OMH Office of Performance Measurement and Evaluation & OMH Division of Integrated Community Services for Children Families Together in NYS

Transcription

1 FAMILY ASSESSMENT OF NEEDS AND STRENGTHS (FANS) REPORT Children s Mental Health Services Staff Development Training Forum, Saratoga NY 12/1/2015 OMH Office of Performance Measurement and Evaluation & OMH Division of Integrated Community Services for Children Families Together in NYS

2 2 FANS Overview The NYS Family Assessment of Needs and Strengths (FANS) is the family version of the Child and Adolescent Needs and Strengths (CANS) assessment tool. The FANS is a family planning and outcome management tool which is completed at admission, every 90 days thereafter and upon discharge The FANS can be inputted by embedded family peer support (Home and Community Based Services (HCBS) Waiver, Residential Treatment Facility, and Community Residence ) or as Community Family Peer Support programs that serve families within a community setting. The use of this tool allows Family Peer Advocates to mentor, build skills, and expand a parent's knowledge when navigating the child-serving system for themselves.

3 FANS Domains 3 Parents internal awareness of external challenges: Two questions Self-Efficacy, Burden & Stress Parent knowledge and skill development: Seven questions Parent Self-Care: Four questions Listening, Communication skills, Organization Skills, Involvement in Services, Knowledge of Family Needs, Knowledge of Rights & Responsibilities, Knowledge of Service Options Talents/Interests, Recreation, Optimism, & Social Resources. Parents voice in service delivery: Four questions Satisfaction with Youth s Living Arrangements, Satisfaction with Youth s Educational Arrangements, Satisfaction with School Participation, Satisfaction with Current Services

4 4 FANS Coding Definition for the Ratings FANS is a strength-based tool dimensions used to identify strengths and needs. Similar to the CANS-NY, the FANS score (rating) is based on a 4-point scale between 0-3, where 0 indicates no need (greatest strength) and 3 indicates greatest need (no strength), Example: Care Giver Organization Skills 0 - Caregiver is well organized and efficient. 1 - Caregiver has minimal difficulties with organizing Caregiver has moderate difficulty organizing ; 3 - Caregiver is unable to organize household.. Constructs: Needs : Are categorized as a 2 or 3 on the scale. Reflects that action should be taken to address an issue Needs Met (or Strength Developed): A change of score from 2 or 3 to score 0 or 1 on the scale.

5 5 About FANS-NY Reports Uptake : The Extent to which programs are reporting FANS in the CAIRS system. Prevalence: Evaluation of First FANS-NY during an episode of care. Cohort: Caregivers with at least one completed FANS Reports: Average dimension scores on first assessment Percent with Needs on each dimension by program type or statewide. Outcome: Evaluation of First and Last FANS-NY during an episode of care. Cohort: Caregivers with at least 2 FANS-NY assessed (at least 30 days apart) during their youth in care episodes. Reports: Average dimension scores on last assessment. Percent with Needs Met on each dimension.

6 6 Programs included in the Report Family Support Services - Children & Family Home and Community Based Services (HCBS) Waiver Cohort: Caregivers of youth in care of selected programs between 10/1/2014 and 6/30/2015. Programs that will be included in Future Reports: Residential Treatment Facility - Children & Youth Community Residence Children & Youth

7 Results : FANS uptake summary reports 7

8 FANS Completion (%) Results FANS Completion Rates (Uptake)* -- by Program Type 8 100% 95.0% % Completed** % Completed with Follow Up*** 80% 60% 50.0% 40% 20% 0% 5.0% 2.3% 4.6% 2.2% FSS HCBS Waiver Statewide N=40 N=2832 N=4041 *Cohort : Caregivers of youth in care between 10/1/2014 and 6/30/2015. ** Proportion of caregivers that had at least one FANS assessed during the care episodes. ***Proportion of caregivers that had at least two FANS assessed during the care episodes.

9 Results: FANS Needs Prevalence Reports 9

10 Needs/Needs Met (%) 10 Results 100% Prevalence of Needs on FANS by FANS Dimension -- Statewide Needs on First FANS (N=198) * 75% 50% 25% 0% 40% 20% 24% 22% 17% 16% 9% 7% 2% 48% 42% 40% 24% 33% 26% 11% 11% Awareness of Challenges Knowledge & Skill Self Care Voice in Service Delivery *Needs : Proportion of caregiver assessed with needs (score of 2 or 3) on first FANS, among those who had completed at least 1 FANS.

11 Results: FANS Outcome Reports 11

12 Dimension Score Results FANS Outcome -- Statewide 12 Avg. Dimension Score on first FANS(N=189)* Avg. Dimension Score on last FANS(N=90)** Awareness of Challenges Knowledge & Skill Self Care Voice in Service Delivery *Cohort: Caregivers of Youth completed one FANS **Cohort : Caregivers of Youth completed two FANS at least 31 days apart during their care episode. N varies due to missing data. Dimension score: Ranges between 0 & 3. A score of 0 indicates no need (greatest strength) and a score of 3 indicates greatest need (no strength).

13 Needs/Needs Met (%) 13 Results 100% 75% 50% 25% 0% 40% N=35 54% Outcome of Needs Met on FANS Dimension -- Statewide 20% N=18 78% 24% N=25 52% N=23 83% 22% 17% Needs on First FANS * N=22 82% N=18 83% 16% 9% N=11 64% N=9 67% Needs Met on Last FANS** 7% 2% N=2 100% N=42 60% N=39 51% 48% 42% 40% N=32 53% 24% N=20 55% N=28 64% 33% 26% N=23 57% N=12 67% 11% 11% N=6 50% Awareness of Challenges Knowledge & Skill Self Care Voice in Service Delivery *Needs : Proportion of caregiver assessed with needs (score of 2 or 3) on a dimension, among those who had completed at least 1 FANS. **Needs met: Proportion of caregiver indicated strength (0,1) on a dimension of their last FANS, among those who completed at least 2 FANS and indicated needs (2,3) on the same dimension on their first FANS. The two FANS must be at least 31 days apart. N varies due to missing data.

14 Dimension Score Results FANS Outcome --Family Support Services Avg. Dimension Score on first FANS()* Avg. Dimension Score on last FANS(N=20)** Awareness of Challenges Knowledge & Skill Self Care Voice in Service Delivery *Cohort: Caregivers of Youth completed one FANS **Cohort : Caregivers of Youth completed two FANS at least 31 days apart during their care episode. N varies due to missing data. Dimension score: Ranges between 0 & 3. A score of 0 indicates no need (greatest strength) and a score of 3 indicates greatest need (no strength).

15 Needs/Needs Met (%) 15 Results Outcome of Needs Met on FANS Dimensions --Family Support Services 100% Needs on First FANS * Needs Met on Last FANS ** N=2 100% 75% 50% 25% 0% 39% N=10 60% 21% N=4 50% 26% N=6 67% 26% N=7 43% N=6 67% N=5 60% 24% 18% 13% N=5 60% N=5 40% 13% 5.30% 55% N=11 45% N=12 53% 50% N=9 67% 53% 32% N=7 57% N=9 56% 42% N=7 N=5 43% 40% 32% 26% 13% N=0 0% Awareness of Challenges Knowledge & Skill Self Care Voice in Service Delivery *Needs: proportion of caregiver of youth in FSS program assessed with needs (score of 2 or 3) on a dimension, among those who had completed at least 1 FANS **Needs met: Proportion of caregiver indicated strength (0,1) on a dimension of their last FANS, among those competed at least 2 FANS and indicated needs (2,3) on the same dimension on their first FANS. The two FANS must be at least 31 days apart. N varies due to missing data.

16 Dimension Score 16 Results Avg. Domain Score on first FANS()* FANS Outcome --HCBS Waiver Avg. Domain Score on last FANS(N=66)** Awareness of Challenges Knowledge & Skill Self Care Voice in Service Delivery *Cohort: Caregivers of Youth completed one FANS **Cohort : Caregivers of Youth completed two FANS at least 31 days apart during their care episode. N varies due to missing data. Dimension score: Ranges between 0 & 3. A score of 0 indicates no need (greatest strength) and a score of 3 indicates greatest need (no strength).

17 Needs/Needs Met (%) Results Outcome of Needs Met on FANS Dimensions* --HCBS Waiver % N=12 92% N=17 88% Needs on First FANS * N=15 87% N=11 91% Needs Met on Last FANS** N=3 100% N=7 86% N=3 100% 75% 50% 25% 0% 41% N=23 57% 19% 23% N=16 63% 23% 15% 13% 7.70% N=6 67% 4.90% N=. 0.70% 0 N=27 67% N=25 52% N=20 45% 45% 40% 36% 20% N=10 60% N=19 68% N=16 63% 32% 26% 7.70% 10% Awareness of Challenges Knowledge & Skill Self Care Voice in Service Delivery *Needs : proportion of caregiver of youth in HCBS-Waiver assessed with needs (score of 2 or 3) on a dimension, among those who had completed at least 1 FANS **Needs met: Proportion of caregiver indicated strength (0,1) on a dimension of their last FANS, among those competed at least 2 FANS and indicated needs (2,3) on the same dimension on their first FANS. The two FANS must be at least 31 days apart. N varies due to missing data.

18 November 30, Domains FANS Domains Statewide Top Two Needs by Domains Top Two Needs Met by Domains Awareness of Challenges: 1. Self-Efficacy 2. Burden & Stress 1. Burden & Stress 2. Self-Efficacy Knowledge and skill development: Self-Care: Voice in Service Delivery: 1. Organization Skills 2. Understanding Service Options 1. Optimism 2. Interest in Recreational Activities Social Network 1. Satisfaction with School 2. Satisfaction with Educational 1. Involvement, 2. Understanding of Rights & Responsibilities, 1. Optimism 2. Talents & Interests 1. Satisfaction with Services 2. Satisfaction with School

19 19 Next Steps Number of FANS in the CAIRS platform needs to be increased to get a representative sample. Completion of FANS is still at the inception phase. Increase to at least 2 FANS for outcome analysis. Correlation b/w the caregiver s FANS scores and respective child/s CANS scores can be examined. This will be extremely important as with the transition to Medicaid Managed Care, programs like Family Peer Support providers will be serving the family for the benefit of the child.