• Serve as consultant & trainer to developmental disability provider organizations (ANCOR, DSN, PPAT, IARF, INARF, NAQ, NYSACRA, APDDA) on variety of topics, including assistance in developing quality enhancement plans & plans of corrections, active treatment, inter-disciplinary team process, QMRP training.
  
• Consult with public & private agencies to review CMS requirements & overcome immediate jeopardy citations.
  
• Joint venture with Pennhurst for Assessment/Technical Assistance – State Division of Developmental Disabilities for review of nine Illinois Developmental Centers (2006 – present).
  
• Provide review, analysis & training to State providers including Nebraska (Beatrice Developmental Center), Washington (Fircrest School), Montana (Montana Developmental Center), Kentucky (Oakwood, Hazelwood), Virginia (Central Virginia Training Center) Wyoming (Wyoming Resource Life Center), Texas (DADS) & Oklahoma (DDSD), California (Harbor & Westside Regional Centers) on Active Treatment, Risk Management, ICF/MR compliance & certification assistance.
  
• Provide Expert Consultant support services to states under review by the United States Department of Justice (Illinois for Howe Developmental Services & Virginia for Central Virginia Training Center)
• Provide jointly agreed upon expert monitoring to U.S. Department of Justice & Attorney General of State of Washington for system review, community placement & risk management analysis at Rainer.
  
• Provide Monitoring Services on Behalf of the North Dakota Department of Human Services for a private provider.
  
• Provide litigation support including review of case records regarding personal injury, alleged abuse, neglect & wrongful death cases; analysis of licensing & certification files, deficiencies & complaints for facilities; interdisciplinary team meeting notes & individual service plans & records of emergency incidents to assess quality of care & compliance with ICF/MR regulations.
  
• Served as expert to Disability Rights Center of Maine, a Protection & Advocacy agency, for review of Individual Service Plans in community settings for AMHI trial.
  Testified at trial as expert.
  
• Design & delivery of mock surveys to assist providers in understanding regulations, survey process & improving quality enhancement efforts.
  
• Design & delivery of abuse & neglect training, including overview of national prevention system.
  
• Design & delivery of Think Like a Surveyor training incorporating how to read & understand Federal regulations, including QMRP requirements, Individual Program Plans & active treatment.
  
• Design & facilitate Active Treatment Symposium for improving residential services.
  
• Provide training to national Protection & Advocacy network on abuse & neglect, investigations & understanding ICF/MR regulations.
  
• Consultant to Quality Trust in Washington D.C. on informed consent/guardianship.
  
• Deliver training programs to private providers throughout the United States, including Connecticut (Ability Beyond Disability), Florida (Florida Mentor), California (Mentor Network) & Florida (Mentor Network).
  
• Develop publications in association with ANCOR including “Positive Outcomes: A Providers’ Guide to Active Treatment”, “The Surveyors Are Coming – Now What”, “ICF/MR Assessments: From Admission to Discharge – What is Expected”, & State Medicaid Fact Sheets for all 50 states.
  
• Develop training modules for providers based on Abuse & Neglect Prevention CMS May 2001 surveyor training.
  Offered through www.hwisoltuions.com.

• Organized Forum-Abuse & Neglect Prevention Initiative. Organized workgroup to identify what could be done within the Federal authority to bring national attention to the issue of abuse & neglect comprised of advocates, Federal & State agencies, & providers. Resulted in design of the Seven Key Components to Prevent Abuse & Neglect & changes in Federal training & guidelines.
• Assisted with redesign of the CMS Appendix Q – Guidelines for Determining Immediate Jeopardy.
• Assisted staff designing the Regulations for the Psychiatric Residential Treatment Centers (AKA Psych under 21). Guided through understanding for legislation governing rule, assisted in designing an implementation plan & reviewed & provided input on guidelines & survey procedures.
• Active in CMS input into Legislation pertaining to new restraint & seclusion requirements. Assisted in meetings regarding definitions, discussions on intent of rule & design of work plan to meet September 2001 deadline for publication of regulations to meet requirements of The Children's Health Act of 2000.
• Liaison & consultant to the United States Department of Health & Human Services, Office of Inspector General as they researched & wrote reports on States & Abuse Investigation. Provided orientation to OIG Inspectors at two-day meeting & ongoing guidance in understanding CMS rules & requirements. Resulting OIG reports included "Reporting Abuse of People with Disabilities."
• Assisted CMS staff in developing the rules & requirements relative to Centers for Medicare & Medicaid Services’ abuse, neglect & restraint rules. Included presentations at national meetings.

• Lead the implementation of Joint/Partnership surveys to increase Federal oversight & regulations enforcement for ICF/MR program, without increase in staff resources.
• Regulation Revisions meetings - Facilitated meetings for CMS staff, providers, consumers & advocates to solicit input as the ICF/MR regulations were reviewed for updating.
• Listening Sessions - Regulators, providers, State & Federal agency staff & consumers were brought together over a series of Listening Sessions to discuss needed improvements in services for person with disabilities. Served as presenter & facilitator. Topics included:
  • Quality of Life for Persons Living in Long Term Care & Persons with Disabilities
  • Developing Community Services for People with Disabilities
  • Services for People with Mental Health & Developmental Disabilities (dual diagnosis)
• Established Crosscutting Developmental Disabilities Workgroup to increase overall communication & coordination efforts among Central & Regional CMS staff who served people with developmental disabilities regardless of the program setting. Included Waiver & ICF/MR staff.
• Coordinated ICF/MR services with Department of Justice, Civil Rights of Institutionalized Persons Act (CRIPA)

• Provided training, consultation & guidance to staff concerning intent & implementation of Accreditation Council (ACD) Standards, State & ICF/MR regulations. AUSS was successful in attaining Accreditation with ACD, now the Council on Quality & Leadership.
• Assisted with continuous quality improvement design & implementation. Supported long-range & short-term planning process. Managed, directed, & supervised staff; including records retention & quality enhancement staff.
• Provided professional supervision to more than thirty Qualified Mental Retardation Professionals (QMRP). Direct staff supervision of quality assurance & records department.
• Provided support for admissions, assessment, habilitation planning, active treatment, & community integration.
• Served as staff advisor to self-advocate organization. Provided support for trips into community.
• Coordinated programmatic activities, including professional support for habilitation efforts. Designed & provided training on various topics including outcome survey process, normalization, community services & community integration.
• Worked with nursing staff to address regulatory requirements including self-assessment of medications, dietary needs, medical issues & active treatment for people with medical issues.

• Directed the planning & implementation of Accreditation Surveys throughout the country.
• Assisted in writing & publication of Accreditation standards of care.
• Conducted training for new surveyors.
• Coordinated review project at 7 institutions in Texas as part of Lelz lawsuit requirements.
• Evaluated agencies to determine if in compliance with standards of care. Wrote final survey reports.
• Composed, edited & approved reports for use by the Council Board of Directors.

• Developed funding proposals & budgets, short & long-range plans.
• Extensive public speaking & technical assistance on local, national & international levels.
• Led the redesign & national expansion of TAPS from seven to thirteen sites.
• Coordinated program design of a series of job seeking & job keeping workshops for consumers.
• Established international committee - employment needs of people with epilepsy. First Chairperson.
• Executive management of entire staff from recruiting through evaluations.
• Piloted project for employment services to people with multiple disability issues.

• Aging & People with Disabilities
• Home & Community-Based Waiver Services for People with Disabilities
• Active Treatment for People who are Medically Fragile
• Functional Analysis of Behavior
• Detecting Systemic Issues of Abuse & Neglect
• Advance Directives, Informed Consent Issues
• Self-Administration of Drugs
• Working With People with Challenging Behaviors - Review of Restrictive Procedures

• Person Centered Planning: Similarities & Differences between Person-Centered Planning & ICF/MR Active Treatment
• Aging & People with Developmental Disabilities: Overview of Health, Safety, Medical & Planning
• Issues for an Aging Population of Individuals with Developmental Disabilities.
• Interviewing People with Developmental Disabilities: Review of Techniques for Communicating with People who do not Speak.

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