Assistive Technology Assessment and Flow Chart

Kit Piltingsrud, Program Coordinator and Assistive Technology Professional, Living Well Disability Services

The DHS Olmstead Plan outlines several key goals that must be accomplished to ensure people with disabilities are living, learning, working, and enjoying life in the most integrated setting possible. One strategy outlined within the plan to achieve person-centered planning goals is to incorporate assistive technology assessments into person-centered planning processes. Learn more about the Olmstead Plan

With new assistive technology devices becoming available all the time, and as needs of individuals change, staff should assess assistive technology needs annually to ensure individuals are given the opportunity to perform as independently as possible.

To help us facilitate this objective, we created the following flow chart and assessment form to guide staff through the assessment process, and to determine the best course of action moving forward.

The documents referenced below are approved by Living Well Disability Services to be copied and modified for use by other organizations and individuals.

A flow chart to investigate how and when to use assistive technology


Visit the Technology Resource Center to learn more

 

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Measuring for Success

A provider’s guide to technology program measurement and valuation

Sandy Henry, Technology Advocate and former community residential services provider

With newly implemented technology support strategies, it is important to measure the success, not only for persons-served and staff, but the financial success as well. To get a full look at the impact technology supports have had on an organization, providers should consider several key factors when assessing the financial output and associated benefits of the plan in place to determine cost effectiveness.

Calculating Costs

Providers should identify and calculate:

  • Any changes in revenue or income
    • Including rate changes and/or new revenue related to technology use
  • All direct cost reductions
    • Reduced employee wages, reduced overtime, avoided cost of recruiting and training new employees, if turnover reduced or staff hours reduced, etc.
  • Indirect costs or savings
    • Management and administration time saved due to reduced turnover and/or reduce staff hours and total number of employees
    • Management and administration time saved with access to better, more timely information that informs managers on activities and needs, and/or reduced time spent on investigations
  • Provider out of pocket cost
    • Cost to rent, purchase, and install equipment, tech vendor support costs, etc.
    • Costs associated with maintaining equipment such as batteries or staff time

 

The calculation of these numbers gives a surface look at cost effectiveness.

It is important to consider the financial impact the addition of technology supports has had on occupancy.  Items such as enabling a provider to continue to serve individuals they otherwise would not be able to, the ability to accept someone with needs not previously able to be served by the organization, and new individuals attracted by the technology enhanced services should also be weighed during calculations.

Calculating time saved of management by having the ability to check on information remotely is also an important factor to consider along with the other benefits realized in the areas that follow.  

Additional Benefits Realized

Workforce – aside from direct reduction of on-site staff hours

  • When individuals served are able to do more things for themselves independently without staff assistance, staff time can be focused on other priority needs and tasks. For example, staff may be alerted if/when someone needs intervention versus continually checking to see if needed.  Even if staff continues on-site, when individuals use technology to change the TV channel, take medications, get up on time in the morning, etc., staff may have more time for administrative and documentation tasks, and relationships between staff and individuals usually improve.
  • Technology offers the potential to document actual occurrences, verifying when staff have done their job or completed tasks, even if something bad were to occur. This may reduce stress and pressure on staff and managers.
  • Managers’ ability to more quickly identify when tasks aren’t being done or to identify when procedures are not followed enables managers to address and correct issues before something bad happens, and to pinpoint training and needed improvement.

Reduction & Investigation of Errors, Omission, Suspected Maltreatment

  • Data from some technology can provide early information about delayed or missed cares and activity of staff, allowing managers to intervene sooner – before there is a pattern of errors and/or a negative outcome or harm.
  • Technology may be used to provide reminders and prompts to busy staff on scheduled cares, such as medications or repositioning, before a care is actually missed.
  • When there is a report of maltreatment, data gathered by technology (e.g., staff movement, individuals served movement/actions, etc.) can help identify whether expected actions by staff were followed or not. This may be used to supplement staff documentation and reporting.

Organizational Growth Opportunity

The ability to add technology that helps staff know where to be and when to be there can enable a provider to serve some individuals they otherwise couldn’t or would have been reluctant to.  Behaviors like elopement, going into other’s rooms, and fall risks are easier to support with technology that keeps staff informed of activity without having to be constantly physically present.  This assists with occupancy by preventing demission when a person’s needs increase and by increasing the number and types of individuals considered for admission.

The use of technology can open opportunity for new types of services and greater flexibility in a provider’s ability to successfully meet individuals’ needs.  Supporting people in their own apartments is a growing area of service that may be added by a provider with little capital investment.  Enabling lower need individuals to move into more independent services opens group settings to admit individuals with higher needs.

The use of technology in support plans is not new, but it is changing the landscape of  the care industry.

There are many benefits realized by providers through the implementation of technology,  and weighing the benefits/costs of these supports into existing offerings has the potential to allow providers to continue providing care in the future as staffing shortages increase.


Learn more about Measurement or to learn the entire process of how to implement technology into care plans, visit the ARRM Technology Resource Center.

Alternate Overnight Supervision – what it is and how to get it

Anna MacIntyre and Deb Amman
Minnesota Department of Human Services

What it is

Legislation, introduced in 2009, made it possible to use monitoring technology in Adult Foster Care (AFC) and Community Residential (CRS) settings in place of on-site overnight staff during normal (overnight) sleep hours.

A proven way to increase both independence and privacy of the person served, this newer monitoring practice is called Alternate Overnight Supervision and can be utilized following a formal assessment of the individual and once informed consent has been given by the person served. Along with obtaining an AOST (Alternate Overnight Supervision Technology) License, defined policies and procedures must be in place.

The person served should:

  • Be reasonably independent and have the ability to request assistance or direction.  
  • Be able to have their needs met within a reasonable timeframe for health and safety by using the least intrusive technology option.

How to get it

Once the technology has been found to match the needs of the individual, the AOST License can be applied for. DHS Licensing provides an AOST Licensing Checklist which identifies all licensing requirements.

Following the submission, barring any open investigations relating to supervision, the Licensing Consultant will review the file within 60 days. If any deficiencies are found within the application, the applicant will have 45 days to correct.

Read the full article on what AOST is (and isn’t) and further explanation on how to obtain and maintain AOST Licensing >

Anna MacIntyre is the policy lead for the Minnesota Department of Human Services, Disability Services Division. She can be reached at anna.macintyre (at) state.mn.us

Deb Amman is a licensing consultant  with the Minnesota Department of Human Services, Office of Inspector General Licensing Division. She can be reached deborah.g.amman (at) state.mn.us

Funding 101 – Disability Waiver Rate System

Download Funding 101 – PDF Handout

Key Points

    • There are numerous funding streams that providers and service recipients can use to support
      technology use.
    • Minnesota has one of the strongest models for funding the use of technology.
    • Providers, technology suppliers, and individuals should work together to determine the right mixture
      of services and funding supports.
    • Remote support for residential services under the Disability Waiver Rate System is recognized as a
      form of supervision on the 6790 and rolled into the service provider daily rate.
    • 24-hour emergency assistance, paid to a service provider, and environmental accessibility adaptations,
      paid to the technology vendor, are available for people living in their own home.
    • Funding for technology is also available under the CDCS waiver and some items through State Plan
      services.

FundingDiagram

*Monitoring technology: 3 supervision/support options. 1) Awake on-site staff 2) Sleep on-site staff 3) Remote monitoring supervision

 

Download Funding 101 – PDF Handout, or visit the Technology Resource Center and learn more about Funding.

Asking the right questions

Utilizing assessment tools to help identify goals and begin conversations surrounding technology.

Assessments for remote monitoring—and technology in general—help teams ask the right questions to identify goals and outcomes technology may assist with. Most technology service vendors and many service providers have their own assessment process to help fine tune outcomes and recommend specific tool options. The following basic questions are a good place to start the conversation:

  1. What is/are the thing(s) the person wants to do with less caregiver intervention?
    Do they want to live in their own home with less staff; be in their own room without staff checking in all the time; get to work; take medications; choose and make their own food; etc.
  2. What are the risks/vulnerabilities if the person did this without or with reduced caregiver intervention?
    What would the caregiver need to know to be comfortable NOT being physically present?
  3. What prompts, tools, or support would the person need to help him/her manage this without having a caregiver physically present all the time?
    Identify only what you want the tool to do at this point; not the technology solution. For example, prompt to take meds, if hasn’t done so; prompt if not out of bed by 7:00 and notify caregiver if not out by 7:30; identify possible falls; prompt or turn off stove, if left unattended.

Assessment templates are included in the Technology Resource Library as examples. The Ohio Remote Monitoring Assessment and Instructions was developed and has been used in Ohio to help teams consider and discuss when remote supervision for a person or group might be appropriate and what the needs are. The Hammer Residences’ Person Centered Technology Support Addendum is used to consider assistive technology on a broader scale. Ohio and Hammer Residences’, Inc. have given their permission for others to use and adapt these tools to meet individual needs.

Visit the Resource Library to review additional tools that may be used to help begin the conversation.