Work being done at the Kansas Neurological Institute to redefine the way services are provided to persons with developmental disabilities has been strongly endorsed by the federal agency charged with surveying the facility and certifying program requirements for clients are being met.

The Health Care Financing Administration (HCFA), a division of the U.S. Department of Health and Human Services, works with the Kansas Department of Health and Environment to survey Intermediate Care Facilities for persons with Mental Retardation (ICFs/MR) such as KNI. In a letter to SRS Deputy Secretary Janet Schalansky, a top official with HCFA's four-state regional office in Kansas City, Mo. said he would like to formalize a partnership the three agencies have developed to improve the federal certification and inspection process at KNI and use it as a nationwide model for similar institutions.

The staff have already joined in a somewhat informal, yet unique partnership effort over a year ago, driven by a unified desire to demonstrate improvement to the traditional models of ICFs/MR programs at KNI," said Wayne Smith, acting associate regional administrator with HCFA. That effort has supported KNI's move to the newer paradigm of a 'person centered support model,'" Smith said. This has achieved impressive and innovative outcomes, reflected in improved lives for persons living and working at KNI."

SRS Secretary Rochelle Chronister echoed the federal official's praise of changes that have taken place at KNI. Chronister recently attended a celebration of the 'team concept' approach to services now being taken at KNI.

It is apparent the employees at KNI have moved away from just working to meet regulations to truly providing for people," Chronister said.

It was a complete change in management style, combined with the implementation of the 'person-centered' approach to working with persons with developmental disabilities, that brought change to KNI, said Robert Day, KNI superintendent. The management change began about four years ago with the advent of the team approach.

We were tired of managing the way we were," he said. We had a 'command and control' style of management. We were always upset with staff and staff were always upset with us. We wanted to do something different."

A number of employee teams were created to examine everything about how they provided service. The teams set goals and create their own process for reaching those goals. One important aim of the teams was to find ways to empower the persons working directly with clients to make decisions, Day said.

We moved away from the professionally-driven model, the 'we know what's best model' to 'we know how to honor persons and create an environment that's best for learning,'" Day said.

Day said the team concept has been incredibly successful.

We've been visited by every state in the midwest and from different regions," he said.

Some tangible effects of both the 'person-centered' approach to working with KNI clients and the changing management style can be seen in the stores and streets of Topeka. People who live at KNI now can be seen doing their own grocery shopping in local grocery stores or just hanging out in coffee shops. Also, most cooking at KNI has moved from a central kitchen and is being done in people's homes within the institution.

They have more real life experiences, more meaningful experiences," Day said. People are living in the community and no longer living protected lives."

Day said they want to work with HCFA to change the surveying method from one inspection and sanction to an encouragement of innovation and improvement." In the past, HCFA surveys often have felt to

employees like police action," and the staff would be terrified because failure to pass a survey can result in the loss of federal funding to an institution.

Myron Reinke, a program review specialists for HCFA who is involved in the survey process, said KNI has transcended" the 389 federal rules and regulations now in place for certification of MR/DD hospitals. Because of the improved programs and outcomes at KNI, HCFA plans to study and change their own rules and regulations, he said.

Reinke said KNI not only meets federal regulations, but has found ways to improve the lives of clients by going around the regulations.

They not only meet the rules and regulations, they have grown beyond them," he said. Now our regulations restrict them. They deal with folks better then the regulations allow."

Reinke said KNI has created a model that will be used nationwide.

They have a quality assurance program that nobody else can match," he said. The amazing thing is that this happened within an institution. Since every state in the Union still has institutions and will have for some time, this will be used as a model nationwide.

If KNI can do it, any institution can do it," Reinke said.

Page Last Updated: May 29, 2001