Michigan Program for Background Checks

1
Michigan Program for Background Checks

• Michigans Long-Term Care
• Conference
• March 24, 2006

2
Statement of the Problem

• Some LTC employees with direct access undergo
  background checks, but not all.
• Process was not comprehensive or systematic, no
  appeal process, and limited training on abuse and
  neglect.
• There is a shortage of qualified health care
  workers.
• Proportion of elderly and disabled is increasing.

3
Current MI Background Check Laws and Status

• Currently only Nursing Homes, County Medical Care
  Facilities, Homes for the Aged and Adult Foster
  Care Facilities
• Primarily of a name check on the Internet
  Criminal History Tool (ICHAT)
• Not in state for at least three years FBI
  fingerprint check

4
Current MI Background Check Laws and Status

• Not Included Psychiatric Hospitals, Hospices,
  Home Health Programs, Home Help, Long Term Care
  Hospitals, and ICF/MRs, New Health Professionals
• Does not include all federally prohibited
  offenses and substantiated findings under abuse
  and neglect
• Takes too long, inefficient, to often inaccurate

5
Michigans Response

• September 2004, Michigan submitted Federal
  Background Check Pilot Project Grant under the
  Medicare Modernization Act of 2004
• CMS awarded 5,000,000 over thirty months
  beginning in January 2005
• One of Seven States in Pilot

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Michigans Response

• Collaborative Partnership
• Michigan Department of Community Health
• Michigan Department of Human Services
• Michigan State Police
• Office of Services to the Aging
• Michigan State University
• Multiple Advocacy and Provider Groups
• Background Check and AANP Advisors

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Michigans Response

• Six Key Features of the program
• Expand the Scope of Michigans Laws
• include Psychiatric Hospitals, Hospices, Home
  Health, Long Term Care Hospitals, and ICF/MRs
  (Michigan is including Home Help.)
• Strengthen Michigans Criminal Background Checks
• include prohibited offenses, substantiated
  findings of abuse and neglect, and registry
  checks

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Michigans Response

• Six Key Features (Cont.)
• Provide Due Process
• Create an Appeal Process
• Speed up the process--enhance accuracy
• Fixed and Mobile Locations (MSP /Identix)
• Electronic Fingerprint (MSP)
• Web-based Provider Interface (MSU)

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Michigans Response

• Six Key Features (Cont.)
• Implement AANP Training
• BEAM(OSA, MSU, MPRO)
• Objective and rigorous evaluation
• MSU (Background Checks and AANP)
• Federal Contractor

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Legislation Process / Decisions

• Broad-Based Legislative Committee
• Met several times, plus subcommittees
• March 2005-January 2006
• Consensus-based process
• Legislation takes effect April 1, 2006
• Federal CMS Compliance Review

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Legislation Process / Decisions

• Decision Rules / Priorities
• Medicaid / Medicare Funding
• Quick Turn Around
• Readily Available
• Full Federal Compliance

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Michigan Program for Background Checks

• Fingerprinting Process
• Timothy Bolles, MSP
• Research and Evaluation
• Lori Post, MSU
• IT Interface
• Robert Fulk MSU

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• FINGERPRINTING PROCESS
• Technology
• Collection Agency
• Fingerprint Collection Locations
• Fingerprint Collection Requirements
• Fingerprint Transmittal Methods

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Michigan Program for Background Checks

• Fingerprinting Process
• Timothy Bolles, MSP
• Research and Evaluation
• Lori Post, MSU
• IT Interface
• Robert Fulk MSU

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RESEARCHEVALUATION
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Research
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Michigan Survey of Households with Family Members
Receiving Long-Term Care Services

• Random Sample of Michigan Households
• N1002
• Stratified by AANP Training
• Provides baseline data of abuse, neglect, and
  exploitation.

18
Total Abuse Incidents Last Year by Market
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Research

• Impact of Aging on Michigans Population
• Labor Force Issues

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Aging Michigan Population

• 1970 to 2030
• Population Estimates and Projections.
• Median age will increase by 5 years.
• Number of persons gt 65 will double
• Causation and correlates of abuse, neglect, and
  exploitation

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Evaluation

• Process
• Impact
• Outcome

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Process Evaluation

• Document the steps to implement the legislation
  and new background check system
• Barriers and Obstacles for duplication in other
  states
• Did we accomplish what we set out to do.

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Impact Evaluation

• Impact of Background Check System and legislation
  on reducing abuse, neglect and exploitation.
• Compare before and after measures of abuse,
  neglect, and exploitation.

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ADULT ABUSE NEGLECTPREVENTION
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Definition

• The Adult Abuse Neglect Prevention grant is a
  program for direct access staff employees and
  managers of long-term care facilities and
  providers of service to adults that addresses the
  issues that precipitate abusive behavior and
  provides preventive solutions for reducing
  incidents of abuse and neglect and for improving
  the quality of care for patients with long term
  illnesses or disabilities.

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Facilities Providers

• Skilled Nursing Facilities/Nursing Homes
• Long Term Care Hospitals, Swing Beds
• Intermediate Care Facilities (ICFs/MRs)
• Psychiatric Hospitals
• Hospices

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Facilities Providers (contd)

• Assisted Living Facilities
• including Adult Foster Care Homes Homes for the
  Aged
• Home Health Agencies
• Adult Services Home Help Workers
• Individual personal care providers not associated
  with personal care agencies

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Geographic Regions

• Upper Peninsula
• Midland/Saginaw/Bay City/Flint
• Southeast Michigan including Detroit
• Southwest Michigan including Kalamazoo

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Goals

• Create an expanded adult abuse and neglect
  prevention curricula incorporating methods of
  staff empowerment, culture change, and
  person-centered care.
• Thus, leading to

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• Increased staff awareness
• Reduced abuse and neglect incidents by employees
• Reduced abuse and neglect incidents by residents
  or patients
• Improved organizational culture

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• Evaluate the impact of the background check
  information and the AANP training on recognition
  and reporting of suspected abuse and neglect.

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• Establish a process to ensure AANP is implemented
  on a regular basis after 2007.

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Curricula

• Definitions
• What is abuse?
• Reporting
• Procedures for each group of providers

• Prevention
• Conflict Resolution
• Stress Management
• De-escalation Techniques
• Person Centered Care Principles

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Timeline2005

• Establish collaborations
• (MDCH, OSA, MSU, PHI, CBC, WSU)
• Convene Advisory Committee
• Develop curricula
• Identify recruit trainers
• 11 Primary Trainers
• 75-80 Specialized Trainers
• Offer Orientations in each region
• Identify and begin surveying participants

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Timeline2006

• Ongoing communication with Advisory Committee
• Trainers in place
• Begin training of 11,000 DAS
• Review and modify curricula as needed
• TeleSage Survey with MSU
• Compile Data

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Timeline2007

• Ongoing communication with Advisory Committee
• Complete training of 11,000 DAS
• Complete surveys
• Compile data
• Draft proposed policy recommendations
• Develop steps to implement AANP statewide

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End Result

• A statewide, tested, training program (including
  manuals) for all direct access staff in the long
  term care continuum that offers cognitive ways to
  prevent abuse.
• Michigans Adult Abuse Neglect Prevention
  Program is the pilot selected by the Centers for
  Medicare Medicaid Services to be offered
  nationwide to ensure the care, safety, and
  comfort of our vulnerable adults in the long term
  care continuum.

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CONTACT INFORMATION

• Gloria Lanum, MDCH--Background Check Grant
  Managerlanumg_at_michigan.gov
• Lauren Swanson, OSAAANP Grant Managerswansonla_at_m
  ichigan.gov
• Ellen Hayes, MSUBackground Check Project
  Managerhayse_at_msu.edu