CQIR AnnualReport 2012 Florida

7/30/2019 CQIR AnnualReport 2012 Florida

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Report Prepared by Kimberly D. ClarkCQIR Systems Analyst

Please direct inquiries to: [email protected]

Report Snapshot

Florida region

served 2,932

clients in FY12.

90% of Florida

Outcome Goals

were met.

About 78% of files

reviewed in the

Florida region met

agency standards

for Compliance &

Quality and Child

Welfare Measures.

For the past three

years, Florida

scored an A inoverall client

satisfaction.

CQIRANNUAL REPORT

2012FLORIDA REGIONANALYSIS

An Action-Oriented Retrospective


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Table of Contents Letter from the Executive Vice President.......................................................................................... 3

Continuous Quality Improvement and Research Team .................................................................... 4

Executive Summary ........................................................................................................................ 5

Story of Hope ................................................................................................................................... 9

Clients Served ............................................................................................................................... 10

Outcome Management .................................................................................................................. 11

Peer Record Reviews .................................................................................................................... 13

Client Satisfaction ......................................................................................................................... 17

Incident Reports............................................................................................................................. 18

Office & Supervisory Reviews ........................................................................................................ 19

Priority Reviews ............................................................................................................................ 20

Employee Recognition .................................................................................................................. 21

Quality Improvement Teams ......................................................................................................... 22

Circuit 9.......................................................................................................................................... 24

Circuit 10........................................................................................................................................ 27

Circuit 13........................................................................................................................................ 30


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Letter from the Executive Vice President

August 17th , 2012

To Our Readers:

This is our 12th year of providing the Continuous Quality Improvement and Research (CQIR) annualreport on the agencys outcomes and other quality improvement activities and results. The CQIR teamtakes great pride in preparing and presenting this report to you, our valued stakeholders.

Over the years our funders have increased their requirements for accountability. We, at One HopeUnited, have been leaders in applying rigorous discipline to ensure that we understand the processes of

our service and manage towards the results. One Hope United, as an agency, values results as a basicpromise of how we do business. We strive to ever increase our ability to understand how we provideservices, how to improve services and the relationship of services to short and long term positivechanges in peoples lives.

There has been a pressure in the broader human service field to inflate numbers and to make estimatesof what a program or agency can accomplish. We will not follow that trend we believe that everynumber should be supported by hard data and that we could describe to any constituent how thenumbers are derived. While we know that our services touch many lives, we will take credit only for thoseaccomplishments we can measure and calculate responsibly and ethically.

This report would not be possible without the collaboration of our partners in the field. We thank them for

participating in the disciplined tasks that allow for genuine quality improvement. With funding pressuresin many programs, case numbers may rise and demands increase thus making time for activities such asdata collection and peer record review challenging. But these activities of quality are part of the OneHope United culture. Through expert time management, supportive supervision and accountableleadership ensuring that all staff take part in the activities, we can assure those we serve the very bestpossible programs.

An unknown author said, Good, better, best; never let it rest till your good is better and your better isbest. That is a driving force on our One Hope United CQIR team. We will keep working with our partnersin excellence to be certain that what we provide is the very best.

In the past 8 years I have been blessed to have the leadership role for CQIR. This is an amazing team ofemployees devoted to excellence. As I have said many times, we never forget that the numbers in ourreports reflect the people we serve as well as our colleagues. They deserve the very best we can offer.

As ever, thank you for your interest. We know you will find the report interesting and thought provoking.We look forward to your feedback and continued work together.

Fotena A. Zirps, PhDExecutive Vice President

Corporate Office111 E. Wacker Dr., Ste. 325Chicago, Illinois 60601

t: 312.922.6733 f: 312.922.6736www.onehopeunited.org


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Continuous Quality Improvement & Research TeamTo support direct service providers and ensure best practice quality of service throughout the agency, theContinuous Quality Improvement and Research (CQIR) team at One Hope United guides theorganization in 14 core tasks (PQI Standards) that are aligned with internal OHU principles and externalCouncil on Accreditation guidelines.

Dr. Fotena Zirps Executive Vice PresidentTina McLeod Assistant to the EVP

Florida Region Hudelson Region Northern Region Research Team

Ruann BarrackSenior Vice President

Jeffrey HonakerCQI Director

Sarah TuningCQI Coordinator

Katurah RobyCQI Coordinator

Ron CulbertsonCQI Coordinator

Linda WeissCQI MedicaidCoordinator

Ryan CounihanCQI Technician

Stan GrimesCQI Coordinator

Elizabeth HopkinsCQI MedicaidCoordinator

Jackie SchedinCQI Coordinator

Katrina Brewsaugh

Director of Research

Kimberly ClarkSystems Analyst

Special thanks to members of the CQIR team that left the team in FY12 including: Stephen Brehm,Rosalyn Thomas and Maria Weber.

Information presented in the Florida region annual report is organized by these CQI Core Tasks:

Outcome Management Peer Record Reviews Client Satisfaction

Incident Reports Office Reviews Supervisory Reviews

Priority Reviews Employee Recognition Quality Improvement Teams

Within each section, the following program categories are reviewed for the Florida region: Counseling,Family Preservation, Placement, Prevention, and Youth Services.

Florida Leadership

Barbara Moss Executive Director

Directors ofPrograms

Neika Berry, Engle Demont, & Michelle Ramirez


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Executive SummaryThis year, OHU programs in the Florida region served 2,932 children and families a 5.43% increasefrom last year. The compliance & quality with which service was delivered in these programs overall wasabout 78%. The efforts of Florida programs overall resulted in 90% of all outcome goals being met.

OUTCOME MANAGEMENT PEER RECORD REVIEWS

Across all programs, 90% of Outcome goals weremet in FY12.

Out of 300 files reviewed in FY12, the Floridaregion compliance & quality was at 78%.

CLIENT SATISFACTION INCIDENT REPORTS

Florida region Overall satisfaction score hasremained above 4.50 (A) for the past three years.

In the Florida region, number of incidents wentdown 9% across most incident types. Educationincidents had the largest increase, up by over 22%from FY11 to FY12.

OFFICEREVIEWS

SUPERVISORYREVIEWS

PRIORITY REVIEWS

In the Florida region, 97% of Office Reviews and91% of Supervisory reviews were compliant.

There were 9 priority reviews conducted in FY12: 1Level III, 2 Level IIand 6 Level Ireviews.

EMPLOYEE RECOGNITION QUALITY IMPROVEMENT TEAMS

There were 27 STAR awards and 6 GALAXYawards distributed this year.

There was an average QIT attendance rate of98.21% in the Florida region.

KEEPING AGENCY PROMISES

Hope The CQIR team welcomed Kimberly Clark, Jeffrey Honaker, Katurah Roby, and Linda Weiss

as new members. CQIR led the hosting of the first annual Golf Tournament in the Florida region. CQIR played a

role in increasing the fund raising activities in the Florida region. CQIR has been involved in providing data and information for bids and grants for future

services.

Collaboration All three regions completed the Quality 2 Practice (Q2P) for Family Preservation and Foster

Care. This was the first Q2P that included all three regions in discussions regarding practiceand improvement in services.

CQIR has worked collaboratively with operations in the Florida region to start-up MentalHealth Services.

CQIR collaborated with the Independent Living Unit in Florida to create new and improvedservice documentation in the Florida region.

Katrina Brewsaugh collaborated with two outside agencies for a presentation on ChildWelfare outcomes at the American Evaluation Associations annual conference.

Hudelson and Northern region staff continues to participate in the Medicaid Committeemeetings co-facilitated by the CQIR Medicaid Coordinators from each region.

Staff from Hudelson and Northern regions assisted each other in an audit to review FY11Medicaid documentation.


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The Charleston Office Manager for Hudelson region offered and allowed the AdministrativeAssistant to enter PRR data saving valuable time for CQIR Coordinators. This is an exampleof collaboration and support of the Regions Leadership of CQIR.

The Hudelson region now has two CQIR Coordinators for the first time. The two Coordinatorshave diversity in their strengths and are able to collaborate and use these strengths toenhance the CQIR presence in the region.

Stan Grimes and Elizabeth Hopkins from the Northern region and Ronald Culbertson andLinda Weiss from the Hudelson region received STAR Awards during FY12.

CQIR facilitated a joint meeting of the Northern region MST program leadership to reviewoutcomes and program opportunities for enhancement.

CQIR organized a multi-disciplinary task force to review the Rebound program modeland make recommendations for changes in the Northern region.

The QIT attendance rate over all Regional Partners was 97.9%. Attendance for Peer Record Reviewers was 96%.

Innovation Katrina Brewsaugh received the Innovation Promise Award in FY12. Dr. Ray Foster provided training, resources, and discussion around formulating an evidenced

based Case Management Model in all three regions. This opportunity was made possible byDr. Fotena Zirps.

Initial steps have been taken to move toward the use of electronic signatures on case notes inCMS. A pilot is expected to be implemented in FY 13 in the Hudelson region.

CQIR Coordinators have increased the use of teleconferences and MegaMeeting in QITsenabling staff visibility during meetings and reducing travel time and expense.

Leadership The CQIR team maintained implementation of the quality activities and processes during the

loss and transition of several team members this past year. Members of the CQIR team were a part of Supervisory Training this past year provided by Bill

Gillis and Dr. Fotena Zirps. Members of the CQIR team published a chapter entitledChild Welfare Information Systems in

the Child Welfare Leagues revised edition of the book What Works in Child Welfare.

The updated and improved Supervisory Protocol was finalized for the Agency in FY12. Florida region CQIR team members developed a partnership with the Social Work program at

Warner University to begin internship programs for Counseling and Case Management. The Hudelson region Residential program received the second highest compliance rate (93%)

in the state on the most recent IPI Post Payment Review. The highest percentage was 94%. CQIR helped facilitate a multi-agency COA peer reviewer training in which a number of

agency staff were certified to be COA reviewers.

Results Sarah Tunning received the Results Promise Award in FY12. The CQIR Team in Florida completed a 100% file review (228 cases) in Tampa prior to

starting services.

The CQIR team completed two Program Evaluations in FY12, one in the Intact FamilyProgram (Northern) and the second in the Youth Diversion Program (Hudelson).

There was an increase in the percentage of programs reaching validity on the ClientSatisfaction Survey across the agency.

The CQIR team updated their performance outcomes to make them more related to impact. On the Client Satisfaction Survey the scores for all Regional Partners were within the fine

tuning range. All eligible Child Development Centers are now accredited by NAEYC. Congratulations to the

Child Development Centers.


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CQIR surveyed staff at all local QITs to determine their level of satisfaction with the QITprocess. Results were very positive.

Glossary of Acronyms

CQIR/T Continuous Quality Improvement & Research Team COA Council on Accreditation IPI Infant-Parent Institute

IR Incident Report IS Information Systems PQI Performance & Quality Improvement PRR Peer Record Review QIT Quality Improvement Team


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RISK MANAGEMENT TOPICS FOR FY13QITS

In reviewing each area assessed in this report, the following actions are recommended in FY13 based onoutcomes, reviews, and incidents in FY12.

Area Reviewed Recommended Actions

Outcome Management Most outcome goals (90%) were met in FY12. Permanency (83%) mostaffected the total percent of goals met. Specifically, the Permanencymeasure related to ensuring that no more than two placement settingswithin 12 months was not achieved. It is recommended that programsidentify risk factors that can be evaluated that most affect this measure.

Peer Record Reviews To close the 6% to 16% gap between where we want to be in regards toCompliance & Quality and Child Welfare Measures and where we are,the specific items noted throughout the year via quarterly reports shouldbe monitored.

In addition, the items highlighted in this annual report, especially Intake,Assessment and Service Delivery should be tracked more closely thisyear.

Client Satisfaction Overall Client Satisfaction for the Florida region is4.61 (A), which is inthe Fine Tuning range.

Incident Reports Hospitalizations, as well as Injuries have gone down by over 35% thisyear. Education incidents and Behavioral Issues have both increased byover 20% this year.

Wherever possible, risk management measures should be employed toreduce the occurrence of avoidable incidents. In particular, lessonslearned from priority reviews should serve as a guide.

Office Reviews Over 97% of all office reviews in the Florida region were compliant.

Supervisory Reviews Supervisory Reviews achieved 91% compliance an 8% increase fromFY11.

Circuit 10 achieved an 83% compliance rating. The area that C10 canmost improve upon in FY13 is in completing staff performance reviewswithin the month they are due.

Priority Reviews Lessons learned should continue to be captured and shared. Case consultations should continue to be utilized to improve outcomes

and mitigate risk for complex or challenging cases.


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Story of HopeStories of Hope share the experiences of One Hope United staff who are protectingchildren and strengthening familiesas well as the real-life stories of

empowerment based on our clients. Often,

names are changed in stories to protect clientsfacing extremely difficult situations androadblocks in their lives. In these stories ouragency illustrates how we serve our mission on a day to day basis and work towards our vision of a safeand nurturing home for every child. The Florida region is pleased to share the following story of hope.

When Julian was 7 years old, he was placed in foster care because he had no caregiver: his legal fatherwas reportedly dead, his mother was incarcerated on a work-release program, and his putative fatherwas apprehended in Texas while attempting to kidnap Julian and take him to Mexico. Julian was placedin a foster home in Florida while his mother, Maria, maintained daily contact with him from her work-

release program about three hours away. Julians foster mother learned about co-parenting and usedsome of those techniques to help Julian and Maria stay in direct contact. When Maria completed herwork-release program about nine months later, she moved back to be near Julian. Maria immediatelybegan supervised visitation with her son and was eager to obtain stable housing and employment so shecould be reunified with him. Julians foster parents helped Maria find a home in the county so she couldbe even closer to Julian and allow him to stay in the same school. His foster parents also invited Mariasmother to a holiday dinner so that she could be with her son. This relationship between the foster parentsand Maria helped lead to Maria and Julian being reunified just three months after she was released fromincarceration. The foster mother spoke to a group of supervisors from the Circuit Case ManagementOrganizations about the case and co-parenting. She said the Family Case Manager she worked withprovided support to her and her family and Maria. Maria and Julian were reunified after 363 days. Aservice provider still works closely with Maria to provide support services. Mother and son have facedchallenges with daily living and Maria sometimes doubts herself, but support from everyone involved withthe family will help ensure long-term success for Julian and Maria.

In these stories our agency illustrates

how we serve our mission on a day toda basis


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Clients ServedIn fiscal year 2012, One Hope United served2,932 clients in the Florida region an increase from FY11(+5.73%). The increase can be attributed to the opening of Circuit 13 in December of 2011.

# of Clients Served in Florida

Circuit 9 1493Circuit 10 766

Circuit 131 673TOTAL: 2,932

Clients Served: Florida Region

51%

26%

23%

C9 C10 C13

Most services were provided in C9, representing 51% of clients served in Florida.

# of Florida Region Clients Served by Fiscal Year2

Program Category FY12 FY11 FY10

Counseling N/A 109 220Family Preservation 573 809 1314

Placement 1686 1863 2312

Prevention N/A N/N/AN N/A AA 536TOTAL: 2,259 2,781 4,382

When discounting the opening of the offices in C13, Florida experienced a decrease (-18.77%). Severalinfluences contributed to this trend:

The Counseling program did not operate in FY12. Circuits 9 and 10 started a Diversion program in FY12 which diverted many clients from Placement

services. In FY13 the number of Diversion cases will be monitored.

1 This number was derived from lead agency reports and FSFN.2 C13 is not included in this table. Due to the transfer of services to OHU there was not a process in place to distinguish clients

by Program Category.


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Outcome ManagementAn outcome or accomplishment can be defined as the result of efforts or outputs (interventions by anindividual or team) within an agency that havevalue to the goals of the agency. Outcome goalsare important to establish because they provide

purpose for the work with children and familiesand should tie either directly or indirectly to themission of the agency. Additionally, outcomegoals create a culture of accountability and also provide an evaluation ofChild Welfare Measures(referring to a clients safety, permanency and well-being). CQIR monitors contract and agency outcomegoals established by federal standards and OHU values.

PROGRAM PERFORMANCE

% of Florida Program Goals Met by Fiscal YearFY2012 FY2011 FY2010

Overall Total 90% 80% 70%

Safety 100% 100% 100%Permanency 83% 67% 100%Well-Being 100% 100% 25%

As an agency, 86% of all established goals have been met cross-regionally. Increasing each year, theFlorida region reached 90% of established child welfare goals.

SAFETY ACHIEVEMENT

Goals Target FY12 FY11 FY10

1. No Substantiated abuse or neglect while in out ofhome care.

99% 99.0% 99.2% 99.2%

2. Children not abused or neglected during in-homeservices.

95% 97.3% 97.0% 95.7%

3. Children served in Family Preservation will remainintact during services.

95% 97.7% 98.0% 96.8%

PERMANENCY ACHIEVEMENT


1. Children reunified within 12 months of the latestremoval.

46% 73.1% 68.3% 66.8%

2. Children will achieve permanency within 24 monthsof latest removal.

32% 79.1% 82.1% 61.5%

3. Children will remain reunified for a period of 6months without re-entry into foster care.

91% 91.5% 90.1% 97.6%

4. Children were not removed within 12 months of aprior reunification (re-entry).

91% 91.3% 90.0% 97.1%

5. Adoptions finalized within 24 months of the latestremoval.

32% 54.9% 59.0% 39.9%

6. No more than two placement setting within 12months.

85% 80% N/A N/A

CQIR monitors contract and agency

outcome goals established by federalstandards and OHU values.


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WELL-BEING ACHIEVEMENT


1. Sibling Visitation: There will be documentedvisitations occurring for children separated in out ofhome care.

50% 89.5% 88.0% 76.7%


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Peer Record ReviewsA Peer Record Review is the process by which CQIR internally examines records in depth for timelycompletion of required activities (a Compliance Review) and for quality of services (a Quality Review).COA standards require OHU to randomlyselect a sample of records to review for all

programs. CQI Coordinators conduct filereviews for each program every quarter andthe results are communicated via a report foreach review date, as well as a quarterly reportthat rolls up all programs in a particular program category. For the annual report, peer reviews are lookedat for the fiscal year beginning July 1st, 2011 through June 30th, 2012. The program categories reviewedfor the Florida Region in this report are: Family Preservation, and Placement. Only Circuits 9 and 10participated in Peer Record Reviews in FY12.

# of Florida Region File Reviews by Quarter

PRR Review Tool Q1 Q2 Q3 Q4 TOTAL

Compliance & Quality 0 0

Adoption 9 8 5 2 24In-Home 29 17 18 20 84

Foster Care Out-of-Home 48 46 56 42 192TOTAL: 86 71 79 64 300

There are 3 tools utilized in the Florida region that assess Compliance & Quality and Child WelfareMeasures (safety, well-being, permanency, and risk management). Results were combined across alltools to produce the following two graphs.

COA standards require OHU to

randomly select a sample of records toreview or all ro rams.


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The goal for each phase of client service is 90%, represented by the black dashed line on charts below.

Compliance & Quality - Overall: Florida Programs

0%

20%

40%

60%

80%

100%

Actual 75% 78% 80% 74% 84%

Cross-Region 88% 83% 84% 82% 88%

Target 90% 90% 90% 90% 90%

Intake Assessment Treatment Plan Service Delivery Closing

In FY12, the Florida region programs were within 6% to 16% of meeting the Compliance & Qualitytargets in all areas measured.

Child Welfare Measures - Overall: Florida Programs

0%

20%

40%

60%

80%

100%

Actual 78% 78% 83%Cross-Region 84% 82% 84%

Target 90% 90% 90%

Well-Being Safety Permanency

The Permanency measure of child welfare is 7% below target. Both Well-Being and Safety are within12% of the desired range.


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Compliance & Quality performance for the Florida region was analyzed by Program Category to producethe following graph.

Program Performance FY12

Compliance & Quality: Florida Region

0%

20%

40%

60%

80%

100%

Family Preservation 78% 78% 80% 78% 46%

Placement74% 77% 80% 73% 91%

Target 90% 90% 90% 90% 90%

Intake AssessmentTreatment

Planning

Service

DeliveryClosing

Family Preservation and Placement programs in the Florida region did not achieve the 90% target onCompliance & Quality measures. However, Florida has made improvements since FY11. FamilyPreservation programs improved in Treatment Planning and Closing categories and Placementprograms improved in Treatment Planning, Service Delivery, and Closing categories. Closing (91%) inPlacement programs was the only category to achieve the 90% target.

To improve performance in FY13, programs should focus on the areas missed most on reviews

throughout the year. Below is a full-year item analysis for each review conducted in FY12 by programcategory. The percentage indicates the percent of files in compliance while the numbers in parenthesesat the end of each statement indicates the number missed out of the total for each review, excludingthose items marked N/A.

Family Preservation

Intake (78%): Is the Clients Rights and Responsibilities receipt in the record and signed by all clientsinvolved in the service? (26/83)

Assessment (78%):o Has the Family Assessment been updated every 6 months? (15/29)o Was a CESAP completed within 5 business days of case inception? (18/42)

Treatment Plan (80%):o Is the current Service/Treatment/Case Plan signed and dated by the client, parent/guardian,

caseworker and supervisor? (23/64)o Was the current Case Plan completed within thirty days of transfer to services? (22/64)

Service Delivery (78%): Is there current dental records for the child(ren) contained in the file ifmedical concerns are the reason for service involvement? (5/12)

Closing (46%): Does the record contain a case closure letter to the family? (9/13)


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Placement

Intake (74%):o Is the Clients Rights and Responsibilities receipt in the record and signed by all clients

involved in services current within one year? (12/23)o Was a CESAP completed within 5 business days of case inception? (34/97)

Assessment (77%):o Has the Family Assessment been updated every 6 months? (53/99)o Was the Initial Family Assessment completed within 15 business days of intake staffing?

(70/142) Treatment Plan (80%): Is the current Adoption Case Plan signed and dated by the client, caseworker,

and supervisor? (10/21) Service Delivery (73%):

o Is there documentation in FSFN that the Case Manager followed up with identified dental careneeds? (69/131)

o Is there documentation in FSFN that the Case Manager monitored educational needs?(56/121)

During fiscal year 2012 there were 30 case managers and supervisors who assisted in reviewing 300files as a part of the CQI peer record review process. These champions of quality serve as an integralpart of the continual process of assessing the quality of our files, providing feedback on how to improve,and ensuring that plans of correction are being completed on time.

Florida

Barbara HesterMonica Sanders

Victoria GurganusDeb KellyAna Cruz

Muriah Davis-DeuthBrooke Anderson

Lia RodriguezDanielle Day

Darby BarwickRobin Sherwood

Janice HuttonBecka KampmanYolanda Walker

Carmen Litt

Ebonie HopkinsTherese HartwellLasonja HoustonLauren Prekop

Jennifer CarmenLaurie Stern

Shawna SweetmanCarissa Arena

Emily GustafsonTamara Aasen

Will JonesCindie Hess-Jaffee

Beverly MitchellStacey Greenberg

Neika BerryTotal Reviewers: 30

Thank you for your time, efforts, and commitment to quality service delivery.


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Client SatisfactionCQIR conducts an annual Client Satisfaction Survey to monitor OHU clients impressions of the serviceswe provide. After all surveys have beenreceived, region and program reports arecompiled to provide stakeholders with a

Consumer Report Card that compares theirprogram to the programs in their programcategory (example: Counseling Programs) andto regions as a whole (example: Federation).Please contact Katrina Brewsaugh, Director of Research for One Hope United, for a report card on anyprogram or region.

Overall OHU Client Satisfaction: Florida Region

3.60

3.80

4.00

4.20

4.40

4.60

4.80

5.00

C9 C10 C13-OHU C13-Transfer

C9 C10 C13-OHU C13-Transfer

FY12 4.64(N=302)

4.76(N=196)

4.81(N=69)

4.37(N=218)

FY11 4.57(N=248)

4.62(N=138)

N/A N/A

FY10 4.57(N=275)

4.52(N=170)

N/A N/A

In the Florida region, C9, C10, and C13-OHU scored in thefine tuning (A) range. C13-Transfer, whichis comprised of cases/clients that were inherited by OHU from another organization, scored in theneedsimprovement (B) range; however this difference is not statistically significant when comparing C13-Transfer with C13-OHU. Both C9 and C10 saw slight increases in Overall satisfaction with OHU inFY12.

2012 2011 20104.61

(N=785)4.59

(N=435)4.50

(N=669)

In the Florida region, overall client satisfaction with OHU has remained above4.50 (A) for the past threeyears. This year, there were 785 surveys returned for Florida Region, an 80.46% change from the 435surveys collected in 2011 due to the opening of C13.

Client Satisfaction Surveys monitor

clients impressions of the services OHUprovides.


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Incident ReportsAn unusual incident is any occurrence that may have the potential for increased risk for our clients andthe liability of our agency. Reportableincidents also include situations that raiserisk to staff or agency property, such as a

theft or natural disaster. CQIR providesmonthly reports on incident trends andcorrelations. Annually, this report rolls updata for the fiscal year and presents incidenttrends by region and program category.

Incident Types by Year: Florida Region Programs

2

177

14 10 35

11 2657

0

177

0 38

2

210

20 16 42 9 42 51

01

47

065

9

211

24 55 97 24 91 72 0

473

2

219

0

100200

300

400

500600

Death

Abus

e&Neg

lect

Sexu

allyP

roble

mat.

.

Injury

Medic

al/Ps

ychia

tric

Educ

ation

Hosp

italiz

ation

Crim

inalA

ct

Beha

viorM

anag

emen

t

Beha

viora

lIssu

es

Clien

t/Car

egive

rPr..

.Ot

her

FY12 FY11 FY10

In the Florida region, there was a decrease in the number of incidents in FY12 compared to FY11.

In the region there were decreases in incidents reported across most incident types. There were threeincident types that increased from FY11:

Education related incidents increased by 22.2%. Behavioral Issues increased by 20.4%. Criminal Acts increased by 11.8%.

Incident reports track situations that may

have the potential for increased risk for ourclients and the liability of our agency.


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Office Systems ReviewsThe Office Systems Review is a process to determine if an office is meeting agency standards. Thisincludes professional appearance, staff response to answering telephone calls, maintaining clientconfidentiality and safety and risk management. CQIR coordinators review OHU office systems annually.

Office Systems Compliance: Florida

97%

3% 0%

Compliant Not Compliant Partially Compliant

Three Office Systems Reviews were completed in the Florida Region: 97% of all office systems reviewswere compliant a 9% increase from FY11. Both Circuits were at or above a 95% compliance rating.

Supervisory Systems ReviewsOn an annual basis CQIR conducts an assessment of supervision provided by each direct servicesupervisor in the organization. The review uses a standardized form and involves a check of a number ofsupervision tasks. Although there are several items addressed, there is a concentration on the frequencyof supervision and quality of documentation of supervisory activities.

Supervisory Systems Compliance: Florida

91%

9% 0%

Compliant Not Compliant Partially Compliant

Eleven Supervisory Systems Reviews were completed in the Florida Region. Supervisors were 91%compliant with items measured an 8% increase from FY11. Circuit 9 was 98% compliant whereasCircuit 10 was 83% compliant.


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Priority review is a process that

examines the quality of services providedto a client or family.

Priority ReviewsA priority review is a process that examines the quality of services provided to a client or family andcompliance with program policies and procedures.There are three levels of priority reviews: TheLevel 1 Priority Review also called a case

consultation is voluntary and can be conductedon any case upon the request of the supervisor.The Level 2 Priority Review are conducted in theevent of a serious injury to a client or a crime.Level 3 Priority Reviews are held when there is a client death or felony.

Program Category Level 3 Level 2 CaseConsultations

TOTAL

Counseling 0 0 0 0Family Preservation 1 1 1 3

Placement 0 1 5 6TOTAL: 1 2 6 9

There were 9 priority reviews conducted in FY12 (down 12 from FY11). The decrease in PriorityReviews in the Florida region can be attributed to a decrease in Case Consultations and a decrease inLevel 2 reviews.

Case Consultations are preventative in nature and are meant to be used as a method to share thoughtsand ideas about a case that may be challenging. Florida conducted 8 less Case Consultations in FY12compared to FY11.

There were two Level 2 Priority Reviews in FY12 (down 5 from FY11). One Level 2 review wasconducted due to a client grievance and one was needed to clarify court proceedings.

There was one Level 3 Priority Review in FY12 (up 1 from FY11). This review was due to the death of aclient. This death was not found to be related to OHUs service provision.

Below are some highlights of lessons learned throughout the year:

As service providers, we have to understand at times we have a limit of our influence on clientsbehaviors and choices.

Collaboration with other service providers should occur to ensure service coordination.

A system should be developed to identify and red flag clients who might have a higher level ofrisk based on their history so that they can be checked on more intently in supervision.

A complete list of lessons learned from reviews can be found in the quarterly reports or by contacting a

member of the CQIR team.


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Page 21 of 30

Employee RecognitionTwo methods of awarding staff excellence are supported by CQIR. The first is the STAR Award forindividual excellence, and the second is the GALAXY Award for team excellence.The awards recognize staff that have gone above and beyond normal work duties,exhibited exemplary performance and done their job under circumstances that are

out of the ordinary. There were 26 Star awards and 3 Galaxy awards distributedin the Florida region this year.

In FY12 we were proud to recognize these Florida employees with a STAR Award.

Quarter 1

Sharmaine Brann Supervisor I (Orlando,FL)

Steven Corvo Case Manager (Sebring, FL) Colleen Delgado - (Orlando, FL) Martin Delgado - (Orlando, FL) Robin Sherwood Case Manager (Sebring,

FL) Sarah Tunning CQIR Coordinator

(Sebring, FL)

Quarter 2

Lisa Kinchen Case Manager (Sebring, FL) Lia Rodriguez Case Manager (Sebring, FL)

Quarter 3

Avanna Alexander Supervisor (Sebring,FL)

Carissa Arena Case Manager I (Orlando,

FL) Diana Campbell Administrative Assistant I

(Orlando, FL) Mallory Dunn Lead Case Manager

(Tampa, FL) Pam Evans Case Manager (Sebring, FL)

Ernestine Frazier Case Manager (Sebring,FL)

Judith Grunkenmeyer Office Manager(Sebring, FL)

Victoria Hancock Office Assistant (Sebring,FL)

Theresa Hartwell Family Case Manager

(Orlando, FL) Cynthia Hess-Jaffe Case Manager II(Orlando, FL)

Rebecca Kampman Case Manager(Sebring, FL)

Jeannine Powell Supervisor II (Sebring,FL)

Nancy Stalter Case Manager (Sebring, FL) Lashaondra Thomas Case Manager

(Sebring, FL) Ashlee Vaughn Case Manager (Sebring,

FL) Yolanda Walker Family Case Manager

Supervisor(Orlando, FL)

Quarter 4

Janice Hutton Case Manager (Sebring, FL) Debra Kelly Case Manager I (Wauchula

FL)

The following teams were presented with a GALAXY Award this year.

Quarter 3

Unit 121 (Sebring, FL) Unit 206 (Orlando, FL)

Unit 849 (Sebring, FL)


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Page 22 of 30

Quality Improvement TeamsEveryone in the agency participates in at least one Quality Improvement Team (QIT). This allows eachemployee the power to implement improvement within their own QIT. The QIT is focused on improvingthe quality of service at the local level using data, effective problem solving and action planning.

Across the agency, there was an overall attendance rate of97.9% in FY12. The attendance rate inFlorida was 98.21%. The following local, service center and regional Quality Improvement Teams wereassembled each quarter this year in the Florida region.

Local

Avengers of QualityRescue Rangers

Excellence Trackers (ET)Improvement Seekers

Q2 = Queens of QualityMighty Women of Quality!

OHU Angels

Team FOCUSPerfect StarsThe A TeamThe Rat Pack

Every day HeroesThe Untouchables

Sassy SoldiersStellar Seven

Elite SixAdvocatesThe A TeamTeam Terrific

The Adoption Option

ServiceCenter

C9 Supervisors - Super SupsC10 Supervisors- No Worries

C13 Supervisors Engels Quality Angels

Regional Promise Keepers


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Page 23 of 30

In FY12, CQIR conducted a survey of all Local QITs to determine levels of satisfaction with the meetingsand the process. Cross-regionally, a total of 276 responses were received, making the survey valid at thestrongest confidence levels. Below is a summary of the results for the Florida region and thenaggregated across the regions.

All FR

Organization of the QIT 4.6 4.8

Purpose of the QIT Meeting 4.5 4.7Facilitation kept the meeting productive 4.6 4.8

Quality of data available 4.4 4.7

Action plan(s) developed 4.5 4.7Value of todays meeting to the program 4.4 4.7

Value of todays meeting to the agency 4.4 4.8

Value of the QIT team generally 4.5 4.7

Overall results were positive with 5 out of the 8 categories scoring in the fine tuning range. The Floridaregion scored the QITs the highest of all the regions with all categories scoring in the fine tuning range.


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Page 24 of 30

Outcome Management Circuit 9PROGRAM PERFORMANCE



Safety 67% 100% 100%Permanency 83% 60% 100%

Well-Being 100% 100% 100%

Circuit 9 achieved 80% of its outcomes in FY12.

SAFETY ACHIEVEMENT


1. No Substantiated abuse or neglect while in out ofhome care.

99% 98.6% 99.1% 99.2%


95% 96.9% 96.1% 96.1%


95% 97.1% 98.0% 92.0%




46% 75.0% 66.0% 56.0%


32% 79.0% 81.0% 68.0%


91% 91.0% 87.0% 95.5%


91% 91.0% 83.0% 95.5%


32% 46.0% 74.0% 45.2%

6. No more than two placement setting within 12months. 85% 80.0% N/A N/A




50% 92.0% 85.0% 83.4%


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Page 25 of 30

Peer Record Reviews Circuit 9Compliance & Quality - Overall: Circuit 9 Programs

0%

20%

40%

60%

80%

100%

C9 78% 79% 83% 78% 89%Florida Region 75% 78% 80% 74% 84%

Target 90% 90% 90% 90% 90%


In FY12, the C9 programs were within 1% of meeting the target in Closing. In all other areas measuredC9 was within 7% to 12% of meeting the Compliance & Quality targets in all areas measured.

Child Welfare Measures - Overall: Circuit 9 Programs

0%

20%

40%

60%

80%

100%

C9 81% 79% 85%

Flordia Region 78% 78% 83%

Target 90% 90% 90%


The Permanency measure of child welfare is 5% below target. Well-Being and Safety are within 9% to11% of the desired range.


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Page 26 of 30

Incident Reports Circuit 9Incident Types: Circuit 9

1

109

13 6 16 9 2

3 220

98

023

152

15 7 26

933 27

0

111

043

5

132

15 8 27

435 34

0

233

1

72

20

50

100

150200

250

Death

Abus

e&Neg

lect

Sexu

allyP

roble

mat.

.

Injury

Medic

al/Ps

ychia

tric

Educ

ation

Hosp

italiz

ation

Crim

inalA

ct

Beha

viorM

anag

emen

t

Beha

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rPr..

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her

2012 2011 2010

In Circuit 9, Abuse and Neglect account for approximately 34% of all incidents and Behavioral Issuesaccount for about 31% of all incidents reported in FY12. Over the past three years Behavioral Issueshave been decreasing each year. Since 2010 Behavioral Issues have decreased by about 57.9%.


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Page 27 of 30

Outcome Management Circuit 10PROGRAM PERFORMANCE



Safety 100% 100% 67%Permanency 83% 100% 100%

Well-Being 100% 100% 100%

Circuit 10 achieved 90% of its outcomes in FY12.

SAFETY ACHIEVEMENT

Goals Target FY12 FY11 FY101. No Substantiated abuse or neglect while in out of

home care.99% 99.7% 99.3% 99.3%


95% 98.2% 98.9% 95.0%


95% 98.2% 99.0% 83.0%




46% 68.0% 76.0% 77.0%


32% 80.0% 83.0% 78.0%


91% 93.0% 98.0% 93.1%


91% 92.0% 98.0% 93.1%


32% 61.0% 39.0% 46.0%

6. No more than two placement setting within 12

months.

85% 80.0% N/A N/A




50% 83.0% 96.0% 73.0%


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Page 28 of 30

Peer Record Reviews Circuit 10Compliance & Quality - Overall: Circuit 10 Programs

0%

20%

40%

60%

80%

100%

C10 72% 76% 72% 68% 70%Florida Region 75% 78% 80% 74% 84%

Target 90% 90% 90% 90% 90%


In FY12, the C10 programs were within 14% to 22% of meeting the Compliance & Quality targets in allareas measured.

Child Welfare Measures - Overall: Circuit 10 Programs

0%

20%

40%

60%

80%

100%

C10 72% 78% 80%

Flordia Region 78% 78% 83%

Target 90% 90% 90%


The Permanency measure of child welfare is 10% below target. Well-Being and Safety are within 12% to18% of the desired range.


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Page 29 of 30

Incident Reports Circuit 10Incident Reports: Circuit 10

1

55

1 115

2 2

32

0

59

012

0

58

5 916

09

24

0

36

0

22

1

44

313

21

114

25

0

28

1

37

0

25

50

75

Death

Abus

e&Neg

lect

Sexu

allyP

roble

mat.

.

Injury

Medic

al/Ps

ychia

tric

Educ

ation

Hosp

italiz

ation

Crim

inalA

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Beha

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FY12 FY11 FY10

In Circuit 10, Behavioral Issues account for approximately 33% of all incidents reported and Abuse andNeglect account for about 31% of all incidents in FY12. Over the past three years Behavioral Issues havebeen increasing each year. Since 2010 Behavioral Issues have increased by about 110.7%..


30/30

Incident Reports Circuit 13Incident Reports: Circuit 13

0

13

03 4

0 13

0

20

03

0

5

10

15

20

25

Death

Abuse&

Neglec

t

SexuallyP

roble

maticB

e...

Injury

Medical/Ps

ychia

tric

Education

Hospitalization

CriminalA

ct

Beha

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anagem

ent

Beha

vioralIs

sues

Clien

t/Caregive

rProperty

Other

In Circuit 13, Behavioral Issues account for ~43% of all incidents reported and Abuse and Neglectaccount for ~28% of all incidents.

OHU began providing services in Circuit 13 in December, 2011. CQI processes take 3-6 months to befully implemented in new programs. Therefore, data related to outcomes and peer record reviews arenot available for FY12. This data will be available for FY 13.

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