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Wisconsin Support for Culture Change

Survey Agency

The state survey agency, the Wisconsin Department of Health Services, Division of Quality Assurance (DQA) has formally promoted culture change and person-directed care since 2005. Key members of the DQA are active members of the Wisconsin Coalition for Person-Directed Care which was founded in 2005. These same staff regularly attend meetings, and serve on the Coalition's Board of Directors, Steering Committee and provide ongoing consultation to the Coalitions' Education Committee.

In 2005, the DQA developed and distributed a memo to all nursing homes in support of the Coalition. The DQA held its annual educational conference for both providers and surveyors. The conference planning committee includes nursing home providers, DQA staff as well as a representative from the State Ombudsman Program. The keynote speaker and two breakout sessions were dedicated to culture change and person-directed care. Even though Thomas Hamilton and Karen Schoeneman of CMS were unable to speak in-person at the annual conference, they provided a prerecorded presentation that was played at the conference that articulated CMS' position regarding culture change. Well over 500 participants attended the conference, including all long-term care surveyors. The DQA new employee education program was updated to incorporate the principles of culture change and person-directed care and emphasize how the OBRA regulations are being actualized by this effort.

In 2006, the DQA held its annual educational conference for providers and surveyors. Thomas Hamilton of CMS provided opening remarks on the culture change movement The keynote speaker and 9 of 27 sessions were dedicated to culture change and person-directed care. Numerous organizations that promote culture change and person-directed care exhibited at the conference including: Action Pact, Inc., BEAM, Inc, (Bringing the Eden Alternative to the Midwest), SAGE (Society for the Advancement of Gerontological Environments) and two nursing homes that have successfully implemented culture change.

In 2007, the DQA revised its state nursing home regulations to eliminate rules that were outdated, overly prescriptive and were viewed as barriers to the culture change movement. The draft rule was discussed and input was provided during a meeting of the WI Coalition for Person-Directed Care. The DQA held its annual conference for providers and surveyors. The keynote speaker and 8 of 27 sessions were dedicated to culture change and person-directed care. Attendance exceeded 600 participants to include providers and all long-term care surveyors. The Coalition also piloted a presentation titled "Changing the Way We Care" that was delivered to 5 different nursing homes within one region of the state. Representatives from the Coalition and DQA delivered these presentations from the provider and regulatory perspectives.

In 2008, the DQA held its annual conference for providers and surveyors and 5 of the 27 sessions were related to culture change. Attendance exceeded 750 participants including providers and all long-term care surveyors. Numerous organizations that promote culture change and person-directed care exhibited at the conference.

In 2009, the WI Coalition for Person Directed Care delivered via DQA webcast equipment, a series of three presentations on Consistent Assignment from the perspective of provider management, facility staff and the consumer. Opening remarks for the first webcast were provided by the DQA Division Administrator. These webcasts are available for viewing through the WI Coalition for Person Directed Care's website located at http://www.wisconsinpdc.org/ The Discussion Forum of the Coalition website was paid for with State CMP funds. Planning continues for DQAs annual conference to be held October 22, 2009. Carmen Bowman will be delivering two breakout sessions on activity programming in nursing homes. Members of the Coalition will deliver a breakout session on culture change from the perspective of providers, family and regulators.