Giving Each Person a VOICE

Minnesota Region 10 revolutionizes quality assurance in services for people with disabilities Services for people with developmental disabilities often leave […]

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Minnesota Region 10 revolutionizes quality assurance in services for people with disabilities

Services for people with developmental disabilities often leave a lot of room for improvement. Yet when the idea of “quality assurance” is mentioned, most people glaze over: same old bureaucratic red tape with no effect on services. That’s why VOICE, the new quality assurance (QA) tool recently developed in southeast Minnesota, is so revolutionary. It works, people are excited about it (no kidding), and other parts of the state are lining up to copy it.

Actually, when stakeholders from 11 southeast MN counties came together to develop VOICE, they came up with more than just a new tool for QA; they actually use the new tool to support a whole new way to license care providers. Their new state-approved alternative licensing system is called The Minnesota Region 10 Quality Assurance.

In 1995, a broad base of stakeholders gathered to address the issue of improving quality: individuals receiving support, family, friends, providers, county staff, advocates, legislators, state staff and educators. This team, from the eleven counties in Southeastern Minnesota, met to discuss the service system for persons with developmental disabilities. The stakeholders worked with area legislators to develop and in 1997 pass legislation that would allow counties to participate in an alternative licensing system that would focus on quality outcomes for people with disabilities and their support providers.

In a letter to State Senator Linda Berglin, Charlie Lakin of the University of Minnesota’s Institute on Community Integration wrote, “The Region 10 Quality Assurance Commission is a Minnesota original. It is of Minnesota, and I know it has the opportunity to bring the best of Minnesota to a process about which most people are deeply cynical—if they care enough to have any attitude at all. Most people have decided that quality assurance is essentially pro-forma and of minimal benefit to the vast majority of Minnesotans with developmental disabilities. I think we are as a state extremely fortunate to have a group of citizens who have stood up to say we shouldn’t accept that. We shouldn’t accept that for people with disabilities, and we shouldn’t accept that as a use of public resources.”

How VOICE Works

VOICE stands for “Value of Individual Choices and Experiences”. The new QA tool is entirely based on the persons receiving services—-their needs, their wishes and making sure that they are getting the support necessary to live life on their own terms. The process starts by the quality assurance manager, LeAnn Bieber, randomly selecting a person with a disability to participate in a VOICE review. (The process is person-first, so the QA manager contacts the individual first.) The participant, along with a number of people close to them (their Quality Circle), is interviewed at length. Interviewers take notes, sort the results into categories, and put together a Learning Portrait, which is intended to engage the participant and his or her Quality Circle in a non-threatening and constructive manner. Finally, information generated from the VOICE reviews is used by the Quality Assurance Review Council to recommend licensing actions. The county then recommends final licensing decisions to the MN Department of Human Services.

Participants speak highly of the VOICE process. Jon C. Huebner says: “My VOICE review made my life better. The two people who interviewed me and talked with me were so patient even when I perseverated. They understood my autism and if they didn’t understand something about me, they were respectful and asked me and then I explained so they could understand what I meant. That felt good. My amazing VOICE review helped me become stronger and braver.”

Jon’s brother James E. Huebner was equally enthusiastic, “It’s hard for me to put into words how fantastic my VOICE review was for me, but I will try. When I had my VOICE review and I put together a group of people, with my family, who are important to me too, and they are my Quality Circle members. One way I can show you that VOICE helped me is that I led my own ‘triple iiiP’ IEP meeting with my twin brother. I believe in myself more and I became braver to try things that are difficult for me, because I know that not only will my family support me, but my quality circle will support me too. Indeed the VOICE review is for the whole country and even the whole world.”

For the past ten years Minnesota Region 10 Quality Assurance has been doing Licensing and Quality Assurance using the following principles: Person Driven, Comprehensive, Integrated, Value Based, Continuous Review Process, and Continuous Improvement.

Ultimately, the goal is better service. “The purpose of the Minnesota Region 10 Quality Assurance System,” says LeAnn Bieber of Region 10 staff, “is to continually improve the quality of services provided to individuals with developmental disabilities. We do this by assessing the value people experience through the support and services received at home, at work or school and throughout the community. By combining results from an ongoing series of these assessments, we are able to develop an accurate sense of the patterns of support in our community. We are also able to identify ‘best practices,’ which could be shared throughout the system, and change areas where improvement is needed.”

What speaks most to the power of VOICE is that the system is spreading. “When stakeholders in other areas learn about our efforts around quality and licensing through the VOICE process, they naturally want MN Region 10 Quality Assurance in their community,” says Dan Zimmer of Region 10 staff. “Three areas of the state are now using VOICE as a Quality Improvement Process. Through these efforts we hope that VOICE will eventually grow to a statewide alternative licensing process.”

Karen Larson is Conference and Outreach Coordinator for Minnesota Region 10 Quality Assurance. If you would like more info visit our Web site at or contact Dan Zimmer at 507-287-2032 or [email protected]

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