F:/Plan/FY16/Annual Report/Annual Report FY16 Polk 2016.12.14.doc 1. POLK OLK OLK OLK COUNTY OUNTY OUNTY OUNTY REGIONAL EGIONAL EGIONAL EGIONAL MENTAL ENTAL ENTAL ENTAL HEALTH AND EALTH AND EALTH AND EALTH AND DISABILITY ISABILITY ISABILITY ISABILITY SERVICES ERVICES ERVICES ERVICES MANAGEMENT ANAGEMENT ANAGEMENT ANAGEMENT PLAN LAN LAN LAN III. III. III. III. FISCAL ISCAL ISCAL ISCAL YEAR EAR EAR EAR 201 201 201 2016 ANNUAL NNUAL NNUAL NNUAL REPORT EPORT EPORT EPORT PREPARED BY REPARED BY REPARED BY REPARED BY: GEOGRAPHIC EOGRAPHIC EOGRAPHIC EOGRAPHIC AREA REA REA REA: Polk APPROVED BY PPROVED BY PPROVED BY PPROVED BY THE THE THE THE GOVERNING OVERNING OVERNING OVERNING BOARD OARD OARD OARD: 12/14/16
Transcript
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GGGGEOGRAPHIC EOGRAPHIC EOGRAPHIC EOGRAPHIC AAAAREAREAREAREA: Polk
AAAAPPROVED BY PPROVED BY PPROVED BY PPROVED BY THETHETHETHE GGGGOVERNING OVERNING OVERNING OVERNING BBBBOARDOARDOARDOARD:::: 12/14/16
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Table of Contents
III. FISCAL YEAR 2016 ANNUAL REPORT A. Introduction ..................................................................................................................................................... 3
B. Services provided in Fiscal Year 2016 ..................................................................................................... 3
C. Individuals Served in Fiscal Year 2016 .................................................................................................. 10
1. Persons Served by Age Group and by Primary Diagnostic ........................................................ 10
2. Unduplicated Count of Adults by Chart of Accounts Number and Disability Type .......... 11
3. Unduplicated Count of Children by Chart of Accounts Number and Disability Type ...... 13
4. Mental Health System Growth/Loss Report ................................................................................... 13
D. Moneys Expended ........................................................................................................................................ 13
1. Total Expenditures by Chart of Accounts Number and Disability Type ............................... 14
3. County Levies .......................................................................................................................................... 16
E. Outcomes ....................................................................................................................................................... 17
1. Progress on Goals .................................................................................................................................. 17
2. Waiting List .............................................................................................................................................. 22
3. Statewide Outcomes (Quality Service Development & Assessment, QSDA) ........................ 22
4. Polk County Region Outcomes by Program................................................................................... 25
5. System Satisfaction ............................................................................................................................... 41
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III. FISCAL YEAR 2016 ANNUAL REPORT
A.A.A.A. IntroductionIntroductionIntroductionIntroduction The Mental Health Re-design prompted counties to form into Mental Health and Disability Service Regions under Iowa Code
Chapter 28E in compliance with Iowa Code 331.390. The Polk County Region received an exemption from this requirement. In
compliance with IAC 441-25, the Polk Management Plan includes three parts: (I) Policies and Procedures Manual; (II) Annual
Service and Budget Plan; and (III) Annual Report. Section III, the Polk County Region Annual Report covers Fiscal Year 2016
(7/1/15 – 6/30/16).
B.B.B.B. Services provided in Fiscal Year 201Services provided in Fiscal Year 201Services provided in Fiscal Year 201Services provided in Fiscal Year 2016666 Polk County service contracts require that all providers meet all applicable licensure, accreditation or certification standards;
however Polk County makes serious efforts to stimulate access to more natural supports in its service provider network.
Successful attainment of positive outcomes, consumer and family satisfaction, and cost effectiveness measures are the most
important factors in continued network participation. PCHS has identified access points within the provider network to assist
individuals or their representatives to apply for services. This section includes:
• Access Standards for Core Services and what we are doing to meet access standards
• Additional Core Services, availability and plans for expansion
25.3(4)b TimelinessTimelinessTimelinessTimeliness: Crisis evaluation within
24 hours.
Results are reported to DHS
quarterly.
See 25.3(4)a
Support for Community LivingSupport for Community LivingSupport for Community LivingSupport for Community Living: (Home Health Aide, Home and Vehicle Modification, Respite, Supported Community Living)
25.3(5) TimelinessTimelinessTimelinessTimeliness: The first appointment
shall occur within four weeks of the
individual’s request of support for
community living.
Results are reported to DHS
quarterly.
Appointments are scheduled but interviews,
acceptance and service start dates are subject
to provider staff capacity and consumer choice
of providers.
SuppSuppSuppSupport for Employment:ort for Employment:ort for Employment:ort for Employment:(Day Habilitation, Job Development, Supported Employment, Prevocational Services)
25.3(6) TimelinessTimelinessTimelinessTimeliness: The initial referral shall
take place within 60 days of the
individual’s request of support for
Results are reported to DHS
quarterly.
Referrals are made within the access time
frame but interviews, program acceptance and
start dates are subject to provider capacity
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25.3(7) ProximityProximityProximityProximity: An individual receiving
recovery services shall not have to
travel more than 30 miles if residing
in an urban area or 45 miles if
residing in a rural area to receive
services.
Family Support: NAMI
Peer Support: Integrated
Services, Integrated Health,
Peer Support Requests made
through the Service Appeal
Board
All services in Polk County are within 30 miles.
Plans for financially supporting NAMI family
support services are subject to adequate
funding.
Service CService CService CService Coordination:oordination:oordination:oordination:(Case Management, Health Homes)
25.3(8)a ProximityProximityProximityProximity: An individual receiving
service coordination shall not have to
travel more than 30 miles if residing
in an urban area or 45 miles if
residing in a rural area to receive
services.
• Broadlawns: (IHH)
• Community Support
Advocates (IHH, CBCM)
• Eyerly Ball (IHH)
• Link (CBCM)
• Easter Seals (CBCM)
• ChildServe (CBCM)
All service coordination providers are located
in Des Moines centrally located and on bus
lines. Service Coordinators are also located on
site at Central Iowa Shelter and Services.
25.3(8)b TimelinessTimelinessTimelinessTimeliness: An individual shall
receive service coordination within
10 days of the initial request for such
service or being discharged from an
inpatient facility.
Results are reported to DHS
quarterly.
People are triaged by an Intake Coordinator
and a Service Coordinator begins to work with
people immediately upon request.
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2.2.2.2. Additional Core Services Available in Region: Iowa Code 331.397(6)Additional Core Services Available in Region: Iowa Code 331.397(6)Additional Core Services Available in Region: Iowa Code 331.397(6)Additional Core Services Available in Region: Iowa Code 331.397(6)
Service Domain/ServiceService Domain/ServiceService Domain/ServiceService Domain/Service AvailableAvailableAvailableAvailable: CommentsCommentsCommentsComments:
Comprehensive Facility and CommunityComprehensive Facility and CommunityComprehensive Facility and CommunityComprehensive Facility and Community----Based Crisis Services:Based Crisis Services:Based Crisis Services:Based Crisis Services:331.397~ 6.a.
24-Hour Crisis Hotline
• Broadlawns Medical Center
• National Suicide Prevention
Lifeline
The Crisis Team has been in place for decades fielding
calls and seeing people in the emergency room. We
also promote the National Suicide Prevention Lifeline on
our websites www.pchsia.org and
http://polk.ia.networkofcare.org/mh/emergency-
services.aspx
Mobile Response
Broadlawns Medical Center
Mobile response for supporting police calls has been in
operation for 15 years. Plans for continued regional
support are subject to adequate sustainable funding.
23-Hour crisis observation & holding
Broadlawns Medical Center
23-hour crisis observation and holding has been in
operation for 2 years. Plans for continued regional
support are subject to adequate sustainable funding.
Crisis Stabilization Community Based
Services
No Not in planning stage
Crisis Stabilization Residential
Services
Broadlawns Medical Center
Crisis Stabilization has been in operation for 2 years.
Plans for continued regional support are subject to
adequate sustainable funding.
Other
Mental Health First Aid - NAMI
Polk County Critical Incident Stress
Management Team - Volunteers,
sponsored by Polk County Health
Services
Hospital Step-Down - Broadlawns
Medical Center
The Polk County Critical Incident Stress Management
Team has been in operation for four years and provides
Critical Incident Stress Management debriefings.
A transitional treatment program for continued
treatment support for up to 2 weeks before returning
Supported Employment We continue to work toward implementing best
practice programs, however did not measure to
fidelity.
Family Psychoeducation Available through NAMI.
Illness Management and
Recovery
Eyerly Ball Available as group therapy when sufficient demand.
Permanent Supportive
Housing
Timmins, Jacobson &
Strawhacker, LLP
PCHS We completed a fidelity assessment and found
program criteria measured to fidelity.
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EVIDENCE BASED
PRACTICE
NO PROGRESS TRAINING IMPLEMENTING PIECES FIDELITY INDEPENDENTLY
VERIFIED
WHAT IS THE REGION DOING TO INCREASE PROVIDER
COMPENTENCY IN EVIDENCE BASED PRACTICES
Additional Core:
331:397(6)d
List agencies List agencies List Agencies How are you verifying? List
Agencies
Narrative
Positive Behavioral
Support
- Candeo
- ChildServe
- Crest Services
-Community Support
Advocates
- Easter Seals
- Eyerly Ball
- Goodwill Industries
- HOPE
- Link Associates
- Lutheran Services In
Iowa
- Mainstream Living
- Mosaic
- Optimae LifeServices
- Progress Industries
- Stepping Stones
- Candeo
- ChildServe
- Crest Services
- Community Support
Advocates
- Easter Seals
- Eyerly Ball
- Goodwill Industries
- HOPE
- Link Associates
- Lutheran Services In
Iowa
- Mainstream Living
- Mosaic
- Optimae LifeServices
- Progress Industries
- Stepping Stones
We are not currently
independently verifying
agencies’ fidelity scales.
Each agency is encouraged
to utilize the PBS fidelity
scale as a foundation for
developing their PBS
strategic plan.
The Positive Behavior Network has been operational
in Polk County for over 10 years.
Peer Self Help Drop In
Center
Plans for supporting peer support drop in center
services are subject to adequate funding. Plan to
implement was put on hold due to lack of ongoing
and sustainable funding.
Other Research Based
Practice: IE IPR
IAC 331.397(7)
Contract with Central Iowa Recovery
The Polk County Region, in partnership with IACP & our other Regional partners continued to discuss how to develop a statewide approach to identifying and
collecting Social Determinant Outcome data, looking at provider practices and competencies, and entering into performance-based contracts/pay for performance.
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C.C.C.C. Individuals Served in Fiscal Year 201Individuals Served in Fiscal Year 201Individuals Served in Fiscal Year 201Individuals Served in Fiscal Year 2016666 Polk County citizens are eligible for county-funded services if they meet financial eligibility criteria as well as one
of the following population group categories: persons in need of mental health services (MI), persons with
intellectual disabilities (ID), or persons with developmental disabilities (DD). This section includes:
� Persons Served by Age Group and by Primary Diagnostic Category
� Unduplicated Count of Adults by Chart of Accounts Number and Disability Type
� Unduplicated Count of Children by Chart of Accounts Number and Disability Type
� Mental Health System Growth/Loss Report
1.1.1.1. Persons Served by Age Group and by Primary DiagnosticPersons Served by Age Group and by Primary DiagnosticPersons Served by Age Group and by Primary DiagnosticPersons Served by Age Group and by Primary Diagnostic
The chart below shows the unduplicated count of individuals funded by diagnosis. Several programs are funded through block
grants, impacting unduplicated counts. Polk County served 9,103 adults and children through county-funded and Title XIX Case
Management programs. In order to have an equal comparison for regional dashboards, Polk County is reporting unduplicated
people served by population group to exclude individuals who do not receive any regionally funded services.
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2.2.2.2. Unduplicated Count of Adults by Chart of Accounts Number and Disability Type Unduplicated Count of Adults by Chart of Accounts Number and Disability Type Unduplicated Count of Adults by Chart of Accounts Number and Disability Type Unduplicated Count of Adults by Chart of Accounts Number and Disability Type
This chart lists the number of adult individuals funded for each service by diagnosis.
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3.3.3.3. Unduplicated Count of Children by Chart of Accounts Number and Disability Unduplicated Count of Children by Chart of Accounts Number and Disability Unduplicated Count of Children by Chart of Accounts Number and Disability Unduplicated Count of Children by Chart of Accounts Number and Disability
TypeTypeTypeType
This chart lists the number of children funded for each service by diagnosis.
4.4.4.4. Mental Health System Growth/Loss ReportMental Health System Growth/Loss ReportMental Health System Growth/Loss ReportMental Health System Growth/Loss Report
This chart lists the net increase/decrease of individuals served.
D.D.D.D. Moneys ExpendedMoneys ExpendedMoneys ExpendedMoneys Expended Polk County citizens are eligible for county-funded services if they meet financial eligibility criteria as well as one
of the following population group categories: persons in need of mental health services (MI), persons with
intellectual disabilities (ID), or persons with developmental disabilities (DD). This section includes
� Total Expenditures by Chart of Accounts Number and Disability Type
� Revenues
� County Levies
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1.1.1.1. Total Expenditures by Chart of Accounts Number and Disability Type Total Expenditures by Chart of Accounts Number and Disability Type Total Expenditures by Chart of Accounts Number and Disability Type Total Expenditures by Chart of Accounts Number and Disability Type
The chart below show the regional funds expended by service and by diagnosis. The “*” designate lines where PolkMIS service
codes track chart of account services at a more granular level were translated into the new format and appropriate COA code for
state reporting purposes.
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2.2.2.2. RevenuesRevenuesRevenuesRevenues
The chart below show the regional accrual funds by source.
3.3.3.3. County LeviesCounty LeviesCounty LeviesCounty Levies
The chart below show the regional levy rates. During FY15, the state implemented property tax reform and rolled back the
taxable valuation on commercial and industrial property to 95% of assessed value. The State then gave us property tax
replacement dollars to replace the tax dollars lost due to the 5% rollback. Polk levied that amount in conjunction with the State
replacement dollars and assumes 0.5% of taxes are uncollectible; so when levying the $14,439,175, Polk only actually received
$14,369,136.
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E.E.E.E. OutcomesOutcomesOutcomesOutcomes
1.1.1.1. Progress on GoalsProgress on GoalsProgress on GoalsProgress on Goals
Polk County Health Services, Inc. exists to support improved access to health care and to promote full citizenship for people with
mental illness, intellectual disabilities, or developmental disabilities. This plan assumes that the state will not mandate
expansion of initial core services or creation of additional core services without additional funding.
a)a)a)a) Strategic Commitment #1: Strategic Commitment #1: Strategic Commitment #1: Strategic Commitment #1: ID/DD/MH Core Service Delivery SystemID/DD/MH Core Service Delivery SystemID/DD/MH Core Service Delivery SystemID/DD/MH Core Service Delivery System
PPPPINNACLE INNACLE INNACLE INNACLE IIIISSUE SSUE SSUE SSUE #1:#1:#1:#1: New federal regulations for Medicaid-funded Home and Community-Based Services must be implemented by
March 2019. The federal regulations requirements are to ensure that individuals receive Medicaid HCBS in settings that are
integrated in and support full access to the greater community. They will also ensure that members have a choice in where they
live and who provides their services.
GGGGOALOALOALOAL:::: The ID/DD/MH service delivery system will fully implement the new federal regulations by 2019.
• The State plan has not been approved by CMS at the federal level. Continue to monitor.
• PCHS Staff continue to look at cost neutral needs that meet federal requirements for the Highland Park Group Home.
PPPPINNACLE INNACLE INNACLE INNACLE IIIISSUE SSUE SSUE SSUE #2:#2:#2:#2: Several states are moving their ID/DD services into managed care arrangements. Iowa will be privatizing
Medicaid and has chosen four managed care organizations (MCOs) to implement Medicaid Modernization by January 1, 2016.
The providers in the Polk Region work together very well and PCHS will work with the managed care organizations to ensure a
smooth transition.
GGGGOALOALOALOAL:::: Work with the provider network to ensure a smooth transition.
• PCHS Staff met with AmeriHealth, Amerigroup, United Health Care, and Wellcare to educate the Managed Care
Organizations (MCOs) on the strengths of the regional disability system service values and supports. In the winter,
Wellcare was eliminated as a viable MCO and the individuals assigned to Wellcare chose a different MCO. Polk County
signed contracts with AmeriHealth and Amerigroup to provide Community Based Care Management (CBCM). The
transition to MCOs faced set-backs in implementation start dates due to lack of preparedness. April 1 was the revised
start date. Polk County individuals with intellectual and developmental disabilities had the option of continuing
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coordination services with their current Case Manager if they chose AmeriHealth. Amerigroup and United MCOs
implemented internal CBCM.
• PCHS Staff completed application and credentialing requirements. PCHS Staff worked with Polk County IT and Iowa
County Technology Services (ICTS) to discuss and develop billing options. Office Ally was chosen due to the low fee.
PCHS Staff worked on resolving Office Ally electronic remittance advice issues.
• PCHS Staff and MCOs met throughout the fiscal year to identify core and additional core services offered. The transition
to MCOs resulted in providers having at least 4 funding streams. PCHS Staff collaborated with our regional
counterparts, ICTS, and providers to implement statewide social determinant outcomes as well as a general approach to
philosophical and process measures. The Quality Service Development & Assessment (QSDA) initiative emphasizes
system stakeholder collaboration as well as a single approach to requirements.
• PCHS Staff hosted several DHS/MCO stakeholder meetings as well as participated in United Way informational meetings.
PPPPINNACLE INNACLE INNACLE INNACLE IIIISSUE SSUE SSUE SSUE #3:#3:#3:#3: Employment services need to be delivered efficiently, effectively, and continue to be in line with national
Employment First values that support increased self-sufficiency in the community.
GGGGOALOALOALOAL:::: The Polk Region will develop an evidence-based Individual Placement and Support (IPS) model that supports mental health
treatment. Additionally, the Polk Region will begin work to align segregated Medicaid funded services impacted by new federal
• Community based employment has aligned with Employment First rules as of May, 2016. The Polk Region continues to
wait on federal approval of the State’s plan in order to move forward with planning for segregated day and employment
settings.
• PCHS Staff was involved in the statewide initiative to align services with Employment First principles which went into
effect in May, 2016 as well as worked through the Employment Guiding Coalition to re-align services and rate
structures within these the new rules.
PPPPINNACLE INNACLE INNACLE INNACLE IIIISSUE SSUE SSUE SSUE #4:#4:#4:#4: The Polk Region is required to ensure that certain evidence-based practices (EBPs) are available and
independently verified to meet fidelity standards (FS). In addition; there are EBPs without fidelity scales already in use, and
others that should be implemented.
GGGGOALOALOALOAL:::: To ensure the availability of appropriate EBPs, including at least the following:
• Assertive Community Treatment or strengths-based case management (FS)
• Integrated treatment of co-occurring substance abuse and mental health disorders (FS)
• Supported employment (FS)
• Family psychoeducation (FS)
• Illness management and recovery (FS)
• Permanent supportive housing (FS)
• International Center for Clubhouse Development (ICCD) Clubhouse Model
• Mental Health First Aid
• Wellness Recovery Action Plan (WRAP)
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• PCHS Staff identified providers who were trained, implementing, and implementing to fidelity and in April, 2016 began
monthly status reports to DHS.
• PCHS Staff participated in the Quality Service Development and Assessment (QSDA). The QSDA initiative works to
integrate and align service philosophy, practice, and outcomes. PCHS Staff lead the practice workgroup which focused
on the evidenced based programs of Permanent Supported Housing and Supported Employment. PCHS Staff presented
at ISAC’s Fall School on the Permanent Supported Housing program and fidelity, participated in ISAC’s Spring School on
the Supported Employment program and fidelity, and received training on becoming an evidence based practitioner.
The PBS Network also collaborated with IACP and other regions to sponsor Technical Assistance Collaborative (TAC) in
providing an overview of all mandated evidence based practices and programs.
• Due to budget constraints, the Polk Region was not able to fund marketing materials for the Family Psychoeducation
program through NAMI nor explore feasibility of additional EBPs.
PPPPINNACLE INNACLE INNACLE INNACLE IIIISSUE SSUE SSUE SSUE #5:#5:#5:#5: The Polk Region must have available the initial core services for priority populations of MH and ID before
serving additional populations or providing additional core services. Since there is a history of serving individuals with DD and of
providing a few other services, it is important to fill any gaps in core services to avoid reducing historical services. Services must
meet established regional service access standards.
GGGGOALOALOALOAL:::: Implement Peer Support and Family Support services. Formalize access to a 24-hour crisis hotline. Establish a system for
monitoring compliance with service access standards.
• All FY16 funding associated with new objectives was eliminated, with the exception of the employment objective. The
$47.28 per capita funding was not continued into FY16, however the Polk Region was allotted a $2 million
appropriation. The PCHS Board and Staff hosted a legislative luncheon in December to share the urgent need to
increase the per capita rate to $47.28. The Polk Region joined other regions to advocate for local control and
predictability in funding during the 2016 Legislative session. PCHS staff facilitated a stakeholder mailing to inform
members and their guardians that services will be reduced to only core services if the per capita rate is not increased.
PCHS Staff coordinated Network Providers to visit the Capitol and to share stories with Legislators regarding the
importance of regionally funded services. PCHS Board and Staff also participated in the ISAC County Day at the capitol
in March.
• The remaining strategies were put on hold due to budgetary constraints and the MCO transition and implementation.
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PPPPINNACLE INNACLE INNACLE INNACLE IIIISSUE SSUE SSUE SSUE #6:#6:#6:#6: The Polk Region is required to ensure network providers are culturally competent and able to provide trauma-
informed care and address multi-occurring disorders.
GGGGOALOALOALOAL:::: The Polk Region will have a system of care that is welcoming and can address the complex needs of all individuals.
• The following trainings were accomplished for FY16:
o Motivational Interviewing (2 sets)
o Co-Occurring Issues (Developmental Disabilities and Mental Illness)
o Frontline Supervisor Competency Training
o Cultural Competency
o Ethics and Boundaries
o PBS Simulation
o PBS Quarterly Membership Meetings (including 10 year PBS celebration)
• PBS provider members and PCHS received technical assistance (TA) through the National Alliance for Direct Support
Professionals on strategies to address a competent workforce. The result of the TA was contracting with NADSP to
develop curriculum for a full three day training on assuring Frontline Staff are trained utilizing the NADSP Competencies
as well as the vetted University of Minnesota Frontline Supervisor Competencies. The training occurred in June and
provider response for the intense training was overwhelmingly positive and the PBS board will continue to repeat this
training on at least a yearly basis.
PPPPINNACLE INNACLE INNACLE INNACLE IIIISSUE SSUE SSUE SSUE #7:#7:#7:#7: Technology is rapidly providing opportunities for collection, analysis, and sharing of data, as well as smart
phone applications that individuals can use to enhance their recovery and resiliency.
GGGGOALOALOALOAL:::: Utilize technology to connect, support, and create value for our stakeholders.
PPPPINNACLE INNACLE INNACLE INNACLE IIIISSUE SSUE SSUE SSUE #1:#1:#1:#1: There continues to be service capacity issues due to inability to hire and retain a qualified workforce.
GGGGOALOALOALOAL:::: Have the capacity to provide all needed services with qualified staff.
• PBS provider members and PCHS received technical assistance (TA) through the National Alliance for Direct Support
Professionals on strategies to address a competent workforce. The result of the TA was contracting with NADSP to
develop curriculum for a full three day training on assuring Frontline Staff are trained utilizing the NADSP Competencies
as well as the vetted University of Minnesota Frontline Supervisor Competencies. The training occurred in June and
provider response for the intense training was overwhelmingly positive and the PBS board will continue to repeat this
training on at least a yearly basis.
PPPPINNACLE INNACLE INNACLE INNACLE IIIISSUE SSUE SSUE SSUE #2:#2:#2:#2: The individuals being served have complexities that cross many systems. The PCHS network needs to include
service providers and other service providers from those systems in order to have the capacity to serve individuals with these
complex needs.
GGGGOALOALOALOAL:::: Develop operational linkages between service systems.
• The Systems Integration Guiding Coalition Task Force was put on hold. Polk County and PCHS Staff continue to
participate in the Criminal Justice Coordinating Council (CJCC), the White House Data Driven Justice Initiative, and the
National Association of Counties’ (NaCo) Stepping Up Initiative.
• A Community Conversation was not held during the 4th quarter to address the MCO transition due to the delayed
implementation.
PPPPINNACLE INNACLE INNACLE INNACLE IIIISSUE SSUE SSUE SSUE #3:#3:#3:#3: Currently new housing is being developed to be affordable to individuals at 80% of medium income. There is
not enough affordable housing for individuals with income below 30% of medium income within Polk County.
GGGGOALOALOALOAL:::: Develop more affordable housing options within Polk County
• PCHS Staff worked with the Continuum of Care Board and Housing Trust to begin looking at affordable housing options.
• PCHS Staff worked with the Continuum of Care Board, Central Iowa Shelter, Centralized Intake, Broadlawns Service
Coordination, and all Homeless Providers to help individuals find housing in the community.
• PCHS Staff continue to work with the Continuum of Care Board and Housing Trust to develop a plan for more affordable
housing options. The Integrated Services Agencies hired a Housing Coordinator to coordinate and support in
developing relationships with landlords as well as helping individuals find affordable housing.
2.2.2.2. Waiting ListWaiting ListWaiting ListWaiting List
While the Polk County Region policy is outlined in the Regional Management Plan, the Service Appeal Board reviews
circumstances in which Polk County funds are authorized, allocated or expended. Another function the Service Appeal Board
fulfills is to review and determine resolution of appeals. During this fiscal year, there were no appeals presented to the Service
Appeal Board. Polk County did not have a waiting list during the fiscal year ending June 30, 2016.
3.3.3.3. Statewide OutcomesStatewide OutcomesStatewide OutcomesStatewide Outcomes (Quality Service Development & Assessment, QSDA)(Quality Service Development & Assessment, QSDA)(Quality Service Development & Assessment, QSDA)(Quality Service Development & Assessment, QSDA)
a)a)a)a) Regional MH/DS Service Development, Delivery, and Assessment ScopeRegional MH/DS Service Development, Delivery, and Assessment ScopeRegional MH/DS Service Development, Delivery, and Assessment ScopeRegional MH/DS Service Development, Delivery, and Assessment Scope
The Polk County Region, in partnership with IACP & our other Regional partners continue to collaborate in implementing a
statewide approach to disability services. The Regions have identified the following four functions:
• Implement service delivery models - learning communities, multi-occurring, culturally capable, evidence based
practices, research based practices and trauma informed care.
• Work to ensure that Providers are utilizing evidence based practices and research based practices.
• Identify and collect social determinant outcome data.
• Enter into performance/value based contracts.
The Regions believed it was important to create a unified vision and standardized approach to the operationalization of these
tasks. They formed the QSDA Committee for this purpose. Membership in QSDA includes representation from the Regions,
Providers, MCOs and individuals familiar with the service delivery system.
b)b)b)b) QSDA Mission and Values/Guiding PrinciplesQSDA Mission and Values/Guiding PrinciplesQSDA Mission and Values/Guiding PrinciplesQSDA Mission and Values/Guiding Principles
• QSDA Mission StatementQSDA Mission StatementQSDA Mission StatementQSDA Mission Statement: QSDA facilitates a statewide standardized approach to the development and delivery of quality
MH/DS services measured through the utilization of outcome standards.
4.4.4.4. Polk Polk Polk Polk County County County County Region OutcomesRegion OutcomesRegion OutcomesRegion Outcomes by Programby Programby Programby Program
a)a)a)a) Integrated Services Program Evaluation Integrated Services Program Evaluation Integrated Services Program Evaluation Integrated Services Program Evaluation SummarySummarySummarySummary
The Integrated Services program consists of the four Integrated Service Agencies as well as Polk County Health Services, where all
share risk and are vested in the program’s success. After two challenging years, the year’s evaluation suggests that the system
met expectations. Of the four programs, three met overall program performance expectations and the remaining program’s
performance fell into the Needs Improvement range.
Program system averages met or exceeded expectations for 14 of 16 outcome areas, resulting in an overall average of 78%. The
system exceeded expectations in five outcome areas: Employment – Engagement Toward Employment, Participant Satisfaction,
Access to Somatic Care, Emergency Room Visits for Psychiatric Care, and Administrative Outcomes. The system met expectations
in nine outcome areas: Community Housing, Employment – Working Toward Self-Sufficiency, Education, Participant
Empowerment, Concerned Other Satisfaction, Community Inclusion, Negative Disenrollments, Psychiatric Hospitalizations, and
Quality of Life. The system was particularly challenged in two areas: Homelessness and Involvement in the Criminal Justice
Van Dongen, C. J. (1996). Quality of life and self-esteem in working and nonworking persons with mental illness. Community
Mental Health Journal, 32(6), 535-548.
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28.
b)b)b)b) Knowledge Empowers Youth Program Evaluation SummaryKnowledge Empowers Youth Program Evaluation SummaryKnowledge Empowers Youth Program Evaluation SummaryKnowledge Empowers Youth Program Evaluation Summary
The KEY program earned an overall Exceeds Expectations
rating for the FY16 fiscal year. The program is a
subsidiary Integrated Services Program for young adults
transitioning from the foster care system. It offers the
same flexibility of services as the Integrated Services
Program. In FY16, the program excelled in eleven
outcome areas (Community Housing, Homelessness,
Employment-Working Toward Self-Sufficiency,
Employment-Engagement Toward Employment,
Education, Participant Satisfaction, Participant
Empowerment, Community Inclusion, Psychiatric Hospital
Days, Quality of Life, and Administrative Outcomes) and
met expectations in three others (Involvement in the Criminal Justice System, Negative Disenrollments, and Emergency Room
Visits for Psychiatric Care). The program was challenged in only one outcome area: Access to Somatic Care.
Consistent with previous evaluations, KEY participants report that they are very satisfied with the services that they receive, the
staff who work with them, and the quality of their lives. In interviews, participants praised KEY staff for supporting them to
become more independent. They appreciated how much staff helped them to be active and engaged in their communities.
Participants credited the program with helping them learn life skills, supporting them to pursue education and employment, and
reconnecting with family members. In interviews, concerned others also praised the program for their support, connecting with
the participants, and providing assistance and insights.
The evaluation results suggest that KEY participants were living typical young adult lives. Almost all KEY participants were
involved and integrated into the community, participating in community activities, attending community events, or visiting local
attractions. Nearly one of every two participants was working at least 5 hours per week, and more than one of every three for 20
or more hours per week. Participants were likely to be enrolled in education, either finishing high school, pursuing post-
secondary education or participating in trainings related to their employment. Most participants were living in safe, affordable,
accessible, and acceptable housing. They spent very few nights homeless, if any. The KEY program reported few jail or
psychiatric hospital days as well. Participants were linked to community providers so that visits to the emergency room for
psychiatric care were rare. The program continued to be diligent in appropriately documenting outcome information and
completing the level of functioning assessments to ensure that participants receive the services that they need and are eligible
for. Overall, participants and concerned others had reason to be pleased with the program.
As has been mentioned in previous evaluations, the KEY program serves an important community function, providing transitional
support for youth in the foster care system to become responsible and productive adults. Several studies have indicated that
continued support of former foster children is cost effective in terms of improved academic achievement and, therefore, income
potential, as well as decreased likelihood of arrests and use of public benefits (Burley & Lee, 2010). Unfortunately, the need for
support for these young adults will likely exist into the foreseeable future as considerable numbers of youth continue to age out
of the foster care system. In FY13 (the most recent available statistics for Iowa, U.S. Dept. of Health & Human Services, 2014),
almost one of every 10 youth leaving Iowa’s foster care system had reached the age of 18 without having been reunified with or
adopted by a family (9.8%), similar to national results (10%). On a national level (U.S. Dept. of Health & Human Services, 2003-
2015), the percent of children aging out of foster care has remained in the 9% to 11% range for the past 10 years, up from the 7%
to 8% reported in the previous years. Most recent statistics (U.S. Dept. of Health & Human Services, 2015) suggest a decline in
the number of children entering and exiting the foster care system in Iowa over the past nine years. Even if the percent aging-
out in Iowa remained at 10%, that would still mean that more than 400 Iowa children are expected to have aged out in FY14.
89%83% 85%
80% 78% 82%88% 92%
0%
25%
50%
75%
100%
2009 2010 2011 2012 2013 2014 2015 2016
KEY Overall Program Performance
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29.
ReferencesReferencesReferencesReferences
Burley, M., & Lee. S. (2010). Extending foster care to age 21: Measuring costs and benefits in Washington State. Olympia:
Washington State Institute for Public Policy,
Document No. 10-01-3902. Available at: http://www.wsipp.wa.gov/rptfiles/10-01-3902.pdf, last visited July 16, 2013.
U.S. Department of Health and Human Services (2014). Administration for Children & Families, Children’s Bureau, Child Welfare
Outcomes Report Data, Iowa's State Data Tables from the years 2009-2013. Generated from :
http://cwoutcomes.acf.hhs.gov/data/overview, last visited July 21, 2015.
U.S. Department of Health and Human Services (2003-2015). Administration for Children & Families, Administration on Children,
Youth and Families, Children’s Bureau. The AFCARS Report, Numbers 10 – 22. Available at
www.acf.hhs.gov/programs/cb/research-data-technology/statistics-research/afcars, last visited July 20, 2016.
U.S. Department of Health and Human Services (December 1, 2015). Administration for Children & Families, Children’s Bureau.
FY 2005-FY 2014 Foster Care: Entries, Exits and In Care on the Last Day of Each Federal Fiscal Year. Children Entering Foster
Care 2015.PDF, Children Exiting Foster Care 2014.PDF, and Children in Foster Care 2014. PDF. Available at
https://www.acf.hhs.gov/programs/cb/resource/fy2005-2014-foster-care-entries-exits , last visited July 20, 2016.
F:/Plan/FY16/Annual Report/Annual Report FY16 Polk 2016.12.14.doc
30.
c)c)c)c) ForensForensForensForensic Assertive Community Treatment (FACT) Program Evaluation Summaryic Assertive Community Treatment (FACT) Program Evaluation Summaryic Assertive Community Treatment (FACT) Program Evaluation Summaryic Assertive Community Treatment (FACT) Program Evaluation Summary
The FACT program is a subsidiary Integrated Services Program, offering the same flexibility as the Integrated Services Programs
but specifically serving adults who are at high risk or have a history of criminal justice involvement. As Pinal (2014) notes in a
recent review article, individuals with mental health issues “who have criminal justice and forensic involvement have an increased
risk of significantly fractured care (Hoge et al., 2009) and a high risk of mortality and poor outcomes (Binswanger et al., 2007)….
Their transinstitutional existence and characteristics make treatment challenging and far more costly (Swanson et al., 2013).
Barriers to uninterrupted care include multiple comorbidities associated with mental health, substance use, and medical illness.
These are often treated in disjointed approaches at different community settings, across numerous hospitalizations, and through
emergency room visits” (pg. 7). To combat this fractured care, the FACT model provides treatment, rehabilitation, and support
services using a self-contained team of professionals from psychiatry, nursing, addiction counseling, vocational rehabilitation,
and the criminal justice system. Services are available seven days per week, twenty-four hours each day to assist individuals with
building independent living and coping skills in real life settings.
The FACT program began serving individuals in November 2011. This year, the FACT program continued to experience growth.
The program started the current fiscal year with 59 participants and ended it with 66 participants. The program reports that it
had 48 referrals during the year, accepting 25 of those, with an average wait time from referral to enrollment of about three
months. Participants were served by a team of six members, including a Team Lead, an Assistant Team Lead/Case Manager, a
vocational specialist, a substance abuse specialist, a housing specialist, and a nurse. All participants who are on probation are
assigned to one probation officer who attends weekly team meetings.
This is the fourth year for the FACT evaluation to have
performance expectations for the outcome measures. It is
additionally the fourth year where the program has
performed in either the needs improvement or does not
meet minimum expectation areas. In FY13 and FY14, the
program’s performance was in the Needs Improvement
category, with performance adjusted per the file review
results. In FY15, the program’s performance declined to the
Does Not Meet Minimum Expectations range, with
performance adjusted per the file review. In contrast to
previous year, PCHS chose not to adjust program reported
results based on file review results. Thus, evaluation results
for FY16 are not directly comparable to FY15. To aid in comparisons, information about the program reported results and what
the adjustment would have been are presented in the comment text for outcomes so that readers can more easily compare this
year’s results and scores to those from previous years.
In FY16, the program’s reported results exceeded expectations in five areas (Employment-Working Toward Self-Sufficiency,
Participant Satisfaction, Emergency Room Visits for Psychiatric Care, Quality of Life, and Administrative Outcomes), met
expectations in five additional areas (Community Housing, Involvement in the Criminal Justice System, Education, Community
Inclusion, and Psychiatric Hospitalization outcome areas), and was challenged in the remaining six outcome areas
Access to Somatic Care, and Negative Disenrollments).
FACT participants continue to report high satisfaction with the program, the staff who assist them, and the quality of their lives
since entering the program. In interviews, many credited the program for helping to improve their access to health care and their
housing situations. They appreciated the program’s assistance with rent and providing incentives for completing outcomes.
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31.
Several mentioned that the program has helped them to reconnect with family, better control their anger, and make healthier life
choices. They felt less isolated and alone because of the support that staff provided and praised staff for being there, especially
when they felt that they had no one else to support them.
Despite challenges, improvements were noted in some outcome areas compared to FY15. Participants were more likely to be
living in safe, affordable, accessible and acceptable living situations. They were reported to have spent fewer days in jail,
psychiatric hospitals, or homeless, and less likely to seek psychiatric care through the emergency room. More participants were
working, both toward self-sufficiency and engaged in employment. They were more likely to be involved in their communities,
and although still challenging, more participants were receiving physicals, ongoing care from a medical specialist or care for an
acute condition from a medical physician during the fiscal year.
Although slightly more satisfied than in FY15, the FACT program continues to struggle with family and concerned others
satisfaction, despite high participant satisfaction. Most concerned others reported that the FACT staff treated the participant with
dignity and respect, and that they were satisfied with the participant’s FACT staff. However, many wanted to be contacted more
frequently to stay informed. About one of every three believed that the participant was not getting the services that he or she
needed.
Results of the outcomes suggest that there is room for improvement in several areas. Despite improvements, the program
reported that participants averaged more than a month of homelessness, with 8 participants spending more than three months
homeless, including two who were homeless for more than half of the fiscal year. In addition, the program continues to struggle
with Access to Somatic Care as well. This year, 7 of the program’s 66 participants did not receive a physical or medical care
during the year. In order to improve performance on this outcome, the program implemented an incentive program, providing
participants gift cards if they accessed somatic care during the year. The program also provided transportation for participants to
get to and from medical appointments, assistance to schedule appointments, and reminders about upcoming appointments.
Finally, the program continues to struggle with documentation expectations both for documentation of outcomes and for the
Participant Empowerment outcome. While providing quality services is essential for programs, accurately documenting those
services is critical to the administration and oversight of those services. The results of the file review indicated that the program
did not meet the expected 93% documentation compliance for Community Housing, Homelessness, Involvement in the Criminal
Justice System, Employment, and Community Inclusion due to a lack of or inconsistent documentation. The program’s overall
performance would have been in the Does Not Meet Minimum Expectations range if reported results had been adjusted based on
the file review.
This is the fourth consecutive year in which the program’s performance on Participant Empowerment failed to meet expectations.
Having individuals develop individualized and measurable goals, reviewing goal progress regularly, addressing employment and
education, and ensuring that services are provided to assist individuals in being successful in accomplishing their goals is
essential to participant empowerment. Despite improvements, FACT continues to struggle with having participant goals in place
and reviewed regularly and documenting participants’ involvement in goal development. Goals are the cornerstone of service
delivery. A participant's goals define what services and supports are provided, what program resources are expended on that
participant's behalf and for how long. Therefore, goal progress needs to be monitored carefully, reviewed with participants
regularly, and goal meetings should be planned well in advance, with ongoing discussions. These are the participant’s goals.
Having them engaged in the goal development process, selecting goals they are interested in achieving and motivated to work
on, and having them agree to work on those goals contributes to participant success. As has been noted in past evaluations,
ongoing monitoring and internal reviews are important program components to success.
The FACT program has struggled with overall performance for its entire history, despite having stable outcome targets based on
the program’s own baseline outcome data from FY12. Over that time, the program has almost tripled the number of participants
served, from 23 at the beginning of FY13 to 66 by the end of FY16, and experienced a lot of staff turnover. This year, the
program reports that it had more stable staff. Devoting additional time and resources to staff training on outcomes;
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32.
implementing additional quality assurance and monitoring of empowerment meetings and plans, as well as outcome entries into
the PolkMIS electronic system may lead to more complete, timely and accurate documentation. Improving the accuracy of the
data should help identify the program’s most urgent needs and allow PCHS to provide assistance to meet those needs.
Performing ongoing fidelity assessments, per the FACT model, may help the program to identify ways to improve their
implementation of the model and, in theory, improve success based on the model. Over the course of the FACT program’s
history, it has yet to meet expectations in any year in the Homelessness, Access to Somatic Care, and Concerned Others
Satisfaction outcome areas. Thus, the program may want to devote additional resources and time to identifying and maintaining
housing for FACT participants, engaging participants in employment, and improving the program’s relationship with concerned
others. Of note, housing and employment are both areas that concerned others raised concerns about during satisfaction
interviews. Family and concerned others may be well positioned to suggest ways to improve and address these issues in
particular and the program is encouraged to reach out to them for ideas and collaboration.
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33.
d)d)d)d) Case Management & Integrated Health HomeCase Management & Integrated Health HomeCase Management & Integrated Health HomeCase Management & Integrated Health Home/Service Coordination/Service Coordination/Service Coordination/Service Coordination Evaluation Evaluation Evaluation Evaluation
SummarySummarySummarySummary
This year, the Case Management (CM) systemthe Case Management (CM) systemthe Case Management (CM) systemthe Case Management (CM) system met expectations with an 86% overall performance. All four Case Management
agencies (ChildServe, CSA, Easter Seals, and Link) met or exceeded expectations in their overall performance. The Case
Management program exceeded expectations in ten outcome areas: Community Housing, Homelessness, Involvement in the
Criminal Justice System, Education Transition, Participant Satisfaction, Family and Concerned Other Satisfaction, Negative
Disenrollments, Psychiatric Hospitalizations, Emergency Room Visits for Psychiatric Care, and Quality of Life. The program met
expectations in seven outcome areas: Employment-Working Toward Self-Sufficiency, Employment-Engagement Toward
Employment, Adult Education, Somatic Care, Community Inclusion, and Administrative outcomes. The system was challenged in
two areas: Case Manager Involvement in Child Education and Participant Empowerment.
Participant and concerned others were very satisfied with the services they received and the staff who worked with them. Case
Managers were often described as knowledgeable, resourceful, and caring. Participants were grateful that Case Managers helped
to coordinate supports so that they could live in the community as independently as possible. Concerned others valued staff’s
extensive knowledge of available services and options to meet participants’ individual needs, as well as assistance with the
transition to managed care organizations.
Participants and concerned others had reason to be satisfied. More than nine of every ten participants were living in safe,
affordable, accessible and acceptable housing. Nine of every ten participants were actively included in their communities,
attending events, participating in activities, or visiting local attractions. More than nine of ten had received somatic care during
the year. More than one of every three adult participants was engaged in employment, working five or more hours per week, and
close to one of every five was working 20 or more hours per week. More than one of four adults were engaged in employment-
related education. Transition activities were completed for all transition age youth, better preparing them for a smooth transition
to adult services or independent living. Although case managers attended school meetings for almost nine of every ten
participants, the system was challenged in this outcome area due to performance at one of the four programs. With the supports
of staff, participants spent very few days homeless, in psychiatric hospitals, seeking psychiatric care through the emergency
room or spending nights in jail. Negative disenrollments were minimal.
The Integrated Health Home / Service Coordination systemThe Integrated Health Home / Service Coordination systemThe Integrated Health Home / Service Coordination systemThe Integrated Health Home / Service Coordination system was challenged by outcome expectations. This is the first year that
IHH and SC outcomes were combined. The combined system achieved an overall 66% performance, resulting in a Needs
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34.
Improvement rating. One program Met Expectations and the other two performed in the Needs Improvement range. The IHH
system exceeded expectations in three outcome areas: Participant Satisfaction, Appropriate Disenrollments, and Administrative
Outcomes. The system met expectations in seven outcome areas: Community Housing, Employment-Engagement Toward
Employment, Concerned Other Satisfaction, Access to Somatic Care, Negative Disenrollments, and Psychiatric Hospitalizations,
Emergency Room Visits for Psychiatric Care, and Quality of Life. The system was challenged in the remaining six outcome areas:
Homelessness, Involvement in the Criminal Justice System, Employment – Working Toward Self-Sufficiency, Adult Education,
Participant Empowerment, and Community Inclusion.
The combined IHH/SC system performed well in a few areas. Nearly nine of every 10 participants (89%) were reported to be living
in safe, affordable, acceptable and accessible community housing. More than nine of every ten (96%) of participants received a
physical or care during the year from a primary care physician or medical specialist. Nearly one of every five participants (19%)
was engaged in employment, working at least five hours per week, although only about one of every ten participants (11%) was
working at least 20 hours per week. Very few participants were negatively disenrolled, and the service coordination tracks 61% of
participants appropriately disenrolled to other services or independence. Programs were successful in supporting participants to
minimize psychiatric hospitalizations and emergency room visits for psychiatric care.
A key measure of any service is the satisfaction of those being served. Despite challenges in many areas, participants and
concerned others reported being satisfied with the services provided, with the quality of their lives, and with the staff who
assisted them. In interviews, participants and concerned others described IHH/SC staff as good resources for information on
available supports. Participants appreciated that staff were open to talking with them about issues. For some programs,
participants and concerned others raised concerns about staff turnover and the impact this has had on continuity of services and
supports.
In contrast, the system averaged high rates of homelessness and involvement in the criminal justice system. The system reported
a total of 5,878 homeless nights, averaging between three and four homeless nights per participant for the year. Total jail days
reported by the system were 4,913, averaging more than three jail days per participant for the year. All IHH/SC programs were
challenged by the Community Inclusion criteria. Of participants, 73% were reported to have met these criteria during the year.
Both the CM and the IHH/SC programsBoth the CM and the IHH/SC programsBoth the CM and the IHH/SC programsBoth the CM and the IHH/SC programs were challenged by the Participant Empowerment outcome area. Participant Empowerment
is based entirely on the file review. Of files reviewed 85% of CM files and 69% of IHH/SC files were found to meet expectations for
the Participant Empowerment outcome. For the CM programs, the most challenging expectation was documentation that
employment or education was addressed with participants throughout the evaluation period. This “gentle hassling” approach
reminds participants that employment and education are potential roles for them in their communities and that services are
available to help them pursue these. The most challenging criteria for IHH/SC programs was documenting that individualized,
measurable goals were in place and reviewed regularly and that participants were involved in goal development. Goals are
55% 58%
75% 72%66%
0%
25%
50%
75%
100%
IHH IHH SC SC IHH/SC
FY14 FY15 FY14 FY15 FY16
Ou
tcom
e B
ase
d P
erfo
rma
nce
IHH, SC, & IHH/SC System Performance
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35.
essential to service provision. They document the agreement between the individual’s choices and desires, the services that the
program is willing and able to provide, and the basis for which funding is provided. Without such plans, services are unguided,
participants do not know what they can expect, and one may question the provision of public funds. Thus, documentation of
goals is critical to the functioning and accountability of service provision.
For both systems, FY16 was a stressful year with the uncertainty of the Managed Care Organization (MCO) roll-out. Based on the
review of case notes and interviews with participants and concerned others, staff in both systems should be commended for their
efforts to help participants to understand and prepare for the evolving changes. Not only did these changes affect participants,
but most programs reported considerable staff turnover. CM programs, in order to meet new expectations of higher case loads,
often did not replace all departing staff. In addition to their typical job duties, new staff had to become acquainted with the
outcomes. Even experienced staff had to learn to work in more systems (e.g., Magellan then IME, and individual MCO’s systems)
while continuing to serve more individuals.
Of note, data entry errors were identified by both the CM and IHH/SC systems during the development of the evaluation report.
Programs are encouraged to review their data frequently throughout the year in order to identify and correct errors in a timely
fashion. With increasing demands on both PCHS and agency staff, the evaluators recommend that data entry safeguards be
incorporated into the electronic data system wherever possible to warn or request confirmation when entering non-
contemporaneous, particularly future, dates.
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36.
182 194252
291377 396 402 430 457
0
100
200
300
400
500
2007 2008 2009 2010 2011 2012 2013 2014 2015
Polk County Network: Average Number of Participants Per Reporting Week
$123 $124 $120$90
$128$144 $137 $145
$162
$0
$25
$50
$75
$100
$125
$150
$175
2007 2008 2009 2010 2011 2012 2013 2014 2015
Polk County Network: Average Weekly Earnings by Year
2.3
2.4
8.9
5.4
3.3
13.7
14.6
13.6
0.0 6.0 12.0 18.0 24.0
2015 Network
2014 Network
2013 Network
Polk County Network: Average Number of Months Spent in Status
Agency Waiting List (WL) Employment Prep (EP) Job Development (JD)
e)e)e)e) Calendar Year 201Calendar Year 201Calendar Year 201Calendar Year 2015555 Community Employment EvCommunity Employment EvCommunity Employment EvCommunity Employment Evaluation Summaryaluation Summaryaluation Summaryaluation Summary
In this ninth year, the Community Employment Evaluation suggests that the supported employment network continues to be
successful in supporting individuals to prepare for, obtain and maintain employment. With the addition of Easter Seals this year,
the network is now composed of five service providers (Candeo, Easter Seals, Goodwill Industries, H.O.P.E., and Link Associates).
The providers are evaluated based on six outcome areas (Barriers to Employment, Negative Disenrollments, Working Toward
Self-Sufficiency, Total Engaged in Employment, Participant Satisfaction, and Administration-File Review). The network and all
providers met or exceeded expectations for overall performance set by Polk County Health Services for the 2015 calendar year.
The Polk County Regional Network continued to grow this
year. The network added a fifth service provider, Easter
Seals. In 2015, the network served approximately 457
participants per reporting week, an increase of 6%
compared to 2014. Agencies served fewer participants
with mental health disabilities and more with intellectual
or other disabilities. In 2015, almost nine of every ten
supported participants had an intellectual or other
disability, compared to one out of ten with mental health
disabilities. Consistent with previous years, participants
were most likely to qualify for Level 3 supports (43%).
For participants who were employed, average weekly
earnings increased by $17 from $145 in 2014 to $162 in
2015, the result of increases in reported hours and wage
rates. Participants’ average wage was $8.68 per hour, and
they worked an average of 21 hours per week. In 2015,
close to 2 of every 5 employed participants were working
20 or more hours per week and earning at least minimum
wage.
Regardless of whether participants acquired employment
in 2015, supported employment participants averaged
more than two years acquiring skills and searching for
employment. In contrast to previous years, participants
spent three-quarters of a year in employment preparation,
likely the result of new structured programs including
Project SEARCH programs, Walgreens’ REDI program, and
