DHS 10.23(6)(b)(b) Community needs identification. Implement a process for identifying unmet needs of its target population in the geographic area it serves. The process shall include input from members of the target populations and their representatives, and local government and service agencies including the care management organization, if any. The process shall include a systematic review of the needs of populations residing in public and private long-term care facilities, populations in need of public or private long-term care services, members of minority groups and people in rural areas. A resource center shall target its outreach, education, prevention and service development efforts based on the results of the needs identification process.
DHS 10.23(6)(c)(c) Grievance process. Implement a process for reviewing and resolving client grievances as required under s. DHS 10.53 (1).
DHS 10.23(6)(d)(d) Reporting and records.
DHS 10.23(6)(d)1.1. Except as provided in this par. and sub. (7), collect data about its operations as required by the department by contract. No data collection effort shall interfere with a person’s right to receive information anonymously or require personally identifiable information unless the person has authorized the resource center to have or share that information.
DHS 10.23(6)(d)2.2. Report information as the department determines necessary, including information needed for doing all of the following:
DHS 10.23(6)(d)2.a.a. Determining whether the resource center is meeting minimum quality standards and other requirements of its contract with the department.
DHS 10.23(6)(d)2.b.b. Determining the extent to which the resource center is improving its performance on measurable indicators identified by the resource center in its current quality improvement plan.
DHS 10.23(6)(d)2.c.c. Evaluating the effects of providing long-term care options counseling and choice counseling under this section.
DHS 10.23(6)(d)2.d.d. Evaluating the effects for enrollees and cost-effectiveness of providing the family care benefit.
DHS 10.23(6)(d)3.3. Submit to the department all reports and data required or requested by the department, in the format and timeframe specified by the department.
DHS 10.23(6)(e)(e) Internal quality assurance and quality improvement. Implement an internal quality assurance and quality improvement program that meets the requirements of its contract with the department. As part of the program, the resource center shall do all of the following:
DHS 10.23(6)(e)1.1. Develop and implement a written quality assurance and quality improvement plan designed to ensure and improve outcomes for its target population. The plan shall be approved by the department and shall include at least all of the following components:
DHS 10.23(6)(e)1.a.a. Identification of performance goals, specific to the needs of the resource center’s customers, including any goals specified by the department.
DHS 10.23(6)(e)1.b.b. Identification of objective and measurable indicators of whether the identified goals are being achieved, including any indicators specified by the department.
DHS 10.23(6)(e)1.c.c. Identification of timelines within which goals will be achieved.
DHS 10.23(6)(e)1.d.d. Description of the process that the resource center will use to gather feedback from the resource center’s customers and staff and other sources on the quality and effectiveness of the resource center’s performance.
DHS 10.23(6)(e)1.e.e. Description of the process the resource center will use to monitor and act on the results and feedback received.
DHS 10.23(6)(e)1.f.f. A process for regularly updating the plan, including a description of the process the resource center will use for annually assessing the effectiveness of the quality assurance and quality improvement plan and the impact of its implementation on outcomes.
DHS 10.23(6)(e)2.2. Measure resource center performance, using standard measures as required by its contract with the department, and report its findings on these measurements to the department.
DHS 10.23(6)(e)3.3. Achieve minimum performance levels and performance improvement levels, as demonstrated by standardized measures agreed to in its contract with the department.
DHS 10.23(6)(e)4.4. Initiate performance improvement projects that examine aspects of services related to improving resource center quality. These projects shall include all of the following:
DHS 10.23(6)(e)4.a.a. Measuring performance.
DHS 10.23(6)(e)4.b.b. Implementing system interventions.
DHS 10.23(6)(e)4.c.c. Evaluating the effectiveness of the interventions.
DHS 10.23(6)(e)4.d.d. Planning for sustained or increased improvement in performance based on the findings of the evaluation.
DHS 10.23(6)(e)5.5. Comply with quality standards for services included in the resource center’s contract with the department in all of the following areas:
DHS 10.23(6)(e)5.a.a. Timeliness and accuracy of the functional screen and financial eligibility and cost-sharing screen.
DHS 10.23(6)(e)5.b.b. Timely and accurate eligibility determination and enrollment procedures.
DHS 10.23(6)(e)5.c.c. Information and assistance services and long-term care options counseling.