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Office of Public Information and Education
For additional information, please call (615) 532-6610 - Pager 1-800-283-0007 ID #7449

For Immediate Release
Wednesday, October 3, 2001

Response to Media Inquiry: State Outlines Community Safety Measures

Nashville, TN — The community-based services network is a vital part of the service delivery system for people with disabilities. "The basic premise of community-based services is to provide the services and supports necessary for an individual with mental retardation to become a part of his or her community," said Barbara Brent, Deputy Commissioner of the Division of Mental Retardation Services.

"We have been very pleased with the level of support that we’ve received from the Sundquist Administration and the legislature in providing rate increases to providers of community-based services in Tennessee, said Brent. Annual costs for individuals being served through the Home and community Based Waiver have increased, as have rate improvements for state and waiver funded services. The Governor requested and received funding from the legislature to give providers consistent rate increases, in FY 2000 (3%) and FY 2001 (3% waiver services, 5% state only services). For 2002 a 3.5% increase was funded for waiver services and a 2.3 % increase was funded for state services. Working in conjunction with families, advocates and others, The Division of Mental Retardation Services (DMRS) has implemented safety measures designed to reduce the incidence of abuse and neglect in the community. "We recognize that there are some potential dangers in the community or natural environment that would not be present in a more structured

environment that exists in a developmental center. For example, a person being injured in an automobile accident," said Brent. "However, we continue to work aggressively to put safety measures in place to ensure the well-being of those living in the community."

The Division of Mental Retardation Services and the Bureau of TennCare take instances of abuse and neglect very seriously, not just for class members (who are party to a class action lawsuit) whose cases were cited in a recent trend study but for all persons receiving services.

Brent continued by saying, "We have several pre-service and in-service training programs for staff and are exploring other ways to enhance the expertise of frontline staff." Additionally, DMRS and TennCare will work together to augment existing training, incident management systems and investigative processes to increase prevention efforts. "We must remain vigilant in preventing abuse, neglect and mistreatment, so that more people can live successfully in the community," she said.

In other action, the Division has already implemented various initiatives to help address the issue of abuse, neglect, and mistreatment. Many of these initiatives resulted from recommendations made by the Quality Review Panel following reviews of rates and trends in complete a "high-risk review" for people receiving services who are seriously or frequently inquired.

Measures Taken by the Division

Revised Policy and Training. In June 2000, the Division issued a revised policy for Incident Management and Abuse Investigations. A new and improved training curriculum for employees was issued at the same time as the policy. Additionally, the Division provided training in abuse and neglect prevention to provider agency managers and trainers in June 2001 using a newly developed curriculum. Plans are now underway to roll out the prevention training to community provider direct contact staff. A staff training video, titled "Don’t Leave Me Alone" was produced and distributed to provider agencies in February 2001 to educate staff concerning the need to maintain and provide needed supervision of class members.

Agency Supervision Plans. The Division required each community provider agency to evaluate supervision practices concerning direct contact staff and submit an updated supervision plan by September 1, 2000. Regional office staff will continue to monitor the quality and implementation of agency supervision plans.

Special Provider Agency Reviews. The Division, in conjunction with the Quality Review Panel, has conducted three special reviews (9/00, 3/01, 7/01) of agencies with high rates of substantiated abuse, neglect, and mistreatment.

Assessment of Supervisory/Management Practices. Through a contractual arrangement, the Division has begun assessing the supervisory capacity of a sample of provider agencies and evaluating the management practices concerning supervision of staff.

Training Concerning Supervisory Techniques. The Division has contracted with the Community Rehabilitation Agencies of Tennessee (CMRA) to provide training to provider and support coordination agency staff in supervisory techniques and strategies.

Discipline Guidelines for Provider Agency Staff. The Division issued an Information Bulletin in January 2001 to community provider agencies requiring that agencies implement specific employee discipline guidelines by April 1, 2001. The purpose of this initiative is to assist agencies in taking fair and consistent disciplinary actions with staff concerning substantiated reports of abuse, neglect, and mistreatment.

Statewide Incident Management Database. The incident management database is now operational and refinements continue to be made to this system. The overall aim with the database is to provide accurate and current information throughout the service system for the agencies and the Division to use in protection from harm efforts.

Restructuring of the Investigations Unit. In May 2001, the Division strengthened the management of the Division’s investigations unit through the recent addition and hiring of a new central office position, Director of Protection from Harm.

High-Risk Reviews. The new incident management policy effective in June 2001 now requires agencies (with the participation of the Independent Support Coordinator) to complete a "high-risk review" for class members who are seriously or frequently injured.

Other Policy Clarification.. Community providers must perform criminal background checks on direct care staff.

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