In response to requests from members, NJACP will begin publishing responses to member inquiries that are occasionally distributed to the membership. Questions range from regulatory to human resources topics. Member questions and member responses do not identify the agency. In addition, responses are published as they are received by NJACP. Thank you to those agencies responding, as NJACP appreciates the time members take to send information and does not endorse any of the responses. We hope this information is helpful. Please see the question below and the responses.

For FY23 is your agency passing the Full  increase of $1.25 per hour to DSP’s or is it deducting the applicable payroll taxes (FICA, NJ-SUI/SDI, Workers’ Comp. Insurance Premium, etc.) from the $1.25?

·        We gave the staff a $1.25 hr increase.

·        Part of the increase will be applied to taxes.

·        We passed along the $1.25 increase per employee in pre-tax dollars.

·        Most likely we would pass the full increase off to the DSP and absorb the cost of the fringe benefits similar to past increases, however it is largely depended on our financial status at that time.

·        We were able to push out the entire $1.25 to our staff with Midland absorbing the applicable payroll taxes. Furthermore, we will be facilitating an additional .50 cent per hour increase in July, 2022.

·        We did an increase of $1/hour last October and added the $1.25 in January minus the applicable taxes. We plan on deducted the taxes again this year.

·        We are passing along the $1.00 and keeping $.25 for pr taxes.

·        Full amount passed to the employee

·        (agency) has previously deducted the applicable payroll taxes. I anticipate will continue to do the same for FY23.

·        (agency) will reduce by the applicable payroll taxes.

·        We have always given the full $1.25 wage increase and will continue to do so..

·        (agency) will most likely deduct administrative fees which usually increases the DSP wage an additional $1.16 instead of $1.25. This is what we did for the last increase.

·        We deduct these fees from the 1.25.

·        For the last two years we did deduct employer taxes from the $1.25 increase and passed on to the employees the difference.

·        We passed the entire amount on to the employees.

Are agencies receiving requests for exemption (medical/religious) from receiving the booster shot from vaccinated employees?  If so-will the agency expect the boosted-exempt employee to test weekly?  Will they expect the boosted-exempt employee to mask like the exempt from vaccine employee?

·        Yes we are receiving exemptions, and if granted, they are then required to test weekly and wear a mask.

·        Yes.  We have staff who have requested medical and religious exemptions from the booster.  Those staff are not required to test weekly.  Only staff who are not fully vaccinated (1 shot J & J/ 2 shots Pfizer/Moderna) must test.  Boosted exempt employees are required to mask.

·        We do expect/require weekly testing as well as mask wearing from employees with an exemption.

·        We have received employees requesting the exemption for religious purposes.  We have advised the employees that they will need to test weekly.  If they miss and do not provide the test within the prescribed period, they are suspended until the information comes.  These employees do not need to mask, otherwise, all employees will know that these employees do not have their shots.  Any employee can and should wear a mask if they feel like they want to.  It is expected that employees respect the people who wear a mask and those that do not.

·        Are agencies receiving requests for exemption (medical/religious) from receiving the booster shot from vaccinated employees?  Yes

If so-will the agency expects the boosted-exempt employee to test weekly?  Yes

Will they expect the boosted-exempt employee to mask like the exempt from vaccine employee?

  

·        Yes. We have received exemption request from vaccinated employees who do not want to get the booster, and yes, they are required to test similar to exempted unvaccinated employees.

·        We currently are requiring bi-weekly testing for any staff who are not up to date with their vaccinations. All staff, regardless of their vaccination status, are required to wear a face mask while in the program.

·        We received one medical exemption for the booster which we accepted and the staff instead needs to test weekly.  We accepted some religious exemptions early on, but not for the booster.

·        Yes, we have received requests for medical/religious exemption from the booster shot. The non-boosted person is required to test weekly along with unvaccinated staff.

·        Yes, employees who have had adverse reactions to the initial series have had medical professionals sign off on medical exemptions to boosters.

·        Yes, any employee that is not up to date with vaccinations need test.

·        Yes, any employee that is not up to date with vaccinations need mask.

·        We are receiving exemption requests from staff based on religious and medical reasons.

·        We do expect the exempted staff person to test weekly.

·        We do expect the exempted staff person to mask up if they are not fully boosted.

·        We did receive one request for exemption from the booster.  We are requiring the exempt employee to test weekly/ twice weekly, depending on the transmission rate.  All of our staff continue to wear masks in our programs.

· Non-boosted exempt still need to test at least weekly for COVID-19 at (agency).  While in the orange zone we are testing 2x a week.  Will return to 1x a week when we go back to yellow.

·        Yes, (agency) has received multiple requests for a medical and religious exemption from receiving the booster shot from already fully vaccinated employees.   Those employees are expected to get tested twice a week (currently due to CALI high readings in NJ regions) if they did not get their booster after 5 months from their 2nd dose.  They must follow the same provisions as the unvaccinated employees with the weekly testing and wearing a well-fitted mask.  They are required to complete our request form for the exemption and it must be approved by the HR Director.

·        We have not had any exemption requests from the booster.  However, had we received an exemption request, the plan was to then request testing twice weekly, as required of our unvaccinated staff that were granted exemptions.

·        Yes, we have employees with primary vaccination and exemptions from the booster.  We understood the EO to require us to treat them as unvaccinated once eligible for a booster and becoming exempt.  Our Policy requires them to test and mask.

·        Yes to all 3 questions

·        As far as I am aware we have 1 employee who had a negative reaction after her second shot that requested exemption from the booster and given the medical reason it is granted. Have not received any others.

·        We have ten (10) staff who have religious exemptions from the Covid vaccine.

·        We have seven (7) staff who received their first 2 vaccines but are declining the booster shot.

·        These staff are required to test on a weekly basis and are expected to mask.

·        We are allowing medical exemptions but not religious. Yes, then the employees who are exempt will have to follow the policies of those who are not considered “fully” vaccinated.

What specific quality measures does your agency use?  For example, do you use the number of UIRs that are submitted, by falls, by missed medications, etc.  Any information will be appreciated.

·        For individuals we generally measure quality across three domains: Individual safety, which is really about incident rates for specific types of incidents; Individual quality of life, which measures progress towards goals and specific indicators of quality of life; and Clinical effectiveness, which measures reduction in challenging behaviors and increase in replacement behaviors, as well as reductions in the use of restrictions or level 3 BSPs.

·        To the question below…we collect data on the items below for our quality management plan, we also look at what is trending nationally for IDD providers which is why we always look at restraints despite it being an incident category that rarely occurs. Same for choking.

–          Use of restraints

–          Choking incidents

–          Falls that result in hospitalization

–          Repeated episode of individual to individual abuse

–          Psychiatric hospitalization

–          # of people served competitively employed

–          # of people served actively involved in civic opportunities/advisory boards

–          Consumer satisfaction survey ratings (this year we are rolling this out with AbleLink software that is meant for folks with cognitive differences so that we can hopefully get more responses to gauge folks satisfaction with our services)

·        For any of the problematic ones above,  we have a plan of correction that is implemented any time those incidents occur.  As a result, the data looks good for all of those incident categories.

·        For the employment and advisory boards- we have a goal to increase these and track data to see each year if we are improving in these areas.

·        We track many quality measures.  Some include: number and types UIRs, number and types of client/family complaints and grievances, quality of notes written by staff, quality of services delivered to our clients, etc.  Many of the things we track are as per DDD and CARF.

·        We do also track all UIRs that are state reportable and those that do not rise to this level for each program we operate.  We look at key ones like med errors (both admin & doc errors), 911 calls, and other more critical types of incidents.

·        We track satisfaction among service recipients, their families/guardians and our staff.

·        We track all maintenance requests for each location and the time to complete the repair or improvement.

·        We track volunteer hours provided at each location and to/with specific service recipients.

·        And many other things, but these are just a few examples across different areas of the agency.

·        Work goes very deep in each program and she tailors the benchmarks to specific needs in that program and among their staff or areas identified to track/address across the agency.

·        Here at (agency) we have agency benchmarks which are tracked via the Program Quality Improvement (PQI) process.  As the Compliance Officer I aggregate the data documentation via the Foothold Technology AWARDS program for all programs and service types into excel worksheets and then with the use of some excel formulas, I am able to identify benchmark scores.

·        I created a separate excel workbook that I reference as I start the review with each program having a separate worksheet with coded algorithms that auto selects the individuals from each program that is to pulled into a report.  This is to ensure there are no biases and complete randomization when reviewing a percentage of notes for each program each month.

·        I develop quarter reports that are shared with all programs.  I meet with each program supervisor to go over the details of the reports, and at times, based on results, share best practice tips or additional training. Each program has a PQI indicator which is another name for program goal.  The indicator is identified based on overall benchmark performance, overall quality of programming, or if there is a special project that needs to get up off the ground.  During these meetings I also review data entered by their staff to ensure the agency is continuously providing education and administrative support with Medicaid compliance to continue to bill honestly and accurately.

·        Additionally this data is shared with the board both in quarterly highlight reports as well as the annual reporting.

Here are the benchmarks:

Residential and Day services

Benchmark #1:   Data documentation it entered within 24 hours of services provided.

Benchmark #2:   Notes are reviewed and approved within 3 days of services provided

Benchmark #3:   Notes are billing ready within 10 days of services provided.

Support Coordination Services

Benchmark #1: Submit completed 8-10 monthly monitoring tools (MT) per week.

Benchmark #2:  Submit MT documentation to the SCS within 7 business days of the contact event

Benchmark #3: Once approved by SCS, MT documentation will be entered in iRecord and the billing system (AWARDS) within 10 days of the event.