218 R.I. Code R. 218-RICR-40-00-5.7

Current through December 3, 2024

Section 218-RICR-40-00-5.7 - Data Management and Continuous Quality Improvement

5.7.1 Collecting and Managing Data

A. The agency must have an information system to collect, analyze, report consumer data, indicators, reports and improvement plans. This information system must be compatible with the Division's client database so that the Division can generate reports directly or via written requests to the agency.

B. The agency must collect measurable indicators identified by the Division:

1. Indicators will be in the following categories: service use, consumer characteristics, unmet needs, gaps, service duplications; and

2. Specific data elements will be specified in the service contract.

C. The agency must gather information in standardized format supplied by the Division and report at intervals specified by the Division.

D. The agency must maintain consumer records that include at least the following:

1. Assessments, care plans, reevaluations, consultations, discharge plans;

2. Release of confidential information documents;

3. Copies of legal documents, such as power of attorney and advance directives;

4. Fees and arrangements for reimbursement and payment; and

5. Identification of and authorization for third party payers.

E. The agency must comply with all current Divisional policies and procedures and with all current state and federal laws and regulations related to confidential consumer information and records.

F. The agency must provide the Division with all evaluation/quality assurance data specified in the contract in the specified format, including but not limited to:

1. Consumer demographics;

2. Units of services provided;

3. Cost data;

4. A sample of care plans for expert review;

5. Information needed to conduct a Division consumer satisfaction survey.

5.7.2Program Evaluation and Quality Improvement

A. The agency must develop and utilize a self-evaluation and continuous improvement system with a statement of program goals and objectives.

B. The agency must revise its program based on the outcome of self-evaluation.

C. The agency should review established program goals, performance compared to goals, measures in place to address areas of concern, and recommendations based on data collected.

D. The agency's continuous quality improvement system should address scope of services, cost effectiveness, evaluation findings, recommendations, timetable for implementing change, identification of individuals and agencies involved in plan.

E. Quality Improvement policy and procedures must address the core services provided by the agency and include:

1. Care process improvement strategies;

2. Degree of coordination with other systems, coordination of plans; and

3. An evaluation of the agency's organizational capacity;

218 R.I. Code R. 218-RICR-40-00-5.7