplement HUD-Held HUD RAP PAC PRAC Non-Insured CA Other PBCA Date of On-site Review: Date of Report: Purpose of Report A. Site Visit B. Desk Review Number of Units Name of Service Coordinator: Date Hired:(mm/dd/yyyy) Project Status: Current Under Mortgage Delinquent Under Mortgage Current under Workout/Modification: Delinquent under Workout/Modification: Foreclosure in Progress A. Qualifications and Training Are Service Coordinator s qualifications consistent with HBK Are training requirements met? First Year 36 hours On going 12 hours Is Service Coordinator training and certification documentation included? Is the Service Coordinator job description & resume on file? Is the Service Coordinator s job description/duties consistent with HBK , Chapter 8.4a.(3)? B. Program Administration Yes No Comments: Yes No Comments: Yes No Comments: Yes No Comments: Yes No Comments: Ye N Comments: Is the Service Coordinator office clearly identifiable, accessible, and private? Yes No Comments: Are the Service Coordinator s office hours clearly posted outside of office? Are the Service Coordinator s files kept locked and confidential? Is a directory of service agencies and contacts maintained that is available to all? Are copies of program (resources/agencies) information packaged provided to clients? (i.e.: pamphlets and brochures) Yes No Comments: Yes No Comments: Yes No Comments: Yes No Comments: What is the functional status of the resident population? Estimated number of frail elderly residents daily living) (deficient in 3 or more activities of Estimated number of at-risk elderly residents (deficient in 1 or 2 activities of daily living) Is the Service Coordinator program fulltime or part-time? Full-time Part-time Comments: Are the Service Coordinator s Yes No hours appropriate for the number of at-risk and frail elderly and non-elderly residents with disabilities? File Review 1. Are tenant files organized and maintained? Yes No Comments 2. Are Intake/Assessment forms part of each case file? 3. Is a case management plan included in each case file? (must include all referrals to community agencies) 4. Is there a signed Release of Information form in each case file? 5. Is the disposition or termination of each case documented? 6. Is there a signed Confidentiality Agreement in each active file? 7. Are the progress notes/status detailed for each case file? 8

9 C. Quality Assurance Does the grant/budget include Quality Assurance? Yes No Comments: Who is the QA provider? Is there a QA contract? Is QA provider a third party? Yes No Is there a job description for the QA provider? Yes No Does the QA provider conduct the following: Yes No Yes No Comments 1. Evaluation of resident satisfaction 2. First review completed 6 months after hire Additional reviews completed every 12 months thereafter 3. Interview of property manager 4. Review of tenant files 5. Interviews with residents 6. Provide written year-end report D. Reports Yes No NA Comments Are the following completed? 1. Grant Award/Amendment (HUD-1044) 2. First-Time Funding Request (HUD-91186) 3. One-Year Budget (HUD A) 4. LOCCS/VRS Payment Vouchers (HUD SCMF) 5. Semi-Annual Performance Report (HUD-92456) 6. Financial Status Report (SF-269A)) 7. Logic Model Report (HUD-96010) 8. Year-End Quality Assurance Report For Owners using annual budget for SC position the date of last annual budget submitted Month Day Year E. Resident Participation Have the residents been interviewed about the service coordinator s role? Are the residents knowledgeable about the service coordinator program? Is there positive feedback about the service coordinator program? Do residents believe the service coordinator program is beneficial? Yes No Comments: Yes No Comments: Yes No Comments: Yes No Comments: List the strengths of the program according to residents. List the weaknesses of the program according to residents WHAT IS A? BasedontheHUDSCReviewform,aService Coordinator Review Checklist has been created and will be presented and reviewed step by step! The Checklist has every item a HUD Rep will request and review during your desk audit (except your hard copy files). We will review the checklist one item at a time and then after reviewing each section of the SC Review Checklist, I will show you how to put a QA Binder together. 9

10 PAGE 1 Project name and address and grant number/project number: Person(s) Interviewed: Purpose of Report Site Visit Date: Desk Review Date: Name of Service Coordinator: Date Hired:(mm/dd/yyyy): * Know your date of hire Type of Housing and Service Coordinator Funding * Example Section 8, PRAC * Service Coordinator programs, whether funded through a grant or other funding streams are all to be monitored by HUD field staff in accordance with program requirements. Number of Units: PART A. QUALIFICATIONS AND TRAINING 1. Are the Service Coordinator s qualifications consistent with program requirements? Qualification of a service coordinator (HUD Handbook, Ch. 8): A Bachelor of Social Work or degree in Gerontology, Psychology or Counseling is preferable A college degree is fully acceptable. Individuals without a degree are acceptable with appropriate work experience. Supervisory experience may be necessary in some team situations in which a professional supervises a number of nonprofessional or paraprofessional "aides". PART A. QUALIFICATIONS AND TRAINING (Continued) 2. Are training requirements being met? First Year 36 hours/year On going 12 hours/year SCs must meet a minimum of 36 training hours of classroom/seminar time before hiring, or must complete this minimum training requirement within 12 months of initial hiring. After the first year of employment, SCs must attend 12 hours of relevant continuing education on an annual basis. 10

11 PART A. QUALIFICATIONS AND TRAINING (Continued) 3. Is the Service Coordinator s training and certification documented in accordance with program requirements? SCs must document their completed training coursework and maintain the information in their program files. For each course, documentation should show the subject matter, length of time, sponsoring organization, dates, and cost. (Grant Agreement, Article V and Handbook Chapter 8, Section 8.9) PART A. QUALIFICATIONS AND TRAINING (Continued) 4. Is the Service Coordinator s training and certification documented in accordance with program requirements? A Training Verification log has been created that lists the Statutory and Core Subject areas so you can easily match up your trainings with the subject areas and the log helps you plan what trainings you need to fulfill before the end of the yearly cycle. The Training Verification log makes it easier to document trainings and easily categorize each workshop/seminar under the statutory subjects and core subjects required by HUD. Also My SCs submit the training verification log with their Semi Annual Report to HUD. The two reporting periods are October 1 through March 31 and April 1 to September 30. Reports are due to Field office representatives no later than 30 days following the end of each reporting period (October 30 th and April 30 th ). PART A. QUALIFICATIONS AND TRAINING (Continued) Our SC s start a New Training Verification Log on October 1 st of every year. They keep current and previous year only in the QA Binder, purge previous copies or put in a separate file if they want to save. Example the audit I did in April 2016, the SCs had training log and The language in the HUD handbook is a bit confusing regarding statutory and core trainings. The Log I have created is based on my companies interpretation of the HUD training requirement stated in the HUD Handbook, Chapter 8. If you chose to use this form first talk to your QA Provider to ensure that this form fits with your companies interpretation of the HUD training requirements. 11

12 Training Verification NAME/PROPERTY DATE:10/1/15-3/31/2016 and the next Semi Annual will be 10/1/15-9/30/16 SUBJECT AREA COURSE OR TITLE SPONSOR DATE HOURS LOCATION COST INITIALS Statutory Subject Areas: The Aging Process Elder Services Disability Services Federal & Applicable State Entitlements Legal Liability Medication/Substance Abuse Mental Health Issues Communicating Effectively Dealing w/ Cognitive Impairments Core Subject Areas: The Professional SC Government Programs & Legal Requirements Community Relations Communications Current Issues Administration/Project Management WHAT IS THE DIFFERENCE BETWEEN STATUTORY AND CORE SUBJECT AREAS? In the HUD Handbook Chapter 8, it states: Service Coordinators must meet the statutory requirements before requesting approval for additional training in other core subject areas. Each year the Statutory subject training areas should be attended first. Once you have fulfilled those specifics subjects you can then start fulfilling your Core subjects. Because the training areas are so broad most of the workshops you will attend can fit under BOTH Statutory subjects and certain Core subject areas. On the next slide is a list of ideas for Core Subjects, however many of the ideas for workshops also fall under the Statutory subject areas. The trainings highlighted in red can be both Core and Statutory subjects. 12

13 IDEAS FOR TRAININGS - The Red Highlights are ideas for Statutory Subjects Core Areas: Skills Areas: 1. The Professional Service Coordinator A. Supportive Services for the Aging/Elder Services Aging Services B. Supportive Service Needs of Non Elderly People with Disabilities Elder Services C. Role of Service Coordinator Legal Liability D. Identifying Service Needs and Availability Elder Services; Disability Services E. Monitoring & Evaluating Services, Effectiveness, Adequacy, & Need for Changes Legal Liability F. Networking G. Creative Strategies in Service Provision Communication Effectively H. Ethics/Confidentiality Legal Liability I. Recordkeeping and Reporting 2. Government Programs and Legal Requirements A. Federal Programs & Requirements Federal & Applicable State Entitlements & Legal Liability B. State Administered Programs & Requirements/Entitlement Programs Federal & Applicable State Entitlements & Legal Liability C. Legal Liability Legal Liability D. HUD's Service Coordinator Program Legal Liability E. Locally Administered Programs Requirements Federal & Applicable State Entitlements 3. Community Relations A. Working with Resident Organizations Communicating Effectively B. Support Networks for Residents Elder Services C. Peer Networks D. Working with Volunteers Communicating Effectively E. Working with Aides Communicating Effectively F. Working with Management Agents Communicating Effectively 4. Communications A. Communicating Effectively in Difficult Situations Communicating Effectively B. Negotiation/Brokering Communicating Effectively C. Counseling Mental Health Issues; Communicating Effectively D. Advocacy Communicating Effectively E. Teamwork/Consensus Building Communicating Effectively F. Motivation Communicating Effectively G. Outreach Strategies Communicating Effectively 5. Current Issues A. An Aging Population/Aging Process The Aging Process B. Medication/Substance Abuse Medication/Substance Abuse C. Mixed Populations Communicating Effectively, Disability Services D. The Disabled Population Disability Services E. Strategies for Dealing with Cognitive Impairment Dealing with Cognitive Impairment; The Aging Process F. Other Health Problems Among the Aging The Aging Process G. Crime and Self protection Legal Liability H. Death and Loss Mental Health Issues; Communicating Effectively CONTINUING EDUCATION REMEMBER Continuing education is necessary in order to be an effective professional. At a minimum, service coordinators must remain current on changing statutes at all levels and current practices in aging and/or disability issues. In California, New Mexico, Massachusetts and Colorado we aren t required to receive CEUs from a trainer to count that training toward the required annual hours CHECK with your company and HUD region to make sure what the requirements for you! PART A. QUALIFICATIONS AND TRAINING (Continued) 4. Is the Service Coordinator job description and resume on file? Get a job description from your organization. If one is not available you can go to AASC website and download the full job description. 5. Is the Service Coordinator s job description consistent with duties being performed? Taken from AASC JOB DESCRIPTION Objective of the position: The Service Coordinator (SC) must work from an empowerment model. The goal of the program is self actualization of residents. Residents should do as much as they are capable of doing themselves. The SC works in conjunction with the property manager. The SC and manager maintain a mutually respectful, collaborative relationship. 13

14 PART A. QUALIFICATIONS AND TRAINING (Continued) Functions: Provides general service management which includes intake, education (services available and application procedures) and referral of residents to service providers in the general community. These social services may include meals on wheels, transportation, home health aides, homemakers, financial assistance, counseling, preventative health screening, and other needed services. Develops a Resource Directory. This directory may include a listing of state and/or local service providers that residents can contact for assistance (e.g. services to families, children, individuals who are elderly, persons with disabilities, emergency assistance). In many cases, State and local governments can also provide a listing of the non profit agencies with which they contract for services. Sponsors educational events which may include subject relating to health care, agency support, life skills, referral sources, etc. PART B. PROGRAM ADMINISTRATION 1. Is the Service Coordinator office clearly identifiable, accessible, and private? TheSCmusthavesufficientseparateandprivateofficespaceavailabletomeetwith residents without adversely affecting normal activities. Remember Your office should be in compliance with ADA, so make sure your residents with wheel chairs/walkers etc. can get into your office and meet with you. 2. Are the Service Coordinator s office hours clearly posted? Have a name plaque with your title and next to the name plaque have your hours posted and sign on the door that states if they are available or in a meeting (optional). 14

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16 PART B. PROGRAM ADMINISTRATION (Continued) 3. Are the Service Coordinator s files kept secure and confidential? Confidential client files. The Service Coordinator should maintain detailed notes regarding any assistance and services provided to the residents. The Service Coordinator must keep the client files in a secured location and accessible ONLY to the Service Coordinator and to management to the extent necessary. 4. Are paper files kept in a locked cabinet? The HUD Rep will check that your key works in your file cabinet to ensure the files are secure. PART B. PROGRAM ADMINISTRATION (Continued) 5. Are electronic files secured with a password? Ensure you can easily access your AASC ONLINE System or other online case management system, always know your password and username. 6. Is a directory of service agencies and contacts maintained and available to all parties? You must set up Service Agency Listing for Resident Self Referral. This directory may include a listing of State and/or local service providers that residents can contact for assistance (e.g., services to families, children, individuals who are elderly, persons with disabilities, emergency assistance). In many cases State and local governments can also provide a listing of the non profit agencies with which they contract for services. 16

17 PART B. PROGRAM ADMINISTRATION (Continued) My Coordinators may use local resource guides and are required to create their own tailored Resource Directory. The SC s enter in all the local agencies they work with into their AASC Online program, they can then create a simply index of categories (ex. Transportation, Food, Legal Aid etc.) and put in an organized binder with Tabs. In the notes section of the contacts they add info on shortcuts, who to talk to, translation of contact if needed and any other info that will help the resident use the directory. Remember it should not be all your contacts just those that relate to resident s needs! They also print one for themselves that is helpful for their own use and when residents meet with the Coordinator face to face. Remember put the Resource Directory in the community room so that the residents can look up referrals on their own without the need of the SC, this will empower them to help themselves. Also, on the weekends residents will have access to emergency services. 17

18 Building communities through service coordination In partnership with 18

19 PART B. PROGRAM ADMINISTRATION (Continued) 7. Are informational packages (i.e., pamphlets and brochures) available for tenants and interested parties? SC should keep info packages in the office. Brochures and pamphlets do not count as part of a resource directory. Many of our SC s have hanging brochure wall holder so residents can see the options of local services and brochures are organized and easily accessible for the SC. Remember seniors do well with visual aides. 19

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21 PART B. PROGRAM ADMINISTRATION (Continued) 8. What is the functional status of the resident population? Estimated number of frail elderly residents (deficient in 3 or more activities of daily living)? Estimated number of at risk elderly residents (deficient in 1 or 2 activities of daily living)? Estimated number of non elderlywithdisabilities? *In order to justify a full time SC position HUD expects to see a minimum of 50 residents that are frail, at risk or non elderly disabled. WHAT ARE BASIC ADULT ACTIVITIESOF DAILY LIVING (ADLS) VS. INSTRUMENTAL ADLS? Basic ADLs Basic ADLs (BADLs) consist of self care tasks, including: Personal hygiene and grooming Dressing and undressing Self feeding Functional transfers (getting into and out of bed or wheelchair, getting onto or off toilet, etc.) Bowel and bladder management Ambulation (walking with or without use of an assistive device (walker, cane, or crutches) or using a wheelchair) Instrumental ADLs Instrumental activities of daily living (IADLs) are not necessary for fundamental functioning, but they let an individual live independently in a community: Housework Taking medications as prescribed Managing money Shopping for groceries or clothing Use of telephone or other form of communication Using technology (as applicable) Transportation within the community 21

22 PART B. PROGRAM ADMINISTRATION (Continued) 9. Is the Service Coordinator program full time or part time? 10. Are the Service Coordinator s hours appropriate for the number of atrisk and frail elderly and persons with disabilities in residence? A part time SC will have 25 or more residents that are frail, at risk or non elderly disabled. A full time SC will have 50 or more residents who are frail, at risk or non elderly disabled. PART B. FILE REVIEW 1. Has tenant signed Release of Information form authorizing HUD and QA staff access to the case file? HUD Requires SC to have in every file a Release of Information or Confidentiality form (AASC online version) stating that HUD and QA Provider can do a file review. AASC online has Confidentiality Form stating that both can review files). Based on information I have received from a HUD Rep, it is expected to be updated annually. If no signed consent, the reviewer cannot review the case file and SC would be likely to have trouble passing review. 2. If no, proceed to Section D. As mentioned You MUST have a Release of Info specifying that HUD can review files. If you haven t done so, it is very important that the SC start getting these signed as soon as possible. PART B. FILE REVIEW (Continued) 3. Are intake/assessment forms included in each case file? Our team of SCs put Intake, Assessment and ADL Assessment on the left side and all the signed documents on the right side. We keep everything updated every year and pull out all old docs. Assessment and Case Management Plans/Service Management Plans and Signed documents should be re done EVERY year. 22

23 PART B. FILE REVIEW (Continued) RESIDENT FILES Based on MJ Housing Requirements All documents in files are updated 1x/year except the Release of Info which is updated every 6 months Always offer to the resident a copy of the Confidentiality Agreement and Release of Info and keep the original in the file. APS Reports are documented in a progress note and a copy is put in hanging folder next to file so it is not loose in the file. Our SCs file non participants in separate section of file cabinet because resident must be willing to participate in the annual updating of info and if they get audited with no updated signed docs, they most likely will not pass audit. LEFT SIDE Intake Assessment Plan (AASC) ADL Assessment (AASC Online) RIGHT SIDE Confidentiality Agreement Case Management/Service management Release of Information (Only used when necessary) 23

24 PART B. FILE REVIEW (Continued) 4. Is a case management plan (or service management plan) included in each case file? (must include all referrals to community agencies). If you do not have a case management plan, talk to your QA Provider about creating one. My team uses the Service Management Plan from AASC online. 5. Is the disposition or termination of each case documented? Print out deactivation form from AASC online or type a progress note stating the reason for leaving property. We keep these deactivate files on residents for 3 years after they move out or pass away and 7 years if evicted or case goes to legal. These files are kept in separate area of file cabinet with tabs for each year to ensure SC pulls them when required. PART B. FILE REVIEW (Continued) 6. Is there a signed confidentiality Agreement in each active file? Required to be updated every year. Important to discuss with resident the protection it provides but also when an SC must report. 7. Are the progress notes/status detailed in each case file? In California the HUD Rep allows us to print out the progress notes when they visit. Our SCs keep all progress notes online protected by username and password more protection for the residents 24

25 PART B. FILE REVIEW (Continued) Info on Progress Note Content Resident need or request (problem statement). Action taken. Be Specific, i.e.. If you are assisting with mail, what did you do translate a bill or document, read a personal letter? lf you sent documentation (what documents, by what method, and to whom calls made, messages, contact name or office. REMEMBER Use quotes as and keep objective with no personal opinion stated. Outcome, resolution or plan of action if there is no resolution at the time. Progress notes are the only secure place that we are allowed to document activity with a resident. It is critical to be able to refer back to accurate information It may help know what steps need to occur, who was contacted, who hasn't responded, etc. You do not have to have progress notes printed out. The HUD Rep will chose a couple of files and then ask you to print out the latest progress notes for those particular residents. ACTION WORDS TO USE IN PROGRESS NOTES Encouraged Enabled Engaged Established baseline Evaluated Examined Explored Extolled Feedback (sought / given) Focused Gave hints Gestured Identified Illustrated Informed Initiated Instructed Intervened Interviewed Labeled Mediated Modeled Negotiated Notified Observed Offered Opposed Pinpointed Planned Played Practiced Praised Problem solved Produced Promoted Prompted Provided Qualified Quantified Questioned Quizzed Reached consensus Reaffirmed Reassured Rebuffed Recommended Referred Reflected Reframed Rehearsed Reinforced Rejected Relabeled Relaxation techniques (offered / provided) Renewed Reported Required Respected Rewarded Role played Shaped Stress inoculation (offered / provided) Struggled Suggested Supported Taught Trained Urged Validated Valued Vented Verbalized Verified Building communities through service coordination In partnership with 25

26 ANNUAL ONSITE QUALITY ASSURANCE REVIEW QA Reviews are required to be submitted to HUD with the Semi Annual Reports in October PART C. QUALITY ASSURANCE 1. Who is the QA provider? The grantee must ensure and provide documentation to HUD that confirms that the individual employed to perform Quality Assurance is qualified to do so. The Grantee shall submit documentation (i.e., a resume) to HUD indicating the qualifications of the individual employed to perform Quality Assurance. The Grantee shall submit such documentation with their first semiannual Federal financial and performance reports. The documentation shall also be maintained in the Grantee s files, for future reference.(grant Agreement, Article I.K., NOFAs, and Handbook Chapter 8, Section 8.5) Example:IhaveanMSWinSocialWork andhaveworkedinthefieldofhousingandthe senior and disabled population for 10 years. PART C. QUALITY ASSURANCE (Continued) 2. Is QA provider a third party? HUD prefers QA Providers not to be employed by ownership or the property management company but instead by a third party organization. Regarding next 8 questions If you do not know the answers, your Administrator or Property Manager should have this information. 3. If yes, is there a QA contract? 4. Is there a job description for the QA provider? 5. Does the QA provider: A.Conduct a QA review annually? The QA provider must conduct one program evaluation review six months following the Program s start date and then one review every 12 months thereafter. The Grantee must provide copies of the program evaluation reports received from the QA provider to the local Field Office staff on or before October of each year. 26

27 PART C. QUALITY ASSURANCE (Continued) B. Interview residents to evaluate resident satisfaction? I interview the residents every other year but administer resident satisfaction survey every year. C. Interview with the property manager to evaluate program I discuss performance of SC with Manager every year. Effectiveness? D. Review resident files for program compliance? E. Prepare written annual/year end report We have the SC create a year end report every year which includes performance. PART D. REPORTS Are the following completed accurately and submitted timely? Make sure your Administrator, QA Provider or Supervisor has these reports prepared for the audit. 1. Federal Financial Report (SF 425)? (Required for grant recipients only) 2. Semi annual Performance Report (HUD 92456) for grant recipients? You should have your latest Semi Annual Report readily available. The Semi Annual Report will also give you the information for Part B. Program Administration Question 9 & 10 on the break down of frail, at risk and disabled residents. Remember when organizing your wellness and educational programs that are required once a month, you should have associations like the Alzheimer's Association or other organizations that you know will not solicit services! These in services are only for education purposes, signing up for services can be done at a later time. PART D. REPORTS (Continued) 3. Other Project Financial reports: a. Annual Financial Statement (AFS) Profit and Loss Statement, Account Do SC expenses agree with itemized expenses on HUD or A? b. When AFS not applicable, narrative report of funds used? c. HUD 925 (s), Release Authorizations, for use of residual receipts? d. Annual narrative report of Excess Income used? 4. Annual/Year End Quality Assurance Report? Get documents from your Administrator/Mgt/QA Provider 27

28 PART E. RESIDENT PARTICIPATION 1. Have the residents been interviewed about the service coordinator s role? If no, proceed to Section F. 2. Are the residents knowledgeable about the service coordinator program? 3. Is there positive feedback about the service coordinator program? 4. Do residents believe the service coordinator program is beneficial? 5. List the strengths of the program according to the residents. 6. List the weaknesses of the program according to the residents. The next two slides are examples of questions HUD will ask and a resident satisfaction survey distributed my SCs every December. SAMPLE OF SERVICE COORDINATOR RESIDENT QUESTIONS HUD WILL ASK RESIDENTS A. Introduction 1. Did management advise you that a SC is available to residents? 2. Do you know the function of a SC? 3. Do you know the SC s name? 4. Do you know the days and hours he/she is available? B. Direct Services Provided 1. Were you interviewed by the Service Coordinator upon his/her arrival and, if so, how? 2. Did you complete a Consent Form? 3. Do you feel a sense of confidentiality and privacy when with the Service Coordinator while in his/her office? 4. What type of services does he/she provide? 5. Were you provided with a contact name or telephone number of agencies or programs? 6. Are you actively involved in any programs or activities? 7. Would you like to be more active or have more interaction with friends or family? 8. Have you any difficulties finding physicians or going to appointments? 9. Are your physician and emergency contact phone number noted (VISIBLY) in case of emergency? 10. Do you have any questions regarding the Service Coordinator and his/her function? 11. Are there any issues or services you would like addressed or provided? C. Case Resolution 1. What assistance did you obtain or solicit from the Service Coordinator? 2. How was your situation resolved? 3. Did you receive contact names or numbers for community agencies or programs? SAMPLE OF RESIDENT SATISFACTION SURVEY (PG 1) RESIDENT SATISFACTION SURVEY (This Survey is distributed 1x year by my SCs) This Survey is completely confidential. You can choose put your name on the bottom or leave it blank. I know what a Resident Service Coordinator is & what they do: Strongly Agree Agree Disagree Strongly Disagree I feel that the Resident Service Coordinator position is necessary in my building. Strongly Agree Agree Disagree Strongly Disagree In the last year, the number of activities I attended that the Resident Service Coordinator planned is: or more I see the Resident Service Coordinator regarding individual issues or problems this many times each year: or more I regularly benefit from the services provided by my Resident Service Coordinator. Strongly Agree Agree Disagree Strongly Disagree 28

29 SAMPLE OF RESIDENT SATISFACTION SURVEY (PG 2) I could benefit from the following services: Transportation Visiting Nurse Personal Care Financial Assistance Help with Banking Making Appointments Home Making Insurance Assistance My Service Coordinator has helped me with following services in the last 12 months: Transportation Visiting Nurse Personal Care Financial Assistance Help with Banking Making Appointments Home Making Insurance Assistance I would be very unhappy if we no longer had a Resident Service Coordinator in our building: Strongly Agree Agree Disagree Strongly Disagree My Resident Service Coordinator is available whenever I need him or her. Strongly Agree Agree Disagree Strongly Disagree I would rate my Resident Service Coordinator as: Top Notch Very Effective Effective Minimally Effective The goal of creating a QA Binder is to have documents and information requested by HUD readily available and organized. The Binder must be: Organized Include an Index Include 10 tabs Updated 1x/year First page of the binder is the Index it corresponds in order with the questions on the SC Review Checklist. If you want to add or delete a tab you can tailor it to your needs. 29

30 2016 QA BINDER INDEX Keep current year and previous year 1) Training Verification Log 2) Training Certificates/ Proof of Training 3) SC Job Description 4) SC Resume 5) Semi Annual Report 6) Service Coordinator Review Forms 7) QA Provider Job Description 8) Resident Surveys 9) Code of Ethics 10) HUD Chapter 8 Handbook SEPARATE BINDER Calendars Flyers/Sign in Sheets TABS Refer to: Part A. Training and Qualifications 1 st Tab is your training verification form. 2 nd tab is where you will document training certificates (CEUS). Your AASC Conference and Chapter Symposium Certificates and any other certificates you receive. Also your confirmations of trainings when you do not receive a certificate of completion. Proof of trainings can be an invoice, agenda, confirming the training attended. Please match the trainings and certificates to their training logs. So at the top of the training log is Aging Process that training will match with the first certificate or agenda and it goes down the line from there. 3 rd tab is the SC job description. 4 th tab is your resume. TABS Refer to: Part B. Program Administration 5 th tab is your Semi Annual Report which will give your HUD Reviewer the information on frail and at risk (Questions 9 & 10). Refer to: Part C. Quality Assurance 6 th tab is the QA Provider job description (if you have a QA Supervisor). 7 th tab copy of your annual Service Coordinator Review Form (or other annual QA Review form used), if you receive a review. Refer to: Part E. Resident Participation 8 th tab is the Resident Survey (if your QA Provider administers one). We provide the survey that the SCs put out to the residents every December. In order to ensure confidentiality, the SCs create a drop box with a slit on top that is taped around the sides and cannot been opened. Mgt puts in mail to support confidentiality. 30

31 TABS 9 th tab copy of the SC Code of Ethics in their Binder. As a group we review these often and it s very important to have them readily available and use them as a reference. 10 th tab The SC HUD Chapter 8. It is important to have this document easily accessible to review SC program requirements. Recently one of my SC who had a HUD Desk review was asked by the HUD Reviewer for her calendars, flyers and sign in sheets. Calendars/Flyers and sign in sheets are evidence to HUD of your monthly Wellness and Educational Programs. Please start a separate binder for these documents. 1 st tab Monthly Calendars (only keep 1 year of calendars). 2 nd tab Sign in sheets and flyers. 31

32 Southern California Q/A Team Madelyne J Pfeiffer, MSW, CFRE mpfeiffer@mjhousingandservices.com Employ Service Coordinators Employ 19 SCs Contracted QA Provider Work with 42 Senior SCs in multiple states (14 different owners and 15 property management co.) Meet face to face and or Teleconference with SCs every month (6 8 hours/month of supervision & AASC online review) Contracted Grant Administrator Provide accounting, financial reporting and monthly LOCCS drawdowns for 17 grants Fundraiser Teach SCs how to fundraise and set annual fundraising goals based on the needs of the community Certified fundraiser: write grants; solicit funds and build partnerships and alliances with local agencies in order to fulfill gaps in services due to limited budgets Program Development Develop and implement afterschool programs and family service programs Supervise After school Coordinators and Family SCs Trainer/Instructor Provide trainings for groups of SCs, Property Managers and Youth and Adult Coordinators around the country Work with Universities to provide training and oversight for MSW students 32