DODD oversees a statewide system of support and services for over 100,000 Ohio residents with developmental disabilities. The actual programs and services are delivered by county boards of developmental disabilities within each of the state’s 88 counties. Because the counties deliver services to people in need, each of them had developed unique business processes and service delivery systems tailored to the needs of their local community. This resulted in widely varying processes, procedures, and providers across counties.
In addition, individual service plans (ISPs) developed for citizens in need were paper-based, often contained conflicting information, or required a multi-step approval process. Size was also an issue.
“The paper-based plans were getting so huge some of them were hundreds of pages,” said DODD CIO Bryant Young. “We wanted to make the entire process electronic, which could reduce the use of paper, improve accuracy, and help encourage collaboration across the teams, which in many cases includes the individual, guardian, case financial manager, Human Rights and Behavior Support Committees, providers and more.”
Several years ago, DODD and 18 county partners referred to as the “county collaborative” embarked on a “person-centered” business transformation process. DODD invited national experts to help them design and develop a new person-centered process for delivering services to people with developmental disabilities in the state.
Considering their desire to fulfill both initiatives, DODD decided to combine their efforts and build a technology-based, person-centered system they dubbed imagine.
“Previously, all 88 counties had their own system for managing cases and ISPs,” said Young. “Some of them may have used the same vendor, but they were running different versions of a system. Our goal was to help them share resources and to develop and provide a free toolset that would help them save money and become more efficient.”
To meet their goal, DODD began evaluating options for a technology-based system that could eventually be rolled out across all 88 counties. They considered in-house development, proprietary solutions, and COTS based solutions, but ultimately opted for Microsoft Dynamics CRM. Deciding factors included ease of customization; time to market; out of the box functionality that addressed usability and privacy concerns; and the ability to interact with legacy data stores. As part of their evaluation process, DODD and imagine project stakeholders also reviewed New York’s Health and Human Services developmental disabilities CRM implementation.
Ohio kicked off the project by asking county staff to manually pilot the person-centered approach using centers of excellence to train staff and collect feedback. The feedback was shared with DODD program and IT staff. DODD IT then analyzed alternatives to support the business transformation through electronic means. After fully reviewing the business case, DODD decided on a multi-faceted approach.
First, they used Microsoft Dynamics CRM as the core platform to support the county boards. The CRM allowed DODD to rapidly develop a configurable yet customized application to support the individual roles in county boards. Administrators, directors, finance managers, and budget support specialists can interact with the application through configurable dashboards that surface alerts and notifications to assist in workflow management. Next, a parallel Web portal was developed to support individuals, families, guardians and providers. DODD was able to link legacy application data to both the CRM and the portal through the use of real-time and batch integration processes.
Young said it took DODD eight months to build the system, which was funded by the department as well as by Medicaid. Overall, imagine helps individuals with developmental disabilities and their families/guardians create and coordinate service plans for skills development and achievement of individual life goals utilizing person-centered principals. Using imagine, an individual (either a person new to the program or someone that needs to revise his or her service plan) enters their demographic information and then works though a guided planning processes that captures information in eight key life areas. Along the way, the system helps the individual articulate needs and goals, such as “learn to cook.” The individual can also customize their page by uploading pictures and entering information about themselves, their likes and dislikes.
The information entered is then shared across the individual’s team of providers, and the team uses the information to develop the ISP. The system is currently in the pilot phase.
“The biggest benefit we’re seeing is the collaboration between the providers,” said Young. “They can all see the plan, they can talk to each other, and they can work together. It allows them to get a full view of that individual person and how best to serve him or her. They’ve never had that before.”
Imagine provides complete information about each individual’s ISP, including agreement and approval, goals, services, providers, funding sources and progress. It also provides an easy method for tracking agreement and approval of the ISP. In addition, imagine keeps all team members informed of outstanding tasks and key changes and replaces manual processes for tracking and calculating local services, budgeting, funding sources, and approval of services.
The imagine application was recently recognized by Microsoft at the annual Convergence 2014 gathering in Atlanta. A few other states, including Pennsylvania and Tennessee, are reportedly looking into similar systems.
Young said from a business perspective, users are very excited about the imagine system. The excitement stems from the focus on person-centered planning and the ability to quickly implement the process. But the true reward comes in seeing the difference person-centered processes have on the individuals the state serves.
“For providers, the system implementation means efforts will become less focused on a ‘prescription’ of service and more focused on what is important to the individual,” he said. “The person-centered processes will improve the life of Ohioans with disabilities and provide them with a voice on how they choose supports, interact with others, and live their life.”
