Florida Statewide Quality Assurance Program Individual Interview Instrument

This information is provided by Delmarva to emphasize areas all providers should be going over with their clients. Questions are asked of the client by Delmarva reviewers. Take time periodically to ensure your clients and YOU understand and/or are aware of their supports and services, their rights and responsibilities, their goal progress, how they are involved in the community, their dreams, preferences, areas of concern, their health, how they make decisions and choices, the goal-making process, emergency procedures, new experiences and learning, etc.

The Individual Interview Instrument (III) is designed to capture information regarding supports and services from the perspective of the individual receiving those supports and services. With this instrument reviewers will gather information regarding person centered supports that result in opportunities for individuals to communicate desired outcomes and to achieve those communicated outcomes. The provider's supports and services should be effectively implemented in accordance with the person's unique needs, expressed preferences, and decisions concerning his/her life in the community. The instrument is to be used as an initial step in determining the impact of those efforts on the person's life.

Aspects of the HCBS Quality Framework Quality Focus Areas captured in the III include Participant-Centered Service Planning and Delivery (Focus Area II), Provider Capacity and Capabilities (Focus Area III), Participant Safeguards (Focus Area IV), Participant Rights and Responsibilities (Focus Area V) and Participant Outcomes and Satisfaction (Focus Area VI). The consultant will determine if each numbered Element of Accomplishment/ Attainment (1-12) is present for each person interviewed.

Examples of Probing Questions are identified for each numbered Element of Accomplishment/Attainment and are potential questions to be asked by the QAR to assist in making determinations. These may vary from interview to interview depending on the needs and communication style of the person being interviewed and the consultant's interview techniques. The QAR will give examples to assist the individual in understanding the questions asked.

ELEMENTS OF ACCOMPLISHMENT/ATTAINMENT AND EXAMPLES OF PROBING QUESTIONS

PARTICIPANT-CENTERED SERVICE PLANNING AND DELIVERY

The person is afforded choice of services and supports.

Can you change your services/provider if you want?

How did you decide what services you needed or who would provide the services?

What choices were you given? (services and provider)

Did you interview prospective providers?

The Person actively participates in decisions concerning his or her life.

Who makes choices in your life? (daily routine, work, activities, health, legal, daily activities)

Do you choose the foods you eat?

Did you choose where you live, work, and recreate?

Did you have options for where you live, work, and recreate?

Does anyone help you with decisions?

The Person directs the design of services and participates in the identification of needed skills and strategies to accomplish desired goals.

Do you know what a support plan is?

Were you involved in your support plan meeting?

What goals are on your plan?

Who chose your goals?

Were you involved in your IP meeting?

Who decided how you should work on your goals?

Do you feel that your team listens to you?

The Person participates in routine review of services, and directs changes desired to assure outcomes/ goals are met.

Does anyone talk to you about your progress on your plan/goals?

Who evaluates your plan?

Who can make changes to your plan/goals?

How are changes made to your implementation plan?

Is there anything about your supports and/or goals that you would like to change?

PROVIDER CAPACITY AND CAPABILITIES

The person has the necessary supports in place to meet needs and goals.

Does staff support you the way you want?

Are there any supports you feel you are not getting?

How does staff support you in reaching your goals?

Do you feel staff knows you, your needs, dreams, and preferences?

Does staff learn about any new needs, dreams or preferences you might have?

PARTICIPANT SAFEGUARDS

The Person is free from abuse, neglect and exploitation.

(Reviewer to give examples of each: abuse, neglect, and exploitation.)

Do you know what abuse means?

Neglect? Exploitation?

What would you do if someone tried to hurt you or treated you badly?

Who could you talk to about this?

Do you know about the abuse hotline?

The Person is safe or has self-preservation skills.

What does being safe mean to you?

Do you feel safe at home, work/day program and in your neighborhood?

Is there anywhere you don't feel safe?

What would you do in case of an emergency at home? In the community? At work?

What would you do in the event of a fire? A hurricane? A tornado? A car accident? Who would help you?

The Person is healthy.

How do you feel?

Do you feel healthy?

Are there things about your health you wish were better?

Do you see doctors when you need to?

Does anything hurt?

PARTICIPANT RIGHTS AND RESPONSIBILITIES

The Person is educated and assisted by supports and services to learn about rights and to fully exercise rights, but especially those that matter most to the person. This includes dignity, respect, and privacy.

Who talks to you about your rights?

What right is most important to you?

Is there anything you want to do that you are not allowed to do?

Do you feel respected?

What does privacy mean to you?

Where do you go when you would like to be by yourself (while at home and work)?

Has there ever been a time when someone has shared your personal information without your permission?

If you feel someone is violating your rights, what do you do?

PARTICIPANT OUTCOMES AND SATISFACTION

The person is achieving desired outcomes/goals or receiving supports that demonstrate progress toward specified outcomes/goals (e.g. an increase in abilities, experiences, choices, increments toward success).

Are you making any progress on your goals?

What can you do now that you could not do before?

What achievements have you had in the past years?

Is there something you are proud of that you have done this past year?

The person is satisfied with the supports and services received.

Have you been asking for something you haven't received?

What do you like most about your services?

What do you like least about your services?

Does anyone ever ask you if you are satisfied with your supports and services?

If you are unsatisfied, have any changes been made to help? Or who can you talk to about it?

The person is developing desired community roles that are of value to the person.

Do you belong to a club or organization, YMCA, synagogue, church, Kiwanis or other groups you are interested in?

Are you a member of any groups? For example church.

Has anyone told you about or showed you different groups to join?

Would you like to volunteer or join a group or a club?

Do you get to choose which group you belong to? Is it enough for you?