D & M CONSULTANTS

OUTCOMES ASSESSMENT MANAGEMENT REPORT

Premier Lodge

Kinsel Lodge

Shared Housing

D & M North Apartment

 October 2005- September-2006

Executive Summary:

D & M Consultants, Inc. operates one supported living apartment program, one shared housing program and two Fairweather Lodge programs for adults with psychiatric disabilities in Oakland County.  One individual resides in the D & M North apartment program located in Auburn Hills, Michigan.  Two individuals reside in the Shared Housing program in Royal Oak.   Funding sources for these programs are Easter Seals of SE Michigan and Community Network Services, Inc.

Eleven individuals reside in the Fairweather Lodge programs: seven at Premier; and four at Kinsel.  Funding sources for individuals in these two lodge programs are Easter Seals of SE Michigan, Training and Treatment Innovations, Inc. and one individual who is private pay.  Individuals in the Fairweather Lodge program own Ever-Glo Janitorial Service, Inc. which is a consumer run janitorial service company.  Ever-Glo contracts with thirteen companies to provide janitorial services.  Ever-Glo Janitorial Service, Inc. annual income for 2005 was $108,257.00.   

D & M Consultants, Inc. has one staff that serves on the Coalition for Community Living Board, a national coalition of individuals serving to promote the Fairweather Lodge philosophy and concept.  A D & M staff is also a board member of the Michigan IAPSRS Board. (Formerly the International Association of Psychosocial Rehabilitation Services).

See attachment F for program characteristics.

For the Outcome Measurement Report, each program was evaluated on eleven objectives addressing program satisfaction, efficiency, effectiveness and access.

The following summarizes progress in each objective area, along with attachments displaying results.

Objective A: Satisfaction

Maximize satisfaction of persons served with D & M Consultants, Inc. services. Percent of individuals scoring an average of 3.0 or higher on satisfaction surveys.

Satisfaction surveys are distributed to persons served in all programs semi-annually in November and May. Individuals served are able to give input regarding satisfaction of services delivered.  Additional areas of input reflect access, privacy, health and safety, self esteem & self sufficiency and informed choice.  All questions asked have a scoring scale of 1.0 to 4.0.  One is the lowest score possible and four is the highest.  Those individuals responding with a score of 3.0 indicate agreement, 4.0 indicates strongly agree.  (See attachment A & B for survey results).

Fourteen individuals were surveyed in November of 2005 with a 100% response.  Eleven individuals resided in the Fairweather Lodge program and three individuals from the apartment/shared housing program.  

All individuals in the lodge program responded with 3.0 or greater.  The average score for all ten individuals was 3.11.  Goal expectancy of 90% was exceeded with the optimal expectancy met of 100%.  Four individuals from the apartment/shared housing program were surveyed and the average score of all three individuals was 3.0, which exceeded the objective of 90% satisfaction.   

The second survey for Fiscal Year 05-06 was distributed in May of 2006.  Thirteen individuals were surveyed and returned for a 100 % response rate.  Ten individuals in the lodge program responded with an average score of 3.25.  Three individuals from the apartment/shared housing program responded with an average of 3.25 as well.   The optimal expectancy was met for this survey period with 100% scoring a 3.0 or higher.     

Recommendations:  In all four service locations, we exceeded the goal expectancy of 90% satisfaction.  Revisions to the satisfaction survey are expected in the next fiscal year to address the length of the survey tool.          

Action Taken from Previous Reporting Period:  The automated management information system was revised in the year 2004. Changes were made to streamline the collection and input system.   Additional areas of input from persons served were added to the survey tool.  D & M scored high in areas of health and safety and access to services.  As always, there continues to be many opportunities for individuals served to give input and suggestions.  There are weekly house meetings at the lodge programs, community meetings at the apartment and shared housing program.

Objective B: Satisfaction

 Maximize satisfaction of Parents/Relatives/Guardians with D & M Consultants, Inc. services.  Percent of parents/relatives/guardians scoring an average of 3.0 or higher.

Satisfaction surveys are distributed to parents/relatives/guardians on a semi-annual basis in December and June.  An identical scoring system as with surveys of persons served is in place.  Survey questions are asked in areas that pertain to access, health and safety, self-esteem & sufficiency and informed choice.  Those surveys returned responding with a score of 3.0 indicate agreement, 4.0 indicates strongly agree.  (See attachment C & D for survey results).

Fifteen surveys were distributed in December 2005, ten of those were returned for a 66.67% response rate.   Eight surveys were returned by family members of participants in the lodge programs.  The average score for satisfaction of services was a 3.72, which resulted in meeting the optimal expectancy of 100%.  Two surveys were returned by family members of program participants in the apartment/shared housing program and the average combined score was 3.88, indicating satisfaction of services and meeting the goal expectancy of 100%.  Survey response that was the highest was in the areas of access, privacy, health and safety.

Fourteen surveys were distributed in June of 2006.  Thirteen surveys were returned for a 92.88% response rate.   Nine surveys were returned by the family members of lodge participants.  Of those nine, the average score was 3.44, which exceeded our goal expectancy of 90%.   Three surveys were returned by family members of participants in our apartment/shared housing program.  The average score was 3.88 which indicated agreement to satisfaction of services delivered.  Surveys from all four programs exceeded our goal expectancy of 90%.   

Recommendations:  As with the survey tool for persons served, it is expected that revisions will be made to questions asked in the next fiscal year.  Recommendations have been made to shorten the length of the survey.     

Action Taken from the Previous Reporting Period:   The return rate for surveys of parents/relatives/guardians is one of the highest we have had since we started our semi-annual collection tool.  Program Coordinators started to use an “acknowledgement” card to let parents/relatives/guardians know we appreciated their response.  This may have contributed to the increased rate of return.    

Objective C:  Satisfaction

Maximize Professional/Stakeholder satisfaction with D & M services.

Percent of surveys which indicate program satisfaction.

The Annual Professional/Stakeholder satisfaction survey was sent out in December of 2005 to individuals from Easter Seals, Community Network Services and Training and Treatment Innovations, Inc. Questions asked pertain to the following seven areas of program performance: Quality, Health & Safety, Staffing, Management, Programming, Dignity & Respect and Overall Satisfaction. The scale is set from 4.0 (strongly agree) to 1.0 (strongly disagree).  

Twenty six surveys were sent out with six surveys returned.  See attachment E.

 Five surveys were returned with an overall score of satisfaction indicating strongly agree.  One survey was returned with an overall score of satisfaction of agree.  The average percentage of satisfaction was 85% which met our expected goal that was targeted.  Feedback received was favorable regarding the professionalism of staff and noticeable respect for quality of care for persons served.

Recommendations:   Although the expected outcome of 85% satisfaction was met, the return rate for surveys was low at 23%.  Recommendation is to move the survey month for Professional/Stakeholder to a different month that is not close to the holidays.

Action Taken from the Previous Reporting Period:   Revisions were made to the survey tool in the form of questions asked and areas of survey.  The automated data collection system was revised to allow electronic input and scoring.

Objective D: Satisfaction

Maximize program satisfaction with D & M Consultants, Inc employees.

Percent of surveys that indicate satisfaction with D & M Consultants, Inc.

Employee Opinion Surveys are distributed in January and June each year.  Three surveys were sent out with three surveys returned in January of 2006.  Surveys for July 2006 were completed, however the data was lost and an analysis was not completed for that survey period.  See attachment F.

Surveys returned scored 100% satisfactions with D & M Consultants, Inc.  Our goal expectancy was 90%.  This objective met the targeted optimal expectancy.  Comments from staff were “Team is the key to our success as well as quality programming”, “Uniqueness of program and the opportunities that it gives to the persons served”.

Recommendations:  Due to the data that was lost for the second survey of the year, it is recommended that additional attention for follow-up on results be implemented.  The survey tool will be evaluated for revisions in next fiscal report period.     

Objective E: Satisfaction

Maximize satisfaction of persons served that exit or change program service delivery.  Percent of individuals who respond satisfactorily to Exit Satisfaction Survey.

Two individuals exited the program for Fiscal Year 05-06.  Both individuals were contacted for follow-up feedback.  One individual responded that they were very satisfied with services while part of D & M Consultants, Inc.; while the other individual indicated they were not satisfied.  Our goal was set for 90% satisfaction and our expected goal was not met with this objective.     

Recommendations:   Response for this objective was completed using two different survey tools. Revisions to the original tool allowed the person giving feedback to indicate level of satisfaction/dissatisfaction.   It is recommended that the survey tool clearly indicate change in services within the program as well, which will allow feedback regarding specific program delivery.           

Objective F: Access

Maximize access to D & M Consultants, Inc. services with persons authorized for placement.  Percent of individuals placed within set timeframe of 14 days or less.

Four individuals were referred for placement during the report period for Fiscal Year 2005-2006.  Two individuals were referred in October of 2005.  One individual was placed within the targeted timeframe of 14 days while the other individual was delayed being placed due to agreed approval from guardian.  That individual was finally placed in November of 2005.  In April of 2006 an individual was referred from an outside case management agency.  That individual was interested in placement at one of the lodge programs.  The process of getting that individual placed took four months for him to be referred to one of our contracting agencies and approval for services.  D & M enlisted the assistance of one of our local legislators to act as an advocate in getting this person placed.   He was finally placed in August of 2006.  One individual was referred in June of 2006 for placement at another lodge program and that individual was placed within the targeted timeframe of 14 days.  

It was our targeted goal to meet access to services by setting timely perimeters that would enable an individual to start participating as soon as possible.  Our targeted goal was set at 100%, however due to outside circumstances we did not reach our objective.    

Recommendations:  D & M continues to believe that timely access to services is of the utmost importance for many individuals referred for placement.  We will continue to be proactive in our efforts to minimize the delays that occur due to restraints placed by outside referral and contracting agencies.            

Action Taken from the Previous Reporting Period:  This is a new outcome objective for this year.     

Objective G: Access

Maximize number of persons served who participate in community outside of program structure.  Percent of individuals who participate in community life outside of program structure.

Data was collected each month for the four program service sites that D & M Consultants, Inc. operates.  Access was defined for this report as participation in community that is outside the program structure of D & M.  For Kinsel Lodge in Southfield and D & M North Apartment Program in Auburn Hills, the optimal goal was met with 100% of persons accessing the community outside program structure.  Activities of participation were; access to health club, pottery class, Church, support groups and college classes.    Individuals who live at Premier Lodge in Southfield, 89% participated in community outside of program structure.   Activities included; golf, biking, college classes and membership to YMCA.  Individuals living in Shared Housing participated in community outside of program structure less than 50%.   Our objective for this goal was met with an average of 81%. 

Recommendation:   D & M Consultants, Inc. embraces the concept that individuals we provide service to benefit from the connections they make outside of program structure.  Opportunities for persons served to feel a part of their environment serves as a catalyst to elevate their status in society.  This in turn provides a positive aspect to the process of their recovery.   It is recommended that staff continue to monitor this objective with and increase in the percentage for next fiscal year.  

Action Taken from the Previous Reporting Period:   This is the first year this objective was measured.  It was a beneficial objective to measure as it helps to identify needs and desires of persons served outside program structure. 

Objective H: Effectiveness

Maximize program effectiveness of D & M Consultants, Inc. by compliance with all Internal Quality Assurance Reviews.  Average percentage score of internal Quality Assurance Reviews. 

D & M Consultants, Inc. participates in a peer quality assurance process.  Peer Quality Assurance Reviews are performed semi-annually.   For this report period, an internal QA was performed in June of 2006.   The average score of all four program sites was 92%.  Our goal expectancy was set for 90%. 

Recommendations:  One internal QA was missed for this last report period due to the personnel changes associated with the position.   It is recommended that the peer QA change the scoring system to percentages aligned by program components such as Fiscal, Safety, and Medication etc.

Action Taken from the Previous Reporting Period:   This is the first time this objective was tracked for the Outcome Measurement Report.       

Objective I: Effectiveness

Maximize program effectiveness of D & M Consultants, Inc. by compliance with all External Compliance Audits.  Average percentage score of External Compliance Audits. 

D & M contracts with three Core Agencies for mental health services.  They are Easter Seals of SE Michigan, Community Network Services and Training and Treatment Innovations, Inc.  At this time Easter seals and Training and Treatment Innovations, Inc. perform annual compliance audits.  In October of 2005, Easter Seals performed an external audit for Shared Housing in Royal Oak.  The score for this audit was 98%.  In March of 2006, Easter Seals performed an audit on both lodge programs, Kinsel and Premier.  Both audits resulted in 100% compliance.  In January of 2006 Training and Treatment Innovations, Inc. performed their annual audit at Premier Lodge and the score was 100%.   The overall average score from all external audits resulted in 99.5%.   Our goal was set at 95% and this objective was met.

Recommendations:  The provider alliance associated with each of these Core Agencies has asked that a system be developed to audit providers once a year rather than having multiple audits each year from each agency.  

Action Taken from the Previous Reporting Period:   This is the first time this objective was tracked for the Outcome Measurement Report.      

Objective J: Efficiency

Staff Retention- Maximize program stability by reducing staff turnover.  Percent of staff within D & M Consultants, Inc. that maintain their employment for 12 months or longer.

D & M believes that maintaining a stable quality staffing pattern is beneficial to the persons we provide service to.  Additionally, it is beneficial to the fiscal solvency of the agency.  Data on staff retention is collected quarterly.  D & M had a total of four staff for fiscal year 05-06.  All four of those staffs were employed with D &M for more than twenty four months.  The staff with the least seniority had been employed with D & M for five years.  This objective was met with 100% staff retention.         

Recommendations:  It is recommended that staff training be monitored for next fiscal year.  

Action Taken from the Previous Reporting Period:   This is the first time this objective was tracked for the Outcome Measurement Report.      

Objective J: Efficiency

Maintain efficiency by reducing the number of psychiatric hospitalizations.  Percent of day’s individuals remain out of hospital for psychiatric symptoms.

D & M Consultants, Inc. has had a long history of maintaining psychiatric stability with the individuals they provide service to.  Having a quality stable staff has contributed to this as well as early recognition of signs and symptoms associated with the onset of relapse.  Decreasing hospitalizations is beneficial to the consumers’ feelings of self worth.  Additionally, it is a positive approach to utilizing budget resources efficiently.

Psychiatric hospitalizations are entered into the automated management information system monthly.  Data is collected for a year end report. For fiscal year 2005-2006 there were 23 days of hospitalization out of 260 billable days of service.  This presented an efficiency rate of 91%.  Out goal expectancy was set for 85%.  We exceeded our goal expectancy for this objective.

Recommendations:  It is recommended that D & M continue to be proactive in their approach of monitoring early onset of relapse.      

Action Taken from the Previous Reporting Period:  This is the first time the new revised information system was utilized to track this objective.

Report compiled by:   Susan J. Yagiela                                      11/06