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To assure senior level quality management, the Office of Program Integrity and Accountability (OPIA) operates a Risk Management System (RMS).  In the case of the Department of Human Services, “Risk Management” is a term given to a set of practices that leads to minimizing possible harm to systems and to individuals. 

Office of Program Integrity and Accountability (OPIA) assembles the data it collects to create a quarterly “dashboard” - reporting performance data from each DDD contracted provider agency across various DHS systems, including licensing, auditing, investigations and critical incident reporting.  This enhances transparency and enables the public to assess provider strengths. 

A Risk Management System seeks to identify factors that may increase those risks and actively promotes practices that will keep risk as low as possible.  The purpose of this Risk Management System is to promote a positive quality of life for all persons with developmental disabilities by ensuring safety and well being.

A Data Driven System for Quality Assurance...
The DHS OPIA Risk Management System is data driven and is designed to meet the required quality assurances of the federal Centers for Medicare and Medicaid Services’ (CMS) guidelines and includes components of the CMS quality framework.  CMS uses the quality framework to measure each state’s ability to meet the assurances in the following areas:
  • Health, safety and well being;
  • Provider qualifications;
  • Fiscal integrity; and
  • Overall system performance.

OPIA assesses these areas by analyzing data from four of its operating units:  the Critical Incident Management Unit, Special Response Unit, Office of Licensing and Office of Auditing.  This analysis establishes the foundation for a quarterly report - or "dashboard" - issued by OPIA.

 
 
Risk Indicator Reports - "Data Dashboard"
This report is called the Risk Indicator Report - DDD Community. It serves as a "Data Dashboard" - which assesses the performance of contracted providers by utilizing measurable indicators of risk.  This methodology gives DHS the ability to identify systemic risks and statewide trends; and it provides the opportunity for quality improvement. 

For better understanding of the terminology used in these reports, go to the Risk Indicator Report - Glossary of Terms. 


Name of Report

Risk Indicator Report - DDD Community 

Comparative Averages - DDD Community 


An important component of the Risk Management System is that it gives OPIA an enhanced ability to organize and assess this data, then inform system partners, dispel myths, and make informed decisions grounded in data.
 
 
OPIA Council on Systemic Risk Assessment...
Once the Risk Indicator Report is disseminated and analyzed, the next level of action is convening an OPIA Council on Systemic Risk Assessment. The Council provides an executive level review of the Risk Indicator Report.

OPIA managers partner with Division of Developmental Disabilities’ (DDD) managers to evaluate – at a systemic level - the triggered thresholds of the report’s critical domains. The Council’s goal is to decide upon a coordinated, comprehensive and efficient course of action to address systemic risk among DDD’s contracted community providers.

The OPIA Council on Systemic Risk Assessment:

  • Focuses and aligns the activities of the participants who are responsible for performing risk management functions.
  • Improves the ability to identify and reduce risk to individuals and the service delivery system.
  • Creates a partnership with those contracted providers to improve delivery of services.
  • Improves the processes and systems which are responsible for creating the data.
  • Recommends the formation of a quality management team to provide technical assistance, training and resolution to the providers.
 
 
Notable Events and Improvements Derived from Data Assessment...
During its operation through six quarters of this and the past fiscal year, the current Risk Management System has accomplished these notable events and measurable improvements:
  • Six quarters of agency data dissemination - 160+ agencies each time
  • Agencies triggering four or more thresholds decreased from seven to one
  • Agencies triggering three or more thresholds decreased from 29 to 15
  • Missing reports to CIMU threshold decreased from 21 to 9
  • Provisional license threshold decreased from 17 to 8
  • Audits missing threshold decreased from 33 to 21
 
 
 
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