Community Strategies:New Hampshire

Comprehensive Program ReviewDecember 21, 2012

Challenges in CS-NH:

• Obtain increased funding for Newmarket.• Continue to resolve the financial cost of fee for service agencies – MCS and

MDS.• Increased clinical presence for staff/client support by utilizing Tom Grinley• Providing services for individuals with substance abuse issues.• Being 100% compliant with all CS-NH inspections due to the changes in state

regulations.• Preparing for Managed Care and the changes put forth by the state and our

funding agencies.• Ensure that all performance reviews are up-to-date.• Utilizing our resources within CRJ/CS-NH to accomplish what needs to be

done.• Utilizing vacation time in a timely fashion with the ability to continue to

accrue vacation time. • Bring up the hourly rate for DSPS to market value and equal hourly rates

based on education and experience.

STAFFING

Staff Turnover RatesPerformance Evaluations

Staff Training

STAFF TURNOVER RATESMay 2012 – October 2012

The current CSNH turnover rate is 23.4% compared to the last CPR of 17.9% Last CPR: Keene = 10%; Manchester and Unity = 0%; Individual Sites = 22% (August 2011 – January 2012) Data obtained from HR Reports

OVERDUE PERFORMANCE EVALUATIONS May 2012 - October 2012

Total of 66 FT and 30 PT overdue performance evaluations between May 2012 – October 2012. Last CPR, a total of 72 FT and 55 PT overdue performance evaluations from August 2011- January 2012.

Data obtained from HR Department & HR Personnel Summary

May June July Aug. Sept. Oct.

FT PT FT PT FT PT FT PT FT PT FT PT

Keene 4 4 3 2 5 4 6 4 5 4 4 4

Manchester 1 0 1 0 0 0 0 0 0 0 0 0

Unity 4 0 5 0 0 0 0 0 1 0 1 0

Individual Sites 1 0 1 0 6 2 6 2 6 2 6 2

Totals 10 4 10 2 11 6 12 6 12 6 11 6

Overdue

Evaluations

2 or more months

FT PT

Keene 5 6

Manchester 0 0

Unity 4 0

Individual Sites 6 2

Totals 15 8

Total 261 training hours were completed May 2012 – October 2012 Average of 7.6 training hours per staff/six months

E Training Hours

MMR Training Hours

Total

Keene 91 0 91

Unity House 58 0 58

Newmarket Program 8.25 0 8.25

Manchester 18.75 0 18.75

Totals 176 85 261

MMR Training Hours = combined and not sorted by individual programs

Data obtained from MMRs and HR Reports

CLIENT RELATED

• Clinical Hours• Walk-Aways• Restraints • New Clients• Medication

EVOLVING MODEL OF CLINICAL SUPPORT Recognition we are serving more individuals with co-occurring disorders The milieu is an essential component of any treatment plan Clinical support of program and staff Greater use of standardized, objective scales and assessments More of a Clinical Case Management approach Person centered, recovery oriented, trauma focused treatment* Continuity in planning across service providers

*When applicable

Please refer to CSNH Clinical Presentation Handout

Community Strategies Day ProgramACTIVELife The ACTIVELife name was chosen because it is the core

mission of the day program. We work to insure that all our individuals are active within their lives. ACTIVELife is NOT an adult daycare…we are not a place where individuals are dropped off for the day to only stay within the walls of the facilities. ACTIVELife is about being out and involved within the community.

Please refer to the CSNH Day Program Handout

Average of 0.79 clinical hours per client/month Total Clinical Hours = 39; last CPR, total Clinical Hours = 188 (August 2011 – January 2012) Last CPR, the average of . 7 clinical hours per client/month

Data obtained from MMRs

Client Walk-Aways

May 2012 – August 2012

August 2011 – January 2012

CSNH 0 0

Client Restraints

May 2012 – August 2012

August 2011 – January 2012

CSNH 1 0

Data obtained from MMRs

New Clients - CSNH

Total of 0 medication incidents and occurrences (May 2012 – October 2012) Last CPR, a total of 7 medications incidents and occurrences, over six months. Data obtained from MMRs

• There was one restraint for May – October 2012; last CPR, there was one restraint (August

2011 – January 2012

• There were zero elopements for May – October 2012; last CPR, there were zero elopements

• There were two incidents involving contraband for May – October 2012; last CPR, there

were zero incidents involving contraband

• There were zero medication incidents for May – October 2012; last CPR, there was one

medication incident

• There are ten clients competitively employed; twenty-seven clients partaking solely in day

activity programs

• There were six site visits by outside regulators/funders from May 2012 – October 2012

• CSNH received 3 written commendations from site visits by outside regulators/funders and

7 deficiencies (over 6 months). However, at the time of the last CPR there were 27

deficiencies so this is an improvement.

• See Handout