While completing a “First page review” aka Therap training- the age old question was asked: “Why can’t we see what is happening at home for someone I support at work?” Provider Admin and access is a tricky beast! It requires a delicate balance that all providers must juggle. It has sparked many a discussion within the “four” walls at NHTC! I heard a rumor that Therap is in the midst of some finesses to the Provider Admin Access(or a complete overhaul);: which is exciting but still begs the conversation that floats in my mind.
How much is too much and when is less too little?
Let’s take for instance my friend Dan.
Dan receives supports from BlueGrounds Agency .
- He lives in a group home with 9 other people. He has 12 different DSP‘S who support him when he is home.
- BlueGrounds also help him with all his medical appointments, that is usually Jenny from the nursing department. Sometimes his service coordinator helps him to get to his dentist, eye doctor and psychologist, her name is Dana.
- During the day Dan splits his week. Monday- Wednesday he goes into the community with an agency job coach, they contract with a local construction company. He has 2 different support staff help him with work. The remaining days he spends in a dayhab room working on rec leisure things, Ryan is his favorite staff.
- He also has expressed some interest in becoming a radio announcer, so the agency vocational director goes with him quarterly to visit local radio stations.
Dan’s goal is to get a good paying job and attend all the Bluegrass opportunities he can find.
At a quick glance Dan has 18 different people who help him in getting to his goal in life, seems manageable. Now toss in the number of people by each of those “programs” – Add 8 more for medical and 15 for dayhab staff for a GRAND TOTAL of 41 support staff in Dan’s life. Now the fun begins of who has what access to what information?
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One could argue that all support staff have access to his health history- his diabetes crosses into all areas of his life. SO ACCESS TO ALL.
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Then there is the support staff implement at home to help Dan make sure he wears clean underwear each morning. How can one argue the importance of the vocational director knowing this information? SO ACCESS TO HOME ONLY.
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Job coach supports him in entering his paycheck into his checkbook ledger each, one could argue it is benign enough information, right? SO ACCESS TO ALL.
The list can go on and on.
So I wonder, how are others determining access? Are there any strong feelings one side or the other? IF it were you receiving supports who would you want to know what?
Cheryl,
I think that this is a very important discussion and one not to be taken lightly. Thanks very much for posting this.
Allison.
I wonder about a need to know status,much like they use in hospitals. One super role could be determined as the gate keeper for an individual and everyone else could go thru that person to either get access to records or be limited to just an answer to a specific question? HIPPA,AHCA,& Delmarva are not going to be happy no matter what solution is arrived at.
Supports are not currently being shared/viewed from agency to agency in Delaware; however, we are working on creating super roles so residential agencies will be the primary holder of the ISP Plans and supports and Day programs will have a super role within the agency so they can put there information into the IPOP’s. The day program will have view access to the ISP Plan, GER’s and edit rights for the IDF so that they can enter there supports into the day program IPOP. This will essentially bring all information into one place. DDDS State staff can view across agencies. Agencies are still reluctant to share all T-logs across the board, but the privileges can be set so they don’t have access in that area. It is our hopes that instead of the individual supports being held by agencies and information lost when moved from one agency to another, that the persons information follows the person. So, instead of agency support, it would be based on individual supports. This would ensure pertinent information and supports are not lost between moves. We have our first set up coming next week. Hopefully, this will go with no hitch. I’ll keep you posted. In my opinion, no matter who the holder of the record the information belongs to the individual. The agency is being paid to provide a service. The individual chooses who will provide there supports. So, all of there information should follow them. This would prevent loss of knowledge and supports which could be vital to successfully supporting the person. That’s just my 2 cents.