Tuesday, December 30, 2014

Blame The QIDP

"The QIDP is responsible for everything."   You have likely heard that phrase spoken by administrators, owners, staff, surveyors, and you may have even spoken it yourself from time-to-time.  It is the quick out and the quick way to blame someone for all the problems.   In most cases, if you questioned the statement, you were quickly pointed to the federal standards and tag number W159, or as some know it, "The QIDP Tag!"  W159 is taken to mean that everything happening at the facility is the responsibility of the QIDP.  While each state is different in interpretations, and in some cases each surveyor is different in interpretations, most would agree that W159 focuses most of the blame squarely on the QIDP.  If we take the meaning at exactly the way it has been expressed then we can conclude that the QIDP is responsible for the following things:
1.  Billing
2.  What the physician does or does not do.
3.  What the nurse does or does not do.
4.  Data input to the state.
5.  Renewing the license for the facility.
6.  Setting up all the diets.
7.  Doing all the psychological
8.  Prescribing psychotropics as needed.
9.  Training staff on everything- OSHA, CPR, etc.
10. etc.

You may be looking at the list and thinking to yourself, "It's impossible for the QIDP to be responsible for all that stuff.  The QIDP doesn't even do our billing!"  You would be right in your assumption, it is impossible for the QIDP to be responsible for all that stuff.  In fact, there is a good chance that the use of W159 should not be the foundation to say the QIDP is responsible for everything, but instead it should be the foundation to say, "The QIDP should coordinate everything."  In other words, you can not be responsible for all those items listed above and you simply can not be "responsible for everything."  If that statement, used so often, that says, "The QIDP is responsible for everything," was true, then you'd have no need for most of the other federal tags.  Why would you need a dietician?  The QIDP can do it!  Why would you need someone in billing?  The QIDP can do it!  Why would you need an Administrator?  The QIDP can do it!  The fact is saying the QIDP is responsible for everything is simply wrong.  It's wrong to place this burden on a QIDP and it's wrong to express this saying.  However, QIDP's reading this, do not think you'll get off the hook that easily.

The fact is, as stated before, the correct expression should be, "The QIDP should coordinate everything".  A closer look at what W159 says will clearly show that the position of the QIDP is not to be responsible for everything, but instead it is to coordinate everything.  

W159 says "Each client's active treatment program must be integrated, coordinated, and monitored by a qualified intellectual disabilities professional."  That is the entire standard, and if you look closely you will notice the words "responsible for everything" can not be found.  In fact, the more appropriate wording that says the QIDP should ensure the program for each individual is "integrated, coordinated, and monitored" comes to light.  More simply put, the QIDP should "coordinate" everything related to the client's programming needs (and those can be many as you know!).  

As you know, W159 continues with questions and guidelines for the surveyor.  Without going into too much more detail, it is easy to read and see that the QIDP's function really centers on coordinating all the services for the people served, or the client.  That responsibility will require a lot of knowledge about what is going on with the person, what is happening around the person, and even the day-to-day basic functions of the home where the person lives.....it will not, however, mean that the QIDP is responsible for everything.  Should the QIDP have a working knowledge of everything that is going on?  Yes.  Should the QIDP be responsible to do everything?  No.  

The function of the QIDP is to coordinate and ensure that services meet the needs of the individual served or the client.  So, blaming the QIDP for everything based on W159 or any other assessment of the facility is simply wrong.   The QIDP should do his or her job and coordinate, but others in the facility program must do their jobs as well.  If you find you are in a facility where problems are constant, do not simply assume the QIDP is responsible.  Look at your administrative structure and deal with the appropriate person(s) for the problem.  Let's take a little time to stop blaming the QIDP for everything and start addressing the area of need.

No comments:

Post a Comment