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By Yolande K. Bestgen
Vice President of Strategic Development
CARF The Rehabilitation Accreditation Commission
Consumers are a very important component of the accreditation process, and the CARF survey process considers their input. This is a brief update on how CARF includes consumers in decisions that affect rehab facilities’ accreditation. Areas in which consumers are involved in CARF, including areas to further develop, include:
• Board of Trustees: Persons who are recipients of the services of CARF-accredited programs serve on the CARF Board of Trustees. They are primarily listed as at-large members and are recruited for their expertise as consumers of services.
• Standards Development: When accreditation standards are developed or revised, CARF holds a planning meeting called a National Advisory Committee (NAC). There are anywhere from 15 to 30 stakeholders who participate on this committee to review and/or to develop standards. These stakeholders include providers, consumers, funders, government regulators, and advocates. The CARF Board of Trustees has established a policy that a minimum of 20% of the participants be consumers.
• Field Review of Standards: Once the NAC has developed the new or revised standards, they are sent to the "field" for review and feedback. All stakeholders are included in the mailing for this review. It is typical to have 500 to 700 copies of the draft standards mailed out. Every piece of feedback is reviewed and brought to the CARF Board of Trustees for final approval of the standards. With such a close scrutiny, we find that once the standards are finalized, there is a significant consensus from all of the stakeholders regarding the new standards.
• Survey Process: The Medical Rehabilitation Division has a cadre of parent liaison surveyors who participate when an organization seeks accreditation for pediatric/family-centered rehabilitation programs. All parent liaison surveyors have children with impairments who have participated in rehabilitation programs. Parent liaisons were selected and trained by CARF and were all nominated by accredited programs.
The parent liaisons telephone parents of children in the program being surveyed and ask parents additional questions about how they were included in the rehabilitation process. The chance for a parent to discuss with another parent, who had the experience of having a child in a rehabilitation program, brings not only additional insight but also the opportunity to talk openly with someone who has been through similar circumstances.
At the CARF Board of Trustees meeting last August, several other initiatives were passed to enhance consumer participation in the survey process for all divisions of CARF. The interview policy was expanded so an organization still can identify a consumer to be interviewed, but CARF surveyors now may also choose one or more consumers to interview during the site survey.
In keeping with the spirit of consumer involvement, surveyed organizations will now also be sent a form to be posted at least 30 days prior to their survey notifying the public of the survey. The poster provides interested individuals several ways of contacting CARF if interested in being included in the survey, including a toll-free comment line as well as increased information on the web site. CARF added a toll-free consumer comment line as well as increased the information on the web site on how consumers can respond to CARF regarding an accredited organization.
A new standard will be added in all divisions' 2001 standards manuals stating that the organization should review all complaints received by consumers and analyze the complaints for trends. The standards specifically refer to complaints received only from consumers and do not cover those complaints an organization receives from other parties. CARF has already received positive comments from consumers, payers, and providers regarding this expanded consumer involvement.
• Education and Training: CARF has several publications that are devoted to consumers and will assist them with techniques to use in selecting a quality provider. This includes a brochure with quick checklist-style questions for the consumer to use when selecting a service provider. There also is an extensive consumer guide on selecting a provider and how to design individualized services.
CARF holds three international conferences each year in the fields of behavioral health, medical rehabilitation, and employment and community support divisions. In recent years, consumers have provided valuable contributions to these conferences through keynote addresses, seminar presentations, and other educational offerings.
Finally, CARF has a web site that is open to the public, and more information can be obtained there. The web site address is: www.carf.org.