The Guidance Center

Family Based Services (FBS)Annual Quality Review

January 1, 2019 – December 31, 2019

1

Contents

Program Overview.......................................................................................................................................3

Demographics..............................................................................................................................................4

Age..........................................................................................................................................................4

Sex...........................................................................................................................................................4

Location of Services.................................................................................................................................5

Service Data.................................................................................................................................................5

Length of Stay..........................................................................................................................................5

Number of Participants...........................................................................................................................6

Diagnosis.................................................................................................................................................6

Program Adherence.....................................................................................................................................7

Audits......................................................................................................................................................7

Staff Supervision......................................................................................................................................7

Staff Training...........................................................................................................................................9

Standardized Functional Assessment..........................................................................................................9

Child Social-Emotional Competency and Effectiveness.........................................................................10

Caregiver-Child Relationship..................................................................................................................10

End of Service Questionnaire Summary....................................................................................................11

Service Questions..................................................................................................................................12

Comments.............................................................................................................................................13

2

Program Overview

Family Based Services is an intensive, nontraditional therapeutic program for children with emotional and behavioral concerns.

Therapists work with families to improve the functioning of the child and to help families cope better with their children’s emotional and behavioral needs.

Utilizing the child and family strengths, a team assists in the development and enhancement of skills necessary for the child’s successful functioning at home, school, and in the community.

Service components include:

Team delivered service Professional and confidential treatment Family, individual, sibling and co-parent therapy sessions Strength Based approach Case management Coordination/collaboration with other service providers Parent Education Crisis Stabilization Aftercare planning and service linkage 24 hour crisis hotline

Goals of the program are to:

Assist with crisis stabilization Support the co-caregiver relationship Empower parents to care for their children at home Strengthen and maintain the family Improve coping skills Provide the family with case management

Demographics

3

Family Based Services (FBS) information contained in this report is for calendar year 2019.

AgeIndividuals within the program range from 0 year of age to 21 years of age. The majority of the individuals in the program are between 6-17 years. The following table demonstrates the age breakdown.

0-5 years 6-13 years 14-17 years 18-21 years 0

5

10

15

20

25

30

35

40

45

1

42

28

4

Ages of Individuals

SexA greater number of males have been served in the program in the past year. The following table indicates the percentage of males and females who received FBS services.

53%47%

Family Based Services Individuals Gender

Male Female

Location of Services

4

There were 8995 services provided during calendar year 2019. These services were provided in a variety of locations with the primary location being in the home at 56.9 %.

Bradford High

Kane Elementary

Floyd Fretz Middle

GGB Elementary

Kane Area Middle

Kane Area High

Otto Eldred Jr/S

r High

Otto Eldred Elem.

Port Alle

gany Elem.

School S

treet E

lem.

Smethport Elem.

Smethport Jr.

/Sr. H

ighOffice

CommunityHome

Port Alle

gany Jr/S

r. High

Custer C

ity Priv

ate School

0

10

20

30

40

50

60

0.085.82

1.4 0.5 1.5 0.9 0.2 0.4 0 3 2.3 0.6

20.8

3.5

56.9

0.7 1.4

Location of Services

Location

Perc

enta

ge

Service DataLength of Stay

The average length of stay in the program was 7.1 months. To calculate this report, individuals were required to be in FBS for at least 90 days.

3.1 3.4 4.3 5.4 6.1 6.4 6.6 6.8 6.9 7.5 7.9 8.5 8.7 8.9 9.1 9.3 9.7 9.910.1

10.314.7

0

0.5

1

1.5

2

2.5

3

3.5Length of Stay in FBS Program in Months

Number of Months in Program

Num

ber o

f Ind

ivid

uals

Number of Participants

5

Number of Participants Enrolled in 2019

Number of Admissions in 2019

Number of Discharges in 2019

0 10 20 30 40 50 60 70 80

74

54

55

FBS Program Participation

Diagnosis

The primary diagnosis of individuals enrolled in Family Based Services was Attention Deficit/Hyperactivity Disorder at 39 %. Major Depressive Disorder was next at 28 %. A complete breakdown of the primary diagnoses is found below.

4%

28%

8%

3%11%

1%5%

39%

1%

Diagnosis

Bipolar Disorder Major Depressive DisorderPersistent Depressive Disorder Generalized Anxiety DisorderAdjustment Disorder Emotional Unstable Personality DisorderAutism Attention Deficit/Hyperactivity DisorderConduct Disorder

Program Adherence

6

To ensure that the Family Based Services are adhering to the program model, several forms of audits as well as intensive supervision and training are utilized.

Audits

The following auditing methods are completed in the program:

1. Community Care Behavioral Health (CCBH) yearly quality reviews2. CCBH annual Fraud Waste and Abuse Audits3. CCBH yearly benchmarking reviews4. Annual licensing visits by Office of Mental Health5. Monthly Chart reviews completed by Program Director

Information of these audits can be found in the Family Based Services Quality Manual.

Staff Supervision

Due to the complexity of family systems and requirement of the model, staff supervision and training continue to be significant areas of focus for the FBS program. Staff receive weekly individual and team supervision along with group supervision. The quality goal is for 100 % of all of the FBS staff to have 1.5 hours of team and 1.5 hours of group supervision each week. It is an expectation of the supervisory session for staff to work on the areas identified in their individual training plans and to continue clinical development.

The following table depicts the average amount of supervision provided to each team member during individual/team supervision for 2019. The amount of supervision reported is from May –December of 2019.

Team/Individual Supervision:

7

M.W (3 months)

D.F (8 Months)

M.H (8 months)

E.R (8 months)

A.P (8 months)

B.W (8 months)

L.R (6 months)

5 5.2 5.4 5.6 5.8 6 6.2

6.1

5.7

5.7

5.8

5.6

5.4

6

Average Hours of Supervision Per Month/ Team/In-dividual (May 2019 - December 2019

Hours Per Month

Empl

oyee

/ # o

f mon

ths e

mpl

oyed

Group Supervision :

M.W (3 months)

D.F (8 Months)

M.H (8 months)

E.R (8 months)

A.P (8 months)

B.W (8 months)

L.R (6 months)

5.4 5.6 5.8 6 6.2 6.4 6.6 6.8 7

6.8

6.4

6.5

6.3

6.2

5.9

6.4

Average Hours of Supervision Per Month/ Group (May-December 2019)

Hours Per Month

empl

oyee

/# o

f mon

ths e

mpl

oyed

The FBS Director maintains supervision logs.

8

Staff Training

To ensure fidelity to the model, staff are required to have regular training. In addition to agency provided training, staff members participate in specific training through the Philadelphia Child and Family Training Center. These training sessions are held on a regular basis covering topics such as: Caregiver Alliance; Non-violent Crisis Intervention; Promoting Interpersonal Experiences; Conceptualization in Power and Privilege; Ecosystem Structure and In Home Family Therapy to name a few. The number of hours of training are noted below.

D.F E.H M.H A.P E.R A.R0

102030405060708090

53.5

35

5358.5

85

50.25

Staff Annual Training Hours Total for 2019

Initials of Staff Member

Hour

s of T

rain

ing

per Y

ear

Standardized Functional Assessment

The Guidance Center utilizes the Summary of Assessment Finding (SAF) to determine the impact of services. This tool was designed to examine family functioning in the domains of Environment, Parental Capabilities, Family Interactions, Family Safety, and Child Well-being.

This assessment is completed by program participants and their family within 30 days of enrollment in the program and at discharge from the program.

From the SAF two questions have been selected to monitor for quality improvement. One is taken from the Child Social-Emotional Competency and Effectiveness domain and the other from Caregiver-Child Relationship domain.

The participants answer questions using the Likert Scale:

1 – Most of the Time

2 = About Half of the time; independently

3 = Can do it, but only with support

4 = Occasionally

5 = Rarely

9

Child Social-Emotional Competency and Effectiveness

For this question, participants are asked to what extent is the child able to resolve conflicts? Pre-FBS the average response was can do it, but only with support. Post FBS, the average responses were About Half of the time; independently.

Pre-FBS Post FBS0

0.5

1

1.5

2

2.5

3

3.53.15

1.85

To What Extent Is the Child Able to Resolve Conflicts ?

Caregiver-Child Relationship

For this domain, parents answer the question, Are Caregivers Attached and Emotionally Responsive to the Child? Using the same scale as noted above, the child’s main caregivers are asked to answer the question. The names of the caregivers are noted on the assessment so comparisons can be made following participation in the program. For this question, the average score Pre-FBS was 2.68. Post FBS the score improved to 2.14 showing some improvement.

10

Pre-FBS Post- FBS0

0.5

1

1.5

2

2.5

32.68

2.14

Are Caregivers Attached and Emotionally Responsive to Child ?

End of Service Questionnaire Summary

Individuals who have received FBS services and their parents/guardians are asked to complete a survey on the last day of services. The first question in the survey is:

Overall, were the services you received from Family Based Services?

Very helpful (3) Helpful (2) Not Helpful (1) No Change (0)

For the summary period, 75 % of the respondents have indicated that the service is very helpful; whereas, 25 % of those who have completed the survey have indicated that the service is helpful.

11

3 = very helpful 2 = helpful 1 = Not Helpful 0 = No change0

1

2

3

4

5

6

7

8

9

10

Were FBS Helpful ?

Service Questions

The questions listed in the following graph are asked of individuals on their last day of services. Individuals respond with either yes or no. The results of the surveys show that 100 % of the respondents feel very positive about the services.

Did therapy team listen & help with needs and concerns

Did team give you helpful information in a way that you could understand?

Did team respect confidentiality ?

Did team include you in treatment planning process?

0% 20% 40% 60% 80% 100% 120%

FBS End of Service Questions

No Yes

12

Comments

The last section of the survey allows participants to share their comments and thoughts on what could be changed to improve Family Based Services. The following word cloud depicts the comments that were offered:

13

Helpful Wish it could have been longerAccommodating

Very PLEASED with program & workers Wonderful Job Amazing People

Professional Hard to Say Good-Bye Supportive

Excellent services