MSC Performance Reports Description
OPWDD has created this page in order to share information about the performance of providers of services. As a first step, we are beginning to share the results of reviews of Medicaid Service Coordination. The report will provide information about how well an agency meets OPWDD’s regulations and also how an agency meets quality standards for service coordination. Each category will have an overall grade in the form of a star and under each star rating will be a listing of the items measured and the percentage at which the service met the regulatory or quality requirement.
The report will be divided into the following categories:
This category will report on whether the Medicaid Service Coordination vendor has systems in place to ensure the quality of services being provided. This section does not address regulatory requirements. It measures whether the MSC agency has established the following:
- Hiring systems to ensure service coordinators are qualified for the position
- A mechanism to establish and communicate standards of practice to ensure quality services
- A mechanism to provide training, supervision and monitoring to ensure service coordinators are providing quality services
- A mechanism to obtain information from stakeholders about their satisfaction and concerns and to respond to the information obtained
- A system to monitor and prevent conflicts of interest
Qualified Provider: This category will report on two (2) areas:
- Service coordinators have education, experience and training required by OPWDD.
- Service coordinators are competent at providing informed choices to individuals, person-centered planning, and assessment of the person’s needs for services.
Choice: This category will report on three (3) areas:
- The individual record of persons who receive service coordination contains a completed and signed form that indicates that the person freely chose waiver services instead of placement in an intermediate care facility.
- Based on interview of individuals and service coordinators, the individual was given the information needed to make an informed choice.
- Based on interview of individuals and review of individuals’ records, the person is supported in making choices in his/her daily life.
Rights: This category will report on two (2) areas:
- The individual has been informed about his/her rights and the process to object to a limitation or denial of rights.
- The MSC ensures that individuals are afforded their rights and live free from abuse and neglect.
Service Planning: This category will report on four (4) areas:
- There is a current ISP that meets OPWDD’s requirements
- The individual and persons of his/her choice are involved in the development of the ISP
- The ISP contains accurate information about the person’s safeguarding needs, health care needs, and fire safety needs.
- The ISP contains accurate information about the person’s valued outcomes, the Natural Supports and Community Resources available to the person and the services the person needs.
Responsiveness of the Service Coordinator: This category will report on three (3) areas:
- The individual, and advocate if applicable, can reach the service coordinator whenever needed
- The ISP is revised timely in response to a significant change in the individual’s life or a needed change in services
- The MSC meets with the individual when/if needed at the location of the individual’s choosing.
Advocacy and Monitoring: This category will report on three (3) areas:
- The MSC ensures that any allegations of abuse involving the person were investigated and that the individual is protected.
- The MSC ensures that the individual is receiving safeguarding and health services identified in the ISP.
- The individual’s natural supports are being maintained and/or increased.
Satisfaction with Service Coordination: This category will report on one (1) areas
- The individual is satisfied with his/her service coordinator and with the services and supports he/she is receiving.
Each category will have an overall rating in the form of stars. Stars are determined as follows:
|VENDOR RATINGS||ALL OTHER RATINGS|
• 100% = Five stars
• 96 to 100%: Five stars
• 80% = Four stars
• 91 to 95%: Four stars
• 60% = Three stars
• 86 to 90%: Three stars
• 40% = Two stars
• 81 to 85%: Two stars
• 20% = One star
• 75 to 80%: One star
• Below 75%: No star