Blair County s HealthChoices Behavioral Health System

Transcription

1 120 Holliday Hills Drive Hollidaysburg, Pennsylvania Blair County s HealthChoices Behavioral Health System 2 nd Quarter October 2016 December 2016 Results Consumer and Family Satisfaction & Outcomes: Survey Findings Detailed Report of Survey Findings: January 2017 Revised 2/10/2017 Survey Administration and Evaluation Services Provided by The Center For Behavioral Health Data Research, INC.

2 Table of Contents I. Summary of C/FST Completed Adult, Family & Youth Surveys... 4 A. Data Collection & Survey Results C. Adult, Family & Youth - Provider Level Analysis... 4 II. Adult Survey Process & Findings... 5 A. Survey Results & Variations on Sample Characteristics... 5 B. Adult C/FST Demographics Survey Questions 6, 7, 9 & C. Adult - Satisfaction with CCBHO Survey Questions D. Adult Provider & Service Level Analysis Survey Questions 16 & E. Adult - Duration of Relationship Question F. Adult Access to Services Question G. Adult Recovery Oriented Treatment Experiences Question I. Adult - Treatment Outcomes Question J. Adult - Issues or Problems with Provider Questions K. Adult - Department of Public Welfare Questions Questions L Adult - Medications Questions 30, 32 & M. Adult Literal Responses to Survey Questions II. Family Survey Process & Findings A. Survey Results B. Family/Caregiver C/FST Demographics Questions 5, 6, 7, 8, 9 & C. Family/Caregiver s Satisfaction with CCBHO Questions 12, 13, 14, 15, 16, 17 & D. Family/Caregiver - Provider & Service Level Questions 19 & E. Duration of Family/Caregiver Provider Relationship Questions F. Family/Caregiver -Access to Services Question G. Family/Caregiver Recovery Oriented Treatment Experiences Question H. Family/Caregiver - Perceptions of Treatment Outcomes Questions I. Family/Caregiver - Provider Issues/Complaints Questions 26, 27, 28 & J. Family/Caregiver - Medications Questions 34, & K. Department of Public Welfare Questions Questions 30, 31, 32 & L. Family/Caregiver Literal Responses to Survey Questions III. Youth C/FST Survey Process & Findings A. Survey Results B. Youth C/FST - Demographics Questions 6, 7, 8, 9 & C. Youth - Satisfaction with CCBHO Question D. Youth - Service Level Question E. Youth Provider Level Analysis Question F. Youth - Access to Services Question G. Youth Recovery Oriented Treatment Experiences Question H. Youth Treatment Outcomes Questions I. Youth Provider Issues/Complaints Questions 20, 21, 22 & J. Youth - Medications Questions 29, 30, 31, 32 & K. Department of Public Welfare - Questions 25, 26, 27 & L. Youth Literal Responses to Survey Questions IV. Provider Responses to FY 15/16 1 st Quarter C/FST Report V. CCBHO Response to C/FST FY15/16 1 st Quarter Report The Center for Behavioral Health Data Research, Inc. January/

3 VI. Technical Notes A. Projected Surveys July 1, 2016 June 30, B. Focus C. C/FST Survey Process D. Survey Methodology Population/Sampling E. Data Analysis and Reporting F. Limitations VII. C/FST Program Member Assistance & Reporting A. Monthly Status & Problem Resolution B. Member Request for Assistance C. Confidentiality, Consent and Protection of Participant Information The Center for Behavioral Health Data Research, Inc. January/

4 I. Summary of C/FST Completed Adult, Family & Youth Surveys A. Data Collection & Survey Results. Annual Surveys Targeted Completed YTD Percent Adult % Parent/Family % Youth % Total % 1 st Quarter 2 nd Quarter 3 rd Quarter 4 th Quarter Y-T-D Completed Surveys Face to Face Surveys Percent 44.4% 56.1% 0.0% 0.0% 51.8% B. Adult, Family & Youth Demographics Zip Code Area 1 st Q 2 nd Q 3 rd Q 4 th Q YTD Percentage Altoona % Hollidaysburg % Duncansville % East Freedom % Claysburg % Roaring Springs % Tyrone % Bellwood % Williamsburg % Martinsburg % Other % Surveys % C. Adult, Family & Youth - Provider Level Analysis Provider Surveys Members YTD 1 st 2 nd 3 rd 4 th YTD Percent Target Surveys Surveys Surveys Surveys ACRP % UPMC Altoona % Primary Health Network % Blair Family Solutions % Anthony Pater Counseling % Children's BH % Home Nursing Agency % NHS Canal Ways % Nulton Diagnostic % Cen Clear/Cove Couseling % Moore Counseling % Impact Counseling % Cove Forge/WDR % Meadows % Pyramid % Blair County D&A Partnership % Family Behavioral Resources % Discovery House % Peer Star % LaRocco Counseling % Others % Totals % The Center for Behavioral Health Data Research, Inc. January/

5 II. Adult Survey Process & Findings This 2 nd Quarter Blair County C/FST Report covers the period between October and December 2016 and provides detail on the 121 adults, 62 family and 29 youth interviews that were completed. A. Survey Results & Variations on Sample Characteristics Variations in sample characteristics between quarters are provided so that the reader may infer what influences, if any, these variations may have had on member response ratings. 2 nd Quarter Adult Sample Characteristics versus 1 st Quarter Comparison: 1. More face to face as a percentage of total surveys 74% (90 of 121) versus 46% (36 of 78). 2. Lower percentage of female respondents 60% (73 of 121) versus 50% (39 of 78). 3. Similar percentage of members between ages % (57 of 121) versus 50% (39 of 78). 4. Similar MH only 68% (82 of 121) versus 69% (54 of 78) *excludes 32 D&A and 7 MH & D&A 5. Similar mix of MH outpatient 19% (121) of 78) versus 21% (16 of 78). The following are C/FST Findings and Recommendations based on the 121 adult surveys completed during the 2 nd Quarter of Fiscal Year 16/17 for the period from October to December Note: Treatment Experiences and Provider Recovery Orientation have been combined, revised and expanded into a new set of questions Recovery Oriented Treatment Experiences (Question 21) can be found on Page 10. Findings Overview Community Care continues to receive high marks from members in being responsive when contacted. 93% of adult members that contacted Community Care during the 2 nd quarter agreed they were responsive to their needs. Although below the 90% benchmark, 80% know how to contact Community Care. 79% of adult members interviewed during the 2 nd quarter knew how to find information on services available through Community Care. This is up from just 73% for the previous four quarters ending June 30, The C/FST surveyor facilitates the sending of another Member Handbook when this situation is encountered. Two of the three questions regarding Access to provider treatment are 88% or above and deal with member ability to receive help in an acceptable amount of time and in being made aware of different services and given a choice. The indicator at just 82% (consistent with being below the benchmark for the past five quarters) continues to be: being made aware of different providers, service options, and given a choice. Note: Per the HealthChoices provider manual, the provider is to ensure, with applicable documentation, that the member is made aware of other providers that provide the service and given a choice to choose the provider. This quarter, nine of the twelve indicators under the combined, revised, and expanded Recovery Oriented Treatment Experiences section were in the 88% to 95% range. The two lowest indicators are Provider encouraged me to develop a WRAP at just 75%, and Provider recommended I do a Mental Health Advance Directive at 64%. The Center for Behavioral Health Data Research, Inc. January/

6 These two indicators continue to be far under the benchmarks even though the wording has been changed from previous quarters. The questions previously asked if the member was encouraged by the provider to develop a WRAP or Mental Health Advance Directive. That has been changed to ask if the provider has simply talked to them about a WRAP or MHAD. The adult responses to Treatment Outcomes was positive with adult members in the range of 84% to 87% feeling that they deal more effectively with daily problems, being more hopeful about the future, believe they are recovering and that treatment is working. 6% (7 of 121) of adults surveyed, lower than 12% (9 of 78) in the previous quarter indicated they had issues or problems with their provider. Six resolved the problem with the program manager. Recommendations Overview Behavioral Health providers should continue to address recovery and resiliency factors (Recovery Oriented Systems Indicators ROSI) as members are transitioned into the community and self-help support systems. These include the ROSI and CCISC indicators addressing a Wellness Recovery Action Plan (WRAP) and developing a Mental Health Advance Directive; developing treatment plans with respect to the member s specific needs and asking the member what goals would help achieve a happy life. The consistently low perception of satisfaction ratings under Recovery Oriented Treatment Experiences should be reviewed and discussed between Community Care and providers. Adult Member Request for Assistance Upon completing the survey, 1.6% (2 of 121) adult members surveyed, compared to 4% (3 of 78) in the previous quarter, expressed interest in having a provider or MCO concern or issue they shared during the interview referred for immediate handling by Blair HealthChoices. The Center for Behavioral Health Data Research, Inc. January/

7 B. Adult C/FST Demographics Survey Questions 6, 7, 9 & 10 Adult Surveys Gender Male 39 50% 48 40% 0% 0% 87 44% % Female 39 50% 73 60% 0% 0% % % Surveys = (N) % % 0 0% 0 0% % % Face-to-Face Response Similarity 50% (18 of 36) of face-to-face survey respondents were male compared to 50% (21 of 42) of telephone interviews. Adult Age Range Age % 4 3% 0% 0% 9 5% 14 5% Age % 33 27% 0% 0% 49 25% 67 23% Age % 33 27% 0% 0% 72 36% 51 18% Age % 24 20% 0% 0% 28 14% 87 30% Age % 24 20% 0% 0% 36 18% 65 22% Age 65 and over 2 3% 3 2% 0% 0% 5 3% 6 2% Surveys = (N) % % 0 0% 0 0% % % 25% (9 of 36) of face-to-face survey respondents were in the age range of 55 to 64 compared to 7% (3 of 42) of telephone interviews. Adult- 1st Diagnosed Less than six months 1 1% 4 3% 0% 0% 5 3% 16 6% Six months to one year 6 8% 1 1% 0% 0% 7 4% 16 6% One to two years 2 3% 9 7% 0% 0% 11 6% 5 2% Two to three years 5 6% 6 5% 0% 0% 11 6% 8 3% Three to four years 3 4% 6 5% 0% 0% 9 5% 6 2% Four years or more 61 78% 95 79% 0% 0% % % Surveys = (N) % % 0 0% 0 0% % % Adult -Primary Service 1 st Quarter 2 nd Quarter 3r d Quarter 4 th Quarter Y-T-D Surveys Mental Health 54 69% 82 68% 0% 0% % Drug & Alcohol 10 13% 32 26% 0% 0% 42 21% Both MH and D&A 14 18% 7 6% 0% 0% 21 11% Surveys = (N) % % 0 0% 0 0% % Face to Face Response Variation 17% (15 of 90) of those interviewed by face-to-face were receiving mental health services compared to 29% (9 of 31) of those interviewed by telephone. 27% (24 of 90) face-to-face adult Methadone maintenance services compared to 0% (0 of 31) of telephone interviews. C. Adult - Satisfaction with CCBHO Survey Questions Adult Member Satisfaction - Community Care Benchmark Yes* 1 st 2 nd 3 rd 4 th YTD Surveys = (N) Know how to contact Community Care 90% 81% 80% 81% 64% Community Care is responsive to my needs 90% 93% 93% 93% 96% Know how to find service availability information 90% 82% 79% 81% 73% * Excludes "not sure" and "n/a" The Center for Behavioral Health Data Research, Inc. January/

8 There were no response variations that exceeded 10 percentage points between face-to-face and telephone respondents. Adult Member Satisfaction - Community Care Benchmark Yes 1 st 2 nd 3 rd 4 th YTD Surveys = (N) I have used complaint process with CCBHO <10 1% 0% 1% 1% I was satisfied with the complaint process 90% 0% n/a 0% 25% I have used grievance process <10 0% 0% 0% 1% I was satisfied with the grievance process 90% n/a n/a n/a 0% There were no response variations that exceeded 10 percentage points between face-to-face and telephone respondents. D. Adult Provider & Service Level Analysis Survey Questions 16 & 18 Adult Treatment Provider Members Surveyed YTD Primary Health Network % Home Nursing Agency % Nulton Diaggnostic % ACRP % UPMC Altoona % The Meadows % Cove Forge % Blair County D&A % Discovery House % Dolminis % PeerStar % Blair Family Solutions % UCBH % Pyramid Healthcare % Moore Counseling % Cen-Clear Services/Cove % Impact Counseling % Anthony Pater Counseling % LaRocco Counseling % Skills % Other % Total: % The Center for Behavioral Health Data Research, Inc. January/

9 Adult Service Level Surveyed Members Surveyed Quarter % Crisis Intervention % MH Resource Coordination % MH Inpatient % MH Mobile Therapy % MH Outpatient % MH Partial Hospitalization % MH BCM (Blended Case Mgt) % Peer Support Services % SA ICM % SA Resource Coordination % Halfway House % Methadone Maintenance % IP/SA Rehabilitation % SA Detoxification % SA Outpatient % SA Partial Hospitalization % Suboxone Maintenance % Medication Management % SA Intensive Outpatient % Club House % Other % Surveys Completed % 17% (15 of 90) adults interviewed face-to-face were receiving mental health outpatient services compared to 29% (9 of 31) of those interviewed by telephone. 27% (24 of 90) adults interviewed face-to-face were receiving mental health outpatient services compared to 0% (0 of 31) of those interviewed by telephone. E. Adult - Duration of Relationship Question 19 Adult - Provider Relationship Less than six months 11 14% 23 19% 0% 0% 34 17% 92 32% Six months to one year 15 19% 14 12% 0% 0% 29 15% 38 13% One to two years 9 12% 22 18% 0% 0% 31 16% 28 10% Two to three years 10 13% 18 15% 0% 0% 28 14% 37 13% Four years or more 32 41% 43 36% 0% 0% 75 38% 88 30% Completed 1 1% 1 1% 0% 0% 2 1% 7 1% Surveys = (N) % % 0 0% 0 0% % % Face to Face Response Variation 24% (22 of 90) of those interviewed by face-to-face were receiving services from their provider for less than six months compared to 3% (1 of 31) of those interviewed by telephone. 30% (27 of 90)) of those interviewed by face-to-face were receiving services from their provider for 4 years or more compared to 52% (16 of 31) of those interviewed by telephone. F. Adult Access to Services Question 20 Adult - Member Access Benchmark Surveys = (N) Made aware of different services & given a choice 90% 89% 88% 88% 75% Made aware of different providers & given a choice 90% 83% 82% 83% 69% Able to get help within an acceptable amount of time 90% 96% 95% 96% 90% The Center for Behavioral Health Data Research, Inc. January/

10 80% (72 of 90) adults interviewed face-to-face indicated they were made aware of the availability of different treatment providers and given a choice compared to 80% (28 of 31) of those interviewed by telephone. G. Adult Recovery Oriented Treatment Experiences Question 21 Adult - Provider Recovery Oriented Treatment Experiences Benchmark Agree/Strongly Agree Surveys = (N) Provider asked me what my goals would be to achieve a happy life (CCISC) 90% 88% 93% 91% 90% Provider helped me identify triggers for replase 90% 88% 90% 89% 86% Provider helped me develop a plan to prevent relapse 90% 87% 88% 88% 85% Provider teaching me skills that are helpful to me (CCISC) 90% 86% 92% 89% n/a Provider acknowledges/rewards me for even small steps towards my goals 90% 92% 94% 93% 85% Provider helps me connect/reconnect to community resources/natural supports. * 90% 74% 83% 79% 71% Encouraged to use consumer-run programs (ROSI) 90% 81% 88% 85% 69% Provider talked to me about a (WRAP) Wellness Recovery Action Plan 90% 47% 67% 57% 36% Provider talked to me about a Mental Health Advance Directive 90% 30% 55% 42% 26% I feel like my provider listens to me 90% 95% 93% 94% n/a I feel like I have a say in treatment. 90% 92% 95% 94% n/a I feel like my provider empowers me 90% 90% 89% 89% n/a n/a = question not previously asked. Wording on some questions slightly changed. 94% (85 of 90) of those interviewed face-to-face agreed the provider is teaching them skills that are helpful to them compared to 84% (26 of 31) of those interviewed by telephone. 80% (72 of 90) of those interviewed face-to-face agreed provider helped them connect or reconnect to community resources and natural supports in their life compared to 90% (28 of 31) of those interviewed by telephone. 72% (58 of 81) of those interviewed face-to-face indicated their provider talked to them about a (WRAP) Wellness Action Recovery Plan compared to 85% (23 of 27) of those interviewed by telephone. (Excludes those that answered not applicable. ) 64% (51 of 80) of those interviewed face-to-face indicated their provider talked to them about a (MHAD) Mental Health Advance Directive compared to 93% 30 of 31) of those interviewed by telephone. (Excludes those that answered not applicable. ) I. Adult - Treatment Outcomes Question 22 Adult - Treatment Outcomes Benchmark Agree/Strongly Agree Surveys = (N) I deal more effectively with daily problems 90% 94% 87% 90% 81% I feel more hopeful about the future 90% 94% 88% 91% 88% I believe I am recovering 90% 90% 84% 87% 85% I feel that treatment is working 90% 96% 85% 91% 90% 84% (76 of 90) of those interviewed face-to-face believed they deal more effectively with daily problems compared to 94% (29 of 31) of those interviewed by telephone. 87% (78 of 90) of those interviewed face-to-face felt more hopeful about the future compared to 100% (31 of 31) of those interviewed by telephone. J. Adult - Issues or Problems with Provider Questions Adult Members Provider Complaints Yes Surveys = (N) Member issues/problems with provider 9 12% 7 6% % 22 8% Was able to resolve issues with provider 6 67% 6 86% % 4 18% The Center for Behavioral Health Data Research, Inc. January/

11 Adult - Provider Issues Surveys = (N) (Member reporting issues) Treatment planning & coordination 1 11% 0 0% % 4 1% Poor communications 4 44% 2 29% % 4 1% Frequent Staff Changes 0 0% 1 14% % 0 0% Frequent provider cancellations 0 0% 1 14% % 4 1% Services not provided when needed 0 0% 0 0% % 1 1% Other 4 44% 3 43% % 9 3% K. Adult - Department of Public Welfare Questions Questions Although the survey instrument utilized may be modified and tailored to individual county MCO and C/FST s needs under the guidance and direction of an independent C/FST Advisory Committee, the Department of Public Welfare, Office of Mental Health and Substance Abuse Services requires the following three questions in all surveys. Adult - OMHSAS Statewide Questions Benchmark Surveys = (N) Treatment improved quality of life* 90% 92% 84% 88% 88% Given chance to make treatment decisions 90% 96% 90% 93% 77% Able to get needed help in last twelve months 90% 96% 88% 92% 92% * Responses are "much better" and "a little better 94% (85 of 90) of those interviewed face-to-face agreed they were given the chance to make treatment decisions compared to 77% (24 of 31) of those interviewed by telephone. L Adult - Medications Questions 30, 32 & 33 Adult Surveys Medications Surveys = (N) Taking behavioral medications 77 99% % % % Person who prescribes medication listens & responds to my concerns 65 84% % % % Have problems getting medications 72 94% 10 9% % 23 9% 90% (77 of 86) of those interviewed face-to-face agreed the person who prescribes their medication listens and responds to my concerns compared to 100% (24 of 24) of those interviewed by telephone. M. Adult Literal Responses to Survey Questions The following literal responses were provided by respondents, If you disagreed or are unsure with any of these statements, please explain why? Question: 20D Access to services: No Comment x s 117 Just got done with the paperwork and intake stuff. Had to stop and wait. Now getting restarted, finally after a long wait. I was made to come to this provider. I was not given a choice in treatment services or providers. I was a patient when it was Altoona Hospital and I just stayed. Question: 21M Recovery Oriented -Treatment Experiences: No Comment x s 112 Came here to learn coping skills rather than use medication to cover up. I didn't like the other CRNP that I had last time, but I really like and feel that Donna Reeves listens and hears me. She cares about what it is I am saying. I am able to bring supports to appointments and they help in treatment and recovery. The Center for Behavioral Health Data Research, Inc. January/

12 "Nothing will help and nothing will help bring my kids and grandchildren back. I have suffered such great loss that I will never be able to live a normal life. They were taken in such a horrible way that I can never have a peaceful life. I spoke with Shane 1 on 1 and he spoke with me with compassion and understanding, I felt like he listened to me. I hated (provider) after a while (14 years). Now I am glad to see the Doctor here at Nulton. Only my 1st appointment with the doctor here at Nulton. I was at PHN for over 14 years (Altoona Regional then PHN) I don t feel I have any say in my treatment or am heard at all about my treatment concerns/goals. Do not recall WRAP or MHAD. The Doctor doesn t listen to me. Question: 22e Outcomes: No Comment x s 111 I didn't really get a chance to work with them other than paperwork and intake and planning. Some days are better than others. I am doing much better and making better decisions, staying out of trouble (jail) since being in treatment. I am still very depressed. I do have seasonal depression but I am doing well I am just getting started with meds not able to give a true accurate assessment on how I am doing with them as of yet. My loss is too great, and pain goes too deep to live a normal life again I left (provider) so I could work on my problems. When I was with (provider) I didn't feel, I got the individual attention and it felt like I was in and out too fast. It was not a personal experience that my mental health should be. Not at this provider. Some days are better than others. Question: 24Provider issues or problems? No Comment x s 117 One provider wasn't showing up when scheduled. I stopped taking my meds that (therapist) was giving me, they were not helping. I have not hope for the future. Problems with the nursing/staff Doctor is very late, at times I will have a very long wait times and then be in and out with the doctor. Question 25 Were you able to resolve these issues? No Comment x s 118 I spoke with Shane after I stopped taking my meds, (therapist) was not giving the meds that I felt I needed. I decided to leave the provider and go to Nulton. The office staff will not help me file a complaint or help me so I am taking steps on my own to make changes. Question: 29A Why were you unable to get the help you needed in the last 12 months? No Comment x s 118 Did not get to use the supportive services yet. I am to be reassigned a new worker this next week. Problems at (provider) caused me to come to Nulton. Nursing staff made me feel like I was not important and my treatment was not individualized person focused. Question: 31 Who prescribes your behavioral health medications other than a Psychiatrist? No Comment x s 76 Trista Pooley, CRNP x 8 Dr. Baumgarten X 11 Danielle Gibbons, CRNP X 4 Donna Reed, CRNP X 7 Carolyn Brumbaugh, CRNP X 12 Dr. Anthony McNigleya X 2 Blair County Drug and Alcohol X1 Question: 33A: Are You Experiencing any problems getting the behavioral health medications that work for you? No Comment X s 109 He feels that the medication they prescribe aren't the right medication for him. It is an insurance issue, not anything because of PHN. Insurance issue, not Dr/medical problem. Just recently started with meds no problems so far Not wanting to give me the meds that I know work for me so I stopped taking my meds all together Can t see eye to eye on the meds that work for me. We disagree on med choices so I stopped taking meds. Meds being given at different providers and always being adjusted, in process of trying to find a new doctor. The Center for Behavioral Health Data Research, Inc. January/

13 My meds are always being adjusted. The doctor is on the right track but something is always added or taken away, previously tried to be asked to be taken off of meds in absolute frustration. However, it is a Medicare issue, but not a provider issue He doesn't have me on the meds I need. Doctor doesn't give meds that I need. Question: 34 Additional Compliments or Concerns No Comment X s 86 Thankful for Danielle Gibbons she listens to me and asks the right questions and gives me prescribes the correct medications. I am very thankful that I have her, she has a very good personality. Everything is great. Frequent cancellations of appointments. I really like my case manager. His case manager (Lauren) is awesome. PHN works very fast for as busy as they are. PHN is very cooperative. Home Nursing is always there when needed. I think they are great people over there! I am very happy. I never got to work with my assigned worker, only do paperwork. Now they are putting me with a new person next week after a several month long wait and lots of paperwork. I really like Donna Reeves. She really listens and cares about what I have to say. Services are excellent. Don't really know about Community Care, but they do a good job here. I hope they keep up the good work. Carolyn and my counselor help me a lot and I am getting the help that I really want. Leah and Carolyn are both helping me a lot and I am getting the help I really want. She is fair about treatment and medications really don t like (specific) insurance I have always been happy here even when it was at the "old place". Dr. Antonowitz and Stephanie helped me get where I am today and where I needed to be - when I get out of in-patient, they make sure I get back with my same doctors and pick back where I leave off. -- When Steph left she made sure I would be with a good match I could work well with - that is Carolyn. I have been with them since the old place and have done very well. I have always been very happy here working with each and every one of them gives me the help and positive influence that i need to live a safe and better life for myself they are a good support system for me. They help as long as you comply. I think the methadone program is great because it gets people off the streets and on the way to recovery. THANK YOU FOR SAVING MY LIFE KEEP UP THE GOOD WORK Dolminis listens to its clients and cares about them Got to speak with Shane face to face and he listened to me and my concerns and this was a great talk and made me feel a great deal better, this felt like a counseling session that I really needed. He gave me some very helpful tools. I haven t been able to find someone to listen, talk and understand like that since Linda has been with the group. I thank Shane for his time Spoke with Shane 1 on 1 and he was a wonderful support and he taught me some tools that have worked to help me a great deal. I thank him for his support and listening. "Donna is great she listens!!" I appreciate the help I am receiving now. It s a lot better than I have had in the past. PHN has been very helpful. Discovery house is and AWESOME facility! I would recommend Discovery House to anybody who feels they are ready to get clean. Staff also treats you like family and they are very helpful Sometimes you have to wait a long time in the office for your appointment. The staff at the (provider) was rude. It is my opinion that they need better staffing to improve care. PHN is a good place. The staff here is very nice. I wish there were more places locally that provided this service to help more people. They offer any help you would need My counselor at F.B.R is a big help, he helps me set and reach goals. My everyday living skills are better because of the time and goals we work on together. 1. (Doctor) has frequent cancellations, extended wait times and rescheduling while on my way to my appointments. 2. When I do see the doctor he is in and out - he is not engaged or interested in what I have to say, his office is set up so that he is far away from his clients and he doesn't have to engage them. He barely speaks or asks questions during office visits. - Like when he is changing meds... he should be asking questions and not just changing my medications without talking to me. Overall I am very pleased with my services I am very happy. They (all of the staff) do a great job. I think Dr. Pontzer is a really good Doctor. I think that people with anxiety need group sizes that are smaller. The Center for Behavioral Health Data Research, Inc. January/

14 When a person is in partial hospitalization program, they should be able to see the Doctor in person... NOT on over a TV screen, especially one from not around here in Pittsburgh. It is hard for telepysh Doc to see your body language when he only sees your face, I think (doctor) needs to be reviewed. Case manager is helpful but doc isn't The Center for Behavioral Health Data Research, Inc. January/

15 II. Family Survey Process & Findings A. Survey Results Variations in sample characteristics between quarters is represented so that the reader may infer what influences, if any, these variations may have had on member response ratings for the quarter. 2 nd Quarter Family Sample Characteristics versus 1 st Quarter Comparison: 1. Fewer face to face - 40% (25 of 62) versus 54% (20 of 37) 2. Lower ratio of male caregivers 15% (9 of 62) versus 30% (11 of 37). 3. Similar percentage of child members age 8 and under 44% (27 of 62) versus 43% (16 of 37). 4. Higher percent of foster/step/adoptive/grandparent 23% (14 of 62) versus 16% (6 of 37). 5. More male member service recipients 66% (41 of 62) versus 59% (22 of 37). 6. Less youth members receiving BHRS 26% (16 of 62) versus 32 %. (12 of 37). 7. More members, 23% (14 of 62) versus 16% (6 of 37), diagnosed four (4) years or longer The following are C/FST Findings and Recommendations based on the 62 family surveys completed during the 2 nd Quarter of Fiscal Year for the period from October to December Note: Treatment Experiences and Provider Recovery Orientation have been combined, revised and expanded into a new set of questions Recovery Oriented Treatment Experiences (Question 23) can be found on Page 20. Findings Overview 68% of family/caregivers (down from 91% in the 1 st Quarter but consistent with the 64% for the prior year s average) reported knowing how to call CCBHO with questions or concerns. 71% (down from 97%) report knowing how to file a complaint or grievance, if they needed to. This is also consistent with the prior year s average. Although just 48% of family/caregivers reported that Community Care participated in their child s ISP/Evaluation meeting, 95% of family members/caregivers reported that Community Care s participation in the ISPT/Evaluation meeting was helpful. Family/caregivers are generally pleased with the three Access to provider treatment services with the indicators ranging from 89% to 98%. Family/caregivers are generally pleased with their provider Recovery Oriented Treatment Experiences with eight of the eleven indicators of satisfaction ranging from 92% to 97% consistent with a similar level of satisfaction last year. The indicator Provider talks to me and my child about how to stay well after treatment at just 69% compared to the four quarter average of 76% continues to be a concern of how providers address recovery and resiliency in young members. Although family/caregiver responses to the three indicators under Treatment Outcomes range between 74% to 87% and continue to fall below the benchmarks, it could be argued that 7-8 of 10 is a positive outcome. Just 3% (2 of 62) family or caregivers reported issues or problems with their provider compared to 13% (5 of 37) in the previous quarter. The number of family/caregivers reporting issues usually fluctuates but is consistently higher than adults and youths interviewed. The Center for Behavioral Health Data Research, Inc. January/

16 Recommendations Overview Family perception of treatment outcomes need to be reviewed and evaluated with providers. The Blair County C/FST, if requested can cross-tabulate the member responses by length of treatment, care level and provider to provide additional insight into this area. Member Request for Assistance Upon completing the survey 0.7%(1 of 62) family/caregiver members surveyed, consistent with 3% (1 of 37) last quarter expressed interest in having a provider or MCO concern or issue they shared during the interview referred for immediate handling by Blair HealthChoices. The Center for Behavioral Health Data Research, Inc. January/

17 B. Family/Caregiver C/FST Demographics Questions 5, 6, 7, 8, 9 &10 Family - Child's Gender Male 22 59% 41 66% % 93 68% Female 15 41% 21 34% % 44 32% Surveys = (N) % % 0% 0% % % There were no response variations exceeding 10 percentage points between family/caregivers interviewed face-toface or interviewed by telephone. Family Surveys Age Categories Age 5 or under 4 11% 9 15% % 21 15% Age % 18 29% % 42 31% Age % 26 42% % 65 47% Age 14 and older 0 0% 9 15% % 9 7% Surveys = (N) % % 0 0% 0 0% % % Caregiver Relationship Parent 31 84% 48 77% % % Grandparent 4 11% 6 10% % 15 11% Aunt/Uncle 0 0% 0 0% % 0 0% Brother/Sister 0 0% % 0 0% Foster Parent 0 0% 6 10% % 2 1% Step-Parent 1 3% 1 2% % 6 4% Adoptive Parent 1 3% 1 2% % 9 7% Surveys = (N) % % 0 0% 0 0% % % 36% (9 of 25) of family/caregivers interviewed face-to-face had a child receiving services that was 6-8 years old compared to 24% (9 of 37) of family/caregivers interviewed by telephone. Family- 1st Diagnosed Less than six months 1 3% 4 6% % 12 9% Six months to one year 5 14% 10 16% % 16 12% One to two years 3 8% 10 16% % 19 14% Two to four years 10 27% 14 23% % 24 18% Four years or more 18 49% 24 39% % 66 48% Surveys = (N) % % 0 0% 0 0% % % 12% (3 of 25) of family/caregivers interviewed face-to-face has a child receiving services that was diagnosed more than 4 years ago, compared to 32% (12 of 37) of family/caregivers interviewed by telephone. C. Family/Caregiver s Satisfaction with CCBHO Questions 12, 13, 14, 15, 16, 17 & 18 Family/Caregiver Satisfaction with CCBHO Benchmark Yes Surveys = (N) Know how to call CCBHO with questions/concerns 90% 91% 68% 80% 64% If I interacted with Community Care it was helpful 90% 93% 91% 92% 85% CCBHO attended child's ISP/Evaluation meeting * 90% 78% 48% 63% 74% CCBHO's ISP meeting participation was helpful 90% 92% 95% 94% 91% * Excludes "not applicable" responses The Center for Behavioral Health Data Research, Inc. January/

18 (excludes not sure and N/A) 82% (19 of 23) of family/caregivers interviewed face-to-face knew how to call Community Care at any time on any day with questions or concerns compared to 62% (23 of 37) of family/caregivers 91% (20 of 22) of family/caregivers interviewed face-to-face knew how to find information about services available to them through Community Care compared to 65% (24 of 37) of family/caregivers 57% (8 of 14) of family/caregivers interviewed face-to-face agreed Community Care attended their child s ISPT/Evaluation team meeting or other treatment team meetings compared to 42% (11 of 26) of family/caregivers interviewed by telephone. 100% (8 of 8) of family/caregivers interviewed face-to-face felt that Community Care s participation in their child s ISPT/Evaluation team meeting or other treatment team meeting was helpful compared to 82% (9 of 11) of family/caregivers interviewed by telephone. Responses without "not sure" and "not applicable" Benchmark Yes Surveys = (N) Know how to file a complaint with CCBHO, if I need to. 90% 97% 71% 84% 66% Have used CCBHO's complaint process? <10% 0% 0% 0% 1% If yes, were you satisfied with CCBHO's complaint process?* 90% n/a n/a n/a 100% Have you used CCBHO's grievance process? <10% 0% 0% 0% 7% If yes, were you satisfied with CCBHO's grievance process?* 90% n/a n/a n/a 100% Have you ever wanted to file a grievance but didn't? <10% 3% 0% 3% 3% Did you feel supported by provider during grievance process? 90% 0% 0% 0% 100% * The C/FST believes the member's opinion of the process would be affected by their satisfaction with the outcome (excludes not sure and N/A) There were no response variations exceeding 10 percentage points between family/caregivers interviewed face-toface or interviewed by telephone. D. Family/Caregiver - Provider & Service Level Questions 19 & 20 Parent/Family Treatment Members Surveyed 1 st 2 nd 3 rd 4 th YTD % ACRP % UPMC Altoona % Blair Family Solutions % Children s Behavioral Health % Cen-Clear % Home Nursing Agency % Canal Ways (NHS) % Nulton Diagnostics % UCBH % Evolution Counseling Services % Primary Health Network % Cove Counseling Center % Moore Counseling % Sun Point % Family Behavioral Resources % Anthony Pater Counseling % Pyramid % Cove Forge % Blair County D&A Partnership % Meadows % Impact Counseling % Other % Surveys Completed % The Center for Behavioral Health Data Research, Inc. January/

19 Family Service Level Surveyed Members Surveyed Quarter % BHRS % Maintaining Strengths % Family-Based Services % Functional Family Therapy % Mental Health After School % MH CRR Host Home % MH Outpatient % MH Partial Hospitalization % MST (Multi-Systemic Therapy) % RTF (Residential Treatment) % PCIT (Parent Child Interaction ) % D&A Outpatient % Blended Case Management % Mental Health - Inpatient % Medication Management % Resource Coordination % Home/School Based % Other % Surveys Completed % 8% (2 of 25) of family/caregivers interviewed face-to-face were receiving BHRS/Wrap Around (TSS, MT BSC) services compared to 38% (14 of 37) of family/caregivers interviewed by telephone. 20% (5 of 25) of family/caregivers interviewed face-to-face were receiving Mental Health Outpatient services compared to 32% (12 of 37) of family/caregivers interviewed by telephone. 44% (11 of 25) of family/caregivers interviewed face-to-face were receiving medication management services compared to 14% (5 of 37) of family/caregivers interviewed by telephone. E. Duration of Family/Caregiver Provider Relationship Questions 21 Family - Provider Relationship Less than six months 3 8% 17 27% % 34 25% Six months to one year 10 27% 13 21% % 29 21% One to two years 9 24% 15 24% % 24 18% Two to three years 8 22% 7 11% % 16 12% Three to four years 1 3% 0 0% % - Four years or more 6 16% 9 15% % 24 18% Completed 0 0% 1 2% % 10 7% Surveys = (N) % % 0 0% 0 0% % % 52% (13 of 25) of family/caregivers interviewed face-to-face has a child receiving services for six months to a year compared to 11% (4 of 37) of family/caregivers interviewed by telephone. F. Family/Caregiver -Access to Services Question 22 Parent-Family - Access to Services Benchmark Surveys = (N) We were made aware of and given provider choice for service 90% 91% 94% 93% 83% We were made aware of and given choice of different services 90% 91% 89% 90% 85% Able to get helpi needed within an acceptable amount of time 90% 95% 98% 96% 90% The Center for Behavioral Health Data Research, Inc. January/

20 96% (24 of 25) of family/caregivers interviewed face-to-face agreed they were made aware of the availability of different providers and given a choice compared to 84% (31 of 37) of family/caregivers interviewed by telephone. G. Family/Caregiver Recovery Oriented Treatment Experiences Question 23 Parent /Caregiver -Provider Recovery Oriented Treatment Experiences Bench Agree/Strongly Agree 1 st 2 nd 3 rd 4 th YTD Surveys = (N) I can count on my treatment provider to be there when I need them 90% 92% 97% 95% 89% I was actively involved /developing my child's treatment goals 90% 95% 97% 96% 96% I believe my child's treatment plan is easy to understand* 90% 95% 97% 96% 97% I believe my child's treatment plan is easy to put into action 90% 89% 95% 92% 89% My child is receiving all the services he/she needs 90% 89% 95% 92% 83% Child is able to apply treatment experiences at home, community & school 90% 78% 84% 81% 66% I feel provider is blaming me when setbacks occur in child's treatment <10% 11% 3% 7% 11% I know places to call or go in the community to continue to get support 90% 86% 92% 89% 75% Provider acknowledges even small steps toward achieving child's goals 90% 84% 92% 88% 90% Provider talks to me & my child about how to stay well after treatment 90% 70% 69% 70% 76% I know someone else who shares my experiences and supports me 90% 62% 60% 61% 78% 76% (19 of 25) of family/caregivers interviewed face-to-face felt their child was able to apply what he/she learns in treatment at home, community and in school compared to 89% (33 of 37) of family/caregivers interviewed by telephone. 84% (21 of 25) of family/caregivers interviewed agreed the providers acknowledges them and their child for even small steps toward achieving child s goals compared to 97% (36 of 37) of family/caregivers interviewed by telephone. H. Family/Caregiver - Perceptions of Treatment Outcomes Questions 24 Parent/Caregiver - Treatment Outcomes Benchmark Surveys = (N) Child deals more effectively with daily problems 90% 87% 87% 68% 73% Child s behavioral health is improving 90% 78% 74% 78% 76% My child's social skills are improving 90% 84% 79% 72% 76% 60% (15 of 25) of family/caregivers interviewed face-to-face believed their child s behavioral health is improving compared to 84% (31 of 37) of family/caregivers interviewed by telephone. 72% (18 of 25) of family/caregivers interviewed face-to-face believed their child s social skills are improving compared to 84% (31 of 37) of family/caregivers interviewed by telephone. I. Family/Caregiver - Provider Issues/Complaints Questions 26, 27, 28 &29 Family Members Provider Complaints Yes Surveys = (N) Member issues/problems with provider 5 14% 2 3% 0% 0% 7 7% 12 9% Were you able to resolve these issues 1 20% 2 100% 0% 0% 3 43% 0 0% The Center for Behavioral Health Data Research, Inc. January/

21 Family - Provider Issues Surveys = (N) Treatment planning & coordination 0 0% 0 0% 0% 0% 0 0% 4 3% Poor communications 3 60% 0 0% 0% 0% 3 43% 4 3% Frequent Staff Changes 1 20% 1 2% 0% 0% 2 29% 1 1% Frequent provider cancellations 0 0% 0 0% 0% 0% 0 0% 1 1% Services not provided when needed 0 0% 0 0% 0% 0% 0 0% 1 1% Other 1 20% 1 50% 0% 0% 2 29% 1 1% * Some members do not identify reasons J. Family/Caregiver - Medications Questions 34, & 37 Family Surveys Medication Surveys = (N) My child is taking behavioral medications 30 81% 38 61% 0% 0% 68 69% 85 62% Person who prescribes listens & responds to my concerns * 20 67% 33 87% 0% 0% 53 78% 60 71% I have problems getting medications that work for my child 5 17% 1 3% 0% 0% 6 9% 11 13% 55% (6 of 11) of family/caregivers interviewed face-to-face reported their child was taking behavioral health medications compared to 67% (6 of 9) of family/caregivers interviewed by telephone. 33% (2 of 6) of family/caregivers interviewed face-to-face reported the person who prescribes their child s medication listens and responds to their concerns compared to 100% (6 of 6) of family/caregivers interviewed by telephone. K. Department of Public Welfare Questions Questions 30, 31, 32 &33 As noted in previous sections, the Department of Human Services, Office of Mental Health, and Substance Abuse Services require the following three questions in all survey instruments. Family - OMHSAS Statewide Questions Benchmark Surveys = (N) Treatment improved quality of life* 90% 95% 89% 92% 86% Given chance to make treatment decisions 90% 92% 97% 94% 86% Able to get need help in last twelve months 90% 84% 92% 88% 84% * Responses are "much better" and "a little better There were no response variations exceeding 10 percentage points between family/caregivers interviewed faceto-face or interviewed by telephone. L. Family/Caregiver Literal Responses to Survey Questions Respondents provided the following literal responses If you disagreed or are unsure with any of these statements, please explain why? Question: 22D Access to Services No Comment x s 61 Feel like there was no choice. Question: 23L Recovery Oriented -Treatment Experiences No Comment x s 58 Have not reached a point to find other who support us and share our experiences Needs more services from different provider. Would like family based The Center for Behavioral Health Data Research, Inc. January/

22 I would like to find community resources that would have a program where my child could socialize and make friends. Question: 24D Outcomes No Comment x s 61 We are early in treatment for a lot of the services. Question: 26A Provider Issues or Problems No Comment x s 61 It is hard to get an appointment Question: 27A Were you able to resolve issue (with provider) please explain No Comment x s 61 Due to frequent counselor changes, not seeing any progression. Question: 31A Inability to Receive Behavioral Health in the past year No Comment x s We were getting mixed messages from the support service providers we spoke to. We were feeling pushed into RTF services by our previous provider so we switched and now we are starting to get better. Question: 33A Other than a Psychiatrist who prescribes behavioral health medications for your child? No Comment x s 56 Dr. Chopra x2 Nason Pediatrics Pediatric Healthcare Associates x3 Question: 35 Experiencing any problems getting behavioral health medications that work for your child? No Comment x s 61 We didn't get along with the doctor so we moved to a new treatment provider. Question: 36 Additional Compliments or Concerns No Comment x s 43 Do not have enough time with the doctor as we would like. The mobile Therapist is wonderful, my child looks forward to seeing him every week Staff is nice and helpful. Very pleased with services. Home Nursing is the easiest to work with. They are a wonderful organization. Very pleased with services. CBH is easy to work with. The insurance has been really great about getting the care he needs. Nulton Diagnostics is wonderful. Home Nursing is awesome. Cen-Clear is wonderful. They understand my child. It helps me help her. Counselor works well with (member). They are great at BFS! They are very helpful and supportive. They have been very good here at HNA. I like that they will schedule multiple appointments ahead of time. CBH does a good job. My child has come a long way. Renee is a gift!! The Center for Behavioral Health Data Research, Inc. January/

23 III. Youth C/FST Survey Process & Findings A. Survey Results The following are C/FST Findings and Recommendations based on the 29 youth surveys completed during the 2 nd Quarter of Fiscal Year 16/17 for the period from October to December nd Quarter Youth Sample Characteristics compared to 1 st Quarter. 1. Fewer youth members diagnosed four or more years ago, 72% (21 of 29) versus 82% (9 of 11) 2. Lower ratio of female treatment recipients 55% (16 of 29) versus 73% (8 of 11). 3. Slightly lower percentage of youth members under age 17 79% (23 of 29) versus 82%. (9 of 11) 4. Lower number of youth members receiving BHRS 14% (4 of 29) versus 18% (2 of 11). 5. Fewer youth respondents reporting issues/problems with provider 0% (0 of 29) versus 9% (1 of 11). Note: Treatment Experiences and Provider Recovery Orientation have been combined, revised and expanded into a new set of questions Recovery Oriented Treatment Experiences (Question 17 can be found on Page 29. Findings Overview 69% of interviewed youths reported knowing how to call CCBHO with questions and concerns compared to 55% for the previous quarter. 79%-86%% of youths acknowledge they were aware they could file a complaint or grievance with CCBHO. In addition, 92% of youths reported speaking to people at Community Care found them to be helpful. Youths surveyed were generally pleased with Access to provider treatment services with all six indicators at 100%. Youth perceptions of Recovery Oriented Treatment Experiences improved from the previous quarter with seven of the eight indicators of satisfaction ranging from 86% to 100%. The lowest indicator at 83% was; I know places I can go or call to continue to get support (support groups, hotlines, communities activities ). Youth perceptions of Treatment Outcomes and satisfaction scores improved significantly ranging 86% to 97% in all five indicators. 0% (0 of 29) surveyed youths, similar with 9% (1 of 11) in the previous quarter had issues or problems with their provider. Member Request for Assistance Upon completing the survey 0% (0 of 29) youths surveyed expressed interest in having a provider or MCO concern or issue they shared during the interview referred for immediate handling by Blair HealthChoices Recommendations Overview Behavioral Health providers should continue to address recovery and resiliency factors (Recovery Oriented Systems Indicators ROSI) as members are transitioned into the community and self-help support systems. These include the ROSI and CCISC indicators, developing treatment plans with respect to the member s specific needs and asking the member what goals would help achieve a happy life. The Center for Behavioral Health Data Research, Inc. January/