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Missouri Support for Culture Change

Survey Agency

The Department of Health and Senior Services (DHSS), the state survey agency, has been very involved with the Missouri Coalition Celebrating Care Continuum Change (MC5) since its inception in 2004. DHSS has appointed a regulatory representative that sits on the Board of the coalition. This representative attends MC5 meetings and he has spoken about culture change and the regulations at Regional MC5 meetings and various educational events across the state. The DHSS Regulatory Representative and other surveyor management staff have been speakers at the Coalition's Culture Change Conference in 2007, 2008 and will again be presenters in 2009. The state survey agency has also provided educational sessions on culture change for all of its surveyors and has given them the opportunity to attend the coalition's conference and other educational events. In the Fall of 2008, the survey agency held a joint surveyor/provider training at which Carmen Bowman presented. This training was held on the final day of the statewide surveyor conference, a forum where all Missouri surveyors are trained, and which was opened to all providers. DHSS has been open to the possibility of changing state regulations that may be seen as barriers to culture change, collecting specific comments and proposed language changes from providers, consumers and other interested parties across the state. We anticipate these changes to be reflected in future rule revisions.

Long-term Care Ombudsman Program

Carol Scott, the Missouri State Long-term Care Ombudsman, was involved in bringing the Eden Alternative to Missouri over ten years ago and is a long-time advocate for individualized care. Julie Ballard, the Assistant State Ombudsman is the Chair of the Missouri Coalition Celebrating Care Continuum Change (MC5). LTCOP has been involved with the coalition since its inception and has helped it to move forward in Missouri. Two regional ombudsmen are leaders of the regional MC5 groups in their areas. Most of the regional ombudsmen attend these regional meetings and are a part of the state coalition. Culture change is a frequent training topic for LTCOP staff and volunteer ombudsmen and they are kept informed as to what is going on around the country. Many of the ombudsmen have also done training for facility staff on culture change and try to promote person-centered care in the homes that they visit. The Assistant State Ombudsman believes that "culture change, person-centered care and involvement in a culture change coalition go right along with the job of being an ombudsman since one of the jobs is to do systems advocacy. Also, as ombudsmen, we are the residents' advocate and we see changing the culture in long-term care as a major way to advocate for the residents. We see promoting culture change in any way we can as a vital role for us. We talk about it at almost every training and presentation we give and invest our time and money into culture change resources and educating others about culture change."