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OIB Live Forum - Monitoring Contracts

We have three experts joining us today. They are Sylvia Stinson-Perez, Kendra Farrow, and Stephanie Jensen. Here is a snapshot of their experience.

Sylvia Stinson-Perez is the new director of the OIB-TAC. She has been in the field of vision impairment and blindness for almost 20 years, including working as the Executive Director of the Lighthouse for the Visually Impaired and Blind (Port Richey, Florida) for 10 years (2008-2018). She has a Masters degree in Social Work, M.Ed in Visual Disabilities, and an MBA. She is also a Certified Vision Rehab Therapist. She has worked in direct service, program management, and administration. Sylvia is also visually impaired.

Kendra Farrow is a certified vision rehabilitation therapist. After completing her degree at Western Michigan, she worked for 14 years in direct service. In 2014 she joined the team at the National Research and training center (NRTC) on blindness and low vision at Mississippi State University. In this role, Kendra designs and conducts training activities, develops plain language summaries for the web site, is an integral member of the older blind technical assistance and training team, and leads several older blind program evaluation projects. Kendra’s personal experiences in working with a multi-disciplinary model have convinced her of the importance of providing quantifiable evidence for the results of services provided to individuals who are blind or vision impaired. She strives to promote best practice, contribute to the literature, and validate tools that will benefit direct service staff and their consumers.

Stephanie Jensen is the OIB program manager from Wyoming. As a state that contracts their Older Blind Independent living services she has been involved in contracting and contract monitoring for the past several years. Stephanie will be our moderator for today’s live forum.

Comments

Bill Tomlin's picture

In our recent survey of OIB programs, we found that 11 states contract all of their OIB services. In addition, 15 states contract some part of their OIB services. What have you found to be the advantages and challenges to contracting services?
Mark Armstrong's picture

As Senior Adult Program Specialist at HKNC, I provide training and workshops in all states. I am wondering, for those who contract all services, are all areas of the state covered? What happens when there are no bids from a contractor in a given area of the state?
Bill Tomlin's picture

Does anyone have any experience with this?
Stephanie Jensen's picture

Wyoming requires that our contractor provide services statewide, but they haven't been able to do it very well. We are working to brainstorm ways to improve this. I have seen a state at one point that didn't get any bids from an area in the state. I think that changed several years later.
Mark Armstrong's picture

Stephanie, I am wondering what technology options are available in your areas? If using technology to reach out to a client in a remote area, is this something that your state would allow? Then again, do the clients have technologies they can use - FaceTime, Skype, or Zoom for example? For some types of training, using telecommunications equipment may be an option for your provider to increase contacts within the state.
Stephanie Jensen's picture

It can be allowed depending on what our contractor has. They have used various platforms for calls with their specialists. The biggest issue is the internet access in the rural and frontier areas, although it is getting better. There is always the old fashioned phone call.
Erin Cates's picture

Hello Mark, here in Arkansas, we have one contractor who is centrally located geographically and covers the entire state. This causes problems because both the rural and outside areas of the state end up receiving less than stellar service, due to time and monetary constraints. Would love to hear how some other states are addressing this issue.
Sylvia Perez's picture

Coverage of large rural areas is a challenge, however, working to have contractors spread across the area is critical. Of course, this can often be a challenge due to the shortage of professionals in the field. I know some are utilizing remote training, such as phone calls for support groups, Hadley courses, and remote assistive technology training. However, it is still important to have a face-to-face initial assessment, and some skills, such as O&M cannot be taught remotely.
Erin Cates's picture

One of the most recurring challenges that we have faced is a disconnect or communication failure between us, as the state agency, and our contractor.
Sylvia Perez's picture

Hi Erin, nice to see you on here. As a previous contractor to the state, communication was a challenge. It is especially challenging when all parties are extremely busy with big caseloads and spread across a large geographic region. One of the strategies we realized would help both the state and the private contractor was to hold "case management" meetings, and to make it easier we alternated between conference calls and on-site visits. When we started this, communication improved greatly.
Mark Armstrong's picture

Erin, as you said, this can be a challenge. I am wondering, if you hold monthly or quarterly meetings between the different entities? This may be beneficial if it is not currently one of your procedures. Perhaps in-person meetings or through technologies such as Adobe Connect or Zoom.
Stephanie Jensen's picture

Our contractor likes it when we come on site. It helps to see how they are doing things. One of the questions that I ask is "How can we help?" Another state contracts with several contractors. They have quarterly calls with their contractors. Because of the "How can we help?" question, I started to join their calls and invited my contractor to their calls.
Sylvia Perez's picture

As I just said, communication is critical for effective contracting and ensuring people get the services needed. Communication helps ensure that everyone has adequate information to help a consumer reach their goals. In addition, an added benefit of regular communication is the positive working relationship that is built between the contractor and state. We always invited our state to participate in activities where consumers were present, which enabled them to get a direct look at the services provided and outcomes being achieved.
Bill Tomlin's picture

What do you think some of the benefits of contracting services would be to a state that is considering moving to this type of system?
Stephanie Jensen's picture

From the way that I understand Wyoming's history, we contract because we weren't able to get the FTE's.
Sylvia Perez's picture

I worked in the private non-profit arena for many years prior to joining the OIB-TAC team. The organizations I worked at had contracts to provide a variety of services, including older blind services. If the state considers the Community Rehab Provider a partner, much more can be accomplished--as the team working on behalf of clients and awareness of blindness/visual impairment are maximized. Some of the benefits I believe our state and our consumers received are the following: * Clients received more services as the agency matched the funds for services, with most CRP's providing anywhere from 25% to 75% of the cost of services * ability to recruit professionals * ability to provide greater outreach services and greater awareness in the community * ability to build more collaborations in the community for extended services, such as to manage secondary disabilities, health issues, and to assist with job placement * ability to access funding for additional adis and devices I am sure others can add to this list.
Kendra Farrow's picture

One benefit we have observed in states that contract parts of their services, is that they can fill in gaps. For instance, there may be an O&M position that is vacant, and a contractor can fill-in until a new service provider is hired. Another state has used a contractor to train peer leaders for support groups.
Mark Armstrong's picture

To me, the benefit of contracting services allows for a reduction in the number of direct staff needed to operate the program. Budget-wise, this may be an advantage. However, the disadvantage would be to ensure quality services are being provided appropriately and consistently by the contractor.
Adele Crudden's picture

When people are very busy, as most service providers are, it is easy to let communication lapse. Regularly scheduled contact is helpful in forcing people to make the time to share both successes and concerns.
Stephanie Jensen's picture

I have learned to make a point to ask the contractor if the quarterly reporting template is workable. If I don't, they won't say anything until after a report is due. Sometimes, I have no idea that the reporting template isn't workable.
Sylvia Perez's picture

Stephanie, you have done a great job to build a collaborative partnership with your sub-contractor. It all goes back to mutual respect for the overall responsibilities and skills of the individual parties and organizations, to communication, and to regular check-backs to determine what is working and what can be improved. And, realizing at the end of the day it is all about helping people who are blind and visually impaired get the best services in what is often a very resource constrained environment.
Bill Tomlin's picture

What are some of the common elements included in a contract to include the statement of work?
Sylvia Perez's picture

It is essential that both the state and the CRP/contractor understand the expectations. Therefore, having a clear statement of work is critical. However, it is also important to ensure that the statement of work or expectations are realistic and provide the professionals delivering the services the freedom to utilize their professional knowledge and skills. For example, stating a consumer must receive a prescribed number of hours of services does not allow for individualized planning, assessment and training. One consumer might need 3 hours and another 30 hours. In addition, how a service is provided specifically is not a prescribed area that should be included in the scope of work. One consumer might need one-on-one training, while another benefits from group training. However, every statement of work should include how the programs will be monitored, how outcomes will be measured and monitored, and the types of services to be provided (i.e. O&M, ADL, AT, adjustment to blindness counseling, etc.). These should be discussed and "negotiated" by both parties to ensure realistic.
Stephanie Jensen's picture

We reference the statute and regulations in the statement of work. These include the types of services to be provided and eligibility. We also include reporting requirements, number of consumers to be served, and a success rate.
Bill Tomlin's picture

When looking at different contract development programs the following things tend to be common in developing a statement of work. i. Project objectives ii. Project Scope iii. Deliverables iv. Tasks to support the deliverables, who will complete these tasks v. Timeline for completion of work vi. How payment will be conducted vii. Expected outcomes viii. Certain terms, conditions, and requirements Having an appropriate statement of work both protects the State and the Contractor. This also gives you the framework to conduct a monitoring program.
Mark Armstrong's picture

Have any of the contracts included team meeting expectations/requirements?
Stephanie Jensen's picture

We don't have a team meeting requirement in our contract. Another state has several contractors. They have quarterly conference calls, but I don't know if it is required by contract.
Sylvia Perez's picture

Mark opens the question of monitoring. How do you monitor to ensure individuals are receiving the services needed and that the services are high quality. In addition, how do you do this while not making it seem like you are looking for problems. This is why communication again is critical. Contractors need to know what they are expected to do, or the scope of work required. They need to know what forms, documentation, and services are to be provided and by whom. For example, if the state expects O&M services to be provided by a certified O&M specialist, this needs to be documented. If a certain level of case documentation is required, this needs to be known to all parties. Regular visits, not just "monitoring" visits need to occur, in order to build a positive working relationship and to discuss any challenges observed to achieving contract outcomes.
Bill Tomlin's picture

Our time is expired, so we are ending the formal part of the “Live” Forum. We will keep an eye on this thread and answer any questions or comments that appear. Remember that you don’t have to be present during a “Live” event - we look at the forum on a routine basis and answer comments as they come in. We encourage you to do the same, or to post questions/comments that you would want to share with your peers. Please fill out the survey that will be emailed to each of you in the next few days.
Mark Armstrong's picture

Thanks for the great forum time today! In many states, contractors play a major role in providing rehabilitation services which makes this topic such a valid one.