[00:00:02.990] - Kimberly Robinson Let me pull my agenda over, this was our agenda for today. So, Teresa, we're gonna record this, Rob. I don't know if you've got it started yet or not, but we're gonna record this meeting as well as like we do all of them. I like having the recordings because we can go back and actually play them. Later, when we want a refresher or so forth. But anyways, I see that just looks like just Ricky and Marsha are on this call right now. There may be other folks coming in, but we'll go ahead and get started. So Teresa you can do roll call. I'd appreciate it. [00:00:43.920] - Teresa George OK. Just let me know if you're here when I call your name. Natalie Alden. Natalie Alden. Erick Collazo. Erick Collazo. Tina Densley. Tina Densley. Patricia Dorell. Patricia Dorell. Suzanne Doswell. Suzanne Doswell. Joanne Hoertz. Marsha Martino. [00:01:27.220] - Marsha Martino I'm here. [00:01:28.810] - Teresa George Thank you. Kevin Mullen. Kevin Mullen. Rhonda Ross, Rhonda Ross. Jeffrey Secure. Jeffrey Secure. Larissa Swan. Larissa Swan. Sean VanGerena. Sean VanGerena. Richard Zeidman [00:01:56.740] - Richard Zeidman Present. [00:01:56.860] - Teresa George Thank you. We have two members present, there is no quorum. [00:02:02.130] - Kimberly Robinson OK, thank you. So what we talked about at our last meeting, we went over the ineligible applicants, the in-service recipient and the one year post closure survey, and it was discussed about perhaps creating a survey that would be kind of like all in one instead of having different ones. It's one that we could use as a universal throughout the life of the client's case. There were a couple council members I know. Dr. Ross, I believe, was one who is going to try and put some recommendations together for revision. Excuse me. She's in Texas. So the time differences pretty early for her over there. Um, I didn't receive any updates from anybody. We had started looking at the closure survey. And what we haven't done at all is look at the process on how we want to do the customer surveys. So what I can do is let me pull up. And I'll bring this over. Bear with me. We can open up for discussion, perhaps we want to look at the surveys that we have done here and see what questions we might want to combine to make it. One survey that was discussed at the last meeting for like the Universal Universal Survey is I'm open for feedback on this, on how you all would like to proceed. [00:03:39.050] - Marsha Martino There are some some normal surveys out there, and that's what I thought Doctor, is that her name Ross, I can't remember... but that she would get. I mean, I think of it. Yeah. I think it would be really great to just. There are some that are out there that are they're not difficult. They measure the kinds of things that that we would want to be measuring. And if we can use those measurements, you know, on admission every six months or end on discharge or however we set up doing it or six months later. But to use one that's standardized, I think would just be a really great thing to do on there. They're used on the population of people with them, with brain injuries. I don't know about spinal cord injuries, but they're used in various, you know, different systems. So it wouldn't surprise me. I just happen to know they're used in brain injury. But I think it'd be great to get one that's that's already used and normed. [00:04:38.310] - Kimberly Robinson OK [00:04:38.330] - Richard Zeidman I'm a little confused why we would want just one survey. I mean, it might be easier. But there are three different really three different categories of people that are going to receive the surveys. And we've got that down right now. If somebody is ineligible, if they're in the program or if they're out of the program. And I think we need to really we should keep those separate. So I'm very pleased with what we have right now. I think, again, we have to look back at the original goals of the survey to find what are what are... Why are we doing a survey to get information to make the program better, more efficient, more user friendly. And I think these three individual surveys do it. I think if you had one survey, it sort of dilutes it. It'll be maybe easier, but it dilutes the content. I think. [00:05:40.100] - Marsha Martino Well, I guess, you know, I think about what [00:05:42.240] - Kimberly Robinson Natalie's coming on. I'm sorry, Marcia, I didn't mean to step on, just wanted you to know that Natalie Alden is coming on as well. I see her logging in. [00:05:54.370] - Marsha Martino OK. Well, I guess I'm thinking back on the questions. And there were we were trying to measure um satisfaction with the process. But there was also working on goals and achieving goals. And if we're trying to show that someone's making progress, then I think a standardized tool. This is beneficial because you show progress over time. If we're looking at satisfaction, then that is kind of separate. It seems like there were a few things rolled into one and then the things you were looking at. So it's showing progress. I just think it makes sense to use a standardized tool and then do something separate for satisfaction. [00:06:42.290] - Richard Zeidman But how would that apply to weigh ineligible applicants? I can see it for someone who who is in service recipient, but not not somebody who's ineligible or we would just eliminate that. [00:06:56.650] - Marsha Martino Then ineligible would be a satisfaction survey. [00:07:00.850] - Richard Zeidman I didn't hear you. Do what? [00:07:04.860] - Marsha Martino I'm sorry, I'm driving... ineligible would be a satisfaction survey. [00:07:18.160] - Kimberly Robinson We could change ineligible to a satisfaction... I mean, we could look at the questions we have there changed the title. But what would you think about combining the one year? This one, the one year post closure survey and the closure survey. What about combining those? Because those seem to be a little redundant and maybe make them one survey. So you would have an eligible would we call that an eligible satisfaction survey? And then you would have an inservice. And then you would have, you know, closure and maybe you include the ineligible and the post closure and closure surveys. Combine those three together, then that brings it down to actual two surveys because you could combine the ineligible questions with an actual closure. And what I could do is, [00:08:35.610] - Richard Zeidman Give an example of what you would be doing there? [00:08:37.720] - Kimberly Robinson OK. So for the the ineligible, you would just rename that the you know, we could make it a satisfaction survey and it can pose questions for clients that were ineligible and for clients that were actually closed one year. And just a closure, closed period. Their case was closed. Maybe, you know, as community reintegrated. So you would narrow this down to two. You would have a satisfaction survey that would include questions for clients that were ineligible. Closed one. Maybe one year or just closed period. And then that can be like a two part, so if they were ineligible, you would ask these questions. If they were closed, for whatever reason, you might ask these questions and then have general satisfaction questions. That would be one survey. The other survey would be for clients that are in service. And that's the one that we talked about that we could give throughout the life of their case. At intervals, you know, maybe three months. Six months a year. Eighteen months. You know, however long they're there in the program. So we could narrow it down to two instead of four. And I can play with this and kind of put an example together on what I'm trying to present to you, I don't think I'm coming across clearly. As to what I'm thinking. [00:10:07.700] - Natalie Alden Hey Natalie's on the line. [00:10:11.550] - Kimberly Robinson Hey Natalie. [00:10:13.620] - Natalie Alden So so from what I'm hearing, and I know that I just got in kind of in the middle of this conversation, you're talking about, you know, how often doing the different types of surveys and when to do them. And what I'm gathering. OK, go ahead. [00:10:33.970] What we were what we're talking about. You're kind of right. We were talking about the last meeting. It was discussed that we may do like a universal survey throughout the life of the case. And Marcia was talking about some that are already out there that maybe we could use. And Ricky's questioning. You know, we have these surveys. He likes the ones that we already have, are ineligible in service and post closure and so we were trying to explain and come up with an idea maybe on how to combine surveys together to make them, you know, of maybe two.. break it instead of having four, we would have two we would have one for inservice clients and then maybe combine the ineligible post closure and closure surveys together. The questions to make it more of the universal one. Or we can go out to the Web like Marcia was talking about. She said there's some out there that we could probably use that's already written. [00:11:47.330] - Natalie Alden And this would be for the one that would be given out during the life of the case. [00:11:53.400] - Kimberly Robinson The life of the case would be the one, the in-service recipient survey. That would be during the life of the case. Because we want to follow up throughout their case to see how things are going for them. [00:12:09.120] - Audience (Inaudible) [00:12:10.000] - Natalie Alden do we have this final draft of what we have from the changes that were made in the last couple meetings? [00:12:17.690] - Kimberly Robinson We do. Let me pull this up. I just had it. [00:12:21.590] - Richard Zeidman That's what was sent with the meeting notice? [00:12:26.080] - Natalie Alden I'm looking at my meeting notice. I'm sorry. Don't. I don't see anything attached to it. That's why i was asking. [00:12:32.210] - Kimberly Robinson In the email, didn't I send.. did I attach it in the email? [00:12:37.700] - Natalie Alden That's what I'm looking for now, I did notice that came up that you know how you get the one and you just accept it and it goes straight to your Calendar. [00:12:45.970] - Kimberly Robinson Yeah. That's the calendar. [00:12:50.450] - Audience Multiple people speaking over each other (Inaudible). [00:12:51.630] - Natalie Alden OK, ok. So. So I know to not look there. It's like I have some other meetings, and that's exactly where, you know, and I'm looking for it. They're like, oh, it was in your meeting calendar one. And I'm like. Oh, and of course, now my little circle thing just wants to do it's thing. [00:13:13.460] - Kimberly Robinson Can you see my... Do you see my desktop Marsha Martino? I'm sorry, Natalie. OK. I have the surveys up. So these are the ones the an eligible one. We were pretty definitive on that one was pretty much done. The in-service recipient survey. We had questions down here is why I had these highlighted. So this one isn't completed because we need. I needed to go back, I think, and just clean this up we were taking out question number five. And putting in six and seven. And I just needed to clean that up. And then on the post closure survey excuse me, looks like that one was a final a final draft. But then I didn't make any of these a final draft, because at the end of our meeting last last time we talked about creating one, that would be what you all were referring to, more like a universal one that would cover multiple surveys. [00:14:20.630] - Richard Zeidman I think on the inservice one we had where you made two questions out of number five. I thought that was the final version of that. Thought we had approve that. [00:14:34.140] - Kimberly Robinson Well, I believe we did, but I didn't change anything on here because we then talked about doing a completely different one. So I left things the way they were. But I can easily. [00:14:46.290] - Natalie Alden My understanding was that particular one. This one that you have right there, were they that's in front of us the inservice one. I thought that was the one that we were going to use during the lifestyle like lifecycle of the cave. [00:15:01.170] - Kimberly Robinson Yes, [00:15:02.410] - Natalie Alden we were going to go give out that same one, and we were just going to give it out more often. So. So you would still have the three. But this one would just go out more often, you know. And then, of course, when closure happens, then they would get the closure one. [00:15:19.590] - Richard Zeidman Correct. [00:15:20.700] - Kimberly Robinson That was the... that was the original plan. [00:15:24.310] - Natalie Alden So we wouldn't really have to create another one. We would have the three. And like you'd have the first one for the people that would get, you know, the ineligibles and all of that you would get. You know, this one, you know, probably at three, nine months, you know, because people are on the program more than two years. Correct. [00:15:48.470] - Kimberly Robinson Typically, yes. There are a few exceptions, but not very many. And we are over Turbin two years is what we try to keep it at. [00:15:58.880] - Natalie Alden Right. And I know, I know sometimes it may go you two and a half years, but I know at that point, usually somebodies, you know, they're being that if they go past two years, from my understanding, when John was on, you know, at that point, they're really focusing on one way or the other, you know, you're going to get some kind of place down one way or the other at that point. [00:16:21.910] - Kimberly Robinson Correct. [00:16:22.400] - Natalie Alden But I know that, you know, if if that. So as far as for this one right here, it you know, we really can't just use this one as the one that goes out during the lifecycle. We wouldn't that we wouldn't need to read a whole nother one. [00:16:38.970] - Kimberly Robinson I agree. And so that's what we were kind of talking about when you came on, that's what we were talking about. At the end of our last meeting it was brought up about using one that's out on the Web as a universal. And maybe not using these. So that's kind of where we're at in this conversation is do we want to use the ones we have? Do we want to combine them? Let me bring my agenda back up. We want to use the ones we have, because the first three here, the ineligible applicants, the inservice and the one year post closure, we pretty much have looked at them, came up with our questions I need to clean up just that one survey there where I had highlighted in blue. And then those would be done when we started talking about, quote, the closure survey. That's when the suggestion came up. About creating the universal one in our last session. [00:17:44.040] - Natalie Alden Yeah I hate... yeah i hate universal surveys. It it it I hate it when you have this survey that got all these questions and you're like That has nothing to do with me. That has nothing to do with me. That has nothing to do with what I'm going on. And I know personally, it just kind of seems like, you know, you get frustrated. It's usually a much longer survey because they're incorporating so many things. And then you don't get the answers that you need because you're being vague in some areas because it's a universal survey. I personally don't like them. [00:18:18.260] - Richard Zeidman I agree with Natalie Alden. It's a one size fits all when it really doesn't. And right now we're up to three separate ones that do fit the three separate categories. And this works to go to something that is as a one size fits all, doesn't seem to do it or wouldn't seem to do it. I think. [00:18:39.370] - Marsha Martino I think that the question came up when it was talking about needing community reintegration goals and the progress that someone had made. I'm sorry, I'm driving and I don't have that in front of me. But there were questions about people moving towards independence and meeting independent schools. And so then there was discussion about. The progress that people make. And so it is a question of their satisfaction towards progress. And then part of the discussion was, is there a measurement of is there any objective measurement towards that that demonstrates that the person has made progress towards independence? There is a standardized twenty five question, extremely relevant standardized test that that Dr. Rorschach's brought up, the Mayo Court, one that I've used before. And I suspect there are others, but it's all about being independent in the community. And twenty five questions. So whether that is, I guess kind of to me, the thing is they're there. It looks like we're trying to measure perhaps two different things. Have you made progress and are you satisfied? And the standardized test of have you made progress? may be beneficial in demonstrating that money is being well spent to show that people are making progress. And so that was kind of that discussion, that it doesn't replace the satisfaction survey, but it does show that people have made progress. And you know, [00:20:19.540] - Audience (Inaudible) [00:20:19.730] - Natalie Alden Right. Right. So if that's the case in there already is one that specifically for progress and that's do it. And it's something totally different than, you know, the client satisfaction survey as far as we're looking at on how how do you feel about your your case manager type thing? You know, progress. One could be something like if if we're going to send something out like, let's say every three months during there, then being there, it could be that we send the satisfaction survey, the progress survey, the satisfaction survey, the progress survey and just, you know, and half up, because I can see where there's merit in knowing both of those information, because, of course, that the progress survey would help the case manager to determine if there's extra things they need to do in order to make this person independent, which is different than us wanting to know if that person is satisfied with the services that they're getting. [00:21:27.940] - Richard Zeidman I think before... somebody should be able to put up a one of these universal services that we're talking about so that we can see it and look at it. [00:21:41.470] - Audience (Inaudible) [00:21:42.640] - Kimberly Robinson Yeah. She was going to see if she could find something. And share it with the group. [00:21:48.080] - Marsha Martino Well, what it... what it would mean would be pulling out the ones like do you participate in social activities? That's on that's on the survey. You know, that's. And those are not the progress. Surveys are not filled out by the individual. They're filled out by the case manager or staff or whatever. They're they're supposed to be objective measures of that person's level of community reintegration. So (Inaudible) or pure satisfaction surveys. And you don't ask someone, did you participate in activity? You could say, are you happy with your level of participation? But it's not asking someone to measure where they are. Are they using public transportation? Are they depending on you know? Those are those come out because those could be objective measures from a standardized tool. And these become satisfaction surveys. [00:22:43.240] - Natalie Alden So, Marcia, are you saying that... The universal survey that you're talking about that actually shows the progress, that would be something that the case manager would take out there to assess where they feel the progress. Is that something they would work with on the client? And they would notate that those those things so that they would be able to work and know better what's going on with client. [00:23:10.760] - Marsha Martino Exactly. Those are the kinds of things that are done on admission, on discharge and typically like every six months or something during services. And then six months or a year after services. So you show that progress is being made and maintained. And they don't. I mean, they're they're pretty basic questions. I don't know. You have to go over them with someone if you know their case. Are you using public transportation? Most case managers would perhaps know that, but you could ask the questions, but they're very basic questions. Are you working again or are you volunteering? You know, I mean, just pretty basic levels or measures of being integrated in the community. [00:23:56.680] - Natalie Alden And I would not have a problem with, you know, the case managers doing that, either with the person or evaluating the person to know where that is and then are our surveys that we've already, you know, put together. I do think, you know, good, because now we're talking about the fact that there's actually two different reasons for the different types of surveys. But I would want to still have the participants do theirs and say whether they're actively participating in stuff and everything in. And because I think that, you know, you're getting two perspectives there. If if the case managers filling out the one as far as progress and they're doing it either with or with the client or by themselves, you know, assessing the clients, you know, that's a very different perspective than the client filling out something based on how they feel. You know, what's going on. So, so for me... Yeah, I wouldn't say. Just for me, I would think that we we would end up keeping our three surveys doing them when we've stated we were going to do them and then they did. The one that Marsha's talking about, that that would be something that the case managers would do in order to maintain, you know, what's going on as far as progress and that for for a client. [00:25:26.010] - Kimberly Robinson OK. That that was going to be my question to recap, to make sure I'm understanding what I'm hearing. And you just did that for me, Natalie. Thank you. It would be the three surveys and then we would come up with the universal one. And I will find time, [00:25:48.100] - Audience (Inaudible) [00:25:48.630] - Marsha Martino I mean, I don't know. You know, maybe the state doesn't care, but got any funding you get. They want to. They want to show that. They want you to show that you're doing something. So, you know, it would make sense to have that. Yeah, the one that I know is is the Mayo. Portland, Mayo, Portland. Scale of something another. But in a while. Portland. If you Google that, you would find that it's it's 25 questions. It might be twenty eight questions. It's been a while since I've done it, but it's it's very simple. [00:26:25.450] - Kimberly Robinson Well, I'll look for that. I'll look for that. [00:26:29.550] - Audience (Inaudible) [00:26:34.590] - Marsha Martino That's one that Ross had brought up, but he named some other ones, too, that happened to be one that I had used. So I know it. I'm sure there are others. [00:26:46.050] - Kimberly Robinson So what I'll do to prepare for our next meeting is all I'll clean up those surveys that we have and make them the final draft, the three, the ineligible, the inservice and the post closure. And I will go out and look for the Mayo Portland Scale Satisfaction survey and have that one right. [00:27:06.530] - Marsha Martino No, it's not that satisfaction. It's not satisfaction. It's measuring the prognosis. It's community reintegration or something. [00:27:16.770] - Kimberly Robinson Thank you. Need you guys to keep me in check [00:27:21.850] - Natalie Alden And Marsha, if you can't if you happen to have time and you are able to Google that and find it, if you can send that over to Kimberly, that would probably work out well. [00:27:35.410] - Marsha Martino I'm not sure if I got able to. I'm sorry. I'm working twelve hours on an easy day. And my sister died two days ago. So I am not in good shape at the moment. [00:27:45.120] - Kimberly Robinson But I'll go out and look for it. I'll go out and look for it. [00:27:48.450] - Marsha Martino Yeah. I'm sorry. I'm just if not good good timing for me at the moment. [00:27:53.200] - Kimberly Robinson And that's OK. I'll look for it. I'll find it. Give me a mission. [00:27:59.800] - Marsha Martino Just. I'm sorry. I just. I just just got in our parking lot. So but I'm sorry not to beat a dead horse, but look at number 10. Do you receive SSI, SSD, ie, Medicaid? Don't we have that answer? Like, why are we asking someone who may have a memory problem or may or may not have the correct information? Why are we asking someone that question. [00:28:24.010] - Kimberly Robinson In in our system, we have of places to enter that information, and at the time when a client comes on, it is the information populated in there. This is for, you know, after a month, three months, six months, that we would want it to go for Medicaid if they actually got Medicaid Act back. Some clients do. Some clients felt the SSI and FCI. We sometimes we get that information for our clients and sometimes we do not. So do we need to have. [00:28:58.830] - Marsha Martino Yeah, I just thought I would enter basic information. I assumed you'd have a look. [00:29:03.950] - Richard Zeidman I thought we eliminated that question in the last meeting. [00:29:09.450] - Kimberly Robinson I have it blacked out. [00:29:12.990] - Natalie Alden So why would we eliminate that question? I actually from from a working perspective for people with disabilities and thinking that they're going to be able to progress in order to be more integrated in community. I just think that that's something the case manager would want to know on whether or not that individual knows if they're receiving as the fire as a C.I.. You know, because I think that if we're looking at trying to hook that person up with the vision of vocational rehabilitation, we want to make sure that if they are receiving one or both of these entitlements, that they understand how work is going to impact that. And, you know, because it can better assess how they're going to move forward and how they're going to make a plan for themselves. Because I've met too many people that don't understand benefits enough that they go out and they end up getting like some little part time job that ends up hurting them more than helping them. But if they knew about work incentives, then they knew about what type of benefits they actually get. It's really empowering for a person with a disability. And I think that the more somebody knows about what they're getting and is actually able to get some kind of education on that, that that is going to help with moving them to be more independent, you know, and and maybe not everybody is going to be able to answer that question. But we also know that most people, when they first are injured, they may end up with SSI temporarily and that this society may end, you know, within five to six months and they may transition to On to a SSDI benefit. And so, you know, and they may know or may not know. And for somebody who doesn't know, I I honestly feel that the case manager couldn't help them pull their records to find out what's going on. And and if somebody maybe need help transitioning, maybe they don't have a family member who's helping them do their application for their SSDI Maybe the hospital helped them get on SSI so that they could get their Medicaid so that they could get paid, but nobody will help them with their SSD application. And so there you're going to end up with somebody being harmed, because once Social Security realizes, hey, you should been getting this other benefit, now they're in this big overpayment. Now they have to pay back all the money. And for somebody who's newly injured, these things can be very stressful. And we don't we don't want that to go on for a client who's their newly disabled. And now they're getting letters from Social Security saying, hey, we're terminating this or we're doing this or we're doing that. And they're freaking out. They're freaking out. And if if nobody is not, [00:32:16.390] - Marsha Martino I don't. And I don't this. I don't disagree at all that that's important information together. I just I mean, now it's a satisfaction survey. It's measuring progress. It's it's measuring cognition. It's measuring. I mean, it's just kind of like, oh, you know, what is this doing? I absolutely agree. That's important information to have. I guess I would have imagined that a case manager would gather that information in some way other than a satisfaction survey. But I mean, if we want this to kind of be gathering all kinds of information, that's it. That's essential information. And I have absolutely run across those situations where that is a nightmare for people. But, you know, is this the best place we're going to get this information is on some satisfaction survey. If it is, then let's go for it. But it just seemed kind of this is kind of like let's gather all this information for everybody, all kinds of it. You know, it just seems like it's a little over the place to me. But, you know, that's this is the way we have to get it then. Go for it. [00:33:21.080] - Natalie Alden Well, and I think if we're trying to make sure that if we're trying to make sure that we're getting as much information so that I mean, as far as for the council and this is just my perspective. My perspective is, you know, if we know the amount of people that are receiving these types of benefits and all of that, then that can help us with understanding what kind of training we may be able to, you know, put forward to say, hey, we think your case managers should be, you know, trained on X because we see that, you know, this is just a question popping up a lot. You know, it's one of those things is if, you know, if somebody is on as a SSDI, this is is the case manager ticking down for someone who is going to be on the program for a full two years, that that at the end of that two years, that person's going to start getting Medicare. Is the case manager gonna be able to help them choose a plan before they get off the program? So that the person actually doesn't go out into the community. And now they're switching from Medicaid to Medicare. And, you know, and they may not be eligible for certain things. We don't we don't want to set somebody up for failure. And we want to make sure that case managers, you know, understand, you know, the resources and the training and basic stuff that they would be able to assist these individuals with. That's just my perspective. [00:34:57.740] - Audience (Inaudible) [00:34:57.780] - Kimberly Robinson I'm sorry. Our case managers do help the clients with their Medicaid filing for Medicaid eligibility and they help them to the best they can with their SS, SSDI. They they do that currently for our clients that are in service, because when we discharge them, we want them to be set up to the best of our ability. [00:35:33.990] - Audience (Inaudible) [00:35:34.110] - Marsha Martino So if there are not a mechanism for it, there's not a mechanism for case managers to gather ongoing changes in in financial status or benefit status. And this is how we're going to gather that then. That makes sense. I guess I'd go back to what's the purpose of this survey? And if it's to update case management information, if it's to gather information, to know what training our staff needs, if it's being I mean, we're it's kind of becoming. And that's fine. If this is the one way we have to gather information periodically from clients, then that, of course, that makes sense. And one piece of it is satisfaction. But then maybe we need to think about what is all the information that we periodically need to gain. And maybe, you know, maybe this needs to have sections and be more extensive. You know, I don't know. But it's kind of like it's becoming. It's kind of taking on a life of its own. So. [00:36:37.970] - Natalie Alden Well, I know I'm looking at the questions in and, you know, being a quadriplegic. And having gone through this, you know, even though I never participated in the program itself, you know. In the early years with all this, if I would have had somebody who was assessing and in and helping me and me being able to go through these questions than me being able to say so is is my housing adequate for my needs? You know, somebody telling me, oh, hey, here, I placed you. But, you know, am I. Do I feel is there adequate? Maybe my case manager thinks their adequate. But but if I don't think they're adequate, then maybe that needs to be addressed. Maybe it needs to be. Why do I not feel like it's adequate, you know? You know, and if I see a question that says SSI or SSDI, I'm thinking about back about when I first was disabled. You know, I didn't even know what SSDI was when I was first disabled. I knew I got SSI, but if it said SSI or SSDI, I would be like, oh, well, what is SSDI? And if my case manager would have said, had I had one said, oh, well, this is what SSDI is, you know, and explained it to me, then I might be like, oh, well, hey, I might be eligible because I know my dad passed away a few years ago. So would I be eligible under that? You know, because I'm disabled and I'm under age 22. Then my case manager be like, well, why, yes, you might be eligible. Let's check into that. You know, I mean, I bet and I'm just kind of saying, you know, seeing these questions and feeling like, you know, when I was first disabled, you know, how could these questions help me be able to know what I should be asking? What should I be thinking? What what? Oh, we're all we're are all of the assessments. And so when I look at this satisfaction survey, you know, if if I'm looking at this in, there are anything where I'm where I have a a no, you know, and I need to actually be like, hey, no, I don't I don't have family or friends available if I need assistance, you know, I don't know what I'm going to do. If if you know, if you guys discharge me, you know, then I would think that that's going to be what we're wanting to know, because that's where we want make sure that that everything's being taken care of. And that's just my perspective is gone through, you know, that traumatic injury and, you know, not having a case manager, not having somebody there in my first year, you know, I remember, you know, at one point in time, you know, I mortgaged my house in order to pay for a power wheelchair that Medicaid wouldn't pay for. You know, I had I had a case manager at the time, guess what? I wouldn't have had to do that, but I didn't know any better because I was only 18. You know? So I think it's important for us to ask questions that it may seem like it's not sure why we want that. [00:40:14.370] - Kimberly Robinson So are you wanting to move forward with the questions on the survey that you're looking at here, this was the closure survey. The satisfaction closure survey. You want to take these questions and make this a different one? Maybe. Implement them into a measuring process progress survey. I mean, where you wanting to go with this? I understand, you know, you're you're talking about the fidelity of the questions and are they good questions, not good questions and and what's necessary to know? What's good to know? For the well-being of the client. So I'm just trying to figure out where you. [00:41:00.530] - Marsha Martino When to give it? Are you saying when this survey should be given? [00:41:08.050] - Kimberly Robinson Well, we had talked about this one being recommendations to make this two weeks, maybe one month, three months, six months. It was never it was just recommendations. [00:41:22.780] - Marsha Martino Oh, so after their closure. [00:41:25.930] - Kimberly Robinson Yeah, this would be. Well, we have a post closure, though, right after their closure. And then this would be a closure follow up at different intervals. [00:41:43.210] - Marsha Martino And. Correct me if I'm wrong, but if someone is closed out from the program and they end up having needs where they need to come back on the program. That is a possibility. [00:41:59.780] - Kimberly Robinson Yes, that's the post closure. That's a post closure. They can come back into the program and the program has funding limits on what I know, how much we can spend for a post closure, but they can come back in. If there's something that they need that we can provide, they can have their case reopened as post closure. So this would be a closure, then you have a post closure survey, your post closure survey? I, I would think is it. Let me go back and look at it here as I'm confusing myself. A one year post closure. So this is after one year. This is when we would do this survey. And then you have this other one that I just had up. This is a closure. That would be done two weeks after closure. Maybe three months, six months, and then you would have the one year. So maybe we need to combine the two closure surveys together, maybe that's where some of our confusion is coming in. I'm not sure. These are the notes from the last one, last meeting we had here. These were some of the notes I put in here. [00:43:24.640] - Richard Zeidman Kim clarify, please. The one that you've got up on the screen now, is this a survey that you're currently using, or is this one that's proposed. [00:43:36.190] - Kimberly Robinson Proposed [00:43:36.380] - Richard Zeidman Thank you. [00:43:36.710] - Kimberly Robinson Right now we aren't doing any surveys because they got put on hold to renew surveys. This was my understanding from previous administration that the surveys were put on hold because we we I say the council was going to be redoing the surveys. And so this is where they've come up again. That's my understanding of what's happened. I know right now we aren't doing any surveys. And in. I can't speak to anything other than what I know. [00:44:11.290] - Richard Zeidman Right now, we have the one year post closure survey, which I think is fine, as is. This particular survey. If we if we sent this out, like you say, period of time, one month, three months, six months after closure, I think this would be fine also. We really should come to. I hate to say, with just three of us here from the council. But, you know, we should come to a decision. I don't even know if we can without having a quorum, but [00:44:48.830] - Audience (Inaudible) [00:44:49.370] - Richard Zeidman survey that you better on the screen now is excellent, as is. And Natalie raised the point this week. Question number 10. Question number 10. Let's leave that. And there can be very important. And this, you know, so we've got we've got through the three surveys plus this. Let's do it, move on. [00:45:12.710] - Marsha Martino I would say the only thing I'd like to see added to this particular survey. Is a space somewhere on the back of the page? Doesn't matter where people can elaborate on their answers. Because if somebody were to you're just a comment section where they can add whichever number and they can elaborate on whatever they want, because if somebody does, you. Let's say doesn't feel their housing needs are adequate, you know, then they can put in the comments section. Why and what they feel would help them. You know. Because because I think that that that would probably be helpful if there's just. You just had at some kind of base to where they can understand, hey, please feel free to state why you. You know. Might have said no to something. You know, and if there's something you feel that would help you. You know. With with that with that particular question. [00:46:27.320] - Richard Zeidman Are you saying to to put it underneath each question or with each question? Or down at the bottom, just half a space for comments. [00:46:35.180] - Marsha Martino Well, know, and that really just depends. I mean, it might be easier if you put like a line or two underneath each question and just gave them the opportunity that if they wanted to comment on that question, I would think it would flow better. And they would understand, especially if you have brain injury, that you would be able to say it right underneath the question. So, like, if if no one is they mark no, that they'd be able to put an explanation why they mark. No. You know, and so we'll still get a yes or no, they can have a checkbox, yes or no. But then have a comment section because. You know, I would want to know I would want to know if somebody is telling me, no, they don't feel like they're for housing needs are met. You know, I would want to know why. I mean, if they're stating, oh, well, because my caregiver is abusing me, you know, I would want to know that, you know, [00:47:32.230] - Richard Zeidman I think that's a good addition. I like. [00:47:37.140] - Kimberly Robinson So what I'm doing, Marsha, I don't know that you can see my screen, but I'm in each block where the question is. [00:47:44.920] - Marsha Martino I'm in my own office now. I can see what you're doing so. Yeah. [00:47:49.890] - Kimberly Robinson I don't know if you like that or if you don't like the format that I can change the format to anything. I'm just throwing some suggestions out. I can do something like that or I can format it back to like these these survey questions. I can format them this way or I would [00:48:14.950] - Audience (Inaudible) [00:48:15.430] - Natalie Alden So, so like I do a lot of PDF documents and stuff. And so yeah. The question and you have to checkboxes and then you have the little syllable area where you can type in, you know, you know your little comments, you know, and you could just have it set up like that for each one. [00:48:33.700] - Kimberly Robinson Like the screen you're seeing now. [00:48:36.360] - Richard Zeidman With more space for the comments, maybe a couple [00:48:38.820] - Natalie Alden not not like, oh, yeah, yeah, not not like the one you have now, like the one you had in the other. [00:48:49.250] - Kimberly Robinson This one? [00:48:51.250] - Natalie Alden I still see the same one. [00:48:54.000] - Kimberly Robinson Oh, my screen hasn't repainted. That's my that's my glorious VPN Internet It's slow. [00:49:01.930] - Richard Zeidman The way you have this, number one now that you've reformatted it. I think that looks sufficient. Have that. That's even better right there. It gives them an opportunity to write in [00:49:12.050] - Natalie Alden Yeah. More like these ones. More like these ones that in in PDF. In the PDdF. Fillable format thing where you can actually put a text box where the comment is and make it a little bit big and let them be able to type right in it. The only problem I have with like the other ones right here that you have is that if you know, if somebody tries to type in there, they're...They're going to have a harder time being able to fit it in that area and and I just deal with a lot of forms that I create a lot of forms and stuff. So I just think the other formatting actually lends itself easier for somebody to fill out. [00:49:55.630] - Kimberly Robinson OK. I can do that. I'll change all of them to be the same. And so this particular survey you wanted to go out? Not two weeks. But this will be one month, three months, six months. How often do you would you like this survey to go out? [00:50:22.390] - Natalie Alden I actually think it should go out one month prior to closure. And then and then after closure. And I say that because of the fact that if somebody is already saying that their housing needs are inadequate. You know, prior to closure, then that means something needs to be done before they're closed. [00:50:53.860] - Kimberly Robinson So one month prior to closure. [00:50:59.660] - Audience (Inaudible) [00:50:59.810] - Marsha Martino is the three months, six months. Does that mean three months into services, six months into services? Is that what that means. [00:51:07.020] - Kimberly Robinson That is after closure. [00:51:09.990] - Marsha Martino OK, [00:51:10.970] - Kimberly Robinson three months after closure. [00:51:12.470] - Marsha Martino OK. [00:51:13.610] - Kimberly Robinson Six months after (inaudible). Do you want six months post closure? [00:51:29.030] - Natalie Alden Yes, I would say if you're doing it one month before closure, three months after and six months after, then when they do, they're here things. Then that works out. [00:51:42.040] - Marsha Martino Wouldn't it make more sense to put the questions that you think are important to know before the person is finished on a on the survey that's given during the time of services, rather than to have to figure out when someone's going to be closed and back up a month and give this this survey? Wouldn't it be better to have those questions asked during services? Well, we have one that they're doing during services and does it have the questions on it that Natalie thinks are important, the housing or I'm not sure what the other ones were but [00:52:23.480] - Natalie Alden Yeah I'd have to compare them side to side. [00:52:26.130] - Richard Zeidman No, I'm looking at now, they are not on there. [00:52:31.440] - Kimberly Robinson No,This what the inservice one, is communicating with your case, Manager method used. This is mostly about case management and were they involved with their services? Again, another case manager. A lot of that is about case management. But if you do this in service one with case management and then you have. This one that one month prior. If it comes down to question number 10, that would cue the case manager that the case is not ready for closure, especially this question right here. They are not ready for. They are not ready for closure. [00:53:26.950] - Natalie Alden That's what I'm thinking, that if they do this, you know, if the case managers thinking, oh, well, I'm going to be closing this person out in a month and they give this survey and they get anything on this survey that basically is, you know, oh, well, this that whatever. Then there are the case managers going to now. No, wait a minute. Maybe I shouldn't be closing this person. This person still is actually telling me I need blah blah blah. And then that would actually prevent the closure and the person would remain getting services for a little bit longer. And then again, when it's a month before the Kate vendors want to close that person out again, you give them this survey. And I and that's kind of why I said a month before closure. So so you could really ascertain whether or not the closure should happen. [00:54:16.970] - Marsha Martino And many people are on a case mangement. [00:54:21.080] - Kimberly Robinson The average caseload is about 40 clients. [00:54:25.090] - Marsha Martino So how (Inaudible). How did the case managers track when they're going to be giving these various surveys that we have? Do they keep a spreadsheet? [00:54:36.900] - Kimberly Robinson Well, that's we haven't come to that part yet. On how [00:54:40.980] - Marsha Martino Because I'm just thinking... I mean, when I've had case managers, they kept spreadsheets. How do you keep put on a spreadsheet? One month prior to closure. I mean, somebody is closure's coming up and it's like, oh, my God, you should have done that a month ago. I just like how do you put that on a spreadsheet when you have 40 people on your caseload? I'm just feeling like it might make more sense to have the questions that are important. Done periodically every three months or six months or whatever, rather than having someone have to figure that what they're going to do a month before somebody closes. I'm just thinking of the practicality of of doing these [00:55:22.190] - Natalie Alden that I can understand that Marsha and yeah, and maybe maybe maybe that's that's what we do is this we have this this one completed like, you know, every. Every three to six months after a person there, you know. And then maybe, you know, that's one of the things that the case manager could use to gauge whether somebody is ready for closure. I mean, if they do this, if they do this after six months and it's somebody who's really progressed great. And and somebody is like, yeah, hey, all of these things are great Look, you know, my housing needs are good. This is good. I'm with the ah blah blah blah. Then, if the person fills out this survey and says everything's great, you know, then, you know, maybe, maybe the case manager is going to be able to look at that and say, be like, you know, OK, yeah. Well then we're going to work toward closure in the next three months. [00:56:19.160] - Kimberly Robinson Let me ask you, do you like this instead of calling it a survey or even doing it as a survey? What if we called it a quarterly case review checklist that the case manager has to do one of these on each client quarterly until closure? [00:56:40.200] - Natalie Alden And that works as long as this is actually where the the biggest beneficiary, the client is the one that's answering the questions, and it's not something where the case manager is deciding, oh, well, yeah, I think their housing is long as is that the actual client who's who's doing it and the case manager is simply maybe assisting them or is, you know, just following up on any of the things that the client feels that that they need help with. [00:57:17.100] - Richard Zeidman I agree with that. [00:57:30.780] - Kimberly Robinson Well, and maybe we don't even call it a checklist. Maybe we call it the Quarterly Case Review Survey. [00:57:38.800] - Audience that would work. [00:57:41.470] - Richard Zeidman How about just the quarterly case review? [00:57:46.440] - Kimberly Robinson Well, I hesitate to use that because we have other things that we call quarterly case reviews that are done, and I don't want to get things intertwined and mixed up. So I would I would want to add survey or checklist or something to it to identify this is different from another quarterly case review that we do. [00:58:11.430] - Richard Zeidman Ok [00:58:11.430] - Kimberly Robinson And this is a survey that the case managers are not going to be sending out. Whoever does these surveys, they're the ones that are going to be sending. I anticipate these are the ones that are going to be sending this survey out. Not the case managers. Case managers need to be separate from this because I don't want them doing their own. [00:58:36.430] - Audience Right. [00:58:36.950] - Richard Zeidman To where on this form, where will it go to? If it doesn't go to the case managers [00:58:43.300] - Kimberly Robinson well, we might have to work on it. And where you want it to come back to, does it come back to the survey center? And then they scan it in to RIMS against the case and put it as a TTD to the case manager to let them know we can do that. A TTD in RIMS is what we call a things to do. It's a reminder to them there's something that they need to go do. So when the person sends out the survey. They can create a TDD to themselves that it's been sent out if we want to give a deadline on when to get it back. If we don't, that's OK. Once they get the survey back, they could create a TDD and assign it to the case manager and include the regional manager so that the regional manager knows a survey came back and they can attach it actually to the TDD, which will also attach to the client's record. And then that notifies the case manager. Hey, here's something that you need to look at. And it's going to clue them that they need to look at these questions because maybe the client's feeling there's something that's missing. And so before closure, these are the things that need to be addressed with that client. That's what I like that. [00:59:57.290] - Natalie Alden I like that because one that the clients kind of feel like, you know, hey, I can be open on this survey. You know, because my case manager is not standing right here. And two, because of the fact that it's going up to Rehm's and it's being put in there, then, you know, the case manager is going to end up getting the information. But they're also going to know that, you know, this is already been through the system. You know, this has already been, you know, uploaded and everything. So it'll be, you know, does I know that I've heard people say that, you know, they felt like they couldn't complain about their case manager because the case manager might do something. You know, there's that fear of retaliation. And so I think that this would be good because then, you know, especially if you're not going to if it's not a reprimand, you know, it's not like, oh, hey, you're doing a bad job. It's more of along the lines of, well, hey, this is the client's perspective. I go out and do reviews at, you know, nursing homes and ayliffe and group homes and such. And when we actually interview our beneficiaries, sometimes they'll tell us something. They'll be like, oh, yeah, I'd really like to have X or I don't like this. Or, you know, oh, man, they feed me too many beans, you know. And and then when we address it with the, you know, the person who's actually doing the care, they're like, man, they've never told me this before. I never knew. And and so sometimes people just feel more comfortable, you know, saying what's going on? To someone that they feel isn't the person in authority. [01:01:42.150] - Kimberly Robinson I agree. So I'm trying to I'm trying to update this as we talk a little bit. That's a typo there. Don't don't mind all my typos and stuff. Please look, look past them right now. [01:02:01.140] - Natalie Alden If you wanted to give it an even a more different name, you could say, Case, the quarterly case client survey. You guys put client in front of survey too. So client, you know, the quarterly case review. Client survey. If you're looking to make sure that you're really distinguishing it from the other things that you have to do. [01:02:23.210] - Kimberly Robinson I do want to distinguish it. That's an excellent suggestion. [01:02:30.610] - Marsha Martino Is this program monitored or accredited by any outside organization? I'm just curious if there are any standards that have to be followed or. You don't go [01:02:43.300] - Kimberly Robinson You mean like... [01:02:45.110] - Marsha Martino Like carf. [01:02:47.590] - Kimberly Robinson No. Not that I'm aware of, no. [01:02:54.570] - Marsha Martino And your funder, does your funder audit you or? [01:03:01.820] - Kimberly Robinson For the trust fun? the only audit that I'm aware of that the program has ever received for general program services is just a security audit. When we were survey when we manage the med waiver. Program Auca would audit records. [01:03:28.780] - Marsha Martino Well, what's interesting. [01:03:34.370] - Natalie Alden Well, that's why there's an advisory council and that's why, you know, we're working on these surveys and stuff to put certain things in there so that, you know, there is some kind of oversight. [01:03:47.630] - Teresa George Kimberly, we also have internal state auditors that other audit state financial records. [01:03:56.450] - Marsha Martino I was meaning more program content than. Clark spells out exactly what you have to do to, you know, what kind of survey I mean, it's you know, you have they tell you they're fairly prescriptive on what you have to measure and how often you have to measure it. [01:04:17.600] - Kimberly Robinson What we did, and we. We don't have anything like that. But what we did add this year to our staff, which, you know, was brought up in our. Advisory Council is we we do have a community health nurse who is a clinician who does audit. She does specific case reviews, she does random or if I need her to do a specific case review, I can request that if I have a case manager that I'm wanting her to look at her caseload to make sure that things are going along the way they're supposed to. She does those kind of audits and then reports back to me any deficiencies that she's seen where things are being missed in a case or oversight, you know. So we do have a clinician on staff now and she assists client or not clients. The case managers that they have questions about if a client truly eligible, she helps to make that determination, especially when we get those cases. It's kind of a gray area. She helps to make that determination because she has an extensive background with brain and spinal cord injuries and case reviews. And I wish I had her credentials right in front of me to tell you I could ramble them all off. She does catastrophic case management. She's been published. She's done expert witness for legal. For not only Iike workman's comp cases, but for traumatic injured clients. Testimonies, so we have her that is also reviewing cases to make sure that we're doing everything that we're supposed to be doing according to our statutes in our policies, which we never had anybody like that before. [01:06:21.290] - Richard Zeidman It's Ricky. I'm going to have to leave the meeting now, but thank you, for everything and let me see at the next one. [01:06:29.800] - Kimberly Robinson OK. I'm sorry, I have to [01:06:34.350] - Audience (Inaudible) [01:06:34.470] - Kimberly Robinson OK, so now I'll follow up on these surveys and put them together in a better format and rework them a little bit and then send them out before the next next meeting in July. And those those meetings have been posted. I think it's slide 10. I'd have to look again. [01:06:51.300] - Natalie Alden So so is our next meeting going to be the one where we can actually vote on these? [01:06:57.140] - Kimberly Robinson If if we have a quorum. And so if we don't have a quorum, we can't vote. [01:07:03.410] - Natalie Alden So you make sure we put that out at the when when you're putting the thing out there. But notice, I'm letting people know that it's really important that we try to get a quorum at that meeting. [01:07:14.490] - Kimberly Robinson Yep, I sure will. Thank you, Natalie. Thank you. All right. Have a great day. [01:07:23.450] - Natalie Alden You, too.